To our knowledge, the adoption of Learning Health System (LHS) concepts or approaches for improving stroke care, patient outcomes, and value have not previously been summarized. This topical review provides a summary of the published evidence about LHSs applied to stroke, and case examples applied to different aspects of stroke care from high and low-to-middle income countries. Our attempt to systematically identify the relevant literature and obtain real-world examples demonstrated the dissemination gaps, the lack of learning and action for many of the related LHS concepts across the continuum of care but also elucidated the opportunity for continued dialogue on how to study and scale LHS advances. In the field of stroke, we found only a few published examples of LHSs and health systems globally implementing some selected LHS concepts, but the term is not common. A major barrier to identifying relevant LHS examples in stroke may be the lack of an agreed taxonomy or terminology for classification. We acknowledge that health service delivery settings that leverage many of the LHS concepts do so operationally and the lessons learned are not shared in peer-reviewed literature. It is likely that this topical review will further stimulate the stroke community to disseminate related activities and use keywords such as learning health system so that the evidence base can be more readily identified.

Center for Health Information and Communication Richard L Roudebush VA Medical Center Indianapolis IN

Department of Health and Rehabilitation Sciences Temple University College of Public Health Philadelphia PA

Department of Medicine College of Medicine University of Ibadan Nigeria

Department of Medicine University of Otago Wellington New Zealand

Departments of Medicine and Neurology Indiana University School of Medicine Indianapolis

Health Management Institute Czech Republic

International Clinical Research Centre Neurology Department St Ann's University Hospital and Masaryk University Brno Czech Republic

Lund University Department of Clinical Sciences Lund Neurology Skåne University Hospital Sweden

Regenstrief Institute Indianapolis IN

Stroke and Ageing Research Department of Medicine School of Clinical Sciences at Monash Health Monash University Clayton VIC Australia

The Florey Institute of Neuroscience and Mental Health Heidelberg VIC Australia

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