Clinical Outcomes - Publications - Faculty & Research - Harvard Business School

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Measure Outcomes & Cost for Every Patient - Institute For Strategy And Competitiveness

these, while often easy to measure, do not always correlate with clinical outcomes. Similarly, structural measures, patient experience, and other indicators are often substituted for outcomes. There are several basic principles of View Details

March 2016
Article

Using Quality Improvement Methods and Time-Driven Activity-Based Costing to Improve Value-Based Cancer Care Delivery at a Cancer Genetics Clinic

By: R.Y. Tan, M. Met-Domestici, K. Zhou, A.B. Guzman, S.T. Lim, K.C. Soo, T.W. Feeley and J. Ngeow

Purpose:
To meet increasing demand for cancer genetic testing and improve value-based cancer care delivery, National Cancer Centre Singapore restructured the Cancer Genetics Service in 2014. Care delivery processes were redesigned. We sought to improve access by... View Details

Keywords: Cancer Treatment; Value Based Health Care; Time-Driven Activity-Based Costing; Health Care and Treatment; Quality; Performance Improvement; Activity Based Costing and Management

Article

Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial

By: Chethan Bachireddy, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini and Katherine L. Milkman

Importance: Few adults engage in recommended levels of physical activity. Financial incentives can promote physical activity, but little is known about how their structure influences their effectiveness; for example, whether incentives are more effective if they are... View Details

Keywords: Physical Activity; Financial Incentives; Motivation and Incentives; Money

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Article

Physician–patient Racial Concordance and Disparities in Birthing Mortality for Newborns

By: Brad N. Greenwood, Rachel R. Hardeman, Laura Huang and Aaron Sojourner

Recent work has emphasized the benefits of patient–physician concordance on clinical care outcomes for underrepresented minorities, arguing it can ameliorate outgroup biases, boost communication, and increase trust. We explore concordance in a setting where racial... View Details

Keywords: Racial Bias; Birthing Outcomes; Concordance; Mortality; Health Care and Treatment; Race

May 2014
Case

Health Care Accountability: Examples in Cancer Treatment

By: Regina E. Herzlinger and Natalie Kindred

This case is designed to support a discussion of the importance of outcomes evidence in empowering the public to make better health care decisions, the desired level of transparency and accountability for health care providers, and the issues with current measuring and... View Details

Keywords: Accountability; Health Care; Cancer; Cancer Treatment; Memorial Sloan Kettering Cancer Center; Cancer Treatment Centers Of America; Vantage Oncology; Radiology; Risk Adjustment; Treatment Outcomes; Health Care Outcomes; Prostate Cancer; Transparency; Health Care and Treatment; Risk Management; Outcome or Result; Health Industry; United States

Research Summary

The Effect of Hospital and Surgeon Procedure Volume on the Outcomes of Primary and Revision Total Knee Replacement: Magnitude and Mechanisms

My role in this study is to assess whether care provider coordination mediates the relationship between surgical volumes and patient outcomes. It is a study involving hundreds of hospitals and thousands of patients, and for the main study, coordination will be... View Details

April 2009
Case

Performance Management at Intermountain Healthcare

By: Richard M.J. Bohmer and Alexander Romney

Intermountain Healthcare is a 21-hospital integrated delivery system serving Utah and southern Idaho that is nationally recognized for its highly structured approach to managing the quality of clinical care. This case describes Intermountain's system for improving... View Details

Keywords: Financial Strategy; Health Care and Treatment; Standards; Service Delivery; Outcome or Result; Motivation and Incentives; Health Industry; Idaho; Utah

June 2016
Article

When Doctors Go to Business School: Career Choices of Physician-MBAs

By: Damir Ljuboja, Brian W. Powers, Benjamin Robbins, Robert S. Huckman, Krishna Yeshwant and Sachin Jain

There has been substantial growth in the number of physicians pursuing Master of Business Administration (MBA) degrees over the past decade, but there is continuing debate over the utility of these programs and the career outcomes of their graduates. The authors... View Details

Keywords: Medical Education; MD; MBA; Physicians; Executive Education; Training; Personal Development and Career; Health Care and Treatment; Health Industry; United States

June 2014
Article

Improving Value with TDABC

By: Robert S. Kaplan

The article discusses the benefits of time-driven activity-based costing (TDABC) combined with outcomes measurement for healthcare organizations. Topics covered include improving resource efficiency, optimizing care over the complete care cycle, and planning and... View Details

Keywords: Goals and Objectives; Activity Based Costing and Management; Health Care and Treatment; Health Industry

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June 2014 (Revised February 2017)
Case

Kathy Giusti and the Multiple Myeloma Research Foundation

By: Richard G. Hamermesh, Joshua D. Margolis and Matthew G. Preble

What do you do when your rising professional career is cut short by an unexpected cancer diagnosis? Kathy Giusti shifted careers, built a new organization that transformed how cancer research is done, and now faces the challenge of sustaining the organization and its... View Details

