Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2012

Open Access 01-12-2012 | Debate

Why technology matters as much as science in improving healthcare

Authors: Robert J Szczerba, Marco D Huesch

Published in: BMC Medical Informatics and Decision Making | Issue 1/2012

Login to get access

Abstract

Background

More than half a million new items of biomedical research are generated every year and added to Medline. How successful are we at applying this steady accumulation of scientific knowledge and so improving the practice of medicine in the USA?

Discussion

The conventional wisdom is that the US healthcare system is plagued by serious cost, access, safety and quality weaknesses. A comprehensive solution must involve the better translation of an abundance of clinical research into improved clinical practice.
Yet the application of knowledge (i.e. technology) remains far less well funded and less visible than the generation, synthesis and accumulation of knowledge (i.e. science), and the two are only weakly integrated. Worse, technology is often seen merely as an adjunct to practice, e.g. electronic health records.
Several key changes are in order. A helpful first step lies in better understanding the distinction between science and technology, and their complementary strengths and limitations. The absolute level of funding for technology development must be increased as well as being more integrated with traditional science-based clinical research. In such a mission-oriented federal funding strategy, the ties between basic science research and applied research would be better emphasized and strengthened.

Summary

It bears repeating that only by applying the wealth of existing and future scientific knowledge can healthcare delivery and patient care ever show significant improvement.
Literature
1.
go back to reference Garber A, Goldman DP, Jena AB: The promise of health care cost containment. Health Aff (Millwood). 2007, 26: 1545-1547. 10.1377/hlthaff.26.6.1545.CrossRef Garber A, Goldman DP, Jena AB: The promise of health care cost containment. Health Aff (Millwood). 2007, 26: 1545-1547. 10.1377/hlthaff.26.6.1545.CrossRef
2.
go back to reference Weil A: Chipping away at the uninsured. Health Aff (Millwood). 2004, 23: 5153-5154.CrossRef Weil A: Chipping away at the uninsured. Health Aff (Millwood). 2004, 23: 5153-5154.CrossRef
3.
go back to reference Rabinowitz AB, Clarke JR, Marella W, Johnston J, Baker L, Doering M: Translating patient safety legislation into health care practice. Jt Comm J Qual Patient Saf. 2006, 32: 676-681.PubMed Rabinowitz AB, Clarke JR, Marella W, Johnston J, Baker L, Doering M: Translating patient safety legislation into health care practice. Jt Comm J Qual Patient Saf. 2006, 32: 676-681.PubMed
4.
go back to reference Beal AC: High-quality health care: the essential route to eliminating disparities and achieving health equity. Health Aff (Millwood). 2011, 30: 1868-1871. 10.1377/hlthaff.2011.0976.CrossRef Beal AC: High-quality health care: the essential route to eliminating disparities and achieving health equity. Health Aff (Millwood). 2011, 30: 1868-1871. 10.1377/hlthaff.2011.0976.CrossRef
5.
go back to reference Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL: The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003, 138: 273-287.CrossRefPubMed Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL: The implications of regional variations in Medicare spending. Part 1: the content, quality, and accessibility of care. Ann Intern Med. 2003, 138: 273-287.CrossRefPubMed
6.
go back to reference Berwick DM, Nolan TW, Whittington J: The triple aim: care, health, and cost. Health Aff (Millwood). 2008, 27: 3759-3769. Berwick DM, Nolan TW, Whittington J: The triple aim: care, health, and cost. Health Aff (Millwood). 2008, 27: 3759-3769.
7.
go back to reference Porter ME, Teisberg EO: Redefining health care: creating value-based competition on results. 2006, Boston: Harvard Business School Press Porter ME, Teisberg EO: Redefining health care: creating value-based competition on results. 2006, Boston: Harvard Business School Press
