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Part II: Workshop Presentations--Framing the Health Care Challenge
Pages 91-114

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From page 93...
... Framing the Health Care Challenge
From page 95...
... In other words, the prob- chronic conditions, but few institutions or systems provide lems are systemic and permeate the health care industry; high quality care for the full range of chronic conditions. In problems are just as prevalent in traditional indemnity, or addition, we have a problem in "scaling up" -- exemplary less managed, settings as in managed care settings.
From page 96...
... Unlike investments in medical technology, investments in information technology do not directly TEN RULES FOR REDESIGNING generate billable services under Medicare or third-party-payer, AND IMPROVING CARE fee-for-service systems. Hence, providers may realize a faster return on investments in a new surgical suite than they will on Private and public purchasers, health care organizations, investments in an automated order entry system.
From page 97...
... 2001. Crossing the Quality Chasm: A New 7.
From page 99...
... In short, the system is fragmented, studies by Lucien Leape and his colleagues at Harvard, iden- fractured, and not patient-centric. tified a variety of medical errors that result in morbidity and Finally, there is the cost of poor quality care, which has mortality caused not because of physician malfeasance but interesting implications for innovation.
From page 100...
... an information technology infrastructure. Next, we could The final issue identified in Crossing the Quality Chasm create flow systems to manage the support activities required is that information technology is not being used in the delivto carry out these processes, retain people, and set new stan- ery system the way one would expect for such an informadards of quality.
From page 101...
... 2001. Crossing the Quality Chasm: A New Health System for the 21st Century.
From page 103...
... Buried in the software of a stem cell is the recipe for each tissue type in your body, as well as UNRAVELING THE GENOME AND EXTENDING the assembly instructions for the organ systems that those THE HUMAN LIFE SPAN tissues ultimately form. A lot of people believe that, once we The business and mission of the health care system will master the instruction sets buried in the stem cells, we will change with two radical scientific advances.
From page 104...
... erly in a household. Care managers will use Web-based tools · Generation 3 combines the repository of clinical data, to navigate knowledge domains to help make better deci the electronic version of the paper chart, and orders sions and get better results.
From page 105...
... We have tried to increase consumer demand for mote the diffusion and adoption of existing best practices. higher quality care and have worked through vehicles, such For example, a program called Improving Chronic Illness as a purchaser institute that brings together public and priCare run by the Group Health Cooperative of Puget Sound vate purchasers.
From page 106...
... promote behavioral change strategies to help improve One of the differences between engineering and medicine people's diets and help them deal with stress. New organizais that engineers believe in the theoretical possibility of per- tions and new functions outside the traditional health care fection; doctors do not.
From page 107...
... A few years ago, my colleagues and I wrote a book on example, often have trouble understanding that health care a fifth level, virtually integrated health systems, collaboraleaders cannot just order physicians to do something. Aca- tions among multiple organizations to improve health demic institutions that have tenured physicians may have the (Coffey et al., 1997)
From page 108...
... Occupational Safety publish "low science" research. and Health Administration standards, Joint Commission on Academic physicians survive not by the quality of patient Accreditation of Healthcare Organizations (JCAHO)
From page 109...
... status of health ______ major major Virtually Diseases (17 categories) Operations ICD-9 Health with (8 Causes poisoning categories)
From page 110...
... department, hospital, multi-institutional systems, and virtu- Don B Chaffin, professor of industrial and operations ally integrated health systems)
From page 111...
... Donaldson, eds. At the virtually integrated health system level (Level 5 in Washington, D.C.: National Academies Press.
From page 113...
... For instance, if a patient is The Henry Ford Health System is a very large integrated getting diabetic care in one system and prostate care in anhealth care system with three major components: hospitals, a other, comparing quality of health care and productivity bemedical group, and a health plan with 600,000 enrollees. comes a difficult issue.
From page 114...
... Instead of paying for quality care, the tutions were asked how their senior leaders evaluate them, current system pays more generously if patients develop they all said by financial performance. They said they were complications.


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