Notes
Chapter 1
1. “The National Health Service: Accident and Emergency,” the Economist, September 10, 2016, 48.
2. “A Prescription for the Future: How Hospitals Could Be Rebuilt, Better Than Before,” the Economist, April 8, 2017, 51.
3. Nick Wingfield, Katie Thomas, and Reed Abelson, “Amazon, Berkshire Hathaway, and JPMorgan Team Up to Try to Disrupt Health Care,” New York Times, January 30, 2018.
4. US health-care data is from National Health Expenditure 2016, published by the Centers for Medicare & Medicaid Services of the US Department of Health and Human Services. Health-care inflation data is from the US Bureau of Labor Statistics (2016). We are grateful to Matt Slaughter for pointing us to this data.
5. Regina E. Herzlinger, Barak D. Richman, and Richard J. Boxer, “How Health Care Hurts Your Paycheck,” New York Times, November 2, 2016.
6. Eric C. Schneider et al., “Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care,” Commonwealth Fund, July 2017.
7. Nicholas Bakalar, “Nearly 20 Million Have Gained Health Insurance since 2010,” New York Times, May 22, 2017.
8. Institute of Medicine, Crossing the Quality Chasm: A New Health System for the 21st Century (Washington, DC: National Academies Press, 2001).
9. Jeffrey R. Immelt, Vijay Govindarajan, and Chris Trimble, “How GE Is Disrupting Itself,” Harvard Business Review, October 2009; Vijay Govindarajan and Ravi Ramamurti, “Reverse Innovation, Emerging Markets, and Global Strategy,” Global Strategy Journal 1, no. 3–4 (2011): 191–205; and Vijay Govindarajan and Chris Trimble, Reverse Innovation: Create Far From Home, Win Everywhere (Boston: Harvard Business Review Press, 2012).
10. Immelt, Govindarajan, and Trimble, “How GE Is Disrupting Itself,” 56.
11. Govindarajan and Trimble, Reverse Innovation.
12. Govindarajan and Ramamurti, “Reverse Innovation, Emerging Markets, and Global Strategy,” 191. This article received the 2012 EBS Best Paper Award in Innovation Management and the 2017 Global Strategy Journal Best Paper Prize.
13. Amos Winter and Vijay Govindarajan, “Engineering Reverse Innovations,” Harvard Business Review, July–August 2015.
14. “US Foreign Aid Saves Money and Lives,” Nature, April 20, 2017, 269.
15. Govindarajan and Ramamurti, “Reverse Innovation, Emerging Markets, and Global Strategy,” 191–205.
16. Pioneering work on Aravind hospital was done by several authors: V. Kasturi Rangan, “The Aravind Eye Hospital, Madurai, India: In Service for Sight,” Case 593-098 (Boston: Harvard Business School, 1993); Sankaran Manikutty and Neharika Vohra, “Aravind Eye Care System: Giving the Most Precious Gift,” Case BP0299 (Ahmedabad: Indian Institute of Management, 2004); Pavithra K. Mehta and Suchitra Shenoy, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion (San Francisco: Berrett-Koehler Publishers, 2011).
17. For two classic publications on the Toyota Production System, see James P. Womack, Daniel T. Jones, and Daniel Roos, The Machine That Changed the World (New York: Free Press, 1990), and Steven Spear and H. Kent Bowen, “Decoding the DNA of the Toyota Production System,” Harvard Business Review, September–October 1999, 96. For an illustration of how TPS might be applied to health care, see Steven Spear, “Fixing Health Care from the Inside, Today,” Harvard Business Review, September 2005, 78.
