The Integrated Clinical Enterprise

Ben Boulden

Stack of books with stethescope

In an effort to further enhance health care delivery,  UAMS has become one of the first academic health centers in the nation to adopt a new system of care aimed at improving the patient experience while creating new efficiencies.

The Integrated Clinical Enterprise has changed the relationship between UAMS Medical Center and the faculty physicians in its College of Medicine, strategically aligning them in support of the triple aim of better patient care and improved patient experience, improving the health of populations and decreasing the cost of care.

The Institute for Healthcare Improvement developed the triple aim concept as an approach to improve health system performance.

As part of the new UAMS Integrated Clinical Enterprise, patient care has been reorganized into patient-centered service lines so everyone involved in the care of patients is part of a defined service line team. “The initiative makes it easier for all of us to pull  in the same direction,” said Roxane Townsend, M.D., vice chancellor for Clinical Programs and UAMS Medical Center CEO. “No longer is a difficulty just the physician’s problem or the hospital’s problem; we share that responsibility together for the patient.”

Julie Moretz, UAMS associate vice chancellor for patient- and family-centered care, said patient experience and quality of care go hand in hand. The service line concept means fewer bumps in care from the front desk to the clinic to billing.“That means patients and families can expect the same level of service across different areas of care,” she said.

The Integrated Clinical Enterprise departs from the traditional academic health center model in which patient care is organized in alignment with its academic departments. That system distributed responsibility for patient care to dozens of departments and divisions such as internal medicine, nephrology, surgery, neurology and orthopaedics.

As part of the Integrated Clinical Enterprise, 15 areas of care at UAMS have been reorganized into service lines that cross departments. They are: women’s services, behavioral health,

primary care, cancer, multiple myeloma, neurosciences, surgical specialties, medical specialties, musculoskeletal, emergency medicine, imaging, pathology, interventional care, pharmacy, and therapeutics and nursing.

“UAMS has historically beaten the national average for overall patient satisfaction scores,” Townsend said. “But, we want to continue to improve the patient experience and push those numbers higher. With these new service lines, UAMS will better coordinate patient care while better controlling costs and strengthening communications in all areas.”

Although clinical care is shifting away from an academically aligned model to one that is more robustly patient-centered, educating health providers remains a central mission of UAMS.

As part of the Integrated Clinical Enterprise, 15 areas of care at UAMS have been reorganized into service lines that cross departments.

“Service lines enhance education at UAMS,” said College of Medicine Dean Pope L. Moseley, M.D. “Students aren’t just exposed to interdisciplinary and interprofessional concepts in the classroom. In this clinical environment, they work with individuals in multiple specialties and health care professions. Students learn how the whole team works together to provide the very best care.”

Educating students of medicine, nursing, pharmacy and other health professions to work in teams is preparing them to work in the kind of team-based clinical care that is a part of the Integrated Clinical Enterprise. That means those team members are communicating with each other and the patient instead of communicating through the patient. Together the care team can engage patients and families in preventive services, promote and reward healthy behaviors and support chronic disease management in ways that improve public health overall and reduce health care costs in the long term.

Moseley said College of Medicine department chairs and faculty recognize the importance educationally and financially of finding new efficiencies that support the educational mission. The chairs remain as the leaders of the faculty, evaluating performance and continuing to engage in all three parts of UAMS’ mission: educating health professionals, scientific research and clinical care.

The university’s senior leadership has been unanimous in its support for the new service line reorganization, making it easier to get the effort off the ground.

As Moseley joined UAMS in July while the change was getting underway, preparation and planning for the new service lines began with his predecessor, G. Richard Smith, M.D.

“The best example of this spirit of collaboration is the fact that Dean Smith and I truly took the door down between the College of Medicine and the hospital and we’ve started acting like a single unit,” Townsend said.

Moseley said UAMS is among the first of academic health centers nationwide to organize along the service line model. In the next 10 years, he expects 50 percent or more will be.

“It’s the reason I took the job,” he said. “It’s an unusual opportunity to participate in a real transformation of an academic medical center. That’s the attraction.”