Fwd: qotd: Institute of Medicine's "Best Care at Lower Cost"

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-------- Original Message --------
Subject: qotd: Institute of Medicine's "Best Care at Lower Cost"
Date: Fri, 7 Sep 2012 13:43:08 -0700
From: Don McCanne <don@mccanne.org>
To: Quote-of-the-Day <quote-of-the-day@mccanne.org>



The National Academies
Institute of Medicine
September 6, 2012
Transformation of Health System Needed to Improve Care and Reduce Costs

America's health care system has become too complex and costly to
continue business as usual, says a new report from the Institute of
Medicine (Best Care at Lower Cost: The Path to Continuously Learning
Health Care in America).

The costs of the system's current inefficiency underscore the urgent
need for a systemwide transformation. The committee calculated that
about 30 percent of health spending in 2009 -- roughly $750 billion --
was wasted on unnecessary services, excessive administrative costs,
fraud, and other problems. Moreover, inefficiencies cause needless
suffering. By one estimate, roughly 75,000 deaths might have been
averted in 2005 if every state had delivered care at the quality level
of the best performing state.

"The threats to Americans' health and economic security are clear and
compelling, and it's time to get all hands on deck," said committee
chair Mark D. Smith, president and CEO, California HealthCare
Foundation, Oakland. "Our health care 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. Our report offers the vision and road
map to create a learning health care system that will provide higher
quality and greater value."

http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=13444

And...

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

Recommendations

Recommendation 1: The Digital Infrastructure
Improve the capacity to capture clinical, care delivery process, and
financial data for better care, system improvement, and the generation
of new knowledge.
Recommendation 2: The Data Utility
Streamline and revise research regulations to improve care, promote the
capture of clinical data, and generate knowledge.

Recommendation 3: Clinical Decision Support
Accelerate integration of the best clinical knowledge into care decisions.

Recommendation 4: Patient-Centered Care
Involve patients and families in decisions regarding health and health
care, tailored to fit their preferences.

Recommendation 5: Community Links
Promote community-clinical partnerships and services aimed at managing
and improving health at the community level.
Recommendation 6: Care Continuity
Improve coordination and communication within and across organizations.

Recommendation 7: Optimized Operations
Continuously improve health care operations to reduce waste, streamline
care delivery, and focus on activities that improve patient health.

Recommendation 8: Financial Incentives
Structure payment to reward continuous learning and improvement in the
provision of best care at lower cost.
Recommendation 9: Performance Transparency
Increase transparency on health care system performance.

Recommendation 10: Broad Leadership
Expand commitment to the goals of a continuously learning health care
system.

http://www.iom.edu/~/media/Files/Report%20Files/2012/Best-Care/Best%20Care%20at%20Lower%20Cost_Recs.pdf

Best Care at Lower Cost: The Path to Continuously Learning Health Care
in America (Full report - 360 pages):
http://books.nap.edu/openbook.php?record_id=13444


Comment: On release yesterday of the Institute of Medicine's new
report, "Best Care at Lower Cost: The Path to Continuously Learning
Health Care in America," headlines throughout the nation proclaimed that
the U.S. health system wastes about $765 billion a year. The articles
reported that the Institute of Medicine has recommended an overhaul to
recover this waste. So what is it that they recommend?

When you read their ten recommendations listed above, it is difficult to
come to any other conclusion than that the efforts to produce this 360
page report have resulted in not much more than, well... platitudes.

The report does list strategies for each of the ten recommendations,
but, perhaps oversimplified, much of it depends on information
technology and really offers little hope that most of this waste could
be recovered.

Instead of stumbling along towards trying to achieve a "learning health
care system," we should first adopt a single payer national health
program. We would then have an efficient infrastructure to which the
recommended strategies that are potentially beneficial could be applied.