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Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/13444.
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Appendix A

Glossary

Community—Groups of people defined in many ways, such as by geography, culture, disease or condition, occupation, and workplace.

Complexity—A property of a system that consists of multiple interrelated components and is also difficult to analyze and understand because of its complicated nature.

Continuous learning and improvement—The process of ongoing measurement and analysis to inform changes in the delivery of care. Continuous learning occurs both intra- and interinstitutionally and relies on the real-time capture and use of data on patient experience, outcomes, and process measures.

Cost—Price multiplied by the volume of services or products used, or the total sum of money spent at a given level (patients, organizations, state, national).

Evidence—Information from clinical experience that has met some established test of validity, with the appropriate standard determined according to the requirements of the intervention and clinical circumstance. (IOM Roundtable on Value & Science-Driven Health Care Charter)

Evidence-based—Being based on reliable evidence while accounting appropriately for individual variation in patient needs. (IOM Roundtable on Value & Science-Driven Health Care Charter)

Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/13444.
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Genomics—A field of study concerned with hereditary information of organisms.

High-value—A characteristic achieved through maximizing value by improving outcomes, lowering costs, or both.

Informatics—A field of study concerned with the effective use of information to answer scientific questions.

Learning health care system—A health care system in which science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the care process, patients and families active participants in all elements, and new knowledge captured as an integral by-product of the care experience (Charter, IOM Roundtable on Value & Science-Driven Health Care).

Patient-centered outcomes—Outcomes of clinical care that are most important to patients.

Price—The amount charged for a given health care service or product. It is important to note that there are frequently multiple prices for the same service or product, depending on the patient’s insurance status and payer, as other factors.

Proteomics—A field of study that examines the structure and function of proteins.

Systems engineering—An interdisciplinary approach to the design, management, and analysis of complex systems to achieve objectives such as efficiency, quality, and safety.

Value—Assessed using the following heuristic: Value= img

Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/13444.
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Page 313
Suggested Citation:"Appendix A: Glossary." Institute of Medicine. 2013. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. Washington, DC: The National Academies Press. doi: 10.17226/13444.
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Page 314
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America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.

The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.

About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.

This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.

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