Obviously, we are seeing a rapid change of the healthcare delivery
system in the United States, and academic health centers must
transform in order to continue to excel in the new environment.
Academic health centers will always excel if we understand what we are
Planning within academic health centers must engage all the different
aspects of the institution because research, education, and clinical care
are highly interdependent. Collective decision-making must be embraced,
and silos must be eliminated. Our institutions must understand their
fundamental strengths and raison d’être. Academic health centers
differentiate themselves from other healthcare providers in several
ways, but notably through the capacity for discovery and excellence in
specialty care. We must not surrender those strengths, and we should
continue to be leaders in those areas, but we also cannot be an Ivory
Tower. Academic health centers must become vertically integrated
organizations that address population health, the continuum of care, and
the fundamental design of healthcare delivery itself. Cost is going to be a
significant area of emphasis, and we need to deliver the best outcomes to
the populations we serve at the lowest possible cost.
The advantage of the academic health center is that we can leverage
tools that no other system can. We can convene leaders from business,
economics, and the behavioral sciences to work with us to create a new
continuum of care. We can bring together a wide range of expertise and
talent from within the academic environment and apply it to all aspects
of patient care. Very few institutions have access to this tremendous
resource. Of course this can help in research and discovery, but other
disciplines can also help us redesign the way we educate and deliver care.
For example, big data and informatics will play an increasingly important
We must challenge our existing paradigm because the world is changing.
role in the way we design and deliver care. Our best chance of success is
to continue to adapt. The world will not be the same forever, and so we
must be resilient and embrace change.
There are always challenges and opportunities. It’s natural for people to
expect business as usual, or that if the present paradigm changes, disaster
will follow. This is why our leaders must be analytic and visionary.
They must have the ability to see the road ahead and to engage their
organizations in comprehensive conversations in order to transform
education, research, and care delivery. They must mobilize stakeholders
at all levels of the institution.
Victor J. Dzau, MD
Institute of Medicine