The Next 20 Years in Healthcare with Professor Carl Nelson

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This webinar covers developments in healthcare and how you can benefit by earning your Online MBA in Healthcare Management. Professor Nelson discusses his extensive background in healthcare and provides insight into the Healthcare Management concentration.


Angela LaGamba: Welcome to Northeastern University’s Online MBA Healthcare Management concentration webinar on the topic the next 20 years in healthcare. My name is Angela, and I will be your moderator for today. Before we begin, I’d like to go over logistics for this presentation and address some commonly asked questions. All participants are in listen only mode. If you have any questions, we encourage you to ask them in the chat box located either on the right-hand side of your screen, or if you’re in full-screen mode, you’ll just need to hover your mouse close to the top of your screen and click on the chat icon. We’ll be addressing your questions throughout your presentation, but also during our dedicated Q&A at the end of the session.

The event is being recorded, so it can also be viewed again at a future time. Your panelists today are Professor Carl Nelson, Enrollment Advisor Hayden Jones, and myself, Angela LaGamba, your host and moderator. Carl Nelson is the associate professor of international business and strategy at Northeastern University’s D’Amore-McKim School of Business. He currently teaches in the area of operations management, healthcare management, and corporate social responsibility. In 1987, he was cited as a distinguished professor by California State University for his contributions to the field of operations management in healthcare services.

He has served as a visiting associate professor of health systems at Tulane University School of Public Health and Tropical Medicine, and is a visiting associate professor in the Health Policy and Management Department of Johns Hopkins University School of Hygiene and Public Health. Also, Professor Nelson will be talking a little bit more about his background, as well, and you’re more than welcome to ask questions through the chat box. We also have Hayden Jones. He’s the lead enrollment advisor for Northeastern University’s online MBA. His role is to help prospective students through the application and admissions process. What can you expect in today’s session?

We’re going to be talking very briefly about Northeastern University and the D’Amore-McKim School of Business online MBA. I know many of you have questions about that and the admissions requirements. We also have Professor Nelson, who’s going to be talking about the next 20 years in healthcare. Like we mentioned earlier, we do have a Q&A session, so feel free to use the chat box, and we will be answering your questions in real time. With that being said, I’m going to hand it over to Hayden Jones, our enrollment advisor, to talk a little bit about Northeastern University.

Hayden Jones: As Angela mentioned, my name is Hayden Jason Jones, the lead enrollment advisor for the online MBA program. For those of you that don’t know who we are, Northeastern University was founded in 1898, and we are very proud of our history, reputation, and our heritage. As part of the heritage, we have a reputation of scholarly research, teaching excellence, and innovative curricula, and this is supported by our acclaimed PhD-level scholars and educators who are leaders in their field. The D’Amore-McKim School of Business was founded in 1922, which the online MBA program is part of, and we’re located in the heart of Boston.

We also have an alumni association of over 200,000 people, of which 40,000 are from the School of Business. We also have chapters all across the world, which provides a great opportunity for networking. To further support our reputation for teaching excellence, we are happy to report that we boast the AACSB accreditation, which is the hallmark of business education. Last year, our online MBA program was ranked No. 1 in the U.S. by Financial Times, and today, our MBA program is ranked No. 36 by U.S. News and World Report. You may be asking why choose our online MBA program?

Some of the reasons are listed here, on this slide, but I’ll just highlight a couple.

You have an opportunity to tailor your degree by choosing from eight in-demand specializations, and I’ll speak more about that later. We have cutting-edge online content that includes interactive multimedia, and leverage our focus on professional work experience and, therefore, don’t ask for the GMAT or GRE as part of our admissions requirement. This program is designed for the more mature business professional. The online program can be completed in as little as 24 months, and you can choose a general MBA, or we have eight different disciplines from which to specialize in. As you can see from the side, healthcare is one of those specializations.

The way the program is structured, you can obtain a specialization if you take three of your five electives in a defined subject area. There is also an opportunity for a dual specialization, so if you take two courses from one discipline and two from another, and then take a course that is shared between those two disciplines, you actually end up with a dual specialization. If you’re confused by what I just said, please reach out to your enrollment advisor, and I’m sure they’ll be happy to clarify this for you. What I’d like to do is just pass it back over to Angela.

