Throughout the United States, health systems are attempting to change decades of operational systems designed to deliver health care as a reimbursable service into systems that deliver health as a population goal.1 Alongside those transformative activities are quality improvement efforts, such as those that aim to reduce hospital-acquired infections, readmissions for heart failure, scheduling delays to see a physician, or long waiting times after arriving for an appointment. Toward both transformation and incremental improvement are calls for the learning health system, ie, clinicians who see every patient encounter as a way to make the next one better.2 Although the federal government is a major investor in health-related research and could accelerate the development of learning health systems, the current efforts toward that goal may need a redesign of their own.