The Dartmouth Symposium on Health Care Delivery Science March 26-27, 2018
Health Care Transformation Playbook: How to Implement Organizational Change in an Uncertain Environment
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Agenda Policy Update. Overview of recent policy changes at the federal level relating to value-based payment. Hope Plavin’16
Session 1: Where Are We Now? Opportunities and challenges facing OneCare Vermont, a state-wide ACO, as it relates to a Next Generation ACO model. Linda Cohen’16 Norman Ward’15 Stephen Leffler’16
Session 2: Leading Change – How to Evaluate Change Opportunities and Differentiate Good Ideas from Bad Ones Panel of Executive Officers discuss decision-making around areas of transformation; including evaluating change opportunities, deciding which ideas to pursue, and determining when to abandon initiatives. Joanne Conroy Janice Nevin Austin Pittman’13
Session 3: Medici Method Innovation Workshop Utilizing diverse perspectives and experiences to generate and refine innovative ideas on health system transformation. Facilitated by The Medici Group
Session 4: Elements of Change Management Discussion among Mt. Sinai Beth Israel’s CMO, COO and VP-HR about the operational, human resources, and managerial strategies involved in the transformation of Mt. Sinai Beth Israel and its subsequent reduction in total bed capacity from 799 licensed beds to 220, of which 70 are medical/surgical. Barbara Barnett’13 Christopher Berner Elizabeth Sellman
Session 5: Transformative Partnerships Four tactics for creating transformative partnerships. Robert Eubanks’19
Session 6: Transformers - Transformation Learning Stations Five presentations about transformative work. David Robson’16 Benjamin Anderson’16 Gregory Makoul’13 Surya Bhatta’18 and Kathryn Becker Van Haste’18 Kevin Bader’18 and John Benson
Session 7: Dimensions of Implementing Change Panelists share strategies for implementing change and creating value at the physician, departmental and organizational levels. Suellen Griffin’15 Alok Sharan’15 Andrew Sorenson’16
2018 Symposium Keynote Speaker Rushika Fernandopulle is the co-founder and CEO of Iora Health, an innovative primary care clinical organization. He is a physician who has spent more than ten years involved in efforts to improve the quality of healthcare delivered to patients. He was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and served as a Managing Director of the Advisory Board Company. He serves on the faculty and earned his AB, MD, and MPP from Harvard University. He completed his clinical training at the Massachusetts General Hospital. Video: http://dartgo.org/symhcds18
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Policy update. Hope Plavin provided an overview of key changes in the contours of the US health policy landscape. This included the roles of federal and state governments, private payers, and newer entrants to the marketplace such as Amazon, and Google. Changes in federal policy leadership, and Medicare and Medicaid payment and priorities were described.
Potential trends for the near future were laid out, including growth in value-based payment and purchasing models, cross-sector partnerships and continued interest in accountable care organizations.
“Do strong financial incentives coupled with better Hope Plavin ‘16 patient engagement and care management improve outcomes & lower costs?”
Video: http://dartgo.org/symhcds18 Slides: http://dartgo.org/symslide18 Session 1. Where are we now?
The State of Vermont is conducting a 5-year Key levers for change are hospital payment experiment with CMS around 1) controlling reform, primary care support, community- healthcare spending growth to 3.5% over 5 years, based services support, and population 2) getting Vermonters into the OneCare Vermont health management. Payment reforms are ACO (70% of commercially insured Vermonters creating new capitated care payment models and 90% of Medicare beneficiaries in Vermont) and all-payer rate setting. Their population through bringing in providers, 3) critically model segments patients into healthy and examining if the model is improving health well (44%), early onset chronic illness quality in Vermont. (40%), complex/high cost/acute care (6%), and chronic illness and rising risk (10%) and focuses resources on acute and high- cost segments.
OneCare ACO’s community-based care aims to address social determinants of health, focusing resources on high-cost, high-risk patients, screening for social Linda Cohen ‘16 Norm Ward ‘16 Steve Leffler ‘16 supports in primary care.
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Session 2. Leading change: How to “whole-person” care model that includes evaluate change opportunities & addressing social determinants of health. differentiate good ideas from bad Joanne Conroy shared her emphasis on engaged listening, communication, and ones. continually scanning the environment for opportunities for change. She explained the Speakers shared examples of and best practices importance of addressing hearts and minds for organizational change. Janice Nevin described and removing barriers to change. Other Christiana’s work to understand and affirm strategies discussed included: how to create organizational values by engaging her entire staff an operating system for continuous in the process and by considering the role of love improvement; prioritizing innovation by in healthcare. Austin Pittman described UHC’s allocating time for it; and the importance of iterative and very large-scale move towards a listening to the customer.
“It starts with just listening. Not for what you want to hear, just listening.”
Janice Nevin Joanne Conroy Austin Pittman ‘13 Video: http://dartgo.org/symhcds18 Slides: http://dartgo.org/symslide18 Session 3. Medici Method innovation workshop.
This session explored how participants can use the diverse perspectives and experiences present in their teams to generate and refine innovative ideas on health system transformation. It was facilitated by Sharang Biswas D’12 Th’13, the Experience Designer at The Medici Group. Key takeaways from the experience: • Form teams as diverse as possible to leverage a variety of perspectives and experiences. • When ideating, aim to generate a large number of ideas, using intersections and connections between seemingly unrelated concepts. • When selecting which ideas to move forward with, use passion and surprise as a guide. • Acquire feedback from non-experts, and use the power of short, focused meetings. • Remember the Smallest Executable Step (SES): test ideas as cheaply and quickly as possible, and don’t be afraid to pivot away from the original idea.
