The U.S. health care industry has neglected engineering strategies and technologies that have revolutionized quality, productivity and performance in many other industries, says a new report from the National Academy of Engineering and Institute of Medicine. This "collective inattention" has contributed to serious consequences in health care — nearly 100,000 preventable deaths per year, outdated procedures, about a half-trillion dollars wasted annually through inefficiency, costs rising at roughly three times the rate of inflation, and 43 million people uninsured. Health care professionals and engineers should work more closely together to address these challenges, said the committee that wrote the report.

INFORMS members John R. Birge and William P. Pierskalla served on the 14-member committee. Birge, a past president of INFORMS, is a professor of operations management at the University of Chicago's Graduate School of Business. Pierskalla, who has delivered several presentations on the topic of O.R. and health care at INFORMS and other meetings, is the Distinguished Professor Emeritus of Decisions, Operations and Technology Management at UCLA's Anderson Graduate School of Management.

"The health care sector is deeply mired in crises related to safety, quality, cost and access that pose serious threats to the health and welfare of many Americans," says Jerome H. Grossman, committee co-chair and senior fellow and director of the Health Care Delivery Policy Program at Harvard University. "Unfortunately, the health care system has been very slow to embrace engineering tools and clinical information technologies that could transform it from an underperforming conglomerate of independent entities into a high-performance system."

Systems-engineering tools, developed for the design, analysis and control of complex systems, have been used by many industries to improve the safety and quality of products and services and to lower production costs. These same tools, in certain circumstances, have been shown to improve the quality and efficiency of health care. If adapted and widely adopted, they could help deliver care that is safe, effective, timely, efficient, equitable and patient-centered — the six "quality aims" envisioned in the landmark report entitled "Crossing the Quality Chasm: A New Health System for the 21st Century."

"While medicine has advanced rapidly in recent decades thanks to new diagnostic and therapeutic technologies developed by engineers, the health care industry has virtually ignored a broad spectrum of other technologies that could radically improve the safety and efficiency of health care," says W. Dale Compton, committee co-chair and Lillian M. Gilbreth Distinguished Professor Emeritus of Industrial Engineering, Purdue University.

Cultural, organizational and policy-related barriers have impeded the widespread use of systems-engineering tools and information technology in health care, the report says. Health care professionals often fail to recognize that they are part of a larger system, and most engineering professionals have a limited understanding of the complex challenges involved in health care. To encourage health care providers to use systems-engineering tools, organizations that have already adopted or promoted the use of such tools — such as the Veterans Health Administration, the Institute for Healthcare Improvement and the Agency for Healthcare Research and Quality — should increase their outreach efforts to educate the larger health care community.

The health care sector remains woefully underinvested in information and communications technologies, the committee notes. Government and private-sector organizations should accelerate implementation of the National Health Information Infrastructure, a 10-year initiative developed by the U.S. Department of Health and Human Services to improve the overall quality of health care, facilitate the exchange of data among health care organizations, public and private payers, regulatory bodies and the research community, and enable patients to become more active partners in their own health care, the report says. The health care community should also take advantage of emerging technologies based on wireless communications and microelectronics to improve the lives and care of patients, especially the elderly and patients with chronic illnesses, who require continuous monitoring and care.

The transformation of the health care system will require dramatic changes in the education and training of health care professionals, engineers and managers and in the way innovation in health care delivery is advanced, the committee adds. To hasten this transformation, the federal government, in partnership with the private sector, universities, federal laboratories and state governments, should establish multidisciplinary centers at institutions of higher learning to bring together researchers, practitioners, educators and students in engineering, health sciences, management, and the social and behavioral sciences. A lead government agency should be identified to coordinate the activities of these centers and ensure that funding is stable and adequate, the report says.

"If the nation takes up the challenge to transform the health care system now, current crises can be abated — costs can be cut, the number of uninsured can be reduced and more Americans can have access to the quality care they deserve and that we are capable of delivering," Grossman says.

The study was sponsored by the National Science Foundation, the Robert Wood Johnson Foundation and the National Institutes of Health. The National Academy of Engineering and Institute of Medicine are private, nonprofit institutions that provide science, technology and health policy advice under a congressional charter.

Copies of the report will be available this fall from the National Academies Press by phone (202-334-3313 or 1-800-624-6242) or on the Internet (http://www.nap.edu).






OR/MS Today copyright © 2005 by the Institute for Operations Research and the Management Sciences.
All rights reserved.


Lionheart Publishing, Inc.
506 Roswell Road, Suite 220, Marietta, GA USA
Phone: 770-431-0867 | Fax: 770-432-6969
E-mail: lpi@lionhrtpub.com
Web URL: www.lionhrtpub.com


Web Site © Copyright 2004 by Lionheart Publishing, Inc.
All rights reserved.