Redesigning healthcare to fit with peopleBMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4536 (Published 23 August 2016) Cite this as: BMJ 2016;354:i4536
- Kim Erwin, assistant professor, communication design methods1,
- Jerry A Krishnan, associate vice chancellor for population health2
- 1Institute of Design, Illinois Institute of Technology, Chicago, IL, USA
- 2University of Illinois at Chicago, Chicago, IL 60612, USA
- Correspondence to: J A Krishnan
Healthcare expenditures vary fourfold across the globe, from less than 5% to nearly 20% of a nation’s gross domestic product.1 Higher levels of spending, however, have not necessarily produced better results, suggesting that some healthcare systems are more efficient than others.2 These observations have led to various efforts to improve the efficiency of care systems.
In Europe and the US, for example, emphasis is increasingly shifting away from the “volume” of care (number of services) to the “value” of care (quality, outcomes, and costs).3 4 Government and other payers are driving health systems to invest in electronic health records, data analytics, performance improvement, and clinical decision support tools. Unfortunately, these investments are often launched as a series of individual fixes targeting different types of apparent underuse, overuse, or misuse of healthcare, disconnected from each other and from workflows in clinical settings. And thus well intentioned reforms are …