Building a Better Delivery System A New Engineering/Health Care Partnership (2005) / Chapter Skim
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Executive Summary
Executive Summary
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The costs of this centered, efficient, and equitable -- the six quality aims envicollective inattention and the failure to take advantage of the sioned in the landmark IOM report, Crossing the Quality tools, knowledge, and infrastructure that have yielded quality Chasm (Box ES-1)
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The report describes the opportunities and HEALTH CARE DELIVERY challenges to harnessing the power of systems-engineering tools, information technologies, and complementary knowl- Systems-engineering tools have been used in a wide edge in social sciences, cognitive sciences, and business/ variety of applications to achieve major improvements in the management to advance the six IOM quality aims for a quality, efficiency, safety, and/or customer-centeredness of twenty-first century health care system. processes, products, and services in a wide range of manu This NAE/IOM study attempts to bridge the knowledge/ facturing and services industries.
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disease-related groups, severity-adjusted capitation for TABLE ES-1 Systems Engineering Tools and Research for Health Care Delivery System Levels of Application Tool/Research Area Patient Team Organization Environment SYSTEMS-DESIGN TOOLS Concurrent engineering and quality function deployment X X Human-factors tools X X X X Tools for failure analysis X X SYSTEMS-ANALYSIS TOOLS Modeling and Simulation Queuing methods X X Discrete-event simulation X X X Enterprise-Management Tools Supply-chain management X X X Game theory and contracts X X X Systems-dynamics models X X X Productivity measuring and monitoring X X X Financial Engineering and Risk Analysis Tools Stochastic analysis X X Value-at-risk X X Optimization tools for individual decision making X X X Distributed decision making: market models and agency theory X X Knowledge Discovery in Databases Data mining X X Predictive modeling X X X Neural networks X X X SYSTEMS-CONTROL TOOLS Statistical process control X X X Scheduling X X NOTE: Italics indicate areas with significant research opportunities.
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Changes must be approached from information/communications technologies that empower many directions, with systems engineering tools that are individual patients to assume a much more active, controlavailable now and with new tools developed through ling role in their own health care; improve access to timely, research. Successes in other industries clearly show that effective, and convenient care; improve patient compliance small steps can yield significant results, even while longer with clinician guidance; enable continuous monitoring of term efforts are being pursued.
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This data pool could support better regulation · voice-recognition systems and oversight of the health care delivery system, population · software that improves interoperability and connectivity health surveillance, and the continuing development of the among systems from different vendors clinical knowledge base. · systems that spread costs among multiple users The NHII could also support another family of emerging · software dependability in systems critical to health technologies based on wireless communications and micro- care delivery electronic systems with the potential to radically change the · secure, dispersed, multiagent databases that meet the structure of the health care delivery system and advance needs of both providers and patients patient-centeredness and quality performance.
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Building on the experiences of recent large-scale, Continuing Education multidisciplinary, research/education/technology-transfer initiatives in engineering and the biological sciences, the Making systems-engineering tools, information techcommittee proposes a strategy for building bridges between nologies, and complementary knowledge in business/ the fields of engineering, health care, and management to management, social sciences, and cognitive sciences availaddress the major challenges facing the health care delivery able and training individuals to use them will require the system. An environment in which professionals from all commitment and cooperation of engineers, clinicians, and three fields could engage in basic and applied research and health care managers, as well as changes in their respective translate the results of their research and advances both into professional cultures.
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Quantitative engineering and health care communities. If we take up techniques, such as financial engineering, data mining, and the challenge to help transform the system now, crises can game theory, could significantly improve the financial, be abated, costs can be reduced, the number of uninsured marketing, and strategic functions of health care organiza- can be reduced, and all Americans will have access to the tions, and incorporating examples from health care into the quality care they deserve and that we are capable of delivering.
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: 397403. Health: A Strategy for Building the National Health Information Infra structure.
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