18. Michael E. Porter and Elizabeth Olmsted Teisberg, Redefining Health Care: Creating Value-Based Competition on Results (Boston: Harvard Business Press, 2006); Clayton M. Christensen, Jerome H. Grossman, and Jason Hwang, The Innovator’s Prescription: A Disruptive Solution for Health Care (New York: McGraw-Hill, 2009); Regina Herzlinger, Who Killed Health Care?America’s $2 Trillion Medical Problem—and the Consumer-Driven Cure (New York: McGraw-Hill, 2007); Donald M. Berwick, Thomas W. Nolan, and John Whittington, “The Triple Aim: Care, Health, and Cost,” Health Affairs 27, no. 3 (2008): 759; J. Y. Kim et al., “From a Declaration of Values to the Creation of Value in Global Health: A Report from Harvard University’s Global Health Delivery Project,” Global Public Health 5, no. 2 (2010): 181; Jim Yong Kim, Paul Farmer, and Michael E. Porter, “Redefining Global Health-Care Delivery, Lancet 382, no. 9897 (2013): 1060. Other notable contributions include: Richard J. Bohmer, Designing Care: Aligning the Nature and Management of Health Care (Boston: Harvard Business Review Press, 2009); Carolyn M. Clancy and Thomas Scully, “A Call to Excellence,” Health Affairs 22, no. 2 (2003): 113; Denis A. Cortese and Robert K. Smoldt, “Healing America’s Ailing Health Care System,” Mayo Clinic Proceedings 81, no. 4 (2006), 492; Brent C. James and Lucy A. Savitz, “How Intermountain Trimmed Health Care Costs through Robust Quality Improvement Efforts,” Health Affairs 30, no. 6 (2011): 1185; John E. Wennberg, Tracking Medicine: A Researcher’s Quest to Understand Health Care (New York: Oxford University Press, 2010).
19. Michael E. Porter, “What Is Value in Health Care?” New England Journal of Medicine 363, no. 26 (2010): 2477.
20. Porter, as quoted on the website of the Institute for Strategy and Competitiveness: http://www.isc.hbs.edu/health-care/vbhcd/Pages/default.aspx, accessed on November 10, 2017.
21. Porter and Teisberg, Redefining Health Care.
22. Ibid., 98.
23. See the section on value-based health-care delivery on the website of Institute for Strategy and Competitiveness, founded by Michael Porter, at https://www.isc.hbs.edu/health-care/vbhcd/Pages/default.aspx.
24. Michael E. Porter and Thomas H. Lee, “The Strategy That Will Fix Health Care,” Harvard Business Review, October 2013, 1.
25. An article in the British medical journal Lancet, citing an independent report, provides these data for Narayana Health and the US average. An older Harvard Business School case study reports the thirty-day mortality rate for Narayana as 1.27 percent and the US average as 1.4 percent. (See Tarun Khanna, Kasturi Rangan, and Merlina Manocaran, “Narayana Hrudayalaya Heart Hospital: Cardiac Care for the Poor (A),” Case 505-078 [Boston: Harvard Business School, 2005, revised 2001].) It is safe to conclude that Narayana’s outcomes are comparable to those of US hospitals.
26. Company data is from annual reports or websites.
27. Biswajit Baruah and Divya Rajagopal, “Narayana Hrudayalaya IPO Oversubscribed 8.63 Times,” Economic Times, December 22, 2015.
28. “Dubai-Based Abraaj Group Buys 72% Holding in CARE Hospitals,” Economic Times, January 14, 2016.
29. Dr. Aravind Srinivasan, Administrator, Aravind Eye Care System, interview with authors.
30. Nigel Crisp, Turning the World Upside Down: The Search for Global Health in the 21st Century (London: Royal Society of Medicine Press, 2010).
31. Barak D. Richman and Kevin A. Schulman, “What U.S. Hospitals Can Still Learn from India’s Private Heart Hospitals,” NEJM Catalyst, May 25, 2017. The authors concluded that “American hospitals could learn a great deal from the organizational focus and structure of their Indian counterparts.”
