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Abstract Objectives In the last two decades, several organizational initiatives have moved Geisinger into closer alignment with the key characteristics of the learning health system (LHS) model. The intent of this experience report is to provide a firsthand view of the potential of the model and of the complex, multifaceted nature of any endeavor designed and implemented to realize that potential. Methods After describing Geisinger, we offer a critical self‐assessment of our progress toward the goal of becoming an LHS, followed by an account of the challenges. Results Geisinger has made incremental but measurable progress in implementing the LHS model, especially in two key domains: in patient‐clinician engagement and science and informatics. Other challenges, however, present significant opportunities for additional forward movement, especially with respect to incentives, culture, and leadership. Conclusion Becoming a fully realized LHS is and will be a long‐term challenge for any organization that embraces this aspiration.