Angela LaGamba: Thanks, Hayden. For our audience, what we would like to do is ask you a question around what area you currently work in. Are you currently working in the healthcare field, yes or no? There is a chat box that will appear on your screen, either on the lower right-hand side, or if you hover – if you’re in full-screen mode, if you hover at the very top and just hit the polling icon, you’ll be able to vote, as well. We see a couple of responses coming in. Hayden and Professor Nelson, it looks like 25 percent of our audience works in the healthcare industry. With that information – thank you to everyone for participating – I’m going to hand it over to Professor Nelson to talk about the next 20 years in healthcare. Go ahead, Professor.

Professor Nelson: One of the virtues of a virtual classroom like this is you’re getting to speak to people all over the country, and sometimes all over the world. I’ve been involved in healthcare for about 3½ decades as an educator, as a consultant. It is an exciting field, and it has been throughout my career. If you’re new to it or considering it, I hope you learn something from this. I’m going to be looking a little bit back at how we’ve come to where we are, and then trying to look forward. It’s a little bit dangerous to make predictions, but I’m confident in some of these that you’ll see before you, so you can certainly ask questions related to anything that comes up.

I have a few slides, and I’d like to go through them with you. This just somewhat repeats what Angela said in her very kind introduction. When I began teaching in the online MBA program, frankly, as a traditional educator, I was a little concerned about the outcomes and the control. I found it a really terrific platform, not necessarily for everyone, but for working professionals who are really able to contribute and learn from each other and work diligently on the material in a short period of time to accomplish many of their career goals. If you’re, again, new to the field, some of this jargon may be challenging, but what I’d like to do is look at where we are and where we have been and speak about some new rules.

Certainly, the dimensions have changed in my career. The progress is accelerating rapidly. Our current approach – and this is really from the Institute of Medicine, their guidelines and some of their recommendations – we have a direction here and a trend, where the patient is going to be more in control of their healthcare, where things are not delivered in silos, on an episodic base, to patients, where the focus really is on shared decision making. Many of the skills that are necessary to accomplish this, both change in clinical attitudes and organizational structures, organizational design, process redesign have been taking place for some period of time.

They’re just greatly accelerating. Certainly with 17 percent of our gross domestic product devoted to healthcare, one of the goals is cost containment and quality improvement that you’ll see throughout this. These are themes that are part of, really, any MBA training. We directly incorporate these through case analyses and project work in our online MBA program here. It’s about cooperation. It’s about re-organization. We have moved greatly, in the field of management, from management based on intuition, certainly, over a long period of time, to management based on evidence, evidence-based management. The same thing is happening, and has been happening, in the field of medicine, so called evidence-based medicine.

These simple rules – just looking at these slides. By the way, the entire webinar, too, will be recorded and will be available, so these slides, if you would like to look at them again or ask me any further questions, even when we’re offline, I’d be happy to respond to them. Let’s just move on here. We speak about paradigm shifts. If that word is new, forgive me. Paradigm is considered to be a current way in philosophy and approach to thinking. In healthcare, we’re really moving to think differently about how we will do our work differently in the future, either as clinicians or as researchers, educators, and administrators.

The focus, moving from individuals to population-based health, from the need to move away from individual providers, a lot more team-based approaches, from so-called episodic to continuous care, from electronic medical records. Many, I think, probably, now, even in this group, have access to their own records through EPIC or other systems, but on an institutional level, sharing this information across different platforms, financial information, clinical information, the use of big data into operable health information technology, some of you may, in fact, be directly involved in that. Then the entire change and shift over time from fee-for-service payment to bundled payments, comprehensive payments, pay-for-performance methods that reward quality, as well as volume.

Population health management, we threw this out, term, earlier. It is what the term suggests. This is for one healthcare organization here in the Boston area, been exceptionally fortunate over the last three or four decades to be working in this field in Boston, certainly one of the medical meccas of the world. This is one large hospital and hospital system looking at how they can bring down costs, focus more effectively on high-risk patients, and what it will take to manage these high-risk patients, particularly patients, as this formerly was a hospital dedicated to the most acute care patients to patients that have, perhaps, acute conditions, but comorbidities and chronic care conditions.

