Healthcare systems must change their approach to delivery

‘Current models of healthcare delivery are no longer feasible or sustainable’ says Joanne M. Shear, President and CEO of Primary Care Transformation Experts, LLC (PCTE).

20th January, 2020
Healthcare systems must change their approach to delivery

What's your name?

Joanne M. Shear

What position do you hold?

I am the President and CEO of Primary Care Transformation Experts, LLC (PCTE). PCTE is a small healthcare consulting firm that specialises in providing subject matter expertise to support organisational healthcare transformations from traditional models of primary care practice to patient centered, team based integrated models. Areas of expertise and experience include vertical and horizontal integration, disease/population management, care/case management and coordination, team-based care models and functioning, virtual care delivery modalities, metrics and measurement and access to care.

What are your day to day responsibilities?

PCTE works with U.S. and international firms/organisation including the Department of Health in Ireland, World Bank Group, IBM, Harvard School of Public Health, CETC (China), HealthTeamWorks, and Acesoglobal.

Our services include:

•supporting development, planning, implementation and evaluation efforts of healthcare organisations as they focus on transforming primary care systems/practices to patient centered, integrated models.

•developing training programs and requisite tools for teaching/training.

•participating as a subject matter expert in training healthcare leaders and providers.

•working with other partners/experts as required to support goal attainment.

•developing and partnering in process improvement efforts to achieve identified goals.

•developing marketing, communication and informational strategies and documents.

•developing and promoting quality metrics as well as reporting tools/documents as needed to further transformation.

•partnering with clients to develop primary care practice models requesting assistance to implement team-based care.

What is your professional background?

I have over 38 years of experience as a family nurse practitioner involved in direct patient care delivery and health care organisational management for the largest integrated healthcare system in the US, the Department of Veterans Affairs, Veterans Health Administration (VHA). The last 8 years of my career I functioned in the role of National Clinical Programme Manager, in the Offices of Primary Care Operations and Primary Care Services and was responsible for implementing VHA’s team based, integrated, patient centered medical home model known as Patient Aligned Care Team (PACT) in all 1,000 primary care sites in the US. I retired from the Department of Veterans Affairs in 2017 and started Primary Care Transformation experts to continue working to transform healthcare to delivery high quality care and patient experience.

You are speaking at the 2020 National Health Summit. What are you speaking about?

My topic is about transforming a national healthcare system from a hospital-based focus to a delivery system located in the community. The increasing cost of the healthcare burden due to changing population demographics is a global issue experienced by all countries. Current models of healthcare delivery are no longer feasible or sustainable. Healthcare systems must change their approach to delivery by shifting low-complexity care such as chronic disease management, prevention and care coordination from expensive hospital systems to the community. Building the expertise and capacity within these community systems is a critical factor in transforming to a person-centered delivery model that meets the needs and expectations of the population.

What main challenges do you see for the healthcare sector in Ireland?

The main challenges in Ireland are very similar to those experienced in other countries including the U.S. Department of Veterans Affairs where I led the transformation efforts. The challenges include money and resources, health information technology, organisational will and planning, plan execution, public acceptance and trust, communication and marketing and clinician involvement at every step.

Where would you like to see the health service in 10 years-time?

I would like to see a model of healthcare delivery based in the community where 90% of a person’s healthcare needs are delivered by a multi-disciplinary team. Care is given at the right time, right place and by the right person. Trolley counting will be a thing of the past because all Irish people will have great access to the care they need and expect in their community. Hospitals will deliver only high complexity and specialty care while the community is responsible for providing acute (not emergent), preventative, chronic, and social care. The entire Irish healthcare delivery system is vertically and horizontally integrated to coordinate and manage the care of its citizens. The use of technology is optimised and information flows back and forth among providers and systems involved in the care. The Irish people are engaged and activated partners in their healthcare needs resulting in improvements in population healthcare outcomes and experience. And, finally, the government recognises significant improvements in cost and quality in terms of effectiveness and efficiencies with good return on investments. The successful transformation of the Irish healthcare system is shared and celebrated widely.

Joanne will be speaking at the 2020 Health Summit on February 6 in Croke Park, Dublin.

For more details visit

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