Richard M.J. Bohmer

Senior Lecturer of Business Administration

Unit: Technology and Operations Management

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(617) 495-6660

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Richard Bohmer, MBChB, MPH, is a New Zealand trained physician on the faculty of Harvard Business School.  He graduated from the Auckland University School of Medicine and has practiced hospital and primary medicine in New Zealand and England.  In 1989 he was part of a clinical team that established and ran a surgical hospital in Sudan.  He attended the Harvard School of Public Health on a Fulbright Scholarship, graduating in 1993 with a Masters of Public Health in Health Care Management, and joined the HBS faculty in 1997.

At the Harvard Business School he teaches an MBA course on health care operations management, co-directs the MD-MBA program and is the faculty chair for two executive programs in health care delivery.  He teaches and consults on health management issues in numerous locations around the world.  Before joining the HBS faculty, Dr. Bohmer was the Clinical Director of Quality Improvement at Massachusetts General Hospital, where he was responsible for planning and implementing the institution's clinical quality improvement program.

Dr. Bohmer's research focus is on the intersection between medical care and management practice and concentrates on understanding how best to design and manage the process of patient care in order to improve clinical outcomes.  He has published in both the management and medical literatures on learning, technology adoption and operations strategy in health care, and on quality improvement and patient safety, and is the author of Designing Care: Aligning the Nature and Management of Health Care (HBS Press, 2009).

Featured Work

Publications

Books

  1. Designing Care: Aligning the Nature and Management of Health Care

    Today's health-care providers face growing criticism - from policy makers and patients alike. As costs continue to spiral upward and concerns about quality of care escalate, the debate has focused on how to finance health care. Yet funding solutions can't address the underlying questions: Why have costs risen in the first place? And how can we improve the quality and affordability of care? In Designing Care, Harvard Business School professor Richard Bohmer argues that these fundamental questions must be answered. A medical doctor himself, Bohmer explains that health-care professionals are tasked with providing two very different types of care - sequential and iterative. With sequential care, a patient can be quickly diagnosed and given predictable, reliable, and low-cost care. But in the case of iterative care, a patient's condition is unknown, and tremendous resources may be required for diagnosis and treatment, often with uncertain outcomes. Bohmer shows that to reduce costs and manage care effectively, sequential and iterative care situations require different management systems. Through stories and cases drawn from years in the field, he reveals how health-care providers can successfully manage both modes. To do so, they must reevaluate traditional roles and embrace continuous learning across the organization. The benefits of this operational redesign? The predictable, responsive, and lower-cost care today's health-care leaders - and patients - seek.

    Keywords: Cost Management; Health Care and Treatment; Service Delivery; Business Processes; Organizational Culture;

    Citation:

    Bohmer, Richard. Designing Care: Aligning the Nature and Management of Health Care. Harvard Business Press, 2009. View Details

Journal Articles

  1. Lessons from England's Health Care Workforce Redesign: No Quick Fixes

    In 2000 the English National Health Service (NHS) began a series of workforce redesign initiatives that increased the number of doctors and nurses serving patients, expanded existing staff roles and developed new ones, redistributed health care work, and invested in teamwork. The English workforce redesign experience offers important lessons for US policy makers. Redesigning the health care workforce is not a quick fix to control costs or improve the quality of care. A poorly planned redesign can even result in increased costs and decreased quality. Changes in skill mix and role definitions should be preceded by a detailed analysis and redesign of the work performed by health care professionals. New roles and responsibilities must be clearly defined in advance, and teamwork models that include factors common in successful redesigns such as leadership, shared objectives, and training should be promoted. The focus should be on retraining current staff instead of hiring new workers. Finally, any workforce redesign must overcome opposition from professional bodies, individual practitioners, and regulators. England's experience suggests that progress is possible if workforce redesigns are planned carefully and implemented with skill.

    Keywords: health care; Work force management; United Kingdom;

    Citation:

    Bohmer, Richard, and Candace Imison. "Lessons from England's Health Care Workforce Redesign: No Quick Fixes." Health Affairs 32, no. 11 (November, 2013): 2025–2031. View Details
  2. Leading Clinicians and Clinicians Leading

    More effective models of care delivery are needed, but their successful implementation depends on effective care teams and good management of local operations (clinical microsystems). Clinicians influence both, and local clinician leaders will have several key tasks.

    Keywords: health care; leadership; Performance; Leadership; Health Care and Treatment; Health Industry;

    Citation:

    Bohmer, Richard. "Leading Clinicians and Clinicians Leading." New England Journal of Medicine 368, no. 16 (April 18, 2013): 1468–1470. View Details
  3. Addressing the Leadership Gap in Medicine: Residents' Need for Systematic Leadership Development Training

    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 inadequately prepared to meet their day-to-day clinical leadership responsibilities. The purpose of this article is twofold: first, to make the case for the need to refocus residency education around the development of outstanding "frontline" clinical leaders and, second, to provide an evidence-based framework for designing formal leadership development programs for residents. The authors first present a definition of clinical leadership and highlight evidence that effective frontline clinical leadership improves both clinical outcomes and satisfaction for patients and providers. The authors then discuss the health care "leadership gap" and describe barriers to implementing leadership development training in health care. Next, they present evidence that leaders are not just "born" but, rather, can be "made" and offer a set of best practices to facilitate the design of leadership development programs. Finally, the authors suggest approaches to mitigating barriers to implementing leadership development programs and highlight the major reasons why health care delivery organizations, residency programs, and national accreditation bodies must make comprehensive leadership education an explicit goal of residency training.

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

    Citation:

    Blumenthal, Daniel Mark, Kenneth Richard Lee Bernard, Jordan David Bohnen, and Richard Bohmer. "Addressing the Leadership Gap in Medicine: Residents' Need for Systematic Leadership Development Training." Academic Medicine 87, no. 4 (April 2012). View Details
  4. Managing the New Primary Care: The New Skills That Will Be Needed

    Developing new models of primary care will demand a level of managerial expertise that few of today's primary care physicians possess. Yet medical schools continue to focus on the basic sciences, to the exclusion of such managerial topics as running effective teams. The approach to executing reform appears to assume that practice managers and entrepreneurs can undertake the managerial work of transforming primary care, while physicians stick with practicing medicine. This essay argues that physicians currently in practice could be equipped over time with the management skill necessary to develop and implement new models of primary care.

    Keywords: Higher Education; Health Care and Treatment; Management Skills; Managerial Roles; Service Delivery; Practice; Health Industry;

    Citation:

    Bohmer, Richard. "Managing the New Primary Care: The New Skills That Will Be Needed." Health Affairs 29, no. 5 (May 2010): 1010–1014. View Details
  5. Leadership with a Small 'l'

    What exactly do we mean by leadership in health care? Does it mean to take formal positions in senior leadership teams in hospitals, trusts, health boards, ministries of health, and professional societies-what might be termed leadership with a big "L?" Or does it mean something fine grained and local-leadership with a small "l?"

