There are many ways to approach outcomes improvement in healthcare. Health Catalyst advocates the three-systems methodology whose individual components remain firm: best practices, adoption, and analytics. There are also various ways to interpret the three systems and this article uncovers nuances in how they are defined. With this unique perspective, organizations may be better able to understand how to develop outcomes improvement projects that not only launch with enthusiasm, but sustain energy over the long-term. Furthermore, outcomes improvement done right is scalable so that small firms, those with fewer resources, can adapt the methodology to improve their performance.