Industry Voices—Why primary care is the future of sustainable healthcare in the U.S.

A male primary care doctor and his patient sit across from each other talking. Both are wearing masks
As the healthcare industry shifts towards a value-based payment model, supporting effective primary care delivery requires an integrated technology ecosystem, built around an EHR designed for clinical users and patients. (Getty/Geber86)

Contrary to current headlines, independent primary care is thriving. During the immense challenges of the COVID-19 period, primary care has shown its resilience, illuminating a path towards sustainable healthcare in the U.S. that is powered by technology. 

As one of the most vital parts of our healthcare system, primary care (especially independent primary care) has faced a multitude of hurdles. As we’ve all experienced, the COVID-19 pandemic has highlighted both the limitations of our healthcare infrastructure as well as the heroism and deep commitment of frontline healthcare workers. Serving on the frontlines of the pandemic, primary care physicians provide not just clinical care to the ill, but education and reassurance to the worried, comfort to families who have lost loved ones, clear information about the safety and efficacy of vaccines and compassionate support to those with long haul COVID-19 symptoms. 

When society shut down in March 2020, primary care practices (PCPs) struggled to provide continuity of care for their usual patients while also responding to the new demands driven by the pandemic. To continue supporting patients, many PCPs quickly integrated telehealth solutions, secured Paycheck Protection Program (PPP) loans, delayed expenses and/or accelerated payments, and sought out support services to help them continue to serve their communities in the midst of a pandemic. 

From the outset of the pandemic, Elation Health monitored its electronic health record (EHR) data weekly to identify pain points and opportunities to support providers during the crisis. As an example, during this time, PCPs experienced a 60% increase in messages from patients and a 30% increase in phone calls, activities that generate very little revenue though are essential for continuity in patient care.

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Fast forward to today: those independent primary care practices have pulled through better than ever, employing technology and leveraging parity reimbursement of telehealth services during COVID-19. Many of them have innovated and reinvented their care delivery along the way, resulting in increases in both their revenue and their patient panels above pre-pandemic levels. In contrast, subspecialty care has fared less well—a reflection of the essential value primary care provides to society even in the most difficult times. 

Designed for sick care from the start

Traditional EHRs have been designed for sick care from the beginning, centered around fee-for-service payment models, and constrained by complex regulatory requirements, which restrict innovation in an industry that depends on integration to create a successful digital ecosystem. This environment puts immense pressure on physicians, particularly independent physicians, who are trying to create more personalized patient interactions and coordinate care across a complex healthcare system. One silver lining is that this tension has given way to innovative delivery platforms often led by primary care physicians who are demanding technology that works for them. 

One recent example of using technology to foster creative healthcare solutions is the Innovation Lab launched by the American Academy of Family Physicians (AAFP) to conduct research on opportunities to modernize family medicine. This research looks at alternative delivery models as well as technology solutions designed to decrease documentation burden, improve the care experience, and make it easier to get paid in a value-based reimbursement model. In one of its key tracks, the Innovation Lab seeks EHRs that are open to innovation through a simple and repeatable process of integration—a clear indication that interoperability is the way forward in a value-based world. 

RELATED: AAFP pilots Elation Health EHR to ease provider burden

Despite the current dominance of traditional, closed EHR platforms, the technology industry is starting to deliver open EHRs and to advocate for the future of primary care. By supporting the high-value activities that only primary care can deliver, value-based EHRs have the potential to help transform our healthcare landscape into one of high performance, much lower costs, and remarkably better outcomes. 

The path to sustainable healthcare in the U.S. starts with delivering more primary care, and more effective primary care, by replacing the systems designed for sick care with systems that promote health. Now is the time to create healthcare that works for those it serves, and a key foundation is modern, open technology that keeps a patient's whole health in mind.

Kyna Fong, Ph.D. is the co-founder and CEO at Elation Health.