Rapid learning: a breakthrough agenda.

A "rapid-learning health system" was proposed in a 2007 thematic issue of Health Affairs. The system was envisioned as one that uses evidence-based medicine to quickly determine the best possible treatments for patients. It does so by drawing on electronic health records and the power of big data to access large volumes of information from a variety of sources at high speed.

Creating a high-performance system for comparative effectiveness research.

Enactment of the federal stimulus and health reform legislation heralds the beginning of a national comparative effectiveness research program. This article suggests how the Department of Health and Human Services (HHS) can, with collaborators, build a high-performing comparative effectiveness research system. New policies and investments should exploit the rapid-learning potential of electronic health records, computerized databases, data sharing, and research networks.

Rapid-learning system for cancer care.

Compelling public interest is propelling national efforts to advance the evidence base for cancer treatment and control measures and to transform the way in which evidence is aggregated and applied. Substantial investments in health information technology, comparative effectiveness research, health care quality and value, and personalized medicine support these efforts and have resulted in considerable progress to date. An emerging initiative, and one that integrates these converging approaches to improving health care, is "rapid-learning health care.

Medicare's future: cancer care.

This paper proposes a national initiative for Medicare patients with cancer. It would include (1) a rapid-learning system for comparative effectiveness; (2) a quality measurement system; and (3) payment reforms to reward high-quality care. In implementing this strategy, the U.

Technologies of health policy.

Major factors in adoption of new national health policies include (1) a crisis or perceived opportunity; (2) a persuasive diagnosis of what is needed; (3) a prescription for new policies; and (4) new technologies that are ready to go. The past twenty-five years illustrate that the development of new policy ideas to where they can be implemented as major nationwide reforms can take a decade or more. Many national policy ideas for evidence-based medicine--such as electronic health records, rapid-learning networks, predictive modeling, Medicare/Medicaid disease management, widespread pay-for-performance, and large consumer-information databases--are in a development phase.

A rapid-learning health system.

Private- and public-sector initiatives, using electronic health record (EHR) databases from millions of people, could rapidly advance the U.S. evidence base for clinical care.

Massachusetts reform plus President Bush's tax credits: a national model?

The Massachusetts health reform offers an important opportunity for a new federal-state strategy to cover the uninsured. President George Bush's proposed health insurance tax credits could be added to the Massachusetts health reform. The combined plan would include Medicaid expansions; offer workers affordable coverage through competitive insurance markets; and provide federal, state, employer, and individual financing.