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.
Graduate Medical Education That Meets the Nation's Health ...
Released: July 29, 2014
Since the creation of the Medicare and Medicaid programs in 1965, the public has provided tens of billions of dollars to fund graduate medical education (GME), the period of residency and fellowship that is provided to physicians after they receive a medical degree; however, there is a striking absence of transparency and accountability in the GME financing system for producing the types of physicians that the nation needs. The Institute of Medicine (IOM) formed an expert committee to conduct an independent review of the governance and financing of the GME system. In its report, Graduate Medical Education That Meets the Nation’s Health Needs, the committee provides recommendations and an initial road¬map for reforming the Medicare GME payment system and building an infrastructure that can drive more strategic investment in the nation’s physician workforce.
Contemporary Issues for Protecting Patients in Cancer ...
Released: July 02, 2014
On February 24 and 25, 2014, the National Cancer Policy Forum of the Institute of Medicine convened a workshop to frame and discuss contemporary issues in human subjects protections as they pertain to cancer research, with the goal of identifying potential relevant policy actions. This document summarizes the workshop.
Assessing Health Professional Education - Workshop ...
Released: April 30, 2014
In an era of evolving technology and changing health and health care environments, creative thinking about assessment methods and tools could be the driver for innovations that are affordable, easily integrated into education, and assess competencies at all levels. On October 9-10, 2013, the IOM Global Forum on Innovation in Health Professional Education held a workshop to explore the challenges, opportunities, and innovations in assessment across the education-to-practice continuum. Issues such as assessment of learners and educators of IPE and team-based care were discussed.
Advancing Workforce Health at the Department of Homeland ...
Released: January 29, 2014
The U.S. Department of Homeland Security (DHS) is responsible for protecting the health, safety, and resilience of its employees as well as guaranteeing effective management of the medical needs of those under DHS care or custody. The DHS Office of Health Affairs asked the IOM to recommend ways to better integrate occupational health functions and operational medicine throughout DHS with the necessary centralized oversight authority. The IOM’s report concludes that in order to ensure mission readiness and to provide DHS employees with occupational health support, strategic alignment through committed leadership, organizational and functional alignment, and management of health and safety information are needed.
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.