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On the heels of last year’s blockbuster report on medical errors and patient safety, the Institute of Medicine (IOM) has issued a new report calling for reorganization and reform to fix the nation’s "disjointed and inefficient" health care system. "America’s health system is a tangled, highly fragmented web that often wastes resources by providing unnecessary services and duplicating efforts, leaving unaccountable gaps in care and failing to build on the strengths of all health professionals," the report says.
The report calls on Congress to create an "innovation" fund of $1 million to subsidize promising projects and publicize the need for significant changes, just as public funds supported the mapping of the human genome. Clinicians, health care organizations, and purchasers should focus on improving care for common, chronic conditions that are the leading causes of illness and that use a substantial amount of health care resources, the report says. But physicians, hospitals, and health care organizations often work independently of each other, rather than coordinating patient care across a variety of settings.
Information technology is the key to health care reorganization, the report concludes, calling for a nationwide effort to build a technology-based information infrastructure. "Health care organizations are only beginning to apply technological advances. For example, patient information typically is dispersed in a collection of paper records, which often are poorly organized, illegible, and not easy to retrieve," the report states.
The report calls for the elimination of most handwritten clinical data within the next 10 years through technology-based systems such as electronic records, patient-provider e-mail, automated medication order entry systems, and computerized reminder systems.
The Report, "Crossing the Quality Chasm: A New Health System for the 21st Century" is available on-line at www.iom.edu. Click on "What’s New" and look under "New Reports."