CLEVELAND -- A new paper in the June issue of New England Journal of Medicine Catalyst Innovations in Care Delivery describes how the University Hospitals (UH) system applied design-based thinking in a re-imagined process for referrals of patients from primary care physicians to psychiatrists in a value-based, high-reliability model. "Referrals from primary care to specialty care represent a critical pathway in the patient journey to wellness. As we move toward value-based payment models, high-reliability referral pathways will be of increasing importance in achieving better outcomes at lower cost," said Patrick Runnels, MD, Chief Medical Officer of Population Health and Behavioral Health at UH, Vice Chair of Psychiatry at Case Western Reserve University and lead author of the paper.