9.
go back to reference Woolf SH: The meaning of translational research and why it matters. J Am Med Assoc. 2008, 299: 211-213. 10.1001/jama.2007.26. Woolf SH: The meaning of translational research and why it matters. J Am Med Assoc. 2008, 299: 211-213. 10.1001/jama.2007.26.
10.
go back to reference Pronovost PJ, Goeschel CA: Time to take health delivery research seriously. J Am Med Assoc. 2011, 306: 310-311. 10.1001/jama.2011.1015.CrossRef Pronovost PJ, Goeschel CA: Time to take health delivery research seriously. J Am Med Assoc. 2011, 306: 310-311. 10.1001/jama.2011.1015.CrossRef
11.
go back to reference Zerhouni EA: Translational and clinical science — time for a new vision. N Engl J Med. 2005, 353: 1621-1623. 10.1056/NEJMsb053723.CrossRefPubMed Zerhouni EA: Translational and clinical science — time for a new vision. N Engl J Med. 2005, 353: 1621-1623. 10.1056/NEJMsb053723.CrossRefPubMed
12.
go back to reference Reis SE, Berglund L, Bernard GR: Reengineering the national clinical and translational research enterprise: the strategic plan of the National Clinical and Translational Science Awards Consortium. Acad Med. 2010, 85: 463-469. 10.1097/ACM.0b013e3181ccc877.CrossRefPubMedPubMedCentral Reis SE, Berglund L, Bernard GR: Reengineering the national clinical and translational research enterprise: the strategic plan of the National Clinical and Translational Science Awards Consortium. Acad Med. 2010, 85: 463-469. 10.1097/ACM.0b013e3181ccc877.CrossRefPubMedPubMedCentral
13.
go back to reference Califf RM, Berglund L, Principal Investigators of National Institutes of Health Clinical and Translational Science Awards: Linking scientific discovery and better health for the nation: the first three years of the NIH’s Clinical and Translational Science Awards. Acad Med. 2010, 85: 457-462. 10.1097/ACM.0b013e3181ccb74d.CrossRefPubMedPubMedCentral Califf RM, Berglund L, Principal Investigators of National Institutes of Health Clinical and Translational Science Awards: Linking scientific discovery and better health for the nation: the first three years of the NIH’s Clinical and Translational Science Awards. Acad Med. 2010, 85: 457-462. 10.1097/ACM.0b013e3181ccb74d.CrossRefPubMedPubMedCentral
14.
go back to reference Califf RM, Harrington RA: American industry and the U.S. cardiovascular clinical research enterprise. J Am Coll Cardiol. 2011, 58: 677-680. 10.1016/j.jacc.2011.03.048.CrossRefPubMed Califf RM, Harrington RA: American industry and the U.S. cardiovascular clinical research enterprise. J Am Coll Cardiol. 2011, 58: 677-680. 10.1016/j.jacc.2011.03.048.CrossRefPubMed
18.
go back to reference Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ: Practical challenges of systems thinking and modeling in public health. Am J Public Health. 2006, 96: 538-546. 10.2105/AJPH.2005.066001.CrossRefPubMedPubMedCentral Trochim WM, Cabrera DA, Milstein B, Gallagher RS, Leischow SJ: Practical challenges of systems thinking and modeling in public health. Am J Public Health. 2006, 96: 538-546. 10.2105/AJPH.2005.066001.CrossRefPubMedPubMedCentral
19.
go back to reference Dawkins R: Climbing Mt Improbable. 1996, New York: W.W. Norton Dawkins R: Climbing Mt Improbable. 1996, New York: W.W. Norton
20.
go back to reference Berwick DM, James BC, Coye MJ: Connections between quality measurement and improvement. Med Care. 2003, 41: 30-38.CrossRef Berwick DM, James BC, Coye MJ: Connections between quality measurement and improvement. Med Care. 2003, 41: 30-38.CrossRef
21.
go back to reference Huesch MD: ’Fit’ between cardiac surgeons and hospitals. Health Serv Res. 2011, 1: 1-26.CrossRef Huesch MD: ’Fit’ between cardiac surgeons and hospitals. Health Serv Res. 2011, 1: 1-26.CrossRef
22.
go back to reference Curry LA, Nembhard IM, Bradley EH: Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 2009, 119: 1442-1452. 10.1161/CIRCULATIONAHA.107.742775.CrossRefPubMed Curry LA, Nembhard IM, Bradley EH: Qualitative and mixed methods provide unique contributions to outcomes research. Circulation. 2009, 119: 1442-1452. 10.1161/CIRCULATIONAHA.107.742775.CrossRefPubMed
