Four young girls pose with Sue Goldie, a MacArthur “genius” award winner, in Haiti.

Health Systems

From its inception as the world’s first School for Health Officers, HSPH has dedicated itself to bridging the latest scientific knowledge and frontline practice.

Since the 1970s, the School has pioneered studies delving into the cost-effectiveness of medical interventions. The 1979 New England Journal of Medicine article “Evaluation of Medical Practices: The Case for Technology Assessment,” (abstract) by Deans Fineberg and Hiatt, helped forge the field of medical technology assessment. Other HSPH papers and books laid the groundwork for evidence-based medicine and health decision science.

In 1988, an HSPH team was asked by Medicare officials to devise an alternative reimbursement scheme for doctors, putting physician payment on a rational basis and emphasizing primary and preventive care. A few years later, the Harvard Medical Practice Study (abstract), the first comprehensive measure of medical injuries and preventable medical errors in hospitals, propelled the modern patient safety movement with the Institute of Medicine reports “To Err Is Human: Building a Safer Health System” (1999) and “Crossing the Quality Chasm: A New Health System for the 21st Century” (2001).

In 2008, School researchers, led by Atul Gawande, joined with the World Health Organization in a Safe Surgery initiative, introducing new safety checklists for surgical teams to use around the world as a simple and effective way to reduce millions of deaths and injuries from medical errors during major surgery.

HSPH has also taken its health systems expertise abroad. In 2006, the School helped create the Public Health Foundation of India, a public/private partnership dedicated to education, policy and practice. In 2005, Sue Goldie received a MacArthur “genius” award for creatively applying the tools of decision science to combat major public health problems. In recent years, Goldie has concentrated her efforts on identifying effective and cost-effective strategies to reduce the burden of cervical cancer, the most common cause of cancer death in women worldwide.

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