In its highly anticipated third report on healthcare quality, the Institute of Medicine called on the federal government to play a lead role in developing clinical standards and taking other major steps to improve quality in the industry.
Without "clear, consistent signals" on how to assess and improve quality, the industry has struggled to reach consensus on the best approach to resolving problems described in the two earlier IOM studies, according to the new 252-page report.
"The current set of activities has not closed the quality gap and is unlikely to do so in the future," said Gilbert Omenn, M.D., chairman of the IOM's committee on enhancing federal healthcare quality programs and professor of internal medicine at the University of Michigan, Ann Arbor.
In 1999 an IOM report quantified the problem of medical errors and a second report in 2001 said the healthcare system must be transformed to bridge a "serious quality gap."
Congressional action and funding -- as well as substantial cooperation from the Centers for Medicare and Medicaid Services -- will be necessary to implement the IOM's recommendations, committee members said. Although the latest treatise focuses on the federal government's role, "hospitals by far are the biggest identified player," Omenn said today at the National Academies of Sciences in Washington, a private not-for-profit group that advises the government on scientific and technical matters.
In its report the IOM recommended that the six federal healthcare programs -- Medicare, Medicaid, the State Children's Health Insurance Program, the Defense Department's Tricare, the Veterans Health Administration and the Indian Health Services -- develop standard performance measures to help the industry's multiple "stakeholders," including hospitals, patients, insurers, regulators and accrediting bodies, among others.
The effort would require a stepped-up investment in information technology such as computerized patient records that help caregivers avoid errors and better inform patients, the report said. While recommending federal support, the IOM did not indicate how much money the hospital community would have to spend.
But federal clinical standards would "provide relief to hospitals," enabling healthcare providers to "speak in one voice," said Elizabeth McGlynn, associate director of Rand Health and a member of the IOM committee.
The IOM also said the federal government should provide financial incentives for physicians and hospitals that achieve higher levels of quality, complementing recent industry efforts to tie reimbursement to quality of care, the report said.
"No other stakeholder has the federal government's ability to produce fundamental change throughout the healthcare sector," the report said. The measures recommended "are not intended to represent another layer of government oversight, but rather to replace the patchwork of quality-measurement activities and projects already under way."
Additional information is available at http://www.iom.edu/iom/iomhome.nsf/Pages/Recently+Released+Reports ">the IOM's Web site.