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May 21, 2008

The “3T’s” Road Map to Transform US Health Care: The “How” of High-Quality Care

Author Affiliations

Author Affiliations: Agency for Healthcare Research and Quality, Rockville, Maryland (Drs Dougherty and Conway); and Center for Health Care Quality, Division of Health Policy and Clinical Effectiveness, and Division of General Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Conway).

JAMA. 2008;299(19):2319-2321. doi:10.1001/jama.299.19.2319

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.