Reports
REPORT 27 | Spring 2024
The Workforce Crisis: Innovative Approaches to Address Current Shortfalls and Prepare for a Sustainable Future
Despite varying statistics on the magnitude of current and projected stafffing deficits, a multitude of studies and analyses indicate that there will be continued significant shortfalls in healthcare professionals for years to come. While the shortage of healthcare professionals dates back decades prior to COVID-19, the pandemic grossly exacerbated the issue. Many healthcare professionals contracted the virus and had to miss work. Others were furloughed due to downsizing or temporary shuttering of services, and many of those furloughed sought alternative jobs because of personal financial needs. Healthcare professional shortfalls result from many complex dynamics beyond the strains introduced by the pandemic, and until these are addressed and solved, shortages are likely to continue in the long term.
REPORT 26 | Spring 2023
Harnessing Emerging Virtual and Digital Health Technologies to Transform Health Care
Digital technologies have transformed many industries, enabling new business capabilities, more efficient and productive staffing models, and a closer connection to consumers. New entrants, supported by digital technologies, have disrupted numerous industries. Digital streaming upended the television network and cable television industries and the video/DVD rental market. Online banking reduced the need for bank staff to provide in-person services and gave consumers more direct and efficient control over their accounts. The addition of digital cameras on mobile phones and tablets reduced the demand for stand-alone cameras and turned everyone into novice photographers. Health care’s adoption and integration of digital technologies have followed a different path. Many digital innovations and technologies have been introduced – from electronic health records to digital imaging to robotic surgery – but due to a myriad of factors, including but not limited to the complexity of the health care delivery system, the digital transformation process has occurred more slowly than in other industries. However, several market forces and global trends are now increasing the pace of change.
REPORT 25 | SPRING 2022
Financially Sustaining the Academic Enterprise
Academic Health Centers (ACHs) are the backbone of health and health care innovation in the United States, in addition to their fundamental mission of educating the next generation of clinicians and researchers. Many of the critical advances in medicine have originated in AHCs, including discoveries that led to mRNA vaccines, radiation therapy, statins, human organ transplant surgery, drugs to treat HIV/AIDS, and cardiac defibrillators. These monumental innovations and discoveries require substantial and sustained research and innovation, core differentiating points of AHCs that embody the passion and mission of academic institutions. However, the AHC research enterprise requires financial support from other sources, even when faculty investigators receive funding from federal sources, private funding from corporations, and philanthropy.
REPORT 24 | WINTER 2019-2020
The Behavioral Health Crisis: A Road Map for Academic Health Center Leadership in Healing Our Nation
The United States is in the midst of a behavioral health crisis. The need for services is growing, but there is a shortage of trained health care professionals, severe deficiency in inpatient/facility capacity, inadequate reimbursement, and a variety of other barriers that make it difficult, if not impossible, for people to access appropriate care in a timely manner. This crisis is compounded by the opioid epidemic, rising suicide rates, and an increasing prevalence of depression, anxiety, and other behavioral health conditions. This perfect storm has created a true health crisis—and a complex one.
REPORT 23 | Winter 2018-2019
Separating Fact from Fiction: Recommendations for Academic Health Centers on Artificial and Augmented Intelligence
Today's health care professionals are bombarded by data from multiple sources—diagnostic, claims, financial, psychosocial, epidemiologic, biometric, genomic, and consumer-generated—and health care data is expected to double every 73 days through 2020. The sheer quantity of such data necessitates a fundamental shift in how it is curated and interpreted. Enter artificial intelligence, which has enormous potential to help clinicians, researchers, learners, and patients alike.
REPORT 22 | Winter 2017-2018
The Hidden Epidemic: The Moral Imperative for Academic Health Centers to Address Health Professionals’ Well-Being
The time is ripe for AHC leaders to claim a central role in acknowledging, owning, researching, understanding, and defeating the epidemic of clinician burnout. What's at stake is nothing less than the "joy in work" that the most productive and empathetic clinicians bring to the workplace; the sense of professionalism that every doctor, nurse, and other health professional has a right to expect from their career; and the satisfaction, quality, and safety that is expected by patients. At stake also are high costs to society—estimated to be as much as $150 billion each year in the United States for physician burnout alone. See appendix below for more details about these costs.
Appendix to Report 22
Estimating the Societal Cost of Physician Burnout
REPORT 21 | Spring 2017
The Academic Health Center: Delivery System Design in the Changing Health Care Ecosystem—Sizing the Clinical Enterprise to Support the Academic Mission
Academic health centers (AHCs) can learn much from the successes and failures of other AHCs in forming health system partnerships. They should take care to regard prospective partnerships through the lens of their prospective partners, and they should also understand the true value of what the AHC brand and infrastructure bring to bear.
