Transitions in Health Care Delivery Discussion Paper

At the core of the value transformation is changing the way clinicians are organized to deliver care. The first principle in structuring any organization or business is to organize around the customer and the need. In health care, that requires a shift from today’s siloed organization by specialty department and discrete service to organizing around the patient’s medical condition. We call such a structure an integrated practice unit (IPU). In an IPU, a dedicated team made up of both clinical and nonclinical personnel provides the full care cycle for the patient’s condition.
—Michael Porter and Thomas Lee

The impact on value of IPUs is striking. With a dramatic contrast compared to regional averages, patients at Virginia Mason’s Spine Clinic miss fewer days of work (4.3 versus 9 per episode) and need fewer physical therapy visits (4.4 versus 8.8).

The shift to value-based health care delivery represents an opportunity to create a more patient-centered organization as well as a more efficient one. Resource limitations and other pressures place a strain on an organization’s ability to change, and organizations respond to these pressures of change differently.

To prepare for this Discussion:

Consider the impact of the transition from volume- to value-based health care delivery in your organization or one with which you are familiar.

Potential transitions to consider may be examples such as the shift from inpatient to ambulatory care, the Patient Centered Medical Home (PCMH) initiative, or the Delivery System Reform Incentive Payment (DSRIP) initiative.

With this in mind, read the Porter and Lee article published in the Harvard Business Review, and compare their strategic proposal with the transition you are considering.

Post a cohesive response to the following:

Describe the nature of the transition in the organization. Discuss and assess how this transition affected operations, based on the organization’s operational resources and limitations. How did the organization respond to the changes? Was the response effective? How does the IPU approach compare to the transition response? Justify your conclusion. Recommend an alternative course of action.