A new report from the Institute of Medicine (IOM) offers a blueprint for a national program to assess the effectiveness of clinical services and to provide credible, unbiased information about what really works in health care. The report, Knowing What Works in Health Care: A Roadmap for the Nation, recommends that Congress direct HHS to establish a program with the authority, expertise, and resources necessary to set priorities for evaluating clinical services and to conduct systematic reviews of the evidence. This program would also be responsible for developing and promoting rigorous standards for clinical practice guidelines, which could help minimize the use of questionable services and target services to the patients most likely to benefit, said the committee that wrote the report.
Although several organizations conduct evidence reviews and develop clinical practice guidelines, a single entity with the authority and resources is needed to determine what works and end confusion, the report says. Lack of coordination has led to duplication of effort, dozens and even hundreds of competing practice guidelines, and uncertainty about which study results and guidelines are the most reliable and objective. This situation complicates the push to empower individuals to become more engaged in choosing and managing their care, the committee said.