24.
go back to reference Garber AM, Skinner J: Is American health care uniquely inefficient?. J Econom Perspectives. 2008, 22: 27-50. 10.1257/jep.22.4.27.CrossRef Garber AM, Skinner J: Is American health care uniquely inefficient?. J Econom Perspectives. 2008, 22: 27-50. 10.1257/jep.22.4.27.CrossRef
25.
go back to reference Wilensky GR, Satcher D: Don’t forget about the social determinants of health. Health Aff (Millwood). 2009, 28: w194-w198. 10.1377/hlthaff.28.2.w194.CrossRef Wilensky GR, Satcher D: Don’t forget about the social determinants of health. Health Aff (Millwood). 2009, 28: w194-w198. 10.1377/hlthaff.28.2.w194.CrossRef
26.
go back to reference Centers for Disease Control and Prevention: Survey Data. 2008, Hyattsville, MD: U.S: Department of Health and Human Services Centers for Disease Control and Prevention: Survey Data. 2008, Hyattsville, MD: U.S: Department of Health and Human Services
28.
go back to reference Swensen SJ, Meyer GS, Nelson EC: Cottage industry to postindustrial care – the revolution in health care delivery. N Engl J Med. 2010, 362: e12-e12. 10.1056/NEJMp0911199.CrossRefPubMed Swensen SJ, Meyer GS, Nelson EC: Cottage industry to postindustrial care – the revolution in health care delivery. N Engl J Med. 2010, 362: e12-e12. 10.1056/NEJMp0911199.CrossRefPubMed
29.
go back to reference Bergman DA, Beck A: Moving from research to large-scale change in child health care. Acad Pediatr. 2011, 11: 360-368. 10.1016/j.acap.2011.06.004.CrossRefPubMed Bergman DA, Beck A: Moving from research to large-scale change in child health care. Acad Pediatr. 2011, 11: 360-368. 10.1016/j.acap.2011.06.004.CrossRefPubMed
30.
go back to reference Mabry PL, Olster DH, Morgan GD, Abrams DB: Interdisciplinarity and systems science to improve population health: a view from the NIH Office of Behavioral and Social Sciences Research. Am J Prev Med. 2008, 35: S211-S224. 10.1016/j.amepre.2008.05.018.CrossRefPubMedPubMedCentral Mabry PL, Olster DH, Morgan GD, Abrams DB: Interdisciplinarity and systems science to improve population health: a view from the NIH Office of Behavioral and Social Sciences Research. Am J Prev Med. 2008, 35: S211-S224. 10.1016/j.amepre.2008.05.018.CrossRefPubMedPubMedCentral
32.
go back to reference Huesch MD, Ong MK, Goldman DP: Commissioned paper on payment reform policy approaches to addressing geographic variation in spending, utilization and high value care and the implications of those approaches. 2012, Washington DC: Institute of Medicine, Institute of Medicine Committee on Geographic Variation in Health Care Spending and Promotion of High Value Care. Huesch MD, Ong MK, Goldman DP: Commissioned paper on payment reform policy approaches to addressing geographic variation in spending, utilization and high value care and the implications of those approaches. 2012, Washington DC: Institute of Medicine, Institute of Medicine Committee on Geographic Variation in Health Care Spending and Promotion of High Value Care.
33.
go back to reference Dzau VJ, Ackerly DC, Sutton-Wallace P, Merson MH, Williams RS, Krishnan KR, Taber RC, Califf RM: The role of academic health science systems in the transformation of medicine. Lancet. 2010, 375: 949-953. 10.1016/S0140-6736(09)61082-5.CrossRefPubMed Dzau VJ, Ackerly DC, Sutton-Wallace P, Merson MH, Williams RS, Krishnan KR, Taber RC, Califf RM: The role of academic health science systems in the transformation of medicine. Lancet. 2010, 375: 949-953. 10.1016/S0140-6736(09)61082-5.CrossRefPubMed
Metadata
Title
Why technology matters as much as science in improving healthcare
Authors
Robert J Szczerba
Marco D Huesch
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2012
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/1472-6947-12-103

Other articles of this Issue 1/2012

BMC Medical Informatics and Decision Making 1/2012 Go to the issue