Despite the constant finger pointing on Capitol Hill, the
nation’s health-care woes cannot be blamed on one particular issue. A
new report from the Institute of Medicine (IOM), identifies a host of
problems are plaguing the health-care system leading to high cost and
poor results.
Michael Mahoney, vice president of consumer marketing at insurance
website GoHealth called the results exiting because “it shows all [areas
of care] have room for improvement.” Just as there is no one cause to
the health-care system’s faults, there is also not one cure to repair
and improve it. In fact, the report shows a combination of more
adaption of electronic records, increasing provider incentives and
better health decisions by patients will help make the system more
efficient, effective and affordable.
The IOM wanted to know why some industries like manufacturing operate
efficiently and the health-care industry is plagued with waste. For
example, the IOM calculated that around 30% of health spending in
2009--roughly $750 billion--went to unnecessary services, excessive
administrative costs, fraud and other problems. What’s more, while other
industries learn from their mistakes, health care hasn’t followed suit.
According to the IOM, one-third of hospitalized patients are harmed
while in the hospital and one-fifth of Medicare patients are
re-hospitalized within 30 days.
The situation isn’t any better when it comes to medical records and
technology. The IOM found that 20% of patients reported that test
results or medical records weren’t transferred to another medical
institution in time for an appointment and 25% said their doctor had to
re-order tests to have the correct information for diagnosis.
Transparency is also lackluster in health care compared to other
industries. For instance, a consumer shopping for an appliance or
booking a hotel has a variety of tools to compare products and rates in
order to find the best price. The study found that 63% of patients don’t
know the cost of their care until they receive the bills and 10% never
find out what their treatment cost.
When it comes to discussing treatment options, less than half of
patients surveyed said they got clear information on the pros and cons
of treatments, and less than half said they were happy with the role
they played in the decision-making process.
So what can be done? According to the IOM in the case of electronic
records, there needs to be improvements in capturing and delivering
clinical data in a reliable and secure manner. The institute recommends
regulatory agencies clarify and improve rules regarding the collection
and use of clinical data to protect privacy, but at the same time allow
access to the data to better coordinate and manage care. According to
the IOM around 75 million Americans have more than on chronic disease,
which required coordination among multiple specialists.
To improve patient care, the IOM recommends medical clinicians and
health care organizations embrace tools that provide reliable access to
current clinical research that can be used at the point of care and that
organizations should provide incentives that encourage the use of the
tools.
It can take years for medical breakthroughs to become mainstream and
commonly prescribed. The IOM referenced beta blockers, which took 13
years to become standard practice after they were shown to improve the
survival rate in heart attack patients.
Patients and their families also need to play a more active role
regarding their health care—they need to ask questions before, during
and after their treatment.
A reward system for doctors and nurses would also improve patient
care. The IOM recommends private and public payers reward continuous
learning and improvement in providing the best care at lower costs. The
IOM says payers structured payment models should be created to
incentivize and support high- quality care focused on the patients’
needs.
To improve transparency, the IOM recommends the industry increase the
availability of price and cost information, quality, and the various
outcomes and effects of different treatments to allow patients to make
more informed decisions.
While the recommendations may go toward bettering the health-care
system, Mahoney at GoHealth says it’s going to take regulation in order
for any real improvements to happen. “All these things require
legislation in order for change. Csonsumers or providers aren’t going to
suddenly stand up one day and be more efficient.”