The Institute of Medicine is recommending that Congress establish a new national program to evaluate the effectiveness of healthcare products and services and end confusion about what works best for patients.
A new report from the institute asserts that providers and payers are overwhelmed with information about clinical effectiveness and are struggling to sift through it all. Multiple organizations are offering sometimes duplicate or competing guidelines on myriad clinical conditions, while other conditions have no guidelines at all, according to the report. Regional disparities, lack of consensus about the most effective interventions, and waste are costing billions, the report said.
Establishing a national program to identify the most effective healthcare services would lead to better, more efficient and consistent care nationwide, the institute concludes. The institute's 16-member committee of providers, insurers and academics recommend that Congress direct HHS to establish a program with the authority, resources and expertise necessary to set priorities for evaluating clinical services and conduct systematic reviews of the evidence.
A system coordinated by a single, national entity that can prioritize and coordinate these evaluations would enable us to sort the wheat from the chaff and make sense of it all, Barbara McNeil, IOM committee chairwoman and head of the department of healthcare policy at Harvard Medical School, said in a written statement.
Although a number of groupssuch as AHRQ, the Blue Cross and Blue Shield Association Technology Evaluation Center, the Food and Drug Administration and the Cochrane Collaborationconduct syntheses of available evidence, no one has the authority to make best practices recommendations.
Sharon Levine, associate executive director at Kaiser Permanente, Oakland, said a government or quasi-government program that would synthesize knowledge and come up with recommendations on best practices would go a long way to helping groups that are already using electronic health records in scientific research, such as Kaiser. "The scope of what needs to be done dwarfs any single institution working on this," Levine said.
Because of the growing interest in large databases based on EHRs, registries and other sources, the information contained in them should be "mined as appropriate," the institute said. "These types of evidence will pose significant challenges, but are likely to prove essential to understanding and improving health and healthcare systems," the IOM said.