The NAM’s early efforts to develop the ideas underpinning the LHS began in 2006, via a series of workshops held over several years from 2006-2013.
[12] Given that the LHS has an expansive definition and scope, many of the early adopters of this approach were health systems that also had embedded research capabilities, such as a formal department or institute.
Along with a growing body of peer-reviewed publications on the specific experience of different systems as they evolve toward continuous learning, review articles have been published to reflect on the growth of the LHS as a whole.
Exemplar organizations are numerous and growing and include both community-based health systems and university-based academic health systems/medical centers in the United States: In many cases, these institutions are engaged in research activities such as the HCSRN, Clinical and Translational Science Awards (CTSA), and PCORnet where the LHS concepts are applied.
Each has also published special issues with thematic emphases on LHS-related topics such as embedded research and ethical, legal, and social implications of the LHS.
Australia, Canada, the United Kingdom and other countries are applying the LHS concepts, offering opportunities to compare and contrast global experiences and develop a richer picture of how the local context, structure of care delivery, and regulatory environment affect the ability to support continuous learning.
Patient involvement in the LHS has grown, partly due to the establishment of the Patient-Centered Outcomes Research Institute, continued emphasis on shared decision-making, and the growing recognition of participatory medicine.
Generation of rich real-world clinical data is an essential "byproduct" of this highly transactional purpose of the contemporary EHR.
However, dissemination of implementation of new evidence can be operationally and technically challenging in many settings, including the original health system that identified a problem based on their own clinical data.
Hence, many disciplines and scientific domains may contribute various types of subspecialty expertise including: As the LHS has matured, leaders and vanguard organizations have identified the requisite skills needed to lead and develop interventions that support learning.
Articles describing multidisciplinary workforce training efforts was published as a supplement to the LHS Journal in 2022, including an experience report summarizing the collective insights from the 11 initially funded Centers of Excellence.
Examples include the National Institutes of Health and AHRQ (federal); and the Robert Wood Johnson Foundation (philanthropic).
Funding provided to personnel within an organization (i.e., a health system) may be designated for internally-directed learning activities with no expectation about developing and publishing generalizable results.
Subsequent articles by Finkelstein et al, as well as Asch and colleagues seek to use examples of learning activities as a means to describe different approaches to research oversight and compliance.