America's Healthcare Transformation, Edited by Robert A. Phillips. pp. 1-376, Rutgers University Press.

America's Healthcare Transformation edited by Robert A. Philips, Executive Vice President and Chief Medical Officer of Houston Methodist, claims that we are in the midst of a fundamental transformation of the practice of medicine and the $3 trillion annual health care industry. Indeed, this claim is persuasively and seamlessly documented by the contents of the book describing 5 domains: patient safety and quality; health care delivery redesign; emerging paradigms in the practice of medicine; health care delivery reform; and the patient experience.

This book is being reviewed in the Journal of Public Health Management & Practice for those interested in the changes undergoing in our health care system. It illustrates the contributions of public health to this transformation and conversely the innovations described if adopted for public health delivery.

The chapter "Use of Registries and Public Reporting to Improve Health Care" is an excellent example of this. Similar to the reporting of public health outcomes, public reporting of health care can be misleading without appropriate clinical and demographic variables adjusting for risks. A prime example used in this chapter is the New York State Cardiac Surgery Reporting System. The authors reference the exemplary work of Ed Hannan, formerly of the New York State Health Department and now on the faculty of the University of Albany School of Public Health.

I would hope this chapter leads one to read more of this important story, which is essentially a public health saga. In 1988, the late and innovative New York State Health Commissioner Dr David Axelrod was concerned about the 5-fold variation in hospital mortality for coronary artery bypass surgery. Because of problems with the previous Health Care Financing Authority mortality studies, the New York State Health Department developed a new registry that included adjustment for patient risks and demographics. In-hospital mortality decreased from 3.52% in 1989 to 2.78% in 1992.1

Others chapters include "Organizing Performance Management to Support High-Reliability Health Care" and "Elimination of Unintended Variation in Clinical Care." Methods are outlined to reduce quality and safety problems in health care by adopting lessons from "high-reliability" industries such as commercial and military air transport. Systems are described to eliminate unnecessary variations in health care. These topics have obvious parallels in public health where efforts are needed to decrease variation in services, upgrade quality, and measure performance.

The nexus between public health and health care delivery (primary care) has been the subject of increasing interest sparking an ASTHO (Association of State and Territorial Health Officials) task force and the 2016 publication of the Practical Playbook by de Beaumont Foundation, Duke University, and Centers for Disease Control and Prevention, also reviewed in this journal.

-Lloyd F. Novick, MD, MPH

Editor

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