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.
Identifying and Addressing the Needs of Adolescents and ...
Released: November 04, 2013
Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). Each year, nearly 70,000 AYAs between the ages of 15 and 39 are diagnosed with cancer. Adolescents and young adults face a variety of unique short- and long-term health and psychosocial issues. Many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs and risks of AYA cancer patients. The IOM’s National Cancer Policy Forum held a workshop to facilitate discussion about gaps and challenges in caring for AYA cancer patients and potential strategies and actions to improve the quality of their care.
Financing Long-Term Services and Supports for Individuals ...
Released: October 22, 2013
At least 11 million adults with disabilities, limitations, and functional impairments in the United States receive long-term services and supports – such as assistance with eating, bathing, and dressing – in order to live independently. The financing of long-term services and supports has become a major issue in the United States. With the projected aging of the U.S. population, the number of individuals needing long-term services and supports is expected to increase substantially. Given the magnitude of the challenged posed by the financing of long-term services and supports, the IOM and National Research Council held a workshop in an effort to foster dialogue and confront issues of mutual interest and concern.
Establishing Transdisciplinary Professionalism for Improving ...
Released: October 07, 2013
In a time of rapidly changing environments and evolving technologies, health professionals and those who train them are being challenged to work beyond their traditional comfort zones and often in teams. A new professionalism might be a mechanism for achieving improved outcomes by applying a “transdisciplinary professionalism” throughout health care and wellness that emphasizes cross-disciplinary responsibilities and accountabilities. The IOM held a workshop to discuss how a shared understanding can be integrated into education and practice to promote a transdisciplinary model of professionalism. Participants in the workshop also explored the barriers to transdisciplinary professionalism as well as the impact of an evolving professional context on health system users, learners, and others within the health system.
Observational Studies in a Learning Health System ...
Released: September 24, 2013
Clinical research is constantly advancing, although perhaps not fast enough to meet the challenges and seize the opportunities presented. New tools are emerging. While challenges remain, these tools have the potential to accelerate the research process and to allow an approach to clinical research that applies the most appropriate methods given the requirements of the situation. This approach includes the leveraging of the information collected in the process of delivering care to drive processes for new insights and continuous improvement, which is at the heart of a learning health system. An IOM workshop, sponsored by the Patient Centered Outcomes Research Institute, was convened to identify the leading approaches to observational studies, chart the course for the use of this growing utility, and guide and grow their use in the most responsible fashion possible.
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.