title: Emerging perspectives on transforming the healthcare system: key conceptual issues.
abstract: BACKGROUND
  Despite reform efforts, today's healthcare system faces multiple challenges. Limitations of the current system result in major gaps between evidence and practice, suboptimal quality, inequitable patterns of utilization, inadequate safety and reliability, and unsustainable cost increases. Furthermore, there are major problems of overuse, underuse, and misuse of healthcare. Beyond the healthcare reform legislation passed in 2010 mandate, major transformation of how U.S. A healthcare system is comprised of multiple levels.
  
  
  OBJECTIVE
  This article briefly outlines the need for transformational change in healthcare and key conceptual issues.
  
  
  METHODS
  We identified literature and concepts relevant to developing a research agenda on transformational change in healthcare. Relevant concepts were further developed through conference presentations and discussions.
  
  
  CONCLUSIONS
  This introduction to the 10th Regenstrief Conference proceedings provides a foundation for understanding key terms, questions, and concepts relevant to the area of transformational change in healthcare.
authors.affiliation: VA Health Services Research and Development Center on Implementing Evidence-based Practice, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA. bdoebbel@gmail.com
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
authors.forename: Mindy E
authors.initials: ME
authors.lastname: Flanagan
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration* / Q000639:trends; D018166:Health Care Reform / Q000458:organization & administration* / Q000639:trends; D006284:Health Plan Implementation / Q000458:organization & administration* / Q000639:trends; D006293:Health Promotion / Q000458:organization & administration; D006301:Health Services Needs and Demand / Q000458:organization & administration* / Q000639:trends; D006801:Humans; D009310:National Health Insurance, United States / Q000639:trends; D011785:Quality Assurance, Health Care / Q000458:organization & administration* / Q000639:trends; D014481:United States