14 Nov 2019
Video

Health Minute: How Can Technology Improve 21st Century Health Care

Article

Patterns of Failure after Involved Field Radiation Therapy for Pediatric and Young Adult Hodgkin Lymphoma

By: Minh-Phuong Huynh-Le, Amanda J. Walker, Scott Duke Kominers, Ido Paz-Priel, Moody D. Wharam and Stephanie A. Terezakis

Involved field radiation therapy (IFRT) is integral in curative therapy for Hodgkin lymphoma (HL), although primarily used in patients with intermediate/high‐risk HL. We present failure patterns and clinical outcomes in a cohort of pediatric and young adult patients... View Details

Keywords: Hematology/oncology; Hodgkin Lymphoma; Involved Field Radiation Therapy; Health Disorders; Health Care and Treatment

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April 2021
Case

ClearChoice Dental Implant Centers

By: Robert S. Kaplan, Ashiana Jivraj and Jane Barrow

The case illustrates the application of value-based health care to dental medicine. ClearChoice Dental Implant Centers was a rapidly-growing network of dentist-owned independent implant clinics. The targeted market included 23 million people, 15% of the US adult... View Details

Keywords: Value-based Health Care; Dental Medicine; Growth and Development Strategy; Expansion; Business Strategy; Customer Value and Value Chain; Customer Focus and Relationships; Health Industry; United States

Article

Assessing the Value of Pediatric Aerodigestive Care

By: Robert S. Kaplan, Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher and Evan Propst

Leaders at six hospitals conducted a research study to assess and compare the health outcomes and costs of pediatric aerodigestive care. Four of the hospitals delivered care with an integrated practice unit (IPU) while two delivered care traditionally, with isolated... View Details

Keywords: Time-Driven Activity-Based Costing; Value-based Health Care; Integrated Practice Unit; Health Care and Treatment; Cost Management; Performance Improvement

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April 2012
Article

Addressing the Leadership Gap in Medicine: Residents' Need for Systematic Leadership Development Training

By: Daniel Mark Blumenthal, Kenneth Richard Lee Bernard, Jordan David Bohnen and Richard Bohmer

All clinicians take on leadership responsibilities when delivering care. Evidence suggests that effective clinical leadership yields superior clinical outcomes. However, few residency programs systematically teach all residents how to lead, and many clinicians are... View Details

Keywords: Health Care and Treatment; Service Delivery; Leadership Development; Training; Programs; Practice

October 2009 (Revised January 2010)
Case

The Joslin Diabetes Center

By: Michael E. Porter, Elizabeth Olmsted Teisberg and Scott Wallace

The Joslin Diabetes Center in Boston, Massachusetts is a leading center for diabetes care, clinician training, and research. The incidence of diabetes is rising precipitously worldwide, challenging quality of life with its complications and rapidly accelerating health... View Details

Keywords: Integration; Service Delivery; Medical Specialties; Health Care and Treatment; Outcome or Result; Corporate Finance; Health Industry; Boston

October 2013
Article

The Strategy That Will Fix Health Care

By: Michael E. Porter and Thomas H. Lee

In health care, the days of business as usual are over. Around the world, every health care system is struggling with rising costs and uneven quality, despite the hard work of well-intentioned, well-trained clinicians. Health care leaders and policy makers have tried... View Details

Keywords: Organizational Change and Adaptation; Strategy; Value; Customer Focus and Relationships; Health Care and Treatment; Health Industry

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February 2009 (Revised June 2019)
Case

Cleveland Clinic: Transformation and Growth 2015

By: Michael E. Porter and Elizabeth O. Teisberg

The Cleveland Clinic's health care services are internationally renowned for quality. In 2008, The Clinic began to restructure the organization into teams defined around patient needs, rather than traditional medical specialties. "Patients First!" takes shape as the... View Details

Keywords: Health; Health Care Operations; Health Care Quality; Health Care; Strategy And Leadership; Strategy Development; Health Care and Treatment; Leading Change; Goals and Objectives; Growth and Development Strategy; Measurement and Metrics; Service Delivery; Organizational Change and Adaptation; Outcome or Result; Health Industry; Cleveland

Article

Surgeons and Administrators Co-Creating Value

By: Michael Nurok, Thoralf Sundt, Robert S. Kaplan and Bruce Gewertz

Most hospitals have arms-length relationships with physicians, viewing them as people they must ‘‘manage,’’ not as potentially valuable strategic partners. But surgeons make clinical decisions every day that have great influence on both patient outcomes and hospital... View Details

Keywords: Value-based Health Care; Collaboration; Healthcare Administration; Health Care and Treatment; Management; Strategy; Value Creation

Article

Better Accounting Transforms Health Care Delivery

By: Robert S. Kaplan and Mary L. Witkowski

The paper describes the theory and preliminary results for an action research program that explores the implications from better measurements of health care outcomes and costs. After summarizing Porter's outcome taxonomy (Porter 2010), we illustrate how to use process... View Details

Keywords: Activity Based Costing and Management; Research; Health Care and Treatment; Health Industry

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