Author: Douglas A. Perednia
Publisher: Pearson Education
ISBN: 0132696967
Category : Health & Fitness
Languages : en
Pages : 26
Book Description
This is the eBook version of the printed book. This Element is an excerpt from Overhauling America's Healthcare Machine: Stop the Bleeding and Save Trillions (9780132173254) by Douglas A. Perednia. Available in print and digital formats. Uncovering the heart of the U.S. healthcare crisis: spiraling, out-of-control complexity The U.S. healthcare system has become absurdly complex. There is no inherent reason that it has to be, nor did anyone consciously design it that way. Let’s be clear: Excessive complexity is a corrosive force in society and human interactions. Social and business systems that become too complex are inefficient, difficult and expensive to maintain, and prone to corruption...
The Incredible Complexity of Healthcare Costs
Author: Douglas A. Perednia
Publisher: Pearson Education
ISBN: 0132696967
Category : Health & Fitness
Languages : en
Pages : 26
Book Description
This is the eBook version of the printed book. This Element is an excerpt from Overhauling America's Healthcare Machine: Stop the Bleeding and Save Trillions (9780132173254) by Douglas A. Perednia. Available in print and digital formats. Uncovering the heart of the U.S. healthcare crisis: spiraling, out-of-control complexity The U.S. healthcare system has become absurdly complex. There is no inherent reason that it has to be, nor did anyone consciously design it that way. Let’s be clear: Excessive complexity is a corrosive force in society and human interactions. Social and business systems that become too complex are inefficient, difficult and expensive to maintain, and prone to corruption...
Publisher: Pearson Education
ISBN: 0132696967
Category : Health & Fitness
Languages : en
Pages : 26
Book Description
This is the eBook version of the printed book. This Element is an excerpt from Overhauling America's Healthcare Machine: Stop the Bleeding and Save Trillions (9780132173254) by Douglas A. Perednia. Available in print and digital formats. Uncovering the heart of the U.S. healthcare crisis: spiraling, out-of-control complexity The U.S. healthcare system has become absurdly complex. There is no inherent reason that it has to be, nor did anyone consciously design it that way. Let’s be clear: Excessive complexity is a corrosive force in society and human interactions. Social and business systems that become too complex are inefficient, difficult and expensive to maintain, and prone to corruption...
Engineering a Learning Healthcare System
Author: National Academy of Engineering
Publisher: National Academies Press
ISBN: 0309120640
Category : Medical
Languages : en
Pages : 340
Book Description
Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
Publisher: National Academies Press
ISBN: 0309120640
Category : Medical
Languages : en
Pages : 340
Book Description
Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
The Price We Pay
Author: Marty Makary
Publisher: Bloomsbury Publishing USA
ISBN: 1635574129
Category : Health & Fitness
Languages : en
Pages : 305
Book Description
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Publisher: Bloomsbury Publishing USA
ISBN: 1635574129
Category : Health & Fitness
Languages : en
Pages : 305
Book Description
New York Times bestseller Business Book of the Year--Association of Business Journalists From the New York Times bestselling author comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it--now with a new Afterword by the author. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of the business of medicine and its elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a road map for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
Big Med
Author: David Dranove
Publisher: University of Chicago Press
ISBN: 022682392X
Category : Business & Economics
Languages : en
Pages : 344
Book Description
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
Publisher: University of Chicago Press
ISBN: 022682392X
Category : Business & Economics
Languages : en
Pages : 344
Book Description
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
Health Professions Education
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030913319X
Category : Medical
Languages : en
Pages : 191
Book Description
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Publisher: National Academies Press
ISBN: 030913319X
Category : Medical
Languages : en
Pages : 191
Book Description
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Evidence-Based Medicine and the Changing Nature of Health Care
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309113695
Category : Medical
Languages : en
Pages : 202
Book Description
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Publisher: National Academies Press
ISBN: 0309113695
Category : Medical
Languages : en
Pages : 202
Book Description
Drawing on the work of the Roundtable on Evidence-Based Medicine, the 2007 IOM Annual Meeting assessed some of the rapidly occurring changes in health care related to new diagnostic and treatment tools, emerging genetic insights, the developments in information technology, and healthcare costs, and discussed the need for a stronger focus on evidence to ensure that the promise of scientific discovery and technological innovation is efficiently captured to provide the right care for the right patient at the right time. As new discoveries continue to expand the universe of medical interventions, treatments, and methods of care, the need for a more systematic approach to evidence development and application becomes increasingly critical. Without better information about the effectiveness of different treatment options, the resulting uncertainty can lead to the delivery of services that may be unnecessary, unproven, or even harmful. Improving the evidence-base for medicine holds great potential to increase the quality and efficiency of medical care. The Annual Meeting, held on October 8, 2007, brought together many of the nation's leading authorities on various aspects of the issues - both challenges and opportunities - to present their perspectives and engage in discussion with the IOM membership.
