Priority Areas for National Action: Transforming Health Care Quality

January 2003

A new report from the Institute of Medicine (IOM) of the National Academies recommends that stakeholders like the U.S. Department of Health and Human Services and other public and private stakeholders should a focus on 20 priority areas or domains of health care. This focus would help contribute to major improvements in health care quality and delivery systems. The IOM report states that collective action in these areas could help transform the entire health care system. Four of the 20 domains are:

• Diabetes — Diabetes is the fifth-leading cause of death in America, and it predisposes people to serious, long-term medical complications, including heart disease, hypertension, and blindness. There are several well-known and effective models for improving the delivery of care. The goal should be to prevent the progression of diabetes cases by properly managing the disease early on.

• Major depression — Treatment rates for depression are significantly lower than those for many other chronic conditions; fewer than half of individuals with depression are correctly diagnosed. National rates of screening and treatment should be improved.

• Severe and persistent mental illness — The goal should be to improve the quality of mental health care in the public sector, which includes state hospitals, community mental-health centers, and various federal and state programs. The federal government should play a larger role to assure higher standards of care across states.

• Care coordination — About 60 million Americans live with multiple chronic conditions, such as hypertension and diabetes. Clinicians and institutions should actively collaborate and communicate to ensure an appropriate exchange of information and coordination of care. This is key in the effective treatment of chronic conditions.

Interestingly, the report reveals that in the selected domains, low-quality care typically does not stem from a lack of effective treatments, but from inadequate systems to carry them out. For more information you can download the full report from: http://www4.nationalacademies.org/news.nsf/isbn/0309085438?OpenDocument

The IOM report was produced from a study sponsored by the U.S. Department of Health and Human Services. The Institute of Medicine is a private, nonprofit organization that provides advice on health policy issues under a congressional charter to the National Academy of Sciences.