Multimodality approach needed to reengineer health care

Noting that changes to the existing health system are necessary, but have proved insufficient to both improve quality and reduce costs, Ari Hoffman, M.D., from the University of California in San Francisco, and Ezekiel J. Emanuel, M.D., Ph.D., from the University of Pennsylvania in Philadelphia, discuss whether a single approach could improve the health care process while controlling costs, with a focus on reengineering the care delivery process.

According to the authors, and based on analysis of models from industry, a multimodality approach is needed to improve quality and reduce costs, which will rethink the overall process rather than focusing on individual tasks. Reengineering involves rethinking, redesign, and application of necessary tools, focusing on health outcomes. Rethinking will address issues such as who provides health services, how they are paid for, and how much should be paid for these services. Redesign could include radical change in the fields of education, research, infrastructure, and public health, as well as new systems of health care delivery and payment. Tools such as electronic medical records, decision support, reform of malpractice, and care coordination should be built on a solid foundation.

"No single change will solve the health care value problem," the authors write. "With a focus on reengineering, the nation may succeed not only in implementing systematic health care reform, but reform that actually improves the health of Americans while simultaneously controlling unsustainable costs."

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Journal reference: Journal of the American Medical Association

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