Comprehensive coordinated care happens when providers and/or systems come together to realize a common goal. Dr. Berwick discussed the triple aim in an effort to improve the healthcare delivery system and now we have progressed to the quadruple aim by adding a fourth dimension to the original 3 dimensions (improving experience of care, improving health of a population and lowering costs) of improved outcomes which is perhaps the most important as it relates directly to our patients. All of our providers at VIPMD have come together in a seamless manner and set sights on achieving the quadruple aim for all of our patients. Integration of multiple services and developing an intrinsic referral matrix helps patients have better outcomes and stay healthier longer.