By Elita Wong. Painting for health care reform, using the McDonald’s business model eradicate needless blindness, and providing affordable maternity care to the poorest women in Kenya through a voucher system—what an unexpected showcase of innovation led by FastForward Health’s (FFH) Andre Blackman and David Haddad at the fourth annual Social Media Week in New York City. This year’s theme was “Empowering Change through Collaboration.”

In health care, storytelling can personalize the human experience and serves as a mechanism of communicating new solutions, advocating for the patient, and coping with grief. This week, FFH screened three documentaries in hopes of encouraging community members to join the global conversation, and to ultimately be inspired to take action. A live twitter feed was projected throughout the evening to capture the reaction of attendees in real time.

Sight is a beautiful gift. “Infinite Vision” is a skillfully crafted film by Pavithra Krishnan, who reports on an ambitious project by Dr. Venkataswamy, or “Dr. V”, to cure blindness on a massive scale. Remarkably, two-thirds of the services provided by Dr. V’s Aravind Eye Care System, which includes over 200,000 sight restorative surgeries per year, are offered free of charge.

In India, blindness is often fatal, leaving patients reliant on their families and subject to a higher mortality rate. According to the producers, 45 million people worldwide are blind, 12 million live in India and over 80% of blindness can be prevented or cured.

The film begins with several interviews with the blind from Madurai, whose cloudy eyes indicate the possibility of a reversible condition. One woman tries to live on water for weeks at a time to relieve the burden from her family. Another man has been blind for ten years and lives in his unfinished home, relying on his daughter to feed him. “If my eyes had light again, I’d be back in the fields,” he said. “…give [money] to my family, my daughter and granddaughters. Only if I earn, they can eat porridge too.”

Dr. V, with his own painful battle with rheumatoid arthritis, began to reach out to villages in South India, and was described as understanding “the core necessities of social marketing…before the term was invented.”

He cites a fast food chain as his initial inspiration, which is certainly unconventional in the public health realm:

See, McDonalds’ concept is simple. They feel they can train people all over the world…to produce a product in the same way and deliver it in the same manner to hundreds of places. Imagine if I could produce eye care, techniques, and methods the same way and make it available in every corner of the world. The problem of blindness is gone.

The audience is able to see the organization grow rapidly from a small, 11-bed eye clinic to the largest, most productive eye care facility in the world.

In Kenya, one in every 38 women dies as a result of pregnancy. “Kadi” is a film that captures the implementation of a new Reproductive Health Output-Based Aid (OBA) Program, which enables impoverished mothers to receive antenatal services and attended deliveries by qualified health workers. It follows community health workers to the rural villages and slums, and captures two complicated births that would have been dangerous to the mother and child if they took place in their homes.

A main obstacle for Kenyans is accessing the health structure since the poor assume that they cannot afford care. This film stands out as it focuses primarily on new health care delivery and financing while still shining the spotlight on individuals and the local communities. However, since transportation was mentioned multiple times as a growing concern, the viewer is left with the impression that this program was more of a safety net for those who already have physical access to an accredited facility, while meeting the low-income standards. Although program directors mentioned that accrediting more facilities would be one direction to go, there still needs to be a short-term solution for rural mothers who are not within walking distance and without a motor vehicle.
The director gives an adequate overview of the voucher system and incites viewers to think about its challenges. Themes of efficiency, cost-shifting, and quality can be seen from a global perspective.

Fellow Disruptive Women Blogger Regina Holliday also presented a mini-documentary “73 Cents” as part of this film festival on Monday.

By Carrie Winans

The Disruptive Women in Health Care blog continually aims to encourage discussion and debate among readers about emerging issues and topics in the health care world. Historically, one of the ways that we have done that is through our weekly round-ups – that is, posts containing summaries and links to some of the big stories in health care news for the given week, with some original commentary and content sprinkled in as well. The way we see it, there is just too much happening in this burgeoning industry; it’s hard to keep up, especially when you’re busy disrupting and making headlines in the health care world yourselves. We know the weekly round-ups have been on hiatus for a while, but are happy to report that they’re finally making a comeback. Each week, we’ll be gathering some of the biggest health care news you can use from at home and abroad for posting on Wednesdays. Feel free to comment on what’s included and send us some links to articles to be considered for next week!

Has your week been too disruptive for you to keep up with the news?  Disruptive Women are on the case!  Here is this week’s round up of some of the most pressing issues here in America and around the world.

