analyzing the impact of systems-based hematologist in the healthcare system at an academic medical center

Over the next decade, there is a predicted shortage of nonmalignant hematologist to maintain the workforce in the united states. to address this, the american society of hematology described the creation of the healthcare systems-based hematologist (sbh). the role of sbh has the potential to provide high-value, cost-conscious care to the healthcare system. in 2011, an anticoagulation and bleeding management medical directorship position for a sbh was created at our healthcare system. we described our 6-year experience as sbh at a 750-bed tertiary academic medical center to improve clinical outcomes while reducing costs. via four different initiatives, we were able to provide high-value, cost-conscious care as sbh by reducing cost of heparin-induced thrombocytopenia management, optimizing blood product utilization using goal-directed algorithms, reducing inappropriate thrombophilia testing and improving inferior vena cava filter retrieval rates. to ensure continuing success as a sbh, business plans need to include education, enforcement, monitoring, feedback, validation of safety and outcomes and a shared vision among leadership.