This volume reports on discussions among multiple stakeholders about ways they might help transform health care in the United States. The U.S. healthcare system consists of a complex network of decentralized and loosely associated organizations, services, relationships, and participants. Each of the healthcare system's component sectors—patients, healthcare professionals, healthcare delivery organizations, healthcare product developers, clinical investigators and evaluators, regulators, insurers, employers and employees, and individuals involved in information technology—conducts activities that support a common goal: to improve patient health and wellbeing. Implicit in this goal is the commitment of each stakeholder group to contribute to the evidence base for health care, that is, to assist with the development and application of information about the efficacy, safety, effectiveness, value, and appropriateness of the health care delivered.

Contents

• The National Academies
• Roundtable on Evidence-Based Medicine
• Reviewers
• Institute of Medicine: Roundtable on Evidence-Based Medicine
• Foreword
• Preface
• Summary
  • COMMON CONCERNS AND THEMES
  • PART ONE. FINDING VALUE IN COMMON GROUND
  • PART TWO. LEADERSHIP COMMITMENTS TO IMPROVE HEALTH CARE
  • REFERENCES
• Part I. Finding Value in Common Ground
  • 1. Guiding Perspective: The Learning Healthcare System
    • OVERVIEW
    • THE LEARNING HEALTHCARE SYSTEM
    • THE SECTORAL STRATEGIES PROCESS
    • PATIENTS, PROVIDERS, AND STEWARDSHIP OF THE EVIDENCE
    • REFERENCES
  • 2. Foundation Stones in the Common Ground
    • BUILDING TRUST: TRANSPARENCY AND VALUE
    • SHARED COMMITMENT TO EVIDENCE-DRIVEN CARE
    • BUILDING LEARNING INTO THE CULTURE OF HEALTH CARE
    • COMMON FOCAL POINT AND TRUSTED SOURCE
    • STAKEHOLDER LEADERSHIP FOR CHANGE
  • 3. Transformational Opportunities
    • FOCUS ON THE VALUE PROPOSITION
    • TRANSPARENT PRINCIPLES AND PROCESSES FOR EVIDENCE INTERPRETATION AND USE
    • NATIONAL PRIORITIES: CHALLENGES OF UNUSED AND UNAVAILABLE EVIDENCE
    • PRODUCING EVIDENCE FOR TODAY’S DECISIONS WITH TOMORROW IN VIEW
    • MEDICAL INFORMATICS: THE NERVE CENTER OF A LEARNING HEALTHCARE SYSTEM
    • INTERDISCIPLINARY EVIDENCE-DRIVEN TEAM CARE AS STANDARD CARE
  • 4. Moving Forward
    • OVERVIEW
    • BUILDING ON COMMON GROUND
    • PRIORITIES FOR COLLABORATION
    • CONCLUDING COMMENTS AND NEXT STEPS
• Part II. Leadership Commitments to Improve Health Care
  • 5. Patients
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 6. Healthcare Professionals
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 7. Healthcare Delivery Organizations
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • INTERVIEWEES
    • REFERENCES
  • 8. Healthcare Product Developers
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 9. Clinical Investigators and Evaluators
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 10. Regulators
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 11. Insurers
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 12. Employers and Employees
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
    • REFERENCES
  • 13. Information Technology
    • SECTOR OVERVIEW
    • ACTIVITY CATEGORIES
    • LEADERSHIP COMMITMENTS AND INITIATIVES
    • NEXT STEPS
• Appendixes
  • Appendix A. Sectoral Strategies Process
  • Appendix B. Workshop Agenda
  • Appendix C. Biographical Sketches of Participants
  • Appendix D. Workshop Attendees

Rapporteurs: LeighAnne Olsen, W Alexander Goolsby, and J Michael McGinnis

Suggested citation:

IOM (Institute of Medicine). 2009. Leadership Commitments to Improve Value in Health Care: Finding Common Ground: Workshop Summary. Washington, DC: The National Academies Press.

Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.