Mass General Ambulatory Practice of the Future (APF) /Innovation Learning Program (ILP)

Our mission is to design the outpatient medical practice that delivers ideal care to patient (in the right place at the right time) and optimizes outcomes for both patients and care providers. We are an innovative patient-centered medical home practice that supports prevention and wellness as well as coordinated care for acute and chronic illness.

Since 2010 the Innovation Learning Program (ILP) has been part of the APF’s “DNA” approach to exploring and implementing the change required to bring sustainable solutions to primary care. ILP’s remit is to increase operational and clinical gains from clinical research and collaboration with public, academic, and private sector device, platform, and technology companies in real-world paraclinical investigation; and to subsequently aggregate and disseminate our findings with the larger primary care community.

Featured Staff

J. Benjamin Crocker, MD

Medical Director – APF

Stephen H. Lynch

Director – ILP

Ben Crocker is a general internist at Mass General and serves as medical director of the Ambulatory Practice of the Future (APF). His clinical interests and expertise include team-based clinic design and care and technology assessment in primary care.

Steve Lynch is the director of the Innovation Learning Program (ILP) at APF and has worked in program development, learning innovation and commercialization leadership roles for over thirty years prior to joining our team here in 2015.

Program Priorities

Our Patient as Master Apprentice

Operational Efficiency/Performance

Experience of Care

Consistent with the Quadruple Aim, the ILP seeks to empower patients to become more self-reliant, confident, informed and engaged partners in health over the long term in close contact with their care team. This vision requires expanding the boundaries of the traditional in office relationship to include greater use of virtual tools for communication, deploying digital therapeutics (i.e. Fit/Twine Health, Welldoc’s BlueStar) to address chronic conditions to enhance and deepen the care team’s insight and better understanding of each patient’s day to day life to create and execute an individualized care plan.

A key driver of this model integrates APF’s Health and Wellness Coaching practice into the extended care team workflow and patient engagement strategy. Patients work with our coach to create a personalized definition of health and wellness then based on that vision, our coach works to help the patient articulate and achieve the goals they have set for themselves. It is never a prescriptive approach, it is a consultative, assistive one allowing the patient to grow by developing their own tools and skills in achieving better self-directed management of health and wellness outcomes.

A second core strategic aim of the program is to focus on incremental improvement of practice workflows with an eye to reduction of administrative and care team burden. This approach also seeks to employ standardization and optimization of technologies wherever practicable to allow practitioners more time to think and treat their panels at ‘top of license’.

Current operational examples of this approach being put into practice are IMMERSE (medication renewal and lab order automated service to reduce burden, increase efficiency and convenience), Scribble (a virtual scribe service), reintroduction of wireless vital sign capture in the EHR, and validation and adoption of point of care testing technology in the primary care setting.

Healthcare is ultimately a people business, perhaps the most people-centric business of any ever invented. For both the consumer (the patient) and the service provider (the care team operating at all levels, in all roles), the main pillars to success in the shared journey of building a health and wellness relationship with each patient remain trust and transparency. At ILP we have established and hold, on behalf of Mass General, both the trademark TransCAREncySM and the associated URL, transcarency.org, respectively. TransCAREncy is the term we use to describe this culture of care: transparency in all aspects of care with our patients and with our institution at all levels.  This trust relationship is the fundamental underpinning of the patient – care team partnership.

Programmatic Highlights

Patient Engagement and Master Apprenticeship

Technology-Supported Apprenticeship in the Management of Hypertension: A Randomized Controlled Trial
Primary Care-Based Health Coaching Intervention for Weight Loss in Overweight/Obese Adults: A 2-Year Experience
Health coaching integration into primary care for the treatment of obesity
Primary Care-Based Health Coaching for the Management of Prediabetes
Welldoc – BlueStar to address treatment of Type 2 diabetes in primary care. Two year industry sponsored research project to test and expand the use of digital therapeutics like Bluestar in the treatment of chronic disease – evaluation of practice workflows, financial and patient engagement / uptake / persistence through the use of digital tools to better manage type 2 DM at a distance and via decision support tools and technologies available through the platform to better inform clinical teams in their decision making.

Operational Efficiency & Performance

Point of Care Testing and Satisfaction

MGHPO Kitty Hawk R&D

Immerse (centralized Rx renewal program) more than 600 providers, more than 300k Rx renewal requests per year, reducing admin burden by 50-65% and risk reduction, across 25 practices since initial pilot at APF in fall, 2016.
Scribble (virtual note transcription service) -- >100 PC providers, work admin reduction.

Ongoing Development Pipeline — Industry Sponsored Programs and Internal Projects

Deployment of Biodigital platform – a real time interactive, 3D body computer aided design content, hosting to be made available to the Mass General care community for use in patient education and clinical reference during visits.
Mass General Patient Experience group with Xavier Systems deploying interactive standalone kiosks at point of care to improve real time patient about their care experience.
Xealth integration with Partners/Brigham Health for deployment of digital therapeutics within the system, including Welldoc BlueStar for type 2 diabetes at Mass General.
Smoking cessation pilot using the Medumo text platform in conjunction with PHS Population Health.
Collaboration with PHS Connected Health in the further development and deployment of PGHD Connect device support and expansion consistent with the Population Health objectives and PHS digital health goals and initiatives in 2020 and beyond.
Care Alliance – The APF Patient Family Advisory Council (PFAC) known as the Care Alliance has long recognized their unique role in providing real world patient feedback and operational input to the care team.