Tuesday, May 29, 2012

A Step in the Right Direction for Interprofessional Education

Valerie P. Pracilio, MPH
Project Manager for Quality Improvement

On May 18th, close to 250 professionals gathered together on the Jefferson campus in Philadelphia to explore ways to redefine education and practice to focus on interprofessional collaboration.

The conference, sponsored by the Jefferson InterProfessional Education Center (JCIPE), attracted key leaders in interprofessional education, including Dr. Carol Aschenbrener from AAMC and Dr. Susan Meyer from the University of Pittsburgh. There is clearly an impetus for change to bring professionals from different disciplines together to practice collaboratively for the benefit of their patients.

Both Dr. Aschenbrener and Dr. Meyer were integral in the development of interprofessional core competencies, which were released a year ago. The competencies serve as the framework for collaborative practice and set the stage for the meeting.  The program highlighted experiences of professionals working to educate and assess competency at their institutions.

A few take-home insights from the conference include:
  • Leadership is needed at the faculty level to integrate interprofessional practice  into the curriculum. Faculty leading those efforts should also represent multiple disciplines.
  • Improvement methodologies such as complexity science and TeamSTEPPS  – a teamwork system designed for health care professionals –  were given as examples of useful tools for collaboration.
  • Students are interested in opportunities to engage with their colleagues through practical experiences, including interactions with patients and opportunities to discuss clinical experiences and challenges.

Dr. Aschenbrener said, “The closer we move toward integration the less team-based care will be an option – it will become a requirement."

Interprofessional collaboration presents an enormous opportunity to learn from one another. Let’s make it happen!

Tuesday, May 15, 2012

Guest Commentary: The Many Meanings of Population Health

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

Last month, I attended the 2012 Keeneland Conference for Public Health Systems and Services Research (PHSSR). This growing body of research examines the organization, financing and delivery of public health services within a community and determines the links between the quality and performance of the public health system and population health outcomes. The conference brought together researchers and practitioners with an eye toward translating research into practice and policy through information exchange, feedback, and collaboration.

Keynote presenters at this year’s Keeneland Conference focused much of their presentations and discussion on defining population health in the context of public health systems, primary care, and the Affordable Care Act. Presenters and attendees seemed to agree that the term “population health” means very different things to different stakeholders. Public health practitioners focus their efforts toward community health, and consider the public to be the population of interest. Health care providers tend to think of population health as the health of their patient population. Insurers and employers think of population health in terms of their enrollees or employees.

The PHSSR research agenda defines the public health workforce, public health systems structure and performance, public health financing and economics, and public health information technology as its top research priorities. These closely align with many of the priorities set forward in other areas of health-related research. Although there are disparate perspectives about the definition of population health, there is no question that a paradigm shift from treatment to prevention is occurring across the United States. As a PHSSR researcher, I look forward to seeing the impact of current research on future practice and policy and ultimately on people’s health.

Sunday, April 29, 2012

American College of Physicians Annual Meeting 2012

I have just returned from an "over the top" Annual Meeting of the ACPE in San Francisco CA---over the top because it was the largest gathering of physician executives of the past seven years with more than 800 docs from around the nation, and the world. I taught the Quality Section of the Physician in Management (PIM) Series. PIM is an intensive, all day, five consecutive day immersion into the world of the physician executive. My session was closed out as we topped 160 attendees for an 8am to 430pm all day overview of the world of healthcare quality and safety. We covered the history of the quality and safety movement, evidence based medicine, practice guidelines, the culture of clinical practice and health reform. The program was very interactive and it is a real privilege for me to engage with so many emerging leaders simultaneously. It was an extra special day because our new book debuted too---HEALTH CARE QUALITY:The Clinician's Primer. I signed scores of books at the ACPE event and I hope you will go to www.acpe.org/publications and order your copy today.Finally, Dr Jim Pelegano, the Director of our Masters Program in Quality and Safety gave his lunch time talk about our program and I am confident that dozens of new applications will be arriving soon due to his enthusiastic presentation. This Annual Meeting of ACPE and the debut of our latest book made for an exciting event. I wish I could "bottle" some of this energy and give every downtrodden doctor a quick sip to perk them up and to join us on the journey to measure and improve the quality of care in our country. Once again, JSPH is at the forefront of this critical issue. DAVID NASH

