biostudies-literatureTrinkley KENIDDK NIH HHSNHLBI NIH HHSNCI NIH HHS1447-1458https://www.ebi.ac.uk/biostudies/studies/S-EPMC9547828biostudies-literatureUnknown97(10)Many health systems are working to become learning health systems (LHSs), which aim to improve the value of health care by rapidly, continuously generating evidence to apply to practice. However, challenges remain to advance toward the aspirational goal of becoming a fully mature LHS. While some important challenges have been well described (i.e., building system-level supporting infrastructure and the accessibility of inclusive, integrated, and actionable data), other key challenges are underrecognized, including balancing evaluation rapidity with rigor, applying principles of health equity and classic ethics, focusing on external validity and reproducibility (generalizability), and designing for sustainability. Many LHSs focus on continuous learning cycles, but with limited considerationAcademic medicine : journal of the Association of American Medical CollegesHow Dissemination and Implementation Science Can Contribute to the Advancement of Learning Health Systems.PMC9547828R25 DK123008P50 CA244688K12 HL137862K23 HL161352Huebschmann AGGlasgow RETrinkley KEHo PMfalseHow Dissemination and Implementation Science Can Contribute to the Advancement of Learning Health Systems.Many health systems are working to become learning health systems (LHSs), which aim to improve the value of health care by rapidly, continuously generating evidence to apply to practice. However, challenges remain to advance toward the aspirational goal of becoming a fully mature LHS. While some important challenges have been well described (i.e., building system-level supporting infrastructure and the accessibility of inclusive, integrated, and actionable data), other key challenges are underrecognized, including balancing evaluation rapidity with rigor, applying principles of health equity and classic ethics, focusing on external validity and reproducibility (generalizability), and designing for sustainability. Many LHSs focus on continuous learning cycles, but with limited consideration2022-01-01T00:00:00Z2022 Oct2025-04-05T09:43:04.363Z2025-04-05T09:43:04.363ZS-EPMC95478283579604510.1097/acm.000000000000480110.1097/ACM.0000000000004801