Are Governance Issues Transforming American Healthcare?

Mark C. SuchmanSociology and LawUniversity of Wisconsin

Plot-lines for the Transformation of Plot-lines for the Transformation of Health CareHealth Care

Humans against Nature– The Tragedy of Colossus Medicus

Humans against Humans– The Rise of Governance: legal doctrines,

professional ethics, organizational rules, community norms, etc.

The Best Healthcare in the World?The Best Healthcare in the World?

Technological PromiseTechnological Promise

Clinical IT could remedy…– Geographic inequity– Medical errors– Fragmented case management– Et cetera, et cetera.

E.g.: CPOE could save 3,000 lives and $1 billion annually.

But cornerstone technologies are rarely adopted

Governance ChallengesGovernance Challenges

System Integration– Economics of standardization

System Integrity– Sociology of trust

System Control– Politics of accountability

A Final WordA Final WordHumans Against Selves/Gods?