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Rising costs, decreasing quality of care, diminishing productivity, and increasing complexity have all contributed to the present state of the healthcare industry. The interactions between payers (e.g., insurance companies and health plans) and providers (e.g., hospitals and laboratories) are growing and are becoming more complicated. The constant upsurge in and enhanced complexity of diagnostic and treatment information has made the clinical decision-making process more difficult. Medical transaction charges are greater than ever. Population-specific financial requirements are increasing the economic burden on the entire system. Medical insurance and identity theft frauds are on the rise. The current lack of comparative cost analytics hampers systematic efficiency. Redundant and unnecessary interventions add to medical expenditures that add no value. Contemporary payment models are antithetic to outcome-driven medicine. The rate of medical errors and mistakes is high. Slow inefficient processes and the lack of best practice support for care delivery do not create productive settings. Information technology has an important role to play in approaching these problems. This paper describes IBM Research's approach to helping address these issues, i.e., the evidence-based healthcare platform.
Date of Publication: Sept.-Oct. 2011