Guide to U.S. Health and Health Care Policy
Author: Thomas R. Oliver
Publisher: CQ Press
ISBN: 1483370453
Category : Political Science
Languages : en
Pages : 1109
Book Description
The contentious passage of the Affordable Care Act in 2010 highlighted the incredible complexity and controversy surrounding health care in the United States. While the U.S. federal government does not provide universal health care, it has an extremely wide reach when it comes to the health of its citizenry. From important scientific and medical research funding to infectious disease control and health services for veterans and the elderly, the pathway to legislation and execution of health policies is filled with competing interests and highly varied solutions. The Guide to U.S. Health and Health Care Policy provides the analytical connections showing researchers how issues and actions are translated into public policies and institutions for resolving or managing healthcare issues and crises. The Guide highlights the decision-making cycle that requires the cooperation of federal and state governments, business, and an informed citizenry in order to achieve a comprehensive approach to advancing the nation’s healthcare policies. Through 30 topical chapters, the book addresses the development of the U.S. healthcare system and policies, the federal agencies and public and private organizations that frame and administer those policies, and the challenges of balancing the nation’s healthcare needs with the rising costs of medical research, cost-effective treatment, and adequate health insurance. Additionally, the book comprehensively addresses significant disparities that exist in the U.S. system and the challenges to public health posed by our increasingly connected world. Taking a comprehensive approach, the Guide traces policy initiatives across time and takes into account the most recent scholarship: Part One: Evolution of American Health Care Policy Looks at the emerging and expanding role of government in the health care sector and the position the U.S. occupies today as the only advanced industrial nation without universal health care. Part Two: Government Organizations that Develop, Fund, and Administer Health Policy (1789-Today) Examines the role each branch of government plays in the forming, executing, and regulating health care policies. The authors examine the origins, organization, budget, and function of major government organizations including the FDA, CDC, and VA. An exploration of legal oversight and the roles states play in the health sector round out this section. Part Three: Contemporary Health Policy Issues: Goals and Initiatives (1920s-Today) Explores the wide range of players in the health care sphere and the role the government plays, particularly in funding them. Special attention is paid to policy issues surrounding medical research and medical professions. This section also looks at the ethical issues in play when making health policy and the inequalities that have plagued the U.S. health care system. Part Four: Contemporary Health Policy Issues: People and Policies (1960s-Today) This part of the book looks in-depth at health disparities in the U.S., health challenges particular to specific groups, mental health, obesity, and the influence of interest groups. Part Five: U.S. Response to Global Health Challenges (1980s-Today) The last section of the book looks beyond the borders of the United States and the serious challenges posed by our increasingly connected world.
Publisher: CQ Press
ISBN: 1483370453
Category : Political Science
Languages : en
Pages : 1109
Book Description
The contentious passage of the Affordable Care Act in 2010 highlighted the incredible complexity and controversy surrounding health care in the United States. While the U.S. federal government does not provide universal health care, it has an extremely wide reach when it comes to the health of its citizenry. From important scientific and medical research funding to infectious disease control and health services for veterans and the elderly, the pathway to legislation and execution of health policies is filled with competing interests and highly varied solutions. The Guide to U.S. Health and Health Care Policy provides the analytical connections showing researchers how issues and actions are translated into public policies and institutions for resolving or managing healthcare issues and crises. The Guide highlights the decision-making cycle that requires the cooperation of federal and state governments, business, and an informed citizenry in order to achieve a comprehensive approach to advancing the nation’s healthcare policies. Through 30 topical chapters, the book addresses the development of the U.S. healthcare system and policies, the federal agencies and public and private organizations that frame and administer those policies, and the challenges of balancing the nation’s healthcare needs with the rising costs of medical research, cost-effective treatment, and adequate health insurance. Additionally, the book comprehensively addresses significant disparities that exist in the U.S. system and the challenges to public health posed by our increasingly connected world. Taking a comprehensive approach, the Guide traces policy initiatives across time and takes into account the most recent scholarship: Part One: Evolution of American Health Care Policy Looks at the emerging and expanding role of government in the health care sector and the position the U.S. occupies today as the only advanced industrial nation without universal health care. Part Two: Government Organizations that Develop, Fund, and Administer Health Policy (1789-Today) Examines the role each branch of government plays in the forming, executing, and regulating health care policies. The authors examine the origins, organization, budget, and function of major government organizations including the FDA, CDC, and VA. An exploration of legal oversight and the roles states play in the health sector round out this section. Part Three: Contemporary Health Policy Issues: Goals and Initiatives (1920s-Today) Explores the wide range of players in the health care sphere and the role the government plays, particularly in funding them. Special attention is paid to policy issues surrounding medical research and medical professions. This section also looks at the ethical issues in play when making health policy and the inequalities that have plagued the U.S. health care system. Part Four: Contemporary Health Policy Issues: People and Policies (1960s-Today) This part of the book looks in-depth at health disparities in the U.S., health challenges particular to specific groups, mental health, obesity, and the influence of interest groups. Part Five: U.S. Response to Global Health Challenges (1980s-Today) The last section of the book looks beyond the borders of the United States and the serious challenges posed by our increasingly connected world.
