The science of Learning Health Systems : Foundations for a new journal

In recent years, health systems across the United States and around the world have faced persistent challenges including the underutilization of necessary care, the overutilization of inappropriate care, rising costs, disparities in access to care, patient safety concerns, outdated public health infrastructures, and an oft-cited 17-year latency between bench and bedside.1,2 This well-documented state of the health of individuals and populations generates an imperative to improve human health, worldwide, through system-level innovations to address what are increasingly recognized as system-level problems.A proliferation of knowledge about "what works" in health care, availability of ever more powerful and affordable information technology, increasingly routine digital documentation of health care delivery, and accumulating understanding of how to inculcate behavior that promotes health, among other factors, combine to place these system-level innovations within reach.A second imperative thus challenges us to capitalize on these opportunities.System-level improvement requires a broad and diverse intellectual community.The necessary transdisciplinary community will be composed of scholars with expertise in social, political, technical, and clinical fields, along with many others who bring critical experience from practice.It follows that a third imperative is to form this community and provide it with a gathering place for its evolving scientific ideas and insights.