In the absence of improved care systems and thinking about quality in different ways, we will not get the kinds of improvement required. Dr. Shine pointed out that current payment policies actually discourage quality improvements. In hospitals, he said, The irony is that if we cause renal failure with inappropriate antibiotic use, the hospital makes more money because it can use more complex DRGs. Chronic care management. While evidence shows that a multidisciplinary team approach greatly improves the management of most chronic conditions, chronic care continues to be plagued by poor health care communications among physicians and hospitals, as well as inadequate technological infrastructures.
Evidence shows that information technology greatly enhances quality initiatives and error reduction.
Yet Dr. Shine claimed that information technology in health care is grossly underfunded. As a result, the industry lacks widely used data standards. Dr. Shine pointed out that thousands of new medical devices are approved each year, while federally-funded research and the Human Genome Project continue to dramatically expand scientific knowledge. The growing knowledge base makes it even more imperative to be able to measure quality and implement quality initiatives. The IOM also wants the government to further invest in technology and a new information infrastructure for health care delivery.