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Healthcare, Technology And Management: A Cross-Cutting Approach To Enhancing Service Delivery

As part of the ONResearch Talks series, Professor Joel Goh talks to ONResearch Partnership Coordinator Ugo Ikpeazu on Healthcare Analytics and Supply Chain Management.

There is a lot of discussion about the current state of the global economy and how industries have been affected both by technology over the past 5 years and by the COVID-19 pandemic more recently. In this current landscape, what does the word evolution mean for your daily business/activities/research?  

When I think of the word “evolution”, it immediately connotes the idea of “adaptation”. Especially with the ongoing COVID-19 pandemic, we have seen industries around the world upend the notion of “business-as-usual” and adapt to the changing times. Some of these adaptions, can be beneficial in the long run and, I hope, will be here to stay. For instance, in many workplaces, employees were forced to adapt by telecommuting (working from home) during the pandemic. I believe that for a number of employees and workplaces, overall productivity has actually improved as a result of reduced time (and stress) spent in commuting to the office. My hope is that adaptations like these can be part of the new normal even after the pandemic is over. 

One of your key interests is the healthcare sector. Looking at healthcare as an essential service and industry, what would you say are some of the more significant changes or developments that have emerged in response to the pandemic?

Beyond the obvious growth in COVID testing and vaccine production, I think the most significant change is not something that you can see on the surface, but rather that there is a shift in our mindset globally. Experts had been warning for many years that humanity is generally ill-prepared for a global infectious disease pandemic, and the past two years of COVID have shown their prescience. Now that we are living in the middle of this pandemic, I believe that most people now recognize the severity of disruption that a global pandemic can wreak on the world, and I hope are better prepared for the future. In the health care industry specifically, there is increased interest in developing pandemic preparedness plans to maximize health systems’ resilience against these sorts of events. 

What major changes would you say businesses in this industry had to make to protect themselves through, and propel their offerings (products and services) out of the pandemic? 

Presently, I think most of the health care sector globally are in fire-fighting mode, where the goal is to keep COVID numbers low and reduce infections in the population. As COVID cases increase, a health system’s capacity for other elective procedures gets reduced, which affects the medical supply chain further upstream. Anecdotally, I’m aware of a few companies that have pivoted to producing devices and equipment (e.g., ventilators, PPEs) to meet the immediate needs of the COVID pandemic.  

I understand that another interest of yours is in applying operations management techniques and principles to improving healthcare delivery. What can you tell us about this? What techniques and principles are you already witnessing that have the potential for disruptive/ transformative impact? How are these techniques being applied in the real world? 

I view the notion of “optimization under uncertainty” as a key principle in operations management. Loosely speaking, optimization refers to making the best possible decision when faced with factors that constrain your decision, whereas uncertainty refers to the set of things that we cannot control. This principle, when applied to healthcare delivery, means that we should aim to deploy our available resources in a way to maximize the benefit (i.e., the “bang-for-buck”) to patients, but also being cognizant of random events that we cannot control. For example, there is a large body of literature that studies donor organ allocation for transplantation. In such problems, organs (a highly scarce resource) must be allocated fairly and to maximize the health outcomes but done so in an environment where many factors are out of the system planner’s control, e.g., when a donor organ is available, the quality of the organ.

Another key principle in operations management is that “incentives matter”. This is important even in health care, a service industry where providers are people whose decisions can be influenced by incentives. Perhaps the most influential real-world example of this principle in practice is the notion of “value-based care”, which is a system of health care that aims to reward providers based on patient outcomes rather than tests or procedures performed, thereby aligning their incentives with longer-term population health outcomes.

Service delivery is one part of the puzzle. Another important part is demand, ensuring that communities, families, individuals have an interest in using critical health interventions, health services and commodities. How are you approaching demand for healthcare services and products? Demand varies depending on context and so increasing demand in a high-income country would be fundamentally different from increasing demand in a low-income or underserved community. What are the key factors to consider when approaching the latter context? What tools should decision makers use to guide improving demand in underserved communities?

I don’t typically work in the area of demand creation: that’s usually a topic considered in the domain of marketing, so I’m sorry that I don’t have too much to say about this. Regarding the difference between health care in high-income vs underserved communities, for many high-income countries, the key issues tend to revolve around chronic disease prevention and treatment, as well as healthy aging. In underserved communities, the problems are more complex, and tend to be a composite of issues around both public health, individual health care, and social issues. 

Beyond healthcare, you are also a keen technology professional. What can you tell us about the Robust Optimization Made Easy (ROME) software which you have co-created? How are you seeing this tool applied and how do you think tools like this can be used to solve problems in the future?

We (myself and my colleague Melvyn Sim) developed this about 10 years ago now, and at the time, the field of robust optimization (a paradigm for optimization under uncertainty) wasn’t quite as developed as it was right now there weren’t many toolboxes available for modeling such problems easily. Our motivation was twofold: we wanted to build this for ourselves to simplify the process of our further research work, and we also wanted to provide other researchers and practitioners with a simple tool to use to build such robust optimization models. We built the software to be used without a particular application area in mind, and I have used it to study problems in project management and financial portfolio optimization. Over the years, a number of students and academics have also contacted me saying that they have used this software, but I’m unaware of the exact application areas that that have used the tool for. 

Thank you so much for your time, before we round up, can you tell us about an idea or project you are working on that you are really excited about?

One project that I’m particularly excited about the operations of on-demand service platforms. This is joint work with my PhD student Eryn J. He and my colleagues Chung-Piaw Teo at NUS and Sergei Savin at Wharton. In this project, we consider the problem of “platform leakage”, where freelancers on the platform may “leak” from the platform by providing services to customers off the platform. This, ass you can imagine, can present a major threat to the sustainability of a platform. However, we also know of other platforms are seemingly immune or resistant to the threat of leakage. In this work, we investigate the key drivers of leakage and aim to derive general principles that can determine the resistance or susceptibility of a given service platform to leakage.

Interviewed by Ugo Ikpeazu, Partnerships Coordinator and Research Associate at ONResearch.

Joel Goh

Joel Goh

Associate Professor, Department of Analytics and Operations, NUS Business School;
Director, J.Y. Pillay Comparative Asia Research Centre;
Associate Director, NUS Global Asia Institute;
Visiting Scholar, Technology and Operations Management Unit, Harvard Business School