Publications

December 2021
Article

Primary Care Access During the COVID-19 Pandemic: a Simulated Patient Study

By: Michael Anne Kyle, Renuka Tipirneni, Nitya Thakore, Sneha Dave and Ishani Ganguli

Background
Primary care practices have experienced major strains during the COVID-19 pandemic, such that patients newly seeking care may face potential barriers to timely visits.
Objective
To quantify availability and wait times for new patient... View Details

Keywords: COVID-19; Ambulatory Care; Policy/economics; Access; Telemedicine; Health Pandemics; Health Care and Treatment

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March 2022
Article

Assessing the Impact of the COVID-19 Pandemic on Clinician Ambulatory Electronic Health Record Use

By: A Jay Holmgren, Lance Downing, Mitchell Tang, Christopher Sharp, Christopher Longhurst and Robert S. Huckman

Objective: The COVID-19 pandemic changed clinician electronic health record (EHR) work in a multitude of ways. To evaluate how, we measure ambulatory clinician EHR use in the United States throughout the COVID-19 pandemic.

Materials and Methods: We use EHR... View Details

Keywords: Health Care; Electronic Health Records; Productivity; COVID-19 Pandemic; Health Care and Treatment; Health Pandemics; Information Technology; Performance Productivity; United States

February 2023
Article

Maintaining Health Care Innovations After the Pandemic

By: Regina E. Herzlinger, Barak D. Richman and Kevin A. Schulman

The COVID-19 pandemic exposed the worst failings of the health care system, but it also stimulated a flurry of innovations that could lead to a much-improved delivery system. These were innovations that were born out of necessity: telemedicine access and use... View Details

Keywords: Health Care; Health Care Industry; Health Care Outcomes; Innovation; Innovation In Healthcare Delivery; COVID; COVID-19 Pandemic; Pandemics; Telemedicine; Telehealth; Ambulatory Care; Vaccines; Innovation and Invention; Change; Health Industry

February 2025
Article

Innovations in Evaluating Ambulatory Costs of Cystic Fibrosis Care: A Comparative Study Across Multidisciplinary Care Centers in Ireland and the United States

By: Emma Brady, Ryan C. Perkins, Kate Cullen, Gregory S. Sawicki, Robert S. Kaplan and Gerardine Doyle

Lead clinicians at two large pediatric cystic fibrosis (CF) centers in the United States and Ireland measured and compared their ambulatory care costs. The clinicians selected three strata of patients (0–11 months, 1–5 years, and 6–17 years of age). Process maps were... View Details

Keywords: Health Care and Treatment; Cost; Service Delivery; Resource Allocation; Health Industry

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August 2012 (Revised February 2021)
Case

Hub and Spoke, HealthCare Global and Additional Focused Factory Models for Cancer Care

By: Regina E. Herzlinger, Amit Ghorawat, Meera Krishnan and Naiyya Saggi

This case compares and contrasts four different models for delivering cancer care in India and the US. Students are asked to select the best model in its alignment with the Six Forces in those two countries and Africa, to which one of the models is considering... View Details

Keywords: Cancer Care Services; Focused Factories For Cancer Care; Hub And Spoke Cancer Care; Cancer Care In The U.S.; Cancer Care In Africa; Cancer Care In India; Health Care and Treatment; Business Model; Six Sigma; Health Disorders; Health Industry; United States; India; Africa

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January 19, 2024
Article

Value-Based Health Care Can Transform the Treatment of Patients with Substance Use Disorder

By: Robert S. Kaplan and Sarah E. Wakeman

U.S. overdose deaths currently exceed 100,000 per year. New facilities, known as bridge clinics, are broadening access to high-quality care by offering outpatient substance use disorder (SUD) treatment with few access barriers. But many of the critical services offered... View Details

Keywords: Health Care and Treatment; Cost; Adoption

3 Jun 2023
Talk

Health Care Innovation Opportunities Created by COVID-19 and How to Make Them Happen

By: Regina E. Herzlinger

The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details

Keywords: Policy; Health Pandemics; Health Care and Treatment; Innovation and Invention; Health Industry; Insurance Industry

2013
Article

The Impact of Electronic Health Record Use on Physician Productivity

By: Julia Adler-Milstein and Robert S. Huckman

To examine the impact of the degree of electronic health record (EHR) use and delegation of EHR tasks on clinician productivity in ambulatory settings.
Study Design: We examined EHR use in primary care practices that implemented a web-based EHR from athenahealth... View Details

Keywords: Electronic Health Records; Health Care; Productivity; Healthcare IT; Information Technology; Performance Productivity; Health Care and Treatment; Health Industry

August 2015 (Revised August 2015)
Case

Hoag Orthopedic Institute

By: Robert S. Kaplan and Jonathan Warsh

Two groups of orthopedic surgeons form a joint venture with a community hospital to establish Hoag Orthopedic Institute, a for-profit hospital and two ambulatory service centers. By controlling and integrating all aspects of the patients' medical treatment, the... View Details

Keywords: Outcomes Measurement; Bundled Payment; Health Care; Activity-based Costing And Management; Measurement and Metrics; Activity Based Costing and Management; Competitive Strategy; Medical Specialties; Health Care and Treatment; Outcome or Result; Health Industry

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18 Apr 2024
Lecture

Innovation Opportunities Created by COVID-19 Can Help: And How to Make Them Happen

By: Regina E. Herzlinger

The crush of patients created by COVID enabled the creation of sites for care outside the traditional hospital, such as retail pharmacies, ambulatory surgery centers, urgent care centers, telemedicine, and wireless sensors. Public policy mirrored these changes by... View Details

Keywords: Policy; Health Pandemics; Health Care and Treatment; Innovation and Invention; Health Industry; Insurance Industry

January 2010 (Revised March 2011)
Case

The Children's Hospital of Philadelphia: Network Strategy

By: Michael E. Porter, Carolyn Daly and Andrew Peter Dervan

In 2009 Children's Hospital of Philadelphia (CHOP) had been recognized as the best children's hospital in the country for six years in a row; but leadership saw CHOP as more than the large main campus in western Philadelphia. Beginning in the 1990s, CHOP had created a... View Details

Keywords: Communication; Health Care and Treatment; Service Delivery; Organizational Structure; Networks; Integration; Health Industry; Philadelphia

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Article

A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal

By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman

U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital... View Details

Keywords: Time-Driven Activity-Based Costing; Cost Accounting; Health Care and Treatment; Health Industry; India; Nepal; United States

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February 2021
Article

Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems

By: A Jay Holmgren, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman and Kevin A. Schulman

Importance: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of use.
Objective: To provide insights into which EHR... View Details

Keywords: Electronic Health Records; Health Care and Treatment; Online Technology; Health Industry; Information Technology Industry

June 2020
Article

Evaluation of Prescription Drug Monitoring Program Integration with Hospital Electronic Health Records by US County-Level Opioid Prescribing Rates

By: A Jay Holmgren and Nate Apathy

Prescription drug monitoring programs (PDMPs) have become a widely embraced policy solution to the opioid epidemic in the US. PDMPs offer prescribers a comprehensive view of patients’ controlled substance prescription history and can be used to monitor and reduce... View Details

Keywords: Prescription Drug Monitoring Programs; PDMPs; Electronic Health Records; Hospitals; Health Care and Treatment; Information Technology; Integration; Performance Evaluation