The Medici Group is a global strategy consulting firm that works with clients to innovate by harnessing the diversity their organizations. Based on the work of CEO, Frans Johansson (author of the Bestselling THE MEDICI EFFECT and THE CLICK MOMENT), The Medici Group engages with clients in the C-Suite to drive sustainable and meaningful progress in innovation culture, leadership model, or frontier growth. https://www.themedicigroup.com/
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Session 4. Elements of change With a new facility under construction, they management. are rethinking care patterns and processes. Old wards have been relocated to available space in existing buildings in other facilities The Mount Sinai health system is reducing beds and specialty hospitals within their system, in their primary facility from 799 beds in 2018 to organized as centers of excellence. 220 beds in 2021 (70 for medical/surgical, the rest for other needs) while reorganizing the system Critical elements of success include around ambulatory care and centers of excellence. continued relationship building with the community, rethinking care models for Key drivers for the reduction are: flexibility, and interpersonal relationship • A move to coordinated care in outpatient building among staff and leadership. settings • Right-sizing an aging facility with 60% occupancy rate in need of $1.3 billion worth of renovation • Shifting patient and payer needs.
Barb Barnett ‘13 Christopher Berner Elizabeth Sellman
Video: http://dartgo.org/symhcds18 Slides: http://dartgo.org/symslide18 Session 5. Transformative partnerships. The four tactics are: Robert Eubanks shared four tactics for creating 1. Invest in relationships before partnering transformative partnerships and explained how 2. Discover a compelling story they relate to two projects he completed in 3. Align leadership priorities Hawaii: using video decision aids for advance 4. Exercise compassion and resilience. care planning and building a home-based palliative care program. For Tactic 1, Robert highlighted listening; Marshall Ganz’s insights on relationships; and the “Strategic Doing Process” from Purdue. For Tactic 2, Robert highlighted the “Transformation always importance of transparency around values and involves loss for someone. a compelling story such as “resist being Compassion and resilience average.” For Tactic 3, Robert stressed are essential responses.” emptying one’s beliefs and listening without judgment as well as four leadership levers that focus on emotions and systems. For Tactic 4, Robert Eubanks ‘19 he shared five practices emphasizing empathy, forgiveness, and self-care.
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Session 6. Transformation learning stations
Supply chain management: Transforming care delivery with a Lessons from rural Nepal. perioperative surgical home. This project, called Maternal Outcomes This transformation story explored the integration of care Modernization (MOM), began as an MHCDS over the perioperative period, with the goal of reducing action learning project. Using mobile phone length of stay (LOS). Approaches employed included technology, MOM improves supply chain care paths, standardization of processes, and enhanced management of drugs to prevent and treat communication, coordination, and data sharing. These postpartum hemorrhage in rural Nepal. More: efforts led to a reduction in LOS from 3.2 days above the https://nepalalp.wixsite.com/dartmouthmhcds national average to 1.5 days below. -Surya Bhatta ’18 -Dave Robson ‘16 Kathryn Becker Van Haste ’18
Improving health & care by listening-Individually & at scale. https://patientwisdom.com/ aims to improve health and care by listening. Prior to their first clinical visit, patients take roughly 10 minutes to visit a patient portal and characterize what is important to them. Patients answer prompts, not questions, on things they truly care about such as their joys, passions, goals, barriers. This information integrates with electronic health records, allowing clinicians to review an “insight summary” before meeting with the patient. Provider recruitment and -Greg Makoul ‘13 retention: How a frontier hospital leverages equity & diversity. “It is a failure of leadership not to A riveting presentation describing how Kearny notice when people need help. I’m County Hospital in remote, rural Kansas has transformed recruitment of primary care constantly on surveillance for what providers through a mission of serving diverse needs to change” populations and advancing social justice. -Benjamin Anderson ‘16
EMERGEnt Properties of a pilot to reduce harm in the SICU. To minimize preventable harms in the ICU environment, an information system was created that united transdisciplinary project teams. The early findings indicated that the system enhanced situational awareness regarding harm intervention, addressed CLABSI, generated improvements relative to existing EHR (e.g., quicker and more accurate confirmation of protocol compliance), and the representative results suggest fewer patients experienced ICU acquired weakness -Kevin Bader ’18 John Benson
Symposium on Health Care Delivery Science, 2018. Dartmouth College. Session 7. Dimensions of implementing change. At West Central Behavioral Health, practice reengineering reduced a list of 220 patients A framework for aligning institutional change waiting 3 to 4 months down to a wait list of initiatives provided a structure for three examples zero, with all patients seen within 3 to 5 of change at different organizational levels. days. Process analysis and improvements at WestMed aimed to achieve better access for patients with Intermountain Healthcare reimagined their spine pain, reducing their wait for an initial organization, transforming a cumbersome consult from 3 weeks to 24-48 hours. system of four hospital geographies, multiple management structures, outdated and inefficient operations into a single hospital region with matrix structures organized around patient needs, efficient decision processes and one Intermountain culture spanning community and specialty care
Alok Sharan ‘15 Suellen Griffin ‘15 Andrew Sorenson ‘16 Video: http://dartgo.org/symhcds18 Slides: http://dartgo.org/symslide18
Symposium Steering Committee Benjamin Anderson Brandon Cole Terri Osborne Class of 2016 Class of 2015 Class of 2015
Barbara Barnett Peter Curran Hope Plavin Class of 2013 Class of 2013 Class of 2016
Chris Blaski Tim Link Alok Sharan Class of 2014 Class of 2015 Class of 2015
The 2018 Dartmouth Symposium on Health Care Delivery Science is supported by: Peter Curran’13 and anonymous donors from the Class of 2017 in memory of Bonni Curran’13.
