Health →
- 06 Apr 2015
- Research & Ideas
After Germanwings, More Attention Needed on Employee Mental Health
The Germanwings tragedy catapulted the issues of mental health and corporate risk and responsibility into the world's headlines. Professor John Quelch argues it's time for companies to make employee mental health more than an afterthought. Open for comment; 0 Comments.
- 02 Apr 2015
- Research & Ideas
Digital Initiative Summit: Freeing Patient Data to Enable Innovation
It's difficult to have innovation without data—which is one reason why the health care industry in the United States is too expensive. One remedy: Make the patient the customer. Open for comment; 0 Comments.
- 01 Apr 2015
- Research & Ideas
The Slow, Steady Battle to Fix Cancer Care
Thomas Feeley is on a quest to make payment procedures for cancer patients easier, hopefully less expensive, and in the process help change how health care is delivered in America. Open for comment; 0 Comments.
- 26 Jan 2015
- Research & Ideas
National Health Costs Could Decrease if Managers Reduce Work Stress
Joel Goh and colleagues estimate that workplace stress is responsible for up to 8 percent of national spending on health care and contributes to 120,000 deaths a year. Is better management the fix? Open for comment; 0 Comments.
- 27 Dec 2014
- Working Paper Summaries
How Should We Pay for Health Care?
Improving provider incentives and reimbursement must become a central component in health care reform. Payments need to align with the value delivered to patients: better health outcomes delivered at lower costs. Today, however, deeply‐flawed reimbursement approaches actively discourage providers from delivering value to their patients. In this paper the authors argue that reimbursement through bundled payments is the only approach that aligns providers, payers, and suppliers in a healthy competition to increase patient value. The authors describe the principles of value‐based bundled payments, how such bundles should be constructed, and why they believe this reimbursement method best aligns everyone's interests around value. They show how recent improvements in measuring patient's outcomes and the cost of care are overcoming the past barriers to wider adoption of bundled payments. They conclude by describing how bundled payments can transform competition in health care, and the longer‐term implications for providers, payers, employers, and health care delivery systems. Key concepts include: A value‐based bundled payment is a single payment for treating a patient with a specific medical condition across a full cycle of care. A bundled payment should cover all the procedures, tests, drugs, devices, and services during inpatient, outpatient, and rehabilitative care for a patient's medical condition. The limited adoption of value‐based bundles to date has been caused by today's fragmented structure for delivering healthcare, and inadequate or non‐existent measurement of costs and outcomes at the medical‐condition level. Recent advances in value‐based healthcare delivery concepts set the stage for much more widespread adoption of value-based bundled payments. Closed for comment; 0 Comments.
- 31 Oct 2014
- Op-Ed
Ebola’s Call To Arms About Disaster Preparedness
US health care has just received a critical wake-up call. Risk management tools used to handle normal disruptions are completely inadequate to quell a major catastrophe such as Ebola, says Gautam Mukunda. Open for comment; 0 Comments.
- 10 Sep 2014
- Working Paper Summaries
Don’t Take ‘No’ for an Answer: An Experiment with Actual Organ Donor Registrations
More than 10,000 people in the United States die each year while waiting for an organ transplant. Policymakers and some economists who have tried to increase the rates of organ transplantation have focused on changing the registration question—usually asked when people renew their driver's license—from a simple opt-in to one in which potential donors have the opportunity to make an active "yes" or "no " choice. The authors provide the first concrete evidence of whether active choice affects registration decisions about organ donation. Somewhat surprisingly, the results suggest that not only does active choice not increase registration, it may decrease the transplantation rate by suggesting to next-of-kin that unregistered donors actively chose not to donate. At the same time, however, experimental results suggest other ways to increase the rates of organ donor registration. For example, people are 22 times more likely to add themselves to the registry than remove themselves from the registry, even though they had been asked previously about organ donor registration. This suggests the effectiveness of making a repeated appeal for organ donor registration. In addition, giving people more information about organ donation increases registration rates. Key concepts include: Giving people the opportunity to make an active choice about donation rather than a simple opt-in does not increase, and may decrease, organ donor registration rates. Asking more than once for organ donation increases the number of donors. We shouldn't assume that "no" is a final answer (i.e., don't take no for an answer). People who are registered donors are unlikely to remove themselves from the registry when given the opportunity to do so Giving people information about the benefits of donation, namely providing a list of organs that might be donated, increases the likelihood of registration. Increasing the number of individuals who register as deceased donors is just one way of addressing the need for transplantable organs. Kidney exchange, in which incompatible patient-donor pairs are matched, has facilitated transplantation of kidneys from living donors. Closed for comment; 0 Comments.
- 18 Aug 2014
- Research & Ideas
Have a Better Idea To Improve Health Care?
Harvard launches an open competition to promote already proven innovations that could increase the quality and lower the cost of health care. Closed for comment; 0 Comments.
- 06 Aug 2014
- Research & Ideas
Climbing Down from the Ivory Tower
Nava Ashraf explains why it makes sense for field researchers to co-produce knowledge with the people they study and serve. Open for comment; 0 Comments.
- 16 Jul 2014
- HBS Case
Marketing Obamacare
HBS Professor John Quelch contends that the success of the Affordable Care Act depends more on marketing than it does on policy. And in Connecticut, he's got just the state to prove it. Open for comment; 0 Comments.
- 23 Apr 2014
- HBS Case
Are Electronic Cigarettes a Public Good or Health Hazard?
A new case study by John Quelch charts the growing popularity of electronic cigarettes and how tobacco companies and regulators are responding. Open for comment; 0 Comments.
