Organization

The Stephen M. Shortell Center for Organizational Research in the Health Sector Publications

Behavioral Health

Behavioral Health Crisis Response

"Medical debt: America’s most urgent health care crisis" Webinar with Alexander Adia

October 1, 2026

Please join us on October 13th from 10:00 to 11:00 AM PST for a conversation hosted by the the Society for Advancing Business, Editing and Writing on medical debt with CHAMP PhD candidate Alexander Adia along with other expert panelists.

Program Details and Registration:

Estimates suggest as many as 4 in 10 adults in the U.S. have some form of health care debt. The resulting financial strain contributes to personal bankruptcy and prevents people from accessing health...

"Aligning Systems, Advancing Health Equity" Webinar with Dr. Amanda Brewster

September 19, 2026
Join CHAMP Co-Director Amanda Brewster on September 29th at 9:00 AM PST to discuss, alongside co-authors, her recent work "Aligning Medical, Social and Public Health Systems to Promote Health Equity".

The path to better health for all communities requires the nation’s public health, medical, and social systems to work more closely together. A new American Journal of Public Health (AJPH) supplement from the Robert Wood Johnson Foundation’s Systems for Action program presents more than a decade of research demonstrating how cross-sector collaboration leads to better...

Incomplete implementation of substance use treatment referrals in U.S. hospitals: What can be learned through a lens of decoupling?

Aryn Phillips
Hector P Rodriguez
2026
Abstract

Hospitals can play a key role in identifying and treating substance use disorders (SUD), and a process known as Screening, Brief Intervention, and Referral to Treatment (SBIRT) exists to assist with this process. However, SBIRT is often implemented in ways that minimize disruption to operational workflows; screening is performed but not referral to treatment. This pattern of hospital practices aligns with and may be indicative of “decoupling,” the symbolic adoption of new practices in suboptimal ways to comply with legitimacy pressures. This study seeks to investigate whether...

Incomplete implementation of substance use treatment referrals in U.S. hospitals: What can be learned through a lens of decoupling?

August 28, 2026

Hospitals are on among those on the front lines of the substance use disorder crisis, but a new study from UC Berkeley's Center for Health Management and Policy Research Research (CHAMP) finds that many hospitals are falling short of their potential to connect patients with treatment. Published in Social Science & Medicine, the study by Aryn Z. Phillips and CHAMP Co-Director Hector Rodriguez finds that nearly half of U.S. hospitals with substance use screening systems in place fail to consistently refer identified patients to treatment. This is a gap the authors examine...

CHAMP Founder to Receive UC Berkeley Emeritus of the Year Award

August 12, 2026

Please join CHAMP and the UC Berkeley Emeriti Association as we honor our 2026 Emeritus of the Year Stephen Shortell! Among his extensive career achievements, Dr. Shortell founded the Center for Health Management and Policy Research and was a Professor in the School of Public Health and Dean of the School of Public Health from 2002-2013. His contributions to health...

Patterns and predictors of clinician use of interoperability tools

Sadaf Ashtari
A Jay Holmgren
Hector Rodriguez
2026

Objectives

Clinicians’ adoption of interoperability tools influences care quality, but evidence of actual use is limited. We analyze clinicians’ use of outside records delivered via Epic Care Everywhere (CE), focusing on use frequency and predictors such as gender, experience, specialty, and role. Differences between pre-pandemic (2018-2019) and pandemic (2020-2021) periods are also examined to see how COVID-19 affected use of outside records.

Materials and methods

De-identified EHR metadata from UCSF clinicians (n = 1442) during pre...

Patterns and Predictors of Clinician Use of Interoperability Tools

June 11, 2026

Most U.S. hospitals can now electronically share patient records across health systems but having the capability and actually using it are very different. A new study from CHAMP affiliate Sadaf Ashtari and colleagues at CHAMP, including Co-Director Hector Rodriguez, takes a look inside clinician behavior to understand who uses interoperability tools, how often, and why.

Published in the Journal of the American Medical Informatics Association, the study analyzed electronic health record metadata from 1,442 UCSF clinicians across nearly 687,000 clinician-day observations,...

Commentary: Vertical Integration - The Upside Potential

June 10, 2026

Professor Stephen Shortell highlights in his recent invited commentary in JAMA Network Open that while the vertical integration of hospitals and physician practices is an irreversible trend driven heavily by doctors seeking financial viability, it has historically resulted in higher costs and prices without a consistent rise in healthcare quality or patient access. Because price regulations alone fail to address these outcomes, Shortell argues that policymakers must instead focus on leveraging the structural advantages of integrated health systems. He proposes a three-pronged policy...

Innovation Culture Declines Drive Exnovation of Patient Engagement Strategies in Primary Care

May 20, 2026

A new paper authored by CHAMP faculty found that nearly half of U.S. primary care practices removed previously adopted patient engagement strategies between 2017 and 2023, a phenomenon the study terms "exnovation." The study, led by CHAMP Co-Director Dr. Hector Rodriguez and published in collaboration with CHAMP Founder Dr. Stephen Shortell and colleagues at Dartmouth's School of Public Health, tracked 714 adult primary care practices over five years and found that while overall adoption of patient engagement strategies including shared decision-making tools, motivational interviewing, and...