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One Doctor's Plan to Overhaul Primary Care

This blog post excerpts an article featuring Dr. Rushika Fernandopulle, co-founder of Iora Health, from the Winter 2015 issue of HealthStream's PX Advisor, our quarterly magazine designed to bring you thought leadership and best practices for improving the patient experience.

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Dr. Rushika Fernandopulle, co-founder of Iora Health, says health coaches have the power to heal the delivery system. 

After spending a decade working to improve how primary care is delivered, Rushika Fernandopulle, MD, a primary care internist, and CEO and co-founder of Iora Health, had a breakthrough—if he wanted something better than a seven-minute visit with his patients, incremental fixes would no longer work. It was time to start over from scratch. “I’ve been working on this long before it was fashionable to think about primary care,” says Fernandopulle, who helped design a team-based care model that deploys health coaches to handle the majority of patient interactions. “As a doctor, I’m trained to diagnose and treat,” explains Fernandopulle, who was executive director of the Harvard Interfaculty Program for Health Systems Improvement. “While that’s important, the big gap in our healthcare system is how do you execute on that when you see patients with diabetes, for example, a few minutes every three months? It’s silly to manage people that way when there are a thousand things the patient needs help on,” he adds.

Coaching Beyond the Telephonic Model

Based in Cambridge, MA, Iora Health was started in 2011 to build a new model of primary care from the ground up, and now serves close to 10,000 patients in 11 primary care practices across six states. From the beginning, Fernandopulle had four key goals: create a better experience for patients, create better outcomes, lower costs, and improve the experience for healthcare workers. Fernandopulle is quick to point out that the health coach model is different than disease management programs in which nurses in a call center monitor patients. Rather, a health coach meets face-to-face with patients to help improve their health and welfare. “We need human beings who can answer questions, hold people’s hands when that’s the right thing to do, and kick them in the behind when that’s the right thing to do,” says Fernandopulle. “We realized that the coaches don’t need to be nurses. The only thing you really need to have is good interpersonal skills like empathy, because we can teach everything else.” 

This article also includes:

  • How to flip a pyramid and put the patient in charge
  • Building a case for value in primary care
  • Iora Health Case Study: How to Be the Right Patient Partner

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