About Publications

Publications from the National Academies of Sciences, Engineering, and Medicine provide objective and straightforward advice to decision makers and the public. This site includes Health and Medicine Division (HMD) publications released after 1998. A complete list of HMD’s publications from its establishment in 1970 to the present is available as a PDF.


  • Digital Data Improvement Priorities for Continuous Learning in ... Released: September 28, 2012
    Digital health data are the lifeblood of a continuous learning health system. A steady flow of reliable data is necessary to coordinate and monitor patient care, analyze and improve systems of care, conduct research to develop new products and approaches, assess the effectiveness of medical interventions, and advance population health. The totality of available health data is a crucial resource that should be considered an invaluable public asset in the pursuit of better care, improved health, and lower health care costs. This publication summarizes discussions at the March 2012 IOM workshop to identify and characterize the current deficiencies in the reliability, availability, and usability of digital health data and consider strategies, priorities, and responsibilities to address such deficiencies.
  • Best Care at Lower Cost: The Path to Continuously Learning ... Released: September 06, 2012
    America's health care system has become far too complex and costly to continue business as usual. Pervasive inefficiencies, an inability to manage a rapidly deepening clinical knowledge base, and a reward system poorly focused on key patient needs, all hinder improvements in the safety and quality of care and threaten the nation's economic stability and global competitiveness. In the face of these realities, the IOM convened the Committee on the Learning Health Care System in America to explore these central challenges to health care today. The product of the committee’s deliberations, Best Care at Lower Cost, points out that emerging tools like computing power, connectivity, team-based care, and systems engineering techniques—tools that were previously unavailable—make the present opportunities for better health care in America. Applying these new strategies can support the transition to a continuously learning health system, one that aligns science and informatics, patient-clinician partnerships, incentives, and a culture of continuous improvement to produce the best care at lower cost. The report’s recommendations speak to the many stakeholders in the health care system and outline the concerted actions necessary across all sectors to achieve the needed transformation.
  • The Richard and Hinda Rosenthal Lecture 2011: New ... Released: October 05, 2011
    More than 10 years ago, the IOM released its landmark report on patient safety, To Err is Human: Building a Safer Health System. The 2011 Rosenthal Lecture featured the Honorable Kathleen G. Sebelius, Secretary of the U.S. Department of Health and Human Services, who presented the new steps that HHS is taking to improve patient safety. A panel of leaders in patient safety followed to discuss patient safety progress and opportunities.
  • Patients Charting the Course: Citizen Engagement in the ... Released: October 03, 2011
    As past, current, or future patients, the public should be the health care system’s unwavering focus and serve as change agents in its care. Taking this into account, the quality of health care should be judged not only by whether clinical decisions are informed by the best available scientific evidence, but also by whether care is tailored to a patient’s individual needs and perspectives. However, too often it is provider preference and convenience, rather than those of the patient, that drive what care is delivered. As part of its Learning Health System series of workshops, the Roundtable on Value & Science-Driven Health Care hosted a workshop to assess the prospects for improving health and lowering costs by advancing patient involvement in the elements of a learning health system.
  • Learning What Works: Infrastructure Required for Comparative ... Released: July 25, 2011
    It is essential for patients and clinicians to know which treatments work best for whom if they are to make informed, collaborative care decisions. Despite this need, only a small fraction of health-related expenditures in the U.S. have been devoted to comparative effectiveness research. As part of its Learning Health System series of workshops, the IOM’s Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss capacity priorities to build the evidence base necessary for care that is more effective and delivers higher value for patients.
  • Engineering a Learning Healthcare System: A Look at the ... Released: July 08, 2011
    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 IOM’s Roundtable on Value & Science-Driven Health Care hosted a workshop, jointly with the National Academy of Engineering, on lessons from systems and operations engineering that could be applied to health care.
  • Digital Infrastructure for the Learning Health System: The ... Released: May 23, 2011
    Like many other industries, health care is increasingly turning to digital information and the use of electronic resources. The IOM’s Roundtable on Value & Science-Driven Health Care hosted three workshops to explore current efforts and opportunities to accelerate progress in improving health and health care with information technology systems.
  • The Healthcare Imperative: Lowering Costs and Improving ... Released: February 24, 2011
    The Roundtable on Value & Science-Driven Health Care held a three-part workshop series to explore opportunities to reduce health care costs without compromising health status, quality of care, or innovation.
  • Clinical Data as the Basic Staple of Health Learning ... Released: February 03, 2011
    Successful development of clinical data as an engine for knowledge generation has the potential to transform health and health care in America. As part of its Learning Health System Series, the Roundtable on Value & Science-Driven Health Care hosted a workshop to discuss expanding the access to and use of clinical data as a foundation for care improvement.
  • Redesigning the Clinical Effectiveness Research Paradigm ... Released: December 06, 2010
    Currently, a substantial gap exists between the knowledge needed and that available for medical care decisions. The IOM Roundtable on Value & Science-Driven Health Care sponsored a meeting to explore the methods, data resources, tools, and techniques that are emerging in the new generation of accelerated clinical research approaches.