Institute of Health Administration

Institute of Health Administration,

RobinsonCollege of Business

Annual Institute Review

Self Study Report

Review Period

Academic Year 2004 – Academic Year 2006

Site Visit Review Committee

Eugene Schneller, Ph.D., Arizona State University (Chair)

Sandra Potthoff, Ph.D., University of Minnesota

Douglas Wakefield, Ph.D., University of Missouri

1. Strengths and Weaknesses

Evaluate the overall strengths and weaknesses of the Institute, referring specifically to each of the five areas in Section A.

A1. Quality of instruction, research, and service associated with the program.

The Institute has been continuously accredited by CAHME and has, over the years, been very responsive to consultants’ recommendations regarding both curriculum and research.

The small number of full-time faculty is very responsive to student needs both in and outside the classroom. However a high proportion of courses are taught by part time instructors.
There is an inadequate critical mass of research-oriented faculty to cover the competencies in health management education and to grow the research institute.
The alumni from Institute programs are highly committed to its work, provide field and career opportunities for students, and also represent an important source for future philanthropic funding.
The Institute is located in the J. Mack Robinson College of Business, which has a national and international reputation for excellence in business education. Within this context, students take advantage of an outstanding faculty for their core business courses, a dedicated group of admissions and administrative staff and strong administrative support from the dean.
Student quality has undergone continuous improvement as reflected by their academic preparation and ability to articulate the ways their education can benefit their careers.
Student advancement, retention, and graduation rates are impressive.
Students have a strong commitment to the clinical production processes - but may not be gaining first-hand exposure and understanding as to how the clinical processes work.

A2. Centrality of the Institute to the University

With health care as a dominant aspect of the US economy, the Institute’s focus is central to the business school and the Institute has the opportunity to contribute at an even higher level. This centrality is enlarged by the university efforts in public health, public policy, and biomedical sciences.
The greater Atlanta metropolitan area is a key asset for teaching and research collaboration. The significant growth in research by the Institute has become central to the development of health policy in Georgia.

A3.Viability of the Institute and A4 Strategic Focus
A clear vision and strategic focus for the unit has not been articulated – especially one that takes advantage of the business school and the broader university environments.
Although the university has identified the health sector as a strategic focus – there does not appear to be a strategy to sustain and grow what is a flagship Institute. Faculty retirements have significantly weakened the unit. There is no apparent succession management planning for the Institute.
A5. Financial Resource Analysis.
The financial model within the college does not fully support or encourage the Institute or individual faculty member to engage in externally funded sponsored activities (incentives to encourage extramurally funded research should be reconsidered).
While it is important to have faculty well connected to the field, the time allocation devoted by the research faculty to residency monitoring may be disproportionate and should be reconsidered.

The infrastructure to secure and manage sponsored grant research in the college of business is not well developed (i.e., grant development, budget support). There are, however, other research centers at the University with whom Institute faculty collaborate. The downside of this external collaboration is that the resources derived from the Indirect funding which are necessary to build a grants management infrastructure are not being returned to the Institute or college of business.
There is a great potential for collaboration in the area of health informatics, process innovation and risk management within the college of business.

2. Historical and Current Context

Given the historical and current context of the department as outlined in Section B, are the Institutes offered and Institute enrollments appropriate from a disciplinary perspective?

Yes. The Institute has a strong delivery orientation. There are numerous opportunities for expansion and synergy within other units within the College of Business and the University.

Are the faculty number, composition, and research productivity sufficient to support the Institutes offered by the department?

No. There is a lack, as a result of retirements and positions not replaced, of sufficient faculty in terms of absolute number and disciplinary mix. This is especially important given the aspirations for new research and strategic direction. An enormous number of opportunities are missed due to the absence of specific disciplinary competencies.

Comment on the relevance of the Institutes, and the degree to which the department’s Institutes serve various needs (community, student, professional).

The Institute and degree is highly relevant given the size of the health sector and its impact on the GDP. The research and service are consistent with needs of the field. Students benefit from the faculty experiences in both the academy and as a result of their service and outside experiences. The faculty, through the residency, sustains their contact with the delivery field and appropriately incorporates their learning from the field into the curriculum. Students value this attribute as keeping the faculty current. However, as suggested above, this effort, by the small number of teaching faculty, may detract from other important activities.

