Large EHR research databases are the key development that makes it possible to create a rapid learning health system. The VA and Kaiser Permanente are the public and private sector leaders; their new research databases each have more than 8 million EHRs. They are likely to add genomic information. New networks with EHR databases—“virtual research organizations”—add even more to these capacities. For instance, HMORN with 14 HMOs has 40 million enrollees and is sponsoring the Cancer Research Network (which has about 10 million patient EHRs) with the National Cancer Institute, as well as the Vaccine Safety Datalink (which has about.
