IOM Calls for ‘Transformed Approach’ to Healthcare
Healthcare in America is at a critical crossroads, marked by this paradox: a unique opportunity to improve care and lower costs because of stunning advances in technology, and the frustration of “missed opportunities, waste, and harm to patients” because of a failure to harness and capitalize on these changes.
That assessment comes in a new report from the Institute of Medicine: Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. The report underscores a message that has been gaining traction in recent years—that the healthcare system has become too complex for business as usual, and that healthcare has much to learn from other industries which have adopted a more holistic “systems” approach to their challenges.
“The threats to Americans’ health and economic security are clear and compelling, and it’s time to get all hands on deck,” says Mark D. Smith, president and CEO of the California HealthCare Foundation. Smith was chairman of the IOM committee that wrote the report. “Our healthcare system lags in its ability to adapt, affordably meet patients’ needs, and consistently achieve better outcomes. But we have the know-how and technology to make substantial improvement on costs and quality.”
The sweeping IOM report, released in early September, paints a sobering picture of just how inefficient healthcare is in this country, calculating that 30% of health spending in 2009, about $750 billion, was wasted on high administrative costs, needless services, fraud, and other problems. Such inefficiency costs lives, with the report citing one estimate that 75,000 deaths could have been prevented in 2005 “if every state had delivered care on par with the best performing state.”
Banks, automobile manufacturers, and the aviation industry have all done a better job at instituting system-wide changes and better meeting their customers’ needs, according to the report. “While healthcare must accommodate many competing priorities and human factors unlike those in other industries, the healthcare system could learn from these industries how to better meet specific needs, expand choices, and shave costs,” reads the report.
The report includes eight broad recommendations (with more detail in each recommendation) that cover everything from the utility of data, to clinical decision support, to financial incentives, to performance transparency.
The report envisions a role for a multitude of stakeholders who, collectively, could bring about the “transformed approach” that is needed. Among them and their roles:
- Standards organization and others “should ensure that digital infrastructure captures and delivers the core data elements and interoperability needs to support better care, system improvement, and the generation of new knowledge.”
- Research organizations and advocacy groups “should facilitate the development, accessibility, and use of evidence-based and harmonized clinical practice guidelines.
- Health education programs, accrediting organizations, and licensing boards “should incorporate basic concepts and specialized applications of continuous learning and improvement” into their requirements, certification or otherwise.
“The imperatives are clear, but the changes are possible—and they offer the prospect for best care at lower cost for all Americans,” the report concludes.
For more information about the IOM report, including the detailed recommendations, click here.
Posted: September 27, 2012