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Describe the enormity and complexity of medicine in the United States.

Describe the enormity and complexity of medicine in the United States.

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Ans) The time may be right for testing the patient-centric, feed-forward collaborative model. Powerful forces at work are creating a climate favorable to the development of collaboratories.

- These forces include communities of professional practice combining patient care and health research, the funding of research by the NIH through the new CTSA approach, the formation of regional health information organizations across the country, the emergence of new scientific paradigms that recognize complexity and the value of multiple research methods, and demands for better quality and value that are measured and transparent.

- An excellent example of these forces coming together can be seen in the new National Quality Forum (NQF) framework that is being considered for measuring the outcomes and efficiency of episodes of care.

- Comparative effectiveness research: Compare biologic interventions, controlling for patient and system attributes.
Comparative performance assessment: Compare systems and care delivery methods, controlling for patient and treatment attributes.

- The bold aim is to achieve better patient and population health and better healthcare outcomes by applying research and education. Accomplishing this aim will require that our health system become composed of learning healthcare systems. We conclude with four key points.

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First, the IOM definition of health stresses the functioning and well-being of the individual and requires patient-reported information to measure health status.

- Second, patient-centric health risks, health stat

us, and health outcomes are an essential component of any comprehensive approach for improving health care and studying health outcomes.

- Third, it will be essential to design feed-forward information systems to accomplish the tripartite aim of improving healthcare outcomes, advancing biomedical research, and enhancing health professional learning.

- Fourth, we believe that developing and testing patient-centric, professionally organized collaboratories can help the nation achieve this bold aim.

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