REPORT 20 | Winter 2016
Synchronizing the Academic Health Center Clinical Enterprise and Education Mission in Changing Environments
In the context of population health management and rapidly changing payment models, academic health centers must focus on their mission—specifically, their commitment to preparing the next generation of health professionals—in determining the optimal size, scope, and character of their health care system.
REPORT 19 | WINTER 2015
Refocusing the Research Enterprise in a Changing Health Ecosystem (PDF)
This report discusses the need for academic health centers to take advantage of opportunities in clinical, translational, and health services research, while preserving and continuing to invest in basic science research.
REPORT 18 | SPRING 2014
A Call to Lead: The Case for Accelerating Academic Health Center Transformation (PDF)
This report describes the imperative for value-based enterprise transformation in academic health centers (AHCs) and offers specific recommendations for implementing such change as well as examples of successful strategies at five AHCs.
REPORT 17 | SPRING 2013
Health Professions Education: Accelerating Innovation Through Technology (PDF)
This report explores the impact and implications of online learning in the health professions and argues that educators must articulate a new vision, pool resources, confront structural barriers, and establish mechanisms for sharing content and best practices to maximize benefit from emerging technology.
REPORT 15 & 16 | Apr. 9, 2012
The Affordable Care Act of 2010: The Challenge for Academic Health Centers in Driving and Implementing Health Care Reform
and Academic Health Center Change and Innovation Management in the Era of Accountable Care (PDF)
Special double-issue: In this special double issue, including Reports 15 & 16, we examine the new health insurance and care delivery landscape as created by the enactment of health care reform legislation in March of 2010.
REPORT 14 | Feb. 4, 2010
The Role of Academic Health Centers in Addressing the Social Determinants of Health (PDF)
This report is written to shine a bright light on the importance of the social determinants of health and the impact they have upon the health and wellbeing of society, as well as to call for research examining which models of health promotion and health care delivery best improve the health of individuals affected by these social factors.
REPORT Special | Nov 18, 2008
Fall 2008 Policy Proposal: A United States Health Board (PDF)
Proposal: A framework for health policy development and strategic direction, with a long-term planning horizon, buffered from the political considerations that attend to every-other-year election cycles.
REPORT 12 | Nov. 3 2008
The Emerging Transformational Role of Informatics (PDF)
Since the publication in 1999 of the Institute ofof Medicine's seminal report, To Err is Human, followed by its 2001 report, Crossing the Quality Chasm, improving both the quality and safety of health care have been major foci of health policy and practice (IOM 1999 and 2001). Much has changed since then.
REPORT 11 | Nov. 3, 2007
Health Care Quality and Safety in the Academic Health Center (PDF)
Evidence of significant problems in the quality of US health care accumulated and generated a genuine sense of urgency in the health sector over the past two decades. Academic Health Centers (AHCs) could have provided stronger leadership in addressing these systemic quality and safety issues; but for the most part, like most of the hospital industry, they focused on the credentials of individual providers and not on systems of care and performance per se.
REPORT 10 | Sep. 1, 2006
Managing Conflict of Interest in AHCs to Assure Healthy Industrial and Societal Relationships (PDF)
Conflict of interest is an increasingly significant problem in the complex relationships between ANG sector health professionals and institutions and their private sector partners and sponsors. COI can compromise the integrity of research, education, health care, and service. Even the appearance of COI can undermine the public's trust in and support for this vital work. For the sake of achieving optimal progress in advancing health and healing, ANG health professionals and institutions must better understand and manage COI.
REPORT 9 | Nov. 1, 2005
Getting the Physician Right: Exceptional Health Professionalism for a New Era (PDF)
The Blue Ridge Group believes that, at the dawn of the 21st Century, given the pace of change and the increasing complexity of systems of clinical care and health care technology, medical competency and medical professionalism in the United States require renewed definitions. These definitions need to recognize population approaches in addition to the traditional focus on the individual patient. While physicians and other health workers have become increasingly sophisticated knowledge workers, the future of medicine as a profession may be at risk. To some commentators and policy makers the demise of medicine as a profession or "privileged occupation" would be a positive development (Reich 2000). We hold the opposite view. We believe that medical professionalism is critical to the values, quality and future of health care and to the research, education and training upon which it is founded.
REPORT 8 | Oct. 1, 2004
Convering on Consensus: Planning the Future of Health and Health Care (PDF)
The Blue Ridge Academic Health Group (Blue Ridge Group) has been concerned with the imperative for health care reform since our Group's inception in 1997. Our second report, entitled, Promoting Value and Expanded Coverage: Good Health is Good Business, advocated the establishment of a "value-driven" and evidence-based health care system, one that... promotes the health of individuals and the population by providing incentives to health care providers, payers, communities and states to improve population health status and reward cost-effective health management" (BRAHG 1998a). In the intervening years, some progress has been made and a great deal has been learned on the subject of national health care reform based upon these and related principles. Nevertheless, as a nation, we have yet to achieve anything approaching effective, system-wide reform.We have yet to bridge the chasm between the reality and the promise of our health care system. In this, our 8th report, the Blue Ridge Group reviews the progress of and prospects for comprehensive health system reform and provides an academic health center (AHC) leadership agenda for reaching this critical goal.
