On June 14, the Institute of Medicine (IOM) of the National Academies released a report examining solutions to the fragmentation of the U.S. health care system.  The report explores a stakeholder workshop that IOM conducted, and the strategies to improve the efficiency and effectiveness of care that the participants discussed. 

From the report: This volume reports on discussions among multiple stakeholders about ways they might help to transform health care in the United States. The U.S. healthcare system is large, multifaceted, unorganized, and influenced by so many commercial forces, interest groups, and myriad decision points that it is sometimes described as a “nonsystem.” This character translates also to the challenges of evidence development and application, with fragmentation and silos of expertise, services, and knowledge, as well as gaps in quality and shortfalls in the ability to translate biomedical research into clinical treatments and improved health outcomes (Institute of Medicine, 2000, 2001, 2007). The various sectors involved in the U.S. healthcare system share an interest in delivering better value for our healthcare investments, and many are working to achieve change. Some efforts have resulted in important movements in specific areas, such as quality improvement and assessment of the clinical evidence, but stronger efforts are needed to coordinate these reforms across the many component sectors of the U.S. healthcare system. In particular, stakeholders in the healthcare system need the opportunity to discuss and collaborate on issues of common concern and to identify areas in which they may work collectively.

Full report: http://books.nap.edu/openbook.php?record_id=11982&page=R1

Institute of Medicine.  (2010).  Leadership commitments to improve value in healthcare: toward common ground.  Olsen, L., Goolsby, W. and McGinnis, J.