GHCブログ
2008年03月28日
1.Define a minimum standard benefit package that realigns the health system toward improving health rather than treating disease. The idea was that the system shouldn’t just focus on people when they become sick, or “patients. 2.Establish a secure electronic medical system ? make the electronic medical record portable, interoperable and broadly available to entire care team (includes X-rays, etc.) 3.Provide complete and accurate information so patients can make informed decisions about their care, includes visibility for adverse events/outcomes. 4.Center care around the individual and families, and coordinate all aspects of patient care. Patients must be active participants in this process. 5.Create a simpler system (i.e. coordinated care team), with a defined leader (primary care or specialist) who is accessible to me, and coordinates/advocates their care of acute and chronic conditions ? advocate to improve quality/efficiency based on evidence.
1.Make the case for payment reform/properly aligned incentives: o prevention/wellness-based o outcomes-based o new form of capitation o receptiveness for new payment modalities (e.g. care coordination) o reimburse for “virtual internet appts.” 2.Universal use of interoperable clinical information technology (common language, systems that talk to each other). 3.Develop programs for high-impact and/or high-cost services (e.g. end-of-life care, preventive, chronic diseases, vulnerable populations). 4.Adopt national quality/ performance standards and report them publicly. 5.Restructure care provision and payment to support coordination of care (e.g. promotion of “care coordination”). 6.Agree to a small set of national health care goals: reduce injuries, reduce costs, reduce inpatient hospitalizations over three years「Purchasers of Care(企業の健保組合、保険会社、メディケア・メディケイドなど)」グループ このグループはなんと40もの政策アイデアを出し合い、そのうち優先度の高いアクションステップが下記6つ。
1.Reward providers who generate good outcomes. 2.Need to have all physicians computerize medical records. 3.Establish coordinated care team as a model for primary care of acute and chronic conditions. Reward primary care physicians to coordinate care. 4.Stop paying for “never events” ? care that causes avoidable harm. 5.Create a patient-controlled health record for everyone that includes not only their records, but also personalized pertinent information tailored to their condition/situation. 6.Integrate people like dieticians and nurse practitioners into new care models that reinforce the general practice.
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