Fast forward: a blueprint for the future from the Institute of Medicine.

A newly released report from the Institute of Medicine outlines an ambitious program for changing the direction of U.S. health care. Crossing the Quality Chasm: A New Health System for the 21st Century recommends switching health system priorities from predominantly acute care treatment to focusing on chronic medical conditions. The report also recognizes 15 conditions that it says should take priority for funding and support from all health care agencies. Evidence-based medicine must be fostered and the entire fabric of medical care must become more patient-centered. The IOM report proposes six aims for our 21st Century health care system. The system we should strive for needs to be: (1) safe; (2) effective; (3) patient-centered; (4) timely; (5) efficient; and (6) equitable. This article looks at some of the IOM recommendations and analyzes their strengths and weaknesses. Ultimately, the report advocates an environmental restructuring of health care in the United States.