Thursday, April 26, 2012

Guest Commentary: April is National Child Abuse Prevention Month

Ruth S. Gubernick, MPH

In 2009, approximately 3.3 million child abuse reports and allegations were made involving an estimated 6 million children. More than five children die every day as a result of child abuse and approximately 80% of those children that die from abuse are under the age of 4 (Source: http://www.childhelp.org/pages/statistics/).

April is National Child Abuse Prevention Month. The Blue Ribbon Campaign and Prevent Child Abuse America (PCAA)’s Pinwheels for Prevention® campaign have shifted to positive messages of supporting families and strengthening communities to prevent child abuse and neglect. But while blue ribbons and pinwheels may raise awareness, there is little evidence to suggest that health promotion alone can change behavior! As a QI Advisor, I facilitated pediatric primary care teams in implementing Practicing Safety, a child abuse and neglect prevention intervention (http://www2.aap.org/qualityimprovement/quiin/PracticingSafety.html ). We identified key strategies to help pediatricians intervene with families at risk of abuse and neglect. This work was supported by a grant from the Doris Duke Foundation to the American Academy of Pediatrics and our research identified strategies that practice teams could successfully implement. The practices we worked with as a result of Practicing Safety would:
  • Discuss crying with all new parents, not just those with expressed concerns. Help parents be aware of their baby’s temperament. Teach new parents how to swaddle their infant.
  • Screen all new moms for post-partum depression using a standardized screening tool, such as the Edinburgh, and conduct follow-up for moms found to be at risk.
  • Encourage parents to read to their baby. Practice enrollment in the Read Out And Read (ROAR) program provides free books in multiple languages and appropriate age levels that can be given to families.
  • Talk about child development at each well-child visit, starting at 6 months, to help parents understand each stage of their child’s development. This can help parents keep their perspective as their child goes through developmental changes. Discuss establishing routines, modeling behaviors and that discipline equals teaching, not punishment.
  • Provide stickers and potty charts for parents who are toilet-training their toddlers, making it a more positive and rewarding experience. Personal Note: My adult daughter was toilet trained that way and she still uses a chart and star stickers to achieve a personal goal!
When working with primary care practices I often start a learning session on the topic of abuse and neglect by describing a story about villagers who spend much time and resources rescuing babies that have fallen into the river as they flowed down to their village. Then one day a villager traveled upstream and figured out how to prevent the babies from falling into the river. I encourage us all to go “upstream” and test and implement strategies that focus on prevention! By ensuring that parents have the knowledge, skills, and resources they need to care for their children, we can help promote children’s social and emotional well-being and prevent child maltreatment within families and communities.

Ruth Gubernick is a JSPH doctoral student.

Sunday, April 22, 2012

TechSolve in Cincinnati, OHIO

This past week I had the distinct pleasure, and honor, of speaking at the TechSolve series of health policy events, at their headquarters just outside of Cincinnati, Ohio. TechSolve is a 25-year-old, not for profit, consulting company that specializes in process improvement in healthcare. According to their own materials, "TechSolve collaborates with healthcare organizations to implement business improvement solutions. These solutions reduce process variation and eliminate wasteful activities - leading to increased capacity throughout and improved patient care and satisfaction"... All music to my ears!! I spoke for four hours about the history of the quality and safety movement in our country and its direct connection to health reform under the ACA. TechSolve brought together many of its key customers and we had an awesome interactive session. They also purchased scores of copies of DEMAND BETTER and I stayed to autograph every copy. TechSolve is a gem...and I am hoping that our school will be further engaged with their ongoing work. I am also convinced that some junior staff at TechSolve will want to join us in our growing on line Masters Degree in Healthcare Quality and Safety. It's a great potential partnership for sure. Stay tuned for more news about the good work of our colleagues at TechSolve and visit them at www.techsolve.org. DAVID NASH

Friday, April 20, 2012

Guest Commentary: Connecting to a sense of purpose in Washington

Pavan Ganapathiraju

When I first joined the one-year accelerated Master of Public Health program at Jefferson, I walked in with a variety of interests. Most students you ask about me will say emergency preparedness. However, I have always been interested in health policy.

