that covers both the business

aspects and health-related as-

pects of all facets of health and

health care. The program is

unique, but others are begin-

ning to appreciate the value of

discussing both the financial

and medical aspects and how

they relate.

Informatics continues to grow

more important in our global

world today. The “cancer

moon shot” is only one exam-

ple of what the future will re-

quire. You have the oppor-

tunity to engage in now and

tomorrow and carry the better

understanding of informatics

and business into the broader

world. Opportunity awaits!

Informatics has become a dom-

inant factor in every aspect of

health and health care. Data,

knowledge, and information

have become drivers in every

initiative from basic science to

population health. Informatics

is a hot topic, driven by such

standards as HL7’s FHIR ®

continue to engage a wide vari-

ety of individuals. From the

Internet of Things to Big Data,

Informatics provides the core

concepts. The number and

kinds of persons interested in

areas of informatics include

government, providers, re-

searchers, payers, all clinical

specialties, vendors, and others.

And it is a fast changing field.

At a recent meeting, the speak-

er suggested that the field of

informatics is changing rapidly

– that in five years we would

see major changes. True, but

as the next speaker said, you

had better be ready for changes

in the next 6 months.

Informatics is a field that does

change rapidly. Technology,

policy and politics, user com-

munities, global endeavors all

are changing rapidly. If we

look at national initiatives,

public and private collabora-

tives, professionals and non-

professionals, and whole socie-

ties we can better understand

the driving power of informat-

ics. Precision Medicine, Pa-

tient Centered Outcomes Re-

search Initiative, Population

Health, Predictive Analytics,

Accountable Care, and Clinical

and Translational Science

Awards are just a few of the

well-funded national initia-

tives. And it is exploding! The

opportunities abound.

Recent studies tell us that our

health is influenced by many

different types of data: clinical,

genomic, behavioral, social,

economic, and environmental.

The amount of data we must

work through has grown expo-

nentially from bytes to exa-

bytes and is still growing. Pri-

vacy and security, data ransom-

ing, and information blocking

are only a few of the topics

with which we must deal. The

cost of health care in the U.S.

is 3 times of any other devel-

oped country, and over 6 times

the average of developed coun-

tries. No longer can we just

focus on a single component of

the overall system. We must

understand the technology, the

business, the applications, the

users, and the policies that

drive change.

I like to wear my MMCi jacket

on trips. It’s an attractive jack-

et, and I think noticeable. I

like it when someone com-

ments on MMCi and asks what

the letters mean. I like to make

the point that it is a program

Informatics — Riding High!

Master of Management in Clinical Informatics

Duke University School of Medicine Spring 2016 Volume 3, Issue 3

The MMCi Exchange

Webinar

May 18th

12:00—1:00 pm DST

Open House

May 6th

8:30 am—2:00 pm

Hock Plaza

Case Competition

June 10th

Hock Plaza

Visit the MMCi web-

site to register for an

event.

http://

www.dukemmci.org/

Inside this issue:

A unique blended

curriculum...

2

Emma Rasiel

Corporate Finance

2

Kevin Schulman

Clinical Informatics

Strategy

3

Will Mitchell

Principles of Strategy

3

MMCi Presents! 4

Ed Hammond, PhD MMCi Director of Academic Affairs

Join us for an

Information

Session

complex financial models that

underlie strategic decisions.

Rather, we focus on what ques-

tions to ask of the financial plan-

ners who build the models; and

which assumptions to challenge

and stress test.

The course begins with the tools

and methodologies used to value

two key forms of financing:

equity and debt. We stress the

importance of the tradeoff be-

tween rates of return versus risk,

and discuss how to measure and

evaluate both of these metrics.

We build relatively simple cash

flow forecasting models, and

discuss which key features of

these models require the most

attention when incorporated to

more real-world, complex fore-

casts.

Page 2

The MMCi Exchange

We go on to look at portfolios

of assets in both corporate and

personal settings, and how the

performance of these models

vary in different economic

scenarios (periods of growth vs

recession). We discuss how to

think about these models when

planning for the short term vs

the long term as well as some

common human biases that can

lead to less than optimal deci-

sion-making. We finish the

course with a brief discussion

about “hedging” (providing

insurance for) negative finan-

cial scenarios.

The Corporate Finance course

provides a framework for stu-

dents to learn about how finan-

cial decisions are made in

almost any context: from run-

ning a hospital to starting a

new medical practice to per-

sonal finance goals. Students

will come out of the course

with an understanding of how

to measure financial perfor-

mance, and – equally im-

portant – how to assess the

potential risks inherent in fi-

nancial decision-making.

It is often the case that corpo-

rate decisions that fit an organ-

ization’s strategic goals may

nonetheless be at odds with

prudent financial management.

In this class, we are not so

much learning how to build

MMCi 525 — Foundations of Corporate Finance

In this edition of the MMCi Exchange, we have focused on the significant trends in informatics and how graduate programs like MMCi serve to meet the sector’s current and future needs for skilled leadership. The Master of Management in Clinical Informatics degree is a unique com-bination of rigorous business and informatics courses. Our Term 3 faculty offer you some insights regarding the value of their courses in becoming effective strategic leaders who are capable of driving innovation in health care through the use of technology. They describe the tools, skills or methodologies their course provides that will help in making health-based decisions, better engaging executive leaders and understanding decision-making at the organizational level.

Emma Rasiel

Associate Professor of the Practice, Teaching Director of the Duke Financial Eco-nomics Center, Director of the Duke in New York Pro-

gram

A unique, blended curriculum…...