Symposium on Health Care Delivery Science, 2018. Dartmouth College.
BIOGRAPHIES
Benjamin Anderson, MHCDS’16 has made it his priority and his mission to improve the health status of residents in rural Kansas, work that reflects his passion for helping the underserved. Since June 2013, Anderson has led Kearny County Hospital, a critical access facility in the small town of Lakin, Kansas, where he is committed to helping underserved and struggling populations. His work in health promotion, health equity among refugees, and physician recruitment and retention have all received national acclaim. In 2014, Anderson was recognized as one of Modern Healthcare’s Up & Comers recognizing young executives who have made significant contributions in the areas of healthcare administration, management or policy.
Carol Ash, DO, MHCDS’17 is a board-certified general internist, fellowship-trained pulmonary, and critical care and sleep medicine specialist with more than 20 years of experience in clinical medicine. She is a graduate of Seton Hall University, and the University of Medicine and Dentistry of New Jersey (UMDNJ). She obtained an MBA at University of Massachusetts Amherst, and fellowship status with the American College of Healthcare Executives. She is a recent graduate of Dartmouth's Master of Health Care Delivery Science program, which offers advanced training in healthcare leadership, teamwork, finance, and operations.
In her current role with Rutgers Robert Wood Johnson Medical School she is medical director of the Critical Care Unit at Robert Wood Johnson Barnabas Health Hamilton. With her clinical leadership expertise, she is helping both organizations to align and launch a new healthcare delivery model that will address resource utilization in the ICU, improve health outcomes, and reduce health costs. This initiative presents a unique opportunity to launch a transformation journey from microsystem, to High Reliability Organization, to a “Culture of Health.”
Dr. Ash has been featured on television and radio, including The Today Show, Good Morning America, CNN, The Weather Channel, MSNBC, Fox's Fox and Friends, CBS Early Show and more. She has been a featured speaker at national business sponsored events including engagements for the National Business Aviation Association (NBAA), the International Operators Convention (IOC), and Corporate Aviation Safety Stand- down (CASS).
Kevin D. Bader, MHCDS’18 is currently the Project Manager for the Bureau of Navy Medicine & Surgery’s (BUMED) “Advancement of Patient Safety for High Reliability Change Management Plan” focusing on the creation and optimization of an enterprise- wide comprehensive patient safety system.
He started at the Johns Hopkins University Applied Physics Laboratory (JHU/APL) in 2013 and in his time with this organization has worked as a health systems engineer in several healthcare delivery applications. He has worked on projects ranging from optimization of outpatient clinics to MOR and ED utilization at various military hospitals throughout the country. He spent considerable time supporting the implementation of Patient- Centered Medical Home in several branch health clinics in Portsmouth, Virginia. He has spent most of his last two years leading several projects focused in Patient Safety. These include leadership in the software development and implementation of a patient harms surveillance system and project management of the Comprehensive Unit-Based Safety Program (CUSP) implementation at multiple hospitals in Navy medicine.
Before JHU/APL, Kevin worked for several years in operations, Lean Six Sigma and supply chain across many industries including manufacturing, pharmaceutical, bio-pharmaceutical, and semiconductor fabrication.
Kevin graduated from The Pennsylvania State University with a Bachelor’s degree in Industrial Engineering and has most recently completed all requirements necessary to receive a Master of Health Care Delivery Science degree from Dartmouth College June 2018.
Barbara Barnett, MD, MHCDS’13, FACEP, FACP is the Chief Medical Officer of Mount Sinai Downtown. She has overall responsibility for quality, safety, clinical excellence, and physician affairs for Mount Sinai locations south of 34th Street in New York City, including Mount Sinai Beth Israel, Mount Sinai Union Square, Mount Sinai Chelsea, and the New York Eye and Ear Infirmary of Mount Sinai.
She spent most of her career as a Residency Director and educator of medical students. In 2010, she became the Associate Chair of Internal Medicine for the NS-LIJ Healthcare system where she developed a passion for hospital operations and subsequently switched gears to focus her attention on Quality and Performance Improvement work. She completed the Greater New York Clinical Quality Fellowship teaching and the e-Coach the Coach program at The Dartmouth Institute. Refusing to accept that status quo, she developed a strong interest in improving care for patients and population health. By focusing on patients with chronic illness, she successfully implemented patient-specific care models. In 2014, Dr. Barnett joined Mount Sinai as Chief Medical Officer of Mount Sinai Beth Israel. In four short years, she has helped lead MSBI to unprecedented improvements in hospital-acquired harm rates, avoidable readmissions, and throughput and efficiency. Dr. Barnett remains a member of the Mount Sinai Beth Israel clinical faculty in internal medicine and emergency medicine and sees patients in the Emergency Department weekly.
Her expertise in alternate care models, performance improvement, medical education, and quality and safety is a tremendous asset during the vast transformation of the health system’s downtown platform. As a part of this work, she has partnered with members of the Downtown leadership team to oversee clinical practice, enhance the ambulatory network, leverage alternate care models to provide safer and more efficient care, help optimize quality, and be an integral part of planning for the new Mount Sinai Beth Israel hospital opening in 2021.
Dr. Barnett completed her medical degree at the State University of New York Health Science Center in Brooklyn. She completed her residency at the Albert Einstein College of Medicine/Long Island Jewish Medical Center and is nationally certified in Emergency and Internal Medicine. Dr. Barnett was a member of the inaugural class of the Master of Health Care Delivery Science program at Dartmouth College.