    Keywords: Decision Choices and Conditions; Leadership; Service Delivery; Service Operations; Organizational Culture; Outcome or Result; Performance Effectiveness; Health Industry;

    Citation:

    Bohmer, Richard. "Leadership with a Small 'l'." BMJ (January 27, 2010): 340:c483. View Details
  6. Restructuring Within an Academic Health Center to Support Quality and Safety: The Development of the Center for Quality and Safety at the Massachusetts General Hospital

    Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execute the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

    Keywords: Health Care and Treatment; Organizational Change and Adaptation; Organizational Culture; Organizational Design; Performance Improvement; Quality; Safety; Massachusetts;

    Citation:

    Bohmer, Richard, Jonathan David Bloom, Elizabeth Mort MD, Akinluwa Demehin, and Gregg Meyer MD. "Restructuring Within an Academic Health Center to Support Quality and Safety: The Development of the Center for Quality and Safety at the Massachusetts General Hospital." Academic Medicine 84, no. 12 (December 2009): 1663–1671. View Details
  7. Learning in a New Cardiac Surgical Center: An Analysis of Precursor Events

    Keywords: Learning; Health; Theory;

    Citation:

    Wong, Daniel R., Imtiaz S. Ali, David F. Torchiana, Arvind K. Agnihotri, Richard Bohmer, and Thomas J. Vander Salm. "Learning in a New Cardiac Surgical Center: An Analysis of Precursor Events." Surgery 145, no. 2 (February 2009): 131–137. View Details
  8. Care Platforms: A Basic Building Block for Care Delivery

    Without significant operational reform within the nation's health care delivery organizations, new financing models, payment systems, or structures are unlikely to realize their promise. Adapting insights from high-performing companies in other high-risk, high-cost, science- and technology-based industries, we propose the "care platform" as an organizing framework for internal operations in diversified provider organizations to increase the quality, reliability, and efficiency of care delivery. A care platform organizes "care production" around similar work, rather than organs or specialties; integrates standard and custom care processes; and surrounds them with specifically configured information and business systems. Such organizational designs imply new roles for physicians.

    Keywords: Health Care and Treatment; Management Systems; Standards; Service Delivery; Service Operations; Business Processes; Organizational Design; Customization and Personalization; Health Industry;

    Citation:

    Bohmer, Richard, and David Lawrence. "Care Platforms: A Basic Building Block for Care Delivery." Health Affairs 27, no. 5 (September–October 2008). View Details
  9. Impact of Cardiac Intraoperative Precursor Events on Adverse Outcomes

    Keywords: Health; Outcome or Result;

    Citation:

    Wong, Daniel R., David F. Torchiana, Thomas J. Vander Salm, Arvind K. Agnihotri, Richard Bohmer, and Imtiaz S. Ali. "Impact of Cardiac Intraoperative Precursor Events on Adverse Outcomes." Surgery 141, no. 6 (January 2007): 715–22. View Details
  10. Prospective Assessment of Intraoperative Precursor Events During Cardiac Surgery

    Keywords: Health;

    Citation:

    Wong, Daniel R., Thomas J. Vander Salm, Imtiaz S. Ali, Arvind K. Agnihotri, Richard Bohmer, and David F. Torchiana. "Prospective Assessment of Intraoperative Precursor Events During Cardiac Surgery." European Journal of Cardio-thoracic Surgery 29, no. 4 (April 2006): 447–455. View Details
  11. Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption

    Keywords: Learning; Knowledge; Performance; Technology;

    Citation:

    Edmondson, Amy, Gary P. Pisano, Richard Bohmer, and Ann Winslow. "Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption." Decision Sciences 34, no. 2 (spring 2003): 197–223. View Details
  12. Hospital Disclosure Practices: Results of a National Survey

    Keywords: Health Care and Treatment; Practice; Health Industry;

    Citation:

    Lamb, Rae M., David M. Studdert, Richard M.J. Bohmer, Donald M. Berwick, and Troyan A. Brennan. "Hospital Disclosure Practices: Results of a National Survey." Health Affairs 22, no. 2 (March–April 2003). View Details
  13. The Effect of Decreasing Length of Stay on Discharge Destination and Readmission after Coronary Bypass Operation

    Keywords: Health Care and Treatment; Health Industry;

    Citation:

    Bohmer, Richard M.J., John Newell, and David F. Torchiana. "The Effect of Decreasing Length of Stay on Discharge Destination and Readmission after Coronary Bypass Operation." Surgery 132, no. 1 (July 2002): 10–16. View Details
  14. Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery

    Keywords: Organizations; Learning; Health Care and Treatment; Health Industry;

    Citation:

    Pisano, Gary P., Richard Bohmer, and Amy C. Edmondson. "Organizational Differences in Rates of Learning: Evidence from the Adoption of Minimally Invasive Cardiac Surgery." Management Science 47, no. 6 (June 2001): 752. View Details
  15. Continuous Quality Improvement Decreases Length of Stay and Adverse Events: A Case Study in an Interventional Cardiology Program

    Keywords: Health; Programs; Quality; Information;

    Citation:

    Hashimoto, H., Richard Bohmer, L. C. Harrell, and I. F. Palacios. "Continuous Quality Improvement Decreases Length of Stay and Adverse Events: A Case Study in an Interventional Cardiology Program." American Journal of Managed Care 3, no. 8 (August 1997): 1141–1150. View Details

Book Chapters

  1. The Recovery Window: Organizational Learning Following Ambiguous Threats

    Keywords: Organizational Change and Adaptation; Organizational Design; Risk and Uncertainty; Opportunities;

    Citation:

    Edmondson, A., Erika Ferlins, Laura Feldman, and Richard Bohmer. "The Recovery Window: Organizational Learning Following Ambiguous Threats." In Organization at the Limit: Lessons from the Columbia Disaster, edited by M. Farjoun and W. Starbuck, 220–245. Blackwell Publishing, 2005. View Details
  2. New Paradigms For Working and Learning

    Keywords: Labor; Learning; Framework;

    Citation:

    Bohmer, Richard. "New Paradigms For Working and Learning." Contribution to Building a Better Delivery System: A New Engineering/Health Care Partnership, edited by P. Reid, W. Compton, J. Grossman, and G. Fanjiang, 133–134. Washington, D.C.: National Academies Press, 2005. View Details
  3. Consumer-Driven Health Care: Management Matters

    Keywords: Health Care and Treatment; Demand and Consumers; Management; Health Industry;

    Citation:

    Bohmer, Richard M.J., Amy C. Edmondson, and Gary P. Pisano. "Consumer-Driven Health Care: Management Matters." Chap. 52 in Consumer-Driven Health Care, edited by Regina E. Herzlinger, 570–588. San Francisco: Jossey-Bass, 2004. View Details
  4. Learning New Technical and Interpersonal Routines in Operating Room Teams: The Case of Minimally Invasive Cardiac Surgery

    Keywords: Groups and Teams; Health Care and Treatment; Practice; Competency and Skills; Training; Health Industry;

    Citation:

