The academic community has a major role to play in redesigning the
healthcare system and workforce; and they must understand the
importance of interprofessional education and collaborative practice.
Academic health centers should undertake team care both experientially
and didactically, while forming new partnerships with the care delivery
system and its components. Some academic health centers understand
this, but others do not. As a result, the product they’re producing does
not align with the emerging healthcare paradigm, which is a system that
improves population health, engages families and communities, enhances
quality, and reduces cost of care.
Payment systems must also join with care delivery organizations and work
together to educate and train the workforce. Leaders of academic health
centers should engage leaders from the marketplace, and collaborate
to produce tomorrow’s workforce. Presidents, deans, and faculty must
get together and understand what is transpiring in the healthcare
marketplace, and also why they risk losing their relevance. Right now,
retraining time and cost is a major burden for the health system. It takes
2-3 years just to retrain new physicians and allied health professionals
because practitioners require a whole new set of skills in the emerging
paradigm. New graduates must possess some understanding of systems
of care—particularly those systems that are horizontally integrated
with employed physicians, nurses, pharmacists, or other healthcare
professionals.
This will require us to ask some salient questions. What is our role in
the new system? How do we design these new systems of care? How do
we understand the information infrastructure, which is increasingly
important to improving outcomes? How do we use real-time outcome
information on the service line to improve quality, reduce cost, and
monitor outcomes? Right now, our knowledge of informatics is very poor,
and this will need to change.
Interprofessional team concepts are poorly taught within academic health
centers. Graduates of health professions schools really have little idea
what teams are or how teams can achieve outcomes by working together
as equals. At the same time, within the marketplace of health, teams
are already being deployed, and yet there is no agreement on how those
teams should be composed, how those teams should be trained, and
how they should be evaluated, particularly in the context of “triple-aim”
outcomes.
In the future, there will need to be a new kind of relationship between
academic health centers and the marketplace of health. We will need to
work together on issues such as workforce development, curriculum and
experiential education redesign, and new financial models that are winwin
for everyone.
Frank B. Cerra, MD
Senior Advisor,
National Center for Interprofessional Practice and Education
Deputy Director,
National Center for Interprofessional Practice and Education
Former SVP,
for Health Sciences and Dean of the Medical School
University of Minnesota