HSS Exam 1

What is Health Systems Science?

Health Systems Science (HSS) is the study of how healthcare is delivered, how healthcare professionals work together, and how systems can improve patient outcomes.

3 Pillars of Medical Education

Basic Science	Disease mechanisms
Clinical Science	Diagnosis and treatment
Health Systems Science	Healthcare delivery and improvement

Why Do We Need HSS?

Excellent physicians can still have poor patient outcomes if the healthcare system creates barriers.

Healthcare Barriers

• Lack of transportation

• Medication costs

• Insurance limitations

• Poor communication between providers

• Fragmented care

• Limited healthcare access

The Six Core Domains of Health Systems Science

Healthcare Structures & Processes

Healthcare Policy, Economics & Management

Clinical Informatics & Health Technology

Population Health

Value-Based Care

Health System Improvement

Healthcare Structures & Processes

Focus: How healthcare is organized.

Examples:

• Hospitals

• Clinics

• Referrals

• Care coordination

• Patient flow

Ask yourself: How does the patient move through the healthcare system?

Healthcare Policy, Economics & Management

Focus: How healthcare is financed and regulated.

Examples:

• Medicare

• Medicaid

• Insurance

• Healthcare costs

• Resource allocation

Ask yourself: Who pays for care?

Clinical Informatics & Health Technology

Focus: Using technology to improve healthcare.

Examples:

• Electronic Health Records (EHR)

• Clinical Decision Support

• Telehealth

• Artificial Intelligence

• Patient Portals

Ask yourself: What technology is helping clinicians make better decisions?

Population Health

Focus: Improving health for groups of people rather than just individual patients.

Examples:

• Vaccination campaigns

• Smoking cessation

• Community health programs

• Chronic disease prevention

Includes: Social Determinants of Health

Examples:

• Housing

• Food access

• Transportation

• Education

• Employment

Ask yourself: What community factors influence health?

Value-Based Care

Focus: Providing high-quality care while controlling costs.

Traditional healthcare asks:

"How much care was provided?"

Value-based care asks:

"Did the patient actually get better?"

Think: Value = Outcomes / Cost

Health System Improvement

Focus: Improving healthcare processes.

Examples:

• Reducing medication errors

• Improving patient safety

• Shortening wait times

• Improving discharge processes

Common tools:

• PDSA Cycle

• Root Cause Analysis

• Lean

• Six Sigma

Ask yourself: How can we improve this process?

Modern physicians have two roles:

—-- Treats individual patients.

Examples:

• Diagnose disease

• Prescribe medications

• Counsel patients

—-- Works to improve healthcare for everyone.

Examples:

• Participate in Quality Improvement

• Improve patient safety

• Report safety concerns

• Work with interdisciplinary teams

• Advocate for patients

• Improve healthcare delivery

Remember: Physicians are leaders, not just caregivers.

Clinician

Systems Citizen

Systems Influence Patient Outcomes

Patient outcomes are affected by more than medical knowledge.

Examples include:

• Insurance

• Transportation

• Cost of medications

• Health literacy

• Social support

• Access to specialists

• Communication between providers

Example:

A physician prescribes the perfect medication.

The patient cannot afford it.

Outcome? The treatment fails, not because the medication was ineffective, but because of a system-level barrier.

Clinical Informatics vs. Health System Improvement

Clinical Informatics	Health System Improvement
Uses technology	Improves processes
EHR	PDSA Cycle
Telehealth	Lean
Dashboards	Root Cause Analysis
Clinical Decision Support	Workflow redesign
AI	Quality Improvement

Technology = —

Processes = —-

Technology = Informatics

Processes = Improvement

Electronic Health Record

Clinical Decision Support

Telehealth

EHR, patient portal, AI, telehealth

Clinical Informatics

Quality Improvement Team

Root Cause Analysis

Lean/Six Sigma

PDSA, workflow redesign, reducing errors

Health System Improvement

Insurance Coverage

Medicare, Medicaid, insurance, reimbursement

Policy, Economics and Management

Community Health

Vaccination campaign, community health, SDOH

Population Health

Cost + Outcomes

Cost and quality together

Value-Based Care

Care Coordination

Patient movement through healthcare

Patient Flow

Structures & Processes

·      HSS is the — of medical education.

·      Healthcare systems influence patient outcomes.

·      Physicians care for —.

·      HSS emphasizes —-.

·      Excellent physicians understand both medicine and the systems in which medicine is practiced.

third pillar

both patients and systems

quality, safety, teamwork, value, and continuous improvement

Physician improving a hospital or clinic process

Systems Citizen

Is the focus on technology? →

Clinical Informatics

Is the focus on improving a workflow or reducing errors? →

Health System Improvement

Is the focus on payment, insurance, or policy? →

Healthcare Policy, Economics & Management

Is the focus on community-level health or social determinants? →

Population Health

Is the focus on balancing outcomes with cost? →

Value-Based Care

Is the focus on how care is organized or coordinated? →

Healthcare Structures & Processes