Guest Commentary: Translational Research for Actuaries

This is the first of a series of four blog postings summarizing issues, methods and results from current research in the Center for Value in Healthcare. We will be presenting a JSPH Forum entitled “Translating Research into Policy and Practice” on January 11, 2012 with more details of the Center’s work.

Rob Lieberthal, PhD
Faculty, Jefferson School of Population Health

I will be talking about my research project funded by the Society of Actuaries (SOA) at the JSPH Center for Value in Healthcare Forum on January 11, 2012. The project is “Validating the PRIDIT method for determining hospital quality with outcomes data.” The goal of our project is to determine hospital quality using publicly available Hospital Compare data.

After funding the project, the SOA organized a project oversight group, comprised of practicing actuaries volunteering to serve the profession by supervising our research project. Actuaries are the professionals who are responsible for calculating and managing the cost of health insurance. They have always played a crucial role in benefit design. In the era of managed care, that has meant more and more involvement in creating and managing provider networks.

Given their professional interest, the oversight group was intrigued by my prior findings and was interested in using these findings to reduce cost and increase quality. I explained that, from my perspective, one of the barriers to putting my results into practice was that healthcare professionals did not seem interested in using my results. Their feedback was that my method might be inaccessible, even to a group as mathematically inclined as actuaries.

As a result of our discussions, our work has become literally translational: they are helping me translate my work from my language into theirs. If we can pair actionable results on hospital quality with an instruction book for how to use the PRIDIT method, we can increase the chance that actuaries put our findings and our methodology into practice.

I have previously noted that actuaries could be the ideal group to bridge healthcare quality and safety data with financial and nonfinancial incentives. This could drive patient behavior and improve population health. This is very much a work in progress, so stay tuned for an update from me on January 11, 2012!

The American Israel Commerce Committee Meeting

This past week I had the privilege of playing co host for the American Israel Commerce Committee meeting on "Healthcare Information Technology". Nearly a dozen amazing young Israeli companies came to Philadelphia to make their "pitches" to raise money AND awareness about their work in the IT sphere of healthcare. Each firm did an incredible job discussing their software and related new tools for building a better infrastructure in our crazy business. The meeting was "bookended" by two panel discussions that I moderated. The first panel of experts tackled the question of "Funding Opportunities" and the second panel discussed "Power Collaborations". The keynote luncheon talk was delivered by David Jones Jr., my colleague and friend. David is the managing director of Chrysalis Ventures in Louisville KY and for many years, has been a driving force behind HUMANA as an active Board Member.

The conference drew more than 100 persons from around the Delaware Valley and the sprited conversations were peppered with Israeli wit and wisdom too. For such a small country Israel produces a disproportionate share of leading IT firms and being able to bring them to our home town was a real treat. The mission of our School of Population Health, and the mission of the AICC, were totally aligned for this important event. To learn more go to www.americaisraelchamber.com. We would welcome your feedback about any of the firms, or the content of the two panels as well. DAVID NASH

Guest Commentary: Reflections on the 2011 APHA Conference

From left, Kevin Scott, MD, Manisha Verna, MD,
MPH, and Rob Simmons, DrPH, MPH, MCHES,
CPH, director of JSPH's Master of Public Health
Program.


Kevin Scott, MD
Instructor & Primary Care Research Fellow
Department of Family & Community Medicine
Thomas Jefferson University

I was fortunate enough to attend the annual American Public Health Association (APHA) conference for the third time and, with each visit, I am more impressed (and less overwhelmed!) by the diversity and quality of programs that are offered.

As a family medicine physician and primary care research fellow interested in improving access to care for marginalized populations, I came to the meeting with a few goals.

First, to take part in the activities of the Refugee and Immigrant Health Caucus and to (hopefully) earn a spot within the Caucus' leadership.

Second, to attend sessions addressing the capacity of Community Health Workers and experiences with their deployment in different environments.

Finally, I also was looking forward to the sessions detailing Canada's truly enormous Housing First project, which evaluated different programs in 5 cities in Canada.

I developed these goals prior to the meeting because the breadth of interesting content can paralyze you unless you are ready for it (and have a plan!).

I was also happy to have the opportunity to meet many luminaries in the public health world (former APHA president, high-level mental health researchers, many CA researchers) while working the Jefferson School of Population Health booth with Rob Simmons, director of Jefferson’s Master of Public Health program. Additionally, I had the opportunity to meet a graduate of the program and her mentor who had piloted some very exciting work with same-site legal services (a program that I hope to adapt for use with the refugees we see in family medicine).

I was elected secretary of the Refugee and Immigrant Caucus and am excited for what promises to be an exciting year of developing high-quality programming, improving intra- and inter-caucus coordination, and planning additional activities before the next annual meeting.

Fortunately, I was also able to network with a number of service providers and fellow researchers in the areas of homelessness, refugee/immigrant care, and community health worker deployment. Hopefully, this momentum will help springboard our efforts to develop a national refugee research network as well as local efforts to evaluate the efficacy of a hybrid community health worker-patient navigator.

Just like the meeting itself, it's hard to contain the entire experience in one short piece, but to summarize, it's a great way to share your research, meet others in your field, learn about cutting-edge techniques, and re-charge your inspiration battery!

