The forgetting health system

Forgetting shapes learning in two different ways. It impedes learning when important lessons are forgotten. Equally, it can be difficult to enact new lessons if we do not let go of old beliefs and practices that are no longer useful. A learning health system (LHS) that wishes to improve health service delivery will need to find ways to remember processes that shape quality and safety ‐ using data that often resides beyond electronic health records. An LHS will also need to “forget”, or programmatically decommission, obsolete practices, whose persistence otherwise leads to unnecessary system complexity and inertia to change.