Posted on in General

I keep wondering why making changes in healthcare are so difficult. It can take up to 15 years to implement simple changes to care guidelines.

When it comes to changing a healthcare system, there is much complexity and enormous inertia.

To accelerate system wide changes that are win win, there is a need for enlightened healthcare managers.

Here is a case study that explains what I mean:

Case study:

Recently, I met the medical director at the Queens Medical System in Honolulu. This is a large multi-hospital not for profit health system. The medical director is a dedicated clinician who has moved into administration.

We spoke about how their system’s insurance payors will immediately approve moving a patient from the hospital to an alternative care facility. This decision is based on the economics of patient care. Hospitals are high cost. Hospice or other such centers are much lower cost.

I suggested that their health system start discussing building new infrastructure to provide lower cost and high quality services. All costs to be financed by the payors.  The conversation ended abruptly. There was no understanding of the opportunity.


To advance healthcare, there has to be an understanding of clinical care, the economics of care and how to develop new capacity delivering new care models. Unfortunately, few individuals have these unique, varied and complimentary skills together with a deep knowledge of the issues.

That is why Rupert Case Management Inc. has funded a graduate scholarship in health management at the Schulich School of Business.  The program is lead by Dr Brenda Zimmerman. The scholarship will go to a 2nd year MBA student in the health management stream. When I met Brenda’s healthcare MBA students last year, I was so impressed that I called the advancement office to see if we could contribute, which we did.

Maybe, the first thing to do in order to accelerate innovation and change in our healthcare system is to sign up for Brenda’s health management courses at the Schulich School of Business.