Best Care at Lower Cost:: The Path to Continuously Learning Health Care in America

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National Academies Press, May 10, 2013 - Medical - 436 pages
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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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1 Introduction and Overview
Managing Rapidly Increasing Complexity
Achieving Greater Value in Health Care
Capturing Opportunities from Technology Industry and Policy
5 A Continuously Learning Health Care System
6 Generating and Applying Knowledge in Real Time
7 Engaging Patients Families and Communities
8 Achieving and Rewarding HighValue Care
9 Creating a New Culture of Care
10 Actions for Continuous Learning Best Care and Lower Costs
Appendix A Glossary
Appendix B A CEO Checklist for HighValue Health Care
Appendix C ACA Provisions with Implications for a Learning Health Care System
Appendix D Biosketches of Committee Members and Staff

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About the author (2013)

Mark Smith (Washington D.C.) has appeared as a featured guest on numerous programs on the FOX, ABC, NBC and CNN networks, as well as on radio. His popular seminars on auric vision and handwriting analysis are consistently booked around the country.

Robert Saunders born in a small rural town in central Illinois in the mid 60s learned through practical life application the idea "hard work never killed any one." After getting a small taste of victory in sales in his early teens he pursued a career in the sales industry. As with most in his field he strived day in and day out to gain greater success, even if it meant relationships torn apart by traveling and long days being away from home. Today he is only after one thing, that is the world will come to know Jesus as their Lord and Savior and have there lives transformed. The life he shares with his wife Jackie is the most free he has ever been.

J. MICHAEL McGINNIS is assistant surgeon general and director of the Office of Disease Prevention and Health Promotion in the U.S. Department of Health and Human Services.

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