Evaluate the appropriateness of the peer institutions selected by the department for comparison.

The list of peer institutions reflects a good mix of Institutes in the US in both business and non-business school academic settings. This is especially important since the Institute has goals related to sponsored research and can thus benchmark itself against its competitors in both business and non-business school settings.

3. Progress toward Goals and Objectives

Taking a disciplinary perspective, evaluate the ways in which the unit has succeeded in meeting its goals and objectives since its last academic Institute review (Section C).

As stated in the self-study, the Institute has made some progress in specifying its mission. There remain, as we discuss in our articulation of strengths and weaknesses, a need to sharpen their mission – specifying their strategic advantage, particularly given their academic home in the business school, and the directions they wish to take.

Is its progress toward meeting its goals and objectives satisfactory?

Neither the metrics nor performance milestones associated with the stated goals and objectives are not clearly specified. The Institute would benefit by defining clear performance metrics and milestones.

What are the factors that have helped or hindered the unit in its effort to meet its goals and objectives?

The unit has been negatively affected by:
The failure to replace faculty who retired since the previous self-study year.
The lack of infrastructure to support sponsored research, especially relating to grants and contracts, within the college.
The lack of university policies that apportion indirect costs to schools and to departments to provide incentives for research.
As a result of course buy-out dollars not flowing back to the department, the educational Institute suffers.

The unit has been positively affected by:
Location in a strong business school.
Strong alumni support
Presence in a geographic location with great health sector resources.
Their student-centered structure and culture.
Their integration with the MBA and faculty relations in other departments.

Evaluate the ways in which these goals have contributed to the College and University Strategic Plans.

We did not formally review the University or College of Business strategic plan. However, based on our conversations with leaders in the administration and College we note that:

The University has systematically invested in newhealth related research and educational platforms that overlap with the educational and research interests of the Institute. While the Institute has collaborated in these efforts outside the Institute, no corresponding investment in the Institute has been made.

4. Quality of the Curriculum

Evaluate the quality of the curriculum from a disciplinary perspective for each of the department’s Institutes (Section D).

We did not formally scrutinize the curriculum at the course level due to the recently completed CAHME review. However, in discussing the curriculum, we noted no deficiencies. We also noted that the curriculum is well-integrated with the core courses in the college of business, which results in a good blend of core business content and healthcare-specific focus.

Evaluate the appropriateness of the learning outcomes and learning outcomes assessments for each of the Institutes.

We did not formally scrutinize the curriculum. The recently held CAHME review will provide a more complete evaluation. However, we did talk to students regarding the appropriateness of courses in regard to their eventual career destinations and found good match between their interests and Institute content.

How have learning outcomes assessments influenced curricular modifications?

We did not evaluate this as the recently completed CAHME review will address this issue.

We do note that Institute faculty is involved in the scrutiny of student performance in the residency. This has provided a good opportunity for gathering data on the needs in the field from both preceptors (e.g., CEOs) and students with subsequent curriculum revisions to meet identified needs.

Have these modifications been effective in improving student learning outcomes?

Based on the appendices provided, it appears that changes indeed lead to appropriate student outcomes. Students report that faculty appropriately brings their research results into the classroom. Parenthetically, this is also a CAHME criterion.

5. Quality of the Students

Evaluate the quality of students, both incoming and graduated students, in the department’s Institutes (Section E) relative to discipline-specific norms.

Based on a review of the appendix materials and meeting a sample of students, they appear to be a cohort of high quality and highly motivated students with a strong passion for the health care field.

Contributing to the quality is the great deal of student diversity in terms of gender, ethnicity, and prior experience and exposure to diverse sectors of the health care system.

Are the quality standards appropriate?

The metrics designated for the Institute are appropriate and guide students into degree options.

Exceptions to the targeted metrics appear to be well managed.

6. Quality of the Faculty

Evaluate the quality of the department’s faculty (Section F). Include in your discussion an evaluation of the faculty with respect to peer Institute faculties.

