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Costello College of Business health care research puts “patients at the center”

Jennifer Anzaldi — Tue, 11 Mar 2025 15:55:18 +0000

Costello College of Business health care research puts “patients at the center” Jennifer Anzaldi Tue, 03/11/2025 - 11:55

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Nirup Menon

Like virtually every other industry, health care is increasingly prioritizing digital transformation. The sector is unique, however, in that its results are measured not only in business terms but also tangible outcomes for people—often, literal life and death. So are newly acquired technologies actually paying off for patients?

Nirup Menon, a professor of information systems at the Donald G. Costello College of Business at 91��, says that the answer is “not always.”

Nirup Menon

His recently published paper in Decision Support Systems tackles the so-called “HIT paradox,” or the widespread perception that health information technologies (HIT) have not yet moved the needle on important outcomes such as productivity, quality of care, and patient safety.

Menon co-authored the paper with Costello colleagues Amitava Dutta and Sidhartha Das.

Based on comprehensive survey data from approximately 6,000 U.S. hospitals, the research team looked into whether those that adopted Clinical Decision Support Systems (CDSS) saw lower mortality rates for cardiac patients.

“CDSS is not only for cardiologists,” Menon explains. “It is hospital-based—a system that helps with clinical decision-making. But we know that many cardiac patients may not necessarily have cardiac as their only problem. There are probably decisions being made about them using all kinds of ailments and medications, and so on.”

The basic idea behind CDSS is to use technology to mine actionable insights from a wealth of patient data, giving clinicians key tools to make informed decisions at the point of care. Theoretically, a hospital with CDSS solutions should be much better equipped to handle complex cases—such as a heart-attack sufferer with diabetes or another comorbidity—in real time than one without.

However, Menon and his co-authors discovered that when it came to preventing deaths from cardiac emergencies, the impact of CDSS was context-specific. Their paper finds a number of complementary effects suggesting that health care technologies need help from their environment in order to be most effective. For example, the presence of cardiac medical services (CMS), e.g. diagnostic catheterization and electrophysiology, was unsurprisingly associated with lower mortality rates—but CMS combined with CDSS was more impactful than either on its own.

“The labor force—by which I mean the physician and the entire team of nurses and technicians—should be trained to use this technology appropriately,” Menon summarizes. “You also need real-time integration between CDSS and other IT systems, because if it’s not well-integrated, the provider will not have all the data at their fingertips. If you don’t provide the right inputs into a CDSS, it’s not going to give you the right outputs.”

Menon points out that the “HIT paradox” isn’t limited to CDSS or any single technology. President Obama’s 2009 economic stimulus package, after all, included tens of billions in financial incentives for health care providers to digitize their patient records. By 2017, 95 percent of U.S. hospitals had adopted electronic patient records. Yet, as Menon tells it, “hospitals are just chugging along. The quality remains the same and the costs are just increasing. Or you might see improvements in one small department. So we are trying to find the variables that create complementarities within large samples.”

Menon knows, however, that the applications of health care tech can be closely targeted to relatively tiny patient populations, too. Another recent paper of his, published in JMIR Medical Informatics, uses causal survival forests, a machine-learning algorithmic technique, to determine which of two chemotherapy drugs promoted the most longevity for terminal prostate cancer patients. Taking into account age, race and comorbidity symptoms, their analysis produced an easy-to-use prescription policy tree that, by itself, could extend patients’ lives by almost two months—if the test sample, comprised of 2,886 veterans treated at VA health centers, was representative of the wider patient population.

“If you go down every branch of the policy tree, the numbers become very small,” Menon says. “It almost becomes like personalized medicine, because you can factor in age, race, gender—although gender didn’t matter in our study—PSA numbers, bilirubin numbers, etc.”

Menon has ongoing research projects aimed at improving health care through technology, at both the patient level (a la the prostate cancer study) and the ecosystem level (a la the CDSS study). One paper in progress focuses on Covid-19 and how the data-sets research scientists selected for their studies influenced their findings. Another looks at telemedicine’s effects on quality of care.

