Objectives Describe the key features of a learning health system (LHS). Describe new features of an LHS needed in order to meet the unique needs of palliative care. Describe the ways that clinical trials, health care quality monitoring, and educational programs fit together in an LHS. Palliative care patients and their families deserve a system of coordinated research and high quality clinical care that informsdand is informed bydthe other and that leads to iterative meaningful improvements in care outcomes that matter. In response, a learning system for palliative care has been forming. First, new methods for conducting high-quality research in this vulnerable population were needed; methodological innovations include enhancements to study design, participant recruitment, and outcomes measures. Contemporary palliative care clinical trials can address practical questions like optimal management of refractory dyspnea, terminal secretions, or existential distress. Second, technology infrastructure is evolving, allowing for standardized data collection, storage, linkage, analysis, and reuse. Palliative care data systems can collect information most meaningful to palliative care (eg, symptoms, physical functioning, quality of life, caregiver burden). Third, a national network of researchers formed, coordinating with clinicians, quality monitoring efforts, and international groups. Working together, we prioritize research questions, match studies to generalizable patient populations, and shorten the time to answers. Fourth, quality measures reinforce best practice; new measures incorporate lessons learned, in concert with the clinical trials. Fifth, efficient evidence dissemination is made possible through new routes. Continuing education activities quickly transfer important innovations to our palliative care workforce. And finally, outreach to healthcare policy-makers guides clinical policy and financing. Over the last decade, elements of this circuitous learning system for palliative care have been conceived, implemented, tested, (sometimes jettisoned), and refined. In addition to methodological innovation, elements such as the Palliative Care Research Cooperative Group (PCRC), QDACT data standards, PC-FACS, and Virtual Learning Collaborative have been coordinated. Federal, philanthropy, and industry sponsors have invested. Overall, together, we are defining a responsive model for evidence development and implementation in palliative care that advances clinical practice and research. This is learning healthcare.