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Crossing the Quality Chasm: A New Health System for the 21st Century
related Web sites (Benton Foundation, 1999), allowing consumers to search for information on specific diseases and treatments, evaluate health plans and clinicians, pose questions to care providers, manage chronic conditions, participate in discussion groups, assess existing health risks, and purchase health-related products (National Research Council, 2000). There is however, much variability in the accuracy and completeness of health information found on the Web (Biermann et al., 1999).
The effect of these trends on health care will be a fundamental transformation in the ways services are organized and delivered and clinicians and patients interact. Individuals are making many of their own decisions about diagnosis and treatment. Increasingly, they are also bringing information to their physicians to obtain help in interpreting or judging its value for themselves.
To better understand how information technology can contribute to improving quality, the Committee on the Quality of Health Care in America held a workshop in September 1999 at which participants identified five key areas in which information technology could contribute to an improved health care delivery system:
Access to the medical knowledge-base. Through use of the Web, it should be possible to help both providers and consumers gain better access to clinical evidence.
Computer-aided decision support systems. Embedding knowledge in tools and training clinicians to use those tools to augment their own skills and experience can facilitate the consistent application of the expanding science base to patient care.
Collection and sharing of clinical information. The automation of patient-specific clinical information is essential for many types of computer-aided decision support systems. Automation of clinical data offers the potential to improve coordination of care across clinicians and settings, which is critical to the effective management of chronic conditions.
Reduction in errors. Information technology can contribute to a reduction in errors by standardizing and automating certain decisions and by aiding in the identification of possible errors, such as potential adverse drug interactions, before they occur.
Enhanced patient and clinician communication. Information technology can change the way individuals receive care and interact with their clinicians. Instead of a $65 office visit and a half-day off work, a 2-minute e-mail communication could meet many patients’ needs more responsively and at lower cost. Similarly, patients would be able to go online and obtain test results, inform their clinicians about how they are doing, send pictures and data, participate in interactive care management services, receive after-care instructions, and participate in support groups. Appropriately structured e-mail communication between patient