TY - BOOK AU - Institute of Medicine AU - National Research Council A2 - Maria Hewitt A2 - Joseph V. Simone TI - Enhancing Data Systems to Improve the Quality of Cancer Care SN - DO - 10.17226/9970 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9970/enhancing-data-systems-to-improve-the-quality-of-cancer-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - One of the barriers to improving the quality of cancer care in the United States is the inadequacy of data systems. Out-of-date or incomplete information about the performance of doctors, hospitals, health plans, and public agencies makes it hard to gauge the quality of care. Augmenting today's data systems could start to fill the gap. This report examines the strengths and weaknesses of current systems and makes recommendations for enhancing data systems to improve the quality of cancer care. The board's recommendations fall into three key areas: Enhance key elements of the data system infrastructure (i.e., quality-of-care measures, cancer registries and databases, data collection technologies, and analytic capacity). Expand support for analyses of quality of cancer care using existing data systems. Monitor the effectiveness of data systems to promote quality improvement within health systems. ER - TY - BOOK AU - Institute of Medicine TI - Coverage Matters: Insurance and Health Care SN - DO - 10.17226/10188 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10188/coverage-matters-insurance-and-health-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Roughly 40 million Americans have no health insurance, private or public, and the number has grown steadily over the past 25 years. Who are these children, women, and men, and why do they lack coverage for essential health care services? How does the system of insurance coverage in the U.S. operate, and where does it fail? The first of six Institute of Medicine reports that will examine in detail the consequences of having a large uninsured population, Coverage Matters: Insurance and Health Care, explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced by members of various population groups of being uninsured. It serves as a guide to a broad range of issues related to the lack of insurance coverage in America and provides background data of use to policy makers and health services researchers. ER - TY - BOOK AU - Institute of Medicine TI - Care Without Coverage: Too Little, Too Late SN - DO - 10.17226/10367 PY - 2002 UR - https://nap.nationalacademies.org/catalog/10367/care-without-coverage-too-little-too-late PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital--based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million -- one in seven--working--age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. ER - TY - BOOK AU - Institute of Medicine A2 - Molla S. Donaldson A2 - Karl D. Yordy A2 - Kathleen N. Lohr A2 - Neal A. Vanselow TI - Primary Care: America's Health in a New Era SN - DO - 10.17226/5152 PY - 1996 UR - https://nap.nationalacademies.org/catalog/5152/primary-care-americas-health-in-a-new-era PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge base—as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systems—important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals. ER - TY - BOOK AU - Institute of Medicine TI - Improving the Medicare Market: Adding Choice and Protections, Summary DO - 10.17226/9281 PY - 1996 UR - https://nap.nationalacademies.org/catalog/9281/improving-the-medicare-market-adding-choice-and-protections-summary PB - The National Academies Press CY - Washington, DC LA - English KW - ER - TY - BOOK AU - Institute of Medicine TI - Medical Technology Assessment Directory: A Pilot Reference to Organizations, Assessments, and Information Resources SN - DO - 10.17226/1090 PY - 1988 UR - https://nap.nationalacademies.org/catalog/1090/medical-technology-assessment-directory-a-pilot-reference-to-organizations-assessments PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - For the first time, a single reference identifies medical technology assessment programs. A valuable guide to the field, this directory contains more than 60 profiles of programs that conduct and report on medical technology assessments. Each profile includes a listing of report citations for that program, and all the reports are indexed under major subject headings. Also included is a cross-listing of technology assessment report citations arranged by type of technology headings, brief descriptions of approximately 70 information sources of potential interest to technology assessors, and addresses and descriptions of 70 organizations with memberships, activities, publications, and other functions relevant to the medical technology assessment community. ER - TY - BOOK AU - Institute of Medicine A2 - Rose Marie Martinez A2 - Erin Rusch TI - Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health: Workshop Summary SN - DO - 10.17226/18552 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18552/understanding-the-connections-between-coastal-waters-and-ocean-ecosystem-services-and-human-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health discusses the connection of ecosystem services and human health. This report looks at the state of the science of the role of oceans in ensuring human health and identifies gaps and opportunities for future research. The report summarizes a workshop convened by the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine. Participants discussed coastal waters and ocean ecosystem services in the United States in an effort to understand impacts on human health. Understanding the Connections Between Coastal Waters and Ocean Ecosystem Services and Human Health focuses on key linkages by discussing the ecosystem services provided by coastal waterways and oceans that are essential for human health and well-being; examining the major stressors that affect the ability of coastal waterways and ocean systems to provide essential services; and considering key factors that can enhance the resiliency of these systems. ER - TY - BOOK AU - Institute of Medicine AU - National Research Council AU - National Research Council TI - Improving Palliative Care: We Can Take Better Care of People With