The three full-time faculty are each strong in their disciplinary areas and appear to be well-qualified to teach the materials they are teaching.

The faculty is supplemented by significant efforts by part-time instructors and executive input that enriches the learning environment.

Those faculty who are very active in sponsored research have a very strong focus on policy related to finance, insurance, and access.

Collaborating faculty from other departments, especially from Risk Management and Insurance, Center for Process Innovation, and Computer Information Systems, with whom we met, are particularly impressive, supportive, and engaging in collaborative efforts.

7. Resource Adequacy

Considering each of the seven areas discussed in Section G, evaluate the adequacy of departmental resources.

As discussed under strengths and weakness, the faculty needs to be strengthened in both number and mix to expand the curriculum and to take advantage of research opportunities.

Current resources are at best, adequate. The staff is very dedicated. The number of full-time faculty is insufficient for anything other than maintaining the status quo, a strategy which we would not endorse.

Resources related to faculty offices, classrooms, and technologies are excellent.

Resources needed to support extramural funding is inadequate.

There is an over reliance on part time instructors.

The alumni represent an important resource to be further tapped for both teaching and for development.

8. Goals and Objectives

Evaluate the goals and objectives that the department has outlined in Section H for the next review cycle.

The strategic plan requires careful reconsideration in light of existing and emergent resources. Each item requires the development of performance metrics and milestones in order to assess progress. Each of the following items should be considered in terms of overall contributions and centrality to a vision statement for the Institute. For each item we have indicated our level of agreement/disagreement with the self-study recommendations:

Goal 1. Reduction of reliance on part-time instructors.

Strongly Agree.

Goal 2. Implement health information specialization.

Strongly agree. See discussion below.

Goal 3. Implement undergraduate major in health informatics.

Strongly disagree given limited resources and the need and opportunity to build a leading program at the graduate level.

Goal 4. Implement a graduate degree in health informatics.

Strongly Agree – see comment below.

Goal 5. Establish a HA cohort in the new PMBA.

Tentatively agree. See comments below.

Goal 6. Expand extramurally-funded research.

Tentative agree. See below.

Goal 7. Improve its peer reviewed publications.

Strongly Agree.

Goal 8. Reactivate the HA doctoral Institute.

Strongly disagree at this time. See discussion below regarding capacity.

Are the goals and objectives appropriate for the unit?

The vision, goals and objectives require careful re-specification to be attentive to resources and emergent opportunities. Performance metrics and milestones to measure progress towards reaching these goals and objectives need to be specified and monitored.

The competitive strategic advantage for the Institute, given the environment in the College of Business and increased competition for graduate students in general health management education, appears to reside inthe emergent alliance in the area of health information management with the CIS department

Directions being taken will be supportive of needs of key health sector organizations including CDC, hospitals, payers, and health supply chain organizations.

Are they in accord with disciplinary trends?

Are the priorities reasonable and changes recommended?

We have carefully reviewed the materials presented to us and the information gained in the course of our two days on campus. We believe that the long term viability and vitality of the Institute, if no changes are made, will be in question. We have four major areas to be considered.

The strategic plan in terms of vision, goals and objectives need to be strengthened to take advantage of resources in the university and in the Atlanta area to populate metrics and milestones associated with progress.

We strongly support the development of a PMBA concentration and support the PMBA as it is launched. A full cohort would require significant investment and should not be developed initially.

Place the bulk of effort into the development of a health information management collaborative. Given the college of business’s unique expertise in this area, this initiative has the potential to make the health informatics initiative world-class in both teaching and research

This should involve the appropriate range of actors in the business school. This should include collaborative research and research support and educational programs.

The Principal units include the Institute of Health Administration, the Department of Computer Information Systems, the Center for Process Innovation, and Risk Management and Insurance.

The Institute should become the hub for this effort.

Decide on the strategic investments necessary to support extramural funding, particularly federal and foundation support.

To achieve above we recommend hiring a minimum of three full-time tenure track and one additional full-time practice track faculty members.

Recruitment should be targeted to supporting the PMBA and the development of the health informatics collaborative. Note that our recommendation is not consistent with the all of the areas of faculty need identified in the self study.