Key Role for IOM
Once the Grand Challenges initiative has been formally launched, the next step will be for the IOM to spur action to solve the challenges. The IOM has the ability to convene panels of experts, and further, the organization has a highly qualified staff of more than 200 available to support these efforts. In addition, the institution can also draw on the resources of the National Academies of Sciences and Engineering and the National Research Council with its staff or more than 1000. “This effort is not as big as a moonshot,” he points out, “but when we put our best scientists and resources together the outcomes are going to be beneficial for everyone.”
An obstacle along the way to achieving this semi-moonshot is funding. U.S. science funding is facing budget cuts, but Dr. Dzau is not deterred. “When there’s not enough funding, we aren’t interested in fighting over the pie; instead we want to come together to find creative new sources of nourishment. Further,” he adds, “the government does provide money for great ideas, such as the Brain Initiative. The power of a great idea is that it brings together government, industry, and academia.”
An overarching issue that ties directly to the size of the pie, and which consistently surfaces during his listening tour, is the problem of excessive and unnecessary regulation and paperwork in both research and health care. Assuming that this issue continues to merit being a priority, how might the IOM deal with it?
“We know from a previous IOM analysis that there’s as much as 30 percent waste in medical care. I believe that a similar situation may exist for research expenditures. We know that excessive paperwork, for instance, accumulates because over the years lawmakers want to make sure that things are done right, and to ensure this, they require more and more paperwork. The end result is a huge bureaucracy with layers and layers of paperwork.”
The good news for Dr. Dzau, and also for the rest of us is, “Legislators are likely to be very interested when they see how much better off we would be if we eliminated paperwork that doesn’t pass a cost benefit analysis.” He is considering undertaking a study on this issue. “In the case of a study of excess paperwork, the anecdotes we’ve all heard about the burden of excess paperwork can be translated into analysis, and once the information is validated, the recommendations become a powerful tool for change.”
Dr. Dzau knows that solutions to a broad array of problems do exist. In some cases a small change in approach, accompanied by relatively minimal expense, can have outsize impact on the problem. An IOM project begun in November is now addressing the serious and occasionally life-threatening problem related to delayed patient scheduling at the Department of Veterans Affairs, the problem of long waits for patients seeking care. “What if,” asks Dr. Dzau, “we get our best systems engineers to use their knowledge of the science of scheduling, and we use this knowledge to study patient flow in order to find what works best for the patients?”
He lowers his head for a moment, and smiles, almost shyly. “You can see why I love this job. The possibilities are endless!”