- 31 Jan 2014
- Working Paper Summaries
The Diseconomies of Queue Pooling: An Empirical Investigation of Emergency Department Length of Stay
Improving efficiency and customer experience are key objectives for managers of service organizations including hospitals. In this paper, the authors investigate queue management, a key operational decision, in the setting of a hospital emergency department. Specifically, they explore the impact on throughput time depending on whether an emergency department uses a pooled queuing system (in which a physician is assigned to a patient once the patient is placed in an emergency department bed) or a dedicated queuing system (in which physicians are assigned to specific patients at the point of triage). The authors measured throughput time based on individual patients' length of stay in the emergency department, starting with arrival to the emergency department and ending with a bed request for admission to the hospital or the discharge of a patient to home or to an outside facility. The findings show that, on average, the use of a dedicated queuing system decreased patients' lengths of stay by 10 percent. This represented a 32-minute reduction in length of stay—a meaningful time-savings for the emergency department and patients alike. The authors argue that physicians in the dedicated queuing system had both the incentive and ability to make sure their patients' care progressed efficiently, so that patients in the waiting room could be treated sooner than they otherwise would have. Key concepts include: This study tests the impact of a queuing system structure on the throughput time of patients in an emergency department that had recently switched from a pooled queuing system to a dedicated queuing system. Patients experienced faster throughput times when physicians were working in a dedicated queuing system as opposed to a pooled queuing system. The benefits of a dedicated queuing system may be due to greater visibility into one's workload and the increased ability for physicians to manage patient flow. Closed for comment; 0 Comments.
- 05 Dec 2013
- Op-Ed
Encourage Breakthrough Health Care by Competing on Products Rather Than Patents
For too long, the science behind breakthrough therapeutics has been locked behind patents held by universities. Richard Hamermesh proposes the market compete on solutions rather than intellectual property rights. Closed for comment; 0 Comments.
- 16 Oct 2013
- Op-Ed
Response to Readers: Combating Climate Change with Nuclear Power and Fracking
Following a contentious online debate, Professor Joe Lassiter expands his argument that nuclear power and fracking are the lesser evils when stacked up against coal power, and presents a way forward. Closed for comment; 0 Comments.
- 15 Jul 2013
- Research & Ideas
Five Imperatives for Improving Health Care
Leaders from Harvard's medical and business schools are exploring ways to improve health care delivery. In a new study, their Forum on Healthcare Innovation delivers five key imperatives. Closed for comment; 0 Comments.
- 18 Apr 2013
- Working Paper Summaries
The Impact of Pooling on Throughput Time in Discretionary Work Settings: An Empirical Investigation of Emergency Department Length of Stay
Improving the productivity of their organizations' operating systems is an important objective for managers. Pooling—an operations management technique—has been proposed as a way to improve performance by reducing the negative impact of variability in demand for services. The idea is that pooling enables incoming work to be processed by any one of a bank of servers, which deceases the odds that an incoming unit of work will have to wait. Does pooling have a downside? The authors analyze data from a hospital's emergency department over four years. Findings show that, counter to what queuing theory would predict, pooling may actually increase procesdsing times in discretionary work settings. More specifically, patients have longer lengths of stay when emergency department physicians work in systems with pooled tasks and resources versus dedicated ones. Overall, the study suggests that managers of discretionary work systems should design control mechanisms to mitigate behaviors that benefit the employee to the detriment of customers or the organization. One mechanism is to make the workload constant regardless of work pace, which removes the benefit of slowing down. Key concepts include: This research offers practical insights for workplace managers and health care policymakers. In workplaces where workers have discretionary control, the potential negative effects of designing pooled systems must be carefully considered. This has implications for designing and managing staffing structures and workflows, particularly in the context of service delivery organizations. Managers should consider implementing group incentives rather than individual incentives to motivate workers. This may encourage fast workers to reduce their speed just enough so that they will not negatively affect the productivity of others by over-utilizing shared resources. While workplaces often seek to incentivize workers through pay-for-performance programs that focus on individual productivity, a group-level approach may help counteract the negative effects that fast workers exhibit on overall productivity levels. In health care, emergency departments may benefit from implementing non-pooled work systems in which patients are assigned to a doctor-nurse team immediately upon arrival. Closed for comment; 0 Comments.
- 13 Feb 2013
- Research & Ideas
5 Weight Loss Tips From Behavioral Economists
Behavioral economists study what motivates people to buy, save, donate, and any other number of actions that build society. The following studies reveal proven methods of encouraging healthy eating and exercise. Open for comment; 0 Comments.
- 21 Jan 2013
- Research & Ideas
Altruistic Capital: Harnessing Your Employees’ Intrinsic Goodwill
Everyone comes to the table with some amount of "altruistic capital," a stock of intrinsic desire to serve, says professor Nava Ashraf. Her research includes a study of what best motivates hairdressers in Zambia to provide HIV/AIDS education in their salons. Closed for comment; 0 Comments.
- 21 Nov 2012
- Research & Ideas
What Health Care Managers Need to Know--and How to Teach Them
Health care business managers are under tremendous pressure to become more innovative, more productive, more accountable. The question, asks Regina Herzlinger, is who is going to teach them these skills? Open for comment; 0 Comments.
Build 'Scaffolds' to Improve Performance of Temporary Teams
Many critical tasks are performed by teams created on the fly, but lack of stability can hinder their performance. Amy Edmondson and Melissa Valentine use the idea of scaffolds to produce greater collaboration and efficiency on temporary teams. Open for comment; 0 Comments.