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and priority reforms
1. From dysfunctional gatekeeping to quality comprehensive care for all
“WHAT?”: OUTCOMES
2. From fragmentation to peoplecentered integration
3. From inequities to fairness and accountability
4. From fragility to resilience
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Multidisciplinary Team-Based Organization
Multidisciplinary teams align clinical services to meet the full range of local health needs. Clinical services address acute illnesses and injuries and manage chronic conditions, including mental health needs. Teams expand community health education, health and nutrition promotion, and disease prevention.
Multidisciplinary teams build long-term trust with empaneled communities, collaborate and communicate internally, and coordinate patients’ movement through the health system and back to the community.
Empanelment creates accountability for health outcomes. Financing and other mechanisms reinforce accountability. Team composition reflects local health and health care needs and socio-economic determinants. Both patient and health outcomes are embedded in the accountability framework.
PHC teams include public health surveillance and outreach capacity. Team structure helps buffer provider absences. Service-delivery organization and leadership ensure team capacity to manage the unexpected.
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Multiprofessional health workforce development Resource mobilization for public health-enabled primary care
Multiprofessional health education builds generalist knowledge, skills, and competencies. Curriculum and practicum reforms facilitate creating multidisciplinary PHC teams. Allocation of financial and human resources is based on evidence of local disease burden, socio-economic conditions, and demographic characteristics. Financing rewards community engagement and supports a tailored essential service package, including primary care and public health.
Multiprofessional education emphasizes “soft” skills to promote shared medical decision-making; empower patients for self-care; contribute to patient satisfaction; and support teamwork and care coordination. Data and IT platforms enable telehealth functions and support EHRs for the empaneled community. EHRs smoothly exchange data with the rest of the health care system, and users can access records confidentially.
Reformed multiprofessional education creates a culture of transparency and social accountability through leadership and team-based performance. PHC teams serve communities without discrimination based on gender, ethnicity, income, sexual orientation, or other factors. Priority setting through a fair, participatory, and transparent process ensures that the essential service package is equitably and efficiently delivered to all. The service package takes account of socio-economic determinants of health and is not subject to ad hoc or geographic rationing.
Health workforce training prepares multidisciplinary PHC teams to prevent, detect, and respond to health emergencies. PHC teams are an effective first level of health system preparedness and response. Financial and human resource surge capacity is built into health sector planning and resource allocation at the local level.
Source: Original table prepared for this publication. Note: EHR = electronic health records; IT = information technology; PHC = primary health care.
