In 2017, the United States spent $3.5 trillion on health. That’s 18 percent of the country’s GDP, and almost six times more than the budget of the U.S. Department of Defense. And yet the country has some of the worst health outcomes among the world's industrialized countries.
The largest portion of health spending in the United States is for the treatment of chronic conditions, many of which are preventable with lifestyle changes. And while preventable health conditions account for 60 percent of all premature deaths, insufficient public funding goes toward disease prevention or addressing the societal and environmental factors that impact a person’s ability to be healthy.
“We want to make a difference,” said Deborah Helitzer, dean of Arizona State University's College of Health Solutions. “That’s why we’re doing what we’re doing.”
What they’re doing in the College of Health Solutions is nothing short of a total transformation. It's a daring step by a college that recognizes that innovative new approaches are critical to tackle the nation’s most pressing health challenges.
Designing from the ground up
The College of Health Solutions was originally formed in 2012 to offer students an education in health studies. It began as a collection of disparate academic units on three campuses whose faculty often worked in isolation from one another.
“The college was an assemblage of degrees, schools and programs that were broadly health-related,” said Julie Liss, associate dean for academic success and professor in the College of Health Solutions. “It felt like 'The Island of Misfit Toys.'”
Helitzer joined the College of Health Solutions in the summer of 2017 and embarked on an effort to better align the college’s mission and structure with the tenets of the university’s charter.
“ASU’s charter says that we take, amongst other things, fundamental responsibility for the health outcomes of our community,” said Minu Ipe, knowledge enterprise architect and senior fellow for leadership and institutional design. “This college had incredible strengths, but was not organized in a way to really deliver against that aspect of our charter.”
Beginning in fall 2017, Ipe and Helitzer led 300 internal and external stakeholders — including ASU faculty, staff and administration, community members and health system representatives — through an extensive process of reimagining what the college could be. An executive visioning team was created to compile and analyze data collected through the process and assemble a vision for the college.
“Traditionally, colleges don’t design themselves from the ground up,” Ipe said. “Most of the time the designs are top-down. So this was an incredible experience of faculty and staff designing the future of their college.”
Throughout the visioning process participants were encouraged to express their hopes and ideas for what the college could be and not feel bound by what it was.
“I think they (Helitzer and Ipe) gave us a lot of courage as a visioning team to be creative, to go down paths, even if they seemed kind of out-there,” Liss said.
After numerous conversations with faculty, staff, administrators and external stakeholders, a new vision and structure for the college emerged. The result is a college reinvented from every angle, by the people who know it best.
“It was an incredible way of tapping into the best ideas of the people we have here to come up with the ideas that are going to drive us in the future,” Ipe said.
Helitzer is confident that the new College of Health Solutions will be more nimble, collaborative and impactful.
“The way we have restructured the college, we are empowering the faculty, students and staff to take ownership,” Helitzer said. “It’s engaging people in different ways than is traditional.”
Connecting silos to facilitate collaboration
The visioning sessions revealed that improved internal collaboration and better streamlining of courses and services could allow the college to have a greater impact on population health. To that end, the primary functions of the college have been centralized, and all schools and departments have been disestablished.
In their place, translational teams and affinity networks offer students opportunities for specialized study on real-world health topics. Academic degree programs remain, and new degrees and certificates are being developed with the input of faculty from a variety of disciplines throughout the college.
“There’s so much redundancy when you have programs that are founded on the same set of knowledge,” Helitzer said.
The new structure capitalizes on the diversity of faculty expertise and the college’s underlying strengths. It encourages greater collaboration between faculty, students and community partners around important health issues.
“There’s always going to be silos of activity — that’s just the way humans are,” said Scott Leischow, professor and director of translational science in the College of Health Solutions, and member of the executive visioning team. “But what we need to do, at minimum, is connect the silos — and better yet, create interconnected teams that evolve as needs change. And that’s what we’re trying to do here; facilitate collaborations in functional ways so we can do a better job of science, of working with communities, and just as importantly, educating students.”
Translational teams connect research to real-world solutions
One of the more significant and highly anticipated concepts that emerged from the visioning process is translational teams.
Translational teams are self-organized groups of faculty, students and community partners who are dedicated to advancing research and knowledge on a significant health topic.
