In the fall of 2016, we participated in the Jewish Healthcare Foundation’s Jonas Salk Fellowship and were challenged to design a healthcare system from scratch.
As a team of six members from diverse health-related disciplines, ranging from health informatics and biomedical engineering to administration, patient care, and policy, each of us brought to the table a different perspective of the system we wanted to improve. After weeks of learning about the intricacies of healthcare from leaders in the field and site visits, we formulated our vision of a health system and proposed it to a panel of regional experts.
In our utopian healthcare system, being part of the community means that you are part of the healthcare system. We consider health care as a basic human right. The emphasis is first on the proactive support of good health and wellness, and second, on the delivery of reactive medical care.
The core component of our model is the creation of community health centers in which each community has its own unique health system. This decentralization of management and operations enables each community health center to attend to the specific needs of its community and people. Within this decentralized organizational structure, some aspects are consistent throughout, such as the system’s funding mechanism in which each member of the community pays a “health tax.” This closely resembles how local property taxes help pay for public schools. Our model harnesses the value of competition by allowing people to vote with their feet—and with competition comes better products and cost containment.
Another essential component of our system is the healthcare team. The core members of the team include a health coach who acts as the primary point person for each patient and coordinates care among the rest of the team, medical professionals, a behavioral specialist, a pharmacist, and a social worker. The patient is at the center of the healthcare team, while each team member’s unique role promotes comprehensive care to meet the diverse needs of the patient.
We believe in the value of continuous evaluation to achieve optimal outcomes. No one knows the problem areas better than those who directly engage with the system on a daily-basis. In line with this, in our model, there are bi-weekly town hall meetings during which the top administrators have the opportunity to hear feedback from both the members of the community and the healthcare teams in order to continually improve the system.
Moreover, we feel that timely adaptation is key to addressing the needs of patients as efficiently and effectively as possible, especially when it comes to adopting new technologies that are safe, secure, and can improve the way healthcare services are provided. In our model, through a fingerprint recognition system, each person’s electronic health record is connected to a completely interoperable digital data repository and management network. Within the network, patients are able to view their records, communicate with their health coach, and even see health care providers through online medical visits. De-identified patient data, such as genomic data, treatment history, and outcomes, are also collected through the system. This allows for advanced health informatics tools to, for instance, recognize effective treatment patterns and help inform diagnosis and clinical care. An interoperable and standardized data collection and resource utilization system also ensures effective and timely action in case of public health emergencies, and facilitates the general improvement of national health and healthcare.
Our utopian health system strives to support patients on the individual level through effective team-based care while incorporating advances in technology to maintain the health of both patients and communities as a whole.
What is your vision of an ideal health system?
We would like to thank our Salk Fellowship group members, Joyeeta Dutta-Moscato, Brian McWilliams, Hanna Morris, and Sarah Robb, for all the expertise and hard work they put into this project to help articulate our ideal health system.