Harvard Business School Case Study - Intermountain
Intermountain Healthcare Case Study
Gina L. Turley
In the Harvard Business School case study of Intermountain Health Care (IHC), we learned about the efforts made by IHC to adopt a new strategy for managing health care delivery that is focused on improving care quality while simultaneously saving money. Beginning in 1986 as a series of experiments tying cost outcomes to traditional clinical trials, IHC’s approach to delivering care became known as “Clinical Integration” which “referred to both an organizational structure and a set of tools” (Bohmer, 2002). The organizational structure required a departure from the traditional administrative management model to one that “involved administrative and medical
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While many have argued that evidence-based medicine is “cookbook medicine” or medicine that strictly adheres to practice guidelines rather than clinical judgment, I disagree. IHC simply developed a model that provides a structure for clinicians to standardize their care, while still allowing for their experience and knowledge of the patient to drive their decisions. This can be seen in IHC’s development of its EMR, which integrates clinical decision support protocols designed by the Development Teams into the data entry process. While the system provides evidence-based guidance, it still affords a measure of physician autonomy by allowing the doctor to provide an override reason (which is often used to refine the protocol). This direct entry of data allows for increased efficiency and more complete documentation (which has the added benefit of increased billing). Once proven successful, this strategy would eventually lead to a “tipping point” of physicians espousing the benefits of the model, a necessity for system wide adoption. Furthermore, as they smoothed out the data collection methods and could produce measurable outcomes, it became possible to align both medical and administrative personnel’s financial incentives to match the organizational goals.
Considering this case study is 11 years old, it is natural to question if this model