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In this talk, Dr. Justin Moore will explore ongoing collaborative efforts between faculty at the Wake Forest University School of Medicine and administrators and clinicians across the Advocate Health system aimed at accelerating the translation of evidence-based practices from clinical trials (T2) into system-wide, population‑level health improvements (T4). Dr. Moore will situate this work within the broader mission of building a true Learning Health System, one that continuously integrates research, practice, and real‑world data to deliver better outcomes at scale. The presentation will provide an overview of key implementation science models and frameworks that guide these translational activities, highlighting how they can be operationalized within a large, integrated health system. Special attention will be given to the organizational and methodological infrastructure required to support implementation at scale, including data systems, workforce competencies, and cross‑departmental coordination mechanisms. Cultural considerations will also be addressed, particularly the shifts needed for academic researchers, operational leaders, and frontline clinicians to work together in ways that are collaborative, nimble, and responsive to evolving evidence and system needs. Dr. Moore will also examine financial and incentive models that enable sustained implementation, scale‑up, and spread, recognizing that even the most compelling evidence-based practices must align with real-world constraints and priorities. Finally, the talk will engage directly with tensions that often arise between traditional academic medicine workflows (e.g., long research timelines, narrow scopes of inquiry, publication‑driven incentives) and the practical realities of the American health system, which demands rapid decision‑making, cost‑effectiveness, and broad applicability. Dr. Moore will outline the challenges these tensions create, as well as emerging strategies to reconcile them. Throughout the presentation, attendees will be invited to consider an evolving vision for a Learning Health System, one that moves beyond aspirational concepts toward practical, executable strategies that bring evidence to practice efficiently, equitably, and sustainably.