ISPOR and the JSPH

For more than a decade and a half, our team from the Jefferson School of Population Health (and its predecessor department and office) has been very well represented at the annual meeting of the International Association of Pharmacoeconomics and Outcomes Research or ISPOR!!! ISPOR is the global leader in research on what works and what doesn't and all of the economic implications for pharmaceutical agents world wide. The annual meeting now draws more than 2,300 persons from all over the globe and it spans nearly a week, counting the pre-courses and related activities. Today, I think ISPOR is more important than ever as health reform and Comparative Effectiveness Research have pushed this agenda to the front page. The cost of pharma agents continues to rise, particularly in the oncology arena. We cannot continue to spend money on products without better proof of their comparative effectiveness and possible role in evidence based care moving forward. ISPOR uniquely fills this research void. This year, one of our fellows, Dr. Kellie Dudash, won acclaim for her podium presentation and came away with the prize for best new investigator---a real coup for her, and for our entire research team too. I am particularly proud of Kellie, Dr. Joe Couto and of course, Neil Goldfarb, our long time Associate Dean for Research. This is further confirmation for me that the JSPH is a national leader in interpreting the outcomes of the ACA and leads the way from an academic perspective in doing research in this arena. Our research supports the notion, covered in this blog many times, that the future means -- NO OUTCOME, NO INCOME!! DAVID NASH

Guest Commentary: Albert Schweitzer Fellowship Celebration of Service

Nicole Cobb Moore, MA
Greater Philadelphia Program Director
Albert Schweitzer Fellowship

The Albert Schweitzer Fellowship (ASF) – Greater Philadelphia Program held its fifth annual Celebration of Service on May 18th at Thomas Jefferson University. The cocktail reception that started the event was warm and buzzing as newly selected Fellows mingled with graduating Fellows, Schweitzer Fellows for Life and a host of academic and community site mentors, local advisory board members, family, friends, and funders.

The ceremony was attended by many distinguished guests and highlighted by keynote speakers, Dr. David B. Nash, Greater Philadelphia Schweitzer Program Chair and Dean of the Jefferson School of Population Health, Sally Harris, Vice Chair of the Schweitzer National Board of Directors, and Sylvia Stevens-Edouard, Executive Director of The Albert Schweitzer Fellowship.

The history of the Greater Philadelphia Program was shared by Dr. Nash, while Sally Harris gave a personal perspective on Albert Schweitzer and the U.S. based Schweitzer Fellowship. Unfazed by major travel challenges to attend this event, Sylvia Steven-Edouard disclosed how she sometimes looks at pictures or reflections of Fellows to rejuvenate her inspiration for the important work that we are doing. Each speaker shared the impact Schweitzer Fellows have on the individuals and communities they serve.

Fellows prepared posters that were presented during the celebration, highlighting their year-long Schweitzer Community Service Projects. Fellows also shared a few words about their Fellowship experience. I would like to share one particular concept that exemplifies the challenges and rewards of the Schweitzer program. When conducting a Schweitzer Project, challenges will inevitably arise, and we label these obstacles “boulders.” Learning to overcome boulders over the course of the Fellowship is one of the most important accomplishments of Schweitzer Fellows. This Schweitzer quote will help explain the symbolism of boulders:

“Anyone who proposes to do good must not expect people to roll stones out of his way, but must accept his lot calmly if they even roll a few more upon it. A strength which becomes clearer and stronger through its experience of such obstacles is the only strength that can conquer them.” -Albert Schweitzer

Throughout the initial Fellowship year, Fellows are reminded of this quote as they conduct their Schweitzer Community service projects, attend graduate level classes and continue to live extraordinary and exceptional lives as our country’s future Leaders in Service.

The celebration this year was enhanced by the first presentation of the Schweitzer-Spirited Award to Neil I. Goldfarb for his humanitarian efforts in the region and for serving as the first program director for the Greater Philadelphia chapter of the ASF.

For more information about the Albert Schweitzer Fellowship – Greater Philadelphia Program, click here.