After enrolling in PBH 509: Public Health Policy and Advocacy, our class was notified of the Annual Health Education Advocacy Summit sponsored by the Coalition of National Health Education Organizations and Partner Organizations that was held in Washington, DC. The agenda for the summit included training on advocacy, discussing priority public health issues, and meeting with Congressional representatives to lobby/advocate for such issues. After hearing about it, I knew I had to take advantage of this experience; it would be a great opportunity to develop new skill sets in advocating and networking.

When I returned from the conference, I was beyond happy. Not only did I get to see the Capitol of our great country for the first time, but I had the pleasure of talking to the offices of senators and representatives from my home state of Illinois. I was skeptical at first, as were most people. As my fellow classmate Alexander Yang , who also went to the summit, said, “We have this assumption that Congressmen are these invisible people you see once in a while on television, but they actually are human.”

Alex’s cynicism is actually very true. When you walk into a legislative office and tell them you are a constituent from their district that gives you the power above them. They are actually very willing to listen to you about issues. This experience proved to me that the system works; our congressmen do listen to our concerns.

Overall, I had a surreal experience being on Capitol Hill and advocating for something I believe in. This experience was very rewarding and I felt like I had a sense of purpose. In my future career, I hope to do some more lobbying/advocating.

Any public health student at Jefferson needs to take advantage of this opportunity when it arises again.

Pavan Ganapathiraju is a student in the Master of Public Health Program at the Jefferson School of Population Health.

Thursday, April 5, 2012

Guest Commentary: A Different Perspective on Patient-Centeredness

Stephen Wilkins, MPH

Running concurrently with the recent Population Health & Care Coordination Colloquium in Philadelphia was the Fourth National Medical Home Summit, at which I was privileged to speak. Patrick Monaghan of the Jefferson School of Population Health noted in his recent post that “patient-centered care appears to finally be at the heart of the way healthcare is delivered in this country. And if it’s not, it’s certainly on the way.”

Now you would think that at a conference on the Medical Home, the care delivery model for value-based care and all things patient-centered, the topic of patient-centered care would be a topic of discussion….but you would be wrong. In fact, I was one of the few speakers that substantively addressed the challenges associated with the concept of “patient-centeredness.”

To be sure, patient-centeredness has arrived at the health care policy level. Health care markets too have discovered the benefits of being patient-centered. Like patient empowerment and patient engagement, the term patient-centered is ubiquitous in both the health care and popular media. The one place you apparently do not find things patient-centered discussed is at conferences dealing with Patient-Centered Medical Homes.

Of course there were presentations about EMRs, embedded care coordinators, population health management, and patient advisory committees. Yes, these are all prerequisites for PCMH certification– but there is nothing inherently patient-centered about any of these things. What was missing at the Summit, and from the current discourse about Medical Homes, is any meaningful discussion of what the providers of care (or the sponsors of PCMH pilots) are doing to engender a patient-centered orientation into the way they communicate with and care for patients.

Perhaps the biggest disconnect between the reality and the promise of patient-centeredness is found in the way physicians communicate with patients. As defined in Crossing the Quality Chasm, patient-centered care begins with the provider understanding the patient’s perspective, e.g., their fears, concerns, expectations, and previous health experiences.

