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Health Care From All Disciplines

May 17, 2010

Jim Yong Kim hasn’t been quiet about his desire to change how health care works in the United States and around the world.

The former professor at Harvard University’s schools of medicine and public health, who became Dartmouth College’s president last summer, isn’t unique in wanting to foster a multidisciplinary approach to solving health care’s problems, but he has been vocal about what he sees as the need to galvanize those efforts under the banner of “health care delivery science.”

Today Kim launches the Dartmouth Center for Health Care Delivery Science, which will serve as a hub of instruction, research and advocacy on the college’s Hanover, N.H., campus. “We think that health care is one of the greatest issues and is something that our students should learn about,” he said. “It’s also one of the really large problems we at Dartmouth have the capacity to tackle.”

The center's mission is to find ways of improving the quality and effectiveness of health care while lowering costs by bringing together experts from the humanities, social sciences, business, engineering and medicine. With a multidisciplinary approach, Kim hopes to find new ways to deliver health care.

The center's courses, research and advocacy work will include students and faculty from Dartmouth Medical School, the Thayer School of Engineering, the Tuck School of Business, the Dartmouth Institute for Health Policy and Clinical Practice, and the college’s arts and sciences division. It’s funded by a $35 million gift from an anonymous donor, who Kim described as “a health care consumer like the rest of us who understood the great problems in health care delivery and shares with us our sense of urgency.”

Though many universities have health policy centers, some medical schools offer courses in "medical humanities" and some hospital systems have taken major steps to improve delivery, “we think this is the first to come at these issues in so many ways” all under one roof, Kim said. Dartmouth-Hitchcock, the health system affiliated with the medical school, will play a large role in the center’s work.

Its co-president, James N. Weinstein, will lead the center’s development with Kim until an executive director is hired. “This is really different in that it’s not just a hospital working on health care delivery,” Weinstein said. “No one else is doing what we’re doing: bringing academics, graduate students, undergraduates, all the resources of a place like Dartmouth to bear on these issues.”

Stacy Lindau, an associate professor at the University of Chicago Medical Center who leads a project aimed at improving health care delivery on the South Side of Chicago, said she thinks Kim is taking a major step in consolidating efforts to lower costs and improve care. “This is less about creating delivery science from scratch and more about calling together a community of individuals, teams, universities – communities that are doing this work,” she said. “Kim seems to be creating the glue around that."

While the Patient Protection and Affordable Care Act signed into law by President Obama in March “improves access, which I think it really did, it was really health insurance reform,” Kim said. “But then you have to take on cost and quality, which is what we’re aiming to do.”

Michael E. Porter, a professor at Harvard Business School who cofounded the Global Health Delivery Project with Kim and Paul Farmer, a Harvard medical anthropologist, said in a statement that the new effort, “with its multidisciplinary approach and unique partnership with a leading medical center, is poised to become a leader in advancing measurement and devising new delivery solutions.”

Dartmouth is primarily an undergraduate institution, and many of the center's courses and programs will be targeted to undergraduates. Kim said he hopes to see students, regardless of major, take an interest in the center’s offerings. “We’d like a greater overall literacy on health care issues,” he said. “A philosophy major might learn something profound about how diet and health impact [his] life in the long run. Or to understand where tax dollars are going.”

About 60 undergraduates are enrolled this spring in a course on health policy and clinical practice, Weinstein said. With a few weeks left in the term, “it’s been very exciting to the students so far.”

The center is also aiming to start a master’s degree in health care science delivery in July 2011. Weinstein said he and other faculty hope to attract a group of 50 physicians, policy makers and business people, among others, to be part of the first cohort. Following the model used by many executive M.B.A. programs, the master’s will span 18 months, with three or four brief sessions in Hanover and the rest of the degree work taking place via the web. Other degrees are likely to follow.

The center will not include a new building, said Roland Adams, director of media relations. "We're using space we already have. That's part of how we're getting this moving quickly." In time, faculty and researchers will be hired.

Though Kim has spoken extensively about his vision for health care delivery science, he’s not sure how faculty will respond to the creation of a major effort that just happens to be in his field of expertise. “They've heard me talk about this, but this center is new and isn’t hitting the airwaves until [today],” he said. “We’re not in any way moving toward health care all the time. This is just the first of many efforts like this at Dartmouth College.”

 

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