    Edmondson, Amy C., Richard Bohmer, and Gary Pisano. "Learning New Technical and Interpersonal Routines in Operating Room Teams: The Case of Minimally Invasive Cardiac Surgery." In Research on Managing Groups and Teams: Technology. Vol. 3, edited by B. Mannix, M. Neale, and T. Grifith, 29–51. Stamford: JAI Press, 2000. View Details
  5. Contending Views of Quality Management in Health Care: Implications for Competition and Regulation

    Keywords: Health Care and Treatment; Quality; Governing Rules, Regulations, and Reforms; Policy; Government and Politics; Health Industry;

    Citation:

    Blumenthal, D., and Richard Bohmer. "Contending Views of Quality Management in Health Care: Implications for Competition and Regulation." In Health Care Policy and Regulation, edited by T. A. Abbott III. Boston: Kluwer Academic Publishers, 1995. View Details

Working Papers

  1. Team Learning Trade-Offs: When Improving One Critical Dimension of Performance Inhibits Another

    Citation:

    Bohmer, Richard M.J., Ann B. Winslow, Amy C. Edmondson, and Gary P. Pisano. "Team Learning Trade-Offs: When Improving One Critical Dimension of Performance Inhibits Another." Harvard Business School Working Paper, No. 05-047, January 2005. View Details
  2. The Recovery Window: Organizational Learning Following Ambiguous Threats in High-Risk Organizations

    Citation:

    Edmondson, Amy C., Michael A. Roberto, Richard M.J. Bohmer, Erika M. Ferlins, and Laura R. Feldman. "The Recovery Window: Organizational Learning Following Ambiguous Threats in High-Risk Organizations." Harvard Business School Working Paper, No. 05-012, August 2004. View Details
  3. Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption

    Citation:

    Edmondson, Amy C., Ann B. Winslow, Richard M.J. Bohmer, and Gary Pisano. "Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption." Harvard Business School Working Paper, No. 02-063, November 2002. View Details
  4. Learning New Technical and Interpersonal Routines in Operating Room Teams: The Case of Minimally Invasive Cardiac Surgery

    Citation:

    Edmondson, Amy C., Richard M.J. Bohmer, and Gary Pisano. "Learning New Technical and Interpersonal Routines in Operating Room Teams: The Case of Minimally Invasive Cardiac Surgery." Harvard Business School Working Paper, No. 00-003, July 1999. View Details

Cases and Teaching Materials

  1. Hospital Clínic de Barcelona

    Keywords: health care; provider organizations; hospital; leadership; organization structure; Leadership; Organizations; Health; Health Industry; Europe; Spain;

    Citation:

    Bohmer, Richard M.J., Daniela Beyersdorfer, and Jaume Ribera. "Hospital Clínic de Barcelona." Harvard Business School Case 614-058, February 2014. (Revised May 2014.) View Details
  2. The Case of the Unidentified Healthcare Companies—2010 (CW)

    This case presents financial statements and selected rations for 14 unidentified healthcare organizations and asks that each set of financial information be matched with one of the following healthcare companies: a biotechnology firm, a community nursing company, a distributor (medical), a DME licensee and seller, a DME developer and seller, a home care provider, a hospital (diversified), an insurer, a lab/diagnostic firm, a medical device manufacturer, a nursing home operator, a pharmaceuticals company (branded), a pharmaceuticals company (generics), and a private practice.

    Keywords: Financial Statements; Financial Management; Health Care and Treatment; Biotechnology Industry; Health Industry;

    Citation:

    Bohmer, Richard M.J., Ethan S Bernstein, Margarita Krivitski, and Srinidhi Reddy. "The Case of the Unidentified Healthcare Companies—2010 (CW)." Harvard Business School Spreadsheet Supplement 611-701, January 2011. (Revised January 2012.) View Details
  3. Columbia's Final Mission: A Multimedia Case (TN)

    Teaching Note to (9-305-032).

    Keywords: Media; News; Media and Broadcasting Industry; Aerospace Industry;

    Citation:

    Roberto, Michael, Richard M.J. Bohmer, Amy C. Edmondson, and Erika Ferlins. "Columbia's Final Mission: A Multimedia Case (TN)." Harvard Business School Teaching Note 305-033, June 2005. (Revised January 2012.) View Details
  4. The Case of the Unidentified Healthcare Companies—2010

    This case presents financial statements and selected ratios for 14 unidentified healthcare organizations and asks that each set of financial information be matched with one of the following healthcare companies: a biotechnology firm, a community nursing company, a distributor (medical), a DME licensee and seller, a DME developer and seller, a home care provider, a hospital (diversified), an insurer, a lab/diagnostic firm, a medical device manufacturer, a nursing home operator, a pharmaceuticals company (branded), a pharmaceuticals company (generics), and a private practice.

    Keywords: Financial Reporting; Financial Statements; Health Care and Treatment; Health Industry;

    Citation:

    Bohmer, Richard, Ethan Bernstein, Margarita Krivitski, and Srinidhi Reddy. "The Case of the Unidentified Healthcare Companies—2010." Harvard Business School Case 611-043, January 2011. (Revised January 2012.) View Details
  5. Lowell General Physician Hospital Organization

    This case focuses on the Alternative Quality Contract (AQC), a novel payment program designed to incentivize providers to deliver less costly, high quality health care. Under the AQC, offered by Blue Cross Blue Shield of Massachusetts, providers received a fixed-dollar budget to cover all care provided to a specific patient population, as well as incentive payments for quality. The AQC was piloted in 2009 by a handful of provider organizations, including a group of physicians belonging to the Lowell General Physician Hospital Organization (LGPHO). The case describes the LGPHO physicians' experience during their first two years under the AQC, allowing students to assess the group's performance as well as potential challenges in the remaining three years of the contract and future contracts and the AQC's value as part of the solution to untenably high U.S. health care costs.

    Keywords: Health Industry;

    Citation:

    Bohmer, Richard M.J., and Natalie Kindred. "Lowell General Physician Hospital Organization." Harvard Business School Case 612-016, November 2011. View Details
  6. Hôpital de Pontoise

    In 2010, Andre Razafindranaly, managing director of a large French public hospital, considers which organizational structure will help them adjust to the changing health sector environment. The move from global budget to activity-based funding has led his and many other public hospitals to suffer losses in recent years. Appointed two years previously, Razafindranaly introduced increasing financial control and encouraged organizational changes such as multidisciplinary wards differentiated by patients' lengths of stay. To what extent should he (and can he) reinforce these measures, which have increased efficiency and reduced the deficit but also generated push-back from his doctors and staff?

    Keywords: Activity Based Costing and Management; Governance Controls; Governing Rules, Regulations, and Reforms; Health Care and Treatment; Leading Change; Service Delivery; Organizational Change and Adaptation; Organizational Structure; Health Industry; France;

    Citation:

    Bohmer, Richard M.J., Daniela Beyersdorfer, and Simon Harrow. "Hôpital de Pontoise." Harvard Business School Case 610-100, June 2010. (Revised December 2010.) View Details
  7. A Pain in the Hip

    Describes in detail the process of diagnosing the cause of a sore hip in a young girl. Referred to the emergency room by her pediatrician, the child is subjected to a set of diagnostic tests over a two-day period, each designed to reduce the uncertainty surrounding the cause of her symptoms. Allows students to examine the process of patient care from the point of view of the patient and her parents, the medical staff, and the hospital's managers.

