Mehra Saral, Tuttle R Michael, Bergman Donald, Bernet Victor, Brett Elise, Cobin Rhoda, Doherty Gerard, Klopper Joshua, Lee Stephanie, Machac Josef, Milas Mira, Mechanick Jeffrey I, Orloff Lisa, Randolph Gregory, Ross Douglas S, Smallridge Robert, Terris David, Tufano Ralph, Alon Eran, Clain Jason, Dos Reis Laura, Scherl Sophie, Urken Mark L
1 Department of Surgery (Otolaryngology), Yale University , New Haven, Connecticut.
Thyroid. 2014 Apr;24(4):615-24. doi: 10.1089/thy.2013.0441.
The current systems of healthcare delivery in the United States suffer from problems that often leave patients with inadequate quality of care. In their report entitled "Crossing the Quality Chasm," the Institute of Medicine (IOM) identified reasons for poor and/or inconsistent quality of healthcare delivery and provided recommendations to improve it. The purpose of this review is to describe features of an innovative web-based program called the Thyroid Cancer Care Collaborative (TCCC) and see how it addresses IOM recommendations to improve the quality of healthcare delivery.
The TCCC addresses the three actionable IOM recommendations directed at healthcare organizations and clinicians to redesign the care process. It does so by exploiting information technology (IT) in ways suggested by the IOM, and it fits within a set of 10 rules provided by the IOM. Some features of the TCCC include: (i) automated disease staging based on three validated scoring systems; (ii) highly illustrated educational videos on all aspects of thyroid cancer care; (iii) personalized clinical decision-making modules for clinicians and physicians; (iv) portability of data to share among treating physicians; (v) virtual tumor boards, "ask the expert," and frequently asked questions modules; (vi) physician workflow integration; and (vii) data for comprehensive analysis to answer difficult questions in thyroid cancer management.
The TCCC has the potential to improve thyroid cancer care delivery and offers several benefits to patients, clinicians, and researchers. The TCCC is a valuable example of how IOM initiatives can improve the healthcare system.
美国当前的医疗服务体系存在诸多问题,常常导致患者获得的医疗服务质量不高。医学研究所(IOM)在其题为《跨越质量鸿沟》的报告中,确定了医疗服务质量差和/或不一致的原因,并提出了改进建议。本综述的目的是描述一个名为甲状腺癌护理协作项目(TCCC)的创新性基于网络的项目的特点,并探讨它如何落实医学研究所的建议以提高医疗服务质量。
TCCC落实了医学研究所针对医疗组织和临床医生提出的三项可操作的建议,以重新设计护理流程。它通过医学研究所建议的方式利用信息技术来实现这一点,并且符合医学研究所提供的一套十条规则。TCCC的一些特点包括:(i)基于三种经过验证的评分系统进行自动疾病分期;(ii)关于甲状腺癌护理各个方面的高度直观的教育视频;(iii)为临床医生和内科医生提供的个性化临床决策模块;(iv)数据的可移植性,以便在治疗医生之间共享;(v)虚拟肿瘤委员会、“向专家提问”以及常见问题模块;(vi)医生工作流程整合;以及(vii)用于全面分析的数据,以回答甲状腺癌管理中的难题。
TCCC有潜力改善甲状腺癌的护理服务,并为患者、临床医生和研究人员带来诸多益处。TCCC是医学研究所的倡议如何改善医疗系统的一个有价值的范例。