John H. Benson is a group supervisor and systems engineer for the Research & Exploratory Development Department and a Principal Professional Staff member of the Johns Hopkins University Applied Physics Laboratory (JHU/APL). His group is focused on conceiving, evaluating and developing concepts that revolutionize care delivery. His technical work focuses on applying systems engineered specifically for health care. He was project manager for Emerge, a grant awarded to Johns Hopkins Medicine to improve patient-centered care using a systems approach. Additionally, he was the project manager and systems engineer for the Individualized Cardiology (inCAR) pilot, a Hopkins inHealth project. The purpose of inCAR is to develop, test, and disseminate a patient-centered, data-driven, cost-conscious, and continuously improving model of individualized care.
Mr. Benson has a BS in Mechanical Engineering, an MS in Environmental Engineering and is a Maryland- licensed professional engineer. He has completed a 5-day Johns Hopkins Patient Safety Certificate Program through the Armstrong Institute for Patient Safety and Quality.
Christopher Berner, JD has served as the Vice President of Human Resources for Mount Sinai Beth Israel in New York City since June 2015. Prior to that, he served as the Chief of Staff to the New York City Commissioner of Labor Relations, and as both the Assistant Vice President for Labor and Employee Relations and Labor Counsel to Montefiore Medical Center in the Bronx. He also practiced labor law for two and half years in Manhattan after graduating for Northeastern University School of Law in Boston, where he grew up. He is a labor relations expert who is trying to become an HR generalist. His main interests involve leadership behaviors, culture change, his family, building Lego brick models, and playing soccer.
Surya Bhatta, MHCDS’18 was born and raised in a small village of the Dhading district of Nepal. He received a Bachelor of Public Health degree from Nepal Institute of Health Science in Kathmandu. Presently, he works as a Country Office Program Director of One Heart World-Wide, a nonprofit health organization based in Nepal. He is passionate about improving the lives of those who have the utmost need. He is a health-development practitioner with more than seven years of experience in managing and taking on leadership roles in health care development interventions focusing on the wellbeing of women, children, and disadvantaged communities. Under his in-country program leadership the One Heart World-Wide program has been scaled up to 12 districts in rural northern area of Nepal. Surya has most recently completed all requirements necessary to receive a Master of Health Care Delivery Science degree from Dartmouth College June 2018.
Sharang Biswas, D’12, Th’13 is an Experience Designer at The Medici Group, a strategy consulting firm that focusses on diversity and innovation. His role at The Medici Group involves creating, customizing, and facilitating workshops that best address clients’ goals. He brings to the team his experience in designing interactive experiences of all kinds, from museum tours and school curricula, to board games and interactive theater.
Sharang is an award-winning game designer and has worked with institutions such as the Metropolitan Museum of Art, the Museum of the Moving Image, Playcrafting, Institute of Play, Games for Change, and NYU. Sharang regularly contributes articles on media and culture to various publications, and presents keynotes and talks at galleries and conferences.
Sharang received a BA in Engineering, a BE in Biotechnology & Biochemical Engineering from Dartmouth, and a Masters in Interaction Design and Creative Technology from ITP at NYU-Tisch School of the Arts.
Linda J. Cohen, JD, MHCDS’15 is a leading healthcare regulation attorney in Vermont who is passionate about working alongside healthcare organizations and providers that need to navigate the evolution from fee-for-service to value-based reimbursement. She brings a deep level of understanding of the barriers faced by providers beyond the law itself, including cultural, financial, operational, employment, privacy, and technological. She works in collaboration with clients to ensure these barriers do not inhibit their success.
Linda works to provide strategic regulatory and legal advice to healthcare organizations as they implement organizational, structural and financial changes based on changing federal and state reimbursement mandates. As a recent graduate of Dartmouth’s Master of Health Care Delivery Science program, she is able to offer healthcare organizations a level of business knowledge, operational expertise and legal skill that is not available elsewhere in the state. With secure knowledge of the current system, as well as the goals for the future, she is able to guide clients to success in both venues.
She has substantial experience in reimbursement issues involving both governmental and commercial payors, having litigated many disputes to conclusion and resolved many through negotiation. She regularly works with organizations participating in Vermont’s All Payer Model partnership with The Centers for Medicare & Medicaid Services (CMS).
Joanne M. Conroy, MD serves as CEO and President of Dartmouth-Hitchcock and Dartmouth-Hitchcock Health, the largest private employer in the state of New Hampshire. Dartmouth-Hitchcock is a nonprofit academic health system that includes: Dartmouth-Hitchcock Medical Center, which is the system’s 429-bed flagship teaching hospital; the Dartmouth-Hitchcock Clinic (a multi-specialty group practice employing more than l ,000 physicians), the Norris Cotton Cancer Center; the Children’s Hospital at Dartmouth-Hitchcock; four affiliate hospitals (New London Hospital, Mt. Ascutney Hospital and Health Center, Cheshire Medical Center, and Alice Peck Day Memorial Hospital); the Visiting Nurse and Hospice for New Hampshire and Vermont; and 24 ambulatory care clinics.
Dartmouth-Hitchcock is New Hampshire’s only academic health system and only Level 1 trauma center and is the largest provider of health care in the state and the second largest in Vermont. The Dartmouth-Hitchcock system trains nearly 400 residents and fellows annually and performs world-class research, in partnership with the Audrey and Theodor Geisel School of Medicine at Dartmouth and the White River Junction VA Medical Center.
Prior to arriving at Dartmouth-Hitchcock, Dr. Conroy served as CEO of Lahey Hospital and Medical Center (formerly the Lahey Clinic), a large, integrated delivery system in Massachusetts with more than 1,400 physicians, 18,000 employees, $4 million in grant funding for medical research and $2 .0 billion in annual revenue.
