The ongoing significant investment in basic science and clinical discovery in the United States continues to produce impressive results. However, the United States struggles to deliver high-quality care and improved health outcomes due to the systematic failure of discoveries to reach patients in a timely fashion.1,2 Despite expenditures that reached $2 trillion or more than $6000 per capita in 2005,3 the United States will continue to fail to fully leverage new clinical discoveries into improved health outcomes unless there is an accelerated transformation of the health care system.4 The research enterprise cannot achieve this alone. We propose a model to transform the US health care system (Figure), intended to accelerate the pace at which innovations are implemented in clinical settings by addressing the “how” of health care delivery.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
T indicates translation. T1, T2, and T3 represent the 3 major translational steps in the proposed framework to transform the health care system. The activities in each translational step test the discoveries of prior research activities in progressively broader settings to advance discoveries originating in basic science research through clinical research and eventually to widespread implementation through transformation of health care delivery. Double-headed arrows represent the essential need for feedback loops between and across the parts of the transformation framework.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 126
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.