They are building up their expertise in this area and, actually, directly involved with many more primary care physicians than before. We’ll speak about that in a minute. I just wanted to give you an example of something that is relatively local. We spoke, too, about patient centeredness. These are good terms, but this is really one of the dimensions of bringing value into healthcare, scientific expertise, this evidence-based management and evidence-based medicine, but also the caregiving, the service-oriented portion of this, where personal knowledge is particularly important. People regularly consult the Internet, WebMD. They’re confused.

They’re looking, really, for a healthcare system that can guide them through these extremely troubling circumstances and times, both the clinical health dimension and the mental health dimension have to be addressed. Choosing the right care option and understanding that choice and managing expectations is part of the clinician’s and the health system’s job. This is a slide that comes from the work of Michael Porter, our Business School colleague here in Boston and really, I think, represents the way in which many healthcare systems have been trying to change, to develop a closer focus to gain market share, as well. Michael Porter and others have worked with organizations like the Cleveland Clinic, where this driving element of increasing efficiency, accumulating experience, getting better data, it’s termed the virtuous circle of value.

You can sort of see the virtue of this to both patients, the healthcare system, in general, and to the providing organization. So it’s about innovation. It’s about IT. It’s about reputation. Even the smaller healthcare systems, too, are healthcare systems that are evolving, some of which are consolidating, take all of this to heart in strategic decision making. Healthcare strategy is one of the specific courses, too, that is part of the training in our online MBA program, that capstone course that is typically part of any MBA program, but here, we specialize it for the healthcare field.

This is a picture of the jubilant group in Washington, D.C., after the Supreme Court came down with its most recent decision on the Affordable Care Act, the King v. Burwell decision that really, if it had gone one way, it might have severely threatened the nation’s ability to provide healthcare for millions. Our moderator, Angela, and Hayden are in Canada. They have a different system than ours. Understanding regulations is particularly important. Understanding the laws in this area, particularly important how reimbursement has changed, and certainly access to healthcare has greatly increased as a result of the Affordable Care Act.

It does bring many challenges, but with those challenges, too, comes an increase in demand and an increase in business for healthcare providers and for insurers and for suppliers in the industry take that to heart. These strategies that are often cited as important for succeeding in the future, for organizations to succeed in the future, one needs to, as an individual considering working in this field or to the study in this field, if you’re a clinician – I can say something to the fact that we have many different students in our courses.

Typically – and I don’t really have direct numbers on this, but since it’s something you may be interested in, typically, in a course, there may be one, two, or three physicians out of a group of, say, 20, folks from the pharmaceutical industry, researchers, insurance people, nurses, nurse practitioners, a variety of students exposed to many of these ideas in a direct and engaging way. Through case analysis and projects and lecturing online and collaborate sessions, where you get to speak directly to the lead faculty instructor – the structure of these courses is that we have a lead faculty person, say myself, developing the course and course material.

Then the sections are actually managed – and I’ve been extremely lucky throughout my contact with this online program to have either retired or working professionals as folks who are our section instructors. They can provide specific information to questions, too, on an ongoing basis. There’s also face-to-face contact that is available with them through the so-called collaborate feature that we use, so online conferences face-to-face, if you wish. These strategies, partnering, finance, strategic management, information systems, again, specifically apply to the healthcare field. Oh, there we have a funny slide. We’re trying to avoid this in all our organizations, buried by paperwork, information technology, though I think I do feel, myself, occasionally buried by the information technology.

Papers are still being generated someplace, but that has been a slow process, I think, finally getting to the level where the effort involved is well worth the potential rewards. In the Boston area alone, in the last year or so, many of our major healthcare providers have invested – say Partners Healthcare investing over $1.3 billion in the EPIC information system, Boston Medical Center is somewhat less, Leahy somewhat less. Information technology, coupled with healthcare, might be a good field to – and I think will continue to be a good field if you look at the employment projections and continuing needs in that area getting a lot more sophisticated.

