One year following its creation, Harvard’s burgeoning Center for Primary Care convened over 400 thought leaders, faculty, practitioners and students from the Harvard Medical School community and beyond to explore innovation and creative solutions to the crisis in primary care.
With practitioners, policy experts and others from across Greater Boston, and reaching as far as Group Health Research Institute in Seattle, Washington and Stanford University Medical School, the Oct. 13 Primary Care Innovations Conference marked the Center’s first major event to bring together thought leaders from around the country to examine primary care innovation. Previous events at the Center gathered members of the HMS primary care community and its affiliates to foster collaboration, strengthen education, and reinforce local and national efforts in primary care.
“We are in an era where the demands on efficiency will be unprecedented,” Harvard University Provost Alan M. Garber, a health care economist and until recently a practicing physician, told the capacity audience in Harvard Medical School’s Joseph B. Martin Center. “The kinds of innovations that will be rewarded are those that make care dramatically more effective and dramatically less costly.”
To cultivate such innovations, the Center for Primary Care was founded in 2010 on the recommendation of a working group appointed by Jeffrey S. Flier, dean of the Faculty of Medicine. “Of all that I’ve had the chance to do in four years, there’s nothing I’m more proud of than this Center,” Flier told the crowd.
Two keynote speakers addressed the scope of the crisis in primary care and the need for innovative solutions.
Arnold Milstein, director of the Stanford Clinical Excellence Research Center, began by quoting Warren Buffet, who has called health care a “tapeworm eating at our economic body.” In the face of that threat, Milstein said, quality primary care offers a bulwark against expensive health crises.
“Primary care innovators are best positioned as near-term national rescuers.” Milstein said.
To effect that rescue, Milstein said, practitioners must learn from the great innovators across many disciplines. Primary care innovators will succeed only to the extent that they break out of their circles and immerse themselves in varieties of innovation models.
He described himself as a “talent scout” seeking the very best models of primary care, detailing practices that had managed to optimize care and lower costs through team-based care, strong relationships with both patients and their families and caregivers, and creative payment structures including health insurance by the medical practice itself.
“It’s not about eureka moments,” Milstein said. Innovation comes from “ordinary people like us who take the time to look at great accomplishments done by others.”
Robert Reid, Associate Medical Director for Health Services Research & Knowledge Translation at Group Health Cooperative in Seattle, delivered the second keynote address.
“Failure of innovation is not in the innovation itself, but in failure to deploy,” said Reid, describing how his organization has worked to create a medical home, a comprehensive approach to primary care that fosters partnerships between patients and their providers to coordinate all aspects of care.
Five years ago, Reid’s organization began its prototype medical home. By lengthening appointments, assembling teams of physicians, enabling electronic communication between doctor and patient, and rewarding quality of care rather than patient volume, measures of patient care improved—for example, ER visits dropped 39 percent—while doctor and staff burnout decreased.
During breakout sessions, conference attendees explored a host of different innovative approaches to enhancing and redesigning primary care.
“The talent, energy, and promise from the primary care community was palpable,” said Jill Bassett, executive director of the HMS Center for Primary Care. “We were thrilled to have the opportunity to bring together health care professionals from multiple disciplines, professions and over 50 different entities to celebrate the role of primary care and move the field forward. We look forward to working together to accomplish great things.”
Andrew Ellner and Russell Phillips, interim co-directors of the Center, are also primary care physicians at Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, respectively. “This conference was an extraordinary event for our community—a chance to share ideas, vision and optimism,” Ellner said. “It provided many vivid examples of the type of innovations and improvements that we hope to help catalyze in our own backyard and far beyond.”
Added Phillips, “The conference was a celebration of the importance of primary care, the necessity for innovation, and the capability of our community to help lead that innovation.”
