Physician/writer Atul Gawande was the winner of this year’s Health Services Research Impact award at the National Health Policy Conference cohosted by AcademyHealth and Health Affairs earlier this week. At Tuesday’s lunch, Gawande was scheduled to receive his award for the important policy impact of his efforts to bring surgical checklists into use around the world to improve quality and patient safety and reduce health system errors.
While historic blizzard conditions here in Washington, D.C., prevented Gawande from accepting his award in person, he did phone in his luncheon speech to a crowd of 300 intrepid health policy wonks eager for a bit of good news that health care can be reformed and systems improved. Author of the new book, The Checklist Manifesto, Gawande spoke of the complexity of health care delivery: “No industry in the world has had to deliver on so many service lines.” He added, “I think we were fooled by penicillin….This led us to believe discovery was the only hard part; execution was easy. But this couldn’t be further from the truth.” He went on to point out how we spend tens of billions of dollars globally on discovery – but not delivery.
Gawande outlined what’s missing from our health care system to increase value for our investment that’s now reaching over 17 percent of GDP:
- He urged far more basic and applied research on systems of care – from the simple solutions to the complex organization.
- He called for “real” national health statistics – down to the local community level. “Our current data is uncoordinated and three years out of date….And we spend less on measuring health care than agriculture,” he said.
- “A dedicated effort to deploy health system knowledge in every locality” is needed, argued Gawande. He noted this work could be housed in a new institute (on the National Institutes of Health model) or could be folded into existing agencies such as the Agency for Health Care Research and Quality or National Center for Health Statistics. “The aim is a better health system. We have substantial work to do in the science of delivery,” he concluded.