This is a general direction. Volume-driven healthcare, providers looking to maximize their revenue, shortening the amount of time they spend with each individual patient, rewarded based on volume, and now to be increasingly rewarded either as individual providers, as providers in a system or department, to so-called value-driven healthcare, where this is a metric, and not completely scientific, we’d have to say, but conceptually of value this so-called value equation, where we try to measure. Administrators do get involved directly in this, increasingly involved in this, as clinicians are involved in measuring quality that’s determined by the structure of services, the processes carried out, and most importantly, increasingly now, measured by outcomes.

Looking at value in a numerator quality, what you get, plus the service, your perceptions of that service, the direct care that is given on a human level, all divided by cost. Some metrics now, and measures, increasingly coming in to play through contracting that move us in that direction. A couple more slides, and then we’ll get to my predictions. These are some directions. Many organizations have been moving in this area, what will be a high-performing healthcare system. Many of the things we’ve spoken about in terms of costs, have spoken about in terms of population health, just earlier here, importance of regulation, and clinical guidelines, care maps, process re-engineering to eliminate waste and inefficiency, these are all tools, too, that we go over in our challenging courses here.

I will speak about what is a challenging course. How many hours a week do I have to spend on this? These are questions that should be in your mind. When we are called upon to design any of these courses, given the time frame and the credits, our expectation is – and Hayden, maybe later, can expand on this if he’d like – but our expectation is that we’re designing a course that requires somewhat on the order of 15 hours of outside work and reading each week. That has to fit into your schedule. Some students new to the field or challenged by the material or wanting to do their best spend considerably more time. Each course, we do ask students, at the end of the course, to estimate the amount of time that they’ve spent.

Looking back at some of mine, I do see variation, but 15 hours a week is a good guideline. We focus on cost a lot in this class. We investigate in this cases – in this program, that is, we investigate cases where we’re looking at provider substitution, treatment substitution, different settings for care, how that is changing, moving from in-patient care to ambulatory care and re-designing the system, itself. My own initial focus on healthcare really began as an operations research, systems analysis person. I’ve been involved with many different studies of this type over the years. Focus on cost and quality improvement, both of which can and should go hand in hand. My predictions. How much time do we have left, Angela?

Angela LaGamba: You have some time left. Go ahead.

Professor Nelson: Good. Okay, terrific. My predictions for 2035, when I’ll be retired on a lake in New Hampshire, so you can’t come after me if any of these are wrong. I think they’re built on evidence and directions we’ve seen and things I’ve just spoken about here this morning. Only the sickest patients will receive in-patient care. The hospitals of yesterday will not be the hospital of the future. It will be, indeed, more greatly focused. It will have options for care outside of the facility. There will be a greater emphasis on continuity of care. You’re discharged from the hospital. What will be the follow up, in terms of meeting? In clinics and outpatient settings, what will be the follow up, in terms of monitoring, let’s say, through telemedicine?

What will be the follow up in terms of virtual care? We are seeing increased payments for primary care to foster population health. It’s not proceeding as rapidly as some would say with the huge debt that medical school students face in getting their degrees and what they owe. Many have, in the past, been encouraged to seek out careers with a better payback, quality of life, and work life that is in their best interests. But now, there have been, and I think we will increasingly see increased payments for primary care loan forgiveness for physicians graduating from this area, nurse practitioners, physician’s assistants, as well. We’ve all read about the third bullet point here, so-called personalized medicine.

This is coming faster than some people thought it would come and slower and on a more complicated basis than others have also predicted, but the direction really – using genomic information for diagnostic purposes, even for prevention, for targeting drugs, has increased in cancer care and, I think, will further develop. One of the challenges of working in this field is understanding the clinical side and the clinical dimensions, the management directions, the regulatory constraints here, the economics. It’s made it really fascinating, at least for Carl Nelson, in looking at this. I learn so much on a regular basis every day. I think that keeps me going. Hyperconnectivity through telemedicine is what we’re seeing more of. Some of you, perhaps, already have experienced this.

Why go to the doctor’s office? Telemedicine coming in for diagnostic purposes, initially, mostly for people who couldn’t travel that easily. They were in a rural setting. But we will see, I think, a good deal more of telemedicine connecting patients with providers and institutions and specialists across the country and across the globe. Affiliations and arrangements with, say, Dartmouth Hitchcock in Hanover, New Hampshire, and the Mayo Clinic in Rochester, Minnesota using telemedicine, second opinions, radiological interpretations, telemedicine for radiology, where specialists are reading radiographic images in places like Nepal and getting information back here to the United States and working overnight.

