The Committee on the Roles of Academic Health Centers in the 21st Century convened in November 2001 with the charge of examining the current role and status of academic health centers (AHCs) in American society; anticipating intermediate and long-term opportunities and challenges for AHCs; and recommending to the AHCs themselves, to policy makers, to the health professions, and to the public, scenarios that might be undertaken to maximize the public good associated with these institutions. Technological, demographic, social, and economic trends will have a significant impact on the roles performed by AHCs. The committee believes that changes will be required in each of those roles if AHCs are to continue to meet the public's needs in the coming decades.

Contents

• THE NATIONAL ACADEMIES
• COMMITTEE ON THE ROLES OF ACADEMIC HEALTH CENTERS IN THE 21ST CENTURY
• REVIEWERS
• PREFACE
• ACKNOWLEDGMENTS
• EXECUTIVE SUMMARY
  • ABSTRACT
  • RECOMMENDATIONS
• Chapter 1. INTRODUCTION
  • Definition of an Academic Health Center
  • A BRIEF DESCRIPTION OF AHCS
  • STUDY FRAMEWORK
  • STUDY PROCESS
  • ORGANIZATION OF THE REPORT
• Chapter 2. FORCES FOR CHANGE
  • THE CHANGING ENVIRONMENT AND THE NEED FOR NEW CAPABILITIES
  • CHALLENGES TO CHANGE WITHIN AHCS
• TRANSFORMING THE ROLES OF AHCS
  • Chapter 3. THE ACADEMIC HEALTH CENTER AS A REFORMER: THE EDUCATION ROLE
    • NEED FOR NEW APPROACHES TO PROVIDE NEW SKILLS
    • FACTORS THAT AFFECT THE ABILITY OF AHCS TO REFORM EDUCATION
    • IMPLICATIONS FOR THE FUTURE
  • Chapter 4. THE ACADEMIC HEALTH CENTER AS A MODELER: THE PATIENT CARE ROLE
    • THE NEED FOR NEW MODELS OF CARE
    • CONTRIBUTIONS OF AHCS TO PATIENT CARE
    • CHALLENGES TO AHCS IN DESIGNING BETTER MODELS OF CARE
    • IMPLICATIONS FOR THE FUTURE
  • Chapter 5. THE ACADEMIC HEALTH CENTER AS A TRANSLATOR OF SCIENCE: THE RESEARCH ROLE
    • CREATING AND APPLYING THE SCIENTIFIC EVIDENCE BASE FOR HEALTH
    • WORKING ACROSS THE CONTINUUM OF RESEARCH
    • IMPLICATIONS FOR THE FUTURE
• CREATING AN ENVIRONMENT FOR INNOVATION
  • Chapter 6. THE CONSEQUENCES OF CURRENT FINANCING METHODS FOR THE FUTURE ROLES OF AHCS
    • CURRENT STATUS OF FINANCING CLINICAL EDUCATION, RESEARCH, AND PATIENT CARE IN AHCS
    • OBSERVATIONS REGARDING CURRENT FINANCING METHODS AND AMOUNTS
    • FUTURE CONSEQUENCES OF CONTINUING CURRENT FINANCING METHODS
    • POLICY OPTIONS
    • IMPLICATIONS FOR THE FUTURE
  • Chapter 7. EXPECTATIONS FOR THE AHC OF THE 21ST CENTURY
    • TRANSFORMING THE ROLES OF THE 21ST-CENTURY AHC
    • RECOMMENDATIONS
  • Chapter 8. CREATING SYSTEMS FOR CHANGE IN AHCS
    • Utilizing Information and Communications Technology
    • Establishing and Measuring AHC-wide Goals for Change
    • Leadership for Strategic Change Throughout the AHC
• REFERENCES
• Appendix A ACADEMIC HEALTH CENTERS: ALL THE SAME, ALL DIFFERENT, OR…
• Appendix B COMMITTEE ON THE ROLES OF ACADEMIC HEALTH CENTERS IN THE 21ST CENTURY

This study was supported by Contract No. 01-267 and 20010609 between the National Academy of Sciences and The Rockefeller Brothers Fund, with additional support from The Commonwealth Fund, the Institute of Medicine, and the National Research Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.