However, many primary care physicians, including those practicing in Medical Homes, still communicate with patients using the same physician-directed style they were taught in medical school. Like the medical interview itself, a physician-directed style of patient communication does not allow much time for the patient’s story or for that matter identifying all the reasons why the patient wants to consult with their doctor. As a result, the patient is the subject of the medical exam…not an active participant.

Patient-centered communication has been the subject of research going back 30 years, including detailed descriptions of effective patient-centered communication techniques. The use of patient-centered communication is directly correlated with improved outcomes, quality, and patient satisfaction. When employed consistently over time, it probably even saves time. Yet the use of patient-centered communication in the Medical Home is not a priority for providers or accreditation agencies.

To bridge this disconnect and eventually realize the promise of patient-centered care, professionals in both the Medical Home and Population Health arenas need to focus more on the true meaning of patient-centeredness and how to integrate the philosophy of patient-centered care and the commensurate communications skills into everything we do.

Stephen Wilkins is the CEO/Founder of Smart Health Messaging, a communication firm committed to improving the quality of physician-patient communication. He is also the author Mind the Gap, a blog dedicated to the same subject. Mr. Wilkins was a contributor to Disease Management and Wellness in the Post-Reform Era, (Chapter 3 - Disease Management & the Medical Home) published in 2011.

Thursday, March 29, 2012

Guest Commentary: Advocating on Capitol Hill

Jeffrey A. Nafash

Skepticism. Nervousness. Inferiority. These are all words that came to my mind when I prepared to venture to Washington, DC to advocate for an issue on Capitol Hill. Who am I? What do I know about issues? Why would my Senator or Representative want to hear what I have to say?

But, that is just it. I do have a voice. I do have an opinion. And, what I have to say matters.

During the weekend of March 9, I was fortunate enough to be an attendee at the Mid-East Regional Conference for the United Nations Association of the United States of America (UNA). UNA members from Pennsylvania and neighboring states came together and spent all weekend preparing for an advocacy visit on Capitol Hill and learning about the needed support for the United Nations. On Monday, teams of advocates marched to their Congressional representatives’ offices and made appeals for support of the United Nations.

The “ask” (what you are posing to your legislator to support) that we had on these particular Hill visits was for the United States Congress to have continued support for the United Nations and their efforts around the world, specifically to maintain funding for necessary programs, ratifying treaties, such as the Convention on the Law of the Sea. These are key issues that our leaders need to be made aware of!

As a Jefferson Master of Public Health Student, I was surprised at how well I was prepared to talk about Global Health issues as they pertain to the United Nations. Thanks to two classes I’m taking this semester – Public Health Policy and Advocacy, and Global Health – I knew the issues and felt prepared to share my stories. We live in a great nation, which has power on the international stage, and need to compel our leaders to ensure our stance in the future. For example, can you imagine a day where American support and funding to the United Nations is either shrunk or completely defunded? The implications would be dire; the United Nations is a great peacekeeping body on the Earth. The United States’ national security and influence in international issues would become a figment of the past.

To my classmates, friends, and the Jefferson community, I would suggest that you become an advocate. Whether you agree with my trip to Capitol Hill or not, pick what interests you and be a voice. Note that not all advocates are going to Capitol Hill and meeting with our Nation’s leaders. We live in a great city that is ripe with issues to be addressed by our local, city government, and at Jefferson we have the support and resources to make a difference.

Jeffrey A. Nafash is a student in the Master of Public Health Program at the Jefferson School of Population Health.

Saturday, March 24, 2012

WHYY RADIO TIMES with Marty Moss-Coane

I’m very much looking forward to Wednesday, March 28th at 10am, when I will be a guest on the acclaimed NPR program Radio Times with Marty Moss-Coane. The show is timed to follow this week’s testimony in the US Supreme Court regarding the constitutionality of health reform (known as the Affordable Care Act), particularly the individual mandate to purchase health insurance. Joining me will be the constitutional scholar Professor Theodore Ruger from the University of Pennsylvania and one of the nation's top political reporters, Dick Polman.