REPORT 7 | May 1, 2003
Reforming Medical Education: Urgent Priority for the Academic Health Center in the New Century (PDF)
Improving health and health care are among the most widely supported and important goals for our nation and the world today. Vitally important to progress in health is the proper education and training of the health professional workforce. Yet there is evidence of increasing dissatisfaction with the predominant models of health professional education, especially with the education of physicians. There is a growing consensus among scholars, policy makers, and health professionals that long-accepted education and training programs from preprofessional preparation through continuing, lifelong learning must be substantially redesigned and modernized to meet the projected health care needs of the 21st century (eg, Ludmerer 1999; AAMC 1998, 2000; IOM 2001, 2003). This report is primarily concerned with needed reform in the education of physicians, the area where the Blue Ridge Group members have the greatest experience and expertise.
REPORT 6 | Dec. 1, 2001
Creating a Value-driven Culture and Organization in the Academic Health Center (PDF)
The academic physician, academic medicine, and the health professions in general are in the midst of an extended period of organizational and professional turbulence. Beginning with the explosive growth of managed care in the 1980s, the relatively closed, professionally self-regulated health services sector has been pushed into a more classically competitive marketplace (Blue Ridge Academic Health Group, 1998b). The 1990s brought additional impetus for change with shifting public policy, changing demographics, increasing consumerism, and the growing influence of information technologies (Blue Ridge Academic Health Group, 2000a and 2001). Now, at the turn of the new century, there is renewed public concern with deficiencies and inconsistencies in the quality of health care delivery services.
REPORT 5 | Jun. 1, 2001
e-Health and the Academic Health Center in a Valuedriven Health Care System (PDF)
The advent of the Internet has been almost universally heralded. It has been compared to most of the important technological milestones in human history, from the capture of fire to the development of electricity, the steam engine, and the telephone. The Internet's dynamic, even explosive, growth is often described using biological metaphors (e.g.,"a squirming, protoplasmic nexus of informational activity" (Valovic, 2000, p. 24)) that suggest the development of a nascent hypertrophic organism of uncertain but highly promising ontogeny.
REPORT 4 | Dec. 1, 2000
In Pursuit of Greater Value: Stronger Leadership in and by Academic Health Centers (PDF)
Leaders of academic health centers (AHCs) have always experienced a widerange of formidable challenges during their tenure. AHCs are complex organizations to lead because of their multiple missions, substantial size, highly specialized products and services, diverse internal and external constituencies, and culture marked by autonomy of faculty and departments. They operate as academic, business, and (in many cases) public organizations simultaneously, in an industry that is in the midst of evolving its production modes (i.e., from cottage to manufacturing to knowledge-based). Across AHCs, financial threats abound as a result of reduced government support and declining clinical revenues.
REPORT 3 | Jun. 1, 2000
Into the 21st Century: Academic Health Centers as Knowledge Leaders (PDF)
Enabled by technological developments and accompanied by an economy undergoing fundamental changes, the knowledge age has arrived. Its impact is already evident in the nature, scope, and pace of competition among businesses, work of individuals, and expectations of the public. As this new era unfolds, organizations are assuming new roles, acquiring new capabilities, developing new business models, and interacting with consumers in different ways. Simultaneously, a flood of advances in the ability to preserve health and treat disease is creating exciting prospects and greater challenges for health care organizations and professionals and their patients.
REPORT 2 | Dec. 1, 1998
Academic Health Centers: Good Health Is Good Business (PDF)
American workers, business owners, taxpayers, policy makers, and health care professionals and organizations face an issue of such magnitude and complexity that it remains unsolved after a century of effort. Despite being a nation of wealth, 43 million people in this country lack health insurance and often go without needed health care services. Moreover, the number of uninsured has been increasing despite a robust economy, an increasing number of firms offering health insurance coverage, and expansion of some public health insurance programs.
REPORT 1 | Mar. 13, 1998
Academic Health Centers: Getting Down To Business (PDF)
Despite the turmoil and challenges AHCs face, the potential is compelling for a renaissance in health care, spirited by a new kind of leadership. Rather than simply enduring the buffeting of external forces, AHCs can transform themselves in response to the changing needs of society and the reality of market forces. They can do so by looking beyond concerns about cost, renewing their focus on health, and emphasizing the value of their services. This renewed focus provides distinct opportunities for AHCs.