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In Philadelphia, They're Building the New Healthcare From the Ground Up

October 23, 2008
by Mark Hagland
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Sometimes, you’ve just got to build it yourself. That’s how David Nash, M.D., one of the leaders of the quality and outcomes movement in American healthcare, describes his decision to lead the launch of a new school at ThomasJeffersonUniversity in Philadelphia.

I’ve known Dr. Nash for many years, and have always been impressed not only with his knowledge and vision, but also his energy and drive. He’s a virtual one-person publishing industry, having published many books and literally many hundreds of journal articles, and given countless speeches and presentations. He is one of the physicians whom I most respect for helping to push his doctor colleagues forward on the path towards evidence-based medicine. And he certainly is one of the most dynamic people I’ve ever met.

Well, now, Dr. Nash is moving forward on a whole new front. Not content to have an office of outcomes and policy research at ThomasJeffersonUniversity, he has led a group of fellow clinician and policy leaders in creating the new Jefferson School of Health Policy & Population Health at ThomasJeffersonUniversity. The new school will open for classes in the fall of 2009, and Dr. Nash called me recently to tell me all about it. Even for David Nash, this represents an ambitious undertaking. But he’s dead serious about the need to change healthcare in America, starting with the training of clinicians and public health professionals. The new school will offer a variety of master’s and doctoral degrees, including an innovative combined medical degree/quality and safety degree. Nash believes strongly in the idea of pushing quality in healthcare from the ground up, including as part of the core curricula of healthcare degree programs. In other words, get ‘em while they’re still new to healthcare careers. What’s more, he wants clinicians and other healthcare professionals to learn about IT and its contribution to healthcare transformation.

As a result, as part of its core curriculum, the Jefferson School of Health Policy & Population health will offer a core course on the role of information technology in quality and safety. As Nash explains it, “We know that IT systems help us close the feedback loop on quality. Without IT, you can’t have the information, and without the information, you can’t measure or manage.”

Nash sees great urgency in moving forward in this area. “I think everybody would agree that the health care system is coming apart at the seams,” he reflects. “And we know we have to do a couple of things. One of them is to promote teamwork via interdisciplinary education; two, promote teamwork via experts; and three, promote care coordination. We have to decrease waste and promote care coordination, those are the only two things we can really do as a system. And Jefferson sees itself as part of the solution, rather than perpetuating the broken system. And we want to create the leaders of tomorrow. That’s the mission.”

What’s more, he says, “The experts and evidence support the fact that reducing waste, improving quality, and improving coordination, are the way we have to go. But in modern medical education, the amount of time spent on these things is minimal. But you can’t create change by perpetuating the status quo. So we’re promoting change by creating change within the belly of the beast, as it were.”

The core course in IT will form a component of both the master’s degree in quality and safety that the new school will offer, as well as in its five-year-, combined, M.D. and master’s in quality and safety program. In other words, people interested in becoming medical doctors and pursuing added work in quality and safety, will formally be learning about the role of IT in the process of quality and safety transformation.

And while everyone is talking about the future, a few leaders like David Nash are actually pushing the healthcare system to move actively towards it. What I like most about all this is that this is an example of an industry leader who understands that fluency in IT will be important for physicians and for public health professionals and healthcare executives alike, and who is putting his energy into making that a part of professional healthcare education where he lives and works. Kudos to Dr. Nash and his colleagues.

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