IOM Report: Better Care at Lower Cost

IOM Report September 2012

Report issued by IOM September 6, 2012

The latest Institute of Medicine report was released on Thursday via webcast, and it is now available on their website–see Better Care at Lower Cost: The Path to Continuously Learning Health Care in America. A Twitter conversation can also be found at #bestcare.

Mark Smith, California HealthCare Foundation (Committee Chair) gave an overview of three key areas highlighted in the report during the webcast. Here is a brief summary:

  • Patient Engagement: Understanding patients’ needs, values, preferences and goals around care is at the heart of better care at lower cost, as is finding ways for patients to take an active role in their healthcare.
  • Incentives: Rewarding systems that deliver high quality care, finding ways to learn quickly and implement and rooting all of this in transparency.
  • Culture: Organizations who are leading the charge in delivering better care at lower costs are doing so with bold and consistent leadership taking their health systems to new heights. Smith mentioned Virginia Mason’s work, as well as the need so great among their peers to learn their strategies, that an entire institute was built to share the Virginia Mason culture. See Virginia Mason Institute and Charles Kenney’s Transforming Health Care.

Foundational elements and policy changes that Smith outlined as necessary to achieve a learning healthcare system include the areas of:

  • Technology: Capturing data with the intent of better care and generating knowledge using digital platforms where care and quality improvement can be done on the same system. Security of data is also key so that healthcare earns the trust and willingness of patients to share their information.
  • Care Improvement Targets: Clinical decision support is key — finding ways to provide real-time, point-of-care evidence for best care.
  • Patient Centeredness: Patient preference should rule the treatment plan taken.
  • Community Links: Prevention of re-admissions focus with the need for a robust system outside the hospital, with greater integration between different institutions. Care continuity within and between different providers was also mentioned. Management science applied to health systems can improve operations and efficiencies to improve patient health.

The final comment posed to the panel highlighted the new skills this report will require of care providers. The need for quality improvement and patient safety training throughout the educational experience was agreed upon as an obvious need–and as mentioned previously on Educate the Young, is so much more than a 90-minute lecture.

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