Healthcare is undergoing a profound transformation. Traditional care models are shifting from doctor-centric to patient- centric. Patients are now savvy health consumers who are not only interested in quality care, but convenience as well. They expect expanded office hours, on call service 24/7, patient portals for email communication, online booking of appointments, and newly emerging services such as e-visits. Also, the new health consumer wants transparency about the cost, quality, and safety of the care that they will receive.
From the caregiver's perspective, healthcare is changing from a focus on sick care to an emphasis on prevention, wellness, and chronic care management. Care will also be more coordinated and integrated. A more long-term trend will be the shift from evidence-based guidelines to personalized 'precision' medicine based on an individual's genetics.
Lastly, healthcare reimbursement is also experiencing reform; we are in a transition from traditional fee-for-service (e.g. payment per visit) to fee-for-value (e.g. payment for quality). These new value-based models incentivize delivery of quality care to our whole patient population and create opportunities for innovation, such as population health management strategies.
In order for Middlesex Health System to endure these stormy times, and thrive in our competitive healthcare market, we must have some guiding principles—an ethical compass perhaps. I propose we adopt Dr. Donald Berwick's famed 'Triple Aim' of providing better quality care, with a better patient experience, at a better cost, but also include one additional goal. Dr. Rishi Sikka, in a recent British Medical Journal, adds a fourth aim of improving the experience of providing care for the caregivers (from administrative staff to nurses to doctors).
The time has come for our health system to embrace the Quadruple Aim. It will unify our efforts to provide high quality consumer- oriented care and ensure joy and meaning in our daily work.