32. Faheem Ahmed et al., “Can Reverse Innovation Catalyse Better Value Health Care?” Lancet 5, no. 10 (2017).
33. Eric Wadsworth, interview with authors, June 2015.
34. Ascension website, “Mission, Vision, and Values,” https://ascension.org/our-mission/mission-vision-values.
35. John Doyle, EVP, Ascension, interview with authors, December 2016.
36. Wennberg, Tracking Medicine; Elliott S. Fisher et al., “The Implications of Regional Variations in Medicare Spending. Part 1: The Content, Quality, and Accessibility of Care,” Annals of Internal Medicine 138, no. 4 (2003): 273; and Fisher et al., “The Implications of Regional Variations in Medicare Spending. Part 2: Health Outcomes and Satisfaction with Care,” Annals of Internal Medicine 138, no. 4 (2003): 288.
37. Richard M. J. Bohmer, “Virginia Mason Medical Center (Abridged),” Case 610-055 (Boston: Harvard Business School, 2010).
38. Michael E. Porter, Carolyn Daly, and Andrew Peter Dervan, “The Children’s Hospital of Philadelphia: Network Strategy,” Case 710-463 (Boston: Harvard Business School, 2010, revised 2011).
39. Michael E. Porter and Elizabeth O. Teisberg, “Cleveland Clinic: Transformation and Growth 2015,” Case 709-473 (Boston: Harvard Business School, 2009, revised 2016); https://my.clevelandclinic.org/departments/heart/depts/heart-vascular-affiliates.
40. David Cook et al., “From ‘Solution Shop’ Model to ‘Focused Factory’ in Hospital Surgery: Increasing Care Value and Predictability,” Health Affairs 33, no. 5 (2014): 746.
41. Pioneer Institute, “Critical Care, Critical Choices: The Case for Tele-ICUs,” July 19, 2011, http://bgc.pioneerinstitute.org/critical-care-critical-choices-the-case-for-tele-icus/, and UMass Memorial Medical Center, eICU, https://www.umassmemorialhealthcare.org/umass-memorial-medical-center/services-treatments/critical-care/services-we-provide/eicu.
42. See www.mercyvirtual.net.
43. Minnesota Department of Health and Minnesota Board of Dentistry, “Early Impacts of Dental Therapists in Minnesota,” Report to the Minnesota Legislature 2014, February 2014, http://www.health.state.mn.us/divs/orhpc/workforce/dt/dtlegisrpt.pdf. The Pew Charitable Trusts, “The Oral Health Crisis Among Native Americans,” Fact Sheet, July 23, 2015, http://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2015/06/the-oral-health-crisis-among-native-americans.
44. Eric R. Yoo et al., “The Role of e-Health in Optimizing Task-Shifting in the Delivery of Antiviral Therapy for Chronic Hepatitis C,” Telemedicine and e-Health 23, no. 10 (2017): 870.
45. James L. Heskett and Roger H. Hallowell, “Shouldice Hospital Limited (Abridged),” Case 805-002 (Boston: Harvard Business School, 2004, revised 2005).
46. Anssi Mikola, interview by authors, September 28, 2017.
47. Diane Daych, interview by authors, August 10, 2016.
48. Rick Tetzeli, “How Former Apple CEO John Sculley Reinvented Himself in Health Care,” Fast Company, November 30, 2016. https://www.fastcompany.com/3065143/how-former-apple-ceo-john-sculley-reinvented-himself-in-health-care.
49. For a roundup, see “The Future of Mental Health Therapy,” On Point, with guest host Jane Clayson, WBUR, June 20, 2017, http://www.wbur.org/onpoint/2017/06/20/the-future-of-mental-health-therapy.
50. Dr. Richard Friedland, interview with the authors.
51. See https://www.globaltolocal.org/about-us/.
52. Crisp, Turning the World Upside Down.
53. Rushika Fernandopulle, Iora Health founder, interviews with the authors, August 2016.
54. Paul Wafula, “Top Indian Hospital Sets Foothold in Nairobi,” Standard Digital, June 7, 2016.
55. Thulasiraj Ravilla and Dhivya Ramasamy, “Efficient High-Volume Cataract Services: The Aravind Model,” Community Eye Health Journal 27, no. 85 (2014): 7.
