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Assessing Health Care Reform (1993)
Institute of Medicine (IOM)

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. "Improving the Infrastructure for Effective Change." Assessing Health Care Reform. Washington, DC: The National Academies Press, 1993.

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Assessing Health Care Reform

Reform proposals should include a specific mandate for the development and continued support of comprehensive data-bases in the health field.

The committee recommends taking steps to improve the nation's survey and statistics capabilities, particularly by instituting a national health care survey that can track progress and identify problems in the implementation of reform efforts.

Reform proposals should promote universal implementation of computer-based patient records (CPRs) and CPR systems among providers. The committee also recommends adoption of an expanded program in information services for health services research and technology assessment at the National Library of Medicine.

The committee recommends an absolute increase in the support for a range of research and information activities that must be carried forth if reform activities are to be implemented and evaluated satisfactorily, particularly in the area of clinical evaluation sciences and health services research.

The committee recommends that certain steps be taken to improve the nation's capacity to carry out effective technology assessment efforts and that reform proposals be explicit about how they will deal with the innovation and diffusion of health technologies over time.

A partnership between the personal health services system and the population-based activities of the public health system, as well as occupational health activities, should be encouraged in the reform proposal.

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