Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system. Table of Contents Front Matter Summary 1 Engineering a Learning Healthcare System 2 Engaging Complex Systems Through Engineering Concepts 3 Healthcare System Complexities, Impediments, and Failures 4 Case Studies in Transformation Through Systems Engineering 5 Fostering Systems Change to Drive Continuous Learning in Health Care 6 Next Steps: Aligning Policies with Leadership Opportunities Appendixes Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Participants Appendix C: Workshop Attendee List Other Publications in The Learning Health System Series

Successful development of clinical data as an engine for knowledge generation has the potential to transform health and health care in America. As part of its Learning Health System Series, the Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss expanding the access to and use of clinical data as a foundation for care improvement. Table of Contents Front Matter Summary 1 Clinical Data as the Basic Staple of the Learning Health System 2 U.S. Healthcare Data Today: Current State of Play 3 Changing the Terms: Data System Transformation in Progress 4 Healthcare Data: Public Good or Private Property? 5 Healthcare Data as a Public Good: Privacy and Security 6 Creating a Next-Generation Data Utility: Building Blocks and the Action Agenda 7 Engaging the Public 8 Clinical Data as the Basic Staple of Health Learning: Ideas for Action Appendixes Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Participants Appendix C: Workshop Attendee List Appendix D: The IOM Committee on Health Research and the Privacy of Health Information: The HIPAA Privacy Rule Other Publications in the Learning Healthcare System Series

This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system's component sectors--patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology--conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.