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Learning to Reduce Waste, Variation and Inefficiency – the Healthcare Learning Experience at #ISPORPhila
As ISPOR enters its 20th year, the organisation today gathers in Philadelphia to kick off the annual international meeting. The plenary focused on the progress of Learning Health Care, a project started nearly ten years ago by the Institute of Medicine (IOM) to provide evidence-based, value-driven, and patient-centred networks of decision-making and delivery innovation.
Why is this important? Ultimately, the IOM estimates that around 30% of US health spending is waste that does not in any way benefit the patient, split into domains such as unnecessary services, expensive administrative costs, inefficient delivery services, excessive prices, missed prevention opportunities and fraud. In addition to this, the variation of how healthcare is actually delivered is staggering, signifying a lack of co-ordination, collaboration and communication.
This is a reality that is set against the background of rapid change, as payment models in the United States are increasingly moving from a volume-based fee for service approach a to a value-based approach linking payments to quality.
So, there is a clear need to develop tools and networks to tackle these inefficiencies. And in a session devoted in large parts to talking about how action is more important than talking, there was frustration - or perhaps impatience - that more progress had not been made, given the widespread need and demand. The will is there, but the size and complexity of the task is enormous.
Still, the panel speakers spoke of the clear strides that had been made in the adoption of electronic health records and the linking together of various health systems and networks through initiatives such as PCORnet, the Collaboratory, and HITECH Act.
Indeed, in the comparatively short life of PCORnet since March 2014, its first phase has created 11 clinical data research networks (CDRNs) and 18 patient powered research networks (PPRNs), split between rare and common diseases. The goal here is to use integrated delivery systems and health/medical centres to create patient cohorts to improve clinical decision-making, and, in particular, remove areas of waste, variation and inefficiency. The rest of ISPOR will go into more detail over this wide array of initiatives and point the direction towards how Learning Health Care can progress even further.
Gustav Ando is the director of life sciences at IHS
Posted 18 May 2015
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