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As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.Table of Contents Front Matter Summary 1 Hints of a Different Way-Case Studies in Practice-Based Evidence 2 The Evolving Evidence Base-Methodologic and Policy Challenges 3 Narrowing the Research-Practice Divide-Systems Considerations 4 New Approaches-Learning Systems in Progress 5 Developing the Test Bed: Linking Integrated Service DeliverySystems 6 The Patient as a Catalyst for Change 7 Training the Learning Health Professional 8 Structuring the Incentives for Change Appendix A Workshop Agenda Appendix B Biographical Sketches of Participants Appendix C Workshop Attendee List Appendix D IOM Roundtable on Evidence-Based Medicine