The field of Healthcare today is filled with opportunities for improvement. Inconsistent treatment, preventable illness, and medical errors that result in injury are all too common, along with enormous inefficiency and waste.

The Institute of Medicine, the medical arm of the National Academy of Sciences, is leading an initiative that descibes a better organizing principle for healthcare – a “Learning Healthcare System.” A learning healthcare system is simply one that continuously “Learns,” meaning that healthcare data from many sources, including electronic medical records is turned into guidelines and knowledge and that knowledge is swiftly translated into practice so that all clinical decisions and processes are based on the best available and most current evidence. New knowledge is in turn generated in the course of practice, and the cycle continues, fostering continuous improvement at all levels: national, organizational, unit, team and individual.

cycle of lhs

To achieve this vision, there must be changes to the way evidence is generated, changes to medical and nursing education, huge changes in incentive structure and culture, changes in process, changes in staff training and performance support, basically enormous changes everywhere.

Right now, my interest is in the opportunities for contributing to this vision in the fields of learning and training. It seems to me that with the TinCan API, we now have the potential means for providing data about training, practice, just-in-time learning and even patient education in a consistent data model that could be correlated with performance and perhaps even clinical outcomes.

We are working the problem from several directions, but IANAC (I am not a clinician) and so of course all suggestions for projects and approaches for any part of this picture are very welcome.