The report concludes that the health care system is too complex and costly to continue business as usual. Authors contend 30 percent of health care spending in 2009 was wasted, and cite a rough estimate that 75,000 deaths could have been averted in 2005 if every state delivered care at the quality level of the best performing state.
The ways that providers train, practice and learn new information cannot keep pace with new discoveries and technological advancements. And care delivery and payment practices lead to inefficiencies and may hinder improvement. “The threats to Americans’ health and economic security are clear and compelling, and it’s time to get all hands on deck,” says Mark Smith, president and CEO at the California HealthCare Foundation.
Better use of data would facilitate better treatment of 75 million patients with more than one chronic condition by improving care coordination and having quick access to best practices, according to the report. “For example, it took 13 years for the use of beta blockers to become standard practice after they were shown to improve survival rates for heart attack victims.”
The Institute of Medicine’s influential reports, To Err is Human and Crossing the Quality Chasm, sparked numerous efforts to improve the quality, safety and effectiveness of care. But for more than a decade the work has been too little to see broad improvements, according to the new report.
Today, opportunities exist to tackle continuing problems, the report states. The opportunities include vast computational power that is affordable and widely available, connectivity, progress in human and organizational capabilities and management science, and increasing empowerment of patients.
Report authors call for federal authorities, standards development organizations and information technology developers to ensure electronic health records and mobile technologies are robust and interoperable. Clinicians should “fully adopt” the technologies and patients should be encouraged to use consumer tools such as personal health records.
The report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America, “demonstrates how a health care system that delivers the best care at lower cost is not only necessary, but also possible,” says Harvey Fineberg, M.D., president of IOM, in a foreword. The report is available here in a free pre-publication version.