On July 5, the inaugural University of Texas Dell Medical School class will begin studies. Offering a curriculum that will differ from traditional medical schools, the school and its teaching hospital, Dell Seton Medical Center at The University of Texas, seek to become an agent of change in the health care industry.


“We believe, in fact, that [in the] health care industry the health focus has been lost,” said Mini Kahlon, vice dean for strategy and partnerships at Dell Medical School. “We want to bring that back and make health front and center.”


To do that, officials at Dell Medical School are creating a new strategy on which health care systems could be built. The school and its surrounding Medical District is aiming to innovate with a new health care payment model—in which patients would pay for outcomes rather than services—and new applications of technology.




Health district aiming to transform care Health district[/caption]

Health care transformation


Nearly four years after Travis County voters approved a 5 cent property tax increase, in part to provide funding to the medical school, the campus is beginning to take shape. The 75,000-square-foot Health Learning Building, where classes will take place, was completed in late May.


About $35 million in annual taxpayer funds will go toward funding the medical school. Also among the founding members of the Medical District is Central Health, a Travis County entity dedicated to making health care more accessible for underserved and uninsured residents.


Central Health President and CEO Patricia A. Young Brown said the Medical District will produce a long-term return on investment for the county’s taxpayers, as the medical school aims to improve the health of Austin-area residents.


“If we do succeed in improving the health of our community, then we have saved costs to the health care system, we have made people healthier … and we are securing the economic future of our community,” Young Brown said.


Construction of the Health Transformation and Health Discovery buildings, where Dell Medical School innovations will be presented and researched, respectively, is set to be completed by August, and the buildings will be fully occupied by 2018.


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The Health Transformation Building will provide a showcase of the types of innovations the school hopes to bring about. Kahlon said the teams in the building’s educational clinics will be more multidisciplinary and structured differently than in a traditional setting. Although a surgeon would typically be the head of an osteoarthritic care team in today’s health care model, a surgeon will not lead a Dell Medical School team, she said.


“If a surgeon is head of the team, then you know that the answer [to an ailment] is going to be surgery, whereas if the surgeon is a member of the team then you know that you are actually vetting all the [care] options,” she said.


The total cost of constructing the campus is $436 million. According to school officials, it is the only medical school in the country to receive most of its funding from local property tax revenue.


With such a substantial sum of its budget coming from the community, Dell Medical School Dean Dr. Clay Johnston said the institution will have a unique relationship with Travis County. Among the goals of the school is to make Austin a model city for health worldwide and address its health disparities by improving health care access for the underserved and uninsured, Johnston said.


Johnston said Dell Medical School is aiming to make health care more affordable by moving away from the traditional fee-for-service model in favor of a system that is value-based. For example, in the fee-for-service model a health care facility gets paid whether a patient’s outcome is good or bad. In a value-based system providers receive monetary incentives for good outcomes and penalties for bad ones.


He said the fee-for-service model is the underlying cause of an annual $25,000-per-family cost of health care in the U.S., by far the most expensive health care system in the world, according to the World Health Organization.


“Health care is not working well,” Johnston said. “[It is] too expensive [and] not [creating] the kind of outcomes we want. It’s not really designed with a desire for health. Because we can start from scratch … we are designing ourselves to be much better aligned with society’s interests in health.”



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Technological innovations are among the ways in which Dell Seton Medical Center—which will open in May 2017—plans an overhaul of the traditional health care system, Seton Healthcare Family officials said.


Christann Vasquez, president of the Dell Seton Medical Center, and Mike Minks, the hospital’s chief information officer, said the technology at the medical center will allow physicians more time with their patients rather than spending their time entering data into a computer.


“One of the areas we really wanted to focus on is, from a patient’s perspective, how can we introduce them to a level of technology that they currently don’t have,” Vasquez said.


Devices at Dell Seton Medical Center—such as instruments that take patients’ temperatures, dispense IV fluids and check patients’ heart rates—will automatically record data in an electronic medical record.


The hospital will also innovate with the use of existing technologies that have been in many households for years. Smart TVs, for example, will not only provide entertainment for a patient but also education. If a patient has received a diagnosis, education on his or her ailment will be provided in the patient’s room via the smart TV. The information will be delivered to patients at their literacy rate, Vasquez said. The TVs will also provide information about the patient’s caregiver at the time he or she walks into the room, a Seton Healthcare Family representative said.


Telemedicine, another existing technology, will be employed at Dell Seton Medical Center in an innovative way as well, Minks said. The hospital’s “telehealth hub” will allow physicians to perform consultations for patients throughout the Seton system. They can perform the consultations before teaching a class at the new medical school or making rounds at the teaching hospital, Vasquez said. In the past the physician would have to drive to the various Seton hospitals, such as ones in Williamson and Hays counties.


“Seton has been a pioneer in telehealth for really the last four or five years,” Minks said. “[The telehealth hub] is growing it. It’s introducing a new service line.”


Students at Dell Medical School will receive unique access to physicians in the operating room during procedures. Lights in the operating rooms will be fitted with cameras, and students will be able to watch and ask professionals questions in real time as an operation is being performed.


Mellie Price, the executive director of technology innovation at Dell Medical School, said the population growth in Central Texas in combination with cultural and economic issues are going to affect the cost and capacity of the Texas health care system earlier than people suspect.


That is, in part, why it is important for the health care innovations at the medical school and its teaching hospital to play a role in changing the health care model, she said.


“We really are doing something truly innovative,” she said. “I feel like that word is thrown around a lot, but when we say innovate, we’re innovating models of care and we’re innovating the business model behind health care.”


Health district aiming to transform care






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