Although I don’t have the expertise to comment as to the constitutionality of the individual mandate, without it we cannot cover an additional 32 million Americans who do not currently have health insurance – it is really that simple. Also, the conversation about the mandate just obfuscates the real issues – we need to rationalize the approach to medical care by paying for value, not volume, reduce medical error and coordinate care. Most importantly, we need to practice population health by engaging in more preventive care and create incentives to change unhealthy behaviors. It promises to be an interesting dialogue…I hope you will have an opportunity to listen, and perhaps call in to share your views.


Monday, March 12, 2012

Guest Commentary: Reflecting on The Twelfth Population Health and Care Coordination Colloquium

Paul Terry, PhD

There were two intrepid features of The Twelfth Population Health and Care Coordination Colloquium that I found refreshing. First, the notion that population health and care coordination leaders can leave their respective worlds to present each other with a cogent case for better integration certainly is timely.

As much as one presenter joked that an ACO is an HMO misspelled, I’d venture that most who chose this conference came with an abiding belief that improving population health while reforming health care delivery are overlapping, if not mutually dependent, movements that will require the kind of transformative leadership Dr. Nash brought to this discussion. The ACO movement may eventually be viewed as the turning point for collaboration between public health and medically trained leaders.

Second, I appreciate that this was a colloquium, Latin for discussion, not a conference. An open sharing of ideas will be required if we are to discern what components of an ACO can foster innovation and avoid ACOs becoming HMOs warmed over.

My presentation at the colloquium focused on the role of financial incentives and the policy issues emanating from section 2705 of the health reform act, which provides for medical premium reductions for employees attaining a health standard such as a healthy BMI. I’ve published elsewhere on “progress based incentives” which StayWell believes represent a fairer and more effective strategy for supporting behavior change than the outcomes-based approach enabled by this new legislation.

It was easy to exchange ideas about the best use of incentives for employer health management programs in my session because we had examples to work from provided in presentations earlier in the day. The medical director from Perdue Chicken disavowed use of incentives in his employee health programs and asserted that his 80% participation rates were a function of smiling nurses and a caring, high-touch approach. He acknowledged the chickens in their “disassembly plants” weren’t quite so lucky. In contrast, a human resources leader from ARAMARK food services described how incentives increased health assessment participation rates to 60% from 20%. Though she didn’t explain whether they based their communications on behavioral economics principles, their employee communications about the loss of premium credits for non-participants suggest they were playing to the principles of “a bird in the hand” and “loss aversion” that I explained in my session.

Finally, Johnson and Johnson, the “granddaddy” of wellness programs, showed how their $500 incentives were yielding consistent 80-85% participation in a range of wellness offerings, which was up from the 26% participation they experienced in the years prior to incentives. For a deeper dive into the science behind best practices in the use of incentives, StayWell has produced a white paper on “The Role of Incentives in Improving Engagement and Outcomes in Population Health Management.”

Each of these progressive company presenters had inspiring success stories to share backed up with impressive metrics. But what I found most attention-getting about these presentations was that they were featured as examples of employers building a “culture of health.” Yet, all of the metrics shared were traditional participation rates, biometric outcomes, or other measures related to individual choices.

We lack a common language for describing our workplace culture of health, not to mention tools for measuring the same. Therein resides a challenge for those of us ready to embrace Dr. Nash’s daunting idea that population health can intersect with care coordination. Culture is defined by how we communicate with each other, our daily rituals, foods we eat, how we treat each other, and what we value and believe in, just to name a few potential measures.

We’re getting increasingly sophisticated about designing individual-level incentives to increase engagement. And as the ACO movement foretells, we’ll continue innovating with pay-for-performance systems and cost-sharing schemes. Our greatest challenge yet will be to define a “culture of health,” invent metrics that quantify its progress, and create incentives that compel organizations to build environments that inspire and support healthy living.

Paul Terry, PhD, is CEO of StayWell Health Management.

