Tell us about your main areas of research
“My major focus has been on the impact of delivery innovations in health care. Specifically I have looked at a wide range of innovations ranging from retail clinics, e-visits, e-consults, telemedicine, and nurse-managed health centers, and their impact on costs, quality, and access to care.”

What are the main driving forces behind the development of new delivery solutions in modern health care?
“I believe there are three major drivers in the US. The first is that we have large areas in the US where there are simply not enough providers. The second is a desperate need to reduce health care spending and the hope is that these innovations can “bend the cost curve.” The third is that many of our patients with chronic illness suffer unnecessarily from preventable chronic illnesses. The hope is that these delivery innovations can lead to improved care.”

Can you give us an example of innovation within delivery that has led to a positive impact on either quality, costs or access in today’s healthcare?
“In the US telemedicine is beginning to gain traction and for many of our patients who live in rural areas or areas with few providers, we find that they receive care for mental illness and dermatology care.”

What are the greatest obstacles to innovations within delivery in the healthcare sector?
“The key barrier is how to introduce this care in a cost-effective manner. Let us take the case of dermatology care. If we offer dermatology care to the entire nation, many people who have minor rashes will seek care. This low-value care simply increases health care spending. At the same time, many people who have severe skin conditions will also now seek care. This high-value care will improve illness and allow people to live healthier lives. How do we offer the service in a manner that increases the use of high-value care, but not low-value care?”

Finally, what do you think will be the next major innovation to fundamentally change delivery systems within healthcare?
“I am most enthusiastic about e-consults. E-consults are a fundamentally new way of providing specialty care. Currently, anytime a patient needs specialty input they need to see the specialist in person. Under e-consults we triage the patient’s need appropriately which I believe improves care and could decrease costs.”

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