MIT Sloan Health Systems Initiative
Our faculty are working with industry leaders to re-design how healthcare is delivered. Working closely with industry leaders, we know how to successfully implement and scale system-level process improvements.
We start by “thinking outside the clinic” with efforts to prevent disease by addressing social determinants of health, such as diet, exercise, and wellness visits. When a health problem does occur, our faculty are at the frontier of operations management, working to streamline the flow of patients and services within and across delivery locations. But simply developing new algorithms and processes isn’t enough to improve operations; our faculty includes leaders in workforce management with a deep understanding of change management and provider engagement at all levels of healthcare delivery.
Our work seeks to ensure that the right person is delivering the right care in the right place at the right time.
Our research focuses on a variety of determinants of health. These include generating and testing innovative ideas to address these determinants, from improving diet and exercise to encouraging wellness visits and drug adherence, to understanding the role that workplace practices have on health.
Erin Kelly is looking at work as a social determinant of health. She is studying how to increase worker resilience and wellbeing through organizational levers such as workplace redesign and organization practices -- thereby going beyond individual wellness programs -- to improve provider satisfaction and health, and impact patient experience and outcomes.
Joseph Doyle is conducting a randomized controlled trial with Geisinger Health on evaluating the impact of their Fresh Food Farmacy effort, a food-as-medicine approach to improve health among food-insecure patients with diabetes.
David Rand and Erez Yoeli use behavioral insights, including reputational concerns and desires to support the public good, along with analytics, to develop and test robust digital health tools. Currently, in Kenya, they are testing a platform combining patient reminders and human interventions to improve adherence to TB and HIV medication. They plan to expand this work to other regions in Africa and elsewhere. Learn more
Sloan researchers work on optimizing operations not only in areas directly related to health, such as hospitals, but also in supply chains and transportation. We specialize in complex optimization problems across services and facilities: areas that are fertile grounds for greater understanding and experimentation.
Dimitris Bertsimas has completed multiple studies on hospital-operations optimization that use data to look holistically at overall operations rather than one group or department. He has developed and begun to integrate a variety of operational decision-support tools with multiple organizations, including Beth Israel Deaconess in Boston and Hartford HealthCare in Connecticut.
Jónas Jónasson has worked on re-designing ambulance operations to improve performance. His recent paper using London Ambulance Service data, shows that teams that encounter critical incidents -- those in which patients have a high probability of dying at the scene -- take more time completing subsequent calls on their shift (for example, 7.5% longer after two critical incidents in one shift). They found that the extra time is used mainly on tasks without standard operating procedures, suggesting there are opportunities for managerial and operational changes to mitigate this effect.
Through a landmark operations research study in Mozambique, Jónas Jónasson and his colleagues investigated ways to speed up not only lab procedures, but also the supply chain itself. They were able decrease turnaround times by an estimated 22% for early infant diagnosis of HIV. This would increase the number of infected babies initiating treatment by seven percent, potentially saving the lives of up to 60 additional children per year. Learn more.
Multiple MIT Sloan projects on kidney exchanges have led to national policies that improve fairness and increase life-years gained. These include changing the paired donation process by enabling longer “chains” of kidney donations and better matching, and work to improve patient decision-making based on personalized data. Another study looked at mitigating negative effects of knowing a kidney was refused by others by including information about the reason for refusal, which may not apply to the current patient. Our organ transplantation research is now expanding into related areas.
New analytics work in liver transplants, by Nikos Trichakis and Dimitris Bertsimas with the United Network for Organ Sharing, is reshaping and improving their policies to mitigate well-known weaknesses, increasing potential lives saved through liver transplants by 400 per year (20%).
Related work on liver transplantation by Nikos Trichakis focuses on ways to support patient decision-making as well, such as ways to help them know the likelihood of better organs being offered in the future, along with the likely trajectory of their health post-transplantation.
While many sophisticated digital technologies are being developed with clinicians in labs, the impact of bringing them into large scale use is not well understood, and is a barrier to realizing their value. Outside pilot efforts, there is not sufficient understanding of the effects of these technologies on the staff who must alter their daily work routines and interactions with patients. Sloan researchers are studying both the processes of change, and the effects of technology on the people and organizations that use them to deliver health care.
Kate Kellogg has worked extensively on the implementation of healthcare workforce reforms in hospitals, health centers, and community healthcare practices. She investigates why altering work practices is difficult and what can be done differently by both managers and frontline healthcare professionals to successfully use new care delivery models. She is extending this to focus to AI tool development as well as implementation. She is also studying instances where AI is providing significantly better results than prior tools, and the impact this is having on work and workforce. Learn More
Paul Osterman is working with the Staten Island Performing Provider System to study how it supports teaching new skills to frontline care workers and integrating them into the Emergency Department through training, certification, and development of innovative work practices, and the impact of these changes on health outcomes.
John Van Reenen studies the role of management in driving quality and the adoption of best practices in healthcare. His ongoing survey of a thousand hospitals across nine countries show that better management is positively correlated with better health outcomes, explained in part by higher investments in human capital via recruitment and pay. He has also found that hospitals located geographically close to universities with both medical schools and business schools have better management practices and better patient outcomes. This may be because those are the places with a higher supply of people trained both in clinical disciplines and in business skills.
MIT Sloan Health Systems Initiative
Kellogg: Understanding Change Management in Healthcare
Kate Kellogg shows that implementing new processes and workflows requires finding those with leverage and giving them tools and tactics to change daily interactions and institutionalize the changes.Learn More