“My foray into health care began with my PhD dissertation, which was on IT in hospitals,” Menon says. “At that time, I was working primarily from a hospital administration point of view. As a business school researcher, it seemed logical to stay there. But as you come across more problems, and you read more, you realize that the patient is the center of everything, not the hospital.”

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George Mason professor furthers impact of telemedicine in Ukraine

Jennifer Anzaldi — Tue, 14 Jan 2025 22:39:16 +0000

George Mason professor furthers impact of telemedicine in Ukraine Jennifer Anzaldi Tue, 01/14/2025 - 17:39

Ukraine’s health care system has been hit hard amid the ongoing war. Power outages, staffing shortages, and the destruction of hospitals have added up to a drastic reduction in available care for the already-vulnerable population. In a desperate attempt to bridge the gap, Ukraine’s Ministry of Health opened the country to telehealth solutions from overseas. But will these prove to be a successful substitute for at least some necessary services, or turn out to be no better than a tech Band-Aid?

Answering that question is where Mariia Petryk, assistant professor of information systems and operations management at the Costello College of Business at 91��, comes in. In her spare time, she works as volunteer director of analytics for TeleHelp Ukraine (THU).

Mariia Petryk

Founded by a cross-disciplinary group of Stanford students shortly after the war’s inception, THU was designed to succeed where other telemedicine initiatives in crisis-affected areas have failed. The founders worked tirelessly to assemble an international volunteer network comprising medical professionals, translators, interpreters and administrative “health navigators.” Aware that medical consultations were only part of the patient journey, THU’s founders sought to address the entire continuum of care.

Petryk stresses that while the project originated at Stanford, the technical team included “people from Chicago, Boston, other California schools…some very active volunteers were in Australia, South Korea, Canada and other countries.”

Petryk, herself of Ukrainian descent, was honored to lend her data science expertise to this worthy project. As analytics director, she manages a dozen or so number-crunching volunteers who measured and documented THU’s impact upon Ukraine’s displaced population during the initiative’s first full year.

As Petryk explains, “The Russian invasion created a humanitarian crisis where a lot of people were internally displaced. And when people relocate to a new place, they don’t know where to go for health care. They also are at higher risk for many issues, including mental health problems. And they don’t know where to turn to treat chronic diseases they may have.”

THU’s primary focus during its first year was delivering much-needed services to this population of war-ravaged internal exiles.

Petryk’s analytical work gave rise to a recent case study of THU published in Journal of Global Health. The paper’s other lead author was Aditya Narayan, a Stanford medical student and THU’s director of implementation and evaluation.

Their findings describe some impressive early successes. THU facilitated more than 1,200 virtual patient appointments from May 2022 to May 2023 alone. Despite often-chaotic conditions, patient attendance rates were above 70 percent for nine of the 13 months studied. As the first year wore on, the THU team found ways to prevent no-shows—for example, employing the popular texting platform Viber to communicate with patients and assigning an individual health navigator to each patient.

Even more impressively, 96 percent of patients reported that their health complaints were at least partially resolved during their visit.

The paper argues that aspects of THU’s model could be adapted for use in other humanitarian contexts. In its initial growth phase, THU had access to advanced technological infrastructure and a wide network of medical providers, by dint of its academic origins. This implies that partnerships with academia could be critical to replicating THU’s success outside Ukraine.

Petryk remains proud of THU’s impact and her role in helping define it. “Based on actual appointments and how much that amount of care would cost at a hospital, THU delivered an estimated $1 million worth of services in its first 13 months,” she says.

Looking ahead to THU’s future, she says, “I can only wish to see this ‘start-up,’ as it were, go for the IPO.”

For more information and to explore volunteering opportunities, visit THU’s website.

