9 minute read
Re-Imagining Healthcare in a Post-Pandemic World
For the past two-and-a-half years, countries have had to deal with the tremendous task of managing a global pandemic. While the world is still in the midst of tackling COVID-19 and adjusting to the many socio-economic changes that it has brought, researchers at the Schulich School of Business have spent the past several years trying to better understand the changes that have occurred in our healthcare system since the pandemic began. From reimagining healthcare systems to coping with a health sector workforce crisis, the issues we face are wide and far-reaching.
The COVID-19 pandemic shook every industry to its core—creating a perfect storm that forced businesses and organizations to re-examine the way they manage their workforce and how they serve the needs of their customers and clients.
But no industry bore the brunt of the pandemic more than healthcare, whose managers and workers were on the front lines of the worldwide battle to contain the spread of COVID-19 infection and illness while also advising governments on appropriate healthcare policies. At the same time, the pandemic magnified a number of healthcare issues that had already been bubbling below the surface — everything from worker burnout and patient backlogs to resource constraints and the adoption of new technologies.
Schulich researchers have been at the forefront of research on these and other key issues, owing in large part to the School’s longstanding leadership in health industry management. One of Schulich’s trademarks is faculty research from across a wide range of disciplines, and health research is a perfect example, with researchers from accounting, economics, sustainability, operations management and information systems, and entrepreneurial studies.
FIGHTING THE PANDEMIC: FREEING UP CRITICAL CARE BEDS AND FINDING PPE EQUIPMENT
One of the biggest news stories around the world at the outset of the pandemic was the critical shortage of Personal Protective Equipment, or PPE. This equipment includes items such as gowns, surgical masks, gloves, and face visors. During the earliest — and deadliest — stage of the pandemic, PPE was in great demand after governments mandated the public use of PPE in stores, restaurants, and public transit. As a result, hospitals faced critical supply shortages, which occasionally left health workers without adequate PPE. This in turn led to higher rates of infection and death among patients.
Adam Diamant, Associate Professor of Operations Management and Information Systems at Schulich and an expert in health industry management, carried out recent research focused on finding an approach for predicting demand for PPE used in hospital settings during COVID-19. Diamant and his fellow researchers employed both stochastic modeling and machine learning to create a methodology for predicting the expected amount of PPE consumed during all healthcare interactions during a patient’s stay in the hospital — a key factor in helping manage healthcare supply chains during the pandemic. “Our research work was the first to propose an analytical model for predicting PPE demand in a clinical setting,” says Diamant.
The pandemic also exposed the inability at times of hospitals to manage the peaks and surges of COVID-19 hospitalizations. A lack of intensive care beds — or threat thereof — was often used as a justification for lockdowns and other restrictive measures. Current research being undertaken by Diamant is investigating a prescriptive approach for managing intensive care unit (ICU) capacity in a network of hospitals during a pandemic. The research explores the benefits of transferring ICU beds between hospitals in anticipation of demand instead of waiting until demand is realized and then transferring patients from hospitals with no idle ICU beds to those with excess capacity.
Diamant is also currently conducting research that includes exploring the impact of scheduling decisions made by surgeons on post-surgical complications, developing a more efficient scheduling framework for assigning home care patients to health practitioners, as well as investigating policies to help clear the backlog of patients seeking MRIs in Ontario as a result of COVID-19.
ADAM DIAMANT
Associate Professor of Operations Management and Information Systems
MOREN LÉVESQUE
Professor of Operations Management and Information Systems; CPA Ontario Chair in International Entrepreneurship
DRUG R&D RESEARCH: IN SEARCH OF HIGHER ROI
Pharmaceutical companies and drug development — everything from vaccines and monoclonal antibodies to antivirals — were front and centre during the pandemic. Spending on research and development by pharmaceutical giants like J&J, Merck, Novartis, and Pfizer amounts to billions of dollars annually and continues to climb. But the increase in R&D spending has not been accompanied by increases in the returns on investment, a growing concern in the biopharma industry.
Moren Lévesque, Professor of Operations Management and Information Systems and CPA Ontario Chair in International Entrepreneurship at Schulich, carried out research with several co-authors that revealed that drug development firms spend too much time on early-stage R&D projects that have little likelihood of commercial success. The result, says Lévesque, is that many of these companies are pulling the plug too late on R&D projects that show few signs of succeeding.
THE ECONOMICS OF ILLNESS TREATMENT AND PREVENTION
Schulich academics are also looking at healthcare from business ethics and accounting perspectives. Irene Henriques, Professor of Sustainability and Economics at Schulich, co-authored a study that found corporate charitable foundations tend to direct healthcare funding to richer communities rather than to regions with the greatest healthcare needs. “What we discovered was that corporate health philanthropy tends to reinforce pre-existing health inequalities and even exacerbate them,” says Henriques.
