IOM calls for improved use of IT in healthcare

"America's healthcare system has become far too complex and costly to continue business as usual," according to the Institute of Medicine (IOM), releasing its 382-page report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America.

"Pervasive inefficiencies, an inability to manage a rapidly deepening clinical knowledge base, and a reward system poorly focused on key patient needs, all hinder improvements in the safety and quality of care and threaten the nation's economic stability and global competitiveness," the IOM wrote. "Achieving higher quality care at lower cost will require fundamental commitments to the incentives, culture and leadership that foster continuous 'learning,' as the lessons from research and each care experience are systematically captured, assessed and translated into reliable care."

In the report, an 18-member expert panel argued for a set of improvement strategies that they said will make information more accessible, engage patients and their families and make care more equitable. This roadmap, includes increased adoption of health IT, increased connectivity, use of new payment models and a re-engineering of healthcare systems.

“Missed opportunities for better healthcare have real human and economic impacts,” the committee said in the report. “If the care in every state were of the quality delivered by the highest-performing state, an estimated 75,000 fewer deaths would have occurred across the country in 2005. Current waste diverts resources from productive use, resulting in an estimated $750 billion loss in 2009.”

The report comes more than a decade after the IOM released To Err is Human and Crossing the Quality Chasm, companion reports that revealed the extensive impact of medical errors. Despite the calls for change in those reports, poorly designed systems, lack of information at the point of care and an entrenched culture have hindered large-scale improvement, the committee said.

“Available knowledge is too rarely applied to improve the care experience, and information generated by the care experience is too rarely gathered to improve the knowledge available,” the report said. “The traditional systems for transmitting new knowledge—the ways clinicians are educated, deployed, rewarded and updated—can no longer keep pace with scientific advances. If unaddressed, the current shortfalls in the performance of the nation's healthcare system will deepen on both quality and cost dimensions, challenging the well-being of Americans now and potentially far into the future.”

The full report is available at IOM's website.