Achieving the Quadruple Aim in a Technology-Driven Transformed Health System: Better Care, Improved Health, Lower Costs and Decreased Medical Liability

James B. Couch, MD
Senior Physician Executive, The JHD Group, Inc., Dallas, TX, USA

Series: Health Care in Transition
BISAC: LAW046000


Volume 10

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Special issue: Resilience in breaking the cycle of children’s environmental health disparities
Edited by I Leslie Rubin, Robert J Geller, Abby Mutic, Benjamin A Gitterman, Nathan Mutic, Wayne Garfinkel, Claire D Coles, Kurt Martinuzzi, and Joav Merrick


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America’s $3 trillion healthcare system is undergoing its most tumultuous changes in a half century. Although covering the uninsured and the individual mandate to purchase insurance has received the most attention, these are not the most important developments driving change. Rather, it is the rapidly accelerating movement from a volume to a value based healthcare financing system that will be most responsible for creating a very different healthcare industry by the end of this decade. Unsustainable cost pressures have been mounting on the government and employers as the ultimate purchasers of healthcare. Left unabated, these forces will render our nation economically destitute and our companies globally uncompetitive in the years and decades ahead. Although the Great Recession provided a five year respite, with the growing economic recovery and the addition of millions of previously uninsured to the marketplace, healthcare cost increases are returning. What can be done to prevent a return to double-digit healthcare inflation in a national economy, business and consumer environment that can no longer sustain that?

The “Quadruple Aim” is a one goal enhancement (i.e. decreasing medical liability) to that of the better known “Triple Aim”, which seeks better care, improved individual and population health and lower costs. The Triple Aim has served as the North Star toward which all reform efforts at least should be pointed. But can achievement of the Triple Aim also result in accomplishing the Quadruple Aim (simultaneously decreasing the risks and actualities of medical liability)? Conversely, what will likely be the enduring value of achieving the Triple Aim if accomplishing the Quadruple Aim is not possible? The overarching theme of this book addresses those questions in the context of a technology-driven, rapidly transforming healthcare industry. (Imprint: Nova)



About the Author


Chapter 1 - The Evolving Post-Reform Healthcare Landscape (pp. 1-12)

Chapter 2 - Information Technologies Driving Healthcare Delivery and Financing Transformation (pp. 13-28)

Chapter 3 - Medical Liability in a Technology-Driven Post-Reform Healthcare Marketplace (pp. 29-44)

Chapter 4 - The Shifting Focus of Medical Liability in a Value-Driven System (pp. 45-58)

Chapter 5 - How to Use Electronic Health Records to Optimize Care Value and Minimize Medico-Legal Risks (pp. 59-80)

Chapter 6 - Medical Liability Risk Implications of Analytics Technologies and Methodologies (pp. 81-94)

Chapter 7 - New Methods to Predict and Prevent Medical Liability Actions (pp. 95-116)

Chapter 8 - How Must the Medical Liability System Change for the Quadruple Aim to be Achievable? (pp. 117-126)

Chapter 9 - Conclusion (pp. 127-132)

Chapter 10 - Epilogue: Achieving the Quadruple Aim in the Next Decade and Beyond (pp. 133-136)


"This brilliantly written book should become required reading by the directors and staffs of medical liability insurance companies and all residency directors to use some of its main messages to help break the cycle of wasteful defensive medicine practices often perpetuated by senior physician mentors." - Charles Aswad, M.D., President Emeritus, Medical Society of the State of New York, Board Member, Medical Liability Mutual Insurance Company (MLMIC)

"Clear; concise; accurate; understandable and optimistic. No quibbles. I like it, a lot!" - George D. Lundberg, M.D., Former Editor in Chief of the Journal of the American Medical Association

"In his book, Dr. Couch, who describes himself as a "radical independent pragmatic centrist," describes the face of medical liability in the world of healthcare reform, in particular how health IT like electronic health records (EHRs) can influence care in ways that can drive healthcare costs and quality either up or down." READ MORE... - Paul Anderson, Editor and director of ECRI Institute's risk management and patient safety publications

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