Health care administration educators are at a crossroads: the health care sector is rife with inefficiencies, erratic quality, unequal access, and sky-high costs, complex problems which call for innovative solutions. And yet, according to our content analysis of top U.S. health administration schools and a recent article in the Lancet, our educational systems focus their curricula on isolated, theoretical subjects, such as analytics and quantitative problem solving, rather than the team-oriented, practical problem-solving skills required for innovation.
All too often, when graduates of these programs enter the workforce, they find themselves unequipped to meet the challenges for innovation of 21st century health care. The following blog post examines the current educational gaps in traditional health care administration and efforts underway to address them. One such effort is the Global Educators Network for Health Care Innovation Education (GENiE) Group, created by Harvard Business School (HBS) Professor, Regina Herzlinger, whose members are working to make innovation a central part of the education of the future leaders in health care.
Interviews with Global CEOs
In 2012, Regina Herzlinger worked with Scriplogix to conduct interviews with 58 leading global health care sector CEOs about their future needs. A quarter of these CEOs noted that they were so dissatisfied with traditional health care administration education that they have developed training programs of their own and would rather hire and train good candidates with little health-related education than accept the “ready-made” graduates of most academic programs.
The CEOs wanted people who could solve problems, work as part of a diverse team, understand and learn from failure, manage change, and innovate through processes, systems, and organizations. The words they used most were leadership, change, and innovation (Exhibit 1).
Exhibit 1: Content Analysis of CEO Interviews
For a more comprehensive look at the results, check out this interactive map of the content analysis.
In contrast, when Regina Herzlinger and her research assistant analyzed health care-related curricula at 26 top U.S. schools, spanning 324 courses, they found the most frequently used words were policy and organization. The words “innovation” and “entrepreneur” were found only 27 times (Exhibit 2).
Exhibit 2: Content Analysis of Health Care–Related Curricula
Across the continuum of undergraduate and graduate education, including schools of public health, business, nursing, health administration, and medicine, there are significant opportunities to add innovation components to all of these curricula and to include innovation as a crucial component of lifelong learning requirements.
Most of the 98 health care administration academics we surveyed agreed that schools are not educating students to be innovative. They noted several barriers to change, including shortages of public health or health administration faculty with appropriate managerial skills and adequate grounding in actual health care delivery, global markets, and holistic perspectives. In addition to these faculty-centric barriers, they noted difficulties in finding data on real-world organizations or material integrating health care and business school curricula.
Clearly change is needed, but for health care to change, the education of its leaders must change.
A History of Management Education
Sweeping change in management education has happened before. For example, in the late 1970’s, entrepreneurial programs at business schools were almost non-existent. Some thought-leading faculty from HBS teamed with a network of entrepreneurs who guest lectured, provided intellectual, financial, and moral support to develop this curriculum.
Entrepreneurship is now a vital component of almost all business administration programs. Aided by this education, for example, approximately half of Harvard Business School graduates become entrepreneurs 15 years out of school. Because the number of MBA graduates in the United States topped 156,000 in 2013 and, according to the the U.S. Small Business Administration, small businesses have generated 67 percent of net new jobs since 1995, the addition of entrepreneurship to the business administration curricula has played an important role on our economic welfare.
The entrepreneurship curriculum continued to evolve. In 2011, for example, HBS revised its curriculum based on the U.S. Army’s “Be-Know-Do” framework, a paradigm that examines the underlying beliefs and values that create a manager’s professional identity and view of the world (“being”); assesses the facts, frameworks, and theories taught (“knowing”); and revamps curricula to favor core managerial skills and methods (the “doing” component).
This framework served as the basis for a new curriculum which focuses on leadership and innovation (the being part), the integration of that learning across the academic year (the knowing component), and global immersion in innovative activities sponsored by businesses (the doing aspect). Teams of students develop, pitch, and launch a micro business, and, as a class, monitor and discuss its successes and failures. As a capstone to the course, student teams present their plan to experienced business leaders who provide feedback and financial rewards.
The GENiE Group
To enable a similar partnership like the one that spearheaded the addition of entrepreneurship to the curricula of business schools, one of us (Herzlinger) formed a group representing global academic institutions, professional organizations, and health care consultancies called the Global Educators Network for Health Care Innovation Education (GENiE) Group. GENiE includes more than 140 academic members interested in introducing innovation into their curricula, and a number of CEO champions who share these interests, including the CEOs of Johnson & Johnson, the American Medical Association, Bessemer Ventures, and athenahealth Inc, among others.
To further this partnership, the GENiE Group has held two annual conferences with 150 global academic and stakeholder attendees at Harvard Business School and Duke University; launched the Harvard edX MOOC Innovating in Health Care and the HBS Executive Education course Business Innovations in Global Health Care; created an archive of innovative programs and a series of videos on health care innovation, including the importance of health care innovation, businesses that support it, and students who become health care entrepreneurs; and surveyed a wide range of constituents to help develop the competencies necessary in an innovation curriculum.
To date, 18 schools have implemented courses or programs in health care innovation. For example, Arizona State University’s W.R. Carey School of Business offers a Master of Health Care Innovation in which students learn how to create and sustain successful cultures of innovation in health care from multiple perspectives.
Likewise, the University of Copenhagen and the Copenhagen Business School are jointly launching a two-year, full time Master of Science program in health care innovation. Faculty from health and business disciplines will partner to train a new breed of health care innovators to tackle the challenges facing modern health care.
We welcome your participation and ideas on the content, format, research, and dissemination of ideas that could best foster teaching of innovating health care.