The Missing Piece in Health Care Reform: Health Care Delivery Science

Email ThisPrint ThisDeliciousDigg ThisGoogleShare to FacebookLinkedInRedditStumble ItShare to Twitter

Dartmouth College has received a $35 million commitment to establish The Dartmouth Center for Health Care Delivery Science, President Jim Yong Kim announced today. The anonymous gift will advance a new field of study, harnessing the knowledge and expertise of faculty across multiple disciplines from the arts and sciences as well as from the medical, business and engineering schools.

Kim said the gift will speed Dartmouth’s work on the next stage of needed health care reform: “The passage of health reform was a historic event that will result in millions of Americans having access to our health care system. Health Care Delivery Science is about ensuring that the care they receive is the best it can be.”

“We know – and this has been documented by the Dartmouth Atlas of Health Care – that there are glaring variations in how medical resources are used in the U.S. More care and more expensive care do not guarantee high quality care,” Kim said. “What we need is a new field that brings the best minds – from management, systems engineering, anthropology, sociology, the medical humanities, environmental science, economics, health services research, and medicine – to focus on how we deliver the best quality care, in the best way, to patients nationally and globally. Those people are here at Dartmouth.”

Senators Judd Gregg, R-NH, and Jeanne Shaheen, D-NH, applauded the new Center:

Senator Gregg noted that studies from The Dartmouth Institute for Health Policy and Clinical Practice “are constantly turned to by policymakers in Washington, especially as they relate to getting better health care at a more affordable cost. The establishment of this new center will put the findings of Dartmouth researchers into practice and will further the Institute’s efforts to advance health care innovation, rein in health care costs, and provide quality care for people throughout the country.”

Said Senator Shaheen: “The formation of the Center for Health Care Delivery Science is great news. This will help Dartmouth remain on the cutting-edge of studying our health system and developing new practices to make health care delivery more efficient and cost effective. I look forward to working with and supporting President Kim and the Center in their efforts, especially as we implement new laws that will provide affordable health coverage to millions more Americans.”

President Kim and senior leadership

The new Dartmouth Center for Health Care Delivery Science is cross-disciplinary. President Jim Yong Kim (center) is working with (from left): Paul Danos, Dean of the Tuck School of Business; Carol L. Folt, Dartmouth Provost; Dr. James N. Weinstein, Co-President of Dartmouth-Hitchcock and Director of the Dartmouth Institute for Health Policy and Clinical Practice; Dr. William R. Green, Acting Dean of Dartmouth Medical School; Joseph J. Helble, Dean of the Thayer School of Engineering. (photo by Jared Leeds)

In addition to integrating across the Arts and Sciences (undergraduate and graduate), the Tuck School of Business, the Thayer School of EngineeringDartmouth Medical School, and The Dartmouth Institute for Health Policy and Clinical Practice, Health Care Delivery Science creates a unique partnership between the College and Dartmouth-Hitchcock, its affiliated academic health system. Dartmouth-Hitchcock will provide the base for innovation and implementation in clinical practice, said Co-Presidents James N. Weinstein and Nancy Formella.

“In the past decade, Dartmouth-Hitchcock has created a number of innovative models in clinical care, including the Spine Center, the first-in-the-nation Center for Shared Decision-Making, and the Comprehensive Breast Program,” Weinstein said. “This is a fantastic opportunity to build new partnerships within the College, and take advantage of President Kim’s experience in tackling the challenge of health care delivery in some of the most difficult settings in the world.”

One of the first initiatives will be a new Masters program in Health Care Delivery Science, offered jointly by The Dartmouth Institute and the Tuck School of Business. Traditional health care management courses have been built around general “best business” practices from a wide range of professions. The Dartmouth curriculum will be unique in its singular focus on discovery and analysis of innovations and real-time implementation in health care. Executive education and distance learning will be incorporated into the new degree program, scheduled to enroll its first class in July 2011. Undergraduate offerings in this field will be developed as well, Kim said.

Dartmouth Provost Carol L. Folt said: “Health care is now one-sixth of the U.S. economy, and arguably as important as any issue we face today. Our undergraduate students, whatever their career path, will be affected by its impact on our economy, national discourse, and of course, will experience health care first-hand as patients or family members of patients. We know that teaching political science, economics, sociology, philosophy, etc. to our students is critical to their liberal arts education. The opportunity to study health care and its impact on society – in its broadest form – will only enhance our ability to produce enlightened graduates and leaders.”