    Keywords: Production; Service Delivery; Service Operations; Performance Improvement; Health Industry;

    Citation:

    Bohmer, Richard M.J. "A Pain in the Hip." Harvard Business School Case 604-012, September 2003. (Revised October 2010.) View Details
  8. Virginia Mason Medical Center (Abridged)

    In 2000, Dr. Gary Kaplan became CEO of the Virginia Mason Medical Center in Seattle, Washington. The hospital was facing significant challenges: it was losing money for the first time in its history, staff morale had plummeted, and area hospitals presented ardent competition. Considerable change was imminent. Within his first few months, Kaplan had rallied the organization around a new strategic direction: to become the quality leader in health care. What Kaplan and his administrators lacked was an effective tool to execute their strategy. Soon thereafter, a series of serendipitous events led to the discovery of the Toyota production system, and the Virginia Mason Medical Center became entrenched in an overwhelming challenge: how to institute a production model in health care.

    Keywords: History; Competition; Operations; Leadership Style; Problems and Challenges; Change Management; Health Care and Treatment; Business Strategy; Growth and Development Strategy; Health Industry; Seattle;

    Citation:

    Bohmer, Richard M.J. "Virginia Mason Medical Center (Abridged)." Harvard Business School Case 610-055, June 2010. (Revised June 2010.) View Details
  9. Columbia's Final Mission

    Describes the 16-day final mission of the space shuttle Columbia in January 2003 in which seven astronauts died. Includes background on NASA and the creation of the human space flight program, including the 1970 Apollo 13 crisis and 1986 Challenger disaster. Examines NASA's organizational culture, leadership, and the influences on the investigation of and response to foam shedding from the external fuel tank during shuttle launch.

    Keywords: Leadership; Crisis Management; Management Skills; Organizational Culture; Groups and Teams; Behavior; Aerospace Industry;

    Citation:

    Bohmer, Richard M.J., Amy C. Edmondson, Michael Roberto, Laura Feldman, and Erika Ferlins. "Columbia's Final Mission." Harvard Business School Case 304-090, April 2004. (Revised May 2010.) View Details
  10. Managing Orthopaedics at Rittenhouse Medical Center (TN)

    Teaching Note for [607152].

    Keywords: Health Care and Treatment; Management; Health Industry;

    Citation:

    Huckman, Robert S., and Richard M.J. Bohmer. "Managing Orthopaedics at Rittenhouse Medical Center (TN)." Harvard Business School Teaching Note 610-070, April 2010. (Revised April 2010.) View Details
  11. Managing Orthopaedics at Rittenhouse Medical Center

    Considers the issues associated with running multiple business models–a private practice and an academic faculty practice--within the confines of the orthopaedics department of a single medical center. Students assume the role of Neela Wilson, Executive Director of Rittenhouse Medical Center, in managing the operational requirements of, and organizational tensions created by, these competing models. In analyzing the case, students have the opportunity to: (1) gain a better understanding of operational focus and the concept of a "focused factory" in health care, (2) consider the concept of a "factory within a factory" in the context of an academic medical center, and (3) build an appreciation of the managerial challenges associated with operating related, and often competing, business units within the same organization.

    Keywords: Business Units; Business Model; Health Care and Treatment; Service Operations; Conflict Management; Competition; Health Industry;

    Citation:

    Bohmer, Richard M.J., Robert S. Huckman, James Weber, and Kevin J. Bozic. "Managing Orthopaedics at Rittenhouse Medical Center." Harvard Business School Case 607-152, June 2007. (Revised March 2010.) View Details
  12. The Duke Heart Failure Program

    Duke University Health System has for the past five years operated a specialized clinic for the management of congestive heart failure, a very common and costly condition in the surrounding community. Nurse practitioners, whose work is guided by highly specified protocols and overseen by cardiologists, staff the multidisciplinary clinic. The chancellor of the health system views the program as a huge financial burden and an undesirable use of academic cardiologists' time. The case examines models of disease management; Duke's heart failure program operations, finances, and outcomes of disease management; and the relationship between its nurse practitioners and cardiologists.

    Keywords: Health Care and Treatment; Health Disorders; Medical Specialties; Time Management; Service Delivery; Service Operations; Outcome or Result; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Laura Feldman. "The Duke Heart Failure Program." Harvard Business School Case 604-033, October 2003. (Revised February 2010.) View Details
  13. Newton-Wellesley Hospital

    How will Newton-Wellesley Hospital (NWH) preserve its private practice tradition while remaining effective and competitive in a healthcare industry demanding increasing integration between physicians and hospitals? This is the decision facing Newton-Wellesley Hospital president Mike Jellinek in 2009, as several trends—higher costs and lower revenues, shifting workforce demographics, and changing reimbursement models—threaten to disrupt NWH's organizational model. Similar to other U.S. community hospitals, NWH has historically been staffed primarily with private practitioners; however, in recent years Jellinek has taken several steps toward further integration, such as hiring primary care physicians and hospitalists, and even proposing formation of a physicians' organization (PO)—a move its veteran private practitioners sharply oppose. In 2009, NWH is renowned for high-quality care and is financially strong; yet, given external pressures, most at the hospital agree that reforms are needed to improve the hospital's and physician's profitability while maintaining highest-quality patient care. Diverging opinions over how to improve the hospital has exposed differences between some private practice physicians and the administration. The crux of their disagreement centers on one question: how to make the organizational changes required to keep NWH effective and competitive in the face of a diminishing revenue growth rate, while honoring its tradition of physician independence.

    Keywords: Business Model; Profit; Health Care and Treatment; Growth and Development Strategy; Organizational Change and Adaptation; Organizational Structure; Competitive Strategy; Integration; Health Industry; Massachusetts;

    Citation:

    Bohmer, Richard M.J., and Natalie Kindred. "Newton-Wellesley Hospital." Harvard Business School Case 609-088, May 2009. (Revised October 2009.) View Details
  14. The Risk Management Foundation of the Harvard Medical Institutions, Inc.

    Through its uniquely proactive approach to medical malpractice risk management, the Risk Management Foundation (RMF) has decreased claims—and premiums—for the Harvard hospitals it insures. The RMF is the captive medico-legal insurer of the Harvard medical institutions and affiliated physicians. Over the last two decades, through a combination of active legal defense and medical error prevention, the RMF has successfully controlled the medico-legal costs of physicians practicing at the Harvard teaching hospitals; consequently, its insured physicians pay notably lower premiums than similar specialists outside the Harvard system. The RMF's success has been due, in large part, to the close working relationships it has cultivated with the insured physicians and hospitals. However, as the hospitals expand their networks into Boston's suburbs, new, less tightly affiliated doctors whose medico-legal risk is higher than those practicing at the hospitals are coming under the RMF's umbrella. This case describes RMF's approach to risk management and the challenges its managers face in accommodating these new physicians.

