IOM: Technology a must to fix 'complex, costly' healthcare

Better use of technology to capture and share health data is necessary for the healthcare industry to make systematic changes that will lead to better quality care and lower costs, according to a new report published today by the Institute of Medicine.

The IOM calls America's current healthcare system "far too complex and costly" to continue on its current path, pointing out the inefficiencies have led to billions of dollars wasted on unnecessary care and tens of thousands of deaths that might otherwise have been prevented.

"Data generated in the course of care delivery should be digitally collected, compiled and protected as a reliable and accessible resource for care management, process improvement, public health and the generation of new knowledge," the authors said. "Healthcare delivery organizations and clinicians should fully and effectively employ digital systems that capture patient care experiences reliably and consistently and implement standards and practices that advance the interoperability of data systems."

The National Coordinator for Health IT, as well as various developers and standards organizations, should oversee the process of building up such a digital infrastructure, according to the authors, who add that patients and the payers also have roles to play in such an undertaking. Patients, the report points out, should be involved in "building new knowledge" and should take advantage of available tools such as personal portals. Payers should "contribute data to research and analytic consortia" that can lead to new insights, according to the IOM.

The report also calls for increased use of clinical decision support, saying that such tools should be "routine" in healthcare delivery. A recently published study in the American Journal of Managed Care concludes that clinical decision support provides the best return among electronic health record functions.

"Clinical decision support systems … can help address cognitive errors, such as attribution, availability bias and anchoring, all of which may contribute to errors and wrong diagnoses," the authors said. "Greater adoption of clinical decision support could be achieved through advances in interoperability with EHR and computerized physician order entry systems from multiple vendors, allowing this technology to be embedded seamlessly in the standard clinical workflow."

The authors point out that "incremental improvements" likely won't succeed in fixing the broken system, and that instead, the entire system must change for progress to be made.

Last fall, the IOM proposed the creation of a new watchdog agency to monitor health IT-related safety issues. In a report commissioned by the Office of the National Coordinator for Health IT, IOM recommended that the U.S. Department of Health & Human Services create and fund the new agency that would, among other things, require health IT vendors to report safety incidents associated with their products.

To learn more:
- download the report
- here's the report's brief
- check out the recommendations at a glance (.pdf)

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