Paperback | $14.95 Trade | £10.95 | ISBN: 9780262517621 | 296 pp. | 6 x 9 in | 19 figures| February 2012
One of the most daunting challenges facing the new U.S. administration is health care reform. The size of the system, the number of stakeholders, and ever-rising costs make the problem seem almost intractable. But in Chaos and Organization in Health Care, two leading physicians offer an optimistic prognosis. In their frontline work as providers, Thomas Lee and James Mongan see the inefficiency, the missed opportunities, and the occasional harm that can result from the current system. The root cause of these problems, they argue, is chaos in the delivery of care. If the problem is chaos, the solution is organization, and in this timely and outspoken book, they offer a plan.
In many ways, this chaos is caused by something good: the dramatic progress in medical science—the explosion of medical knowledge and the exponential increase in treatment options. Imposed on a fragmented system of small practices and individual patients with multiple providers, progress results in chaos. Lee and Mongan argue that attacking this chaos is even more important than whether health care is managed by government or controlled by market forces.
Some providers are already tightly organized, adapting management principles from business and offering care that is by many measures safer, better, and less costly. Lee and Mongan propose multiple strategies that can be adopted nationwide, including electronic medical records and information systems for sharing knowledge; team-based care, with doctors and other providers working together; and disease-management programs to coordinate care for the sickest patients.
"Dr. Lee and Dr. Mongan present a compelling vision of a more efficient, reliable, and patient-centered health care system. The authors' call for fundamental payment and delivery system reform to achieve an integrated delivery system accountable for achieving the best health outcomes and prudent use of resources is right on target. Strong leadership from the provider community like this is exactly what's needed to lead the U.S. health care system toward higher performance, lower cost, and better care."
—Karen Davis, President, The Commonwealth Fund
"The toughest part of health reform will be after the politicians finish with us, and we health care insiders have to figure out how to create a higher-quality system that is more affordable. Refreshingly frank, non-partisan, and easy to read, Chaos and Organization in Health Care takes on this challenge and lays out a vision for how our system can achieve integrated care. Lee and Mongan are not afraid to take on the sacred cows of the delivery system and they do so in an entertaining way. I highly recommend this book to physicians as well as anyone else involved in improving our health care system."
—Robert Galvin, Executive Director of Health Services and Chief Medical Officer, General Electric
"Two of the most skilled and admired senior health care executives in America offer their diagnosis and prescription for a troubled, unsustainable health care system. Their insights rest on decades of experience and sound science, and their recommendations are textured and sophisticated. I hope we have the courage and discipline to listen to them and act."
—Donald M. Berwick, President and CEO, Institute for Healthcare Improvement