Case #2271.0

Integrating Systems at Scale: Coordinating Health Care in Houston

Publication Date: November 8, 2023
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This case concerns the Patient Care Intervention Center (PCIC) a values-based health technology social enterprise in Houston, Texas. This organization was founded to tackle fundamental problems in social and health services in the United States. It was initially focused on homeless superusers of the health system, that received inadequate care at high cost, notably through frequent use of emergency rooms. However, it became clear that this was only a symptom of broader system issues, especially around coordination failures across siloed health and social services and failures in case management.

PCIC designed an approach that integrated two innovative features: values-based client diagnosis and case management, based on the values, concerns, and aspirations of individual clients, and a platform-based approach to sharing data both on clients and services, with tailored technological solutions for individual health and social organizations. It has been highly successful both in outreach and contract growth. By 2022, 850 agencies were providing data, involving six million individuals, with some 1,500 referrals within the system each month within the Houston area. However, PCIC faced challenges in further scaling, with respect to finance for developmental needs, human resources, and the threat of competition from large private players that offered platforms that were significantly inferior in terms of tackling the underlying system failures, but potentially attractive to health and social organizations. The case frames both the strategic questions for PCIC and the challenges of changing an essentially dysfunctional system.

Learning Objectives:
Students will:
1. Understand market and government failures within a system diagnostic of influences on health status, including social determinants of health
2. See the possibility of designing service provision adapted to a client’s values and aspirations, in “values-based care”
3. See the potential role of technology in providing a platform based solutions to coordination challenges
4. Understand both the potential and challenges for a social enterprise seeking to solve problems through a revenue based model


Other Details

Teaching Plan:
Available with Educator Access
Case Author:
Michelle Fakler
Faculty Lead:
Michael Walton
Pages (incl. exhibits):
United States