Why delivery and management matter

the need

Every day, physicians, medical staff, community workers and their colleagues wrestle with the challenge of delivering healthcare more efficiently and effectively to those who most need it. Many agree on the need for innovation in care delivery models, programs and clinical and back-room operations.

Enterprises could benefit from new approaches to management, logistics, organizational change, finance, marketing, design, technology use, strategy and systems. Applying them appropriately requires deep engagement in the specifics of each situation, but many organizations lack needed resources. With no well-developed way to share lessons learned, emerging innovations and practical improvements fail to be documented and disseminated.

the challenge

Inequalities are particularly stark in some African countries. Life expectancy between the world’s richest and poorest countries can vary by more than 40 years, a report shows. The World Health Organization examined primary health care systems around the world, and uncovered huge inequalities and inefficiencies. See warning over health inequalities from the BBC, Tuesday, 14 October 2008. From CNN the same day, the story WHO slams global health care reported that the WHO director calls for universal coverage: health care disparities, she said, makes the world “neither stable nor secure.”

On June 11, 2008, the New York Times’ Nick Kristof asked Are Doctors Screwing Up Public Health? in a piece that considered Josh Ruxin’s argument in Democracy Journal that we need to reward efficient corporate practices among public health practitioners.  Ruxin’s full article is Doctors Without Orders. To improve global health, he argued in Summer 2008, what we need isn’t just Bill Gates’ billions, but Microsoft’s managers.

PIH Medical Director Joia Mukherjee reflects on the past two decades of fighting the spread of HIV/AIDS in One world, one hope, a multitude of voices, January 2008. She notes:

During 2001, our group worked with faculty members from Harvard to publish the “Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries.” Partners In Health and Zanmi Lasante published the first report of The HIV Equity Initiative in the Lancet and the Bulletin of the World Health Organization.  In these articles, we described 60 and then 150 patients in Haiti on antiretroviral therapy.  We reported on the general outcomes: the patients were doing well and had gained weight; the price of ART had dropped considerably with the entry of generic drugs on the market (thanks to activism by Doctors Without Borders (MSF) and others); and community health workers accompanying patients on ART were the backbone of the program addressing adherence and social support.

These themes are, of course, interrelated. As you’ve seen, the next task–of scaling up–may require management skills and approaches to address needs for basic healthcare globally. Consider the challenge of scaling up healthcare in Rwanda, presented in a newsletter article on Rwanda’s new healthcare model and in talks at MIT’s School of Humanities, Arts and Social Sciences and at MIT Sloan School of Management.

the opportunity

Why not partner community programs, clinics, hospitals, and medical practices with students and faculty to work on practical solutions? By grounding focused projects in current management techniques and building in data and evidence, such efforts can explore and improve upon innovative solutions to pressing challenges. Back on campus, both classroom and research benefit.

the inspiration

Mind, hand, management and health care

Modern medicine could reduce disease greatly, yet fails to reach millions. Innovations in management may help address the constraints. We focus on organizations on the front lines of care delivery, studying the issues, interacting with experts, and connecting students with real-world leaders and managers in varied settings to explore what works and what’s needed. Our partners have taught us much, and by embedding students’ field experience in an iterative learning process, we aim to bring rigor to action. Along the way, we put MIT’s tradition of mind and hand into practice and build on our commitment to connect education and impact.

–Anjali Sastry, Senior Lecturer

Leave a Reply

Your email address will not be published. Required fields are marked *