Healthcare Management
Digital Infrastructure for the Learning Health System
Health and health care are going digital. As multiple intersecting plat- forms evolve to form a novel operational foundation for health and health care—the nation’s digital health utility—the stage is set for fundamental and unprecedented transformation. Most changes will occur virtually out of sight, and the pace and profile of the transformation will be determined by stewardship that fosters alignment of technology, science, and culture in support of a continuously learning health system. In the context of growing concerns about the quality and costs of care, the nation’s health and economic security are interdependently linked to the success of that stewardship. Progress in computational science, information technology (IT), and biomedical and health research methods have made it possible to foresee the emergence of a learning health system that enables both the seamless and efficient delivery of best care practices and the real-time generation and application of new knowledge. Increases in the complexity and costs of care compel such a system. With rapid advances in approaches to di- agnosis (such as molecular diagnostics), therapeutics, genetic insights into individual variation, and emerging measurement modalities (such as within proteomics and imaging), clinicians and patients must sort through expo- nentially increasing numbers of factors with each clinical decision. At the same time, healthcare costs are draining the purchasing power of consum- ers and handicapping the competitiveness of U.S. businesses, yet health outcomes are falling far short of the possible.
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