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Appendicitis, Hospitals, and Blended Learning
March 10, 2013 - 9:00pm

This past week I had the opportunity to spend some quality time at the hospital.  My younger daughter (8th grade) had her appendix out.  Her loss of an appendix was my gain for thinking about some of things that higher ed can learn from hospitals.

My daughter had her appendix out at 1:00pm on Thursday, and by 9:00pm we were home. Surgery that previously involved an overnight (or multi-night) hospital stay is now routinely done on a same-day schedule. The advance that made this compressed hospital stay possible is the laparoscopic appendectomy.  This minimally invasive surgery eliminates the need to make a large incision in the abdomen, as the technique involves making 3 small cuts and inserting surgical instruments and a tiny camera to remove the appendix.   

Laparoscopic surgery enables better utilization of the expensive fixed costs of the hospital (rooms, nursing care, etc.), as the space not taken up by a laparoscopic patient allows for more patients to be admitted. The scarce resource of the hospital is utilized primarily for the action that can only happen at the hospital, the surgery.  The recovery time can be managed at home. (Which also has been shown to have benefits for the patients, including faster recovery and lower probability of infection).

Higher ed and health care share many traits in common. We are both high fixed costs industries whose prices are increasing at unsustainable levels.   We both suffer from variation in outcomes. We both serve a social mission, operate in a heavily regulated and scrutinized environment, and are both attempting to reinvent ourselves to accommodate changing public policy and financial realities.  

My experience with my daughter's appendicitis has me wondering if we can also push for similar productivity gains in higher ed.   

Our classrooms and labs are much like the hospital rooms, expensive fixed cost assets that cannot easily be increased to meet demand. Blended learning may allow us to educate more students without the expense of building and maintaining more classrooms and labs, as we can run more classes through existing facilities.   

Over the past few days I've witnessed firsthand the unbundling of medical care.   What was once an event (having your appendix out) that took place completely within the walls of the hospitals has been transformed into episode that unfolds at both at the hospital (surgery) and at home (recovery).   There is little doubt that medical care will become less hospital-centric as time goes on, as hospitals are simply places too expensive to deliver any services that can be accomplished somewhere else.  

It is also clear that a non-hospital-centric approach to health care, whether this be focus on wellness or the moving of some care to satellite locations or the home, can in fact improve both individual and population health outcomes.   My daughter is better off recovering at home than in a hospital room.

Will higher ed follow a similar trajectory as health care?

Is the campus like the hospital?

How well does the analogy between blended learning and same-day surgery hold?   

Are there opportunities to have discussions between medical and educational professionals about productivity?  

What can higher ed learn from health care?


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