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IOM Report: Best Care at Lower Cost
Multipronged Solutions Necessary to Fix Ailing U.S. Health Care System
By Sheri Porter
The Academy gave the report a thumbs-up.
"We agree with the majority of the report's recommendations," said AAFP President Glen Stream, M.D., M.B.I., of Spokane, Wash. "The report is consistent with what we've been saying for a long time and lends the very credible voice of the Institute of Medicine to the Academy's efforts to promote the patient-centered medical home (PCMH)."
- A new report released by the Institute of Medicine says the U.S. health care system is underperforming and wasting health care dollars.
- Report authors call on stakeholders to begin a process of developing a "continuously learning health care system" that will produce the best patient care at a lower cost.
- Many of the report's recommendations are consistent with the AAFP's efforts to promote the patient-centered medical home model of care.
According to the report, in 2009 alone, about $750 billion in health care dollars was wasted on unnecessary services, administrative costs and fraud. Report authors suggest that as many as 75,000 deaths could have been averted in 2005 if every state had delivered care at the quality level of the best performing state.
The report focused on a list of action items that touch many facets of health care. Authors urged health care stakeholders, including government agencies, to
- manage the rapidly increasing complexity of the digital infrastructure and improve the capacity to capture data on the clinical aspects of patient care and the health care delivery process, as well as financial data;
- clarify and improve regulations governing the collection and use of clinical data to ensure patient privacy and facilitate the seamless use of clinical data for care coordination and improved care delivery;
- accelerate the integration of decision support tools to ensure that decisions made by clinicians and patients are supported by the best current evidence;
- involve patients and families in decisions regarding their health and health care;
- promote community and clinical partnerships, as well as services aimed at improving individual and population health;
- improve coordination and communication within and across organizations, and reward health care professionals who perform these tasks effectively;
- optimize health care operations to trim waste, streamline health care delivery and promote activities that improve patient health;
- structure payment to reward continuous learning and the provision of quality care at a lower cost;
- increase performance transparency and availability of information on the quality, cost and outcomes of care; and
- commit to continuous learning and improvement as a priority for everyone involved in health care, including patients, families and clinicians.
Role of Family Physicians
"We hope that they will find this report useful in their efforts to fully adopt health technology systems and to develop practices that are centered around patients and their family members," said Redberg.
"We want family physicians to be able to make full use of the wealth of health information that is now available so that they can more readily identify the most effective and efficient approaches to their patients' care," she added.
Redberg noted that she and her fellow IOM committee members intentionally didn't set priorities for achieving any one particular goal first "because we believe that each of the recommended actions is equally important and integral to one another."
And even though the committee refrained from setting a deadline by which all recommended work should be completed, Redberg said the digital infrastructure necessary to achieve the goals outlined in the report could be in place by the end of the decade.
New Report Outlines Successes of PCMH Model in Variety of Public, Private Demonstrations
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