From 2008 to 2014, she served as Chief Health Care Officer of the Association of American Medical Colleges (AAMC), focusing on the interface between the health care delivery system and academic medicine, paying particular attention to how health care in academic settings can manage the challenge of health care reform and the operational implications of the Affordable Care Act. Dr. Conroy represented the interests of approximately 350 teaching hospitals and health systems, including 40 Veterans Affairs medical centers, through the AAMC Council of Teaching Hospitals and Health Systems.
From 2001 to 2008, she served as Executive Vice President of Atlantic Health, Chief Operating Officer/ President of Morristown Memorial Hospital, a 695-bed flagship teaching hospital.
From 1986 to 2001, Dr. Conroy served many roles at the Medical University of South Carolina, including Vice President for Medical Affairs, Chair of Anesthesiology and Senior Associate Dean of the College of Medicine.
Robert Eubanks, MHCDS’19 has worked for HMSA – Hawaii Medical Service Association (non-profit BCBS Health) for 23 years. In recent years, Robert has played important key team roles in a number of innovative HMSA initiatives to improve the healthcare system. These initiatives include Patient Centered Medical Home, American College of Physicians Medical Neighborhood Pilot, Pay for Quality Programs for Hospital Care, Primary Care and Specialty Care; Advance Care Planning with Video Decision Support Tools, and HMSA Supportive Care / Palliative Care Pilots. Robert is a current student in the Master of Health Care Delivery Science program at Dartmouth College and will expect to receive his degree in February 2019.
Robert A. Greene, MD, MHCDS’14, FACP provides consulting services in the areas of population health management, transition from fee-for-service to total cost of care payment models, quality improvement, clinical analytics, performance management, and system strategy.
Dr. Greene was most recently Executive Vice President and Chief Population Health Management Officer for Dartmouth-Hitchcock (DH). Working in close collaboration with other DH clinical and administrative leaders, he had accountability and oversight for population health management programs and ACO work across DH. He led the development and implementation strategies required to succeed under population-based reimbursement models. He also played a key role in employee wellness and external population health initiatives, working with programs at DH and with partners in the community.
Prior to coming to Dartmouth-Hitchcock, Dr. Greene was Senior Vice President for Innovation and Applied Analytics at UnitedHealthcare (UHC) in Minnetonka, Minnesota. In that position, he led the Clinical Analytics Division of UHC, where he was responsible for coordinating clinical performance measurement across the company. He also was in charge of research and development for UHC’s national physician public reporting program, the UnitedHealthcare Premium designation program; analytic support for patient-centered medical home pilots; clinical performance measurement for performance based contracting and value-based incentives; and multiple provider-facing quality improvement programs.
Additionally, he was the executive sponsor for design of the UHC Patient Centered Care Model (PCCM), a model of care that integrates the medical, behavioral, and social needs of patients especially those with multiple complex chronic diseases; and alignment of UHC clinical models under the PCCM framework.
Dr. Greene is a 1978 graduate of Harvard College and a 1986 graduate of the University of Pennsylvania, School of Medicine in Philadelphia, PA. He completed his Internship and Residency in Internal Medicine at Strong Memorial Hospital in Rochester, N.Y. He completed a Master of Health Care Delivery Science at Dartmouth in 2014.
Dr. Greene practiced internal medicine for 18 years. He has worked on clinical performance measurement, quality improvement and economic issues in medicine since the mid-1980s. He is also an assistant professor at The Dartmouth Institute for Health Policy & Clinical Practice (TDI).
Dr. Greene has published numerous papers in the areas of performance measurement, quality improvement, and population health, participated on multiple national expert panels, and has spoken and consulted on related topics across the country.
Suellen Griffin, MSN, MHCDS’15, FACHE is President and CEO of West Central Behavioral Health. She has worked in the area of behavioral health for more than 40 years and has extensive experience in program development and organizational management. Prior to her current position at WCBH, she worked at St. Vincent Catholic Medical Centers (SVCMC) in New York City for 31 years, holding nine different positions including VP of Operations and Nursing for all behavioral health programs in the eight-hospital system.
Suellen is a Psychiatric Nurse Practitioner who holds a Master’s Degree in Nursing from Yale University and a Master’s Degree in Health Care Delivery Science from Dartmouth College. In addition, she is a Fellow of the American College of Healthcare Executives and is an Adjunct Instructor in Psychiatry at The Geisel School of Medicine at Dartmouth. Suellen is President of the New Hampshire Community Behavioral Health Association. In addition, she served with the Army Reserves and is a veteran of Desert Storm.
Stephen Leffler, MD, MHCDS’16 is Chief Population Health and Quality Officer for the UVM Health Network and a professor of surgery at the UVM College of Medicine. Appointed in 2017, he is responsible for the strategic direction and coordination of quality, patient safety, care management and population health programs for the network. He works closely with clinical and administrative leadership across the system as well as with accountable care organizations, OneCare Vermont and Adirondacks ACO. Dr. Leffler served as Medical Director of the Emergency Department at the University of Vermont Medical Center until October 2011 and served as President of the Medical Staff at University of Vermont Medical Center from 2010 to 2011. He was the Chief Medical Officer at the University of Vermont Medical Center from 2011-2017. He has served on numerous clinical committees during his more than two decades as an emergency medicine physician, and has been a key collaborator on significant organizational initiatives, including UVM Medical Center’s regional STEMI project, an innovative program to ensure heart attack victims receive life-saving care as rapidly as possible. A past president of the Vermont Chapter of the American College of Emergency Physicians, Dr. Leffler received his medical degree from the UVM College of Medicine and completed residency training in emergency medicine at the University of New Mexico before joining the UVM/Fletcher Allen faculty in 1993. Dr. Leffler completed his Master of Health Care Delivery Science at Dartmouth in 2016.