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CMS Administrator Marilyn Tavenner addressing Care Innovations Summit attendees. Image courtesy of Kaiser Health News.

“I think we would all agree that these are not ordinary times, that this is not an ordinary conference, nor is it an ordinary time in health care,” commented Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner, in her address at the first ever Care Innovations Summit Thursday. In saying so, Tavenner captured not only the essence of the problems facing our nation’s health care system and the reason that over a thousand national thought leaders, senior government officials and industry experts had gathered, but also inspiring attendees with the idea that, by being there, they had the opportunity to be a part of the solution.

Driving the day at the Care Innovations Summit, which was hosted by the Center for Medicare and Medicaid Innovation (CMMI), Health Affairs and the West Wireless Health Institute, was the notion that American innovation could solve any problem, and the thousand-plus attendees were the innovators to solve this one. Emphasizing CMMI’s founding mission of better health, better care and lower costs, speakers across sectors, industries and areas of expertise continued to echo each other’s cries that it was all possible, if people began collaborating and innovating across fields.

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For the past several years I have run this post and just as it was those years, it is this year a very important message.

By Robin Strongin. We, as a nation, have made progress and I believe Dr. King would be proud.  But our work is far from complete–particularly where health care is concerned.  Another doctor, Dr. John M. Eisenberg, a physician of tremendous stature whose life was also tragically cut short (not by an assassin’s bullet but by brain cancer) was equally passionate about the dignity of life and justice for all Americans.   Dr. Eisenberg, who among other things, served as the Director of the Agency for Health Care Policy and Research (as AHRQ was known back in the day), cared deeply about access to and the integrity of health care for all Americans– regardless of skin color.

Twelve years ago, on January 14, 2000, Dr. Eisenberg gave what is, in my opinion, a brilliant speech to the employees of the Department of Health and Human Services.  As with the past two years I want to share his words with all of you today — as a reminder of how far we’ve come, and how far we still have to go.

BIRTHDAY OBSERVANCE OF DR. MARTIN LUTHER KING, JR.: REMEMBER! CELEBRATE! ACT! A DAY ON, NOT A DAY OFF!

When I was invited to welcome you to the Department of Health and Human Service’s 26th observance of Martin Luther King Jr.’s birthday, my first thought was about how honored I was to be asked.  My second thought was about what Martin Luther King’s birth could mean to a rebirth of health care in this country.  Few have had as much impact upon American consciousness.

But what did Martin Luther King think about health care?

My colleagues and I searched through his writings and his speeches, and realized that he didn’t give speeches about health care.  Martin Luther King Jr. was confronting the basic nature of American society.  He had mountains to move–and mountaintops to climb–for this country so that today we can address the issues of high quality health care for all Americans.

If Dr. King were alive today he’d be 71 years old.  He’d be eligible for Medicare.  Like many 71-year olds, he might be dealing with a chronic medical condition–maybe arthritis, or hypertension, or diabetes.  What would he think of the health care system we have today?  What would he think of the medical care he might receive?  And what advice would he be giving the Department of Health and Human Services?

No, Dr. King didn’t give many speeches about health care.  But like the rest of society, health care had to change too.

When I was a teenager in Memphis, before the Medicare program was passed, the Baptist Hospital was the biggest in town, and the proudest of the care it gave.  But if you were African American in Memphis and you went to the Baptist Hospital, you’d go in through a back entrance.  And you’d go to a segregated ward, where you would be in a big room with about 15 or 20 other people.  And your doctor, if he was black, wold not have privileges on staff.  And the same would have been true for Dr. King in Montgomery or in Atlanta.

Dr. Vanessa Gamble, who is the new director of minority afairs at the Association of American Medical Colleges here in Washington, has documented the incredibly important role that Medicare and Medicaid played in helping to desegregate hospitals.  Medicare was a lever that lifted equity and equality in hospitals.  In 1965, our Department issued regulations madating that hospitals had to be in compliance with the Civil Rights Act–which had been passed just the year before–in order to be eligible for Federal assistance or to participate in any federally assisted program.  The passage of Medicare and Medicaid legislation that year made every hospital a potential recipient of federal funds, and therefore obligated every hospital to comply with civil rights legislation if they wanted to get paid. (more…)

By Glenna Crooks. I came of age in the “Keep on Truckin” era and like many boomers, intend to do so for decades to come. I like my independence (!) and my own desires pale by comparison to my Mom’s – who’s into her 80’s and still running circles around me.

