Sentinel Observatories for Health System Innovation March 1, 2014 | Astronomical observatories point to outer space to learn about the cosmos and our role within it. Health observatories have a similar purpose but focus on the universe of forces that affect people’s health on the ground, including planned interventions. With a rare place-based and wide-angle view of health dynamics for a given population, local health observatories—modeled on those in Europe—could be positioned to study trends over time, spot opportunities, and spread innovations to improve health and health equity. Reforming the US health system may be a national priority, but change will arise locally due to variations in healthcare services, public health activities, as well as social, economic, and environmental conditions. A network of sentinel observatories, housed within organizations that already have the right skills and stakeholder connections, would enhance our ability to understand and improve health system performance, while taking into account local conditions and priorities. Even a few sentinel sites could engage stakeholders from various sectors in a collective effort to move beyond categorical programs, discern the underlying patterns from diverse data sources, and ultimately, enact higher-leverage interventions. Observatories provide an ideal vantage point for tracking how far, how fast, and how effectively the movement for health reform is progressing, while highlighting local variations that might contain clues for better results. This initiative, based on a earlier ARRA proposal, combines investments in prevention and wellness, comparative effectiveness, and health IT to fill a gap in the nation’s local health infrastructure. NIH proposed a similar strategy to create “community health laboratories” and we are actively communicating with them to align our endeavors. Without an observatory network, numerous opportunities to understand and improve health systems could be neglected or delayed. Solomon S. Sentinel Observatories for Health System Innovation. CDC FY 2011 Budget Initiative Proposal.