“Learn or perish” would be an apt slogan for health systems today. The rate of change in health care is high. Technological advancements, research, innovation, and market dynamics all drive the soaring complexity of the health care system. In order to survive, health systems must learn how to adapt, and in the process – we argue – address health literacy. One aspect of a learning health system (LHS), according to the charter and vision of the Institute of Medicine’s (IOM) Roundtable on Evidence-Based Medicine, is “to generate and apply the best evidence for the collaborative healthcare choices of each patient and provider.” This means that integrating new knowledge into practice, requires adaptation to the unique context of patients and their families. Learn more about models to translate knowledge into practice here: https://news.nnlm.gov/bhic/eccc.