Gregory Makoul, MD, MHCDS’13 is internationally recognized for expertise in physician-patient communication and shared decision making as well as a radical common sense, person-centered approach to health care innovation. He is Founder and CEO of PatientWisdom, Executive-in-Residence at AVIA, and Founding Director of the Connecticut Institute for Primary Care Innovation. He is also Professor of Medicine at the University of Connecticut School of Medicine, following 15 years on the faculty at Northwestern University Feinberg School of Medicine. Dr. Makoul devoted six years to care transformation as Senior Vice President and Chief Innovation Officer / Chief Academic Officer at Saint Francis Care, an integrated delivery system based in Hartford, gaining real-world experience to complement his work in academic medicine. He was recently named a Learning Health System Research Pioneer by the Association of American Medical Colleges. The tools he developed for teaching and assessing communication skills and for measuring empathy – as well as his award-winning series of videos for bringing patient perspectives into health care – are used worldwide. Dr. Makoul earned a BA from Wesleyan University, a PhD in Communication Studies from Northwestern University, and a MS in Health Care Delivery Science from Dartmouth College.
Ellen Meara, PhD is a health economist known for her work modeling the effects of public policies and regulations on health care utilization, overall health, and economic outcomes. Her research often focuses on the impact of public policies and regulations on publicly insured populations in Medicare and Medicaid. Meara looks closely at the economic impact of changes to insurance coverage, payment strategies, and the implementation of care delivery innovations. Much of this work focuses on disabled populations, including people with mental illness and substance disorders. She has extensive experience tracking trends in medical spending over time and for different populations.
Meara is co-faculty director of the Master of Health Care Delivery Science program at Dartmouth; she is a co- editor of the Journal of Health Economics, and a research associate of the National Bureau of Economic Research. She earned a BA from Northwestern University in mathematical methods for social sciences and political science, and a PhD in economics from Harvard University.
Kirsten Meisinger, MD, MHCDS’18 is the Medical Staff President for the Cambridge Health Alliance (CHA) as well as a Regional Medical Director in Primary Care and the CHA Site Visit Liaison.
Dr. Meisinger has an active panel as a Family Doctor at the Union Square Family Health Center, a CHA practice, and has been Medical Director of the site since 2008. Union Square Family Health Center is a highly decorated Patient Centered Medical Home (PCMH) which, in 2012, was selected as a Robert Wood Johnson Foundation LEAP practice: one of 30 notable ambulatory care sites in the US.
Dr. Meisinger was National Faculty Co-Chair for the Center for Medicare and Medicaid Services (CMS) initiative “Transforming Clinical Practices Initiative” (TCPi) 2016/17 as well as the co-chair of the CMS ICOAG Affinity Group. She will continue as faculty through 2018.
Dr. Meisinger has done extensive consulting both nationally and internationally on Patient Centered Medical Home development and health care system transformation. She has faculty appointments at Tufts University and Harvard Medical School and is the faculty lead at the Institute for Healthcare Improvement Latin American team. She is a member of the expert panel for Australia’s national Health Care Home Initiative in conjunction with AGPAL. She has ongoing projects in Nicaragua, Nepal and China.
Dr. Meisinger earned a BA from Brown University, her medical degree from Case Western Reserve University and completed a Family Medicine Residency at the Greater Lawrence Family Health Center in Lawrence, Massachusetts. She has most recently completed all requirements necessary to receive a Master of Health Care Delivery Science degree from Dartmouth College June 2018.
She speaks fluent Portuguese, Spanish and French. She can get away with ordering food in German. She likes caring for living creatures in her homelife. She lives in Massachusetts with her husband and 3 children, a dog, and a huge garden.
Janice E. Nevin, MD, MPH President and Chief Executive Officer, Christiana Care Health System is a visionary and collaborative health care leader. As leader of the largest health system in Delaware, Dr. Nevin is pioneering value-based care, leading a transformation from a health care system to a system that truly impacts health. She is nationally recognized for innovation in patient- and family-centered care and population health.
Dr. Nevin is dedicated to advancing The Christiana Care Way, the health system’s promise to serve its community with expert, respectful care in partnership with patients and their families in ways they value and can afford.
Christiana Care is a national leader in quality and safety, with top ratings for medical excellence and patient safety in the CareChex 2018 Hospital Quality Rankings. These include No. 1 rankings in the United States for trauma, stroke, neurological and pneumonia care.
Under Dr. Nevin’s leadership, Christiana Care developed Carelink CareNow, a unique data-driven care coordination platform to proactively address patients’ social and behavioral health needs in addition to their medical needs. Carelink CareNow supports patients across the continuum of care and is demonstrating better health outcomes while reducing the cost of care. Carelink CareNow earned the 2017 John M. Eisenberg Patient Safety and Quality Award, the nation’s preeminent recognition for quality and safety in health care, and a 2017 Stand Up for Patient Safety Management Award from the National Patient Safety Foundation.
Consistently named one of the nation’s best hospitals by U.S. News & World Report, Christiana Care has been among Truven Health Analytics’ 100 Top Hospitals in the U.S. and was the only major U.S. teaching hospital to earn Truven’s select Everest Award for outstanding improvement consecutively in 2016 and 2015. The American Hospital Association named Christiana Care one of the nation’s “Most Wired” hospitals in 2017 and 2016 for the innovative integration of care and technology. Christiana Care has twice earned Magnet® designation for nursing excellence from the American Nurses Credentialing Center.
