Introduction to the Special Issue: Teaching Healthcare Operations Research, Part 1

Health care is the largest sector of the economy of all developed nations, comprising anywhere from about 9% of GDP in Western Europe to more than 17% of GDP in the United States. As operations researchers, health care presents an important area of study and application. Health care is a public good; its provision is important to society as a whole and to all of us as consumers.

The promise of health care is health: the attainment of a longer and fuller life. However, the link between health and health care is, at times, tenuous. Moreover, health care is an expensive business that annually consumes ever more of society’s finite output. A common question amongst governments is whether the provision of health care is sustainable. In the Province of Nova Scotia health care consumes more than 45% of the provincial budget; moreover, health care spending appears to have no natural upper limit. How big a share of societal output can health care consume before other public goods (roads, schools, libraries) are squeezed out, resulting in a lower quality of life even though that life might be longer? Clearly, the provision of health care is important for society and, as operations researchers, an area deserving of much respect and attention.

I know that health care is important and expensive and challenging, because I was taught this. I recall attending a health care policy class as a young doctoral student and listening to my brilliant professor describe the business of health care. I came to the class with a good technical background – lots of queuing theory, lots of linear programming, and lots of simulation – but I had little real knowledge of how health care functioned. Health care, I was taught, was a business, but a business like no other. This came as a revelation. I’d worked in the field long enough to know that it was difficult to apply models in health care, but I didn’t know why. What I learned is that while it is easy to formulate the constraints in a health care model, coming up with the objective function was often the challenge.

This special issue on teaching health care operations research sits at the junction between OR theory and OR practice and the intersection between modelling and care. Good technical skills are of little value if researchers don’t understand why health care functions the way it does; system change is impossible, even for those immersed in the business, if a conceptual model of how the system functions has not been formulated. Teaching healthcare to operations researchers and operations research to health care professional is an important duty with broad implications for society and its members.

In this issue, we see three papers that explore the interface between operation research, education, and health care. Two papers are classical case studies in which health care concepts and operations research models are integrated through an illustrative problem that must be resolved by students. The third paper applies OR methods to determine the optimal allocation of time and channels to the delivery of concepts in an MBA program aimed at working health care professionals. All three papers are excellent; they are engaging, clear and they tell a compelling story. In short, they make good reading.

Bordoloi presents an eminently readable paper on the use of linear programming to optimize the delivery of OR course content in an MBA program aimed at physicians, nurse managers, hospital administrators, pharmaceutical managers and other professionals. The program involves both online and classroom delivery channels. Students—who are working professionals—have limited time in which to absorb complex operations research concepts. In his paper Bordoloi uses linear programming models to determine the amount of time and the delivery mechanism (classroom presentation, face-to-face games, online lecture, blogs, online assignments, etc.) to ensure the best possible coverage of material using the most effective delivery mechanism. While aimed at health care MBA classes, such methods could be employed in a variety of settings covering a range of areas of application.

Kopcso, Simon, and Gao provide a case study and teaching note in the area of pharmaceutical development. The case is aimed at undergraduate engineering and graduate MBA students. The particulars of the case involve a decision problem in which a firm must select a development option for two potential drugs used to treat idiopathic pulmonary fibrosis. The decision problem involves two players – one a larger firm with experience in clinical trials and the second a smaller firm holding the license for a particular drug of interest. The case illustrates the importance of structured decision making and supports the use of decision trees for determining the potential costs and benefits of various courses of action. The case is quite clear and is an excellent resource for instructors looking to illustrate a real world decision problem.

The last paper in this edition, by Proano, uses a case study approach to teach production management to engineering undergraduate students. The case describes planning for and dealing with the outbreak of pandemic influenza on a university campus. In this case, which is designed to run over a term, students are responsible for developing mechanisms for predicting the number of individuals who will become infected and for identifying what policies should be implemented to deal with the outbreak once it becomes pandemic. The case introduces a number of technical components, such as forecasting and epidemiological disease models, and places them in a decision context in which the future may not be predictable from the past. Instructors seeking a refreshing way to teach application of advanced modelling topics will, no doubt, be interested in this paper.

Finally, I would like to add a personal note to this editorial. I am listed as one of the guest editors on this special edition, but truly contributed very little. The work on this edition was largely done by my co-editor, Murray Côté, and the editor-in-chief, Armann Ingolfsson. Early in the review cycle, my 10-year old son James and I lost his mother and my wife, Angela Blake, to a congenital heart defect. Murray and Armann, my long time colleagues, proved once again to be my very good friends, picking up the slack for me and getting this special edition to press without a hiccup. I would like to dedicate this special edition to them.