Creating a high-performance system for comparative effectiveness research.

Enactment of the federal stimulus and health reform legislation heralds the beginning of a national comparative effectiveness research program. This article suggests how the Department of Health and Human Services (HHS) can, with collaborators, build a high-performing comparative effectiveness research system. New policies and investments should exploit the rapid-learning potential of electronic health records, computerized databases, data sharing, and research networks. A national database for effectiveness research studies should be established by presidential order. HHS will need to support all of these pieces and take the lead in creating a rapid-learning culture for the US health system.