Dr. Nevin led Christiana Care to become a founding partner in eBrightHealth, a first-of-its-kind alliance of health systems and hospitals to increase access to health care services and improve the quality and affordability of care for Delawareans, and eBrightHealth ACO, an accountable care organization to improve care coordination, clinical quality and value in Delaware and the region.
In 2017 Dr. Nevin was inducted into the Delaware Women’s Hall of Fame and was recognized among 100 Great Healthcare Leaders to Know in 2017 by Becker’s Hospital Review. For her commitment to the community, she received Delaware’s Grassroots Champion Award from the American Hospital Association and the David G. Menser Award from the Wilmington Senior Center, both in 2017. She was named the 2016 Woman of Distinction by the Girl Scouts of the Chesapeake Bay.
Dr. Nevin serves on the Strategic Planning Committee of America’s Essential Hospitals, the Federal Reserve Bank of Philadelphia Economic and Community Advisory Council and the boards of directors of the Delaware State Chamber of Commerce, United Way of Delaware and Delaware Community Foundation. She is a member of the Delaware Business Roundtable Executive Committee, and the CEO Council for Growth of the Chamber of Commerce for Greater Philadelphia. Dr. Nevin graduated from Harvard University and earned her medical degree with honors from Sidney Kimmel Medical College at Thomas Jefferson University. She completed her family medicine residency at Thomas Jefferson University Hospital and her master of public health degree at the University of Pittsburgh.
Austin Pittman, MHCDS’13 is Executive Vice President, Enterprise Healthcare Value at UnitedHealth Group (UHG). In this role, Austin develops solutions to deliver superior care for the people UHG has the privilege to serve. Prior to this role, Austin was the Chief Executive Officer of UnitedHealthcare Community & State. UnitedHealthcare is a division of UnitedHealth Group (NYSE: UNH) which is a diversified health and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.
Previously, Austin was President of UnitedHealthcare Networks (UHN). Austin and his UHN team created focused high-performing provider care networks ready to support the largest expansion of health coverage in this lifetime.
Austin also served as Chief Growth Officer for UnitedHealthcare Employer & Individual. He was appointed to that role in 2009 after serving in leadership roles within UnitedHealthcare’s local markets as health plan CEO of North and South Carolina, and President of Texas and Oklahoma.
Austin has worked in the health care industry for more than 20 years, having begun his career working in various roles for both a community-based behavioral health facility and Baylor Health Care System.
Austin earned a Master of Health Care Delivery Science from Dartmouth College, a Master of Science in Business/Human Relations from Amberton University in Dallas, Texas, and a Bachelor of Science degree from McMurry University in Abilene. Austin also served in the United States Marine Corps.
Hope A Plavin, MHCDS’16 has over 34 years of experience with health system planning, design and implementation. At the New York State Department of Health Hope was responsible for a wide array of initiatives and responsibilities including helping to craft a proposal to provide universal health care for all New Yorkers (UNY*Care). She also spent more than a decade with the AIDS Institute – working on issues ranging from quality oversight, to harm reduction initiatives to development of HIV Special Needs Plans. She also created and managed implementation of a Governor’s initiative to create a multi-sector response to community health that engaged a diverse set of constituencies including public safety, education, public health and mental health, code enforcement and education to bring a cohesive and integrated set of interventions and services to communities and individuals most at risk of adverse outcomes. While with the Office of Quality and Patient Safety, she drafted regulations guiding implementation of New York’s All Payer Claims Data Base and Statewide Health Information Network of New York. As New York State’s SIM director, she was responsible for NY’s $100M grant intended to transform the health delivery system to promote, support and incent primary care as the crux of health promotion and care, wellness and management of chronic conditions. Hope received her B.A. in Economics from the State University of New York at Stony Brook; an M.P.A. from Rockefeller College, State University of New York at Albany and an M.S. in Health Care Delivery Science from Dartmouth College. Hope has also completed professional education courses at the Kennedy School, Harvard University.
Helen Rhodes, MD, MHCDS’17, FACOG completed her residency training in Obstetrics and Gynecology at The University of Texas Health Science Center at Houston in 1992 and has been practicing in the Houston area ever since. Inspired by knowledge acquired from the MHCDS Program, Dr. Rhodes opened a gynecology-only micro practice in 2017 which has allowed her to provide comprehensive, high quality, affordable care following evidence based guidelines to women in Coastal Texas communities. Additionally, she serves as both the Medical Director and Laboratory Director for two plasmapheresis centers. Most recently, Dr. Rhodes began partnering with rural hospitals to provide OB/GYN care to women in under served areas of Texas and Kansas. Dr. Rhodes is passionate about spending time with her patients and helping them navigate the complex, rapidly changing health care system.
David Robson, MD, MHCDS’16 is an orthopedic spine surgeon at Missouri Baptist Medical Center in St. Louis Mo. He currently serves as Chairman of the Department of Surgery, the OR Governance Committee, the Surgical Peer Review Committee, and sits on the Medical Executive Committee, as well as the Foundation Board of Directors. He was formally Medical Staff President and Division Chief of Orthopedic Surgery.
He is passionate about perioperative care delivery emphasizing data driven decisions to increase quality and the optimization of care during the 90 day perioperative window. The Surgical Home project was his Dartmouth group ALP and has grown to be a successful implementation with astonishing reductions in length of stay, complication rates, cost savings, decreased narcotic use, and patient satisfaction.
Elizabeth Sellman, MPA began her healthcare career after a personal tragedy compelled her to seek a profession with more meaning. She was a successful business owner in the retail industry, wholesale and light manufacturing, before returning to school in her thirties to embark on a career in healthcare administration.
