Usman Khan (KU Leuven, Belgium)
Federico Lega (University of Milan, Italy)

Health Management 2.0

ISBN: 978-1-80043-345-8, eISBN: 978-1-80043-342-7

Publication date: 28 June 2021


Khan, U. and Lega, F. (2021), "Prelims", Health Management 2.0 (European Health Management in Transition), Emerald Publishing Limited, Leeds, pp. i-xiv.



Emerald Publishing Limited

Copyright © 2021 Usman Khan and Federico Lega. Published under an exclusive licence by Emerald Publishing Limited

Half Title Page

Health Management 2.0

Series Title Page

European Health Management in Transition

Series Editors:

Federico Lega, Full Professor of Health Management and Policy, Director of the Research and Executive Education Center in Health Administration, University of Milan

Usman Khan, Visiting Professor in Health Policy and Management KU Leuven Institute for Healthcare Policy (Leuvens Instituut voor GezondheidszorgBeleid LIGB), Belgium

Healthcare is currently undergoing an unprecedented period of change, which is presenting a challenge to the fundamental tenants of health management and policy established over the last decades. The differentiated nature of the change agenda and the pace of change has been such that there has been limited space or time to provide a structured or comprehensive response, or to consider at a strategic level how health management teaching and practice should evolve and develop. This then is the focus for the European Health Management in Transition series, published in association with the European Health Management Association (EHMA).

Books in the series investigate how changes to the health and social care environment are leading to innovative and different practices in health management, health services delivery and design, roles and professions, architecture and governance of health systems, patients' engagement and all other paradigmatic shifts taking place in the health context.

The books provide a roadmap for managers, educators researchers and policy-makers to better understand this rapidly developing environment.

Books in the Series:

Usman Khan and Federico Lega: Health Management 2.0: Meeting the Challenge of 21st Century Health

Axel Kaehne and Henk Nies (eds): How to Deliver Integrated Care: A Guidebook for Managers

Title Page

Health Management 2.0

Transformational Leadership for Challenging Times


Usman Khan

KU Leuven, Belgium


Federico Lega

University of Milan, Italy

United Kingdom – North America – Japan – India – Malaysia – China

Copyright Page

Emerald Publishing Limited

Howard House, Wagon Lane, Bingley BD16 1WA, UK

First edition 2021

Copyright © 2021 Usman Khan and Federico Lega

Published under an exclusive licence by Emerald Publishing Limited

Reprints and permissions service


No part of this book may be reproduced, stored in a retrieval system, transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise without either the prior written permission of the publisher or a licence permitting restricted copying issued in the UK by The Copyright Licensing Agency and in the USA by The Copyright Clearance Center. Any opinions expressed in the chapters are those of the authors. Whilst Emerald makes every effort to ensure the quality and accuracy of its content, Emerald makes no representation implied or otherwise, as to the chapters' suitability and application and disclaims any warranties, express or implied, to their use.

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

ISBN: 978-1-80043-345-8 (Print)

ISBN: 978-1-80043-342-7 (Online)

ISBN: 978-1-80043-344-1 (Epub)

List of Figures and Tables

Figure 3.1. Health Organisations and Managers in Transition. Source: Lega (2020).
Figure 5.1. In Search of New Protagonists…the Leagers.
Table 2.1. Health System 1.0 vs Health System 2.0.
Table 2.2. Evolution of Health System1.0.
Table 4.1. Health Management 1.0 vs 2.0

About the Authors

Usman Khan is a health policy and management professional with over 30 years' experience within the public, private and not-for-profit sectors. He spent a decade as Managing Director of Matrix Consulting and additionally held appointments as non-Executive Chair of Camden and Islington NHS Trust and Turning Point, the not-for-profit social care provider.

Usman has subsequently spent the last two decades focussed on European health policy. During this period, he took leadership roles as Executive Director of the European Health Management Association and subsequently the European Patients Forum. He is currently Senior Advisor at FIPRA International in Belgium and at the Good Governance Institute in the United Kingdom, as well as being a Visiting Professor in Health Management and Policy at KU Leuven.

