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Center for Health Organization and Transformation (CHOT)

Center Overview

The Center for Health Organization Transformation (CHOT) conducts research that supports major management, clinical, and information technology innovations in health care. CHOT's mission is to advance the knowledge and practice of transformational strategies in evidence-based management and clinical practice.

Management research in health care is plentiful but has offered little to effectively address questions about how and why certain innovations work. There are many prescriptions in publications and management seminars on what to do and how to it. There are publications providing very thoughtful postmortems on failed electronic medical record systems, failed health information exchanges, short-lived and unsuccessful applications of management improvement techniques, and - on a grand scale - failed attempts at mergers or integrated delivery systems. There are fewer examples of carefully structured health care innovation efforts accompanied by real-time formative evaluation, comparing across sites or over time via quasi-experimental models, and providing scientific evidence of effectiveness or return on investment.

The promise of CHOT, and where it has proved itself, is in its ability to powerfully connect health systems with university researchers and students. CHOT's research model relies on the knowledge and experience of health care leaders to guide academic research. Such connections promise to bring more resources to the health systems to better address their management and clinical innovation interventions and broader transformational efforts. This cooperative model ensures that the research is both meaningful and applicable to the health care industry and provides immediate support for decision-making by CHOT members.

Universities

University of Louisville
University of Alabama
Pennsylvania State University
Texas A&M University
University of Washington

View Center Website

Center Personnel

Robert Weech-Maldonado
Center Staff
+1 205 934 5266
rweech@uab.edu

Christina Mastrangelo
Center Staff
+1 206 543 4043
mastr@uw.edu

Bita Kash
Center Staff
+1 979 862 6777
bakash@sph.tamhsc.edu

Christopher Johnson
Center Staff
+1 502 852 3788
cejohn23@louisville.edu

Research Focus

CHOT supports major management, clinical, and information technology innovations in health care. Its cooperative research among universities, health systems, and other health-related industries relies on a multidisciplinary approach to advance and link system design and organizational technologies in innovation research. The three main areas in which CHOT conducts research are:

Implementing evidence-based innovation across settings.
Investigating research-informed strategy.
Validating innovations in health care delivery.

Awards

1624727

Phase II I/UCRC Pennsylvania State University Site: Center for Health Organization Transformation

Phase II I/UCRC Pennsylvania State University Site: Center for Health Organization Transformation

The U.S. healthcare system is a global leader in terms of scientific and clinical technology development. However, with expenditures at 17.1% of the GDP, significant gaps in terms of access and quality exist, along with rates of morbidity and mortality that are substantially worse than other industrialized nations. The mission of CHOT is to advance the knowledge and practice of transformational strategies in evidenced-based healthcare management and clinical practice. The development of transformative approaches will necessitate involving partners from all sectors of healthcare including IT providers, systems solutions providers, care providers, insurers, and employers with large healthcare coverage programs. The realization that a "one-size-fits-all" approach to healthcare is unsustainable has motivated the modeling, development and deployment of personalized advanced wellness systems (PAWS). PAWS transcends traditional boundaries existing within healthcare systems, ranging from personalized patient care models (from a patient?s perspective), to personalized drug delivery systems (from a healthcare decision maker's perspective). CHOT is the only industry-university cooperative research center focused on innovations in healthcare delivery. The Center's interdisciplinary approach will deliver integrated and broadly applicable solutions and will enhance the education of the next generation of healthcare policy experts, physicians, nurses, and engineers. Undergraduate and graduate students become a part of a high-performing multidisciplinary organization that provides an ecosystem for networking, leadership, and career placement. It is expected that the work of the Center will result in improved health care quality and more effective use of financial and system resources in the health system, while providing immediate decision support to industry.

CHOT has identified four research areas in order to meet the needs of our members as well as the healthcare industry: macro-systems innovation; health quality, safety, access, and efficiency; patient-centered care and population health interventions; electronic health records and information exchange. The underlying theme of personalized advanced wellness systems (PAWS) is achieved through fundamental research in value-based care, time-driven activity based costing, person-centered care, medical device design and integration, emergency department benchmarking, community paramedicine, telehealth and wellness, and precision medicine and precision health. A concerted plan of seven research projects will be supported by research methods in systems engineering. In particular, systems thinking and system dynamics methods will be combined with simulation, data analytics, and machine learning in order to develop models that can inform the prospective assessment of interventions and innovations. In order to bridge gap between what is learned/discovered and what is done in practice/ management, knowledge-to-action (KTA) initiatives will be pursued, with a view toward technology readiness in order to increase the impact of these projects. Read More >

1738359

Phase II IUCRC University of Louisville: Center for Health Organization Transformation (CHOT)

The University of Louisville (UL) applies to become a Phase II research site addition for the NSF Industry-University Cooperative Research Center (IUCRC) for Health Organization Transformation (CHOT). The American health care delivery system falls short of care that is safe, effective, patient-centered, timely, and equitable. Health care organizations are continually innovating in both management and clinical practices to address care efficiency shortcomings, offer the latest clinical technologies, and remain competitive. To attain significant progress on all of these fronts requires transformational changes in health organizations that fundamentally alter practices and culture, and lead to better health care. UL CHOT applies and refines a comprehensive transformation framework that will guide, research, and advance organization transformation in health systems, especially hospitals, clinics, and physician groups. With health spending rising exponentially, government, industry, and the public share growing concerns about a range of health care issues related to the organization and payment for health care services. New care models also require a shift in the types of clinicians that staff healthcare organizations. UL CHOT is committed to conducting research to understand what the optimal mix of these new services will be under new value-based ways of providing healthcare for the benefit of a diverse patient population.

UL CHOT's multi-disciplinary research team proposes to join the existing CHOT university sites, adding value through its in-depth integration of expertise in population health management, health information system design, and health systems sciences that will create new synergies that allows the research to be highly relevant, and incorporate best practices and the latest technology. UL CHOT will conduct mixed-methodology, applied research on the antecedents, execution, and effects of transformational interventions and strategies that combine evidence-based management, clinical and information technology innovations, and ongoing organizational learning and cultural change. Transformational efforts in health systems frequently ignore or prematurely treat several individual and organizational elements as "fixed" or immutable. Transformational strategies call for significant reexamination and, often, realignment of values, processes, and structures characterizing a health system. Such major innovations (i.e., LEAN, cutting-edge clinical innovations and information systems) call for leadership, significant cultural change, inter-professional alignment, elements of process reengineering, and effective monitoring and feedback. Our industry-guided research program identifies the factors that produce desired results from these kinds of transformational interventions in health systems. UL CHOT will contribute significantly to the efficiency and quality of care offered by industry partners by enabling more effective implementation of the aforementioned tools and strategies. Read More >

The opinions, findings, and conclusions or recommendations expressed are those of the Center author(s) and do not necessarily reflect the views of the U.S. National Science Foundation.