Cancer SN - DO - 10.17226/10790 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10790/improving-palliative-care-we-can-take-better-care-of-people PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - As a society, we have made amazing gains in being able to detect and treat cancer. Even so, about half the people who are told by their doctors that they have cancer will die within a few years. This means that every year about one million people find out that they have cancer and are treated, and about one-half million people die of cancer nationwide. So far, most cancer research and treatment has focused on trying to cure cancer. There hasn't been much attention paid to other important issues, such as pain control and taking care of other troubling symptoms. Now more and more people are aware that there are cancer care needs beyond just trying to cure it. Attention is now being paid to helping people with cancer cope better with the problems that may arise when people are being treated or as they approach death. ER - TY - BOOK AU - Institute of Medicine A2 - Emily Ann Meyer A2 - Kathi Hanna A2 - Kristine Gebbie TI - Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program SN - DO - 10.17226/11269 PY - 2005 UR - https://nap.nationalacademies.org/catalog/11269/cord-blood-establishing-a-national-hematopoietic-stem-cell-bank-program PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - With the potential for self-renewal and differentiation, the possibilities for stem cells are enormous. One specific type of stem cell, the hematopoietic progenitor cell (HPC), which is derived from umbilical cord blood (as well as adult bone marrow and mobilized peripheral blood), holds particular promise. To make the most of these HPCs, the Institute of Medicine was asked to consider the optimal structure for a national cord blood program and to address pertinent issues related to maximizing the potential of stem cell technology. Cord Blood: Establishing a National Hematopoietic Stem Cell Bank Program examines: The role of cord blood in stem cell transplantation The current status of blood banks already in existence The optimal structure for the cord blood program The current use and utility of cord blood for stem cell transplants The best way to advance the use of cord blood units and make them available for research Expert advice from leaders in the fields of economics, public health, medicine, and biostatistics combine to make this very timely and topical book useful to a number of stakeholders. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Crystal J. Bell A2 - Anne Frances Johnson TI - The Use of Telehealth for Disability Evaluations in Medicine and Allied Health: Proceedings of a Workshop SN - DO - 10.17226/26650 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26650/the-use-of-telehealth-for-disability-evaluations-in-medicine-and-allied-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Over the past few years the common use of telehealth technology has been rapidly expanding. While remote models of care have been successfully used in rural communities for decades, the adoption of telehealth rapidly expanded during the COVID-19 pandemic, narrowing some gaps in care access and equity while exacerbating health care inequities in other ways. At the request of the Social Security Administration, the National Academies hosted a workshop on March 9 and 10, 2022 to examine the use of telehealth for patient evaluation. The workshop explored the evolution of telehealth and commonly used terminology, the impact of inequities in digital access, privacy and cybersecurity concerns, its use in a variety of allied health and medical specialties for patient evaluation, and interstate licensure related to providing telehealth care. This publication provides a high-level summary of the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Jonathan R. Davis TI - Managed Care Systems and Emerging Infections: Challenges and Opportunities for Strengthening Surveillance, Research, and Prevention: Workshop Summary SN - DO - 10.17226/9760 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9760/managed-care-systems-and-emerging-infections-challenges-and-opportunities-for PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - This workshop summary report examines how the managed care revolution has created both problems and opportunities in the fight against infectious diseases. It highlights ways in which managed care systems can aid research, develop clinical guidelines, manage the use of antibiotics, support public education efforts, and monitor the spread of emerging infections and microbial resistance. ER - TY - BOOK AU - Institute of Medicine A2 - Henry J. Aaron A2 - Hellen Gelband TI - Extending Medicare Reimbursement in Clinical Trials SN - DO - 10.17226/9742 PY - 2000 UR - https://nap.nationalacademies.org/catalog/9742/extending-medicare-reimbursement-in-clinical-trials PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Increasingly over the past five years, uncertainty about reimbursement for routine patient care has been suspected as contributing to problems enrolling people in clinical trials. Clinical trial investigators cannot guarantee that Medicare will pay for the care required, and they must disclose this uncertainty to potential participants during the informed consent process. Since Medicare does not routinely "preauthorize" care (as do many commercial insurers) the uncertainty cannot be dispelled in advance. Thus, patients considering whether to enter trials must assume that they may have to pay bills that Medicare rejects simply because they have enrolled in the trial. This report recommends an explicit policy for reimbursement of routine patient care costs in clinical trials. It further recommends that HCFA provide additional support for selected clinical trials, and that the government support the establishment of a national clinical trials registry. These policies (1) should assure that beneficiaries would not be denied coverage merely because they have volunteered to participate in a clinical trial; and (2) would not impose excessive administrative burdens on HCFA, its fiscal intermediaries and carriers, or investigators, providers, or