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  • Core Versus Chore: Using Human-Centered Design to Solve Burnout and Inefficiency in Healthcare

Core Versus Chore: Using Human-Centered Design to Solve Burnout and Inefficiency in Healthcare

by Grace E. Terrell, MD, MMM, FACP, FACPEBook

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What if healthcare could run smoother — and your team could thrive — instead of barely surviving?

Modern healthcare is overwhelmed by inefficiency, burnout, and tech overload. Promises of revolutionary tools often leave practices drowning in complexity, while staff morale plummets and patient outcomes suffer. But what if the issue isn’t the technology itself — but how we think about the work?

Enter Core Versus Chore, a groundbreaking book from Grace E. Terrell, MD, MMM, FACP, FACPE, that flips the script on healthcare improvement. Using human-centered design principles, Terrell delivers a real-world framework to separate what truly matters — the core mission of patient care — from the endless administrative and technological chores that hold teams back.

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This isn’t theory. It is a battle-tested, practical guide from someone who has lived the challenges of healthcare leadership firsthand. Packed with actionable strategies, Core Versus Chore equips healthcare leaders to untangle inefficiencies, prevent burnout, and harness the transformative power of AI and technology.

Learn to:

Spot real solutions: Identify technologies that streamline workflows instead of creating more chaos.

Prevent burnout at its source: Address the friction points that drain your team’s energy before they spiral into fatigue.

Lead innovation with confidence: Turn the rapid pace of change into a strategic advantage, especially in the age of AI.

Perfect for:

Physicians stepping into leadership roles

Healthcare administrators craving sustainable solutions

Clinical practice managers battling inefficiencies

Health system executives navigating technological disruption

Whether you are a seasoned leader or just starting your journey, Core Versus Chore delivers clarity, confidence, and tools to help you lead smarter, not harder. Stop patching problems — start solving them at the root.

Because your patients deserve better. Your team deserves better. And so do you.

"This book doesn't just diagnose healthcare's efficiency problems — it provides the surgical precision needed to fix them."

About the author

Grace E. Terrell, MD, MMM, FACP, FACPE, is a national thought leader in healthcare innovation and delivery system reform, and a serial entrepreneur in population health outcomes driven through patient care model design, clinical and information integration, and value-based payment models.

She is chief medical officer at IKS Health, an international healthcare company designing simple solutions for the complex problems in healthcare, using the “core vs. chore” framework. She has been a practicing general internist for more than thirty years. She has served as CEO of several companies, including Eventus WholeHealth, LLC., a company focused on providing holistic care to medically vulnerable adults and Cornerstone Health Care, one of the first medical groups to make the “move to value” by lowering the cost of care and improving its quality for the sickest, most vulnerable patients. She was the founding CEO of CHESS, a population health management company, and the former CEO of Envision Genomics, a company focused on the integration of precision medicine technology into population health frameworks for patients with rare and undiagnosed diseases.

Terrell has served as vice chair of the U.S. DHHS’ Physician-Focused Payment Model Technical Advisory Committee, the chair of the board of the AMGA, and is a founding member of the Oliver Wyman Health Innovation Center. She is the author of several books, including Value-Based Care and Payment Models, Reframing Contemporary Physician Leadership: We Started as Heroes, and Strategies for Recognizing and Eliminating Gender Bias for Healthcare Leaders.She is currently executive in residence at Duke University School of Medicine’s MMCi Program, a senior advisor for Oliver Wyman Health and Life Sciences consulting practice, and a member of the board of trustees of Guilford College.

Contents

  • Introduction: Imagine the Practice of the Future
  • Part One: Reimagine the Chores to Fortify the Core
  • Remembering the Core
  • Chapter 1: Unnecessary Chores
  • Chapter 2: Information Chaos
  • Chapter 3: Requirements for Fixing Healthcare Delivery
  • Chapter 4: More Efficient and Effective Clinical Workflows
  • Chapter 5: More Efficient and Effective Administrative Workflows
  • Chapter 6: More Efficient and Effective Value-Based Care Workflows
  • Chapter 7: The Important Difference Between Professionalism and “Top of License”
  • Chapter 8: Scope of Practice
  • Chapter 9: Designing the Well-Functioning Clinical Team
  • Chapter 10: Your Mission Is Your Core
  • Chapter 11: What Has To Be Done Where?
  • Chapter 12: Identify the Chores
  • Chapter 13: Pajama Time Is Evil
  • Chapter 14: Platforms Can Diminish Chores
  • Chapter 15: The Purpose of Clinical Documentation and Its Devolution
  • Chapter 16: Clinical Documentation Is a Chore
  • Chapter 17: Don’t Let Clinical Decision Support Become a Chore
  • Chapter 18: When Did Primary Care Become Just Screening and Referring?
  • Chapter 19: Reclaiming the Core
  • Part Two: Human-Centered Design Will Improve Healthcare
  • Rebuilding Healthcare
  • Chapter 20: Human-Centered Design: Building Systems That Heal, Not Harm
  • Chapter 21: Using Human-Centered Design and Humans-in-the-Loop to Fight Bias in Healthcare
  • Chapter 22: The Five Stages of Health Information Technology
  • Chapter 23: Design-Integrated Virtual and Digital Health
  • Chapter 24: From Vision to Action: Strategy, Tactics, and the Future of Healthcare
  • Chapter 25: It’s Moral Injury, not Burnout
  • Chapter 26: Burnout Is Gendered: The Disproportionate Toll on Women Physicians
  • Chapter 27: Redesigning Healthcare’s Financial Engine: Solving the Hidden Drivers of Dysfunction
  • Chapter 28: Hospitals as Airports: Rethinking Healthcare through System Design
  • Chapter 29: Global Human Capital and Pragmatic Technology
  • Chapter 30: Rethinking the Healthcare Team: Beyond the Lone Physician
  • Chapter 31: Patients vs. Consumers
  • Chapter 32: Precision Medicine Is Patient-Centered
  • Chapter 33: Population Health and the Rubik’s Cube: A Framework for Human-Centered Redesign
  • Chapter 34: Fixing Our Broken Healthcare System by Understanding Non-Western Culture’s Approaches to Health and Well-Being
  • Chapter 35: Design for Wellville: A Human-Centered Approach Beyond the Social Determinants of Health
  • Chapter 36: Whole Person Care Matters in the Total Cost of Care
  • Chapter 37: How Medical Needs Are Evolving Faster Than the System Can Keep Up
  • Acknowledgments
  • References