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This is a time of uncertainty when it comes to health care, with shifting premiums, plans, and a murky future leaving many underserved and unsure of where to turn. That’s why Harris Health System in Harris County, Texas, is a welcome relief and source of leadership right now. Harris Health is a safety-net health system, which means that its main line of business is caring for the underserved in the community of Harris County. For those who have little or no insurance and are in need of health care, this revolutionary care system is a beacon of light in a dark time. Harris Health System includes 18 community health centers, five same-day clinics, five school-based clinics, three multi-specialty clinic locations, a dental center, a dialysis center, mobile health units, a rehab and specialty hospital, and two full-service hospitals. Ben Taub Hospital is a Level I trauma center, and the Lyndon B. Johnson Hospital is a Level III trauma center. They’re providing important services to their community and also providing the highest level of trauma care for those who are the most seriously injured or ill. For an area that was hit hard by Hurricane Harvey, a storm that was downgraded to a wind/rain event in Harris County, Harris Health System has helped assuage concerns about care being available to the needy during this difficult time. Hurricane season is nothing new to Harris County or to Harris Health System. George V. Masi, the president and CEO of Harris Health, says, “This is not new to us. We’ve been through a number of these going back the last 10 years. We drill constantly, especially as we get close to hurricane season. We’ve put our plans in place. We do tabletop exercises, which help us anticipate what we would do in case of [a] hurricane or a flood event, or a wind event. We did likewise this year in May and early June; we practiced and exercised. And that was very fortuitous for us, because we had the mother of all storms with Harvey.” Hurricanes and storms the size of Harvey can hit a community hard, as seen by the devastation that has afflicted the country this hurricane season. Harris Health System is a leader in preparedness and preparation for these times. And while leadership can and must shift in the midst of these storms, Harris Health System can be a guide for how to do so. According to Masi, “What happens oftentimes is that the formal leadership structure has to morph into one that responds with what you have in place at the time. In the case of a hurricane like this one, and more importantly in a heavy rain and flooding event, the formal structure has to be flexible enough so that the players that we have in place on a bright sunny day, doing what they do normally and routinely, can change dramatically. Because there will be a number of people who can’t get into work. People that were at work in the rideout team can’t leave. In this case, we had the rideout team in place at both our hospitals for seven days. So you rely heavily not only on the first line of leadership, but, in many cases, the second and third and fourth line of leadership, to pick up the slack and to take upon themselves those roles that you would normally anticipate the most senior leadership to have. It’s a great testing ground and training ground for the total leadership team, because in a case like Harvey, it’s all-hands-on deck for a protracted period of time—24 hours a day, seven days a week.” Harris Health System has a new strategic plan called “The Bridge to 2020” that was ratified into existence on October 26, 2017. It speaks to a transformational model of care. Harris Health is focusing on what the health care needs of the community will be in the coming decade and on how it will meet those needs in the best possible way. George V. Masi explained the differences between the new plan and the old one: “What’s different about the approach we’re taking is that we are very heavily emphasizing wellness and prevention. Not at the expense of acute care, which we provide in our clinics and hospitals, but as two additional dimensions of what we do and how we do it. The bottom line is that we aim to mitigate disease and mitigate injury, if not eliminate it, so that patients don’t have to rely on the acute care model for all their health care. We want to push the health care enterprise as far forward into the community and into individual’s lives so that we can minimize the need for acute care. Oftentimes, the acute care incident could have been avoided.” This type of preventative care could mean attempting to help and care for pre-diabetics before their issues become debilitating in size and scope, which can be a huge financial strain on the family of the afflicted, as well as on the community at large. It could also mean educating drivers on the risks of drunk driving, texting and driving, etc., before an accident occurs. Harris Health System’s “The Bridge to 2020” has three pillars that address the thought and care taken when putting the plan together. The first pillar is the patient’s care, focusing on providing high-quality patient care at a cost that is at a level of efficiency that equates to value-based care. The second pillar is the family, meaning the staff of Harris Health: the physicians, the nurses, the administrators, the technicians, the housekeepers, everyone who provides that care and the environment for that care. The third pillar is their home, meaning the infrastructure: the facilities, the equipment, all the tangible assets that are important to maintaining the currency of those assets. They want to make sure they’re maintaining equipment, that it is safe and state-of-theart, that their buildings are modern and well equipped. The strategic plan articulates what this transformational model of care should look like over the next three years, but Masi says that it’s a living, breathing document. “The journey never ends. At some point, it will be the bridge to 2024, 2025, as we keep improving both in terms of quality and efficiency, and outcomes.” This plan is incredibly unique and cuttingedge, which is something the Harris County community should be grateful for. It’s going to be a true partnership between the patients and the system. Says Masi, “The objective is to make this a healthier community, and we do that one patient at a time. We are here to facilitate that wellness. This is a contract with the patient, meaning we as a health system can’t do this in a vacuum. We need to encourage patients, convince patients, and facilitate patients in this health care modeling so that in partnership we can make the future better for all of us in the community. We want to work with patients to make sure that if they are insulin dependent, we have timely prescription refills; if there are language barriers to understanding why it’s important to take this medication at that frequency, we have that language capability in place to coach patients.” Another added benefit of the plan is the use of health care navigators. “Health systems can be very, very complex. We have health care navigators to help patients understand the way forward in terms of our health care. We’re seeking a partnership between the health care system that we call Harris Health and the patient who is a member of the community, all moving towards a better outcome and better life,” Masi told us. It’s a welcome and moving story of leadership in what is proving to be an unhealthy health-care climate for the country. Hopefully, Harris Health System can be a guide for many states to introduce and implement this kind of comprehensive care in a real and meaningful way.