After completing her MPA degree, Elizabeth combined her business acumen with healthcare principles and spent the next 17 years in progressively more advanced leadership positons at Northwell Health. She led clinical departments, service lines and hospital operations teams and was responsible for growing many successful programs.
Most recently, Elizabeth has been a part of the Mount Sinai Health System in NYC as Senior Vice President and Chief Operating Officer at the Mount Sinai Beth Israel Hospital (MSBI). In addition to oversight of support services at MSBI, one of her primary roles has been leading the local effort for facility transformation. As the hospital prepares to transition to a smaller facility two blocks away, Elizabeth has been a key leader in hospital consolidations and program shifts to other health system hospitals and in planning for the new hospital. Partnering with clinical, labor, and quality leadership, she is the operational piece of this enormously complicated transformation.
Alok D. Sharan, MD, MHCDS’15 is an Orthopedic Spine surgeon who focuses on minimally invasive spine surgery as well as cervical spine surgery. Currently he serves as the Co-Director of the Westmed Spine Center. Previous to WestMed, he was Chief of the Orthopaedic Spine Service at Montefiore Medical Center.
He obtained his undergraduate degree at Boston University where he was enrolled in the Seven Year Accelerated BA/MD program. During his undergraduate years, he majored in political science. As part of his degree, he had the opportunity to work in Capitol Hill assisting in health policy issues for Congressman Richard Neal. After receiving his undergraduate, he received his MD degree at the University of Medicine and Dentistry of NJ. Following medical school, he subsequently completed his orthopedic residency at Albany Medical Center and a spine surgery fellowship at NYU-Hospital for Joint Disease. During that period, he was named as an AO Spine Fellow and an AAOS Washington Health Policy Fellow. In 2015, he completed a healthcare management degree at Dartmouth College titled Master of Health Care Delivery Science.
Dr. Sharan has received numerous recognitions for his clinical work including Best Doctor Award by Castle Connolly, New York Magazine Best Doctor, along with Westchester Magazine Best Doctor. Internationally, he has been awarded the Srivastava Oration from King George Medical School in Lucknow, India for his overseas work to help improve spine care in India.
A prolific author, he has over 100 publications, abstracts, and book chapters. He has co-edited a textbook entitled “Basic Science of Spinal Diseases”. Dr. Sharan currently serves as a Deputy Editor for Digital Health Transformation for the publication Clinical Spine Surgery. In addition, he has been very involved in the digital health field. He is often asked for advice from digital health companies and sits on the board of many digital health IT companies.
Robert Shumsky, PhD is a Professor of Operations Management at the Tuck School of Business at Dartmouth. His research focuses on the improvement of service operations, with particular emphasis on the coordination of service supply chains in which service provision is split among multiple firms. He has conducted research on the U.S. air traffic management system and studied transportation operations for state agencies and the Federal Aviation Administration. He has also served as a consultant for both manufacturing and service operations, including call centers and health care providers. Professor Shumsky has published recent articles in Manufacturing and Service Operations Management, Operations Research, and Management Science and currently serves in various editorial positions for several academic journals. His is currently the Co-Director of Dartmouth’s Master of Health Care Delivery Science program. He received his PhD degree in Operations Research from MIT.
Andrew Sorenson, MHCDS’16 currently Director for Corporate Decision Support and Population Health Analytics at Intermountain Healthcare in Salt Lake City, is an experienced leader who creates value within organizations by developing strategies to solve complex business problems and by directing analytic resources on teams he oversees to ensure the success of those strategies. These qualities have allowed him to progress quickly from entry level analyst, responsible for carrying out ad-hoc analytical requests, to director of an advanced, multi-department analytic team responsible for the development and execution of solutions which support key company-wide initiatives.
Kathryn Becker Van Haste, MHCDS’18 serves as Health Policy Director for Senator Bernie Sanders of Vermont and is responsible for health, veterans, and business outreach throughout the state. Before relocating to Vermont in 2015, Ms. Van Haste spent over a decade in Washington, D.C., where she held various positions in the United States Senate and House of Representatives, including her most recent position as Health Policy Director for the Senate Budget Committee (minority staff). Prior to that role, Ms. Van Haste headed up the health policy team on the Senate Veterans’ Affairs Committee during Senator Sanders’ tenure as Chairman, where she helped author and negotiate comprehensive, bipartisan legislation to ensure veterans’ access to high quality health care. Ms. Van Haste has also worked for Congressman Peter Welch and former Senator Jim Jeffords. She holds a master’s degree from Norwich University, a bachelor’s degree from the University of Vermont, and is a proud member of Dartmouth College’s Master of Health Care Delivery Science Class of 2018.
Norman Ward, MD, MHCDS’15 is Chief Medical Officer for OneCare Vermont Accountable Care Organization and Executive Medical Director for Accountable Care Services at the University of Vermont Medical Center. He is a graduate of the Warren Alpert Medical School of Brown University. He did his Family Medicine residency in Rochester, NY at the University of Rochester/Highland Hospital Family Medicine Program and served a two year National Health Service Corps obligation in Georgia. Dr. Ward is an Associate Professor of Family Medicine at the Robert Larner, M.D. College Of Medicine at The University of Vermont since 1987. He continues to see patients at South Burlington Family Practice. In his current role at OneCare, he is focused on effectively educating Vermont’s hospitals and providers about “value-based” health reforms, integrating community continuum of care providers with the traditional medical community, and increasing patient and family engagement. He is past President of the Vermont Medical Society and the Fletcher Allen Medical Staff. He serves on the Vermont Medicaid Clinical Utilization Review Board and the Brown Medical Alumni Association Board of Trustees. Dr. Ward completed the Dartmouth Master of Health Care Delivery Science program in 2015.