The “learning health system” (LHS) model represents a relatively new, highly promising, and paradigm-shifting
approach to the delivery of health care. A LHS is characterized by its capacity to continuously study every
health care interaction to generate objective evidence and actionable knowledge, engage stakeholders, and
develop targeted processes to improve outcomes. The LHS requires development of infrastructure where
science, informatics, incentives and culture are aligned, and advances in Health Information Technology (HIT)
facilitate the generation of new evidence as an integral byproduct of care delivery. Realizing this vision also
requires dramatic transformation of many existing drivers of healthcare delivery and scholarly pursuit, in
particular the creation of an appropriate workforce of well trained, diverse investigators who will become
leaders in LHS research and operations. Our proposed Center of Excellence in Promoting LHS Operations
and Research at Einstein/Montefiore (EXPLORE) is a collaboration between the Albert Einstein College of
Medicine and Montefiore Health System (MHS), a large, integrated, accountable-care-oriented academic
medical center that serves the Bronx and New York's Lower Hudson Valley region. We will leverage the efforts
of MHS to deliver high quality services to a largely minority, socioeconomically disadvantaged community,
while at the same time responding to the financial and service delivery imperatives of accountable care. Our
proposed program will engage and build upon a strong education and training infrastructure at Einstein and an
innovative informatics and value-based care delivery infrastructure at MHS. We will leverage the educational
and research support resources of Einstein's Institute for Clinical and Translational Research (ICTR), the home
our Clinical and Translational Science Award (CTSA), including didactic components of its Masters in Clinical
Research and its AHRQ/PCORI- sponsored R25 patient-centered outcomes research coursework, the
informatics infrastructure of the Center for Health Data Innovations, and the resources of Montefiore's
Network Performance Group (responsible for quality of care, operational excellence, and patient safety at
MHS), to create a novel career development program in LHS research. We will identify the most talented,
motivated, and multidisciplinary clinicians and other faculty to enroll, equip them with the knowledge and skills
to conduct, implement, and disseminate high quality and actionable LHS research, and provide them a
sustainable career path as LHS research leaders. Our Scholars and mentors will contribute to a national LHS
Research Collaborative, with Einstein-Montefiore's contribution driven by the expertise within and experience
gleaned from our unique institutional program and resources. This will be accomplished through curriculum
sharing and cross-institutional education; inter-institutional PI/PD and Scholar-Mentor interactions, including
cross-institutional mentoring when feasible and appropriate; research cooperation, including dissemination of
research findings and multi-center research initiatives; and sharing PCOR/CER methodological advances.
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