The Center to Advance Palliative Care at the Mount Sinai School of Medicine in Manhattan is teaching academic, community and faith-based hospitals how to establish palliative care programs to relieve suffering and improve the quality of life for patients with advanced illness and their families. As a result, the American Hospital Association reports a 90 percent increase in palliative care programs in the past five years;(21) today one in five hospitals has a program.(22) U.S. News & World Report now considers palliative care as a criterion in its annual ranking of the country’s top hospitals.(23) These are significant outcomes for Director Diane E. Meier, M.D., and the Center’s partners.

Transforming Care at the Bedside, managed by the Institute for Healthcare Improvement, is redesigning how hospitals can better meet the expectations of their patients. For example, when a nurse arrives for work at the University of Pittsburgh Medical Center’s Shadyside hospital, the first thing she does is pick up her noncellular, personal phone. Until recently, the prime communications device available to a nurse was her own footpower, as she raced up and down halls to fulfill her job duties. According to the hospital, the use of a personal phone saved each nurse 20 minutes each shift by allowing him or her to immediately respond to issues as they came up. Hospital-wide, this provided $420,000 worth of time that could be diverted back to patient care.(24)

Such successes signal us that enlightened leadership and inspired organizations are discovering new ways to serve patients better, and improve health outcomes and the well-being of entire communities. Now the question is: How will we know when the new ways of doing business are really working? The answer: We will know because tomorrow will be profoundly different from today. We’ll see the differences in both big and little ways.

For example, today, our care is based on office visits. Tomorrow, our care will be determined by what kind of care we need, when we need it and how we need it—in the office, on the phone or over the Internet.

Today, the autonomy of the professionals rules our care. Tomorrow, it will be our needs, values and choices as patients that predominate. And we will have all the information necessary as patients to make the right choices.

Today, our medical and health care information is for others to know and for us to wonder about. “Knowledge is power” and much of the knowledge about us is kept secret from us. Tomorrow, no more secrets; knowledge will be a power tool that is shared freely. We’re finally going to know as much about our health care as the system knows so we’ll be able to make informed health care decisions for ourselves and our families.