The path we propose involves the evolution of policy (rules and regulations), practice (the way healthcare decisions are made and care is delivered), and healthcare information technology (HIT) in a synergistic (mutually beneficial) way. That is, changes in policy and practice focus on enabling healthcare providers and consumers to improve care quality, prevention services, and emergency preparedness by establishing operational and payment systems supporting the development and use of innovative HIT tools for building knowledge and supporting clinical decisions. The goal of these transformed healthcare systems and tools is continuous improvement in healthcare delivery and consumer wellness at a price everyone can afford.

We offer the following map based on the Wellness-Plus Solution™, which recommends policies and technologies designed to stimulate dialogue and spark creative ideas about the best ways to traverse the Yellow Brick Road in search for a cure for the American healthcare crisis.

Policy & Practice Recommendations

In manufacturing, continuous improvement results in a guaranteed tolerance at a set price for each thing purchased. For example, a one-inch bolt with 16 threads per inch and a tolerance of one-millionth of an inch, might sell for 10 cents each. You could increase the tolerance to one-billionth of an inch and pay $10 per bolt, instead of 10 cents. But do you need a $10 bolt to get the job done, or is it excessive? You must be an educated consumer to know the difference.

As the saying goes, everyone needs a car for transportation, but you don’t need a formula one racing car to drive to work every day. Likewise, everyone needs good healthcare, but we don’t all need a quadruple bypass every day, even though we may need long-term care for chronic situations. In this way, policy is needed to assure the healthcare delivery system accommodates people’s preexisting medical conditions and predisposition to illness.

When buying a car we must be assured that it has an adequate level of safety and mechanical integrity, and provides a level of comfort and appeal reflected by its brand. The government sets minimum safety, emissions, mileage, and defect standards. Manufacturers, transportation safety associations, consumer groups, insurance companies, and others provide information we need to be educated consumers. Not until these issues are handled are we able to shop around for the best buy.

A similar thing should be done for healthcare. That’s why the Wellness-Plus Solution recommends economic and strategic policies for funding and implementing innovative programs and information technology supporting:
  • Consumer-centered, universal healthcare
  • Continuous quality improvement
  • Comprehensive clinical outcomes research
  • Diagnostic and treatment prescription decision support
  • Personalized, evidence-based plan of care selection, coordination, and execution assistance
  • Stakeholder collaboration, including RHIOs, practitioner-researcher collaboration networks, and non-profit consumer watchdog groups
  • Patient education, wellness, and compliance
  • Case management, home health care, and the advanced medical home model
  • Biosurveillance
  • Biopsychosocial healthcare
  • Research complementary & alternative medicine and human genetics & genomics
  • Multidisciplinary diagnostic & referral centers

These policies and practices must focus on reducing errors and omissions, increasing patient safety, and better outcomes, while controlling healthcare expenditures and making quality care available to all. Unfortunately, today’s healthcare delivery system reflects the $10 per bolt example, when we could be getting high-quality care for a fraction of the cost by implementing the policies consistent with the Wellness-Plus Solution.

Next: Technology Recommendations

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