Health Systems Innovation at Academic Health Centers: Leading in a New Era of Health Care Delivery.
Challenged by demands to reduce costs and improve service delivery, the U.S. health care system requires transformational change. Health systems innovation is defined broadly as novel ideas, products, services, and processes-including new ways to promote healthy behaviors and better integrate health services with public health and other social services-which achieve better health outcomes and/or patient experience at equal or lower cost. Academic health centers (AHCs) have an opportunity to focus their considerable influence and expertise on health systems innovation to create new approaches to service delivery and to nurture leaders of transformation. AHCs have traditionally used their promotions criteria to signal their values; creating a health systems innovator promotion track could be a critical step towards creating opportunities for innovators in academic medicine. In this Perspective, the authors review publicly available promotions materials at top-ranked medical schools and find that while criteria for advancement increasingly recognize systems innovation, there is a lack of specificity on metrics beyond the traditional yardstick of peer-reviewed publications. In addition to new promotions pathways and alternative evidence for the impact of scholarship, other approaches to fostering health systems innovation at AHCs include more robust funding for career development in health systems innovation, new curricula to enable trainees to develop skills in health systems innovation, and new ways for innovators to disseminate their work. AHCs that foster health systems innovation could meet a critical need to contribute both to the sustainability of our health care system and to AHCs' continued leadership role within it.
A.L. Ellner is associate physician and assistant professor of medicine, Division of Global Health Equity, Brigham and Women's Hospital, and codirector, Harvard Medical School Center for Primary Care, Boston, Massachusetts. S. Stout is director, Harvard Medical School Center for Primary Care Innovation Fellows Program, and executive external lead for health improvement, Institute for Healthcare Improvement, Boston, Massachusetts. E.E. Sullivan is research and curriculum director, Harvard Medical School Center for Primary Care, Boston, Massachusetts. E.P. Griffiths is a medical student, University of California, San Diego School of Medicine, San Diego, California, and a master of public health candidate, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. A. Mountjoy is a medical student, University of California, San Diego School of Medicine, San Diego, California, and a master of public health candidate, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. R.S. Phillips is director, Harvard Medical School Center for Primary Care, and William Applebaum Professor of Medicine, Harvard Medical School, Boston, Massachusetts.
Andrew L
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Ellner
Somava
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Stout
Erin E
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Sullivan
Elizabeth P
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Griffiths
Ashlin
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Mountjoy
Russell S
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Phillips
D000046:Academic Medical Centers / Q000458:organization & administration*; D003479:Curriculum; D003695:Delivery of Health Care / Q000458:organization & administration*; D019033:Delivery of Health Care, Integrated; D018166:Health Care Reform / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D009936:Organizational Innovation; D017712:Peer Review, Research; D058996:Quality Improvement; D014481:United States