On December 1, 1999, the Institute of Medicine released a report entitled To Err is Human: Building a Safer Health System. Although its authors hoped to spark a national movement, they had little cause for optimism. After all, early efforts by advocates like Berwick and Leape and organizations like the National Patient Safety Foundation had barely moved the needle of public and professional attention.
The IOM Report succeeded beyond its framers’ wildest dreams, and the movement they spawned turns ten today. Please indulge me while I spend a nostalgic moment recalling the remarkable spin that launched the patient safety field. I’ll then segue to a summary of my assessment of what we’ve accomplished over the past decade (I outline this more fully in an article in this week’s web version of Health Affairs, which I hope you’ll take a look at).Continue reading…
The U.S. can cut health-care spending by $250 billion a year within a decade, a
congressionally chartered panel will say this month in a bid to
show costs can be contained even if all Americans are insured.
A report from the Institute of Medicine, which advises the
federal government on health care, will counter “stingy”
estimates from the Congressional Budget Office, said Arnold
Milstein, planning chairman of the institute’s working group on
health costs. The panel’s annual figure is five times the amount
the budget office says the U.S. will save under a bill in the
House of Representatives, according to the budget office’s July
17 letter to House Ways and Means Committee chairman Charles
The preliminary findings from the institute, part of the
National Academies in Washington, will be issued amid a growing
debate over the health-care overhaul proposals that President
Barack Obama is urging Congress to pass. The report will help
bolster the argument that covering the nation’s 46 million
uninsured won’t bust the budget, advocates of the bill say.
This week the Institute of Medicine (IOM) released its list of the top 100 topics that should be addressed in comparative effectiveness research (CER) now — thanks to $1.1 billion in the American Recovery & Reinvestment Act
— that the federal government actually has the resources to do
substantial CER. IOM has prioritized the list by creating four
quartiles, noting that the first quartile is the highest priority
In order for the federal government to make good use of the huge pot of CER money, there are at least five things that they need to do to ensure its value and actually change care delivery.
I’m all for trying to find out whether me-too drugs add any significant
value. However, the greatest opportunities for implementing delivery
system change that improves care effectiveness and efficiency relate to
innovations in how care is organized and delivered, and how insights
are communicated to the broad range of health care actors — most
That’s why I was heartened by the IOM’s top 100 list — though
certainly I’d move a few up a quartile or two. The list has many
projects that fit my priorities, including a strong emphasis on CER to
reduce health disparities.