Changing Values in Medicine


Book Description




Evidence-Based Medicine and the Changing Nature of Health Care


Book Description

Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.







Beyond the HIPAA Privacy Rule


Book Description

In the realm of health care, privacy protections are needed to preserve patients' dignity and prevent possible harms. Ten years ago, to address these concerns as well as set guidelines for ethical health research, Congress called for a set of federal standards now known as the HIPAA Privacy Rule. In its 2009 report, Beyond the HIPAA Privacy Rule: Enhancing Privacy, Improving Health Through Research, the Institute of Medicine's Committee on Health Research and the Privacy of Health Information concludes that the HIPAA Privacy Rule does not protect privacy as well as it should, and that it impedes important health research.




Medical Innovation in the Changing Healthcare Marketplace


Book Description

A wave of new health care innovation and growing demand for health care, coupled with uncertain productivity improvements, could severely challenge efforts to control future health care costs. A committee of the National Research Council and the Institute of Medicine organized a conference to examine key health care trends and their impact on medical innovation. The conference addressed the following question: In an environment of renewed concern about rising health care costs, where can public policy stimulate or remove disincentives to the development, adoption and diffusion of high-value innovation in diagnostics, therapeutics, and devices?




Crossing the Quality Chasm


Book Description

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.




An Introductory Philosophy of Medicine


Book Description

In this book the author explores the shifting philosophical boundaries of modern medical knowledge and practice occasioned by the crisis of quality-of-care, especially in terms of the various humanistic adjustments to the biomedical model. To that end he examines the metaphysical, epistemological, and ethical boundaries of these medical models. He begins with their metaphysics, analyzing the metaphysical positions and presuppositions and ontological commitments upon which medical knowledge and practice is founded. Next, he considers the epistemological issues that face these medical models, particularly those driven by methodological procedures undertaken by epistemic agents to constitute medical knowledge and practice. Finally, he examines the axiological boundaries and the ethical implications of each model, especially in terms of the physician-patient relationship. In a concluding Epilogue, he discusses how the philosophical analysis of the humanization of modern medicine helps to address the crisis-of-care, as well as the question of “What is medicine?” The book’s unique features include a comprehensive coverage of the various topics in the philosophy of medicine that have emerged over the past several decades and a philosophical context for embedding bioethical discussions. The book’s target audiences include both undergraduate and graduate students, as well as healthcare professionals and professional philosophers. “This book is the 99th issue of the Series Philosophy and Medicine...and it can be considered a crown of thirty years of intensive and dynamic discussion in the field. We are completely convinced that after its publication, it can be finally said that undoubtedly the philosophy of medicine exists as a special field of inquiry.”




Redefining Health Care


Book Description

The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets. In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change. The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.




Health Professions Education


Book Description

The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.




Restoring Humane Values to Medicine


Book Description

Does reading poetry make you a better clinician?Can euthanasia be understood in terms of the meaning of a life?What is the moral and existential significance of life-threatening experiences? Australian surgeon, poet, philosopher and humanist, Miles Little addresses these and other fascinating questions in this collection of papers.Miles Little is one of the most original and engaging voices in contemporary medical ethics and philosophy. He ranges across the sciences and the humanities, creating hybrid fields of inquiry ("ethonomics"), interrogating orthodoxies and engaging different fields of human knowledge and experience.The papers in this collection were chosen by his readers, who also engage here with Miles Little's work in a short commentary that follows each paper. The range of the commentators reflects the breadth of Little's appeal and influence: academics and clinicians, philosophers and ethicists, novelists, public health practitioners and cancer survivors - each reflects, agrees or disagrees.Like Little's work itself, this Reader is an open and unfolding dialogue that includes many different perspectives.Commentators include: Murray Bail, Robin Downie, Nancy Dubler, Stan Goulston, Jill Gordon, Paul Komesaroff, Steve Leeder, Paul McNeill , Gavin Mooney and Bernadette Tobin