On time, driven by cost given these capabilities. Finally, telemedicine is not a new term at all, but it is something, I think, to think about incurring with increased emphasis in the future. Then we have the big data movement and data analytics, not only providing appropriate diagnoses, but also guiding us all maybe in a big brother way, and certainly there are ethical dimensions of all of that, which we’ve been speaking about here this morning. Big data does have its challenges, in terms of confidentiality and things that you would be worried about, but using that appropriately to guide decision making to make judgments. Finally, the robot will see you now.

That’s scary to some of my young physician friends or physicians in training. You’ve heard of IBM’s Watson on Jeopardy. You probably know that in conjunction with the Cleveland Clinic, IBM’s Watson’s built-in diagnostic capabilities, they’ve outperformed in some tests now with the information and data available to it and decision-making capabilities incorporated in it. They’ve actually outperformed some cancer specialists in diagnostic purposes, so will the robot see you now, or will a virtual doctor see you now? Twenty years, yeah, I think we’ll be a little bit more confident . Generally, robots are used to assist in surgeries.

Outcomes are somewhat varied there, but for more standardized procedures. One can really learn, I think, as part of this program, any direct study of the healthcare industry, learn, I think, quite a bit from one’s own professional career, but also for one’s own wellbeing. One of the neat things about healthcare is we’re all engaged. We’re engaged in it as children, as adults, as parents, as caregivers for our older parents and, ultimately, as professionals. We’d all like to improve on these faults, eliminate waste and inefficiency wherever possible to achieve better outcomes. With better outcomes, with achieving an institution’s mission, we’re also looking at increasing that institution’s margin.

Without a margin, there’s no mission; without a mission, there’s no possibility of a margin, using that term loosely because many of the organizations here we’re dealing with are non-profit institutions, but they, too, of course, have to look at their bottom line. Just quickly in my last slide, these are our current healthcare specialization offerings, healthcare finance, an overview of the healthcare industry, strategic decision-making course I’ve spoken about before, and health informatics course that is also on the books and quite challenging. All of these taught by people like myself, people directly participating in the industry with, really, a wealth of experience.

Do I have another slide here, Angela, or am I ready to turn that back to you? Okay, Angela, I think you can take over now. Thank you. I hope I didn’t go over too much. These professors drone on and on and on.

Angela LaGamba: No, you’re actually quite all right, Professor, and you’ve been getting a quite a few questions. To our audience, I encourage you to continue to send in those questions. We’ll be getting to our Q&A session in a few minutes. Professor, you’ve actually given us quite a bit to think about. What I’m going to do now is bring Hayden Jones, our enrollment advisor, online to talk a little bit about the admissions requirements. Go ahead, Hayden.

Hayden Jones: Thank you, Angela. I won’t take too much longer. What I’m going to do is just go over the admissions requirement. They’re fairly simple. We require that you have a minimum of five years of full-time professional work experience, an undergraduate degree from a regionally accredited institution with a GPA of 3.0 or above on a scale of a 4.0. Now, if you don’t meet the above requirements, it doesn’t automatically disqualify you from being accepted into the program. I would ask that you reach out to your enrollment advisors for some counseling. The application requirements, again, very straightforward, very simple.

On average, it takes about two weeks, depending on how disciplined and focused the applicant is, but we require an updated resume, statement of purpose, two letters of recommendation, actually professional letters of recommendation. We do accept academic references, as well. We require all U.S. post-secondary transcripts or equivalent for international students, and there is a $100.00 non-refundable application fee. Northeastern is committed to supporting our veterans. The online program has recently become a part of the Yellow Ribbon program. If you fall under this program, then it means that most, if not all of your tuition will be covered by the government and Northeastern.

For more information, I recommend that you visit the website, as listed on the slide there. Lastly, as part of our commitment to our alumni, beginning fall of this year, the D’Amore-McKim School of Business will now offer the Double Husky scholarship to all Northeastern alums who have completed a degree at one of our colleges. In addition, the $100.00 application fee would be waived. Again, I encourage you to visit our website for more detailed information about the Double Husky scholarship. That’s the end of my part. I would just like to pass it back over to Angela.