56. Landon Thomas Jr., “An Investor’s Plan to Transplant Private Health Care in Africa,” New York Times, October 8, 2016.
Chapter 2
1. Unless otherwise noted, quotes from Dr. Devi Shetty are from an interview with the authors, February 2013.
2. Kounteya Sinhai, “India Doesn’t Have Even 1 Hospital Bed per 1,000 Persons,” Times of India, October 10, 2011.
3. Pavithra K. Mehta and Suchitra Shenoy, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion (San Francisco: Berrett-Koehler Publishers, 2011).
4. Aravind Eye Care System, Activity Report 2016–17, pp. 16–17.
5. Email communication by Dr. N. Krishna Reddy, CEO, Care Hospitals.
6. “Dubai-Based Abraaj Group Buys 72% Holding in CARE Hospitals,” Economic Times, January 14, 2016.
7. LV Prasad website: http://www.lvpei.org/eye-health-pyramid.php.
8. Gullapalli N. Rao et al., “Integrated Model of Primary and Secondary Eye Care for Underserved Rural Areas: The LV Prasad Eye Institute Experience,” Indian Journal of Ophthalmology 60, no. 5 (2012): 396.
9. See http://www.lvpei.org/aboutus.php.
10. Aravind Eye Care System, Activity Report for FY 2016–17, pp. 16–17.
11. Atul Gawande, “Big Med: Restaurant Chains Have Managed to Combine Quality Control, Cost Control, and Innovation. Can Health Care?” the New Yorker, August 13, 2012.
12. Aravind Eye Care System, Madurai, February 2013, and follow-up interview with Dr. Aravind Srinivasan, January 2017.
13. Unless otherwise noted, quotes from Dr. Ajaikumar are from an interview with the authors, December 2012.
14. Nikhil R. Sahni et al., “Surgeon Specialization and Operative Mortality in United States: Retrospective Analysis,” British Medical Journal 354 (2016): i3571.
15. Unless otherwise noted, quotes from Dr. N. Krishna Reddy, CEO, Care Hospitals, Hyderabad, are from an interview with the authors, February 2013.
16. Andrew J. Epstein et al., “Coronary Revascularization Trends in the United States, 2001–2008,” JAMA 305, no. 17 (2011): 1769–1776.
17. Aditi Nayak et al., “Use of a Peritoneal Dialysis Remote Monitoring System in India,” Peritoneal Dialysis International 32, no. 2 (2012): 200; K. S. Nayak et al., “Telemedicine and Remote Monitoring: Supporting the Patient on Peritoneal Dialysis,” Peritoneal Dialysis International 36, no. 4 (2016): 362.
18. Pavithra K. Mehta and Suchitra Shenoy, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion (San Francisco: Berrett-Koehler Publishers, 2011).
19. Communication with Dr. K.S. Nayak, November 2016.
20. See https://www.indiamart.com/aurolab/profile.html.
21. Vivek Wadhwa, “This Indian Start-Up Could Disrupt Health Care with Its Powerful and Affordable Diagnostic Machine,” Washington Post, November 18, 2014.
22. Myshkin Ingawale, “ToucHb: The Story of Prick Free Blood Testing,” video, TED conference, Long Beach, California, February 2012: https://www.youtube.com/watch?v=RyeQt0GodsE.
23. Unless otherwise noted, quotes from Eric Wadsworth are from an interview with the authors, March 2013.
24. Atul Gawande, The Checklist Manifesto: How to Get Things Right (New York: Metropolitan Books, 2009).
25. Unless otherwise noted, quotes from Dr. Raghuvanshi, Vice Chairman and CEO, Narayana Health, Bangalore, are from an interview with the authors, February 2013.
Chapter 3
1. Unless otherwise noted, all quotations from Devi Shetty are from interviews with the authors, conducted in February 2013 and January 2017.
