title: Toward a science of learning systems: a research agenda for the high-functioning Learning Health System.
abstract: OBJECTIVE
  The capability to share data, and harness its potential to generate knowledge rapidly and inform decisions, can have transformative effects that improve health. The infrastructure to achieve this goal at scale--marrying technology, process, and policy--is commonly referred to as the Learning Health System (LHS). Achieving an LHS raises numerous scientific challenges.
  
  
  METHODS
  The National Science Foundation convened an invitational workshop to identify the fundamental scientific and engineering research challenges to achieving a national-scale LHS. The workshop was planned by a 12-member committee and ultimately engaged 45 prominent researchers spanning multiple disciplines over 2 days in Washington, DC on 11-12 April 2013.
  
  
  RESULTS
  The workshop participants collectively identified 106 research questions organized around four system-level requirements that a high-functioning LHS must satisfy. The workshop participants also identified a new cross-disciplinary integrative science of cyber-social ecosystems that will be required to address these challenges.
  
  
  CONCLUSIONS
  The intellectual merit and potential broad impacts of the innovations that will be driven by investments in an LHS are of great potential significance. The specific research questions that emerged from the workshop, alongside the potential for diverse communities to assemble to address them through a 'new science of learning systems', create an important agenda for informatics and related disciplines.
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Friedman
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Rubin
authors.affiliation: Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brown
authors.affiliation: Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Melinda
authors.initials: M
authors.lastname: Buntin
authors.affiliation: National Library of Medicine, Bethesda, Maryland, USA.
authors.forename: Milton
authors.initials: M
authors.lastname: Corn
authors.affiliation: George Washington University, Washington, District of Columbia, USA.
authors.forename: Lynn
authors.initials: L
authors.lastname: Etheredge
authors.affiliation: University of Illinois, Urbana-Champaign, Illinois, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Gunter
authors.affiliation: Stanford University, Stanford, California, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Musen
authors.affiliation: Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Platt
authors.affiliation: Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: William
authors.initials: W
authors.lastname: Stead
authors.affiliation: University of Virginia, Charlottesville, Virginia, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Sullivan
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Van Houweling
mesh_terms: D016494:Computer Security; D019992:Databases as Topic; D019033:Delivery of Health Care, Integrated; D033181:Information Dissemination; D007256:Information Systems / Q000458:organization & administration*; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D014481:United States
keywords: learning health system; population health; research agenda; system science