Costs are a major concern for patients, clinicians, providers, commissioners and governments (Akerman 2015). Claims have been made that the Learning Healthcare System can help to solve the cost crisis in healthcare (Institute of Medicine 2010). At the same time, the considerable costs of implementing, maintaining and administering the required infrastructure have often been overlooked (O’Hanlon 2015).
Many of the claimed savings have face validity. For example, the potential for earlier diagnosis, more personalised treatment regimes, fewer medical errors and cheaper research methodologies would seem to suggest significant potential for direct and indirect savings. However, there has been little robust economic evaluation of the elements of Learning Healthcare Systems that already exist and little economic appraisal of the elements that have been proposed (Simpson 2015).
There will be some scepticism about potential savings following the failure, so far, to realise the efficiency gains that had been hoped for from EHRs (Simpson 2015). Economic evaluation and appraisal work is urgently required to complete the case for or against the development of the various components of the Learning Healthcare System.
Evidence