Imagining the World Anew: Iora Health’s COVID-19 Response

  • Arundhati Roy
  • Re-organize around populations and not practices. We used to think about care structured around a physical practice, and created staffing models and workflows largely around this. Now we think of small flexible teamlets- a doctor or NP, along with two health coaches building a relationship and taking responsibility for a small fixed population.
  • Meet patients where they are. Instead of this team sitting in a practice and making the patients always come to them, they can interact with patients in a variety of ways, based on patient need and preference. We still feel strongly there is a role for meeting in person to build the relationship, for certain clinical encounters where laying on of hands is important, and for some serious conversations but for most other things email, text, or video can work better. When we first reacted to COVID we likely swung too far, only having 8% of our synchronous encounters be in person. We are already at 16%, and think the right amount will likely settle somewhere closer to 20–30% for our population.
  • Centralize the right set of services. We believe there are a set of things we do which do not depend on a direct relationship with the patient and these are best taken off the plates of our clinical teams and centralized and eventually automated as best we can. We are starting with processing faxes (it is amazing to us that in 2020 we are still getting over a half a million faxes a year!), and moving on to record requests and other such functions. Note we are not centralizing things where we think relationship matters, like requests to schedule a visit which are actually requests for care and thus the team that knows the patient best can best respond to their needs in a flexible and appropriate way.
  • Create the right sort of technology to augment care. We believe there are many workflows in primary care, such as medication management and chronic disease care, which can be helped with better technology. Note this is not what current Electronic Health Records do — they simply record care and help bill more; we need a new set of tools to optimize care. We need these to help patients and care teams improve self efficacy, not replace it.

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Rushika Fernandopulle is a practicing physician and co-founder and CEO of Iora Health, a venture backed, national de-novo primary care group based in Boston MA.

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rushika fernandopulle

rushika fernandopulle

Rushika Fernandopulle is a practicing physician and co-founder and CEO of Iora Health, a venture backed, national de-novo primary care group based in Boston MA.

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