This post is part of a series featuring interviews with some of the fascinating individuals who joined our community for the 2014-2015 year. Conducted by our 2014 summer interns (affectionately known as "Berkterns"), these snapshots aim to showcase the diverse backgrounds, interests, and accomplishments of our dynamic 2014-2015 community.
Q&A with Rebecca Weintraub
Berkman fellow and faculty director of the Global Health Delivery Project
interviewed in summer 2014 by Berktern Melinda Sebastian
What drew your interest to the Berkman Fellowship at Harvard?
At the Global Health Delivery Project we have been building a piece of software for 5 years with no formal training and no expertise, so we did a search for community Internet and society, and Berkman came up. We realized that before we embark on designing the next set of features, we needed to find advisors. I was very compelled by watching Ethan Zuckerman’s talks, particularly his discussion on bridge professionals. I identified the early adopters in our community of 13,000 global health professionals, who participate with us on GHD online, who truly are bridge professionals in their 180 countries. I hope to discuss with the Berkman community how best to incentivize and stimulate these global health professionals.
The Global Health Delivery Project is a “professional virtual community” with many partnerships. What does that look like in practice for MDs around the world?
The Global Health Delivery Project sits between Harvard Medical School, Brigham Women’s Hospital and Harvard Business School. All 3 institutions have helped us seed GHDonline, which is our platform for over 100 professional virtual communities. The 13,000 members are also architects, engineers, nurses, policy makers, vendors, physicians, and midwives. It’s all stakeholders who are participating in their health care delivery system. There’s no cost to be there, and in our public communities we have 3 moderators in each community, many of whom are Harvard affiliated faculty. Some are now in other countries, where they help guide and discuss our professional virtual communities.
You emphasize patient values at the Global Health Delivery Project. What factors influence patient values, and why would they be different globally?
First, there is a long-standing discussion, and this is probably for another time, of how to define values. Our group adopts Michael Porter’s definition that value is the health outcome, per unit of cost. We then extrapolated and built a framework where we looked at four principles of value-based health care delivery. These are for both the patient level, a patient who now has a new medical condition, and for thinking about preventative medicine. For example, If we think about a sub-population that has a set of risk factors and you’re trying to design your delivery system to generate value for populations, you hope that you prevent operative complications.
The 4 principles of the value-based healthcare delivery framework are:
Designing your program, and choosing an activity set along a value chain. The value chain is literally the map and configuration of the set of activities.
Those value chains should be layered on top of each other, and through that you see what is needed. It may be the number of hospital units, healthcare workforce, or power, electricity, and water that is shared through the health system to ensure that you are providing the configuration of care you’ve designed for that medical condition.
Value-based healthcare systems incorporate their context and their ecosystem in the design of their program, as well as determinants of health such as why people either maintain themselves as healthy or how they actually understand their own illness in their contexts.
The values generated in this system are designed and tested to stimulate economic development. Principally, this has been discussed in the health economics literature as the idea that ensuring a healthier population will lead to a more robust economy.
Is there anything else that you are working on the coming year that you would like to highlight here for the Berkman audience?
I am thrilled to join the Berkman community. For one, seek advice on how to analyze the content that we have on the Global Health Delivery Project and to figure out a set of incentives and to maintain and improve our participation. Secondly, we had a call to dig through that participation on a private virtual community to learn how it could be deemed continuing medical education or continuing professional development. Thirdly, we have a significant number of lurkers on the site who ask us to think through ways in which we could be highlighting new innovations and new ways of thinking to serve. For example, how to serve not only a minister of health but also the US market as well. This is a process of ideation and innovation that happens virtually, and thinking about how to maintain the stimulation that’s occurring already within the virtual community.
Where do you see yourself, or the organization in 10 years if you had a dream world?
I would like there to be a universal badge for managers of health care delivery. Many of my colleagues and my students come from different professional backgrounds. They might have gone to nursing school, or physical therapy. They’re anthropologists, they’re economists, and many of them become managers of a system. And in a manner similar to what is provided for architects and engineers for lead accreditations, I think there is a huge advantage for us creating an international digital badge. Then, you could know that a specific person has the following qualifications, an understanding of finance, HR, supply chain, logistics, so that they can then manage any system.