Healthcare Engineering and Health Services Research: Building Bridges, Breaking Barriers: A Workshop.

摘要

Few would dispute that the rapidly escalating cost of health care is one of the most pressing issues facing our nation today. Even a cursory review of the media reveals intense public concern over a healthcare system that can use the most advanced technology to miraculous therapeutic effect, but whose emergent behavior is far from ideal. A number of observations suffice to make the point: (1) The cost of healthcare is more than 15% of the U. S. economy - these costs are growing at more than three times the rate of inflation; (2) Tens of thousands of Americans die and many more are harmed each year by disjointed, malfunctioning healthcare processes; (3) Waste accounts for perhaps as much as 40% of healthcare costs; (4) 46 million citizens lack access to basic care; (5) Fragmentation limits performance; and (6) The healthcare delivery system is complex to the point of straining human comprehension. Rapidly rising healthcare costs threaten the competitiveness of U. S. manufacturing and service companies in the global economy, creating intense pressure to move offshore. Indeed one can make the case that the best way to help competitiveness prospects for U.S. industries as a whole is to improve healthcare delivery. The joint National Academy of Engineering/Institute of Medicine (NAE/IOM)1 report Building a Better Healthcare System makes a compelling, thoroughly documented case for deploying engineering methodology and research in partnership with the health care provider community to improve the delivery of health care. It calls for the establishment of thirty research centers around the country to realize this vision of the engineering profession as an active partner in addressing this burning national issue. While engineers have been actively involved in health care delivery for many years, especially in the development of key technologies in areas such as imaging, biomedical devices, and information technology, their contributions to the delivery of health care have been much more limited. While many leading hospitals introduced industrial or management engineering groups to improve their operations, these groups were largely phased out over the last two decades due to rising cost pressures and administrative complexity. However the impact of rising health care costs on the U. S. economy is creating a turning point where health care provider incentives are aligning with the need for cost reduction. The time is ripe for the body of engineering knowledge on designing, modeling, and controlling complex systems to be applied to health care delivery. Currently this is being done mostly by individual researchers or, at best, small, largely disconnected research groups.