Jason Lee (Health Affairs Blog) raises a strikingly similar big issue to that posed by Scott MacStravic. Lee writes:

“Given rapid innovation in medical technology, waste and uneven quality of care, patient safety problems, a chronic access crisis, and cost increases as far as the eye can see, how can we expedite knowledge generation and systematically translate what we know into what we do? How do we create evidence-based, high-value, efficient delivery systems?”

How indeed.

Lee was reacting to a recent Health Affairs paper highlighting how electronic health records can promote a “Rapid-Learning Health System.” He calls our attention to a catalytic essay by Lynn Etheredge who persuasively argues that “with large, computer-searchable EHR (Electronic Health Record) databases and new research software, studies that would now take years will be doable, at low expense, in a matter of weeks, days, or hours.”

He was taken — and so was I, for that matter — by the possibilities inherent in Etheredge’s vision. Yet, like one handed a precious but very fragile gift, he is worried about it being broken.

“if we portray EHRs to policy and decision makers as the answer to a host of problems that beset our health care system, build one expectation upon another (quality improvement, cost savings, error reduction, etc.), do we not risk bringing the whole house of cards down by creating high hopes and building unrealistically high expectations?. . . I just don’t think that it is a good strategy to sell them together. I would hate to see the failure of one to cause the demise of the other.”

Electronic health records are not going away anytime soon (see my “Top Ten Reasons Why EMRs are Here to Stay”). The question of the development of rapid learning systems on a national scale is a different matter altogether. Lee’s concerns may be well founded. For these systems to emerge, it will take large private and government funding sources getting along with each other for the public good. This is always a difficult proposition. Market forces are often fragmented and government has not exactly been a faithful financial partner when it comes to health care. Yet there’s something here for everyone and that’s what makes the future of rapid learning systems so intriguing.