Steps That May Support a Learning Health Care System
| Knowledge translation |
| Develop meaningful use of the EHR to support diagnostic and therapeutic support based on evidence |
| Develop a computable representation of research evidence and make that available to EHR systems as a Web service |
| Develop a means of providing diagnostic or therapeutic prompts within an EHR that works across a variety of EHR systems |
| Turning data into knowledge |
| Develop a standardized means of using archetypes based on CEN/ISO 13606 within EHR systems |
| Maintain up-to-date terminology services that can be used by both clinical and research systems |
| Promote the wide reuse and archiving of defined research data elements via CEN/ISO 11179 |
| Start to link well-defined clinical concepts with well-defined research concepts by mapping archetypes to defined data elements |
| Create domain specific data models, linking together via BRIDG to enable sharing of archetypes and data elements between domains |
| Create open-source middleware capable of brokering data exchange and clinical research activities (recruitment, follow-up, etc) between clinical systems |
| Extend clinical research standards to enable sharing computable representations of clinical study protocols between systems |
BRIDG = Biomedical Research Integrated Domain Group; EHR = electronic health record; CEN = European Committee for Standardization; ISO = International Organization for Standardization.