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Fall 2005 Vol. 5 No. 3

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©Rob Colvin/ Engineering Better Health Care

Since the late 1990s, health care costs have been rising at double-digit rates -- three times faster than inflation -- claiming a growing share of Americans' income, inflicting economic hardships on many, and decreasing access to care. At the same time, 43 million Americans are uninsured, close to 100,000 patients die each year as a result of medical mistakes or negligence, and more than a half-trillion dollars is wasted annually because of inefficiencies in the health care system.

One way to help address these challenges is for the U.S. health care sector to take advantage of engineering strategies and technologies that have revolutionized quality, productivity, and performance in many other industries, says a recent report from the National Academy of Engineering and Institute of Medicine.

"Health care is deeply mired in crises related to safety, quality, cost, and access that pose serious threats to the welfare of many Americans," said Jerome H. Grossman, co-chair of the committee that wrote the report. "Unfortunately, it has been very slow to embrace engineering tools and clinical information technologies."

"Systems-engineering tools," which are developed for the design, analysis, and control of complex interactions among various parts of a system, have been used by many businesses to improve the safety and quality of products and services and to lower production costs. The report says that when applied to the health care sector, these tools could help deliver care that is safe, effective, timely, efficient, equitable, and patient-centered -- the six "quality aims" envisioned by the Institute of Medicine for the health system of the 21st century.

"While medicine has advanced rapidly in recent decades thanks to new diagnostic and therapeutic technologies developed by engineers, the health care industry has virtually ignored a broad spectrum of other technologies that could radically improve the safety and efficiency of care," said study co-chair W. Dale Compton.

Engineers and health professionals should begin working together to hasten the transformation of the health care system, the report says. The federal government, in partnership with the private sector, universities, and state governments, should establish multidisciplinary centers at institutions of higher learning to foster the formation of collaborations, which would eventually lower the barriers that have impeded the widespread use of engineering and technology in health care. Also, organizations that have already adopted or promoted the use of systems engineering tools should step up their outreach and spread the word about their successes.   -- Patrice Pages

Building a Better Delivery System: A New Engineering/Health Care Partnership. Committee on Engineering and the Health Care System, National Academy of Engineering and Institute of Medicine (2005, 276 pp.; ISBN 0-309-09643-X; available from the National Academies Press, tel. 1-800-624-6242; $39.00 plus $4.50 shipping for single copies).

Jerome H. Grossman, senior fellow and director of the Health Care Delivery Policy Program, Harvard University, Cambridge, Mass., and W. Dale Compton, Lillian M. Gilbreth Distinguished Professor Emeritus of Industrial Engineering, Purdue University, West Lafayette, Ind., co-chaired the committee. The study was funded by the National Science Foundation, Robert Wood Johnson Foundation, and National Institutes of Health.

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Copyright 2005 by the National Academy of Sciences