participants in clinical trials. Explicit rules would have the added benefit of increasing the uniformity of reimbursement decisions made by Medicare fiscal intermediaries and carriers in different parts of the country. Greater uniformity would, in turn, decrease the uncertainty about reimbursement when providers and patients embark on a clinical trial. ER - TY - BOOK AU - Institute of Medicine A2 - Karen Adams A2 - Janet M. Corrigan TI - Priority Areas for National Action: Transforming Health Care Quality SN - DO - 10.17226/10593 PY - 2003 UR - https://nap.nationalacademies.org/catalog/10593/priority-areas-for-national-action-transforming-health-care-quality PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - A new release in the Quality Chasm Series, Priority Areas for National Action recommends a set of 20 priority areas that the U.S. Department of Health and Human Services and other groups in the public and private sectors should focus on to improve the quality of health care delivered to all Americans. The priority areas selected represent the entire spectrum of health care from preventive care to end of life care. They also touch on all age groups, health care settings and health care providers. Collective action in these areas could help transform the entire health care system. In addition, the report identifies criteria and delineates a process that DHHS may adopt to determine future priority areas. ER - TY - BOOK AU - Institute of Medicine A2 - Jane S. Durch A2 - Linda A. Bailey A2 - Michael A. Stoto TI - Improving Health in the Community: A Role for Performance Monitoring SN - DO - 10.17226/5298 PY - 1997 UR - https://nap.nationalacademies.org/catalog/5298/improving-health-in-the-community-a-role-for-performance-monitoring PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits. ER - TY - BOOK AU - Institute of Medicine A2 - Cheryl Ulmer A2 - Bernadette McFadden A2 - David R. Nerenz TI - Race, Ethnicity, and Language Data: Standardization for Health Care Quality Improvement SN - DO - 10.17226/12696 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12696/race-ethnicity-and-language-data-standardization-for-health-care-quality PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement. ER - TY - BOOK AU - Institute of Medicine A2 - Michael A. Stoto A2 - Lawrence W. Green A2 - Linda A. Bailey TI - Linking Research and Public Health Practice: A Review of CDC's Program of Centers for Research and Demonstration of Health Promotion and Disease Prevention SN - DO - 10.17226/5564 PY - 1997 UR - https://nap.nationalacademies.org/catalog/5564/linking-research-and-public-health-practice-a-review-of-cdcs PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Health promotion and disease prevention are central priorities in the Centers for Disease Control and Prevention (CDC) vision. To advance research in these areas, Congress authorized and CDC established a program of university-based Centers for Research and Demonstration of Health Promotion and Disease Prevention to explore improved ways of appraising health hazards and to serve as demonstration sites for new and innovative research in public health. Begun in 1986 with three centers, there are now fourteen. In response to a CDC request to evaluate the program, Linking Research and Public Health Practice examines the vision for the prevention research centers program, the projects conducted by the centers, and the management and oversight of the program. In conducting the evaluation, the IOM committee took a broad view of how prevention research can influence the health of communities, and considered both the proximal risk factors for disease prevention and the more distal conditions for health promotion and improved equity in the distribution of risk factors. Month? ER - TY - BOOK AU - Institute of Medicine A2 - Stanley B. Jones A2 - Marion Ein Lewin TI - Improving the Medicare Market: Adding Choice and Protections SN - DO - 10.17226/5299 PY - 1996 UR - https://nap.nationalacademies.org/catalog/5299/improving-the-medicare-market-adding-choice-and-protections PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sector—yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed care—how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system. ER - TY - BOOK AU - Institute of Medicine TI - Assessment of Diagnostic Technology in Health Care: Rationale, Methods, Problems, and Directions SN - DO - 10.17226/1432 PY - 1989 UR - https://nap.nationalacademies.org/catalog/1432/assessment-of-diagnostic-technology-in-health-care-rationale-methods-problems PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Technology assessment can lead to the rapid application of essential diagnostic technologies and prevent the wide diffusion of marginally useful methods. In both of these ways, it can increase quality of care and decrease the cost of health care. This comprehensive monograph carefully explores methods of and barriers to diagnostic technology assessment and describes both the rationale and the guidelines for meaningful evaluation. While proposing a multi-institutional approach, it emphasizes some of the problems involved and defines a mechanism for improving the evaluation and use of medical technology and essential resources needed to enhance patient care. ER - TY - BOOK AU - Institute of Medicine A2 - Joe Alper TI - Population Health Implications of the Affordable Care Act: Workshop Summary SN - DO - 10.17226/18546 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18546/population-health-implications-of-the-affordable-care-act-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement. Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health. Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the "doctor's" office. Improving the health of the population - whether in a community or in the nation as a whole - requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action. ER - TY - BOOK AU - Institute of Medicine TI - Crossing the Quality Chasm: A New Health System for the 21st Century SN - DO - 10.17226/10027 PY - 2001 UR - https://nap.nationalacademies.org/catalog/10027/crossing-the-quality-chasm-a-new-health-system-for-the PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change. ER -