Angela LaGamba: Great. Thank you so much, Hayden. What I’d like to do now is get our audience involved. We do have for you. Why are you interested in healthcare? We have a couple of options here around the growth industry. Perhaps there’s a desire to impact someone’s life, or maybe there’s some competitive earning potential, or perhaps you recognize the need to change how the industry functions. If there’s another reason, as well, we will leave this poll open throughout the Q&A, so you’re more than welcome to fill in those responses, and then we will share the aggregated poll results with everyone. While you’re filling that in, let’s move into our question and answer session.

Many of you have sent in questions, and I encourage you to continue to do so. The first question that we have come in is for you, Professor. That question is around the program, itself. One of our students wants to know do aspects of the program focus on specific current events, such as the shift in public health programs, Medicaid, to private managed care companies, and also how will that affect the private sector healthcare companies? Go ahead, Professor.

Professor Nelson: There have been, in the minds of many, a cutback in – and maybe too significant a cutback in public programs and charity hospitals and programs that meet the needs both culturally – whoops, what am I – okay, here we go. Sorry, I just saw a new slide pop up and wondered what was happening there, but this is the question and answer session, so here we go. Yes, cultural competencies, particularly important. There are many opportunities, weight loss, dietary programs, things that institutions maybe – traditional institutions can’t directly deliver upon in an effective manner, mental health, substance abuse. Do those types of programs need to be in more traditional institutions, or can they be shifted over?

I would say it would be discussed, in terms of current events. In some of these classes, there may be a case or two in development. But also, if you have a particular expertise or interest in that area, as we’re talking about changes within the industry, as your weekly typical structure might be to write and deliver some short papers answering some questions, but also, through these discussion boards that are set up, that would provide a great opportunity for you to push your class and your individual instructor to more specifically address those questions. I don’t have any specific projections in that area for you, but to say that where there is a need, that need should be addressed, but more specifically, in our economic system surrounding healthcare, it is really based on an ability to pay and shifting regulations and payment schemes.

So different segments of the industry have been affected this way, outpatient radiographic services, say, for example, through changing regulations and payment schemes. As we consolidate our insurers, as they get more powerful, as that industry consolidates, who’s paying is important, as the federal government’s role increases in this area. That will greatly shape reimbursement and the responses of – and the entrepreneurial opportunities, which we really haven’t spoken of. Maybe that’s the direction you’re interested in taking. That was the origin of your question.

There are courses, too, within the general MBA program, where entrepreneurship – online MBA program where entrepreneurship and opportunities for business plan development will be encouraged, but currently, not specifically in any of the electives that I’ve identified. Is there another question? I hope that helps.

Angela LaGamba: It does. To our audience, if you have a follow-up question for the professor, feel free to send that through. Hayden, the next question is for you. The question is can you talk a bit more about the healthcare specialization and the course offerings that are provided through the MBA program? Go ahead, Hayden.

Hayden Jones: the professor. As mentioned, let me go through the structure of the MBA program. A total of 18 courses, 13 of them are core MBA classes, so you get to understand business, overall, and then you have your five electives. The professor, I guess, on a slide there, had the number of – oh, there it is – the healthcare courses that you have to choose from. Perhaps he may want to go into more detail about those courses. It wasn’t specific enough. I know he did touch on them.

Professor Nelson: One of the nice features, too – these are generic subject areas, in many ways, but we do regularly try to update, too, these courses and the cases and the case materials, too, to reflect changes or interesting developments. I am a proponent – and this maybe also ties back to the question about discussing current events – of having our students directly look at current events on a regular basis, working with healthcare professionals, as well.

For example, in the healthcare finance class, one of the requirements is for students to both join the Healthcare Financial Management Association themselves, as student members, that provides a wealth of information and material, but also we have students reach out to – and we’ve been really successful in this endeavor – to Health Finance Management Association leaders within the field to engage in dialogues with them, questions on changes within the industry, and on reimbursement. It’s not just stale textbook learning through case studies, through actual project work, through monitoring and scanning health industry related news, and developing that habit.

