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Publications

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    • All HBS Web  (224)
      • Faculty Publications  (48)

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      • 2022
      • Working Paper

      Causal Inference During A Pandemic: Evidence on the Effectiveness of Nebulized Ibuprofen as an Unproven Treatment for COVID-19 in Argentina

      By: Sebastian Calonico, Rafael Di Tella and Juan Cruz Lopez Del Valle
      Many medical decisions during the pandemic were made without the support of causal evidence obtained in clinical trials. We study the case of nebulized ibuprofen (NaIHS), a drug that was extensively used on COVID-19 patients in Argentina amidst wild claims about its...  View Details
      Keywords: COVID-19; Drug Treatment; Health Pandemics; Health Care and Treatment; Decision Making; Outcome or Result; Argentina
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      Calonico, Sebastian, Rafael Di Tella, and Juan Cruz Lopez Del Valle. "Causal Inference During A Pandemic: Evidence on the Effectiveness of Nebulized Ibuprofen as an Unproven Treatment for COVID-19 in Argentina." NBER Working Paper Series, No. 30084, May 2022.
      • January 17, 2022
      • Article

      Reducing Racial Disparities in Cancer Outcomes

      By: Kathy Giusti and Richard G. Hamermesh
      A disproportionate number of Black patients die from cancer in the United States. A key to addressing this problem is enrolling more Black patients in clinical trials. A strategy consisting of these three parts can help accomplish this goal: 1) centralize information...  View Details
      Keywords: Cancer Trials; Racial Disparity; Health Testing and Trials; Race; Strategy
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      Giusti, Kathy, and Richard G. Hamermesh. "Reducing Racial Disparities in Cancer Outcomes." Harvard Business Review (website) (January 17, 2022).
      • 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
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      Nurok, Michael, Thoralf Sundt, Robert S. Kaplan, and Bruce Gewertz. "Surgeons and Administrators Co-Creating Value." Annals of Surgery 274, no. 6 (December 2021).
      • June 2021
      • Article

      Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative

      By: Casey J. Allen, Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala and Matthew H.G. Katz
      We used national administrative data to assess multiple domains of value associated with enhanced recovery pathways for patients undergoing pancreatic surgery. Value metrics included in-hospital mortality, complication rates, length of stay (LOS), 30-day readmission...  View Details
      Keywords: Value-based Health Care; Health Care and Treatment; Analytics and Data Science; Outcome or Result; Measurement and Metrics; Performance Improvement
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      Allen, Casey J., Jarrod S. Eska, Nikhil G. Thaker, Thomas W. Feeley, Robert S. Kaplan, Ryan W. Huey, Ching-Wei D. Tzeng, Jeffrey E. Lee, Steven J. Frank, Thomas A. Aloia, Vijaya Gottumukkala, and Matthew H.G. Katz. "Developing a Value Framework: Utilizing Administrative Data to Assess an Enhanced Care Initiative." Journal of Surgical Research 262 (June 2021): 115–120.
      • Article

      Use of Connected Digital Products in Clinical Research Following the COVID-19 Pandemic: A Comprehensive Analysis of Clinical Trials

      By: Caroline Marra, William J. Gordon and Ariel Dora Stern
      Objectives: In an effort to mitigate COVID-19 related challenges for clinical research, the U.S. Food and Drug Administration (FDA) issued new guidance for the conduct of ‘virtual’ clinical trials in late March 2020. This study documents trends in the use of...  View Details
      Keywords: Connected Digital Products; Telehealth; Remote Monitoring; Health Testing and Trials; Research; Governing Rules, Regulations, and Reforms; Information Technology
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      Marra, Caroline, William J. Gordon, and Ariel Dora Stern. "Use of Connected Digital Products in Clinical Research Following the COVID-19 Pandemic: A Comprehensive Analysis of Clinical Trials." BMJ Open 11, no. 6 (2021).
      • May 2021
      • Article

      Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency

      By: J. Hart, K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels and S.D. Halpern
      Background: Clinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence....  View Details
      Keywords: Choice Architecture; Health Care and Treatment; Interpersonal Communication; Decision Choices and Conditions; Competency and Skills
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      Hart, J., K. Yadav, S. Szymanski, A. Summer, A. Tannenbaum, J. Zlatev, D. Daniels, and S.D. Halpern. "Choice Architecture in Physician–patient Communication: A Mixed-methods Assessment of Physicians' Competency." BMJ Quality & Safety 30, no. 5 (May 2021).
      • 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
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      Kaplan, Robert S., Ashiana Jivraj, and Jane Barrow. "ClearChoice Dental Implant Centers." Harvard Business School Case 121-082, April 2021.
      • 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
      Keywords: Disease Management; Team-based Care; Health Care and Treatment; Groups and Teams; Performance
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      Pany, Maximilian J., Lucy Chen, Bethany Sheridan, and Robert S. Huckman. "Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care." Health Affairs 40, no. 3 (March 2021): 435–444.
      • 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
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      Holmgren, A Jay, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman, and Kevin A. Schulman. "Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems." JAMA Internal Medicine 181, no. 2 (February 2021): 251–259.
      • February 2021
      • Article

      Health Care Measurements That Improve Patient Outcomes

      By: Robert S. Kaplan, Lara Jehi, Clifford Y. Ko, Andrea Pusic and Mary Witkowski
      This article describes the challenges and solutions in determining whether a patient’s treatment has been successful. Such an assessment depends on multiple factors, including the patient’s pretreatment status; the qualifications of personnel performing the treatment;...  View Details
      Keywords: Outcomes Measurement; Health Care and Treatment; Outcome or Result; Measurement and Metrics
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      Kaplan, Robert S., Lara Jehi, Clifford Y. Ko, Andrea Pusic, and Mary Witkowski. "Health Care Measurements That Improve Patient Outcomes." NEJM Catalyst Innovations in Care Delivery 2, no. 2 (February 2021).
      • December 2020 (Revised April 2021)
      • Case

      IBM Watson at MD Anderson Cancer Center

      By: Shane Greenstein, Mel Martin and Sarkis Agaian
      After discovering that their cancer diagnostic tool, designed to leverage the cloud computing power of IBM Watson, needed greater integration into the clinical processes at the MD Anderson Cancer Center, the development team had difficult choices to make. The Oncology...  View Details
      Keywords: Decision Making; Innovation Strategy; Knowledge Management; Knowledge Use and Leverage; Operations; Failure; Information Technology; Applications and Software; Health Care and Treatment; Product Development; Health Industry; Information Technology Industry; Technology Industry; United States; Houston; Texas
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      Greenstein, Shane, Mel Martin, and Sarkis Agaian. "IBM Watson at MD Anderson Cancer Center." Harvard Business School Case 621-022, December 2020. (Revised April 2021.)
      • 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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      Kaplan, Robert S., Chris Hartnick, Mahek Shah, Steven M. Coppess, Alisa Yamasaki, Kaalan E. Johnson, Jeremy Prager, Christopher T. Wootten, Thomas Gallagher, and Evan Propst. "Assessing the Value of Pediatric Aerodigestive Care." NEJM Catalyst Innovations in Care Delivery 1, no. 4 (July–August 2020).
      • Article

      Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding

      By: Samuel Lite, William J. Gordon and Ariel Dora Stern
      IMPORTANCE
      Although the Health Information Technology for Economic and Clinical Health (HITECH) Act has accelerated electronic health record (EHR) adoption since its passage, clinician satisfaction with EHRs remains low, and the association of HITECH with health...  View Details
      Keywords: Health Care and Treatment; Information Technology; Laws and Statutes; Innovation and Invention; Entrepreneurship; Venture Capital
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      Lite, Samuel, William J. Gordon, and Ariel Dora Stern. "Association of the Meaningful Use Electronic Health Record Incentive Program with Health Information Technology Venture Capital Funding." JAMA Network Open 3, no. 3 (March 2020).
      • Article

      Navy Medicine Introduces Value-Based Health Care

      By: Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter
      In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could...  View Details
      Keywords: Military Health System; Health Care and Treatment; Cost Management; Projects
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      Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400.
      • 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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      Bachireddy, Chethan, Andrew Joung, Leslie K. John, Francesca Gino, Bradford Tuckfield, Luca Foschini, and Katherine L. Milkman. "Effect of Different Financial Incentive Structures on Promoting Physical Activity Among Adults: A Randomized Clinical Trial." JAMA Network Open 2, no. 8 (August 2019): 1–13.
      • July 2019
      • Article

      Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements

      By: Derek A. Haas, Xiaoran Zhang, Robert S. Kaplan and Zirui Song
      In 2016, the Centers for Medicare & Medicaid Services (CMS) launched its first mandatory bundled payment program, the Comprehensive Care for Joint Replacement (CJR) model, by randomizing metropolitan statistical areas (MSAs) into the payment model. The paper analyzed...  View Details
      Keywords: Medicare; Medicaid; Bundled Payments; Health Care and Treatment; Cost Management; Performance Evaluation; Outcome or Result
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      Haas, Derek A., Xiaoran Zhang, Robert S. Kaplan, and Zirui Song. "Evaluation of Economic and Clinical Outcomes Under Centers for Medicare & Medicaid Services Mandatory Bundled Payments for Joint Replacements." JAMA Internal Medicine 179, no. 7 (July 2019): 924–931.
      • July 2019
      • Article

      The Impact of Price Regulation on the Availability of New Drugs in Germany

      By: Ariel Dora Stern, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim and Ameet Sarpatwari
      The 2011 German Pharmaceutical Market Restructuring Act (“AMNOG”) subjected branded, non-rare disease drugs to price regulation based on an assessment of their clinical benefit. Assessment outcomes range from “major added benefit” to “less benefit than the appropriate...  View Details
      Keywords: Regulation; Pharmaceuticals; Healthcare; Health Care and Treatment; Price; Governing Rules, Regulations, and Reforms; Pharmaceutical Industry; Germany
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      Stern, Ariel Dora, Felicitas Pietrulla, Annika Herr, Aaron S. Kesselheim, and Ameet Sarpatwari. "The Impact of Price Regulation on the Availability of New Drugs in Germany." Health Affairs 38, no. 7 (July 2019): 1182–1187.
      • Article

      TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear

      By: Robert S. Kaplan, Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller and John I. Lowenstein
      Purpose  To perform a cost analysis comparison for managing common ocular disorders in an eye emergency department (ED) versus an urgent care setting using a time-driven activity-based cost model (TDABC) to assist physicians and staff in appropriate allocation of...  View Details
      Keywords: Time-driven Activity-based Cost Model; Emergency Room; Urgent Care Clinic; Cost; Analysis; Activity Based Costing and Management; Health Care and Treatment
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      Kaplan, Robert S., Jonathan Chou, Mahek Shah, Amy Watts, Matthew Gardiner, Joan Miller, and John I. Lowenstein. "TDABC Cost Analysis of Ocular Disorders in an Ophthalmology Emergency Department versus Urgent Care: Clinical Experience at Massachusetts Eye and Ear." Journal of Academic Ophthalmology 10 (2018).
      • Article

      The IT Transformation Health Care Needs

      By: Nikhil R. Sahni, Robert S. Huckman, Anuraag Chigurupati and David M. Cutler
      In recent years, health care organizations have made sizable investments in information technology. They’ve used their IT systems to replace paper records with electronic ones and to improve billing processes, thereby boosting revenue. But so far, IT has been of little...  View Details
      Keywords: Health Care and Treatment; Information Technology; Performance Improvement; Business Model
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      Sahni, Nikhil R., Robert S. Huckman, Anuraag Chigurupati, and David M. Cutler. "The IT Transformation Health Care Needs." Harvard Business Review 95, no. 6 (November–December 2017): 128–136.
      • September 2017 (Revised December 2017)
      • 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
      Keywords: Precision Medicine; Healthcare; Innovation; Cancer; Cancer Research; Health Care; Technology; Health Care and Treatment; Innovation Leadership; Disruptive Innovation; Entrepreneurship; Decision Choices and Conditions; Health Industry; Insurance Industry; Utah; United States; North America
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      Hamermesh, Richard G., Kathy E. Giusti, Robert S. Huckman, and Julia Kelley. "Intermountain Healthcare: Pursuing Precision Medicine." Harvard Business School Case 818-018, September 2017. (Revised December 2017.)
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