Book Review Health AffairsVol. 36, No. 11: Global Health Policy The Future Of Health Care, TodayKevin M. Simon AffiliationsKevin M. Simon ([email protected]) is a third-year psychiatry resident in the Department of Psychiatry and Behavioral Sciences at Morehouse School of Medicine, in Atlanta, Georgia, and an American Psychiatric Association Public Psychiatry Fellow.PUBLISHED:November 2017Free Accesshttps://doi.org/10.1377/hlthaff.2017.1043AboutSectionsView PDFPermissions ShareShare onFacebookTwitterLinked InRedditEmail ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsDownload Exhibits TOPICSSystems of careClinicsHealth care providersBehavioral health careOrganization of careChronic carePrescription for the Future, the latest book by Ezekiel Emanuel, addresses one of the most important and emotionally charged questions facing American health care today: How can health care organizations effectively address the nation’s Quadruple Aim—improving patient and provider experiences and the health of the population while decreasing costs? Emanuel, a professor in and chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania, simplifies this and other complex topics for readers and at times may force them to question long-held beliefs. When it comes to health care, the United States has a paradoxical history of leading in medical technological and procedural advances while also lagging behind in most health and health care domains. As Emanuel writes, in “life expectancy, infant and youth mortality, immunization rates, behavioral health, asthma survival, and control of diabetes—the United States falls well below other developed countries.”Emanuel first addresses the importance of the less frequently discussed health system improvements made since the passage of the Affordable Care Act, including innovative bundled payment models, new hospital readmission policies, and the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Yet Emanuel stresses the continued need for health system improvement, for patients such as “Miss Harris”—a ninety-five-year-old who had an automatic implantable cardioverter-defibrillator placed after a syncopal episode on a hot day. Though she had an expensive medical device and saw multiple specialists, Miss Harris lacked adequate home health assistance and could not explain what role each of her medical experts played. According to Emanuel, such disconnects likely occur because “none of these providers share a common electronic medical record or care plan.” Miss Harris will seem familiar to many readers; she could be their family member, patient, or friend.Emanuel then shares vivid examples and case studies collected from nearly twenty medical organizations and companies nationwide that have successfully transformed parts of their delivery system, such as clinic design or patient registration. “When Dean Clinic [in Madison, Wisconsin] was building a new clinic, they named patients and staff to the design committee to ensure that their values were incorporated into the building itself,” Emanuel writes. Patients of ChenMed, in Florida, have an individual identification card (the ChenMed card) that alerts the receptionist and a health aide of their arrival and checks them in, reducing the need to complete forms. Emanuel highlights what he sees as the twelve key practices necessary for health system transformation, drawing lessons not from the titans that everyone seems to know and regard as the best, but from a select group—including small physician offices; large, multispecialty group practices; accountable care organizations; and even for-profit companies—whose members have largely flown under the radar. The transformational practices they employ include streamlining appointments via open-access scheduling, focusing services on managing high-cost chronic care, providing comparative performance data, and integrating behavioral health and primary care services. When available, Emanuel provides the evidence that supports these initiatives. Of course, Emanuel recognizes that no organization can enact all twelve practices simultaneously, so he separates them into three tiers of priority.The book’s last third examines big questions about the future of health care, pondering the advantages and limitations of virtual medicine, whether the transformational practices described are actually scalable, and how to pick a good doctor. Prescription for the Future offers both a history lesson and a blueprint for improving health care delivery in the United States by focusing on these lesser-known, standout medical organizations, which have achieved care that is higher quality, more patient focused, and lower cost. Ultimately, to improve outcomes and care and transform the efficiency and effectiveness of US health care, Emanuel recommends that organizations prioritize the approaches on his list, starting with a few key practices: namely, scheduling, performance measurement and reporting, chronic care coordination, and innovations related to sites of service. This book will serve as an essential guide to the future of health care, not only for professionals employed in one of America’s largest economic sectors but also for readers who want to distinguish competent and progressive medical teams from outmoded practitioners to ensure that they get the best that health care has to offer today. Loading Comments... Please enable JavaScript to view the comments powered by Disqus. DetailsExhibitsReferencesRelated Article Metrics History Published online 6 November 2017 Information© 2017 Project HOPE—The People-to-People Health Foundation, Inc.PDF download