Page 3

Spring 2016 Volume 3, Issue 3

I enjoyed writing Clinical Informat-

ics Strategy. It’s interesting that the

course uses several cases I have

developed or co-developed. We

also read several of my research

articles in the class as supporting

readings. Overall, the class is real-

ly a great summary of a lot of our

research into innovation in the

health sector.

The framework for the class is to

understand basic business models

and frameworks where technology

has been utilized to improve quality

and reduce cost of services. The

start of the course is very focused

on these concepts: scale, network

economics, disruptive innovation,

business process improvement. in

health care.

We then look at telemedicine

through the lens of workflow,

and the economic value of

connectivity in health care. In

the later part of the course, we

explore different business

models including mHealth,

business transformation, and

conclude with the idea of Lean

Start-Up. The case for this

last class features two MMCi

graduates from Nairobi,

Kenya.

The course is all case-

based. This means that we

have an active discussion on

actual business cases for every

one of our sessions togeth-

er. We ask questions about

business strategy, leadership,

and even debate these points

among students in the class.

Overall, we’re respectful

but challenging of the cur-

rent paradigm.

From my perspective, the

opportunity to challenge the

status quo is not a personal

issue, it a question of

of business models and

frameworks. We ask hard

questions in class, and the

answers might lead us to

make different decisions in

our organizational roles.

The core frameworks we

develop point to different

business models supporting

technology deployment and,

frankly, result in some pret-

ty tough questions that need

to be addressed to best un-

derstand the role of technol-

ogy in health care. We’re at

MMCi 539 — Clinical Informatics Strategy

an interesting juncture in

the health care industry-

we’ve invested a lot in core

technology but have yet to

achieve the value creation we

expected. We need to

understand why this has been

the case so that we can make

better decisions as managers

going forward about our tech-

Kevin Schulman, MD, MBA

Director, MMCi Program Gregory Mario and Jeremy

Mario Professor of Business

Administration

Associate Director, DCRI

MMCi 557 — Principles of Strategy

We use multiple strategic

frameworks about market,

industry, and business analy-

sis, all pointing to ways to

create profitable customer

value. Because this is health

care, we work with a complex

customer environment, with

Will Mitchell

Visiting Professor Professor of Strategic Man-

agement in the University

of Toronto’s Rotman

School of Management

decision makers and major in-

fluencers including patients and

their families, health care

professionals, regulators, and

others. Moreover, we

work hard to deliver a triple

bottom line of performance –

organizational success, career

development, and social impact.

This is a challenging task and

one that is exciting to use the

tools of strategy to accomplish.

As a base for developing in-

sights, we will use a mix of

cases, current materials, framing

lectures, and active ongoing

discussions with the highly

experienced and knowledgeable

participants that make up the

class. These materials work in

close complement to the Clini-

cal Informatics Strategy course

that also runs in Term 3, while

also incorporating key elements

of the financial analysis that

students will be learning during

the term.

Throughout the class, I will

push students to develop a

personal point of view about

opportunities in health care and

work with class mates in de-

veloping the implications of

their ideas. Strategy is partly

about developing ideas for

creating new value and, just as

much, about encouraging a

group of people to engage with

and help shape ideas. The

classroom is a safe environ-

ment to develop and practice

the communication skills that

are needed to be an effective

strategic leader.

The starting point of strategy is

to develop a vision for the type

of value that your organization

wants to create, as well as

major strategic themes within

that vision. The vision and

strategic themes guide the

decisions that individuals and

groups within organizations

will need to make in their daily

work and in their longer

term activities. Our goal in

the class is to help students

link the high level vision to

these daily decisions, so that

one’s organization has a

chance to excel in a compet-

itive environment.

Throughout the course, we

draw from research in strate-

gy and healthcare. This

work helps identify relevant

patterns that provide in-

sights for how to identify

opportunities for your or-

ganization. In parallel, we

bring the ideas from re-

search to life by drawing on

the experience of the faculty

and students in the class in

making tough decisions in

real time situations. Overall,

we bring research and expe-

rience together in a way that

will help solve specific

problems and seize new

opportunities.

The May 6th Open House will include a class observa-tion of Clinical Informatics

Strategy

Master of Management in Clinical Informatics

2424 Erwin Road, Suite G06

Durham, NC 27705

Phone: 919-613-0310

E-mail: mmci@duke.edu

http://www.dukemmci.org/

The MMCi Exchange

Consulting Panel presents to the Class of 2016 Vijay Mohan, Director, Pharma and Life Sciences Advisory, Price Waterhouse Coopers and MMCi Class of 2015 alum, Donna Schmidt, RN, Director, Price Waterhouse Coopers, Audrey Lysko, MBA, Manager, Kyle Gibler, MD, MBA Senior Associate at McKinsey, Victor Palli, Deputy Director, Healthcare IT, JBS International and MMCi Class of 2011 alum

Bringing Business Innovation to Health Care

NC HIMSS Annual Conference Jen Maddocks (Lft) and Cathy Vanliew (Rt), Class of 2015. Congratulations to Jen for an impressive keynote address: Patient Engagement through Technology.

“Those who think, present.” Aayush Jain

CIO Panel presents to the Class of 2016 Mitch Krieger, MD, FACS, MMCI Class of 2013, Associate CIO, Cleveland Clinic, Ben Alexander, MD, CMIO, Wake Med, Eric Poon, MD, MPH, CHIO, DUHS

Dr. Ed Hammond speaks to prospective students and alumni regarding the “Digital Transformation of Health Care”

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