Why Healthcare Needs to Be Unbundled and Rebundled
Rewired: Why Healthcare Needs to Be Unbundled and Rebundled” explores how today’s health systems, built around institutions instead of patients, are failing. Using Rashida’s story from rural Bangladesh, it shows the cost of fragmented care and argues for a new architecture: unbundling rigid programs and rebundling them around the patient journey. The article calls for future-ready, patient-centered systems that improve outcomes, reduce costs, and evolve with technology.
Building Blocks for a Health System That Flows
Rewired in Practice: Building Blocks for a Health System That Flows shows how fragmented, disease-specific tools can be transformed into a seamless system when connected through shared infrastructure. Using Naliaka’s story from rural Kenya, it illustrates how interoperable building blocks, patient profiles, workflows, knowledge libraries, registries, payment rails and shared interface can turn isolated apps into an integrated backbone of care. The article makes the case that rewiring isn’t about replacing what exists, but enriching it through common components that enable continuity, accountability, and efficiency across programs.
From Programs to Journeys
Rewired for People: From Programs to Journeys” shows how health systems built around vertical programs fragment care, leaving patients, caregivers, and health workers to struggle across disconnected services. Through Mariama’s story in Sierra Leone, it illustrates how rewiring connects programs into seamless journeys that follow people across life stages and conditions. Shared building blocks — profiles, workflows, registries, and knowledge libraries — transform isolated encounters into continuous care, reducing duplication, improving outcomes, and building trust. The article argues that true health system legitimacy comes not from program outputs, but from people’s lived experience of care that flows.
Paying for Outcomes, Not Activity
Rewired Economics: Paying for Outcomes, Not Activity” examines how misaligned financing models undermine health systems by rewarding activity instead of results. Through Sita’s story in rural India, it shows how patients face unpredictable costs, health workers receive skewed incentives, and clinics struggle with shortages when money follows history and paperwork rather than need and outcomes. The article outlines how rewiring can integrate capitation, bundled payments, performance incentives, and fee-for-service through shared building blocks like patient profiles, workflows, registries, and payment rails. The result: financing that is fair, predictable, and accountable — ensuring resources flow where they matter most and creating a virtuous cycle of better outcomes and greater efficiency.
Shared Infrastructure for All
Fragmented systems mean patients like Mutesi in Rwanda face gaps in care when clinics, hospitals, and programs don’t align. Technology alone cannot ensure continuity or fairness — governance is what creates trust, stewardship, and connection across systems. This article explores the principles and operating models needed to govern shared infrastructure so that patients, providers, governments, and innovators can all benefit.
AI, Innovation, and Systems that Learn
Rewired Futures: AI, Innovation, and Systems That Learn explores how AI and innovation can thrive when plugged into shared health infrastructure. It shows how rewired systems move from rigid to adaptive, reactive to predictive, and fragmented to learning ecosystems — where every patient interaction strengthens the whole. With clear governance and guardrails, the future of healthcare is not more apps, but smarter systems that learn, adapt, and deliver fairer care for all.
A Vision for Integrated, Outcome-Driven Systems
SmartCare PHC brings the Rewired vision into practice — an integrated, outcome-driven system where care flows around people, not institutions. Built on modular building blocks, flexible financing, inclusive governance, and adaptive learning, SmartCare unifies patient journeys, supports health workers, and strengthens whole systems. It is not another app or vertical program, but a framework countries can adapt and scale to deliver connected, resilient, and future-ready primary health care.