University of Utah - Care by Design Program

In 2003, the University of Utah Health Care Community Clinics (CCs) developed and initiated a series of research-informed, self-funded phases of practice redesign under the name Care by Design (CBD). CBD utilizes organizing principles of appropriate access, care teams (CTs) incorporating the efforts of advanced practice medical assistants, and planned care supported by a robust, augmented electronic medical record.

Care By Design consists of three components--the Care Team Model, Appropriate Access, and Planned Care--which allow community clinic providers to plan each patient's care from before they enter the clinic through postappointment follow-ups.

The Care Team model is a patient-centered collaboration between medical assistants (MAs) and physicians to minimize wait times and engage patients more in their own care. MAs assume a central role in "delivering" the visit, from greeting the patient and taking the medical history to drawing blood and documenting the physician's exam. 

Appropriate Access balances the needs of patients who want same-day appointments with those who have chronic illnesses and must be regularly seen and scheduled in advance. Planned Care uses evidence-based tools in electronic medical records to make each patient's visit more effective.