Friday, March 2, 2012

Guest Commentary: The Twelfth Population Health & Care Coordination Colloquium

Patrick Monaghan
Director of Communications
Jefferson School of Population Health

If there was one unifying theme to the Twelfth Population Health & Care Coordination Colloquium, hosted in Philadelphia this week by the Jefferson School of Population Health, it’s that patient-centered care appears to finally be at the heart of the way healthcare is delivered in this country. And if it’s not, it’s certainly on the way.

Patient-centered care, and the systems that are helping bring it about, were on the lips of many presenters, from Ed Wagner, Founding Director of the MacColl Institute for Health Innovation, who helped open the Colloquium on Monday afternoon, to Michael B. McCallister, Chairman and Chief Executive Officer, Humana, Inc., whose keynote, Reinventing Health Care: From Treating Sickness to Creating Well-Being, kicked off Day Two of the three-day conference.

Dr. Wagner spoke of medical practices focusing on methods to help patients become effective self-managers in controlling chronic diseases such as hypertension and diabetes, and the key role of building effective clinical teams who can instill confidence in patients and their families to take on a more prominent role in their health care.

James E. Pope, Vice President and Chief Science Officer for Healthways, released results of the Gallup-Healthways Well-being Index for 2011 on Monday afternoon. The index measures which state’s residents have the best sense of overall well-being, based on physical health, happiness, job satisfaction and other factors that affect quality of life. The results? Hawaii (big surprise) came out on top. West Virginia, which ranked at the very bottom, has some work to do in terms of well-being.

Another highlight was the talk given by Dr. Richard Baron, who left his Philadelphia practice last year to join the Center for Medicare & Medicaid Innovation in Baltimore. Dr. Baron’s work is providing solid evidence that when medical practices follow the coordinated care model established by Medical Homes and Accountable Care Organizations, the results point toward better patient outcomes.

Here at the Jefferson School of Population Health, plans are already underway for the Thirteenth Population Health & Care Coordination Colloquium.
The hope here is that, by this time next year, patient-centered care shows even more evidence to becoming the rule, not the exception.

Friday, February 24, 2012

Colloquium Offers Introduction to Concepts of Population Health

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

On February 27-29, the Jefferson School of Population Health will be hosting the “Population Health and Care Coordination Colloquium” in Philadelphia, PA. I have the privilege of speaking during the pre-conference symposium “Introduction to Population Health.”

We are hopeful that many of our blog readers will be attending both the larger conference and preconference! In case you aren’t able to attend in person, you can participate remotely via the live or archived Internet webcast. (The webcast will be available beginning Monday, February 27.)

This conference brings together numerous stakeholders and experts in the field of population health and care coordination. The preconference session where I will be speaking will focus on introducing participants to the concepts of population health. The session is most appropriate for those new to the field of population health. During this session, participants will learn about how population health is defined and operationalized using a variety of examples from epidemiology, chronic care, health reform, and the patient perspective.

When I spoke last year, I was struck by the sophistication of my fellow speakers and the audience. The questions and discussions we had were thought provoking and interesting. I look forward to a similar experience this year. I hope blog readers will be able to join us at some or all of the Population Health and Care Colloquium!

Wednesday, February 22, 2012

A Dual Role at the Population Health Colloquium

Rob Lieberthal, PhD
Faculty, Jefferson School of Population Health

This is another in a series of blog posts previewing the Twelfth Population Health & Care Coordination Colloquium, taking place February 27-29 at the Philadelphia Downtown Marriott Hotel.

I am excited to be both a speaker and an attendee at the 2012 Population Health & Care Coordination Colloquium, previously highlighted on this blog This will be my first time at the Colloquium, so I feel like I am jumping in with both feet. It promises to be an amazing three-day program.

