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The HealthPathways Community, a global network of local health systems, is collaborating to get evidence and policy into practice at scale and improve the quality and experience of care for patients and clinicians. Based on a shared vision and values, the HealthPathways Community has developed a scalable approach to local care pathway development, to enable learning health systems. Each pathway is developed collaboratively by local clinicians, using a facilitated workgroup model to build relationships and reach agreement about local care processes. HealthPathways optimises patient flows and makes best use of the health workforce by supporting clinicians to practice at the top of their scope, reducing unwarranted variation in care. The HealthPathways Community has grown to include over 60 local health systems across New Zealand, Australia, the UK, and Canada, collectively responsible for the care of over 30 million people. Clinicians viewed HealthPathways guidance over 16 million times in the last 12 months. During the COVID-19 pandemic HealthPathways was used to rapidly get evidence and policy into practice across New Zealand and Australia, with pathway updates occurring daily. The community is collating examples improved quality and efficiency of care including reduction in low value diagnostics, improved prioritisation of outpatient consultations, and reduced acute demand. These have been translated into cost-savings of $9.76 per $1 invested in pathways. Recently the community has been developing methodologies for addressing equity issues in pathways. Key lessons from the development of the HealthPathways Community include the importance of shared vision and values, partnership and collaboration, effective local stakeholder engagement, agile development processes, and robust clinical governance. We aim to continue to grow the HealthPathways Community, strengthening the network to benefit all members. We are exploring the application of AI large language models to both the development and user experience of pathways.