Foundations of Systems-Based Hematology: Thematic Analysis of Expert Interviews to Guide Curriculums and Promote Growth Open Access

• SBH is increasingly important for delivering high quality care to patients with hematologic disorders using HSS principles

• A SBH curriculum applying HSS principles to the care of patients with hematologic disorders could help formalize and advance SBH

Systems-Based Hematology (SBH) is an emerging discipline focused on optimizing care delivery for patients with hematologic disorders within complex healthcare systems. Despite growing importance, the field lacks a formal definition, standardized curriculum, and clear career pathway, hindering widespread adoption and training of future SBH experts. We sought to define core principles, competencies, challenges, and future directions of SBH to identify foundational components for a potential educational curriculum. Semi-structured interviews were conducted with eight SBH experts. Expert participants were identified through their committee involvement with the American Society of Hematology. Five overarching themes emerged: The Accidental Expert: SBH careers have developed organically and reactively in response to pressing institutional needs, not through formal training; Defining the Unseen: experts define the field pragmatically by its function and roles; The SBH Toolkit: success requires a hybrid skillset combining clinical hematology expertise with Health Systems Science (HSS) principles; The Architect's Dilemma: the field's growth is hindered by interdependent challenges of building a curriculum, awareness, and securing resources; Charting the Future: the discipline is poised for growth, driven by increasing healthcare complexity and specialization.SBH represents the nexus of HSS principles and hematology care. Formalizing SBH requires a multi-pronged approach, including developing a standardized curriculum that equips learners with a hybrid skillset, creating clear value for health systems and patients, and fostering a community of practice through professional societies. These findings provide a foundational framework for developing educational resources and institutional support necessary to continue advancing SBH.