Amin Mawani, Associate Professor of Accounting and Director of Schulich’s Health Industry Management Program, has studied the role of tax policy in promoting healthcare and determining the cost-benefit analysis of illness prevention programs. Mawani was part of a team of York University researchers that published research several years ago showing that web-based community intervention for York students experiencing stress, anxiety, and depression was clinically effective in reducing the symptoms experienced by students. Follow-up research is intended to show that such web-based interventions are not only clinically effective but also cost-effective.
THE LOOMING CRISIS IN OUR HEALTHCARE WORKFORCE
Dr. Abi Sriharan is the Senior Krembil Fellow at Schulich and an internationally recognized, awardwinning scholar. The Oxford-trained academic frequently consults multinational organizations such as the World Health Organization on issues such as strengthening health systems and human capital strategy.
A lot of her research work has lately focused on the healthcare work culture and the health workforce, which is grappling with an unprecedented increase in job vacancies due to job transitions and early retirements. The crisis is being driven by multiple factors, including pandemic stress and burnout, demographics, and the so-called “Great Resignation” — the large-scale withdrawal from the workforce by a growing number of employees. “We’re in the midst of a health workforce crisis,” says Sriharan. “But we can’t wait — the time to address the workforce crisis is now.” The main challenge for healthcare organizations and leaders is to “create work environments that are more employee-friendly,” says Sriharan. One solution is to explore more innovative and flexible workplace employment practices, citing the trend toward “work-sharing” in the US and the introduction of “flexible working rights” in the UK as a way to improve work/life balance and reduce staff turnover.
Another solution, she says, is to “use the power of AI and Big Data and automation to supplement human aspects of healthcare. Digital technology needs to be more fully embraced.” As just one example, she points to AI-based scheduling, which has been shown to reduce burnout and boost engagement for healthcare professionals.
Sriharan is also looking at workplace issues through a gender lens. When it comes to gender, she notes that 75% of healthcare workers are female, 42% of physicians are female, and more
DR. ABI SRIHARAN, Senior Krembil Fellow at Schulich, is looking at workplace issues through a gender lens: than 90% of long-term care workers are female. But Sriharan says many female healthcare workers are leaving their occupations. “If we don’t address the needs of female healthcare workers, we’re going to face a number of potential problems,” she says.
The bottom line, says Sriharan, is “we need a different work culture in healthcare” and a new type of high-performance healthcare leader — one who embraces innovation, change, and experimentation.
Researchers like Sriharan and faculty members from a number of different disciplines at Schulich continue to make valuable contributions to healthcare research that often break new ground and tackle real-world problems. *
75%
of healthcare workers are female
42%
of physicians are female
MORE THAN
90%
of long-term care workers are female
Robert Krembil
(MBA ’71, Hon LLD ’00)
In September 2021, Schulich officially launched the Krembil Centre for Health Management and Leadership, made possible by a generous $5 million donation from the Krembil Foundation and Schulich graduate Robert Krembil (MBA ’71, Hon LLD ’00), a name synonymous with healthcare research and philanthropy in Canada.
The Centre has established itself as a leading global hub of industry outreach, education, and research. A cornerstone component of the Krembil Centre is the Krembil Chair in Health Management and Leadership, created to develop the School’s research capacity in the healthcare field and expand Schulich’s reputation as an international thought leader in health sector strategy, transformation, and organizational leadership.
Joseph Mapa, the Director of the Krembil Centre and the Executive Director of Schulich’s Health Industry Management Program, was appointed as the inaugural holder of the Krembil Chair in the fall of 2021. Mapa, who served as President and CEO of Mount Sinai Hospital for a number of years, brings years of real-world experience and extensive connections to the health industry in his role as Chair.
“We’re living through transformational changes in the health sector,” says Mapa, citing everything from inefficiencies in care delivery and increasing healthcare costs to bottlenecks in the adoption and implementation of new medical technologies and the use of AI and Big Data to drive greater efficiencies in healthcare services. “The Krembil Centre is uniquely positioned to address these challenges.” A key mission of the Centre is to help bridge the gap between research, health sector leaders, and government policymakers. One of the ways the Centre is doing this is through biannual summits featuring global thought leaders. The Centre’s inaugural Summit, “Leading the Way Post-COVID,” held in collaboration with Deloitte, featured topics such as long-term care and the impact of COVID-19, as well as the digital future of healthcare. The second Leadership Summit, held in collaboration with Accenture, focused on workplace culture, talent, and leadership.
Joseph Mapa, Director of the Krembil Centre and the Executive Director of Schulich’s Health Industry Management Program