    Keywords: Cost Management; Insurance; Health Care and Treatment; Risk Management; Performance Improvement; Safety; Health Industry; Insurance Industry; Boston;

    Citation:

    Bohmer, Richard M.J., Stephen P. Bradley, and Natalie Kindred. "The Risk Management Foundation of the Harvard Medical Institutions, Inc." Harvard Business School Case 610-014, September 2009. View Details
  15. Columbia's Final Mission

    On February 1, 2003, the Shuttle Columbia disintegrated upon re-entry into the Earth's atmosphere, and the seven astronauts onboard lost their lives. Explores Columbia's final mission from the perspective of six key managers and engineers associated with NASA's Space Shuttle Program. An introductory video and interactive timeline present background information. An application replicates the desktop environment of six real-life managers and engineers involved in decision making during the period prior to Columbia's re-entry. Each student is preassigned a particular role and, through a password system, enters the role-play application. Students review the protagonists' actual e-mails, listen to audio re-enactments of crucial meetings, and review space agency documents. Students must be prepared to play the role of the protagonist in a classroom re-enactment of a critical Mission Management Team meeting that took place on Flight Day 8 (January 24, 2003). Students examine the organizational causes of the tragedy rather than focus on the technical cause.

    Keywords: Decision Choices and Conditions; Leadership; Crisis Management; Management Teams; Organizational Culture; Aerospace Industry;

    Citation:

    Bohmer, Richard M.J., Amy C. Edmondson, Michael Roberto, Laura Feldman, and Erika Ferlins. "Columbia's Final Mission." Harvard Business School Video Case 305-032, March 2005. (Revised May 2009.) View Details
  16. Performance Management at Intermountain Healthcare

    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 clinical performance that makes use of the organization's extensive set of standardized clinical protocols and associated clinical process and outcome measures. The measures underpin a sophisticated set of financial incentives that are applied to both administrative and clinical staff. The case allows students to evaluate the strengths and weaknesses of financial incentives in clinical medicine.

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

    Citation:

    Bohmer, Richard M.J., and Alexander Romney. "Performance Management at Intermountain Healthcare." Harvard Business School Case 609-103, April 2009. View Details
  17. Virginia Mason Medical Center

    In 2000, Dr. Gary Kaplan became CEO of the Virginia Mason Medical Center in Seattle, Washington. The hospital was facing significant challenges: It was losing money for the first time in its history, staff morale had plummeted, and area hospitals presented ardent competition. Considerable change was imminent. Within his first few months, Kaplan had rallied the organization around a new strategic direction: to become the quality leader in health care. What Kaplan and his administrators lacked was an effective tool to execute their strategy. Soon thereafter, a series of serendipitous events led to the discovery of the Toyota production system, and the Virginia Mason Medical Center became entrenched in an overwhelming challenge: how to institute a production model in health care.

    Keywords: Health Care and Treatment; Management Analysis, Tools, and Techniques; Production; Organizational Change and Adaptation; Problems and Challenges; Quality; Competition; Seattle;

    Citation:

    Bohmer, Richard M.J., and Erika Ferlins. "Virginia Mason Medical Center." Harvard Business School Case 606-044, October 2005. (Revised October 2008.) View Details
  18. Partners in Health: The PACT Project

    Partners in Health is a Boston-based, not-for-profit that provides health care to people in some of the poorest regions of the world, including Haiti, Malawi, Rwanda, and Peru. In 1998, PIH established a program (PACT) in Boston to bring care to AIDS and TB patients who were not well served by existing care delivery systems. Describes PIH's programs in the developing world and the way in which lessons learned in these countries informed the design and management of PACT. Examines the balance between customized and standardized approaches to care and challenges students to examine their preconceived notions of the social role of a health care delivery organization. Dr. Heidi Behforouz, PACT's director, must decide whether a service design honed in developing countries can be rolled out more broadly in one the world's richest nations.

    Keywords: Health Care and Treatment; Nonprofit Organizations; Non-Governmental Organizations; Developing Countries and Economies; Service Delivery; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Josh Friedman. "Partners in Health: The PACT Project." Harvard Business School Case 608-065, September 2007. (Revised February 2008.) View Details
  19. Clinical Change at Intermountain Healthcare

    Provides a detailed description of the way in which several improvements and innovations in clinical care were arrived at. Describes individual insights, how these were evaluated and validated, and how they were translated into improved medical practices. The changes in medical care include improvements in primary care, intensive care, and inpatient ward care. Detailed descriptions of each innovation are provided, along with a description of the processes of innovation, generation, and capture. It relates closely to Intermountain (A), which describes the organizational structure Intermountain has put in place to support these processes.

    Keywords: Health Care and Treatment; Innovation and Invention; Business Processes; Performance Improvement; Practice; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Erika Ferlins. "Clinical Change at Intermountain Healthcare." Harvard Business School Case 607-023, October 2006. (Revised January 2008.) View Details
  20. Information Technology and Clinical Operations at Beth Israel Deaconess Medical Center

    Describes the history of clinical computing at Boston's Beth Israel Hospital and the development, since the 1996 merger to form the Beth Israel Deaconess Medical Center, of an information system designed to support the delivery of patient care. The hospitals' CIO, John Halamka, MD, has overseen the development of an information system that places physicians at its center. Describes the design and function of five major components of the system: the On-Line Medical Record, ePrescribing, Physician Order Entry, the Emergency Department "dashboard," and the Performance Manager. Provides students with an opportunity to identify key design principles for health care information systems, and to discuss the unique implementation challenges that the health care delivery setting raises for CIOs and CEOs.

    Keywords: Health Care and Treatment; Product Design; Service Delivery; Information Technology; Software; Health Industry; Boston;

    Citation:

    Bohmer, Richard M.J., F. Warren McFarlan, and Julia Rose Adler-Milstein. "Information Technology and Clinical Operations at Beth Israel Deaconess Medical Center." Harvard Business School Case 607-150, June 2007. (Revised October 2007.) View Details
  21. Istituto Clinico Humanitas (C): Pronto Soccorso

    Follows on from the cases Istituto Clinico Humanitas (A) and (B). Describes the design and running of the new Humanitas Emergency Department. Istituto Clinico Humanitas has developed a very efficient operating system for dealing with elective (largely surgical) patients. By opening an emergency room, however, the institution is now called upon to care for complex and highly variable medical patients. Asks if the previous operating system is appropriate for this new patient population and in what ways might it require modification to meet these patients' unique needs. The concept of hospital-within-a-hospital is central to Humnitas' new design, and the case examines if this is feasible in this setting.

