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- Article
A Cost Comparison of Cataract Surgeries in Three Countries—United States, India, and Nepal
By: Jiayin Xue, John Hinkle, Mary-Grace Reeves, Luo Luo Zheng, Vengadesan Natarajan, Shyam Vyas, Radhika Upreti Oli, Matt Oliva, Robert S. Kaplan, Arnold Milstein, Geoff Tabin, Jeffrey L. Goldberg and Kevin Schulman
U.S.-based cataract surgeries are costly compared with those performed in high-quality Indian and Nepalese eye centers. The authors used time-driven activity-based costing to evaluate phacoemulsification surgery across four sites: a U.S.-based academic hospital...
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- July 2021
- Supplement
Adaptive Platform Trials: The Clinical Trial of the Future? (C)
By: Ariel D. Stern and Sarah Mehta
This (C) case provides an update on the work of the Global Coalition for Adaptive Research (GCAR) and also illustrates how adaptive platform trials can nimbly respond to a global pandemic.
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- Article
Regulatory, Legal, and Market Aspects of Smart Wearables for Cardiac Monitoring
By: Jan Benedikt Brönneke, Jennifer Müller, Konstantinos Mouratis, Julia Hagen and Ariel Dora Stern
In the area of cardiac monitoring, the use of digitally driven technologies is on the rise. While the development of medical products is advancing rapidly, allowing for new use-cases in cardiac monitoring and other areas, regulatory and legal requirements that govern...
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- June 11, 2021
- Article
Addressing Demographic Disparities in Clinical Trials
By: Kathy Giusti, Richard G. Hamermesh and Mark Krasnow
Disparities in health care are not just limited to the delivery of care. They also exist in the way that clinical trials are structured. Women, people of color, and the elderly often are not adequately represented. This article offers three strategies for addressing...
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- 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...
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- 2021
- Working Paper
Regulatory Approval and Expanded Market Size
By: Benjamin Berger, Amitabh Chandra and Craig Garthwaite
Regulatory review of new medicines is often viewed as a hindrance to innovation by increasing the hurdle to bring products to market. However, a more complete accounting of regulation must also account for its potential market expanding effects through quality...
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- Article
A Megastudy of Text-Based Nudges Encouraging Patients to Get Vaccinated at an Upcoming Doctor's Appointment
By: Katherine L. Milkman, Mitesh S. Patel, Linnea Gandhi, Heather N. Graci, Dena M. Gromet, Hung Ho, Joseph S. Kay, Timothy W. Lee, Modupe Akinola, John Beshears, Jonathan E. Bogard, Alison Buttenheim, Christopher F. Chabris, Gretchen B. Chapman, James J. Choi, Hengchen Dai, Craig R. Fox, Amir Goren, Matthew D. Hilchey, Jillian Hmurovic, Leslie K. John, Dean Karlan, Melanie Kim, David Laibson, Cait Lamberton, Brigitte C. Madrian, Michelle N. Meyer, Maria Modanu, Jimin Nam, Todd Rogers, Renante Rondina, Silvia Saccardo, Maheen Shermohammed, Dilip Soman, Jehan Sparks, Caleb Warren, Megan Weber, Ron Berman, Chalanda N. Evans, Christopher K. Snider, Eli Tsukayama, Christophe Van den Bulte, Kevin G. Volpp and Angela L. Duckworth
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes the challenge of encouraging vaccination more urgent than ever. We present a large field experiment (N = 47,306) testing 19 nudges delivered to patients via...
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Keywords:
Vaccination;
COVID-19;
Nudge;
Influenza;
Field Experiment;
Health;
Communication Strategy;
Behavior
- May 2021
- Article
Choice Architecture in Physician–patient Communication: A Mixed-methods Assessments of Physicians’ Competency
By: J. Hart, Yadav, K., Szymanski, S., Summer, A., Tannenbaum, A., Zlatev, J., Daniels, D. and Halpern, S.D.
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....
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- 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...
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- April 2021
- Case
ClearChoice Dental Implant Centers
By: Robert S. Kaplan, Ashiana Jivraj and Jane Barrow
The case illustrates the application of value-based health care to dental medicine. ClearChoice Dental Implant Centers was a rapidly-growing network of dentist-owned independent implant clinics. The targeted market included 23 million people, 15% of the US adult...
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- April 2021
- Article
Today's Surgeon Compensation Models Fall Short: Aligning Incentives to Create More Equitable and Value-based Compensation Models
By: Susanna Gallani, Mary Witkowski, Lauren Haskins, Haley Jeffcoat, Vinita Mujumdar and Frank Opelka
Modern medicine is undergoing a transformation that involves innovative surgical approaches, increased medical treatment options, clinical care pathways that require collaboration beyond hospital walls, and health data captured by electronic health records and other...
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- Article
A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018
By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan
Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and...
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- March 2021
- Article
Provider Teams Outperform Solo Providers in Managing Chronic Diseases and Could Improve the Value of Care
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...
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- Article
Ushering in Safe, Effective, Secure, and Ethical Medicine in the Digital Era
By: William J. Gordon, Andrea Coravos and Ariel Dora Stern
From clinical trials to care delivery, advanced, digitally enabled technologies and analytics offer new approaches to how we think about medicine, health, and biology. The COVID-19 pandemic has accelerated this conversation, and forced a roadmap, once measured in years...
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- February 2021 (Revised August 2021)
- Case
Marvin: A Personalized Telehealth Approach to Mental Health
By: Regina E. Herzlinger, Thomas Arsenault, Julia Kelley, Carin-Isabel Knoop, Andrew Nguyen and Eshani Sharma
More than one third of Americans were said to suffer some type of behavioral health ailment at some point in their lifetime, with many people requiring chronic therapy or intervention. Despite significant clinical needs, access to reliable treatment has been difficult...
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- February 2021
- Article
Assessment of Electronic Health Record Use Between U.S. and Non-U.S. Health Systems
By: A Jay Holmgren, Lance Downing, David W. Bates, Tait D. Shanafelt, Arnold Milstein, Christopher Sharp, David Cutler, Robert S. Huckman and Kevin A. Schulman
Importance: Understanding how the electronic health record (EHR) system changes clinician work, productivity, and well-being is critical. Little is known regarding global variation in patterns of use.
Objective: To provide insights into which EHR... View Details
Objective: To provide insights into which EHR... View Details
- 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;...
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- 2021
- Working Paper
The Health Costs of Cost-Sharing
By: Amitabh Chandra, Evan Flack and Ziad Obermeyer
We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in...
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- 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...
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Keywords:
Decision Making;
Innovation Strategy;
Knowledge Management;
Knowledge Use and Leverage;
Operations;
Failure;
Technology;
Information Technology;
Software;
Health Care and Treatment;
Product Development;
Health Industry;
Information Technology Industry;
Technology Industry;
United States;
Houston;
Texas
- 2020
- Working Paper
The Market for Healthcare in Low Income Countries
By: Reshmaan Hussam, Abhijit Banerjee, Jishnu Das, Jeffrey Hammer and Aakash Mohpal
New research clearly identifies trust as an important driver of the demand for healthcare. However, doctors who realize that patients may not trust them may also alter their behavior in response. We assemble a large dataset that assesses clinical performance using...
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