2. Pioneering work on Narayana Health includes Tarun Khanna, Kasturi Rangan, and Merlina Manocaran, “Narayana Hrudayalaya Heart Hospital: Cardiac Care for the Poor (A),” Case 505-078 (Boston: Harvard Business School, 2005, revised 2011).
3. Ibid.
4. Mayo Clinic financial statements (January–June 2016) and Cleveland Clinic’s Annual Report for calendar year 2016.
5. Draft Red Herring Prospectus, September 2015.
6. Unless otherwise noted, all quotations from Ashutosh Raghuvanshi are from interviews with the authors, conducted in 2013, 2016, and 2017.
7. Seema Singh, “Magnificent Obsession,” New Scientist, February 2, 2002.
8. From Al Jazeera production Indian Hospital, Part 1, 2012.
9. Prabakar Kothandaraman and Sunita Mookerjee, “Healthcare for All: Narayana Hrudayalaya, Bangalore,” case study (New York: United Nations Development Programme, 2007).
10. Geeta Anand, “The Henry Ford of Heart Surgery: In India, a Factory Model for Hospitals Is Cutting Costs and Yielding Profits,” Wall Street Journal, November 25, 2009.
11. Budhaditya Gupta, Robert S. Huckman, and Tarun Khanna, “Task Shifting in Surgery: Lessons From An Indian Hospital,” Healthcare: The Journal of Delivery Science and Innovation 3, no. 4 (December 2015): 245–250.
12. Khanna, Rangan, and Manocaran, “Narayana Hrudayalaya Heart Hospital.”
13. See http://extreme.stanford.edu/projects/noora-health-formerly-care-companion.
14. Priti Salian, “Poor Country, Top Doctors: A Hospital in India Shows How to Separate a Nation’s Wealth from the Quality of Its Health Care,” TakePart, March 18, 2016.
15. Aravind’s strategy for high-quality surgery at ultra-low cost is described very well in the following sources: V. Kasturi Rangan, “The Aravind Eye Hospital, Madurai, India: In Service for Sight,” Case 593-098 (Boston: Harvard Business School, 1993); and Pavithra K. Mehta and Suchitra Shenoy, Infinite Vision: How Aravind Became the World’s Greatest Business Case for Compassion (San Francisco: Berrett-Koehler Publishers, 2011).
16. Anand, “The Henry Ford of Heart Surgery.”
17. “Narayana Hrudayalaya: A Model for Accessible, Affordable Health Care?” Knowledge @ Wharton, July 1, 2010, http://knowledge.wharton.upenn.edu/article/narayana-hrudayalaya-a-model-for-accessible-affordable-health-care/.
Chapter 4
1. Wayne Wright, interview with authors, April 20, 2017.
2. Unless otherwise noted, all quotations from Devi Shetty are from telephone interviews with the authors, conducted in February 2013 and January 2017.
3. Robert Pearl, “U.S. Health Care Needs a Wakeup Call from India,” USA Today, January 29, 2017.
4. Unless otherwise noted, all quotations from Viren Shetty are from telephone interviews with authors, conducted in February 2013 and February 2014.
5. Tarun Khanna and Budhaditya Gupta, “Health City Cayman Islands,” Case 714-510 (Boston: Harvard Business School, 2014, revised 2016); John Doyle, interview with authors, December 2016.
6. Unless otherwise noted, all quotations from John Doyle are from an interview with the authors, December 20, 2016.
7. Jim Doyle, “Ascension to Build $2 Billion ‘Health City’ in Caymans,” St. Louis Post-Dispatch, April 10, 2012.
8. Khanna and Gupta, “Health City Cayman Islands,” Exhibit 7, “Nine Point Request by Dr. Shetty to Cayman Government.”
9. Ibid.
10. Fred Goldstein, “Health City Cayman Island—Medical Tourism May Be One Way to Lower Healthcare Costs,” Accountable Health blog, January 13, 2016, https://accountablehealth.wordpress.com/2016/01/13/health-city-cayman-island-medical-tourism-may-be-one-way-to-lower-healthcare-costs/.