    Keywords: Health Care and Treatment; Organizational Change and Adaptation; Service Operations; Service Delivery; Customer Focus and Relationships; Health Industry; Italy;

    Citation:

    Bohmer, Richard M.J. "Istituto Clinico Humanitas (C): Pronto Soccorso." Harvard Business School Supplement 607-022, August 2006. (Revised September 2007.) View Details
  22. Collaborating to Improve

    Madison Memorial Hospital is deciding between a variety of quality improvement strategies. Highlights quality improvement collaborative—organized programs popularized by the Institute for Healthcare Improvement in which teams from multiple institutions work together to improve care in a specified topic area (e.g., infection rates)—as a potential strategy. Allows debate around the criteria for selection of quality improvement strategies. Also motivates the discussion of the effectiveness of collaboratives and, more broadly, the effectiveness of intra-organizational versus inter-organizational approaches to improvement.

    Keywords: Health Care and Treatment; Service Delivery; Performance Improvement; Quality; Groups and Teams; Cooperation; Integration; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Ingrid M. Nembhard. "Collaborating to Improve." Harvard Business School Case 608-054, September 2007. View Details
  23. The Challenge Facing the U.S. Healthcare Delivery System

    Discusses the challenges currently facing the U.S. health care delivery system. These challenges frame the problems managers of delivery organizations are currently facing. They include a burgeoning gap between demand and supply. Demand for health care services is increasing as the population ages, chronic diseases become more common, and medical technology increases. Yet, the supply of nurses and physicians is decreasing. Moreover, as both regulators and the general public become more interested in the quality of care delivered, there is evidence of substantial quality failures. In response to these challenges, regulators have introduced new forms of payment and financial incentives for doctors and delivery organizations, and managers have experimented with several new service models and delivery organization designs. They include the use of new professionals and other assistive personnel, such as nurse practitioners and physicians' assistants, in-store clinics, focused factories and concierge care.

    Keywords: Health Care and Treatment; Health Industry; United States;

    Citation:

    Bohmer, Richard M.J., and Carin-Isabel Knoop. "The Challenge Facing the U.S. Healthcare Delivery System." Harvard Business School Background Note 606-096, June 2006. (Revised June 2007.) View Details
  24. Intermountain Health Care

    Intermountain Health Care (IHC), an integrated delivery system based in Utah, has adopted a new strategy for managing health care delivery. The approach focuses management attention not only on the facilities where care takes place but also on physician decision making and the care process itself, with the aim of boosting physician productivity and improving care quality, while saving money. This case explores the challenges facing Brent James, executive director of the Institute for Health Care Delivery Research at IHC, as he implements new structures and systems (including a data warehouse for care outcomes, electronic patient records, computer workstations, clinical data support systems, and protocols for care) designed to support clinical process management across a geographically diverse group of physicians with varying levels of interest and dedication to IHC. Also highlights an innovative strategy for creating and disseminating knowledge at the individual and organizational levels to maintain high standards in care delivery.

    Keywords: Ethnicity Characteristics; Innovation Strategy; Cost Management; Information Technology; Organizational Structure; Technology Adoption; Performance Improvement; Problems and Challenges; Adoption; Change Management; Cost vs Benefits; Health Care and Treatment; Health Industry; Utah;

    Citation:

    Bohmer, Richard M.J., Amy C. Edmondson, and Laura Feldman. "Intermountain Health Care." Harvard Business School Case 603-066, October 2002. (Revised March 2013.) View Details
  25. Istituto Clinico Humanitas (A)

    Istituto Clinico Humanitas is a newly built private hospital, south of Milan, Italy, that has attained unusual profitability while treating public system patients. The hospital was built and is managed by Techosp, a subsidiary of Techint, a global engineering and consulting firm. Techosp created a design and management system that emphasizes optimizing patient throughput and utilization of all of the hospital's facilities. Physicians are all fully employed and have a significant financial incentive to maximize efficiency. The executive team is now considering whether to affiliate with the University of Milan medical school and, in effect, become Italy's first private academic medical center. The general manager must consider the effect of this affiliation on the hospital's performance.

    Keywords: Health Care and Treatment; Management Analysis, Tools, and Techniques; Management Systems; Infrastructure; Managerial Roles; Integration; Performance; Health Industry; Milan;

    Citation:

    Bohmer, Richard M.J., Gary P. Pisano, and Ning Tang. "Istituto Clinico Humanitas (A)." Harvard Business School Case 603-063, September 2002. (Revised April 2006.) View Details
  26. Shared Decision Making

    The Foundation for Informed Medical Decision-Making has created an interactive videodisc system that provides patients with customized support regarding medical treatment or screening decisions when they face a choice between two equally effective courses of action. The videodiscs, known as shared decision-making programs (SDPs), were the result of considering grant-funded research into treatment outcomes and patients' preferences concerning varying medical treatments. Over a six-year period, the foundation has partnered with a variety of commercial firms to manufacture and market the SDPs. Despite robust evidence supporting the effectiveness of the SDPs and the enthusiastic response of early purchasers, the foundation has been unable to widely disseminate the product and faces major debt.

    Keywords: Decision Choices and Conditions; Borrowing and Debt; Health Care and Treatment; Innovation Strategy; Technological Innovation; Product Marketing; Distribution Channels; Production; Partners and Partnerships; Research and Development; Information Technology;

    Citation:

    Bohmer, Richard M.J., Karen Sepucha, and Laura Feldman. "Shared Decision Making." Harvard Business School Case 604-001, October 2003. (Revised January 2005.) View Details
  27. Bridges to Excellence: Bringing Quality Health Care to Life

    General Electric launched Bridges to Excellence Diabetes Care Link, a program through which enrolled physicians receive bonuses of up to 10% of their salary for delivering quality care to diabetic patients covered by a participating employer or health plan. A day later, the Wall Street Journal labeled the program a "bribe." The case explores this accusation and the assumption that purchasers and consumers must explicitly pay for quality in heath care. Also allows evaluation of a specific program from design (e.g., financial reward structure) to implementation (e.g., parties involved). The question of scalability arises, as does the criteria by which to judge success.

    Keywords: Health Care and Treatment; Motivation and Incentives; Programs; Ethics; Quality; Moral Sensibility; Service Delivery; Compensation and Benefits; Health Industry;

    Citation:

    Bohmer, Richard M.J., Ingrid Marie Nembhard, and Robert Galvin. "Bridges to Excellence: Bringing Quality Health Care to Life." Harvard Business School Case 604-030, September 2003. (Revised January 2005.) View Details
  28. Organizational Learning in the Face of Ambiguous Threats

    Keywords: Learning; Risk and Uncertainty; Crisis Management; Organizational Culture; Organizational Structure; Groups and Teams;

    Citation:

    Edmondson, Amy C., Michael A. Roberto, and Richard M.J. Bohmer. "Organizational Learning in the Face of Ambiguous Threats." Boston: Harvard Business School Publishing Class Lecture, 2005. Electronic. (Faculty Lecture: HBSP Product Number 9297C.) View Details
  29. Evolution of Treatment, The: The Case of Diabetes

    Scientific knowledge surrounding diabetes mellitus has grown over the last century to include its cause, treatment, and prevention strategies. However, the type and level of care that patients receive is suboptional. This case examines the forces in industry, knowledge, education, public policy, and reimbursement that drive the management of this disease and the potential for innovation in the management of other chronic diseases.