First, I will be speaking as part of a four-faculty-member team in the Advanced Applications in Population Health pre-conference “boot camp”. I will lead off the morning with a talk on “The Economics of Personalized Medicine and Genomics.” After my talk, attendees should be able to assess genomic approaches from the point of view of a patient and a population, critique current approaches to assessment of personalized medicine, and evaluate the economic outcomes of genomic medicine for different populations. The complexity of the healthcare system will be a theme of the Advanced Applications pre-conference, where other speakers will discuss why patients need help making healthcare choices, and how population health interventions must invovle a systems approach. I am looking forward to explaining why the economic perspective is a crucial part of the improvement of population health.

Second, I will be attending a number of sessions featuring national leaders in population health. There are two sessions that I am especially looking forward to:
  • The health plan panel on Monday evening will bring in speakers from four major health insurers, who will continue to play a critical, and expanding role, in population health management under health reform.

  • Wednesday morning will feature a closing keynote from Chris McFadden, who I first met as a speaker at the JSPH Health Policy Forum . Chris and his partners are putting real money on the line when it comes to health care, so I am sure that his perspectives will be informed by a keen eye for where the emerging areas of opportunity in health care lie.

I am very much looking forward to the full experience at the Colloquium. I hope that my colleagues will help me to refine my own ideas, give me new ones, and introduce me to new partners. I am also looking forward to having a little fun, both at the Sunday night book club and the group fitness classes I see peppered throughout the program. It will be a packed schedule, and I hope to see you there!

The Twelfth Population Health & Care Coordination Colloquium will be February 27-29 at the Philadelphia Downtown Marriot Hotel. To register, or for further information, www.PopulationHealthColloquium.com, or call 800-503-7439.

Friday, February 17, 2012

The VHA Annual Clinical Meeting 2012

I have been totally immersed in the VHA Annual Clinical Meeting in Miami FL for the past two days. It is one of the most stimulating meetings of the past year. Peter Pronovost did an outstanding job connecting DO NO HARM to the real work of reducing catheter associated infections. He got raucous applause. My panel comments focused on the book WHERE GOOD IDEAS COME FROM by Steven Johnson. I told the audience that our School of Population Health was all about "adjacent timing"---the notion that good ideas really do take a long time to come to fruition. We were ready to go to create our school because of 17 years of previous hard work in health policy!! Steven Johnson himself was stimulating and provocative claiming there really is no eureka moment. Other faculty pointed out how far we still have to go to get the kind of cultural change necessary to improve the quality and safety of care.The final speaker, Tom Goetz, is focusing on his book about prevention and wellness----he believes, as do I, that the patient is the source of control. Tom is the EDITOR of WIRED and he knows at a visceral level what he is talking about as a real leader of on line learning. The VHA is a national leader for improvement and I am confident that they will continue to make great headway in changing how we practice to reduce error and improve outcomes and lower costs, all at the same time. HATS off to the VHA for a job well done. I look forward to learning more about their newly funded Hospital Engagement Network, or HEN---one of 26 CMS funded national networks for improvement. Finally, all the attendees got a copy of my book DEMAND BETTER and I signed copies until my hand hurt. A great policy day all around!! DAVID NASH

Friday, February 10, 2012

Guest Commentary: Systems Engineering for Population Health

James F. Pelegano, MD, MS
Program Director
Master of Science in Healthcare Quality and Safety/Management

This is the first in a series of blog posts previewing the Twelfth Population Health & Care Coordination Colloquium, taking place February 27-29 at the Philadelphia Downtown Marriott Hotel.

When we use the phrase “systems engineering” it is not unusual to immediately jump to a manufacturing context. However, the operational approach to population health requires that we engineer systems that bring us a measurement of the health outcomes within a population so that we can more appropriately select our interventions and construct policies that allow us to standardize and analyze our care of specific populations.

The “systems” of which we speak involve multiple components that work together to achieve the goals of evidence based high quality care. During the preconference presentation, Advanced Applications in Population Health, of the Population Health and Care Coordination Colloquium we will be using a defined population, neonates, to illustrate these components.

