Advancing Family Medicine in a Model Unit: A Living Lab for Health Care Design and Innovation

IntroductionThe population in need of primary care is rapidly growing and increasingly complex with respect to chronic disease burden. We must develop alternative and more efficient approaches to managing patients if we are to increase access to care without sacrificing continuity; however, there is little guidance for innovation strategies at the practice level. MethodsThe Mayo Clinic Department of Family Medicine engaged in a 2-year multistage planning process to develop plans for a Model Unit (MU) to identify opportunities for innovation to improve daily practice. The purpose of the MU is to operate as a "living lab" capable of driving continuous advancements within the context of a real-world health system with the goal of delivering high-quality care to a greater number of patients. ResultsKey lessons from the planning stage led to the development of a contextualized, incremental, and continuous approach to design and innovation. In its first phase, the MU includes 3 interventions that are novel to the unit itself, including nurse-led hypertension management, incorporating telehealth visits into routine clinician schedules, and ambient documentation to replace clinician-generated visit notes. We present a description of the overall MU approach including early-stage implementation findings and our evaluation strategy. ConclusionsThe MU structure is a generalizable model for identifying opportunities and operationalizing practice improvement activities in a strategic and pragmatic way that incorporates real-time feedback from clinicians and staff with the expectation of continuous and phased evolution.