Integrated Health Delivery Systems: Meeting Our Future Health Care Challenges
By William O’Neill, M.D.

The University of Miami Health System-UHealth combines excellence in lifesaving clinical care with the Miller School’s groundbreaking research and innovative medical education. This combination makes us a comprehensive health system that stretches across a wide geographic area, serving patients both locally and from around the world.

To put it more simply: UHealth is a 900-person, multi-specialty academic group practice made up of some of the best minds in medicine who are uniquely qualified to treat the most complicated of cases.

How does that translate into clinical care? Let me give you a relevant example. I recently cared for a delightful but tragically ill 83-year-old woman. She was referred to me so we could consider her for our percutaneous aortic valve protocol, which is a minimally invasive procedure to replace a diseased aortic valve. When I first met her, while she was bothered by symptoms of aortic stenosis, she was most plagued by a diffuse upper body rash. In addition, she tearfully admitted that she had a large lump in her breast.

This woman highlights the challenges in our current highly complex, fragmented health care system in the United States. In order to treat her properly, multiple specialties were required, including dermatology, oncology, surgery, radiology, and cardiology. At UHealth we are fortunate to have more than 900 specialists and primary care physicians. We can provide integrated health care that eliminates the siloed, fragmented health system of the past.

I was able to get my patient seen by a dermatologist and a physician on the breast service that same day. A treatment plan to work up her breast lesion and treatment for her rash both took place that day. Since she lived in Palm Beach County, having all these services under one roof saved her an enormous amount of time and effort. When I saw her a week later, her rash was gone, she felt better, and was being scheduled for admission for her breast surgery.

As Americans age, we will face an increasingly complex patient population with more and more co-morbidities. According to the Centers for Disease Control and Prevention, about 88 percent of Americans over age 65 have at least one chronic health condition, and by 2030, the number of people age 65 and older will more than double to about 71 million. Such an increase in the population of older Americans—they will comprise around 20 percent of the U.S. population—makes it imperative that we figure out how to integrate care for these patients, or costs will skyrocket and outcomes will deteriorate. There is no doubt that integrated health care delivery—only possible in an academic medical center setting—is the best way to deal with this complex patient population.

In fact, physicians in South Florida recognize this, and that is why they
refer these types of patients to our health system. I am proud to work at UHealth and confident to know I have more than 900 friends and colleagues
to call on for immediate consultation. Now we have to spread the word: If you are really sick, UHealth is the place to go.

William O’Neill, M.D., is executive dean for clinical affairs at the Miller School and chief medical officer for the University of Miami Health System.