The day may come, however, when our family may need to provide her with the support I see my friends providing to their parents. Some individuals who would like to be more independent, can’t be. The enabling systems to allow that aren’t sufficiently well developed and public policies haven’t yet caught up with the needs of older people and their family caregivers.

That’s why just a few weeks ago Disruptive Women launched Health In Place. This blogsite reported on the launch event. I recommended it as reading to catch up on and a movement to follow – and better yet, engage in.

Perhaps it was HIP that raised my own awareness and made a very small article news article jump off the page over the holidays.

It was about the Aetrex GPS Shoe (www.aetrex.com/aetrex-gps/), which uses GPS tracking technology embedded in the right heel to do real-time tracking of the wearer.  GPS tracking sends a signal to a central monitoring station to show the wearer’s location and relays that information to a tracking website for monitoring by caregivers.

Even better, caregivers can set up a geographic boundary known as a “geozone” and if the individual wanders off and leaves it, are notified via an email or SMS text to a mobile phone. Caregivers can also get emergency tracking in case they need to locate a loved one immediately.

What a wonderful application of availably technology to health and caring. I’ve written extensively about the nature of healing and healers and how our traditional definitions (which restrict “healers” to those in clinical roles) are narrow and no longer sufficiently embracing of the variety of those who contribute to our health and care.

I’m not sure if the folks at the GTX Corporation (www.gtxcorp.com) believe they are healers, but in my book, they are. Bravo to them for what they’re doing to contribute to lowering costs of care, lowing the risks associated with family caregiving and improving the quality of life for those involved.

The following is a guest post by by Dr. Olaoluwatomi Lamikanra, a Public Health Practitioner.

By Olaoluwatomi Lamikanra. Since the introduction of mobile phones in Nigeria, the number of users has increased exponentially and usage is pretty much found in both rural and urban areas.

With regards to the internet, Nigeria has about 43 million users (total population over 155 million) which far exceeds by more than double the next African country on the list-Egypt.¹

 
There are many projects associated with mobile health in Nigeria and with the exponential growth of mobile and internet users; there is an ever increasing market. Different sectors of the economy which have an impact on the health of the populace also stand to gain a lot from the introduction of mHealth initiatives. Water, Sanitation, Agriculture, Finance and Development are a few of the sectors. In Kenya, the introduction of the mPESA, a mobile phone application where moneys can be sent via mobile phones all around the country has solved the problems of money transfers. No longer do people in rural areas have to wait until someone is visiting from the city before money arrives. They receive the money as soon as it is sent from a PESA center. At a recent WaterHackathon event organised by CCHub in Lagos, one o f the tools suggested for Water development was a mobile system to facilitate the sharing of water resources in hard hit areas.²

Examples of some projects already in place include Mobile Community based Surveillance.mCBS is a mobile platform which is given to Traditional Birth Attendants to report vital maternal and child health indicators in real time using mobile phones. Using texts designed for this purpose the TBA can transmit alerts to nearby health officials who can respond immediately thus reducing delays in reaching appropriate care at a facility.³ Other mHealth projects currently being developed in Nigeria  is being collated by Ime Asangasi (@Imeasangasi- twitter handle) here.

REFERENCES:

1. http://www.internetworldstats.com/stats.htm (accessed 26th December 2011)
2. http://www.cchubnigeria.com/watermeetup (accessed 26th December 2011)
3. http://ehealthnigeria.org/where-we-work/list-of-implementations/mobile-community-based-surveillance-mcbs/

On December 6th, the Disruptive Women in Health Care® blog launched a new initiative, Health in Place™ (HIP), aimed at reframing how and where people of all ages, and across the wellness span, maintain their health, broadly defined. With an advisory board comprised of experts from within and outside health care, HIP hopes to develop an incubator for innovation to address health challenges in unconventional ways and capitalize on the potential for technology to reshape how and where we receive, and maintain health.

“If we are going to prevent the projected escalation in chronic illness, which threatens to overwhelm our health care system, we need to develop new and better ways to elevate the health of our fellow citizens. The good news is that the next frontier in consumer health and well-being is right on our doorstep – literally,” said Robin Strongin, Creator of the Disruptive Women in Health Care blog and HIP. “We crafted this new initiative to advance the next wave in consumer health and well-being, bringing the best of health care to the places where we spend virtually every hour of every day.” (more…)

By Val Jones. There aren’t too many grandmothers developing mobile health apps these days, but I met a charming one (Jill Campbell) at the mHealth Summityesterday. Jill is a 60 year-old woman from Texas who has been actively concerned for the safety of herself and her daughter over the years.

