This is an archived article that was published on sltrib.com in 2012, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

There's something growing in Utah that the rest of the nation desperately needs and it's not wheat. It's a new crop of physicians and nurses. A new generation of caregivers that aren't focused on pay for procedure, or even on specializing in heart stents or colonoscopies by the pound.

We all know our nation's health care system is in a time of turmoil and transition. The Affordable Care Act is only one part of the puzzle. Enormous changes are underway among commercial health insurance companies, care delivery systems, even in how care is delivered at the federal level via the Department of Veteran's Affairs and Office of Personnel Management.

There is change all around us and a new recognition that an effective health care system is one that improves care at lower costs. Primary care just happens to be the foundation of this new model of care and that's where this new crop of caregivers comes in.

What's underway in Utah is groundbreaking and a model for the rest of the nation. It started with the great strides we've seen in Utah as the state has effectively held down the cost of care. Salt Lake City is ranked with the eighth lowest cost of care in the nation and health care spending is at $2,979 per person.

It also factors into the reason Utah is ranked one of the top states for business. The concept of Care by Design, providing better access to coordinated primary care, led by the University of Utah, is an incredibly important step toward even better, more cost-effective care.

The kind of gains seen at Hill Air Force Base where $300,000 a year in taxpayer savings is realized through simply improving the care diabetics receive illustrates the difference coordinated primary care makes.

But what's next? Better coordinated, connected and integrated primary care is becoming the new standard of care in many states like Utah. But until now, what has been lacking is a blueprint for delivering the next generation of physician who can really make this model work.

That's what the Institute for Healthcare Transformation the U. is developing is all about. It's about building a new breed of doc and nurse who put the patient at the center of the process. It is about teaching these caregivers new ways of doing business, and how to use data and technology to shed light on what they are doing and how they are doing it.

The challenge is a big one and the Institute for Healthcare Transformation is taking it on. The next generation of doctors will have to have new skills in managing population health. That means keeping diabetics stable and keeping asthmatics out of the ER. They'll have to understand how to use data in new ways and use analytics to predict which patients will get sicker and how to prevent that.

They'll need new understanding of health technology as they consult their iPad and log into mobile apps and monitor patients remotely. More important, the next generation will need to understand how to take unnecessary costs out of health care. Today 30 percent of the $2.5 trillion in U.S. health care spending is considered unnecessary.

Today about 10 academic medical centers around the nation are trying to do this but the U. and the Institute for Healthcare Transformation are beating them to it. By not only focusing on how health care is delivered, but by sharing research and education this program is setting itself apart from any other national health care transformations.

The next grand challenge is to align the resources, the talent and the partners to deliver on the promise of a new breed of primary caregivers.

Paul Grundy, M.D., is IBM global director of healthcare transformation. He is also an adjunct professor in the Department of Family and Preventive Medicine at the University of Utah School of Medicine and president of the Patient Centered Primary Care Collaborative.