The authors of the lead essay in this issue propose a set of fiscal and other levers for accelerating Canadian healthcare reform. Among the mechanisms they endorse is the concept of a learning health system, which would encourage collaboration and information sharing between jurisdictions. From health system performance measurement to exchange of best practices, a number of the foundational elements of learning health systems have parallels or antecedents in functions undertaken by pan-Canadian organizations that address healthcare issues relevant to multiple jurisdictions. Experiences and outcomes of these organizations may therefore be instructive when considering proposals for healthcare reform, such as those made by Gardner, Fierlbeck, and Levy.