Guest Commentary: Humana CEO Charts Course to Better Health Care

Patrick Monaghan
Director of Communications
Jefferson School of Population Health

Mike McCallister didn’t mince any words as he addressed the capacity crowd gathered on May 12 in Connelly Auditorium for the 20th Annual Dr. Raymond C. Grandon Lecture.

“We have an absolute disaster on our hands if we don’t address population health,” the Humana, Inc. chairman of the board and CEO noted. “If we don’t get ahead of this, we’re toast.”

McCallister’s talk, “A Roadmap to Creating a Real Health Care System,” touched on the unintended consequences of health reform; how real problems persist and are getting worse in the wake of reform, and how behavior change – one person at a time – can help fix our broken system. He dispelled a myth or two about what is driving health care costs (hint: it’s not insurance company profit margins), while pointing (poking?) a not-too-indirect finger at America’s collective midsection.

We’re simply not taking care of ourselves and are therefore becoming an obese nation, McCallister said, leading to diabetes and other chronic illnesses.

This came as no surprise to the health care professionals gathered for the lecture. What was surprising, perhaps, were a series of pilot programs put into place by Humana to address the issue within its own ranks. The goal is “to help people achieve lifelong well-being.” Based on some numbers disclosed by McCallister, it seems to be working at Humana.

The “Well-Being Pilots” introduced to Humana associates include:

• Personal Health Score:
- Purpose: Provide objective clinical data coupled with actionable information to drive health improvement
- Results: More than half (55%) of associates improved their individual score

• Personal Well-Being:
- Purpose: Improve participants’ sense of their own overall well-being
- Results: After five months, associates’ “thriving” self-assessment increased from 26%to 41% and “suffering” decreased from 10% to 6%

• The BiggestLoserClub.com:
- Purpose: Deliver a social, mobile and virtual weight loss pilot for associate participants who have a BMI ≥ 28 and a desire to adopt healthy behaviors
- Results: Total pounds lost for all members = 3,474.40 lbs.

• Win, Place, Show Me The Money:
- Purpose: To understand the efficacy of financial incentives in facilitating behavior change and healthy weight maintenance relative to weight loss over time
- Results: Total net weight loss across all participants = 8,657.81 lbs.

McCallister’s talk – and the pilots he outlined – received rave reviews from Thomas Jefferson University Panel Reactors Janice Burke, Rebecca Finley and Mary Schaal. They liked the idea of such programs, designed to “make healthy things fun and fun things healthy.” Such ideas need to take root across the country in order for real change to occur, noted Mary Schaal – a real health care revolution, if you will.

We’d all love to see the plan.

Humana CEO Mike McCallister to visit JSPH on 5/12/11

The Jefferson School of Population Health plays host to a very special guest this Thursday when Humana CEO Mike McCallister visits campus to speak at the 20th Annual Dr. Raymond C. Grandon Lecture.

During Mike’s tenure as CEO, Humana has gained a reputation as the industry’s leading consumer company, leveraging innovative products, processes and technology to better serve more than 10 million health plan members nationwide.

As befits an industry leader, Humana is well positioned to be responsive to the changing demands in this era of health reform as they transform their offerings to focus on prevention and wellness. The company has already begun implementing pilot programs in accountable care; I’m looking forward to hearing some of Mike’s insights on how ACOs will move from the conceptual phase to real-world application.

Moreover, Mike has personally met with President Obama to discuss health reform. It’s an honor to host someone who has the President’s ear on this key topic and we here at JSPH are thrilled and looking forward to Thursday. Hope to see you there!

The 20th Annual Dr. Raymond C. Grandon Lecture, “A Roadmap to Creating a Real Health Care System,” is scheduled for noon to 2 pm Thursday, May 12 in Connelly Auditorium in the Dorrance H. Hamilton Building, 1001 Locust Street, Philadelphia.

