Portland, Ore.

OHSU School of Medicine Dean on committee that created report

America’s health system is ailing and bold new initiatives are needed to move the system forward, says a new report from the Institute of Medicine of the National Academies. Computerized health information and records, greater access to health coverage, and medical liability reform are among the areas that offer the greatest potential for improvement.

The report outlines five strategic areas in which demonstration projects could test strategies to solve some of the most pressing health care concerns. The proposed projects were developed in response to a request from Tommy Thompson, the secretary of the U.S. Department of Health and Human Services, for ideas to address the mounting problems that threaten to overwhelm America’s health care system.

"Individually many health systems are trying to fix their local problems, but there are larger challenges in the health care environment which need to be addressed. The federal government could provide a stimulus to learn from state and regional experiences," said Christine K. Cassel, M.D., dean of the Oregon Health & Science University Medical School and a member of the IOM Committee on Rapid Advance Demonstration Projects: Health Care Finance and Delivery, which wrote the report.

The five proposed demonstration areas are information technology development, expanded health insurance coverage, malpractice reform, chronic disease management and primary care enhancement. Performance measures would gauge success of the initiatives, with the goal of achieving initial improvements in each area within two years of implementation and significant progress toward reform within five years, according to the report. Many of the project ideas build on existing innovations, and all but one — expansion of health insurance, are not expected to require additional funding over the long term after upfront investments.

The report was sponsored by the Institute of Medicine and the National Research Council, which are private, nonprofit institutions that provide science, technology and health policy advice under a congressional charter.