Redesign of the Health Care Delivery System

Abstract

THE GOVERNING DESIGN PRINCIPLE OF THE US HEALTH care system has been described as an “edifice complex” and a “field of dreams” complex—if the health system builds it, the patients will come. This clinician-centric approach to the design of delivery of health care is obsolete, contributing to health care of inferior quality and excessive cost. To meet the patient-centered needs of a modern health care system, the United States should consider adopting the Bauhaus design principle of “form follows function.” Form follows function was the guiding principle of the Bauhaus school of crafts and architecture, founded in Germany in 1919 by Walter Gropius. The structure of a chair or house was to follow logically from the intended function of that form. The Bauhaus movement emphasized rational and simplified design, reconciling craftsmanship and technology under a spirit of populism and modernism. These principles are applicable to the design of a modernist health system. Traditionally, approaches to health care delivery design view the extravagantly rococo structure of the existing health care system and propose additions or minor alterations to this dysfunctional structure. What if there was a different starting point—the intended function of the health system— and planners worked backward to determine the form most suitable to that function?