Seeking to reinvent primary care, Iora Health to open Boston area medical practice

Iora Health, a Cambridge startup aiming to “reinvent primary care” with a novel model for payment and delivery of care, plans to open its first Boston area primary care practice at the start of 2013, CEO Rushika Fernandopulle said in an interview.

The practice will include two sites, at the Lahey Clinic in Burlington and at the Dorchester headquarters of the New England Regional Council of Carpenters, Fernandopulle said. The 20,000-member union is initially sponsoring the new practice for use by a portion of its members, he said.

The practice will follow the model of Iora Health’s two existing primary care practices, which opened early this year in Las Vegas and Hanover, N.H. The model focuses on spending more on primary care, with the goal of drastically reducing overall health care costs and improving health outcomes down the line.

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The Big Shortage: Rethinking The Need For More Primary Care Doctors

August 2nd, 2012

Editor’s note: For more on ways that the traditional primary care model could be rethought, see the Health Affairs May 2010 thematic issue “Reinventing Primary Care.”

Although primary care is regarded as the backbone of the healthcare system, there are serious concerns that we will not have enough primary care physicians to meet the needs of the population, particularly given the upcoming expansion of insurance coverage made possible by health care reform. The response to this shortage has been to do all we can to increase the supply of primary care physicians. But there are deep changes underway in technology and society that point to a radically different notion of primary care, one which requires not more primary care physicians, but a fundamentally new approach to providing primary care.

Currently, patients see their primary care doctors about three times a year. Typically, these appointments last 20 minutes at most. If you generously assume an equal amount of consultation time by phone, patients interact with their doctors for two hours a year on average, leaving 8,758 hours on their own. In other words, virtually all decisions patients make about their health take place without their primary care physician.  In reality, only patients and their loved ones – not doctors or nurses or anyone else – can manage their health. The job of the primary care physician, then, should be to create and manage a system of care that will provide their patients with the tools to do just that.

Such an approach would align primary care with other major social trends: more and more people resisting having decisions made for them, preferring and demanding to take control of their own health. These trends have been hastened by the availability of new technologies, especially the Internet, which is quickly democratizing access to information.

A recent survey of low-income Californians, commissioned by the Blue Shield of California Foundation, found that an overwhelming majority of patients preferred to see a doctor than any other kind of care provider. But when researchers probed deeper, they found that many patients were open to receiving care from a team of healthcare professionals, and through non-traditional means like text messages, email, and other online tools. In fact, the patients who were the happiest, most loyal, and most proactive about their own health were those who had an ongoing relationship, not with a single doctor, but with a regular care team.

Lessons From Iora Health

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