Precision Community Health by Bechara Choucair

Precision Community Health by Bechara Choucair

Author:Bechara Choucair [Choucair, Bechara]
Language: eng
Format: epub
Tags: SOC057000 Social Science / Disease & Health Issues
Publisher: Island Press


Learning

In 1999, the Institute of Medicine (renamed the National Academy of Medicine in 2015) began to develop an idea called the Learning Healthcare System. The first report from the initiative was titled To Err Is Human, and the key finding was disturbing: an estimated 44,000 to 98,000 Americans may die annually as a result of medical errors. That would rank medical errors as one of the top ten leading killers if such errors were considered a formal cause of death.12 The fact is, until relatively recently, most physicians did not focus much effort on analyzing the scientific evidence on what is effective and under what circumstances. Sometimes the data do not exist; sometimes they exist but are hard to find; and sometimes doctors are not convinced that changing their approaches to treatment will actually lead to better outcomes for their patients.

The idea of evidence-based medicine emerged in the twentieth century as a response to these trends. The goal was to improve care by integrating individual clinical expertise with the best available external evidence.13 It marked a significant advance, and it highlights the importance of both a rigorous scientific base for practice and physician judgment. However, the increased complexity of health care requires a deepened commitment to examining evidence relevant to the treatment of individual patients.

This is not to suggest that physicians have anything less than their patients’ interests at heart. Far from it. The fact is that most simply can’t keep up with the pace of new discoveries, new data, and new ways of thinking about how to make the best possible clinical decisions. We can hardly blame them for that. Ask most practicing physicians what they need most, and they’ll tell you it is to spend more time with their patients. Yet they could spend literally every waking hour immersed in the details of new scientific knowledge, including about disease management, medical technologies, regenerative medicine, and the growing utility of genomics and proteomics in tailoring disease detection and treatment to each individual. The amount of research is vast, and currently the share of health expenses devoted to determining what works best is about one-tenth of 1 percent.14

By the early 2000s, it was becoming clear that an evidence-based approach was not sufficient by itself and certainly had little impact on public health. What was needed was a wholesale change in the development and application of evidence for health care. The Institute of Medicine led the effort, recognizing the role that information technology could play by improving data collection and management. But the Institute wanted to go beyond that to conduct a thorough reevaluation of how health care is structured to develop and apply evidence—from health professions training to infrastructure development, patient engagement, payments, and measurement. As the Institute said in its 2007 report, “The nation needs a healthcare system that learns.”15

The Institute of Medicine’s Learning Healthcare System was a platform that allowed evidence-based real-time analysis of health data for a broad range of uses, including primary care decision making, public health activities, consumer education, and academic research.



Download



Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.