One of the least publicized features of President Bill Clinton's Health Security Act is Section 5008, which provides for regional professional foundations (RPFs), consortia of practicing physicians, academic health centers, medical schools, schools of public health, and other professional organizations. The tasks of the RPFs are to develop programs in professional lifetime learning; to foster collaboration among health plans and health care providers within a region to improve the quality and appropriateness of medical care; to participate in outcomes research; and to develop innovative ways to increase patients' participation in their choices of medical care. RPFs also are asked to ensure the timely dissemination of information about quality improvement programs, practice guidelines, research findings, and ways of using health professionals most effectively.We believe that RPFs can fill a gap in programs for assuring quality of care and for improving the scientific and ethical basis of clinical decision making. An innovative, patient-centered health system depends on learning what works and what patients want and on empowering providers to adapt to change. RPFs can build the knowledge needed to improve health care. This Commentary explains how RPFs can enhance innovation and improve quality of care and makes suggestions for their implementation.
Conceptual FrameworkPopulation-based, regional focus. The principal advantage of RPFs is their population-based focus on building a professional infrastructure for quality, outcomes research, and lifetime learning in local communities and regions. The local and regional focus is important because the health care industry also is localized in its organization. In addition, there are extensive variations in practice style among communities within regions. A population-based focus would provide increased knowledge of the illness burden of
John Wennberg is director of the Center for the Evaluative