Guest Commentary: Translating Research into Practice for Public Health Preparedness

Tamar Klaiman, PhD, MPH
Assistant Professor
Jefferson School of Population Health

Recently, the movement toward evidence-based practice in both clinical medicine and public health has received increased attention. However, bridging the gap between science and practice remains challenging. In the field of public health emergency preparedness, science is continually evolving, making its translation into practice particularly difficult.

There are potential threats to the public’s health from various types of emergencies including natural disasters, bioterrorism, chemical accidents, and emerging infectious diseases. In just the past few months we have seen tsunamis, nuclear accidents, floods, and tornadoes cause devastation around the world. Given the very real threats to the public’s health, it is imperative that the public health system be prepared to respond to such emergencies.

Traditionally, measuring emergency preparedness has focused on capacities such as checklists and inventories of equipment and supplies; however, this only scratches the surface of creating a public health system that is truly equipped to deal effectively with emergency situations.

Researchers have been working to better define preparedness through the development and testing of rigorous metrics used to evaluate public health system preparedness. While these metrics are grounded in science and have been tested in a variety of situations, translating those metrics into action in local health agencies across the country, and globally, has been a challenge. Similar to clinical medicine, there is great variation in public health performance, and reducing variation continues to be a goal for systems improvement experts across the public health system.

Given the drastic reductions in funding for local public health agencies across the country, public health practitioners will continue to have difficulty securing the resources necessary to conduct, consume, and translate research into practice. The lack of investment in such translation could leave the public vulnerable to numerous public health emergencies, the results of which may be profound.

Guest Commentary: Health Literacy and the PPACA

Marlon Satchell, MPH
Project Director
Jefferson School of Population Health

A little over a year after Congress passed the Patient Protection and Affordable Care Act (PPACA), the United States is gradually implementing the key features of this legislation. With a timeline of approximately 5 years to full implementation, it is important to recognize the opportunity that is being given to legislators, insurers, health care providers, community groups and other stakeholders not only to reshape the health care system itself, but also to reshape the way in which health care-based information is transmitted to and understood by consumers.

Some of the milestones in the PPACA related to providing information directly to consumers, and their expected completion dates include:

• Putting information for consumers online (Implemented July 2010)
• Establishing consumer assistance programs in the US (Funding awarded October 2010)
• Free preventive care; Preventing disease and illness (Beginning 2010)
• Free preventive care for seniors (Effective January 2011)
• Improving care for seniors after they leave the hospital (Effective January 2011)
• Understanding and fighting health disparities (2012)

Evidence shows that only 12% of the US population has adequate health literacy. The US Department of Health and Human Services (HHS) defines health literacy as “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” Health literacy is dependent upon factors including communication by health care professionals, lay and professional knowledge of health topics, and the context in which information is provided. It directly affects individuals’ ability to navigate the health care system, fill out forms and documentation, locate providers and services, share their own health history, manage their medications, engage in self-care and chronic disease management, and understand health-related risks and benefits. HHS has identified the improvement of health literacy as a key goal and released the National Action Plan to Improve Health Literacy in 2010. This plan provides seven steps towards creating information that is “accurate, accessible, and actionable.”

Adequate health literacy is crucial to the success of the aforementioned milestones because these milestones involve a degree of understanding and buy-in from the patients and consumers themselves. Individuals must be able to understand the risks inherent in certain behaviors, they must be aware of the importance of preventive care, and they must know how to manage their own care, particularly after an event such as hospitalization.

Historically, some of the challenges associated with the improvement of health literacy have included a lack of funding for provider training and patient education; the breadth of institutions, services, providers and products available; and a lack of understanding of rapidly changing medical terminology, technology, and treatment.

The implementation of these components of the PPACA provides an ideal opportunity for health care providers, insurers, and others to better inform the public, and to create a foundation upon which the public can gain a better understanding of their health care. While health literacy and the challenges associated with providing information in a manner that is comprehensible for patients and consumers is not a new problem facing the American public, the PPACA provides a prime opportunity for government, health care, insurers, and community groups to develop and disseminate appropriate and consistent health care-related information enabling all patients and consumers to be better informed of their own health and health care-related information.