11. Khanna and Gupta, “Health City Cayman Islands.”
12. Shamille Scott, “Health City Set to Install Solar Farm,” Loop, June 1, 2015.
13. HCCI company data.
14. Pearl, “U.S. Health Care Needs a Wakeup Call.”
Chapter 5
1. David Grubin Productions and WTTW Chicago, RX: The Quiet Revolution (Public Broadcasting Service, 2015), http://www.pbs.org/program/rx-quiet-revolution, and Janis Quinn, “TelEmergency Network Provides Vital Link to Rural Hospitals during Times of Trauma,” CenterView, May 16, 2011.
2. These criteria were spelled out in HRSA’s call for proposals for creating national Telehealth Centers of Excellence. See https://www.hrsa.gov/ruralhealth/programopportunities/fundingopportunities/default.aspx?id=347d8709-69bb-493c-bfc5-0b0a655dbd6a (accessed on Nov 26, 2017).
3. David Pittman, “Mississippi Emerges as Telemedicine Leader,” Politico, February 26, 2015; “Telemedicine Receives A-Rating in Mississippi,” North Sunflower Medical Center, http://northsunflower.com/nsmc-news/telemedicine-receives-a-rating-in-mississippi.
4. Unless otherwise noted, all quotations from Kristi Henderson are from interviews with the authors, conducted in August 2016 and February 2017.
5. See https://www.umc.edu/news/News_Articles/2016/October/UMMC-telehealth-enters-next-chapter-of-remote-patient-monitoring.html.
6. Henderson Testimony before US Senate Committee on Commerce, Science and Transportation, April 21, 2015.
7. For median income, see US Census Bureau, “Median Household Income by State,” 2012–2016 American Community Survey 5-Year Estimates, https://www.census.gov/search-results.html?q=median+household+income&search.x=0&search.y=0&search=submit&page=1&stateGeo=none&searchtype=web&cssp=SERP. For poverty level, total population, and rate of educational attainment, see US Census Bureau, Quick Facts: Mississippi, https://www.census.gov/quickfacts/table/PST045215/28. For children in poverty, see Jerry Mitchell, “246,000 Mississippi Children Living in Poverty,” Clarion-Ledger, July 21, 2015. For percentage of rural dwellers, see the Rural Health Information Hub webpage for Mississippi: https://www.ruralhealthinfo.org/states/mississippi.
8. United Health Foundation, “America’s Health Rankings: 2016 Annual Report,” http://www.americashealthrankings.org/explore/2016-annual-report/state/MS.
9. For overall ranking, see the Commonwealth Fund, “Overall Ranking, 2017,” http://datacenter.commonwealthfund.org/#ind=1/sc=1. For percentage of primary doctors, see the Association of American Medical Colleges, “2017 State Physician Workforce Data Report,” https://members.aamc.org/eweb/upload/2017%20State%20Physician%20Workforce%20Data%20Report.pdf, 11. Number of uninsured is from the 2014 Commonwealth Fund reporting for 2011–2012, http://www.commonwealthfund.org/publications/fund-reports/2014/apr/2014-state-scorecard.
10. Mississippi State Department of Health, “1999 Report on Hospitals,” http://msdh.ms.gov/msdhsite/_static/resources/122.pdf; Rural Health Information Hub, “Critical Access Hospitals,” https://www.ruralhealthinfo.org/topics/critical-access-hospitals.
11. Unless otherwise noted, all quotations from Michael Adcock are from an interview with the authors, February 8, 2017.
12. Richard L. Summers, Kristi Henderson, Kristen C. Isom, and Robert L. Galli, “The Tenth Anniversary of TelEmergency,” Journal of the Mississippi State Medical Association 54, no. 12 (2013): 340–341.
13. Kristi Henderson, quoted by Louise Plaster in “Can Mississippi Emerge as the South’s Next Health Tech Hub?” in Telemedicine 2 (Fall 2015): 29.
