Learning What Works:
 Infrastructure Required to Learn Which Care is Best

 A Learning Healthcare System Workshop
IOM Roundtable on Evidence-Based Medicine

July 30-31, 2008

The National Academy of Sciences Building
Lecture Room, 2100 C Street NW
Washington, DC  

The workshop agenda, common themes, and presentations are available below. 

Assessments of the quality and efficiency of the nation’s healthcare delivery system find its performance far too often inconsistent, expensive, inequitable, and sometimes harmful--certainly delivering overall value far below what should be expected. Especially in the face of a steady increase in new diagnostic and treatment options, this is in part a result of underinvestment in the development of evidence on the relative effectiveness of different choices. The Institute of Medicine’s (IOM) Roundtable on Evidence-Based Medicine is sponsoring a series of workshops to explore issues, strategies and opportunities for the development of a learning healthcare system—one structured to ensure that each patient receives the right care at the right time.  

Of the more than $2 trillion spent annually on health in the United States, less than one-tenth of one percent is estimated to be devoted to learning what works best in health care. To improve the effectiveness and value of the care delivered, there is a need for greater insights into the relative effectiveness of clinical interventions and care processes – through expanded trials and studies, systematic reviews, innovative research strategies, clinical registries, the translation and provision of information, and decision support. Several recent initiatives have proposed the development of an entity for expanded study of the comparative effectiveness of interventions. In addition to such long-term strategies, significant potential exists that with appropriate investment and coordination could enable immediate progress.  

To inform the policy discussion on these issues, the Roundtable is convening a workshop, sponsored in part by the Commonwealth Fund, on July 30-31, entitled, Learning What Works: Infrastructure Required to Learn Which Care is Best. This meeting explored, through invited presentations, the current and future capacity needed, including skills and workforce, data linkage and improvement, study coordination and result dissemination, and research methods innovation.