Building Ontario's Health AI: A Learning System Approach.

Artificial intelligence (AI) is advancing rapidly in Ontario's health system, yet adoption remains uneven due to limited governance and system-wide learning structures. This paper examines ten AI governance frameworks against OECD principles and assesses their suitability for integration into the Learning Health System (LHS) Action Framework. Most frameworks align with high-level expectations but lack the breadth needed for end-to-end clinical application. We propose an enhanced LHS model that pairs a readiness assessment with a quality assurance model, enabling equitable and scalable AI adoption across care settings.