14. Email from Ryan Kelly, February 1, 2017.
15. Ellen Zane, interview with the authors, August 9, 2016.
16. Data USA, “Ruleville, MS,” https://datausa.io/profile/geo/ruleville-ms/#income.
17. Gabriel Perna, “Mississippi’s Diabetes Problem with Telehealth and Care Management,” Healthcare Informatics, November 14, 2014.
18. American Diabetes Association, “The Cost of Diabetes,” http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html.
19. Testimony of Kristi Henderson before the US Senate Committee on Commerce, Science, and Transportation, April 21, 2015.
20. Neil Versel, “Mississippi Telehealth, Remote Monitoring Pays Dividends for Diabetics,” MedCityNews, September 13, 2016.
21. Summers et al., “The Tenth Anniversary of TelEmergency.”
Chapter 6
1. Eric Larsen, “Lessons from the C-Suite: Anthony Tersigni, President and CEO of Ascension,” The Advisory Board, December 10, 2014, https://www.advisory.com/research/health-care-advisory-board/blogs/at-the-helm/2014/12/qa-ascension- health.
2. Institute of Medicine Committee on Quality of Health Care in America, Crossing the Quality Chasm: A New Health System for the 21st Century (Washington, DC: National Academies Press, 2001).
3. Nina Martin, “The Growth of Catholic Hospitals, By the Numbers,” ProPublica, December 18, 2013.
4. Unless otherwise noted, all quotations from John Doyle are from an interview with the authors, December 20, 2016.
5. Unless otherwise noted, all quotations from David Pryor are from an interview with the authors, December 2016.
6. Douglas McCarthy and Elizabeth Staton, “Case Study: A Transformational Change Process to Improve Patient Safety at Ascension Health,” Quality Matters: Innovations in Health Care Quality Improvement, Commonwealth Fund, January 2006.
7. David B. Pryor et al., “The Clinical Transformation of Ascension Health: Eliminating All Preventable Injuries and Deaths,” Joint Commission Journal on Quality and Patient Safety 32, no. 6 (2006): 299–308.
8. Wanda Gibbons et al., “Eliminating Facility-Acquired Pressure Ulcers at Ascension Health,” Joint Commission Journal on Quality and Patient Safety 32, no. 9 (2006).
9. Unless otherwise noted, all quotations from Rhonda Anderson are from an interview with the authors, February 13, 2017.
10. Ryan W. Buell, “Compass Group: The Ascension Health Decision,” Case 615-026 (Boston: Harvard Business School, 2014, revised 2016).
11. Loretta Chao, “Hospitals Take High-Tech Approach to Supply Chain,” Wall Street Journal, October 21, 2015.
12. Kaiser Family Foundation, https://www.kff.org/health-reform/press-release/nearly-half-of-the-uninsured-or-15-7-million-people-are-eligible-for-medicaid-or-subsidized-affordable-care-act-coverage-analysis-finds/.
13. Dave Barkholz, “High-Deductible Health Plans Prompt Some Hospitals to Cut Low-Income Patients a Break,” Modern Healthcare, December 10, 2016.
14. Paul Barr, “Ascension Health’s Approach to Standardizing Its Operations,” Hospitals & Health Networks Daily, March 18, 2015.
15. Anthony R. Tersigni, “It’s Time to Come Together to Improve Our Healthcare System,” The Hill, April 24, 2017.
16. Johnny Smith of Ascension, interview with the authors, July 2017.
17. See “PVF’s Vision: High Efficiency and Keen Focus on the Patient,” Horizon: The Pacific Vision Foundation Newsletter, Spring 2015, http://www.pacificvisionfoundation.org/wp-content/uploads/2016/01/PVF-Newsletter-single.page-Spring.2015.pdf; and Robert Crum, “An Innovative Ophthalmological and Financial Model for People at All Economic Levels,” Robert Wood Johnson Foundation report, April 6, 2015. The report noted: “For the millions of Americans who are uninsured, indigent, or underinsured, medical care is delivered through a system that is both separate from, and unequal to, the care delivered to the rest of Americans.”
