Technologies of health policy.

Major factors in adoption of new national health policies include (1) a crisis or perceived opportunity; (2) a persuasive diagnosis of what is needed; (3) a prescription for new policies; and (4) new technologies that are ready to go. The past twenty-five years illustrate that the development of new policy ideas to where they can be implemented as major nationwide reforms can take a decade or more. Many national policy ideas for evidence-based medicine--such as electronic health records, rapid-learning networks, predictive modeling, Medicare/Medicaid disease management, widespread pay-for-performance, and large consumer-information databases--are in a development phase.