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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
Materials and Methods: We use EHR... View Details
- May 2021
- Article
Making Doctors Effective Managers and Leaders: A Matter of Health and Well-Being
By: Lisa Rotenstein, Robert S. Huckman and Christine K. Cassel
The COVID-19 crisis has forced physicians to make daily decisions that require knowledge and skills they did not acquire as part of their biomedical training. Physicians are being called upon to be both managers—able to set processes and structures—and leaders—capable... View Details
- March 2021
- Article
Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care
By: Maximilian J. Pany, Lucy Chen, Bethany Sheridan and Robert S. Huckman
Scope-of-practice regulations, including prescribing limits and supervision requirements, may influence the propensity of providers to form care teams. Therefore, policy makers need to understand the effect of both team-based care and provider type on clinical... View Details
- 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
Objective: To provide insights into which EHR... View Details
- Article
Toward a Corporate Culture of Health: Results of a National Survey
By: Michael Anne Kyle, Lumumba Seegars, John M. Benson, Robert J. Blendon, Robert S. Huckman and Sara J. Singer
Context: The private sector has a large potential role in advancing health and well-being, but attention to corporate practices around health tends to focus on a narrow range of issues and on large businesses. Systematically describing private sector engagement in... View Details
- Article
Can Big-Box Retailers Provide Local Health Care?
National retailers, most notably Walmart and Best Buy, are making big bets on their ability to fill this need for local health care. At first glance, these moves are a bit surprising given that these companies have not traditionally been focused on health care... View Details
- September 2018
- Article
Discretionary Task Ordering: Queue Management in Radiological Services
By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
Work-scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details
Keywords: Discretion; Scheduling; Queue; Healthcare; Learning; Experience; Decentralization; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry
- March 2018
- Supplement
Improving Access at VA
By: Ryan W. Buell and Robert S. Huckman
In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans... View Details
- March 2018 (Revised February 2020)
- Teaching Note
Improving Access at VA
By: Ryan W. Buell and Robert S. Huckman
In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans... View Details
- March 2018
- Teaching Note
Twine Health
By: Robert S. Huckman and Ariel D. Stern
In late 2014, Dr. John Moore (CEO), Frank Moss (chairman), and Scott Gilroy (CTO) of Twine Health (Twine) had to resolve several challenges that threatened to restrict the widespread dissemination of its sole product, Twine. Twine was a cloud-based platform that... View Details
- September 2017 (Revised February 2023)
- Case
Intermountain Healthcare: Pursuing Precision Medicine
By: Richard G. Hamermesh, Kathy E. Giusti, Robert S. Huckman and Julia Kelley
Headquartered in Salt Lake City, Intermountain Healthcare operates 23 hospitals and hundreds of clinics in Utah and Idaho and provides insurance to approximately 850,000 patients through its insurance arm, SelectHealth. In 2013, Intermountain, known for its commitment... View Details
- November 2016 (Revised August 2020)
- Case
Improving Access at VA
By: Ryan W. Buell, Robert S. Huckman and Sam Travers
In 2015, the Department of Veterans Affairs (VA) ran the largest healthcare system in the United States, with over 1,700 sites of care that served nearly 9 million veterans. One year earlier, a scandal had erupted over a cover-up of the excessive wait times veterans... View Details
- October 2016 (Revised March 2019)
- Case
Carrum Health: Scaling Bundled Payments
By: Robert S. Huckman and Sarah Mehta
Founded in 2014, Carrum Health helped self-insured employers located in three markets (San Diego, California; Seattle, Washington; and San Francisco, California) save money on their employees’ planned surgeries. It did so by contracting directly with top-quality... View Details
Keywords: Health Financing; Health Insurance; Value-based Healthcare Reimbursements; Bundled Payments; Innovation; Scale; Health; Health Care and Treatment; Cost Management; Growth and Development Strategy; Decision Choices and Conditions; Health Industry; California; San Francisco; San Diego; Seattle
- December 2015
- Article
Task Shifting in Surgery: Lessons from an Indian Heart Hospital
By: Budhaditya Gupta, Robert S. Huckman and Tarun Khanna
We present a case study that illustrates task shifting, the transfer of activities from senior to junior colleagues, in the context of cardiac surgery at the Narayana Health City Cardiac Hospital (NH) in India. The case discusses the factors driving the adoption of... View Details
- 2017
- Working Paper
Discretionary Task Ordering: Queue Management in Radiological Services
By: Maria Ibanez, Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
Work scheduling research typically prescribes task sequences implemented by managers. Yet employees often have discretion to deviate from their prescribed sequence. Using data from 2.4 million radiological diagnoses, we find that doctors prioritize similar tasks... View Details
Keywords: Discretion; Scheduling; Queue; Healthcare; Learning; Experience; Decentralization; Delegation; Behavioral Operations; Operations; Service Operations; Service Delivery; Performance; Performance Effectiveness; Performance Efficiency; Performance Improvement; Performance Productivity; Decisions; Time Management; Cost vs Benefits; Health Industry
- 2016
- Working Paper
Cohort Turnover and Operational Performance: The July Phenomenon in Teaching Hospitals
By: Hummy Song, Robert S. Huckman and Jason R. Barro
We consider the impact of cohort turnover—the planned simultaneous exit of a large number of experienced employees and a similarly sized entry of new workers—on operational performance in the context of teaching hospitals. Specifically, we examine the impact of the... View Details
- March 2015
- Case
The I-PASS Patient Handoff Program
By: Robert S. Huckman and Michael Norris
In 2015, the I-PASS Patient Handoff Program Team, led by six pediatricians around the U.S., had to determine the best way to disseminate their program that had been proven to reduce communication errors in patient handoffs in hospital settings. Should they turn it into... View Details
- February 2015
- Article
The Great Recession, Insurance Mandates, and the Use of In Vitro Fertilization Services in the United States
By: Sorapop Kiatpongsan, Robert S. Huckman and Mark D. Hornstein
Objective: To investigate the relationship between economic activities, insurance mandates, and the use of in vitro fertilization (IVF) in the United States.
Design: We examined the correlation between the coincident index (a proxy for overall economic... View Details
Design: We examined the correlation between the coincident index (a proxy for overall economic... View Details
- September–October 2013
- Article
Learning from Customers: Individual and Organizational Effects in Outsourced Radiological Services
By: Jonathan R. Clark, Robert S. Huckman and Bradley R. Staats
The ongoing fragmentation of work has resulted in a narrowing of tasks into smaller pieces that can be sent outside the organization and, in many instances, around the world. This trend is shifting the boundaries of organizations and leading to increased outsourcing.... View Details
- April 2012
- Article
Broadening Focus: Spillovers, Complementarities and Specialization in the Hospital Industry
By: Jonathan R. Clark and Robert S. Huckman
The long-standing argument that focused operations outperform others stands in contrast to claims about the benefits of broader operational scope. The performance benefits of focus are typically attributed to reduced complexity, lower uncertainty, and the development... View Details