The need for systems integration in health care.

ROGRESS IN PATIENT SAFETY AND QUALITY HAS BEEN slow, despite increasing recognition of risk across the health care system. Efforts to reduce harm to patients or to improve quality of care often focus on a single, local intervention or a collection of local interventions, usually seeking to improve a single care process. Although valuable, this approach is incremental, resulting inmodest,thoughneeded,improvements.Mostqualityimprovement efforts miss a larger opportunity to improve and redesign the fabric of health care. It appears that a systemsintegration approach that incorporates the fundamental building blocks of health care, from equipment and technologytoclinicalinsightandworkflowprocesses,isneeded