Manisha Verna, MD, MPH

Attending the 2011 Annual APHA meeting – my first – was an exciting opportunity.

My capstone project was accepted as an oral presentation in the vision care section (Knowledge and perceived barriers about diabetic retinopathy among patients with diabetes in an urban academic environment). There was a discussion about the availability of onsite optometry in primary care practice- benefits and costs associated with it. This is a take home message to improve the practice.

Volunteering at the Jefferson School of Population Health booth was quite fascinating, as it allowed a chance to meet and greet like-minded people. Discussing our school’s educational programs, the faculty and courses with students and public health leaders provided a venue to feel proud of the Jefferson community.

I met with one of our new faculty members – Dr. John Oswald – who teaches a course on International Health, a subject of great interest to me. I volunteered to give a guest lecture on the health care system of India, and now will also give presentations on some other developing and developed countries (China, Russia, Cuba, and Congo).

I highly recommend attending the APHA meeting; it provides a doorway to meet the public health workforce and learn from their experiences.

Guest Commentary: Translating Public Health Systems Research into Practice

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

As part of the On Saturday, October 29, I attended a Public Health Systems and Services Research (PHSSR) lunch n’ learn in Washington, DC, an affiliate meeting of the American Public Health Association’s Annual meeting. The lunch n’ learn focused on translating research into practice.

The field of PHSSR seeks “to explore the impact of specific public health strategies on the quality and performance of the United States public health system.” PHSSR is distinct from -- but related to -- the established field of Health Services Research (HSR), which has traditionally focused on the delivery of medical services.

Those of us who are trained researchers talk a lot about translating our research into practice; however, for most scientists it takes over 15 years for our work to be used practically. This session gave specific examples of how PHSSR is impacting the work public health agencies conduct across the country. One example was the use of social networking analysis, which can help us better understand how organizations work and pinpoint areas for improvement. The results of social network analysis include depictions of how different departments communicate and cooperate. This work allows managers to see where problems lie in their departments and address them. Data collected before and after a social network analysis show that the analysis leads to measurable improvements in health department activities.

It is helpful for me to attend similar sessions periodically to remind me not only how important research is to practice, but to find inspiration in what others are doing. I am hopeful for the future of PHSSR and its impact on public health practice!

Guest Commentary: Reflections from the SOPHE 62nd Annual Meeting “Leveraging the Power of Health Education: Changing Systems”

Rob Simmons, DrPH, MPH, MCHES, CPH
Clinical Associate Professor
Program Director, Master of Public Health
Jefferson School of Population Health

I had the privilege to participate in the 62nd Society for Public Health Education (SOPHE) Annual Meeting in Washington, DC last week. Over 400 professional health promotion professionals and students attended the meeting. The theme was “Leveraging the Power of Health Education: Changing Systems”. Some of the highlights included:

• An opening presentation on the National Prevention Strategy by the US Department of Health and Human Services (HHS) Secretary Kathleen Sebelius, who presented the first-ever HHS 2011 Healthy Living Innovation Awards. National and local organizations and agencies were honored for their efforts in preventive health programming in such categories as healthy workplace for large and small employers, non-profits, local and state government, schools, health care, and community health initiatives.

• Transforming Systems for Health presentations by Karen Lee, Director of New York City’s Healthy Eating and Living Initiative, and Larry Cohen, Executive Director of the Prevention Institute in Oakland, California.

• Seeking Synergy to Enhance Health, Well-Being, and Performance presentation by James Prochaska, developer of the Transtheoretical Model of Change (Stages of Change).

• The Perspectives of a Grassroots Advocate presentation by Michael O’Donnell, noted national leader on workforce health promotion and editor of the American Journal of Health Promotion

• Panel presentation on Building Capacity of Health Professionals and Workers for the 21st Century featuring Dr. Jim Plumb of the Jefferson Medical College, Department of Family and Community Medicine on Jefferson’s innovative Population Health College within the College program for Jefferson medical students.

In addition to all the excellent sessions and networking, I was able to participate in a pre-conference workshop on evaluation of health promotion programs and policies by Richard Windsor, noted national and international behavioral science researcher and author of Evaluation of Health Promotion and Disease Prevention and Management Programs: Improving Population Health Through Evidenced-Based Practice. We look forward to working with Richard here in Philadelphia as Jefferson will be part of a national research study on the use of smoking cessation for pregnant women in our clinical practices over the next few years.

A wonderful, entertaining closing session was led by Todd Park, Chief Technology Officer for the “Open Government Initiative” for the US Dept. of Health and Human Services. Todd, a founder of the innovative data company, AthenaHealth, described the plethora of health initiatives using data technology and innovation linking data developers and health information users in the creation of open data sources for health. Todd led us through the maze of rapidly changing health data innovations, including “Blue Button” technology, health quality indicators, health data “Paloozas”, Health 2.0 developer challenges, and health education initiatives and games such as “Asthmapolis” and “Farmville.” The national link is www.healthdata.gov.

Having been a member of SOPHE since 1974 and having served as its national president and treasurer, I could not have been prouder to experience the tremendous growth of this national organization representing the field and profession of health promotion and health education. I look forward to SOPHE’s Annual Meeting next year in San Francisco and The Silicon Valley with its expected theme of advancing technologies to promote health.