Viewing Health Care Delivery as Science

Challenges, Benefits, and Policy Implications

Until health care delivery is treated like a science with goals, measures of quality, and systems to collect data and monitor improvements, the U.S. will not be able to effectively improve patient care and safety, according to this essay by two Johns Hopkins University health care policy experts, appearing in the special issue Health Services Research in 2020.

While the United States has had tremendous success in biomedical research, it has demonstrated poor performance in bringing treatments effectively and efficiently to patients. According to the authors, this is due to a lack of investment in understanding and improving the science of health care delivery.

Key Points:

  • Treating health care delivery as a science requires developing relevant measures of patient care quality. This necessitates confronting thorny issues, such as discerning between preventable versus inevitable harm.
  • Meaningful quality “scorecards” and goals must be useful to both consumers buying health care and clinicians trying to improve care, and also must be relevant from the hospital unit level to the national level.
  • Reliable, consistent tracking of quality measures depends upon a robust data infrastructure, which will require investment in health information technology and trained personnel.
  • The authors recommend creation of a regulatory structure in health care quality, similar to that of the SEC or FASB in financial regulation, to develop standards for, oversee and require the collection of data for public disclosure.
  • They believe, however, there is a need for innovation in meaningful reporting of data to the public and clinicians, and contend the private sector would compete to do this.
  • The authors call for development of a “health care quality profession” with formal and credible roles within organizations.

According to the authors, it is time to rapidly mature the science of health care delivery in order to raise quality and lower costs of health care in the U.S.