    Keywords: Policy; Health Care and Treatment; Innovation and Management; Knowledge Use and Leverage; Management; Management Analysis, Tools, and Techniques; Health Industry;

    Citation:

    Bohmer, Richard M.J., Jeffrey D. Street, and Laura Feldman. "Evolution of Treatment, The: The Case of Diabetes." Harvard Business School Case 302-023, November 2001. (Revised September 2004.) View Details
  30. QuickMedx Inc.

    QuickMedx has created a chain of small kiosks, located in drugstores and shopping malls in the Minneapolis area, that cater to patients with a limited range of very simple primary care conditions. Service is rapid and cheap and patients wait only a few minutes to be seen. The kiosks provide an alternative to the primary care physician's office and the emergency room. Clinical care itself is highly standardized and is delivered by nurse practitioners whose decisions are governed by detailed protocols. The company is now considering its expansion strategy. Should it increase the number of kiosks or widen the currently restricted range of conditions treated?

    Keywords: Health Care and Treatment; Decision Making; Disruptive Innovation; Expansion; Service Delivery; Business Processes; Design; Management; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Jonathan P Groberg. "QuickMedx Inc." Harvard Business School Case 603-049, July 2002. (Revised April 2003.) View Details
  31. Design and Management of Health Care Delivery Processes, The

    Discusses the design and management of clinical processes in health care. Presents a framing of the clinical process as a problem-solving process that fundamentally involves learning along two dimensions and at least two levels. The two dimensions are: 1) learning in the short term about the disease and the patient in whom it is manifest and 2) learning, over time, about the disease and its treatment, as an independent phenomenon unconnected to a specific patient. The two levels at which this learning takes place are the individuals treating the patient and the organization in the context of which care is delivered.

    Keywords: Management Analysis, Tools, and Techniques; Service Delivery; Management Practices and Processes; Learning; Health Care and Treatment; Health Industry;

    Citation:

    Bohmer, Richard M.J. "Design and Management of Health Care Delivery Processes, The." Harvard Business School Module Note 603-107, April 2003. View Details
  32. A Father's Love: Novazyme Pharmaceuticals, Inc.

    John Crowley, CEO of Novazyme Pharmaceuticals, a start-up biotechnology firm developing an orphan drug to treat a rare lysosomal storage disorder from which his children suffer, must choose between a partnership and a buyout to have sufficient funds and support to get the drug to the market. Accompanying this dilemma are questions relating to Novazyme's clinical trial strategy, marketing, sales, production, and pricing. This case introduces students to the FDA drug approval process and government-supported financial inducements to develop drugs for small patient populations. Also provides insight into the nature of strategic relationships in the biotechnology and pharmaceutical industries.

    Keywords: Technological Innovation; Business Startups; Partners and Partnerships; Financing and Loans; Governing Rules, Regulations, and Reforms; Sales; Price; Product Development; Motivation and Incentives; Decision Choices and Conditions; Biotechnology Industry; Pharmaceutical Industry;

    Citation:

    Bohmer, Richard M.J., and Bradley Campbell. "A Father's Love: Novazyme Pharmaceuticals, Inc." Harvard Business School Case 603-048, October 2002. View Details
  33. Catalyst Medical Solutions

    Faced with a drop in the NASDAQ, four eHealth entrepreneurs must decide between two distribution strategies for their new company's technology. The team, comprised of three full-time resident physicians and an MBA, has developed software to enable electronic documentation and billing of medical and surgical procedures. The initial strategy was to distribute the technology through individual hospital intranets. Under pressure from venture capitalists and a "dot-com" frenzy in the market, the team starts to develop an "Internet portal" strategy, distributing the software over the Internet and adding traditional e-commerce services. When the stock market crashes in April 2000, the team must decide whether to push on with the Internet strategy or return to the intranet model. Throughout the case, a variety of new product development and team learning issues are explored: What is the optimal team composition? How quickly can the team overcome technical challenges? Who should their lead users be? How well do they understand the market? How quickly can they learn to work together, raise money, and build partnerships?

    Keywords: Product Development; Health Care and Treatment; Distribution; Strategy; Venture Capital; Software; Partners and Partnerships; Borrowing and Debt; Information Technology Industry; Service Industry;

    Citation:

    Edmondson, Amy C., Richard M.J. Bohmer, and Naomi Atkins. "Catalyst Medical Solutions." Harvard Business School Case 601-014, July 2000. (Revised November 2001.) View Details
  34. Boston Medical Group

    Describes the structure of a variable compensation plan for physicians implemented by a Massachusetts medical group practice. Examines issues such as balancing group and individual risk and selection of performance metrics (productivity and patient satisfaction).

    Keywords: Customer Satisfaction; Health Care and Treatment; Executive Compensation; Management Practices and Processes; Risk Management; Standards; Risk and Uncertainty; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Bruce L. Hall. "Boston Medical Group." Harvard Business School Case 600-086, February 2000. (Revised April 2001.) View Details
  35. Customers in Health Care, The

    Reviews the current literature on the consumers of health care, primarily patients. Discusses their stated preferences, the sources of information they use in making their selections of plan and provider, and their behavior.

    Keywords: Customers; Health Care and Treatment; Information; Planning; Behavior; Health Industry;

    Citation:

    Bohmer, Richard M.J. "Customers in Health Care, The." Harvard Business School Background Note 600-118, March 2000. (Revised January 2001.) View Details
  36. Complexity and Error in Medicine

    Reviews the issues underlying the rate of error in medical practice and discusses the range of potential management interventions to decrease the risk of error.

    Keywords: Health Care and Treatment; Management Practices and Processes; Risk and Uncertainty; Complexity;

    Citation:

    Bohmer, Richard M.J. "Complexity and Error in Medicine." Harvard Business School Background Note 699-024, October 1998. (Revised April 2000.) View Details
  37. Patient Care Delivery Model at the Massachusetts General Hospital, The TN

    Teaching Note for (9-699-154).

    Keywords: Health Industry; Service Industry; Massachusetts;

    Citation:

    Edmondson, Amy C., Richard M.J. Bohmer, and Emily Heaphy. "Patient Care Delivery Model at the Massachusetts General Hospital, The TN." Harvard Business School Teaching Note 600-083, April 2000. View Details
  38. Oxford Health Plans (A): Specialty Management [and] Oxford Health Plans (B): Crisis Strikes TN

    Teaching Note for (9-898-042) and (9-800-366).

    Keywords: Business or Company Management; Crisis Management; Medical Specialties; Health Care and Treatment; Health Industry; United States;

    Citation:

    Heskett, James L., Richard M.J. Bohmer, and Jody H. Gittell. "Oxford Health Plans (A): Specialty Management [and] Oxford Health Plans (B): Crisis Strikes TN." Harvard Business School Teaching Note 800-322, March 2000. View Details
  39. Changing Physician Behavior

    A review of strategies to change physician behavior including feedback, profiling, consensus-based guidelines, care paths, and computer systems. Discusses the strengths and weaknesses of each observation.

