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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Blinkhorn: Health Care Innovation


(Host) Commentator Tom Blinkhorn has worked in development of social services around the world. But as 2013 confronts the nation with a fresh set of challenges in implementing the Affordable Health Care Act, an innovative pioneer program at Dartmouth college designed to help meet those challenges has caught his attention.

(Blinkhorn) On Saturday morning, January 19, 45 mid-career professionals from 17 states plus France and India will receive Dartmouth college's very first master of science degree in health care delivery.


The graduates are all mid-level professionals, ranging in age from 30 to 60, about 40%are women. Most already have advanced degrees in several areas. They include surgeons, nurses, a chief information officer, chief medical officer, a state senator from Oklahoma, a lawyer, Robin Lunge, who is also Vermont's Director of Health Reform and Jose Montero, who is Director of Public Health for New Hampshire.

For the last 18 months they have been learning how to become leaders of change in helping the nation get closer to a very elusive goal: Better health care at lower cost for all citizens. The goal is worth pursuing since healthcare represents a huge and growing portion of the national and world economy and particularly since the United States spends 50 percent more on health care than any other country, yet is ranked 37th among nations in health care performance.

The Dartmouth program, according to Director Katy Milligan, is uniquely different from other more traditional master's programs in the health sector, for several reasons.

First, training is provided jointly by two of Dartmouth's centers of excellence - the Tuck School of Business with its extensive experience in management and leadership know-how, plus The Dartmouth Institute's expertise in the science of measuring health care delivery and outcomes in an effort to reduce costs and improve care.

Secondis the distance learning feature. This is made possible via the internet and a specially tailored web portal. During the 18 month program, there are four residential periods on the Dartmouth campus for about one week each. The rest of the time students communicate with each other and faculty through live audio-visual and internet connections atany time. The idea is that students can keep their day jobs yet engage in substantive learning for short, but intense, sessions.

Finally,students work in teams on specific projects designed to be put into practice right away and aimed at improving care at the patient level.

One particular project has an extraordinary challenge - to define precisely the basic benefits package that will be offered to Vermont's citizens under the state's new single-payer system. Robin Lunge is working with a team that includes a surgeon from Idaho, a Washington DC health care consultant and an anesthesiologist from Dartmouth Hitchcock medical center.

Jose Montero, the New Hampshire Director of Public Health, is part of a different team learning how best to implement realistic strategies to improve access and quality of health care services despite limited financial resources.

One of the surprises from experience with the first class is that students would like the program to last longer.

But since that's not possible, the class of 2013 has decided to support a special legacy project involving an annual symposium to share experiences after graduation and thus keep the learning alive and relevant.