Children can teach us many things – and how to transform health care is no exception. For the past several decades, almost every child diagnosed with cancer has been placed in some type of clinical trial. As a result of this learning, over the past three decades, we have achieved an over 60 percent improvement in five-year survival rates for children diagnosed with cancer – leading to survival rates of over 80 percent. Yet, when it comes to adults with cancer, we do not learn from over 97 percent of them; fewer than three percent ever participate in cancer clinical trials. So it should come as no surprise that, overall cancer remains the second leading cause of mortality, killing over 500,000 Americans every year, and that many cancer drugs are effective less than 20 percent of the time. This tragic disparity illuminates the power of learning from experience in health care and the urgent need for it.
The LHS vision recognizes that the status quo in health care and health is unsustainable and unjust. Indeed, if insanity entails repeating the same thing over and over and expecting different outcomes, then the status quo in health care is insane because it too often fails to learn systemically from health outcomes.
Some horrific consequences attributable to the failure to learn include:
- Wasting $750 billion per year (almost one in three health care dollars) on treatments that do not work or are fraudulent.
- Taking a leisurely 17 years for lessons learned to go from research to practice (and double that length of time for health care quality itself to double, by some measures)
- Prescribing treatments for some of the deadliest diseases that work significantly less than half the time.
- Killing up to 400,000 Americans every year due to medical errors in hospitals alone (an estimate which itself has grown fourfold in less than a decade and a half).
- Ranking 40th in infant mortality while spending three times as much as other industrialized nations on health care.
- Making treatment decisions where only 20 percent of the knowledge used to inform some of them is itself evidence-based.
Proponents of the LHS vision recognize that the most shocking of these statics are symptoms of a non-learning, non-health, non-system, and will work together to fight this disease that adversely affects the life and health of every American as well as our nation’s fiscal health. As our nation invests $150 billion or more to transform our health information technology infrastructure, we simply cannot afford not to maximize the impact of this historic investment by ensuring that data captured digitally is securely shared and silos are broken down in order to enable rapid learning and sharing of such lessons learned to ultimately transform health care and health