When Dr. Rushika Fernandopulle began medical school, he wanted to become a physician who would not only address a patient’s present concerns, but also maintain their health in the long run. As he continued in his studies, however, he witnessed numerous obstacles that prevented physicians from providing patient-centered care. Strained by the burden of medical documentation, providers spent increasingly less time with patients. Long workdays led to missed family dinners and burnout. In turn, the care that patients received did not, as he imagined, lead to a healthier life.
Dr. Fernandopulle was motivated to redefine the healthcare system for the betterment of both patient and physician well-being. In 2011, he co-founded Iora Health, a value-based primary care provider committed to lowering healthcare costs while improving healthcare outcomes.
In a conversation with Dr. Rainu Kaushal, senior associate dean for clinical research and chair of population health sciences, Dr. Fernandopulle shared his experience and vision with faculty and students of Cornell's Executive MBA/MS in Healthcare Leadership Program at the 2023 Luminaries in Healthcare Leadership event.
When he was in medical school, he pursued a master's degree in public policy from Harvard University to increase his understanding of the business of healthcare. He noted that the student body comprised people who were not only doctors and nurses but also in education and defense work. Though working in distinct fields, they were alike in seeking to improve existing systems.
“The motivating question was: how do we transform the healthcare system? I realized very quickly that if we want to make progress, we have to build it,” he explained. Dr. Fernandopulle began with a consumer- or patient-focused approach, intending to deliver intensive, redesigned primary care. When he started an independent practice, he initiated practices of emailing and texting patients and allowing patients access to their entire medical records, both radical choices at the time. He introduced the use of “health coaches,” people who worked in tandem with physicians to ensure that patients maintained their eating habits, took their medication, and took steps to prevent hospitalizations. “The thing that heals people is relationships, so I sought to rebuild the system on relationships, with the goal of improving health.”
In founding Iora Health, the mission of transformation informed a culture of intrinsically motivated physicians and staffers, and service to underserved populations. He and his team traveled to low-income communities, aiming to provide care to patients earlier in life, thus offsetting their costs once they were 65 or older. With continuous efforts to scale his business, Dr. Fernandopulle could simultaneously compete with other providers and provide data showing that his models were both novel and practical. Iora Health merged with One Medical in 2021 and was recently acquired by Amazon.
“I often tell physicians not to be risk averse,” he said. “The worst thing that happens is you try, and it fails.” While developing Iora Health, he continued to work as a physician, a choice that gave him perspective while he refined his business strategy and built relationships. In pursuing the business of healthcare, he emphasizes, “We need big change, not little change. And maybe what we need is the courage to just start over.”
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