The Four Pillars of an Integrated Health Care System


In the January/February 2014 issue of Texas MD magazine, Dr. Greg Sheff, Ascension Ascension Seton’s executive vice president of clinical systems, outlines the “four pillars” required to provide patients with the right care, at the right place, at the right time – and for the lowest cost.

Gregory Sheff MD EVP 2013 Executive Vice President of Clinical Systems

Gregory Sheff MD EVP 2013 Executive Vice President of Clinical Systems

By Dr. Gregory Sheff

When it comes to health care, many consumers hear a lot about great physicians, compelling research or cutting-edge clinical therapies.

But advancements that can directly impact most lives are occurring behind the scenes, where providers are working together to create an integrated health care system that provides the right care, at the right place, at the right time and for the lowest cost.

Traditional hospital systems deliver care in specific, yet siloed settings, with minimal coordination and no overall plan for a patient’s health. An integrated health care system breaks down those walls to build a proactive, cohesive continuum of care supported by four primary pillars – teams, information, access and healthy living.

For physicians, nurses and other medical providers to truly be able to listen and connect with patients, we must first be able to listen to and connect with each other by operating as a team.

That means taking an inventory of our facilities, other physicians and community partners across Central Texas; figuring out how these pieces of the puzzle fit together into a single cohesive delivery system; and then investing in the infrastructure that glues those pieces together.

Once that infrastructure is created, information can flow freely within teams, eliminating duplicative and unnecessary costs and allowing teams to work as one in navigating each patient through the continuum of care, leading to more positive outcomes and a more comforting experience for the patient.

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The core component of the integrated health care system is the ability to share data. Through electronic medical records and health information exchanges, we now can quickly determine the correct tests or treatments needed for a patient as well as proactively find and alert patients to potential health risks – and stay in touch with patients who are high risk or have just had a procedure.

This information also makes population health more achievable. Physicians can stay up to date not just with a patient in the office but all of their patients in real time. Providers can analyze the health needs of an entire population to discern overall health trends and which communities need which resources most.

Central Texas is large geographically with a diverse population, so it’s essential that every person has access to the right care at the right time.

Acute care cannot be concentrated in select facilities in Austin; it must be equally accessible across robust, clinically integrated networks throughout Central Texas.

At Ascension Seton, we’ve been exploring ways to use telemedicine and other means to provide all of our services to outlying areas, and are actively involved with Central Health, Travis County’s health care district, to provide high-quality health care to the underserved and under-funded.

The University of Texas at Austin’s new Dell Medical School will also provide access to the latest medical research and talent through its undergraduate education programs.

Healthy Living
With rapid population growth in Central Texas, providers cannot afford to be reactive, interacting with patients only after they are sick.

Just as we are proactively reaching out to patients to alert them to potential health risks, we are reaching out to patients to help them stay well and lead healthy lifestyles.

By initiating wellness conversations with patients outside of the doctor’s office and remaining accessible to the patient through various support systems and programs, we can encourage patients to take a greater role in the decision-making process for their health and practice better self-care.