In order to provide an operational understanding of the basic principles, we will use actual clinical cases and data to illustrate how IT systems, international benchmarking, data analysis, outcomes trending, standardized care and focused peer review all combine to create these essential clinical systems. By looking at a specific population we can better understand how these various components work in coordination. We will also look at the interfaces of the various components to better understand what is required from each of the specific parts of the system with respect to information flow and to overcoming specific barriers to success.

The focus on a well-defined population will allow us to be very concrete in our approach and will provide a basis for approaching other well defined populations.

Thus, the learning will be transferable to the development of other clinical systems within these other populations. The participant will leave with an understanding of how these systems are constructed and operationalized at the population/provider interface.

It is only by engineering at this population/provider interface that we can be successful in translating theory into practice and thus impact the determinants that influence the outcomes distribution in the population.

The Twelfth Population Health & Care Coordination Colloquium will be February 27-29 at the Philadelphia Downtown Marriot Hotel. To register, or for further information, www.PopulationHealthColloquium.com, or call 800-503-7439.

Thursday, February 2, 2012

Guest Commentary: Third Annual Schweitzer Day of Service – North Philadelphia

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

"I don't know what your destiny will be, but one thing I know: the only ones among you who will be really happy are those who will have sought and found how to serve." - Albert Schweitzer

The Albert Schweitzer Fellowship (ASF)’s Greater Philadelphia Schweitzer Fellows Program held its Third Annual Day of Service on Saturday, January 21st at the Zion Baptist Church’s Educational Annex/Community Center in North Philadelphia.

Thirty-two volunteers—including current and potential Schweitzer Fellows, friends, family members, and 10 students from Youth Build Philadelphia Charter School—braved the snowy weather to scrap, sand, and repair the church’s fellowship hall (a space that helps to facilitate the church’s health and social service programming).

From replacing broken light bulbs to painting the walls with paint generously donated by several local businesses, the volunteers worked from 10 am to 4 pm to revitalize the 49’ by 59’ hall.

The volunteers’ efforts were lauded by Zion’s Cornelius D. Pitts, PharmD, who serves as a site mentor for current Schweitzer Fellow Lawrence Onishi (who is working to expand the church’s health literacy offerings).

“I just want to directly thank you for your time, compassion and dedication in providing such heartfelt assistance,” Pitts told the volunteers. “‘Service with joy’ is the phrase that came to mind for me … and that is what we are all called to. I suspect that [this service day], although admirable, is only a slight indication of the path you've chosen to follow in your lives, as is the mission of the Albert Schweitzer Fellows program. The energy you expend in these efforts will inspire others to do the same... and that is how the world will be changed for the better.”

For more information about the Greater Philadelphia Schweitzer Fellows Program, visit www.schweitzerfellowship.org/philadelphia.

For photos of the service project, go to http://www.facebook.com/media/set/?set=a.10150541197031728.376273.72710636727&type=3

Sunday, January 8, 2012

Population Health Colloquium 2012 in Philadelphia

The 2012 Population Health Colloquium will be the biggest and the best ever!! All of the major policy leaders in our field will be coming to Philadelphia from February 27through the 29th at the Marriott Convention Center Hotel. Outstanding speakers including Mike McCallister from Humana, Peggy O Kane from the NCQA, Richard Baron from the CMS Innovation Center and Ed Wagner from the Group Health Cooperative will headline the program. We will review the impact of health reform on our delivery system and the push toward practicing a different kind of medicine--namely, population based care. In addition, at two special pre conference workshops,key faculty from the Jefferson School of Population Health will be presenting on topics such as "Population Health as a Foundation of Health Reform" to "The Myth of Consumer Choice-- What will take its Place?". Finally, at a unique Sunday Night Book And Author Event, just prior to the Conference on February 26th, five nationally prominant authors will be speaking about their award winning books including DAVID ANSELL from Rush in Chicago discussing his book, COUNTY--Life and Death and Politics at Chicago's Public Hospital. For more information log onto www. PopulationHealthColloquium.com. I sure hope to see you there!!! DAVID NASH