I call it a habit. Maybe for me it’s a habit. One can at least feel more confident, both at the personal level or for one’s organization, that you’re up on current trends and current thinking and understanding current problems and the impact of technical changes or regulatory changes or different models that are out there, benchmarking your own organization against other organizations some of the leaders in the field, some of the directions that they’re taking. Many of our courses are oriented around cases that not only published at the Harvard Business School, but cases that our own lead faculty instructors have developed themselves and may teach, too, on different platforms.

I know our health information course is taught by a leading physician here in the Boston area, at Boston Medical Center. These folks, too, are not just teaching MBAs, but they’re teaching our physicians in training. I, too, have a joint appointment at Tufts Medical School, too, in their M.D. MBA program. So just speaking around that, but I just want to say that these courses do provide a framework. My advice is to take that strategy course at the end of the sequence because it does have elements that will in finance and understanding of the industry and health informatics and technology change.

Angela LaGamba: Thank you, Professor.

Professor Nelson: Too long an answer? Too long an answer.

Angela LaGamba: No, not at all. I think you actually have a follow-up questions from one of our students around the courses. One of our audience members was wondering are students required to participate in internships as part of any of these healthcare management specialization courses?

Professor Nelson: No, they’re not. Currently, it doesn’t involve any sponsored internships, no.

Angela LaGamba: Thank you, Professor. The next question that we have is for you, Hayden. Hayden, one of our audience members wanted to know how the application deadlines work for 2015. Go ahead, Hayden.

Hayden Jones: Typically, the application deadline is a month before classes actually start. That’s the typical deadline. We encourage all applicants to get your application in as soon as possible, complete it as soon as possible, get a decision, because that’s the most important piece of this whole puzzle. Now, the next start date, August 24th, I believe, the application deadline is – that’s the completed – the deadline to submit your completed application portfolio is August 3rd. The next start date after that would be October 12th, and I guess September 12th would be the deadline to submit your completed application portfolio. We have another start date in November, and that would be the last one for the year, but we do have three more start dates in the fall.

Angela LaGamba: Thank you, Hayden. The next question that we have is for you, Professor. One of our audience members wanted to know if you consider the U.S. to have a high-performing healthcare system, and if not, what we can do to modify this? Go ahead, Professor.

Professor Nelson: We do very well in some areas, and very poorly in some others if you look at comparative statistics. Where would I rather raise my family, in terms of healthcare? Difficult question. I think if they’ve had – if they had clinical problems or developmental problems or problems dealing with complicated cases, I would still prefer the United States, high performing in terms of clinical excellence. However, this is really a complex subject on many levels. Personally, I believe that healthcare should be delivered on the basis of need, rather than demand. Single pair systems do have significant advantages.

It’s well documented, the waste and inefficiency in our healthcare system is, I think, well documented, duplication, medical arms races, these things that are out there that we have to live, but I think that are increasingly coming under control. I am more optimistic, as the years go by, that we’re going to get things better for more people. Many of our incentives just have been historically skewed the wrong way. I think that will be changing. I don’t know what your own – if you want to have a follow-up question for that dialogue. I think I wouldn’t – we’d love to have, with anyone, in any course, over a period of time. That’s my opinion.

Angela LaGamba: Thank you, Professor. To our audience members, if you do have a follow up to that, feel free to send a note through the chat box. Professor and Hayden, we do have a couple of more questions coming in through the chat box. I wanted to check in with both of you to see if you had another five or ten minutes to do a couple of follow-up questions from the audience, if that works for you?

Professor Nelson: Sure. Absolutely, yeah.

Angela LaGamba: Let’s keep on going through the questions. We did have a follow up for you, Professor. One of our audience members wanted to know can you please describe the field of health informatics and healthcare – sorry, health information systems, and if there’s any job growth potential in that area, in your opinion? Go ahead, Professor.

Professor Nelson: Sure. With the commitment of many major healthcare systems to electronic medical records, with the funding under the High Tech Act – in the United States, some years ago, the
$34 billion committed to upgrading health information technology in physicians’ offices and in hospitals, there’s certainly been a growth in employment. One of my current – just to make things local here, one of my current Tufts M.D. MBA students, a young woman, just entered medical school and getting her MBA, as well, just came from implementing the EPIC system at Partners Healthcare here in Boston, a two-year stint. There are, I think, many levels of this, both in terms of development of these systems and implementing them.

