Harvard School of Public Health Projects

Today’s Managing Health Care Costs Indicator is 12

I’m taking a break from my usual commentary on news, opinion pieces and recent research to celebrate great work done by 12 groups in this fall’s class in “Managing Health Care Costs” at the Harvard School of Public Health.  The final project (in groups of 4-5) was to describe an innovation that could genuinely lower health care costs, and build a business plan to make it happen.  (Full information on the project is on page 40 of the course syllabus, which is available without Harvard ID).

The class is comprised of 58 students, including physicians, medical students, public health students, dentists and lawyers.  Most will graduate with an MPH or an MS in Public Health this May, although a minority will graduate with an MS in May, 2013.

Here is a list of the projects, with brief descriptions which probably don’t do each project justice.   A few of these projects mirror work happening right now – although many represent potential innovation that is not, to my knowledge, yet being tried.  The good ideas represented here are one more reason to be optimistic that we can effectively address the rising cost of health care in the US.

Diabetes Disease Management
Web-based education and training for patients, case managers, and physicians, with a decision-support module for electronic medical records to promote evidence based practice.

Reference Pricing
Firm will provide consulting and on-line tools to facilitate reference pricing initially in New Hampshire, and later expand to other geographies.   Note that this is already happening – see for instance Castlight, Thomson Reuters, Change|Health Care, and Health Care Blue Book.  See Catalyst for Payment Reform for more details on reference pricing.

Farm Fresh Food
Nonprofit will provide crates of locally grown food with appropriate cooking instructions and other ingredients to be distributed through schools, with initial grant funding and graduating to redirection of current farm subsidies.

Decision Software for End of Life Care
Software and consulting services to help hospitals decrease variation and futile care at the end of life

Real Time Cost Tracker
Software and GPS device to simplify implementing time derived activity based costing (TD-ABC) in hospitals.  See a post on the Robert Kaplan/ Michael Porter article in HBR this fall.  We have to know where the resource costs are to lower them - and this would be a very helpful tool to lower the barriers to TD-ABC.

USB Medical Record Card
Expanding on the experience of using cards with embedded chips in France and Taiwan to improve coordination of care and decrease duplication.

Handwashing Monitor
Putting cameras near sinks outside ICU patient rooms and remotely monitoring handwashing.   This approach has been successful at decreasing contamination in meatpacking plants – a good example of taking learnings from other industries.

Readmission Prevention
With a predictive modeling tool to identify those at highest risk of readmission

Medicaid Fraud Detection
Using a combination of software and human claims auditors

Pioneer Accountable Care Organization
Developed a business plan to convert a primary care practice to a Pioneer ACO

End of Life Surgical Check List
Add-ons to hospital EMR systems to alert surgeons and others to likely outcomes based on the terminal patient’s comorbidities.

Thanks to this year's class for great projects!