Healthy,Resilient and Sustainable Communities After Disasters

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Controlling Costs and Changing Patient Care

With great speed and relatively little public awareness, a significant change has occurred in the way some decisions are made about a patient's medical care. Decisions that were once the exclusive province of the doctor and patient now may be examined in advance by an external reviewer—someone accountable to an employer, insurer, health maintenance organization (HMO), or other entity responsi…

A New Health System for the 21st Century

The American health care delivery system is in need of fundamental change. Many patients, doctors, nurses, and health care leaders are concerned that the care delivered is not, essentially, the care we should receive (Donelan et al., 1999; Reed and St. Peter, 1997; Shindul-Rothschild et al., 1996; Taylor, 2001). The frustration levels of both patients and clinicians have probably never been hi…

For the Public's Health: Investing in a Healthier Future

In 2009, the Robert Wood Johnson Foundation asked the Institute of Medicine (IOM) to convene a committee to examine three topics in relation to public health: measurement, the law, and funding. The committee’s complete three-part charge is provided in Box P-1. The IOM Committee on Public Health Strategies to Improve Health explored the topics in the context of contemporary opportunities and c…

Health IT and Patient Safety

The Institute of Medicine (IOM) report To Err Is Human estimated that 44,000-98,000 lives are lost every year due to medical errors in hospitals and led to the widespread recognition that health care is not safe enough, catalyzing a revolution to improve the quality of care.1 Despite considerable effort, patient safety has not yet improved to the degree hoped for in the IOM report Crossing the …

Partnering with Patients to Drive Shared Decisions, Better Value, and Care Im…

On February 25 and 26, 2013, the Institute of Medicine’s (IOM’s) Roundtable on Value & Science-Driven Health Care, with support from the Gordon and Betty Moore Foundation and the Blue Shield of California Foundation, hosted a workshop, called Partnering with Patients to Drive Shared Decisions, Better Value, and Care Improvement. The goals of the workshop were to identify and explore issues,…

Proposed Revisions to the Common Rule for the Protection of Human Subjects in…

The ethics of human-subjects research has captured scientific and regu- latory attention for half a century. Honoring the Belmont Report’s princi- ples—respect for persons, beneficence, and justice—ought to mean keeping abreast of the universe of changes that factor into the ethical conduct of research today. The U.S. Department of Health and Human Services (HHS) took a giant step in this…

An Update on Research Issues in the Assessment of Birth Settings

More than 30 years ago, the Institute of Medicine (IOM) and the National Research Council (NRC) convened a committee to de- termine methodologies and research needed to evaluate childbirth settings in the United States. The committee members reported their findings and recommendations in a consensus report, Research Issues in the Assessment of Birth Settings (IOM and NRC, 1982). On March 6 and …

Informing the Future: Critical Issues in Health

The health sector now constitutes more than 14% of the nation’s Gross Domestic Product (GDP)—a level projected to rise to 16% within the next few years. Approximately half this amount is spent through the public sector, a share that will also rise in the coming decade. Policymakers face difficult decisions about how to obtain the best value for these large and growing expenditures.

Improving Health Literacy Within a State

Health literacy is the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions. Nearly half of all American adults—90 million people—have inadequate health literacy to navigate the health- care system (IOM, 2004). The Institute of Medicine (IOM) convened the Roundtable on Health Literacy to addr…

Food Safety Policy, Science, and Risk Assessment: Strengthening the Connection

The Institute of Medicine's (IOM's) Food Forum was established in 1993 to allow science and technology leaders in the food industry, top administrators in several federal government agencies from the United States and Canada, representatives from consumer interest groups, and academicians to openly communicate in a neutral setting. The Food Forum provides a mechanism for these diverse groups to…

ENHANCING THE POSTDOCTORAL EXPERIENCE FOR SCIENTISTS AND ENGINEERS

The Committee on Science, Engineering, and Public Policy (COSEPUP) has, for some time, been concerned with the many issues that surround the education and training of scientists and engineers in the United States. Its 1993 report, Science, Technology, and the Federal Government: National Goals for a New Era, emphasized the importance of human resources to the research enter- prise. A second rep…