I refer you to some of the predictions, the Health Information Management System Society is a good place to go. I mentioned Health Financial Management Association with respect to finance. As a key industry group in that area, they have, I think, looked very directly at this. I don’t believe it’s going to go away. Implementation is an issue. These systems are going to be upgraded. We’re going to have a lot more interoperability. Individuals in their homes are going to be involved in telemedicine a lot more. That’s going to tie in our personal – our iPhones are having more applications in this area. There have been many startups, as well, into developing these medical applications for both patients and providers. It’s a good bet. It’s a good bet, to answer your question.

Angela LaGamba: Thanks, Professor. The next question that we have from our audience was around electronic medical records. One of our audience members was curious to see how you think this would work in the future and if security would be a concern that would be resolved by 2035? Go ahead, Professor.

Professor Nelson: The more we learn about this, the more we see challenges, whether it’s retail, whether it’s target, healthcare has not been immune from this. The level of sensitive information is just overwhelmingly valuable, perhaps, to individual parties. I think as we get – we will have some major stumbling blocks along the way. There will be some huge data breaches that are going to cause people to re-evaluate the information that they include in medical records. There are unintended consequences of electronic medical records and their implementation that have come forth in recent years. Certainly, one of the unintended consequences is that loss of confidentiality and the potential for hacking.

It’s something we may have to just live with. The benefits may outweigh these costs. The penalties, the ability to track individuals who are hell bent on gaining access to our medical records, will probably need to increase. Of course, they’re more interested in selling our financial information, getting access to our bank accounts and credit cards than our medical records, at least when it comes to some of the global spying. That trend to focus more on EMRs and interoperability, I think, will continue and should continue cautiously, as it has been.

But I don’t see anything really crashing in the future that would deter me, maybe even create more opportunities for health information technology specialists to delve deeper into why these faults or challenges do come up and to develop better systems. I think that’s what we’re looking for. So yeah, a lot of challenges out there. I hope that answers that question as best as I can.

Angela LaGamba: Thank you, Professor. Then the final question that we have from our audience today is how can healthcare professionals help their organizations innovate as they head towards 2035? Go ahead, Professor.

Professor Nelson: That’s terrific. Become a champion. Find out who the champions are for development for ideas. Look outside your own organization. Benchmark against others within your geographic area nationally, internationally. Innovation can come in small steps, I think, in big steps. I think it’s important to be at a place where it’s encouraged. I believe a good understanding of the industry and developments in the industry and confidence in the terminology and the concepts and the background you’d gain from further study should give that individual an edge up in becoming an innovator. We’re all interested in breakthrough technologies.

Sometimes they can be awfully simple. Innovation has its risks and rewards and understanding of those risks and rewards. Doing that earlier in one’s career, rather than later in one’s career, is probably going to be beneficial. I think the entrepreneur in you, if you’ve asked that question, will lead you in the right direction, with the help of others in seeking out people not only internally, but externally, who are interested in this, whether it’s, say, reducing a medical cost ratio for a large healthcare system – we’re at 1.03 and how do we get it below – through innovation, through safety, through information technology, through reduction in re-admissions, schemes that are out there, schemes that need to be developed through careful analysis and data and consultation and teamwork, I think, in the end, will prove to be the best way to forward. It’s a general response to a broad question, but it’s a great question. I’m glad you asked it.

Angela LaGamba: Thank you, Professor. That is all the time that we have for today. I wanted to thank both Hayden Jones and Professor Nelson for taking the time to talk to us about the healthcare specialization in the online MBA at Northeastern University. If you do have any additional questions, you can find Hayden’s contact information on screen, and you can also send us a note through the chat box, and we’ll be sure to get back to you. We would also love to hear your feedback on what you thought of today’s webinar. We do have a poll, if you click on the polling icon. We do take feedback and implement that in future webinars. Again, thank you to everyone for participating in today’s webinar on the topic of the next 20 years in healthcare. This concludes our session, and have a wonderful day!