As the US healthcare system stumbles toward a new consensus built around the "triple aim" of increased access, improved quality,
and lower cost, the push is on for new ideas that can test the boundaries of current practice. The Affordable Care Act (ACA)
creates a range of incentives to promote this goal, which has added to the momentum around novel reform approaches. Business
management schools have jumped with gusto into the fray, providing much of the intellectual heft for integrative, outcomes-oriented
programs that stress patient wellness and require medicines to do more than just treat disease.
One institution, Brown University, has gone a step further than many of its counterparts, with a new 16-month Executive Master
of Healthcare Leadership (EMHL) program dedicated to empowering mid-career health professionals with the diverse interests,
skill,s and capabilities to challenge that status quo and "transform" healthcare as we now know it. The centerpiece of the
curriculum is a requirement that each student initiate a "Critical Challenge Project" within their sphere of expertise to
address this aim, probing the way healthcare services are currently organized, delivered, or financed.
Strafing those silos: The Critical Challenge project
An underlying goal of the Critical Challenge Project is to attack the bureaucratic or process silos that prevent different
parts of the system from cooperating to advance a more holistic population health agenda. The emphasis is as much on doing
something differently as doing something important, engaging stakeholders across the system to achieve a measurable result
that will allow the student to assess—quantitatively or qualitatively—the effects of its implementation.
The Critical Challenge Project is a key criteria for admission; it also serves as the basis for much of the EMHL's formal
coursework, the student's final grade, and subsequent priorities upon his or her return to the workplace. Students give
regular progress reports on their project in a peer group exchange format, allowing diverse points of view to be incorporated
in plans and objectives going forward. "This is not a static exercise," says EMHL Program Executive Director Judith Bentkover.
"We see it as a way to test theory against practice, with transformative system change as the ultimate objective."
As a complement to this month's cover feature on 15 Emerging Pharma Leaders for 2014, Pharm Exec made a recent visit to Brown's first EMHL class of 28 mid-career professionals, most under age 40, and representing a wide
range of sectors and occupations in the healthcare field, from traditional big Pharma to health community activists. The purpose?
To highlight a few of the more ground-breaking Critical Challenge projects being pursued by this highly motivated class of
young entrepreneurs—and thus to open a window on the future of healthcare. A talk with five students indicates a diversity
of approaches, but all share the EMHL program objective of exposing the silo thinking that blocks progress toward changes
that everyone says they want, but are hard to achieve in practice.