PharmaExec Magazine features Bloodbuy

Brown University's Masters in Healthcare Leadership: A Mission to Transform

Aug 01, 2014

By William Looney

Pharmaceutical Executive

As the US healthcare system stumbles toward a new consensus built around the "triple aim" of increased access, improved quality, and lower cost, the push is on for new ideas that can test the boundaries of current practice. The Affordable Care Act (ACA) creates a range of incentives to promote this goal, which has added to the momentum around novel reform approaches. Business management schools have jumped with gusto into the fray, providing much of the intellectual heft for integrative, outcomes-oriented programs that stress patient wellness and require medicines to do more than just treat disease.

One institution, Brown University, has gone a step further than many of its counterparts, with a new 16-month Executive Master of Healthcare Leadership (EMHL) program dedicated to empowering mid-career health professionals with the diverse interests, skill,s and capabilities to challenge that status quo and "transform" healthcare as we now know it. The centerpiece of the curriculum is a requirement that each student initiate a "Critical Challenge Project" within their sphere of expertise to address this aim, probing the way healthcare services are currently organized, delivered, or financed.

Strafing those silos: The Critical Challenge project

An underlying goal of the Critical Challenge Project is to attack the bureaucratic or process silos that prevent different parts of the system from cooperating to advance a more holistic population health agenda. The emphasis is as much on doing something differently as doing something important, engaging stakeholders across the system to achieve a measurable result that will allow the student to assess—quantitatively or qualitatively—the effects of its implementation.

The Critical Challenge Project is a key criteria for admission; it also serves as the basis for much of the EMHL's formal coursework, the student's final grade, and subsequent priorities upon his or her return to the workplace. Students give regular progress reports on their project in a peer group exchange format, allowing diverse points of view to be incorporated in plans and objectives going forward. "This is not a static exercise," says EMHL Program Executive Director Judith Bentkover. "We see it as a way to test theory against practice, with transformative system change as the ultimate objective."

As a complement to this month's cover feature on 15 Emerging Pharma Leaders for 2014,Pharm Exec made a recent visit to Brown's first EMHL class of 28 mid-career professionals, most under age 40, and representing a wide range of sectors and occupations in the healthcare field, from traditional big Pharma to health community activists. The purpose? To highlight a few of the more ground-breaking Critical Challenge projects being pursued by this highly motivated class of young entrepreneurs—and thus to open a window on the future of healthcare. A talk with five students indicates a diversity of approaches, but all share the EMHL program objective of exposing the silo thinking that blocks progress toward changes that everyone says they want, but are hard to achieve in practice.

Bridging the information gap

For Chris Godfrey, senior vice president at Dallas-based venture capital firm HealthCap Partners, market signals are often missing in healthcare, resulting in more uncertainty and less efficiency in the deployment of human and capital assets. His project revolves around Bloodbuy, a small start-up enterprise he founded to create a more transparent and structurally cohesive process for the exchange of price information and supply of blood products between distributors and hospitals.

"If you want to improve the market," Godfrey says, "the best place to start is with the core commodity of healthcare, which is blood. Essential services literally cannot be provided without it, so I see it as a critical pathway into the health system—and, unfortunately, the logistics of pricing and supply devised by blood center distributors are often non-transparent and lack much accountability to the hospitals that depend on predictability in the supply chain. Godfrey notes that the FDA mandates uniform standardization in the composition of blood products, which means there should be little differentiation in pricing—the product itself is the same. Yet a strong spot market exists in many parts of the country for blood products, with the result that hospitals face wide gaps in what they have to pay for blood, making it harder to accurately account for their needs.

To remedy this, Bloodbuy has developed data technology to help hospitals overcome the fragmented supply chain and lack of transparency in pricing by broadcasting their blood needs to a broader audience, avoiding the traditional dependence on a few local outlets. "It's essentially about diversifying risk, so that as a hospital I am going to have a better chance of getting the blood products I need, when I need them, at the optimal price point." It also works for the blood centers, which face a strategic dilemma as reform slows acute care utilization, which leads to less demand for their commodity. "Bloodbuy's technology enables them to address this slowdown by helping them penetrate new geographies and acquire new customers." It's a precision response to a gap unmasked by the drive toward system reform, helping customers out of their silo to connect to a relevant area of unmet need, with greater efficiency at each end of the market as the intended result.