The problems of health care throughout the world are not primarily ones of medical knowledge or even political will. They are problems of effective management and execution. A critical part of the solution — the development of a science of health care delivery, an utterly new field of science — will require models, methods, and metrics that don’t exist today.
“It’s been a true adventure, and this class has been our co-creator,” said program director Katy Milligan D’90, T’07. “I think the success of the program is a testament to their entrepreneurship, their engagement, and their commitment to changing the world.”
One of the first commitments of the Dartmouth Center for Health Care Delivery Science, when it began its work in 2010, was to provide financial and instructive support for the world’s first graduate program in health care delivery science. Dartmouth’s Master of Health Care Delivery Science (MHCDS) program features a low-residency model of hybrid pedagogy, organized by the Tuck School of Business and the Dartmouth Institute for Health Policy and the Clinical Practice (TDI). The emerging field joins the three pillars of medicine—scientific research, clinical practice, and evaluation science—to determine how best to deliver medical intervention to everyone who needs it.
This past January, health care professionals in the inaugural class of Dartmouth’s Master of Health Care Delivery Science (MHCDS) program were celebrated at a special investiture ceremony at Dartmouth College’s Hanover Inn. The MHCDS class of 2013, the first to complete the program, will officially receive their degrees in June, at the commencement ceremony held for all graduating classes of Dartmouth’s undergraduate and graduate programs.
Students were on campus in the second week of January for their final 10-day residency, a session designed to synthesize all they’ve learned with practical application in the real world. One example of this synthesis: A health care outcome simulation built by the non-profit incubator ReThink Health allowed the students to play out different kinds of investments in community health, from bike paths and better school lunches to new hospital wings, determining their health care costs and outcomes over 10 or 20 years. “It was a springboard for discussion,” said Milligan, “and then the students debriefed to talk about policy lessons, teamwork, and how different investments require different coalitions.”
One other example: A team of five participants from the Long Island Jewish Medical Center (LIJ) focused on improving the quality of life for people with chronic obstructive pulmonary disease (COPD), a non-curable ailment that can cause shortness of breath, chronic bronchitis, and emphysema. After taking the Health Care Marketing and Population Health courses, the MHCDS team used data analysis to discover that the top three populations with COPD in their system were Korean, Chinese, and Pakistani.“We started to transition our patient education to target people in those communities and their leaders,” explained Michael Goldberg MHCDS’13, the associate executive director of finance at LIJ. The results of the effort have been promising, with substantial decreases in 30-day readmission rates, ICU use, and mortality for COPD patients, while maintaining the cost-per-case in a rising cost environment. “It’s exciting,” said Goldberg, “because our system has asked us to be the model for managing chronic care patients as part of a bundled payment initiative.
“The power of this program to me is that we don’t only improve our system,” said Goldberg, “but our peers will apply our project across the U.S. That will truly change the cost of health care while improving it at the same time.”
Visit MHCDS, mhcds.dartmouth.edu.