News Column

Reforming health systems

August 1, 2014

Valerdi, Ricardo

Tilt RISE OF HEALTHCARE COSTS IN the United States and the implementation of the Affordable Care Act have led to greater demands on the healthcare system. Systems engineering plays an important role in not only increasing efficiency but also improving the quality and affordability' of care. In a joint report in 2005, the National Academy of Engineering and the Institute of Medicine recommended the systematic application of systems engineering approaches for reforming our healthcare delivery system.

Professor Bill Rouse ol Georgia Tech edited Engineering the System of Healthcare Delivery m 2010. It is an excellent resource that covers a range of topics, includi ng electronic medical records, economic incentives and organizational transformation.

A 2014 report titled "Better Health Care and Lower Costs: Accelerating Improvement through Systems Engineering" was produced by the U.S. Presidents Council of Advisors on Science and Technology' (PCAST), on which Rouse selves. The report, which was informed by a group comprising PCAST members and prominent healthcare and systems engineering experts, identifies actions for enhancing healthcare across the U.S. through greater use of systems engineering principles:

l Accelerate the alignment of payment incentives and reported information with better outcomes for individuals and populations. It involves the implementation of outcomes-based payment and will promote transparency' through more meaningful information for providers and patients.

2. Accelerate efforts to develop the nation's health-data infrastructure. It involves interoperable electronic health records and accessible health information to accelerate information sharing.

3. Provide national leadership in systems engineering by increasing the supply of data available to benchmark performance, understand a community's health and examine broader regional or national trends. It would include inventory of existing data sources, identifying opportunities for alignment and integration, and increased awareness of their potential; expanding access to existing data through open data initiatives; promoting collaboration with other federal partners and private organizations; and creating a more focused and deep datascience capability' through advancing data analytics and implementation of systems engineering.

4. Increase technical assistance to healthcare professionals and communities in applying systems approaches. Provide hands-on support to small practices to develop the capabilities, skills and tools to provide better, more coordinated care to their patients.

5. Support efforts to engage communities in systematic healthcare improvement. Incorporate systems engineering principles at the community level; set, assess and achieve population-level goals; promote systems thinking at the community' level; and encourage grantees lo engage stakeholders outside of the traditional healthcare system.

6. Establish awards, challenges and prizes to promote the use of systems methods and tools in healthcare. Recognize healthcare providers successfully applying systems engineering approaches.

7. Build competencies and workforce for redesigning healthcare. Ir involves educating clinicians, disseminating best practices, funding innovative health professional curricula that include systems engineering and implementation science, and funding systems engineering centers of excellence to build a robust specialty in health improvement science.

Systems engineering tools and methods will play a major role in improving the value of the healthcare system and patient health. -;Ricardo

Develop the nations health-data infrastructure.

Valerdi is an associate professor at the University of Arizona in the Department of Systems and Industrial Engineering He is the co-editor-in-chief of the Journal of Enterprise Transformation, a collaborative venture between HE and INCOSE. Reach him at

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Source: Industrial Engineer

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