PROJECT SUMMARY/ABSTRACT US healthcare policy, practice and research leaders have expressed increased interest in the vision of the ?learning healthcare system,? a set of organizational goals and arrangements in which healthcare delivery processes are continuously studied and improved, largely by applying formal research methods to data and experience generated during routine care delivery activities. A core element and requirement for a successful, productive learning healthcare system is robust research and analytical capacity and infrastructure. ?Embedded? or ?partnership? research programs are research teams located within healthcare systems that design and conduct studies that aim to contribute to health system performance and improved patient care while simultaneously developing new scientific knowledge. Such programs contribute to the realization of the learning healthcare system vision and are found in selected health systems, including the US Department of Veterans Affairs, Kaiser Permanente Southern California, and a small number of additional public, private and academic health systems. The expert meeting proposed in this application will convene approximately 50 policy, practice and research leaders to (1) review and discuss the vision and desired features of embedded research programs, (2) describe and carefully examine existing examples and models for embedded research programs, assessing their strengths and weaknesses and diverse features, and (3) produce guidance and a set of recommendations for policy, practice and research stakeholder activities that will facilitate significant growth in the number, size and performance of embedded research programs in the U.S. Based on the highly successful Department of Veterans Affairs ?State of the Art Conference? model, the proposed activity will include extensive pre-meeting preparation, a highly structured two-day meeting involving a small number of brief lectures and a series of small-group working sessions, and extensive post-meeting dissemination and follow-up activities to operationalize the recommendations and facilitate their implementation. The overall goal of this initiative is to contribute to more rapid realization of the vision of the learning healthcare system in which research is conducted on an ongoing basis to guide continuous improvements in healthcare delivery quality, safety, equity and value.