Federico Lega, PhD, is a Full Professor of Health Policy, Management and Economics at Milan University and Director of the Research Center in Health Administration (HEAD).

Since 2020 Federico is also leading the Center for Applied Research in Health Economics, Organization and Management, at IRCCS hospital Galeazzi, Milan, Italy.

His research interests focus on health leadership, organisational design, change management and innovation in health services delivery and strategy-making and competitive positioning of pharma and medical technology industries.

Federico regularly advises leaders of health organisations and authorities, leads master and executive programmes in health management and leadership, collaborates with WHO and holds visiting roles in several universities in Europe, USA, UAE and China.

He is the past President of EHMA board and chair of its scientific advisory committee. Federico is Editor-in-Chief of the journal Health Services Management Research and associate editor of BMC HSR and MCRR. He has published 10 books and over 150 journal articles.


The best stories are always the ones that bear retelling. So it is with the frog in the pan of water. We are told that the frog who is dropped into a pan of boiling water will immediately jump for his life. However, the frog put into a pan of cold water, which is then slowly heated, will not respond to his predicament until it is too late! Likening the twenty-first century health manager to a frog may not be the most auspicious of book introductions, but it does help to set the scene on this occasion.

Modern European health systems have developed significantly over the 75 years since their inception at the end of the Second World War and have in no small part been responsible for the resultant increase in life expectancy and reductions in morbidity. So too have the cadre of healthcare managers made their contribution to improving the economy and efficiency of health systems. Yet the analogy with the frog in the pan holds, because much of the change that has been witnessed appears to have been piecemeal and reactive. Slow to react to emergent challenges such as the rapid growth in non-communicable disease and apparently unable to deliver integrated care or to reorientate care towards prevention and early diagnosis and away from reactive treatment and potentially burdensome care, European health systems and the managers running them have often appeared to be in a game of catch up.

Then came the COVID-19 crisis of 2020. Even at this point in the pandemic's progress it is apparent that it represents the most significant system disrupter that global health systems have had to deal with in more than a century. Whether such disruption is enough to persuade the frog to jump out of the pot is uncertain. Early learning suggests that evolutionary steps such as telemedicine have been fast tracked in response to the disruption to health and care services witnessed during the early waves of the crisis, whilst some long-standing barriers to organisational cooperation have been set aside in response to the call to rally around a common point of need.

The saying goes that one swallow does not make a summer, so it is uncertain as to whether the individual changes that are becoming evident will in combination come to represent the paradigm change which this book contends will be necessary for the long-term sustainability of European health systems. As a consequence, this volume remains part critique and part call to arms, with our hope being that it helps to inform, provoke, motivate and drive health managers to take meaningful steps towards the leadership role required in times of Health Management 2.0.

Usman Khan and Federico Lega

April 2021


This is the second volume in the Emerald Points Series European Health Management in Transition. The book has been in gestation for more than two years, and during its development, we have been able to draw upon the support of a significant number of colleagues and friends, who we would like the opportunity to thank.

First and foremost, our thanks go to the European Health Management Association, its Membership, Board and Executive. Without the support of EHMA this Book Series would not have got off the ground, and without the advice, comment and support of EHMA Members, this volume would not be as complete as we hope it now is.

We would also like to thank our own academic homes of KU Leuven and Milan University as well as Mark Exworthy, Siegfried Walsh, Alexandre Lourenço and Andrew Corbitt-Nolan for advice on particular chapters as well as the volume itself. Our respective partners provided much additional critical input and support for which we are grateful.

Further, much credit goes to the health leaders and managers we worked with over the years. Every research, consultancy, training programme designed, developed and conducted with them was an extraordinary learning experience. Thank you, for your trust in us, for your insights and for your collaboration.

Finally, we must give thanks to the whole of the Team at Emerald Publishing for the fantastic support they have given us and in particular to Jen McCall who ensured we got things off the ground and to Kim Chadwick for seeing us to the finishing line.