Future workshop addressed multiple components central to the work of the Roundtable on Value & Science-Driven Health Care:

  • Facilitate collaborative healthcare choices of each patient and provider.
  • Ensure innovation, quality, safety, and value in health care.
  • Foster the transformation of the American healthcare system into a learning health system that generates and applies evidence naturally.
  • Emphasize prevention and health promotion as means to increase value.
  • Instill principles of accountability, care coordination, expectation setting, incentive alignment, and patient-centered focus.

This chapter contains a brief summary of the workshop’s three keynote addresses followed by individually authored pieces based on those presentations. The three keynote talks were a commentary by Brent C. James on “Learning Opportunities for Health Care,” W. Dale Compton’s discussion of “Teaching Opportunities from Engineering,” and Donald M. Berwick’s presentation, “Observations on Initiating Systems Change in Health Care.”

Engineering a Learning Healthcare System: A Look at the Future

The first two keynote addresses together outlined the landscape of issues the workshop was designed to address and framed many of the most important questions that workshop participants would explore. The third keynote address, delivered near the end of the workshop, added further depth to the intellectual framework of the workshop and contributed additional specific suggestions for moving forward in engineering a learning healthcare system.

Reflecting the fact that the workshop was sponsored by the Institute of Medicine (IOM) Roundtable on Value & Science-Driven Health Care in cooperation with the National Academy of Engineering (NAE), the program opened with two talks that addressed, respectively, issues in health care and opportunities for addressing those issues from the realm of engineering.

The first presentation, “Learning Opportunities for Health Care” was by Brent C. James, executive director of the Institute for Health Care Delivery Research and vice president of medical research and continuing medical education at Intermountain Healthcare. Based in Salt Lake City, Intermountain Healthcare is an integrated healthcare system of hospitals, clinics, a large physician group, and a health maintenance organization/ preferred provider organization insurance plan covering more than 450,000



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