The
New England Journal of Medicine recently posted an article entitled “Cottage Industry to Postindustrial Care—The Revoluion in Health Care Delivery.” The article argues that the health care industry needs to standardize value generated processes and report them transparently to the entire community. In essence it is a “call to statistics” to transform the health care system.
“U.S. healthcare is broken,” the authors write. “Although other industries have transformed themselves using tools such as standardization of value-generating processes, performance measurement and transparent reporting of quality, the application of these tools to health care is controversial….”
Despite the growth of mega hospital companies and the evolution of large physician groups, the US health care system is still a group of isolated practitioners who balk at the idea of standardization. Services are highly variable. Many physicians complain that much of the standardization of medicine is just a mere algorithm and it’s “cookbook” medicine. This has resulted in over utilization of tests, exams, surgeries and appointments.
I guess the crucial question is: is the current health care system making America sicker? Is over-utilization to blame? Maybe my questions are overstating the fact.
However, the article points out the fragmentation of care has led to suboptimal performance. U.S. patients receive only about half of scientifically advisable care. Many unnecessary procedures are performed, leading to avoidable complications and costs.
Three actions must take place to improve the healthcare system: 1. Prudent standardization of medical practices based on sound scientific principles, not politics. 2. Meaningful measurement of outcomes with statistically valid outcomes 3. Respectful and widespread reporting and transparency.
Taking these three steps will go a long way in improving how Americans receive good healthcare and reducing costs.
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