However, there is a much greater need to design a system that will promote quality in the first place. Although we have had many technological advances, measurements have shown that they have not had much impact in improving outcomes, compared to their cost, primarily because our system has been incapable determining and promoting the optimum use of this technology. Standards of practice vary tremendously between communities and between individual practitioners. Integrated staff model organizations have demonstrated that better standards of practice can be recognized and encouraged, and errors, such as incompatible medications, can be greatly reduced. In this modern age of information technology we now have the opportunity to integrate our entire health care system.
Structural design is the key to quality.
With a rational system in place, quality assessment can be elevated to a more noble purpose, and that is to provide a basis for continuing improvement in our health care structure. As long as we continue with our fragmented health care system, quality improvement will remain only a dream. Let's defragment our system by starting with a foundation of a publicly administered, universal risk pool. We have the resources for high quality care for everyone. Let's start using our resources wisely.