Ms. Spence, who had started a school for troubled youths before switching to health care administration, died June 10 of cancer. She was 72 and lived in Cambridge.
At Emerson, staff members praised Ms. Spence for making a point of meeting those who worked in all manner of jobs — conversing over coffee or lunch, and seeing firsthand what equipment and staffing issues needed to be addressed.
“I think people like to work in places where they have some input,” she told the Globe then. “By now they realize that I am not checking up on their work or just yes-ing them. They know they will see some action from their suggestions.”
Inheriting a hospital with an operating deficit, Ms. Spence left a surplus when she stepped down in 1994, having increased the facility’s cash reserves and expanded its staff and service area.
During the 1991 interview, she said the impression she made on those she met was amplified by the difference between their expectations and reality.
“I can’t count the number of people who tell me how surprised they are to discover I am only 5-foot-4,” Ms. Spence said. “They have some image before meeting me that I must be a large woman, at least 6 feet. I actually think my height is an advantage in managing people because it makes me less threatening.”
She was no less determined, however, and the hospital board was sorry to see her leave.
“We wish we could look forward to another 10 years of Rina’s energetic and talented administration,” Katharine B. Simonds, who chaired Emerson’s board at the time, said in a letter to hospital staff when Ms. Spence stepped down.
She guided Emerson through a period when managed care was rapidly expanding, changing the financial landscape for health care providers.
“Whether we like it or not, our modern health care system is enormously complex,” Ms. Spence wrote in a 1992 opinion essay for the Globe. “To make it work effectively, all of us — politicians, physicians, regulators, hospital trustees, nurses, and hospital administrators — must learn better how to work with each other and to cope with very different expectations.”
Little more than three years later, she had left Emerson behind and had raised money from investors to open the first Spence Center for Women’s Health, which allowed acupuncturists and herb therapists to practice in the same facility as primary care physicians and gynecologists.
“What I’ve done is consolidate a lot of services under one roof,” Ms. Spence told the Globe in 1995, about a month before the first center opened in Cambridge. “Women spend all day serving other people. I want this to be a place where we serve them, where we make it easy for them to get their health care.”
At the time, she envisioned opening 40 or more such centers across the country, but her concept of combining traditional and nontraditional medical practices in side-by-side offices turned out to be ahead of its time.
“People liked the nontraditional practices, but didn’t use them,” she told the Globe in 1998, after selling her centers in Cambridge, Newton, and Wellesley to Brigham and Women’s Hospital, which had helped develop them.
“Whether people used them or not, having those services available was important,” she added, “because it said to the patient that this is a place that is open to trying alternatives.”
The oldest of four siblings, Rina Klausner was born on Oct. 24, 1948, in Far Rockaway, N.Y., and spent her early childhood in New York City and Israel.
Her mother, Bracha Turgeman, had been a professional dancer. Her father, Samuel Klausner, retired as a sociology professor at the University of Pennsylvania.
In the 1995 Globe interview, Ms. Spence said that watching her father spend his days reading and writing about the world helped set her on a different path.
“I never wanted to be like that,” she said. “I love the research and the information and the trends and sociological movements. But I have always wanted to be a doer, not just a watcher.”
She became fluent in French and attended Lycee Francais, a private, bilingual prep school in Manhattan.
At Boston University she studied education, graduating with a bachelor’s degree and a master’s.
After launching an alternative school for troubled youths, she returned to graduate work, studying public administration and receiving a master’s from what is now the Harvard Kennedy School.
Ms. Spence started a consulting firm and became executive director of the Commonwealth Health Care Corporation, which was formed to create a prepaid health plan for Boston’s Medicaid recipients.
“We had to cancel the program because it was way, way out in front of the trend,” she said in 1995. “Now everything is prepaid. I always say I’m about 10 years too early with things.”
Ms. Spence married Gary Countryman, a former chief executive of Liberty Mutual Insurance, in 2008.
Her previous marriages — including to Harry Spence, with whom she had two children, and William Becklean — ended in divorce.
“She was a hands-on mom, but she was go, go, go, 24/7,” said her daughter, Rebecca of Taos, N.M. “She was a strong mother in the same way that she was strong in her career. She really taught me how to be independent as a woman in this culture. My mother was 100 percent self-made.”
In addition to her husband and daughter, Ms. Spence leaves two sons, Avi Garbow of Washington, D.C., and Adam of New York City; her father, who lives in Philadelphia; two sisters, Tamar Klein of Easton, Conn., and Daphne Klausner of Philadelphia; a brother, Jonathan Klausner of New Jersey; and six grandchildren.
A private burial service was held. A public memorial gathering will be announced.
Ms. Spence, who two decades ago launched iEmily, a website that provided health information to adolescent girls, served on corporate and nonprofit boards through the years, and had been a health care consultant in the Middle East.
“In the last few years I have focused a lot on artificial intelligence, machine learning, and its implications for institutions and for health care and for the industry,” she said earlier this year in an interview posted on the website of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, on whose advisory board she sat.
Rebecca said that with such expansive work and responsibilities, even to the end, her mother “was a role model more than anything. She wasn’t a stay-at-home mom. She was the complete opposite.”
Bryan Marquard can be reached at [email protected]