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On the heels of last year’s report on medical errors and patient safety, the Institute of Medicine of the National Academies has issued a report calling for reforms to fix the nation’s "disjointed and inefficient" health care system. "Americans should be able to count on receiving care that uses the best scientific knowledge to meet their needs, but there is strong evidence that this frequently is not the case," says William C. Richardson, chairman of the committee that wrote the report. Richardson is president of the W.K. Kellogg Foundation in Battle Creek, MI.
"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 to subsidize promising projects and publicize the need for significant changes. Clinicians, health care organizations, and purchasers should focus on improving care for common, chronic conditions that are the leading cause of illness and use a substantial amount of health care resources, the report says. But it says 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. The report called 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, titled "Crossing the Quality Chasm: A New Health System for the 21st Century," is available on-line at www.iom.edu. Click "What’s New" and look under "New Reports."