Little is known about which specific treatment is safest and most effective for a particular patient. A lack of empirical evidence regarding the effectiveness of the various approaches to anesthesia, perioperative medicine, and pain management are barriers to effective and consistent care. Without this empirical evidence to match the unique characteristics of the patient with the relative effectiveness of different treatment options, clinicians are likely to rely on what they learned in their training from mentors. Consequently, this phenomena can perpetuate unwarranted variability in their practices. Unfortunately, effective systems to help the practitioner integrate relevant measures and monitor patient outcomes have not existed until recently. The Institute of Medicine (now the National Academy of Medicine) called for the development of learning health care systems. As envisioned by the Institute of Medicine, a learning health system (LHS) leverages a patient-centered...

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