Christine Cassel

The President’s Council of Advisors on Science and Technology (PCAST) has released a report to the President, Better Health Care and Lower Costs: Accelerating Improvement through Systems Engineering.

The report comes at a critical time for the United States and for the health-care system in particular, with millions of Americans recently gaining health-care coverage due to the Affordable Care Act (ACA). At the same time, the health-care system is challenged by rising costs, which now approach a fifth of the United States’ gross domestic product (GDP). A significant portion of those costs, however, does not produce better health or quality of care.

In consultation with a working group including experts from the health and engineering sectors, PCAST, in its new report, identifies a comprehensive set of recommendations to address these cost and quality challenges, including through an interdisciplinary approach known as systems engineering. Among the barriers that limit the spread of systems engineering in health care is the predominant payment system -- the fee-for-service method often discourages efficient care.

To overcome this challenge, PCAST notes that providers should be paid for value -- e.g., patient health-outcomes -- rather than the volume of tests or treatments administered. Systems engineering also depends on the availability of high-quality data that can be used for measuring progress, analyzing current challenges and opportunities, and enabling patients and providers to make more informed decisions. Finally, the report speaks to the need for the United States to build a health-care workforce that has the necessary “know-how,” recommending that systems engineering concepts should be embedded in education and training for a wide variety of people involved in health care, from clinicians to administrators to public-health officials.