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A Vision for Better Health and Health Care

April 26, 2017

By: Victor Lee

A Vision for Better Health and Health Care

Most companies are formed with an aspirational vision and a plan to work toward that vision. Components of that plan might include setting strategic priorities, goals, and tactical actions that are intended to directionally align everyone’s collective work effort. What if we had a national vision and plan for health and health care—what would it look like? A recent publication entitled “Vital Directions for Health and Health Care” might be an obvious place to start.

The origins of this body of work trace back to the National Academy of Medicine (NAM, formerly known as Institute of Medicine) which is an independent nonprofit organization of health professionals that serves in an advisory capacity to the nation by addressing the most salient issues in health and health policy. The NAM had commissioned a variety of white papers on health care topics, 19 of which were summarized by the authors, along with many other publications and data. Briefly, the Vital Directions were organized into the following framework:

Source: Dzau VJ, et al. Vital Directions for Health and Health Care: Priorities From a National Academy of Medicine Initiative. JAMA. Published online March 21, 2017. doi:10.1001/jama.2017.1964.
There has been much focus recently on the merits and shortcomings of the Affordable Care Act (ACA), as well as a proposal to repeal and replace the ACA with the American Health Care Act. However, these vital directions transcend any single piece of legislation from congress or rulemaking from the U.S. Department of Health and Human Services. If we are to achieve better health, better care, and smarter spending, not only do we need the right dosage of laws and regulations to guide us there, we also need innovative technology solutions and a skilled workforce to execute on the master plan.

Further exploring our ability to work on these vital directions, in an accompanying editorial, Don Berwick asks 4 thought-provoking questions about whether our nation is ready and willing to execute on the vital directions strategic plan:

  • Does this nation commit to basic health care as a human right, denied to no one?
  • Does this nation commit to improving continually the health of communities by addressing prevention and the social determinants of health?
  • Does this nation commit to reducing the costs of its health care by eliminating waste in all its forms, and not by harming either care or health?
  • Does this nation commit to navigating to these aims using science, evidence, and learning, not doctrine, as its guide?


While we may debate the answers to these questions for years to come, we do have a track record of making progress toward the three core goals in the Vital Direction framework. In particular, our health care industry is replete with initiatives that enable us to experiment and learn about approaches that will most effectively improve the value of health care. In future blog posts, I plan to summarize some of the most prominent past and current efforts to nudge our nation to value-based care.

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