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Editor's Notes: What Thursday, September 6 Meant for Healthcare

October 2, 2012
by Mark Hagland
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The release of the latest IOM report was significant--but its significance won't be fully understood for some time yet

Many in healthcare remember what happened on November 1, 1999 (though they may not recall the date itself): on that day, the Institute of Medicine released a groundbreaking report, "To Err Is Human: Building a Safer Health System." That report, which was also published in book form, initiated the first serious, industry-wide, nationwide conversation about patient safety and medical errors that had reached the ears of the general public.

What made the mainstream media sit up and take that report seriously was a single statistic: that somewhere between 44,000 and 98,000 Americans were dying every year, in hospitals alone, from fully preventable medical errors—the equivalent, it was pointed out, of a jumbo jet crashing every day and killing all the passengers on board. And while I’ve often criticized my mainstream media journalist colleagues for being lazy when it comes to their healthcare policy reporting—their failure to articulate fully the important policy choices facing the American people during the healthcare reform debate in 2009 and 2010 was a particularly egregious example—it’s kind of hard to ignore a statistic of 98,000 annual preventable deaths. Thus, in November 1999, Americans from all walks of life were made aware of the issue of patient safety in new and important way, creating a watershed moment for our country.

Meanwhile, Sept. 6, 2012 passed far more quietly. Yet the report that the IOM released on that date—the organization’s third major report in 13 years—is one that I would argue will have an increasingly important impact over time.

That’s because "Best Care at Lower Cost: The Path to Continuously Learning Health Care in America" was released at a particularly propitious point in the evolution of the healthcare industry in the United States, relative to the core changes it is urging. In contrast to 13 years ago when "To Err Is Human" was released, "Best Care at Lower Cost," which focuses on the idea of compelling the healthcare industry forward on a system-wide journey of continuous learning, was published at a time when pioneering patient care organizations were already moving down a path towards sustained, continuous performance improvement.

Of course, most patient care organizations nationwide are still very, very early in their journey; and the 10 core recommendations that the report makes, which would move the U.S. healthcare system toward a far more data-driven, patient-centered, community-linked, new-payment-model-facilitated care delivery model, will take years, if not decades, to fully build. But in contrast to the situation 13 years ago, some of the care delivery models that will be required going forward are already emerging.

When it comes to the efforts that leading medical groups are making in all this arena, the October cover story in the print edition of our magazine offers a discussion among the leaders of such diverse organizations as Hunterdon Healthcare Partners in Flemington, N.J., Cornerstone Health Care in High Point, N.C., and the Physician Services Division at the UPMC health system in Pittsburgh, describing the initiatives they’re participating in, in order to lay the groundwork for what I’ve regularly been calling the new healthcare.

So though "To Err Is Human" hit the U.S. healthcare industry as a shockwave in 1999, and though the release of "Best Care at Lower Cost" was a far quieter affair, there’s no question in my mind that the map that this latest IOM report lays out is one whose path the healthcare system will turn to countless times as a point of reference, as we move forward to transform the healthcare delivery system on behalf of our patients and communities.

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