“My daughter took a self-defense class,” Jill explained, “And she was taught the ‘fight or flight’ response to escape harm. I’m 60 years old. I’m not good at fighting and not very fast at fleeing. So what’s my third option?” Jill created the WatchMe 911 app to provide the solution.

“I first started thinking about a personal alarm system before smart phones even existed. I saw that there were car alarms and house alarms, and wondered why there weren’t personal alarms. At the time I imagined that the personal alarm would go through an answering service system, but since smart phones were created, it can all be tied together in an app format.”

Jill demonstrated the WatchMe 911 app to me during our interview. It contains features such as a panic button that can be armed in advance. Two taps on the smart phone screen and a circle of friends and 9-1-1 are contacted immediately with your GPS location and an alert message. The panic button is a favorite for women who are concerned for their safety when walking late at night or in dimly lit parking lots or alleys.

The “Monitor Me” feature allows the user to schedule messages to friends in advance of a potentially dangerous situation. The message will be sent at a specific time unless disarmed by the user. This is helpful in situations where, for example, a user is out for a run without their phone and might become injured or threatened. They can set the alarm to send out a call for help to friends, with a pre-programmed description of the trail that they’re on. This feature is also popular during blind dates when users would like their friends to check in with them at a certain time. (more…)

By Pam Cipriano. We use our smart phones to manage most of our social life–calendars, communications, coupons, you name it.  So why not health care?  Perhaps you are already taking advantage of some amazing mobile health applications, or wireless monitoring devices that not only take measurements but can also report them to your health care provider or personal health record.  A renowned expert on disruptive innovations, Clayton Christensen (The Innovator’s Dilemma and The Innovator’s Prescription) who has diabetes, revealed in an interview with Health Affairs several years ago*, his methods for using his glucose meter and algorithms, mail order testing, and email communication, allow him to stay on top of his care and progress, rarely needing to go to provider’s office for care.  Even though he may be an outlier, more and more people, young and old, are able to benefit from the advances in mobile technologies.  Being accustomed to mobility, consumers are empowered by technology that liberates them from the bureaucracy of inconvenient schedules, poor parking options, laborious waiting, and mysterious fee schedules. 

Today, you can receive text messages, voice mail, or email reminders for just about anything from medications, to testing, to health tips, or appointments.  Information and help where you want it, when you want it, and how you want it are transforming the relationship between you and your providers.  Teens get help with diet and smoking cessation as well as disease management.  Elders and their care givers get live follow up and real time transmission of important vital signs through remote patient monitoring that can alert providers to developing problems at home.  Ambient assisted living systems that track movement at home, and personal emergency response systems help elders stay at home but alert others when a condition changes over time or in an emergency.

Mobile personal monitoring is getting a boost from other companies who recognize people want to be on the go, and are not held back by the need to monitor or address health needs in traditional ways.  In the next several years, Ford Motor company plans to provide “First Assist” emergency health care instruction through its OnStar system. They will provide allergy alerts based on day-to-day location indices of allergens, and glucose level monitoring alerts via dashboard applications.  Future plans also include voice requests for health information and updates, seat sensors to detect electrical heart rhythms/problems, and stress reduction responses.  Leveraging existing technologies such as GPS, telecommunications, and internet access is catapulting us into an age of ubiquitous computing where our environment is instantaneously and unobtrusively enabled by computer assisted functions. (more…)

By Hope Ditto. Did you watch the ABC News special edition of 20/20 featuring Rep. Gabrielle Giffords – an honorary Disruptive Woman if there ever was one — that aired a few weeks ago? (If not, you can view “Gabby Giffords and Mark Kelly: Courage and Hope” in its entirety here). The hour-long program chronicled Giffords’ remarkable recovery after being shot in the back of the head this past January. In particular, it focused on her — at times difficult — journey to regain her speech, which she was able to accomplish thanks in part to music therapy [exemplified in the lifelong work of Disruptive Woman and music therapy expert Concetta Tomaino, DA, MT-BC, LCAT].

According to ABC News’ Bob Woodruff, Giffords lost her speech as a result of aphasia, defined as “the inability to speak because of damage to the language pathways in the brain’s left hemisphere.”

Tomaino, the Executive Director and co-founder of the Institute for Music and Neurologic Function (IMNF), is an international authority on the clinical applications of music and neurologic rehabilitation. She has studied extensively the role of music therapy in treating aphasia sufferers.

