In the United States there are up to 400,000 unintended patient deaths every year. Additionally, receiving healthcare is the third leading cause of death in the country. The Institute of Medicine established a goal that by 2020, 90 percent of all healthcare decisions would be evidence based. Today, only 30 percent of decisions are evidence based, which has led to patients receiving roughly 55 percent of the care that they require when entering the current healthcare system.