An important new Institute of Medicine report: Best Care at Lower Cost: The Path to Continuously Learning Health Care in America

There is a clear sense of determination within the report that significant progress in health care is certainly possible.

Gary S. Kaplan, MD, Chairman and CEO

The recent IOM report was authored by a committee that included Virginia Mason Chairman and CEO Gary S. Kaplan, MD. According to the report, published by National Academies Press, inefficiency, mountains of data, and “other economic and quality barriers hinder progress in improving health and threaten the nation’s economic stability and global competitiveness.”

For all the problems in the system, however, the committee was emphatic in its finding that “the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost” (IOM report description).

Dr. Kaplan told reporter Cheryl Clark, senior editor of HealthLeaders Media Online, that “we tried to address a big-deal problem in a way that is very comprehensive, because we feel much of what has been said to this point has been in bits and fragments.”

The report is intended in part to generate greater urgency for change among health care leaders. “The first thing to come from this is awareness,” observed Dr. Kaplan. “Too many providers are saying to themselves, ‘We’re alive and well; we know change is coming, but we’re banking that change will be glacial, so we don’t have to do much right now. We’re profitable.’”

In her New York Times article, Annie Lowery pointed out the committee compared health care to other industries. From her article: “If banking were like healthcare, automated teller machine transactions would take not seconds but perhaps days or even longer as a result of unavailable or misplaced records,” the report said. “If home building were like healthcare, carpenters, electricians and plumbers would work with different blueprints, with very little coordination.”

Yet there is a clear sense of determination within the report that significant progress in health care is certainly possible. The report listed 10 specific recommendations to improve care, control costs and reduce waste, summarized by HealthLeaders Media:

1. Improve the capacity to capture clinical, care delivery process and financial data for better care, system improvement and the generation of new knowledge.
2. Streamline and revise research regulations to improve care, promote the capture of clinical data and generate knowledge.
3. Accelerate integration of the best clinical knowledge into care decisions.
4. Involve patients and families in decisions regarding health care tailored to fit their preferences.
5. Promote community-clinical partnerships and services aimed at managing and improving health at the community level.
6. Improve coordination and communication within and across organizations.
7. Continuously improve health care operations to reduce waste, streamline care delivery and focus on activities that improve patient health.
8. Structure payment to reward continuous learning and improvement in the provision of best care at lower cost.
9. Increase transparency on health care system performance.
10. Expand commitment to the goals of a “continuously learning” health care system.

If you had to choose one of these recommendations to begin your improvement journey, which one would it be and why?

Sources:

Clark, C. (2012, Sept. 7). IOM Urges 10 Major Healthcare Fixes. HealthLeaders Media. http://www.healthleadersmedia.com/content/LED-284173/IOM-Urges-10-Major-Healthcare-Fixes##

Lowery, A. (2012, Sept. 11). Study of U.S. Health Care System Finds Both Waste and Opportunity to Improve. The New York Times. http://www.nytimes.com/2012/09/12/health/policy/waste-and-promise-seen-in-us-health-care-system.html?_r=1

The National Academies Press, (2012, Sept. 6). Best Care at Lower Cost The Path to Continuously Learning Health Care in America, report description, http://www.nap.edu/catalog.php?record_id=13444#description

The National Academies Press, (2012, Sept. 6). Best Care at Lower Cost The Path to Continuously Learning Health Care in America. http://www.iom.edu/Reports/2012/Best-Care-at-Lower-Cost-The-Path-to-Continuously-Learning-Health-Care-in-America.aspx