Transformational Systems Strategy

Health care is getting crowded — Big Tech and health IT start ups are muscling their way into the field, and transforming patients into consumers. Additionally, CMS is pushing payor models towards capitated payments, influenced by quality metrics and good patient outcomes. Yet other entrants are realizing this through ownership of both provider and payor side care delivery. All this is happening as health systems are squeezed for labor and space.

In this environment, patients have choice. Existing health systems require investment in digital front doors to improve access and must focus on patient throughput to free-up existing resources. How can they serve the most patients safely, comprehensively, and efficiently? New market entrants are carving their niches, largely in the outpatient setting — start-ups that focus on just in-home care, mental health virtual care, and more abound. This provides existing healthcare systems a unique advantage; by virtue of already built ambulatory, acute, and post-acute facilities, it can provide the comprehensive wrap-around services that start-ups may not.

This scenario is where primary care trained physicians hold the biggest advantage in facilitating transformational systems change. Primary care trained physicians, especially full/broad spectrum ones, have the largest experience in the health care landscape because their touchpoints at every care stage. In residency, I provided continuity care in patients’ own homes, the clinic, in nursing homes and skilled nursing facilities, urgent care, on the pediatric and adult medicine floors, the ICU, and the labor floor. That scope carries inherit knowledge of systems traits that affect care, influence patient outcomes, and, with intimate knowledge of the patients themselves, provides all this at affordable costs.

Now give that primary care physician training in business strategy, team building, workflow assessment, and health technology, and you have a clinical informaticist who can inform leadership’s vision effectively, or lead themselves. Primary care physicians, together with clinical informatics, (or ideally two-in-one) is a potent combination for a health system to facilitate its sustained growth in this changing field, while preserving patient outcomes.