Working collaboratively across academic disciplines, inside and outside the college, and with community partners, translational teams will develop innovative solutions to costly and complex system-level health problems.
“We will be a college that can work at the speed of real problems in the real world, versus working at the speed of traditional academia, which is slow,” said Chris Wharton, assistant dean of innovation and strategic initiatives in the College of Health Solutions, and a member of the executive visioning team.
Translational teams will engage in research, using biomedical research, clinical trials, behavioral and policy interventions, and analysis of big-data resources and technology innovations, with the goal of having a major impact in the space and shortening the cycle from discovery to implementation.
“Most innovations take 17 years between the time they are discovered and the time they are used,” Helitzer said. “We can do it at a much faster pace because we already understand the science.”
Students in the College of Health Solutions will have the opportunity to spend their entire college career participating on a translational team, providing them with unprecedented opportunities in research, teamwork and problem-solving.
In the past, students began their experiential learning in their sophomore or junior year. The new model has them beginning immediately.
“We thought, let’s have students out there right away,” Wharton said. “Get them learning about a potential area they want to have a degree and career in. They’ll get as much experience and learning out in the field as they could in the classroom.”
As a participant on a translational team, students will build relationships with faculty and community partners and gain hands-on experience in their chosen field.
“The community partners we talked to said, ‘We care less about what the students are learning in terms of the discipline-specific content, at the undergraduate level, and more about critical thinking, ability to interface with data, communication, problem-solving, leadership skills,’” Liss said. “It was clear that the community wanted our students embedded in their organizations and businesses so that they can train some of those skills in experiential learning.”
Already, translational teams have been formed around the following topics:
- Autism spectrum disorder
- Hearing loss in adults: Communication, connection and community
- Value-based payment for oral health in Arizona
- Improving language outcomes in children with developmental disabilities
- Metabolic disease
Affinity networks focus on methodology and practice
In addition to the formation of translational teams as a means to advance health discovery and provide students with practical experiences, the college is introducing affinity networks to support the teams.
“The notion of affinity networks is built on the premise that collaboration and team efforts are fundamental to what we do,” Leischow said. “The affinity networks are collaborations that are focused on interests pertaining to methodology or practice. They are not tied to addressing a particular health problem.”
Affinity networks consist of faculty, staff and students who are of similar mindsets, use similar research or educational approaches and methodologies, and who have a common interest. Topics addressed by affinity networks will be varied; one could work on student success and retention, while another looks at health disparities and inequity.
“We recognize that no health problem can be solved by one group of people or one discipline,” Helitzer said. “So the whole idea is that this new model is really going to improve the way we address health and health care.”
An affinity network that is already established is the Health Policy and Equity Network, which seeks to reduce health disparities and effectively translate evidence into policy by engaging with community members and policymakers and bridging silos among these stakeholders.
A culture of risk and innovation
Ipe credits ASU’s culture of innovation and high tolerance for risk as linchpins in the success of the redesign process, in addition to Helitzer’s leadership style.
“It is ASU’s culture of innovation, and the recognition that we need to constantly adapt and evolve, that I think allowed a process like this to even happen,” Ipe said. “ASU’s culture allows people to go off and think about big changes, and then the institution’s leadership supports that fully.”
It’s a unique culture in the world of higher education, one that isn’t lost on Helitzer. “I’m an out-of-the-box thinker, and I feel like I’ve been given a gift to lead these very important changes,” she said.
“The way Deborah led this process allowed it to be what it is,” Ipe said. “She came in with a vision, but she was willing to put that aside to let this process become what it is. And in doing so, she gave space to her colleagues to come up with something that was so completely different.”
Poised for impact
The disestablishment of academic units, the streamlining of academic programs, and the creation of translational teams and affinity networks are outcomes of a vision formulated entirely from the ground up.
Given the space to think freely and dream big, the executive visioning team developed one of the most innovative models for a college in the nation.
“I’m excited for the possibility this gives ASU to make a significant and lasting impact on the health outcomes of our communities,” Helitzer said. “I look forward to all that we will accomplish together.”
Top photo: Dean of the College of Health Solutions Deborah Helitzer (middle row, second from the left) shows off her ASU pitchfork with students from the college. Photo courtesy of Shelley Marie Images