Jeff Immelt, Chairman and CEO of General Electric and a Dartmouth trustee said: “As an employer of 300,000 people around the world and with $3 billion of our resources going into health care for our people each year, there are few issues more important to me and to GE than the quality and cost of health care. I’m proud of Dartmouth for taking this on, for applying expertise from across the College to the challenges, and for partnering so effectively with the Dartmouth-Hitchcock health system.”

The Dartmouth Center for Health Care Delivery Science will focus on five areas with a goal of improving the quality, effectiveness, and value of health care for patients, their families, providers, and populations. Priorities will include:

Research:

  • An expanded research agenda at Dartmouth and with partners around the country, building on the pioneering work of The Dartmouth Institute for Health Policy and Clinical Practice, and focusing on high-impact aspects of health care delivery.
  • An international research network that will bring together innovation centers to develop, study and disseminate best practices.
  • A grant award program to encourage research in the field.

Education:

  • A new curriculum in the delivery of health care to be incorporated into medical education at Dartmouth.
  • A consortium of medical schools committed to integrating Health Care Delivery Science into their academic programs.
  • Undergraduate courses, cross-disciplinary offerings through the Tuck School of Business, Thayer School of Engineering, Dartmouth Medical School and the Arts and Sciences, and new distance and executive learning opportunities.
  • A journal of health care delivery science, to advance dissemination, research, and learning.

Collaboration:

  • Partnerships across a diversity of health care systems in the U.S. and beyond, to define best practices and integrate them into clinical practice.
  • Joint efforts with academic institutions nationally and internationally to expand the new field of Health Care Delivery Science.
  • Intellectual “lab” spaces for leaders in business, industry, government, academia, to create new synergies and pathways for innovation.

Implementation:

  • Demonstration projects to provide proof of concept, e.g. The Spine Center at Dartmouth-Hitchcock, Shared Decision-Making, and initiatives to improve population health.
  • Development and deployment of measures that go beyond clinical outcomes, to evaluate quality and value of care, with patient-reported data and longitudinal tracking incorporated into enhanced Health Information Technology.
  • On-the-ground teams and distance-teaching to facilitate adoption and integration of proven “best practices” in diverse clinical environments nationally and internationally.

Advocacy:

  • New Communities of Practice nationally and internationally that demonstrate quality and value in health care.
  • Advocacy for changes in policy at the federal and state levels – and globally – to promote and support new models of care.
  • Comprehensive outreach across a range of audiences – health care providers and systems, policymakers, consumers, and others – to inform, educate, and engage.

Michael E. Porter, Bishop William Lawrence University Professor at Harvard Business School and author of Redefining Health Care: Creating Value-Based Competition on Results, said: “For 30 years, researchers at Dartmouth have pioneered the measurement of performance variation in U.S. health care, and given us clear evidence of the serious value problem in health care delivery. This Center, with its multidisciplinary approach and unique partnership with a leading medical center, is poised to become a leader in advancing measurement and devising new delivery solutions. I look forward to working closely with the Center and its leaders.”

Kim said the anonymous donor chose Dartmouth as the place to lead in this area, based on the institution’s record of accomplishment in health systems research and implementation, its established graduate programs, history of collaboration and innovation across campus, and the investment the Trustees have already made in pursuing health reform through establishment of The Dartmouth Institute.

“This is a donor who believes deeply in the moral and economic imperatives of changing the way health care is provided in this country – and throughout the world,” said Ed Haldeman, Chair of the College Board of Trustees.

“The donor also chose Dartmouth because of President Kim’s background and his ability to lead one of the great institutions of the world to mobilize its strengths and tackle one of the great challenges of our time. The Trustees and I fully expect that this is the first of a number of initiatives Dartmouth will launch in the coming years. This spring President Kim and Provost Folt are launching a strategic planning process that will identify other initiatives that build upon Dartmouth’s many strengths,” Haldeman said.

For more information about the Dartmouth Center for Health Care Delivery Science, please visit http://tdc.dartmouth.edu.