Definition of Serious and Complex Medical Conditions
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309172608
Category : Medical
Languages : en
Pages : 127
Book Description
In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.
Publisher: National Academies Press
ISBN: 0309172608
Category : Medical
Languages : en
Pages : 127
Book Description
In response to a request by the Health Care Financing Administration (HCFA), the Institute of Medicine proposed a study to examine definitions of serious or complex medical conditions and related issues. A seven-member committee was appointed to address these issues. Throughout the course of this study, the committee has been aware of the fact that the topic addressed by this report concerns one of the most critical issues confronting HCFA, health care plans and providers, and patients today. The Medicare+Choice regulations focus on the most vulnerable populations in need of medical care and other services-those with serious or complex medical conditions. Caring for these highly vulnerable populations poses a number of challenges. The committee believes, however, that the current state of clinical and research literature does not adequately address all of the challenges and issues relevant to the identification and care of these patients.
The Changing Economics of Medical Technology
Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030904491X
Category : Medical
Languages : en
Pages : 225
Book Description
Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.
Publisher: National Academies Press
ISBN: 030904491X
Category : Medical
Languages : en
Pages : 225
Book Description
Americans praise medical technology for saving lives and improving health. Yet, new technology is often cited as a key factor in skyrocketing medical costs. This volume, second in the Medical Innovation at the Crossroads series, examines how economic incentives for innovation are changing and what that means for the future of health care. Up-to-date with a wide variety of examples and case studies, this book explores how payment, patent, and regulatory policiesâ€"as well as the involvement of numerous government agenciesâ€"affect the introduction and use of new pharmaceuticals, medical devices, and surgical procedures. The volume also includes detailed comparisons of policies and patterns of technological innovation in Western Europe and Japan. This fact-filled and practical book will be of interest to economists, policymakers, health administrators, health care practitioners, and the concerned public.
Making Medicines Affordable
Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 0309468086
Category : Medical
Languages : en
Pages : 235
Book Description
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.
Publisher: National Academies Press
ISBN: 0309468086
Category : Medical
Languages : en
Pages : 235
Book Description
Thanks to remarkable advances in modern health care attributable to science, engineering, and medicine, it is now possible to cure or manage illnesses that were long deemed untreatable. At the same time, however, the United States is facing the vexing challenge of a seemingly uncontrolled rise in the cost of health care. Total medical expenditures are rapidly approaching 20 percent of the gross domestic product and are crowding out other priorities of national importance. The use of increasingly expensive prescription drugs is a significant part of this problem, making the cost of biopharmaceuticals a serious national concern with broad political implications. Especially with the highly visible and very large price increases for prescription drugs that have occurred in recent years, finding a way to make prescription medicinesâ€"and health care at largeâ€"more affordable for everyone has become a socioeconomic imperative. Affordability is a complex function of factors, including not just the prices of the drugs themselves, but also the details of an individual's insurance coverage and the number of medical conditions that an individual or family confronts. Therefore, any solution to the affordability issue will require considering all of these factors together. The current high and increasing costs of prescription drugsâ€"coupled with the broader trends in overall health care costsâ€"is unsustainable to society as a whole. Making Medicines Affordable examines patient access to affordable and effective therapies, with emphasis on drug pricing, inflation in the cost of drugs, and insurance design. This report explores structural and policy factors influencing drug pricing, drug access programs, the emerging role of comparative effectiveness assessments in payment policies, changing finances of medical practice with regard to drug costs and reimbursement, and measures to prevent drug shortages and foster continued innovation in drug development. It makes recommendations for policy actions that could address drug price trends, improve patient access to affordable and effective treatments, and encourage innovations that address significant needs in health care.