Informing the Future Critical Issues in Health, Fifth Edition (2009) / Chapter Skim
Currently Skimming:
Charting a Course for the Future of Health Care
Charting a Course for the Future of Health Care
Pages 5-16
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From page 5... ...
Recent efforts have focused on improving the organization and operation of the nation's largest health agency; working to assess what diagnostic, therapeutic, and preventive services work best; gauging the overall health of the nation's population; and identifying ways to build an even stronger foundation of evidence-based medicine that effectively captures the promise of scientific discovery and technological innovation and enables doctors, nurses, and other health professionals to provide the right care for the right patient at the right time. reitalizing Health and Human Serices The U.S.
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From page 6... ...
Defining a st-century ision HHS currently lacks a clear vision of how to provide the greatest value in protecting and improving health in today's climate of varied, complex, and sometimes changing health needs. By defining such a vision -- along with a complementary mission statement that defines a small number of measurable, time-specific goals -- HHS can help individuals in Congress, throughout HHS -- the largest of all federal the federal government and the health departments, spending sector, and across the nation at large to approximately $ billion a day -- understand the role and importance of the profoundly affects the department's work.
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From page 7... ...
This effort will require expanded information sharing, both within the department as well as with external organizations, in order to better evaluate and inform the health care system. Strengthening the health care workforce Analysts predict serious shortages across the health care spectrum of people with the right backgrounds, training, and skills.
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From page 8... ...
Its 2009 program-level expenses were projected at $326 million, making it by far the smallest PHS agency. NOTE: ACF = Administration for Children and Families; AHRQ = Agency for Healthcare Research and Quality; AoA = Administration on Aging; CDC = Centers for Disease Control and Prevention; CMS = Centers for Medicare and Medicaid Services; FDA = Food and Drug Administration; HRSA = Health Resources and Services Administration; IHS = Indian Health Service; OCR = Office for Civil Rights; OIG = Office of the Inspector General; OMHA = Office of Medicare Hearings and Appeals; ONCHIT = Office of the National Coordinator for Health Information Technology; PHSSEF = Public Health and Social Services Emergency Fund; SAMHSA = Substance Abuse and Mental Health Services Administration; SCHIP = State Children's Health Program, a component of Medicaid.
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From page 9... ...
Assessing what works in health care Solving some of the nation's most pressing health policy problems may hinge on the capacity to identify which diagnostic, therapeutic, and preventive services work best for various patients and under various circumstances. As many studies have documented, spending on ineffective care contributes to Soling some of the nation's rising health costs and insurance premi- most pressing health policy ums.
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From page 10... ...
The committee should consider a range of topics, including new, emerging, and well-established health services and technologies for prevention, diagnosis, and treatment. The highest priorities should be the clinical questions of patients and clinicians that have the potential for substantial impact on health outcomes across all ages by reducing the burden of disease, health disparities, and undesirable variation in the delivery of health services As part of its charge, the program also would develop and promote rigorous standards for creating clinical practice guidelines, which could help clinicians and patients make informed decisions about appropriate health care for specific clinical circumstances, minimize use of questionable services, and target services to the patients most likely to benefit.
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From page 11... ...
Below the dashed line, decision makers and developers of clinical recommendations interpret the findings of systematic reviews to decide which patients, 1-1 health care settings, or other circumstances they relate to. SOURCE: Knowing What Works in Health Care: A Roadmap for the Nation, p.
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From page 12... ...
The meeting drew heavily on discussions of the IOM's Roundtable on Evidence-Based Medicine. Through the Roundtable, the IOM has char acterized evidence-based medicine to mean that to the greatest extent pos sible, the decisions that shape the health and health care of Americans -- by patients, providers, payers, and policy makers alike -- will be grounded on a reliable evidence base, will account appropriately for individual variation
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From page 13... ...
The intensity of health care services delivered for similar conditions varies significantly across geographic regions, particularly in areas that require discretionary decision making. However, the higher spending regions often do not deliver better quality care, and hence offer substantial opportunity for reduced spending without sacrificing health outcomes.
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From page 14... ...
Electronic medical records and clinical data registries, for example, offer tremendous potential both to generate new evidence and to augment randomized clinical trials. Capitalizing on such rewards will require addressing privacy and proprietary issues that now limit data access and sharing.
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From page 15... ...
Behavioral factors include both healthful activities, such as engaging regularly in at least moderate physical exercise, and harmful behaviors, such as smoking, drinking to excess, or being obese. Factors related to the performance of health systems include per-capita spending on care, pervasiveness of insurance coverage among populations, and rates of childhood immunization and adult preventative services, among others.
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From page 16... ...
Until now, only experts with the technological capability to search arcane data had the capacity for this kind of examination. As the nation moves increasingly toward "patient-centered medicine," in which patients play an active role in their treatment regimens, it will be important to develop effective ways to boost public knowledge about health issues.
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