Interprofessional…Not a Buzzword, Not an Option

Happy New Year!! In this newly minted year 2014, we find ourselves grappeling with the national implementation of healthcare reform. With each passing day, we are exposed to previously unforseen realities necessary to administer this new national model of healthcare to patients. More importantly, many paradigms that have been in existence for decades-and in some cases centuries- are readily transforming right before our eyes. I encountered several events in the past 60 days that have confirmed for me the inevitabilities that I foresaw as far back as 2007…that interprofessional collaborations will absolutely be necessary to provide healthcare to larger numbers of patients, while substantially improving the health of communities.

In recent meetings with the executive leadership team of USF Health and external healthcare executives, the interim dean for the USF Morsani College of Medicine, Dr. Harry Van Loveren, has made bold public proclamations. They have been among the most assertive I have witnessed in such settings.  He stated on several occasions that the current healthcare system must begin to allow the most appropriate clinicians to engage patients in order to provide the care they need, “regardless of that clinician’s ability to bill for the service.” I have rarely heard this publicly from a physician, especially a physician specialist; privately I hear it all of the time.  I echoed his comments, with the understanding that our health systems must move towards value-driven care models with shared risks between the health system(s) and the payers.  In this fee-for-value system, improved patient outcomes trump an individual clinician’s ability to simply bill for services rendered. In this model, multiple clinical professionals come together to surround and provide each patient with the ideal care they need to achieve the best possible health outcome for that patient.  In these value-based systems, we strive for optimum population-health, one patient at a time.

USF Health is a very unique clinical environment, even by today’s standards for health science centers.  We have attempted to create a clinical and educational environment that unifies the talents and ambitions of all health professionals for the purpose of improving healthcare and safety for patients. The cultural change that has been required for this transformation has been enormous, but necessary and worthwhile.  We now find ourselves yearning for a truly integrated USF Health community, coalescing the educational, research, clinical, cultural, and administrative missions to create a high functioning, very efficient environment.

The healthcare arena is also yearning for this integrated model.  In a blog posted by the American Society of Health-Systems Pharmacists Executive Vice-President Paul Abramowitz, authors in an article published by Health Affairs stated that “pharmacists belong in Accountable Care Organizations and integrated care teams.” The authors very elegantly articulate the value of pharmacists on integrated healthcare teams; I can make the same assertion that this holds true for numerous health professionals, including public health clinicians, health coaches, and social workers. This was recently supported by Tom Frieden,  Director of the U.S. Centers for Disease Control and Prevention, in a recent Q & A stating the role of public health in clinical care.    In an at-risk financial health model, we believe that having these integrated teams will significantly reduce the amount of financial waste in the system, while producing improved health outcomes.

We must change how we train health clinicians.  The obstacles that exist in our curricular-driven academic models must be overcome. Ingenuity and innovation must overtake tradition and convenience.  In a blog posted by Dr. Stephen Klasko, president of Thomas Jefferson University,  he challenges the lack of educational transformation in our health academic institutions. Many will disagree with him; I happen to disagree with those that disagree!  And, the health industries are agreeing with me, one exec at a time.  With health reform now here, regardless of the politics, it is time to create integrated models of care. Here in the USF College of Pharmacy and USF Health, we are attempting to aggressively push those boundaries, while maintaining academic and clinical integrity.  Our destination? Successful interprofessional collaborations. Patients are waiting!

There is no more time to ponder whether interprofessional care teams should occur; patients deserve our best. As I would post on twitter: #ThinkInterprofessional #ThinkTeam #LetsMakeItHappen

Twitter – @KevinBSneed ; @futuristpharmd

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