Publications from the National Academies of Sciences, Engineering, and Medicine provide objective and straightforward advice to decision makers and the public. This site includes Health and Medicine Division (HMD) publications released after 1998. A complete list of HMD’s publications from its establishment in 1970 to the present is available as a PDF.
Large Simple Trials and Knowledge Generation in a Learning ...
Released: September 24, 2013
Despite a robust clinical research enterprise, a gap exists between the evidence needed to support care decisions and the evidence available. Streamlined approaches to clinical research provide options for progress on these challenges. Large simple trials (LSTs), for example, generally have simple randomization, broad eligibility criteria, enough participants to distinguish small to moderate effects, focus on outcomes important to patient care, and use simplified approaches to data collection. Significant opportunities, including the wide-spread adoption of electronic health records, could accelerate the potential for the use of LSTs to efficiently generate practical evidence for medical decision making and product development. To address these opportunities, as well as challenges, the IOM held a workshop to highlight the pros and cons of the design characteristics of LSTs, explored the utility of LSTs on the basis of case studies of past successes, and considered the challenges and opportunities for accelerating the use of LSTs in the context of a U.S. clinical trials enterprise.
Partnering with Patients to Drive Shared Decisions, Better ...
Released: August 15, 2013
In an efficient health care system, care choices are democratized and based on the best evidence. Though the infrastructure and cultural changes necessary to transform the patient role are significant, empowering patients to become partners in—rather than customers of—the health care system is a critical step on the road to achieving the best care at lower cost. Increased patient engagement in care decisions, value, and research is crucial to the pursuit of better care, improved health, and lower health care costs. This publication details discussions at the February 2013 IOM workshop which gathered patients and experts in areas such as decision science, evidence generation, communication strategies, and health economics to consider the central roles for patients in bringing about progress in all aspects of the U.S. health care system.
Implementing a National Cancer Clinical Trials System for the ...
Released: July 15, 2013
Recognizing the recent transformative advances in cancer research that necessitate modernization in how cancer clinical trials are run, as well as inefficiencies and other challenges impeding the national cancer clinical trials program, the National Cancer Institute asked the IOM to develop a set of recommendations to improve the federally funded cancer clinical trials system. These recommendations were published in a 2010 IOM report. In 2011, the IOM’s National Cancer Policy Forum (NCPF) held a workshop to engage stakeholders in discussions about the changes they planned to implement in response to the IOM report. Two years later, the NCPF held a second workshop in which stakeholders reported the changes that they have made thus far to address the IOM recommendations, and discussed additional actions needed to improve the system.
Core Measurement Needs for Better Care, Better Health, and ...
Released: June 24, 2013
Initiatives are under way throughout the nation to improve health care quality, improve the health of the American population, and reduce health care costs. These initiatives take on increased urgency in the face of shortfalls with respect to what is possible in health and health care. Despite spending almost one-fifth of the economy’s output on health care, the quality and safety of care remains uneven. While there are multiple obstacles to improving the nation’s health care system, one essential element for sustained progress is the capacity to reliably and consistently measure progress across all aspects of health and the health care system. To consider these issues, the IOM held a workshop, sponsored by the Blue Shield of California Foundation, to explore in depth the core measurement needs for population health, health care quality, health care costs, and engaged people. An IOM study panel is being developed to build on this work and propose a core measure set.
Interprofessional Education for Collaboration: Learning How ...
Released: May 13, 2013
Over the last 100 years, much of the landscape has changed with regards to the health professions and the settings in which these professionals work. Due to societal shifts and technological innovations, changes to the health professions are underway in many parts of the world that call for new models for how health professionals are educated. The IOM Global Forum on Innovation in Health Professional Education held two workshops which set the stage for defining and understanding interprofessional education and provided living histories of speakers from around the world who shared experiences working in and between Interprofessional education and Interprofessional or collaborative practice.
Fostering Independence, Participation, and Healthy Aging ...
Released: April 18, 2013
An increasingly important aspect of the social and environmental factors that determine whether an individual has a disability is the technology to which that person has access. Technology-driven assistive and adaptive products have improved functioning and quality of life for people of all ages. Furthermore, there is great potential for technology to increase a person’s disability-free years. The IOM-National Research Council Forum on Aging, Disability, and Independence hosted a workshop to examine the ways in which technology can foster independence and healthy aging among working-age individuals with disabilities and among individuals who are developing disabilities while they age.
Delivering Affordable Cancer Care in the 21st Century ...
Released: February 11, 2013
Spending on health care currently accounts for 18 percent of the United States’ GDP. By 2037, that percentage is expected to increase to 25 percent of GDP. Spending on cancer care is expected to increase because of the rapid influx of new cancer diagnoses as the population ages. Also, as more expensive therapies and technologies become the standard of care, there are concerns that the costs of cancer treatment could begin to outpace health care inflation as a whole. The IOM held a workshop to examine the drivers of current and projected cancer care costs as well as potential ways to curb these costs while maintaining or improving the quality of care.
The Role of Telehealth in an Evolving Health Care ...
Released: November 20, 2012
Since the 1996 IOM report, Telemedicine: A Guide to Assessing Telecommunications for Health Care, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth. The IOM held a workshop to examine how the use of telehealth technology can fit into the U.S. health care system.
Reducing Tobacco-Related Cancer Incidence and Mortality ...
Released: November 01, 2012
Tobacco use is the leading cause of preventable death in the United States, causing more than 440,000 deaths every year. Tobacco use is linked to the development of 18 different types of cancer and accounts for at least 30 percent of all cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing the smoking rate by half since the first U.S. Surgeon General’s report on smoking in 1964, progress in reducing tobacco use has slowed in recent years. The IOM held a workshop to examine current challenges in tobacco control and to explore potential policy, outreach, and treatment strategies that could reduce tobacco-related cancer incidence and death.
Digital Data Improvement Priorities for Continuous Learning in ...
Released: September 28, 2012
Digital health data are the lifeblood of a continuous learning health system. A steady flow of reliable data is necessary to coordinate and monitor patient care, analyze and improve systems of care, conduct research to develop new products and approaches, assess the effectiveness of medical interventions, and advance population health. The totality of available health data is a crucial resource that should be considered an invaluable public asset in the pursuit of better care, improved health, and lower health care costs. This publication summarizes discussions at the March 2012 IOM workshop to identify and characterize the current deficiencies in the reliability, availability, and usability of digital health data and consider strategies, priorities, and responsibilities to address such deficiencies.