Dr. Denis Cortese, president and chief executive officer of the Mayo Clinic, offered a healthy dose of insight about the crucial importance of patient-focused care during a speech at the National Press Club on Good Friday.

Mayo is renowned worldwide for its expertise in medical diagnosis, and Dr. Cortese drew on these capabilities to help policymakers think differently and more strategically about health reform. Here are a few key points he made:

• The U.S. doesn't have a health care "system." There was no conscious effort and no engineers were involved in getting us where we are today. Therefore, it is a fallacy to say that "our system is broken" and to try to "fix it" with a particular set of policies.
• Change, instead, must focus on putting the needs of the patient first. Patients want personal, high-value health care, and the concept of teamwork is essential to delivering care that focuses on what patients most want and need: prevention, early diagnosis, control of chronic illnesses, enhancing their quality of life, wellness -- and staying out of the hospital. And to know we are delivering quality care, we must measure outcomes. Was the procedure safe, timely, coordinated, compassionate, and affordable? All of these are important to patients.
• The most important thing we can do to improve patient care is to create learning organizations. They can be real brick and mortar facilities or virtual networks where information is exchanged rapidly and where everyone is learning how to produce high quality care with the best outcomes, deliver safe care, and create the best value for patients. This is where systems engineers could help, in figuring out how to locate the sources of errors and create learning organizations.
• Payments need to reward providers and patients for results, not for process. Right now, Medicare is spending money it doesn't need to spend by paying for the worst service, the worst outcomes, and the most expensive care. And Medicare's inefficiency drives inefficiency everywhere else. Getting rid of Medicare price controls is essential to paying for quality.

Having 90,000 avoidable hospital deaths a year is the equivalent of a major airliner crashing every two and a half days, Dr. Cortese said. That is unacceptable, but the lack of information is driving these mistakes. People get the right medical advice only about half the time. We need to exchange information in real time to improve, and we need transparency of outcomes, safety, and costs. We need teamwork to integrate care from diagnosis through treatment. And that care must be individually focused. Physicians need to think of themselves as team leaders and coordinators of the medical team.