New Directions in Healthcare Management
Katharina Janus has healthcare management in her blood: she grew up hearing stories of her great-great-great aunt, who founded and managed a hospital in Germany in the 1800s. “I was guided by her spirit of entrepreneurship, of active involvement in patient care, of making improvements within the setting you work in,” she says. “It made a big impact on me when I was young and trying to decide what to do with my life.”
Family history and an insatiable curiosity led Janus to where she is today: a founder and director of the Center for Healthcare Management at Columbia, a consulting, research, and convening organization whose members include some of the healthcare industry’s brightest minds. Janus also holds two faculty positions that span oceans: she’s an adjunct associate professor of Health Policy and Management at the Mailman School of Public Health and a professor of Healthcare Management at a university in Germany.
Starting out her career working in a hospital system in California, Janus found herself asking questions constantly. Seeking the expertise and experience of her co-workers, bosses, and leaders at other hospitals, she wanted to find out: What in the system works—for patients, for doctors, for insurers? What doesn’t? What moves people to get the care they need? Janus’ questions—and the answers she dug up—served as the basis for her first forays into research and later inspired her to get her PhD.
Now, as she spearheads the Center for Healthcare Management, she’s still asking questions. “Managed care is more than just the ‘magic triangle’ of quality, cost, and access—it’s more refined and holistic,” says Janus. “We have to take the next step, which is to include the perspectives of all the parties involved: patients, providers, and payers.”
Capturing insights from all these different players in the healthcare industry is a central focus area for the Center. Its expert members are diverse, too: known as the “Care-Tank,” their resumes include backgrounds working in hospitals, universities, insurance companies, and more.
“My goal has always been to bring the best minds together, no matter where they come from,” says Janus. “The Care-Tank is a cross between a think-tank and a do-tank. It grew out of my past collaborations with people from very different organizations, from all over the world, which is unusual for this field.”
Many of the questions Janus and the Care-Tank have tackled recently are ideological ones: they are working toward a better understanding of the underlying philosophies of healthcare systems around the world. In the United States, for example, the major focus is on excellence in care—but that care may not be available to all. In the United Kingdom, the emphasis is less on top-notch quality of care and more on providing care for everyone.
Understanding country philosophies provides a foundation for understanding successful elements within the system; Janus has learned that one country’s system can’t be imported and imposed on another. “In one of my first interviews with a hospital CEO, he told me something that’s stuck with me: culture eats strategy for lunch every day,” says Janus. “Change has to be aligned with ideology.”
In addition to learning about broader systems, Janus also looks below the surface to find valuable insights from specific organizations or individual hospitals that can be transferred elsewhere. Identifying and sharing lessons on things like how best to motivate doctors, implement IT innovations, or work with insurers, is a major part of the Care-Tank’s annual forum.
“I started organizing the forums because I was bored with traditional conferences,” says Janus. “We created a new, very interactive format—we call it a Knowledge Party, a dinner party with content.” In keeping with the spirit of a Knowledge Party, you won’t spot a single PowerPoint on the forum’s agenda—they aren’t allowed—instead, there’s a high premium on face-to-face conversations.
Now in its fifth year, attendees of the 2016 Forum, which takes place in Berlin on June 9-10, will focus on planning for the future of the global healthcare industry. As ever, Janus has big questions she wants answered: What will healthcare look like in 2026? How can we build a roadmap to improve how we organize, pay for, and deliver care?