Engineering a Learning Healthcare System: A Look at the Future. Workshop Summary

摘要

The fundamental notion of the learning healthcare systemcontinuous improvement in effectiveness, efficiency, safety, and qualityis rooted in principles that medicine shares with engineering. In particular, the fields of systems engineering, industrial engineering, and operations research have long experience in the systematic design, analysis, and improvement of complex systems, notably in such large sectors as the airline and automobile industries. Working cooperatively with the National Academy of Engineering (NAE), the Institute of Medicine (IOM) organized Engineering a Learning Healthcare System: A Look at the Future to bring together leaders from the fields of health care and engineering to identify particularly promising areas for application of engineering principles to the design of more effective and efficient health carea learning healthcare system. This report presents the summary of the meetings discussions. Currently, the organization, management, and delivery of health care in the United States falls short of delivering quality health care reliably, consistently, and affordably. As health care continues to increase in scope and complexity, so will the challenges to efficiency. In part, the capacity to address these challenges will depend on the ability to develop information about the relative effectiveness of interventions in a fashion that is more timely and practical than is typically the case for individually designed prospective studies, such as randomized clinical trials. It will also depend on the ability to design delivery systems in which the dynamics at the component interfaces are much more efficient. In both cases, the adaptation of engineering principles to facilitate continuous learning will be key.