Health Care as if Health Care Mattered

Thomas Frieden, Health Commissioner for New York City, and Farzad Mostashari, Assistant Commissioner for the New York City Health Department’s Primary Care Information Project, assert in the February 27, 2008 issue of JAMA that recent prominent approaches to improving health care are missing the mark. They propose that the most important goal of the nation’s health delivery system should be maximizing health – and this goal should be the overarching principle for all other efforts.

Three interventions that have been major focus areas for health care improvement efforts: information systems (i.e., electronic health records), financial incentives for preventive health care (for example, pay-for-performance), and improvements to care management and work-flows in primary care settings (such as consistent, evidence-based treatment of chronic conditions), are failing to live up to their potential because they are being implemented separately rather than in tandem, and without the maximizing health as their organizing principle.

The authors outline the reasons behind the failure of these three approaches, on their own, to improve health outcomes, and present an alternate approach that will bring the three together under the umbrella goal of maximizing health. Included in the article is a description of the key features of effective electronic health records and an approach currently being implemented in New York City.

Please click here to read the article.