10 Rules for Health Care Reform
Appendix B: Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century, 10 Rules for Health Care Reform
- Care based on continuous healing relationships. Patients should receive care whenever they need it and in many forms, not just face-to-face visits. This rule implies that the health care system should be responsive at all times (24 hours a day, every day) and that access to care should be provided over the internet, by telephone, and by other means in addition to face-to-face visits.
- Customization based on patient needs and values. The system of care should be designed to meet the most common types of needs but have the capability to respond to individual patient choices and preferences.
- The patient as the source of control. Patients should be given the necessary information and the opportunity to exercise the degree of control they choose over health care decisions that affect them. The health system should be able to accommodate differences in patient preferences and encourage shared decisionmaking.
- Shared knowledge and the free flow of information. Patients should have unfettered access to their own medical information and to clinical knowledge. Clinicians and patients should communicate effectively and share information.
- Evidence-based decision making. Patients should receive care based on the best available scientific knowledge. Care should not vary illogically from clinician to clinician or from place to place.
- Safety as a system property. Patients should be safe from injury caused by the care system. Reducing risk and ensuring safety require greater attention to systems that help prevent and mitigate errors.
- The need for transparency. The health care system should make available to patients and their families information that allows them to make informed decisions when selecting a health plan, hospital, or clinical practice or when choosing among alternative treatments. This should include information describing the system's performance on safety, evidence-based practice, and patient satisfaction.
- Anticipation of needs. The health system should anticipate patient needs rather than simply reacting to events.
- Continuous decrease in waste. The health system should not waste resources or patient time.
- Cooperation among clinicians. Clinicians and institutions should actively collaborate and communicate to ensure an appropriate exchange of information and coordination of care.
28 Focus Areas of Healthy People 2010
- Access to Quality Health Services
- Arthritis, Osteoporosis, and Chronic Back Conditions
- Chronic Kidney Disease
- Disability and Secondary Conditions
- Educational and Community-Based Programs
- Environmental Health
- Family Planning
- Food Safety
- Health Communication
- Heart Disease and Stroke
- Immunization and Infectious Diseases
- Injury and Violence Prevention
- Maternal, Infant, and Child Health
- Medical Product Safety
- Mental Health and Mental Disorders
- Nutrition and Overweight
- Occupational Safety and Health
- Oral Health
- Physical Activity and Fitness
- Public Health Infrastructure
- Respiratory Diseases
- Sexually Transmitted Diseases
- Substance Abuse
- Tobacco Use
- Vision and Hearing