Faculty Spotlight - David Hutton
David Hutton holds a Ph.D. from Stanford's department of Management Science and Engineering with a focus on health policy modeling. Prior to joining Stanford's Ph.D. program, David worked for a consulting company that focused on mathematical modeling and for several Silicon Valley software companies. David's current research is focused on health policy and medical decision making. His research and influence on national and international hepatitis B policy earned him the first place prize in the "Doing Good with Good OR student paper competition" from the Institute for Operations Research and Management Science. Dr. Hutton teaches HMP 610: Cost Effectiveness Analysis, HMP 654: Operation Research for Applied Health and HMP 655: Operations Modeling.
What has been your career path in global health up until now?
My global work probably started with my doctoral dissertation work, I was looking at Hepatitis B which is actually not that prevalent here in the US, 1 in 1000 people have it but in the Asian Pacific Islander population, the prevalence is about 5-10%. It made sense to look at the cost effectiveness of the Hepatitis B vaccine policies in China. I worked with a liver transplant surgeon who had a lot of contacts in the Chinese Ministry of Health and WHO in China, we were able to share our work with them which had an influence on some policy changes for vaccinations in children. The surgeon that I worked with is still a Hepatitis B advocate and is trying to see if there are other ways we can do analyses to convince Chinese government officials to try to provide free or reduced cost coverage for treatment of Hep B and/ or find ways to convince the drug manufacturers that their prices are too high to be cost effective.
I also have supervised/advised the analysis of many students doing work globally. I worked with a master's student in Epidemiology who went to Egypt to look at the cost effectiveness of Hepatitis C screening and treatment. I published an article with a Fogarty Fellow from Guatemala who was interested in looking at the cost effectiveness of the treatment of a heart condition from a Guatemalan perspective. There is also a medical student who did data collection and analysis on cataract surgeries performed in India. She worked with this organization called the Aravind Eye Care System, a network of hospitals that provides cataracts surgeries. The founder of the Aravind hospital has said, McDonalds can consistently produce a burger at very low cost and very high quality and we want to be the McDonalds of cataracts surgeries and they have actually succeeded. Not only do they provide this to paying customers but they are provide free cataract surgeries to people who cannot afford it and part of the reason they can do that is because they are so efficient at the process.
I am working on one other project with Professor Mark Wilson where we are looking at how to optimally allocate resources for Malaria prevention. We are doing this based off of Western Kenya, looking at building a framework for modeling and allocating resources in interventions- like bed nets and spraying people's home- across the interventions and over time. We hope to start in Western Kenya and then build a framework to be used on a greater scale.
What advice do you have for students who’d like to get involved in global public health work or research?
Go for it. There is a lot to learn and contribute. You can learn from the US system, there are a lot of good and bad parts, and we want to find the best ways to take the good from the US system and the good from the other systems and find ways to both improve our healthcare system and systems around the globe. Being open minded about the different systems can be valuable and effective. For example, different countries use different methods for resource allocation. Here is the US we have a very fragmented healthcare system with a lot of different players, the UK for example is much more centralized and they have a better sense for the responsibility of budgets for overall population health. What is interesting to me is that here in the US we shy away from talking about costs, but we also realize that cost is a big problem. In the US we would prefer to sweep those cost problems under the rug and assume that they will go away somehow. In many other countries there is much more of a realization that they need to really focus on costs and because many of them have much more limited health budgets, they need to use their resources efficiently. What you might be willing to pay for health gains might be different from country to country. Here in the US we open up our wallets to almost anything but in other countries maybe it is not appropriate for them to spend millions of dollars on MRIs when they could spend that money on schools and roads instead. So, I think we can learn a lot when exposed to how different people in different countries deal with public health issues.
As students, what can we do to prepare for global health work in terms of skills or coursework?
I think the biggest thing is to be open and understand that there are different ways of doing things and be open to learn from that. Just because things are not done the way they are here in the US doesn't mean it is wrong, it is something we can learn from. We usually say global health and we think about going to Africa or very low income countries. But, I think students should be open-minded about different parts of the globe. I think it is also very interesting to look at middle income countries and even high income countries and think about what can we learn and contribute. There are certainly desperate problems in low income countries but there are many opportunities to learn from middle and high income countries. Zoe McClaren teaches a class on lower income countries [Health Policy Challenges in Developing Countries, HMP624], Jersey Liang on moderate income countries [Healthcare Organization; An International Perspective, HMP 677] and Scott Greer on high income countries [Comparative Health Policy and Management in High Income Countries, HMP 625].
I would recommend students build skills where they can contribute. In my area of research, if you were interested in cost effectiveness analysis it is good to have general economic skills, good statistical skills and modeling and analysis skills.
Are there more opportunities for students to engage in your projects, currently or in the future? What skills would they need, and what could they expect to learn?
I am always happy to talk to students [meeting in person or by email] who are interested in working on projects. Right now I am working with four different students on various projects.
What is your passion/inspiration/mission?
Maybe this ties into the cost effectiveness analysis work that I do and maybe this reflects my engineering background, but I am very interested in efficient and effective use of our healthcare resources. Here in the US we spend almost 18% of GDP on healthcare and we are getting pretty good outcomes. But health outcomes could be much better if we could use those resources more efficiently. Or think about how much more we could invest in education or better roads if we could get the same health outcomes at a lower cost. These issues are probably even more important in other countries. For, example, we can look at China. In the US, we often talk about the rise of China and how fast China is growing, but still China has a long way to go if they want have a standard of living equivalent to what we have here in the US. They need to be cognizant of how to use their healthcare dollars efficiently to get the best possible health outcomes while keeping healthcare costs low so that they can invest in improving their standard of living. There are tons of low hanging fruit where we can find ways to do things better and make tremendous cost saving and health improvements.
What is your favorite part about China?
The hospitality of the people that I have encountered there. Maybe this is part of being on a UM delegation with Martin Philbert and they treat you better but we have always been received very well and they have always been very willing and excited to work with us. The food is also excellent and the scenery is beautiful.
Learn more about Professor Hutton’s work:
- From the Department of Health Management and Policy: David Hutton's faculty profile