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Paige McDonald and colleagues detail key domains, tools, and actions required to enact learning health systems for continuous intelligent improvement in healthcare Despite an increased focus on quality improvement in healthcare over the past 50 years, many of the same problems persist. This disconnect has been described as the 60-30-10 challenge: only 60% of care, on average, aligns with evidence or consensus based guidelines; another 30% of care is waste or of low value; and 10% of patients experience adverse events.1 These statistics have persisted for over three decades.2 Even with technology providing increasing volumes of data and more sophisticated analytical techniques such as machine learning and artificial intelligence, progress continues to be painfully slow. Learning health systems provide a pathway towards continuous improvement and innovation in healthcare through the routine collection, analysis, and more timely use of data. The US Institute of Medicine first proposed

Joshua rubinPaigel mcdonaldPaul simpsonT foley thomasSarah gilmanJeffrey braithwaiteKenneth harwoodRobert verheijJessica phillipsPaige mcdonaldTomj foleyRachael hintonNewcastle universityHealth foundationMq healthResearch future fund