    Keywords: Health Care and Treatment; SWOT Analysis; Behavior; Strategy; Health Industry;

    Citation:

    Bohmer, Richard M.J. "Changing Physician Behavior." Harvard Business School Background Note 699-124, February 1999. (Revised March 2000.) View Details
  40. Medscape

    Medscape is a health care Web site that focuses on delivering high-quality information to health providers and consumers. This case describes Medscape's formation and business model and asks, How is this model unique and is it sustainable?

    Keywords: Business Model; Customer Focus and Relationships; Service Delivery; Web Sites; Information Industry;

    Citation:

    Bohmer, Richard M.J., and Lisa Shapiro Strovink. "Medscape." Harvard Business School Case 600-056, March 2000. View Details
  41. Aspect Medical Systems

    Entrepreneur Nassib Chamoun has created an innovative anesthesiology device that monitors patients' consciousness levels during surgery. This case tracks how Chamoun and his executive team built the infrastructure of the company and actively managed the adoption process through product design and development, clinical trials, close work with regulatory agencies, selection of appropriate lead users, and active management of the learning process for the lead users. Now faced with a relatively unfavorable market and increasing competition, Chamoun must decide how to increase current and future adoption of the monitor. Three options are presented: contracting for OEM deals with large, well-established distributors; expanding the range of services offered to include other aspects of the perioperative process; and exploring the use of the monitor in other clinical areas such as Alzheimer's.

    Keywords: Decision Choices and Conditions; Entrepreneurship; Independent Innovation and Invention; Infrastructure; Product Design; Product Development; Problems and Challenges; Adoption; Competitive Strategy; Technology Industry;

    Citation:

    Bohmer, Richard M.J., and Naomi Atkins. "Aspect Medical Systems." Harvard Business School Case 600-076, March 2000. View Details
  42. E2M Health Services

    Outlines the growth of an innovative diabetes disease management organization from 1994-99. Having demonstrated the success of their model in managing diabetes populations in Texas and New York State, the CEO and president must decide the future strategy of the company and figure out where their core competencies lay. Options include focusing on the current model (which is based on developing strong patient-caregiver relationships and on immediate access to clinical data via database technology), branching into online health assessment tools, or conducting research on health and cost outcomes for pharmaceutical, medical device, or insurance companies. Illustrates the importance of aligning incentives of clinicians, hospitals, and patients to effect behavior change. Students can discuss the types of financing markets in which the company's model will work best, who is best suited to provide this type of disease management, and who should pay for it (e.g., physician, hospitals, pharmacists, insurance companies, or outside providers).

    Keywords: Business Model; Customer Focus and Relationships; Decision Choices and Conditions; Financial Markets; Revenue; Innovation and Invention; Business or Company Management; Marketing Strategy; Internet; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Naomi Atkins. "E2M Health Services." Harvard Business School Case 600-077, February 2000. View Details
  43. Medicine, Incentive Compensation, and the Law

    Summarizes legal issues in structuring a health care incentive plan, such as tax laws and federal regulations. Draws from an interview conducted with a New England lawyer in October 1999.

    Keywords: Motivation and Incentives; Compensation and Benefits; Law; Health Care and Treatment; Taxation; Laws and Statutes; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Bruce L. Hall. "Medicine, Incentive Compensation, and the Law." Harvard Business School Background Note 600-087, February 2000. View Details
  44. Patient Care Delivery Model at the Massachusetts General Hospital, The

    Examines the implementation of a new patient care delivery model at Massachusetts General Hospital. Uses clinical and financial data to examine different choices for staffing non-physician health care professionals and to understand the challenges of managing change across multiple professions in the hospital environment. Recently promoted to senior vice president of Patient Care Services, Jeanette Ives Erickson must decide whether a model for patient care delivery is the best way to improve care and reduce costs in the midst of extreme budget pressures and a rapidly changing health care environment.

    Keywords: Change Management; Service Delivery; Health Care and Treatment; Health Industry; Massachusetts;

    Citation:

    Edmondson, Amy C., Richard M.J. Bohmer, and Emily Heaphy. "Patient Care Delivery Model at the Massachusetts General Hospital, The." Harvard Business School Case 699-154, March 1999. (Revised February 2000.) View Details
  45. HealthPartners

    Presents the efforts by HealthPartners to create competition among health care providers in Minnesota on the basis of both quality and price. Also provides some insight into the strategies for changing physician behavior.

    Keywords: Health Care and Treatment; Service Delivery; Behavior; Competition; Health Industry; Minnesota;

    Citation:

    Bohmer, Richard M.J., and Nancy Dean Beaulieu. "HealthPartners." Harvard Business School Case 699-131, February 1999. (Revised November 1999.) View Details
  46. Tufts Health Plan

    Describes the introduction of capitation by a managed care company and the challenges of managing financial risk in the Medicare population. Focuses on the relationship between the health plan and physicians.

    Keywords: Health; Behavior; Motivation and Incentives; Risk and Uncertainty; Insurance; Health Industry; Insurance Industry;

    Citation:

    Bohmer, Richard M.J., and Nancy D. Beaulieu. "Tufts Health Plan." Harvard Business School Case 699-160, March 1999. (Revised October 1999.) View Details
  47. Note on Physician Compensation and Financial Incentives

    A review of the use and effectiveness of financial incentives in changing physician behavior.

    Keywords: Change; Finance; Compensation and Benefits; Performance Effectiveness; Behavior; Motivation and Incentives;

    Citation:

    Bohmer, Richard M.J., and Melanie M Harshbarger. "Note on Physician Compensation and Financial Incentives." Harvard Business School Background Note 699-151, February 1999. (Revised October 1999.) View Details
  48. Note on Managed Care

    Presents an overview of managed care. Describes the relationship between provider and insurance companies, examines the implications for consumers, and discusses financial arrangements and operational characteristics commonly observed in the industry. Also provides a background to other HBS health care cases.

    Keywords: Customers; Insurance; Health Care and Treatment; Service Operations; Relationships; Insurance Industry;

    Citation:

    Bohmer, Richard M.J. "Note on Managed Care." Harvard Business School Background Note 698-060, May 1998. (Revised September 1999.) View Details
  49. Dana-Farber Cancer Institute, The

    Describes the death of a cancer patient in one of the nation's premier cancer treatment centers and examines the organizational and process characteristics that may have contributed to the medical error.

    Keywords: Health Care and Treatment; Quality; Service Operations; Management Practices and Processes; Business Processes; Failure; Health Industry;

    Citation:

    Bohmer, Richard M.J., and Ann Winslow. "Dana-Farber Cancer Institute, The." Harvard Business School Case 699-025, March 1999. (Revised July 1999.) View Details

Presentations

  1. A Framework for Measuring the Quality of Medication Prescribing Using Administrative Data

    Keywords: Framework; Quality; Standards; Health Care and Treatment;

    Citation:

    Stafford, R. S., Richard Bohmer, and R. Gaudette. "A Framework for Measuring the Quality of Medication Prescribing Using Administrative Data." Paper presented at the Association for Health Services Research, January 01, 1999. View Details