18. Bruce Spivey, interview with authors, February 13, 2017.
Chapter 7
1. Email from Rushika Fernandopulle, September 16, 2016.
2. Unless otherwise noted, all quotes from Rushika Fernandopulle come from an interview with the authors, August 17, 2016.
3. Unless otherwise noted, all quotes from Liam Donohue come from an interview with the authors, August 18, 2016.
4. Unless otherwise noted, all quotes from Eric Wadsworth come from an interview with the authors, July 29, 2016.
5. In fact Eric Wadsworth, cofounder of Dartmouth’s Master of Health Care Delivery Science program, has found that at Iora’s center in his area, overall visits to specialists have gone down while visits to certain types of specialists have gone up.
Chapter 8
1. Ellen Zane, interview with authors, August 9, 2016.
2. Gary Kaplan, interview with the authors, August 3, 2016.
3. Richard M. J. Bohmer, “Virginia Mason Medical Center (Abridged),” Case 610-055 (Boston: Harvard Business School, 2010).
4. Michael E. Porter and Robert S. Kaplan, “How to Pay for Health Care,” Harvard Business Review, July–August 2016; Brent C. James and Gregory P. Poulsen, “The Case for Capitation,” Harvard Business Review, July–August 2016.
5. Zeke Emanuel et al., “State Options to Control Health Care Costs and Improve Quality,” Center for American Progress, April 11, 2016, https://www.americanprogress.org/issues/healthcare/reports/2016/04/11/134859/state-options-to-control-health-care-costs-and-improve-quality/.
6. Gary Kaplan, interview with authors, August 3, 2016.
7. D. Cook et al., “From ‘Solution Shop’ Model to ‘Focused Factory’ in Hospital Surgery: Increasing Care Value and Predictability,” Health Affairs 33, no. 5 (2014): 746.
8. Diane Daych, interview with authors, August 10, 2016.
9. Christy Ford Chapin, “How Did Health Care Get to Be Such a Mess?” New York Times, June 19, 2017.
10. Patricia A. McDonald, Robert S. Mecklenburg, and Lindsay A. Martin, “The Employer-Led Health Care Revolution,” Harvard Business Review, July–August 2015, 38.
11. Mark Brohan, “Investors Pump $4 Billion into Digital Healthcare Startups So Far This Year,” Internet Health Management, July 7, 2016.
12. Robert Pearl, “U.S. Health Care Needs a Wakeup Call from India,” USA Today, January 29, 2017.
Appendix A
1. A. Haripriya et al., “Complication Rates of Phacoemulsification and Manual Small-Incision Cataract Surgery at Aravind Eye Hospital,” Journal of Cataract & Refractive Surgery 38, no. 8 (2012): 1360.
2. D. F. Chang, “Tackling the Greatest Challenge in Cataract Surgery,” British Journal of Ophthalmology 89, no. 9 (2005): 1073.
3. See the following articles on these points: R. D. Ravindran et al., “Incidence of Post-Cataract Endophthalmitis at Aravind Eye Hospital: Outcomes of More Than 42,000 Consecutive Cases Using Standardized Sterilization and Prophylaxis Protocols,” Journal of Cataract & Refractive Surgery 35, no. 4 (2009): 629; A. Haripriya, D. F. Chang, and R. D. Ravindran, “Endophthalmitis Reduction with Intracameral Moxifloxacin Prophylaxis: Analysis of 600,000 Surgeries,” Ophthalmology 124, no. 6 (2017): 768.
4. Stephen S. Rauh et al., “The Savings Illusion—Why Clinical Quality Improvement Fails to Deliver Bottom-Line Results,” New England Journal of Medicine, December 29, 2011; John E. Wennberg, Tracking Medicine: A Researcher’s Quest to Understand Health Care (New York: Oxford University Press, 2010).
5. See Vijay Govindarajan and Ravi Ramamurti, “Delivering World-Class Health Care, Affordably,” Harvard Business Review, November 2013, 117.