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The work-from-home blues have a secret source: nostalgia

Jennifer Anzaldi — Thu, 19 Sep 2024 14:25:23 +0000

The work-from-home blues have a secret source: nostalgia Jennifer Anzaldi Thu, 09/19/2024 - 10:25

For at least two years, CEOs have been trying to bring employees back to the office, citing remote work’s supposed negative effects on productivity, morale, and creative collaboration. Managers, we’re told, are having a hard time monitoring and motivating dispersed teams. But what if bringing employees back to the office won’t put the genie back in the bottle?

Kevin Rockmann, professor of management at the Donald G. Costello College of Business at 91��, argues that the furor over remote work masks deeper cultural issues at play in many organizations. This cultural malaise has employees pining for an imagined past where they felt grounded and connected with their colleagues. In short, remote workers aren’t unmanageable—they’re suffering from pangs of nostalgia.

Kevin Rockmann

Rockmann’s recently published research paper in Journal of Management (co-authored by Jessica Methot of Rutgers University and Emily Rosado-Solomon of Babson University) documents the results of surveys conducted during the height of Covid (September 2020). The thrice-daily surveys were delivered over a two-week period to 110 full-time professionals. Respondents were asked to report on their feelings of nostalgia, as well as emotional coping strategies, task performance, and counterproductive work behaviors (e.g. withholding support from colleagues and stealing time from their employer).

The overwhelming majority of participants (98 out of 110) admitted to experiencing nostalgia for life before Covid. And these feelings could have either positive or negative outcomes, depending on how the respondents dealt with them. Rockmann points to two pathways that showed up across the surveys as a whole, which he labels “approach” and “avoid.”

One way respondents reacted to nostalgia was to use so-called “cognitive change” strategies, which help regulate emotions through shifts in perspective. For example, someone feeling sad about being trapped at home during the pandemic could think to themselves, “It could be so much worse. At least I don’t have Covid like so many others.” These strategies seemed to evoke empathetic responses, leading the survey participants to reach out to colleagues to check in or offer assistance.

Equally prevalent in Rockmann’s results, however, was a much darker pathway. Instead of reaching out to others in response to nostalgia, respondents tended to turn inward in an attempt to minimize the emotional discomfort. Psychological researchers call this sort of reaction “attentional deployment.” “It’s a defense mechanism whereby you don’t feel you have the means to really connect with others, so you leverage your attention away from the source of pain,” Rockmann explains. This pathway led to incidents of “acting out”—the above-mentioned counterproductive work behaviors.

Rockmann says these Covid-era findings remain relevant for at least two reasons. First, survey respondents’ written comments sound like they could have been written yesterday, rather than four years ago. Common nostalgic themes revolved around co-workers, the structure of co-located work, etc.—all oft-heard plaints of remote workers in 2024. Second, the normalization of remote work well predated Covid—as Rockmann’s past research on the topic has documented. Covid accelerated an inevitable transition that was already well underway. Therefore, workers of a certain age would likely be feeling some nostalgia, even if there had never been a Covid pandemic.

“While return-to-office may make sense for some companies, I would emphasize that nostalgia cannot be fixed that way. Nostalgia is about longing for the past—or, more accurately, longing for a return to how we remember the past, usually through rose-colored lenses.”

How can organizations help employees conquer nostalgia, or at least encourage healthier ways of coping with nostalgia? The obvious answer might be what CEOs are trying to do—end remote work altogether. “While return-to-office may make sense for some companies, I would emphasize that nostalgia cannot be fixed that way. Nostalgia is about longing for the past—or, more accurately, longing for a return to how we remember the past, usually through rose-colored lenses,” Rockmann says.

Any political demagogue will tell you that people are most susceptible to nostalgia when they feel isolated and afraid. The fact that nostalgia is so widespread in today’s workplace would seem to confirm Rockmann’s past research showing how organizational cultures fail to promote positive relationships among employees.

Combating the nostalgia epidemic will require a cultural reset for many organizations. “Managers will need to engage much more closely with employees, asking sensitive questions (e.g. “What do you miss about working here before Covid?”) and co-creating individualized solutions to help employees fully adjust to the major changes in their working environment,” Rockmann says.

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