Building Real Utopias: The Theory and Practice of Healthcare System Transformation

What does it take to achieve durable change in healthcare systems? Positioned as a model that will transform healthcare delivery, the Learning Health System has been steadily adopted since 2007 as a method for aligning interest-holders, integrating data from clinical research and the electronic health record, and organizing healthcare improvement work. As the Learning Health System nears 20 years of implementation, the field is moving from initial demonstrations of feasibility to a concerted focus on conceptual foundations, including social science approaches to culture, equity, and policy. This presentation will provide a brief history of the Learning Health System and a critical consideration of the model’s potential for healthcare systems transformation. Working in the traditions of problem-solving sociology and the real utopias project, I will draw from ethnographic research and practice-based work to extend the conceptual foundations of the Learning Health System model and discuss how these new foundations can facilitate transformative change.