Table 1.

Simple Rules for the 21st Century Health Care System

Current ApproachNew Rule
Source: Crossing the Quality Chasm: A New Health System for the 21st Century.41
Care is based primarily on visitsCare is based on continuous healing relationships
Professional autonomy drives variabilityCare is customized according to patient needs and values
Professionals control careThe patient is the source of control
Information is a recordKnowledge is shared and information flows freely
Decision making is based on training and experienceDecision making is evidence-based
Do no harm is an individual responsibilitySafety is a system property
Secrecy is necessaryTransparency is necessary
The system reacts to needsNeeds are anticipated
Cost reduction is soughtWaste is continuously decreased
Preference is given to professional roles rather than the systemCooperation among clinicians is a priority