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For America to consistently deliver reliable performance and improve patient outcomes, providers must apply computing capabilities and analytical tools that allow clinicians to share real-time insights from routine patient care. In short, the entire U.S. healthcare system must transform itself into a continuous learning machine that drives efficiency and curbs costs, a new study released by the Institute of Medicine (IOM) concludes.

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America says the healthcare industry, unlike the banking, airline, and auto industries, lags far behind in its ability to establish the practices and procedures that raise its performance level. Furthermore, the report said the industry has not done enough to provide patients and clinicians with timely, relevant, and useful information, and added that inefficiencies in healthcare have cost the nation in lives and treasure.

"If the care in every state were of the quality delivered by the highest-performing state, an estimated 75,000 fewer deaths would have occurred across the country in 2005. Current waste diverts resources from productive use, resulting in an estimated $750 billion loss in 2009," says the report.

[ For another point of view on PHRs, see Why Personal Health Records Have Flopped. ]

The report urges healthcare leaders to structure incentives to reward the best outcomes for patients and suggests that a cultural change needs to occur in which health organizations are continuously learning from the transfer of knowledge at every patient interaction. This will require "systematic problem solving; the application of systems engineering techniques; operational models that encourage and reward sustained quality and improved patient outcomes; transparency on cost and outcomes; and strong leadership and governance that define, disseminate, and support a vision of continuous improvement," the report asserts.

According to Dr. Paul Tang, VP and chief innovation and technology officer at Palo Alto Medical Foundation, "We are not tying our information systems to the full extent [they] could be used to generate real knowledge and to make sure that new knowledge is applied." Tang also serves on the IOM's Committee on the Learning Health Care System in America, which produced the report.

The report recognizes the opportunities that mobile technologies and EHRs offer in capturing and exchanging data among healthcare providers and urges the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations to develop robust and interoperable systems.

The report also suggests that initiatives be developed to encourage patients to become more actively engaged in their care by adopting technology tools such as personal health information portals.

Along with the report, IOM published several recommendations, including:

-- Improve the capacity to capture clinical, care delivery process, and financial data.

-- Accelerate integration of the best clinical knowledge into care decisions.

-- Promote community-clinical partnerships and services aimed at managing and improving health at the community level.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)