Tomaino speaking at the 2010 Disruptive Women Holiday event -- Music and Art Therapy: A Demonstration of Healing.

As she explains, “For someone recovering from a brain injury, music can be a gateway to speech. They may not be able to speak words, but they often can sing lyrics to familiar songs.”

Prompted by the inspiring story of Giffords’ successful treatment, the American Music Therapy Association asked Tomaino to teach a full-day class about Traumatic Brain Injury (TBI) and music therapy at their annual conference (you can see a description of the class and learn more about the conference here).

The work of Tomaino and others in the music therapy space has revolutionized how doctors treat not just aphasia, but a wide range of other neurological conditions as well. An article in today’s edition of USA Today highlights music therapy treatments for other medical conditions and diseases (and includes an interview with Tomaino!). You can learn more by visiting IMNF’s Facebook page and YouTube channel.

Tomaino participated in last year’s Disruptive Women Music and Therapy Holiday Event (see a recap — including photos and video of the event – here.

By Robin Strongin. A recent report from Rock Health (Disruptive Woman Halle Tecco is their Founder and Managing Director) provides an overview of current and emerging medical sensors. These include sensors made by fitbit, BodyMedia, Basis, and AliveCor.

The report says that by 2014 – there will be 400 million consumer sensor oriented devices, comprising a $4 billion market! Disruptive Women in Health Care hopes to contribute to developements in this area through its Health in Place Initiative.

To view the Rock Health report click here.

The breast and colon cancer app are designed to provide newly diagnosed breast and colon cancer patients with personalized information about their diagnosis and are based on the My Breast Cancer Coach and My Colon Cancer Coach online tools. Basically, patients answer just a few simple questions and then get an individualized treatment guide that addresses their specific tumor type and diagnosis –leading to a more empowered patient and a informed dialogue between patients and their healthcare providers. You can check out or download the free app for iPhone here: http://goo.gl/ql1Wd or here for the Android: http://goo.gl/CMLrM.

The Ovarian Cancer Symptom Diary App will help you learn about the risks, signs and symptoms of ovarian cancer. This first-of-its-kind application allows a woman to track symptoms that could indicate ovarian cancer, and alerts her if she should make an appointment with her doctor for further testing. To download app click here.

By Robin Strongin.  Some women are not afraid to celebrate their age.  Today, our nation has something, and someone, wonderful to celebrate.  The Statue of Liberty, ‘Liberty Enlightening the World,’ was a gift of friendship from the people of France to the people of the United States and was dedicated on October 28, 1886. The celebration theme selected by the National Park Service (think of them as Lady Liberty’s Accountable Care Organization) to mark this auspicious anniversary is ‘Honor History, Envision the Future.’

This got me thinking about the Disruptive Women in Health Care – past and present and how their vision of the future has also enlightened our world.  Here is a snapshot of my list. Who is on your list?

• Marie Curie—a contemporary of Lady Liberty, the original poster-child for STEM having discovered radioactivity, winner of not one but two Nobel prizes (for physics and chemistry) and, in her spare time, she became the first woman professor at the Sorbonne.
• Hillary Clinton—architect of health reform 1.0, and oh yes, a Senator and Secretary of State, who continues to champion the rights of women and girls, and
• Florence Nightingale—the original health services researcher who laid the foundation for today’s field of nursing; not only do new nurses take the Nightingale Pledge but International Nurses Day is celebrated around the world on her birthday. And, oh yes, she too is known as the Lady with the Lamp.
• My Mother. Enough said.

For her birthday, Lady Liberty is getting  a high-tech uplift: Internet-connected cameras on her torch that will let viewers gaze out at New York Harbor or see visitors on the grounds below. For more information on the birthday celebration or the webcams click here.

By Jane Sarasohn-Kahn. “56 million U.S. Consumers Access Medical Information from Electronic Health Records,” asserted Manhattan Research’s press release of October 12, 2011. This statistic, fresh out of the firm’s 2011 Cybercitizen Health survey, is among several stunning numbers that demonstrate a growing trend: U.S. health citizens’ embrace of their personal health information in digital formats, via electronic channels.

To kick the tires on the survey a bit, I spent time on the phone with the “3 M’s” of Manhattan Research — Meredith Ressi, President; Monique Levy, VP of Research; and, Maureen Malloy, Senior Healthcare Analyst who can recite the survey data backwards and forwards. Together, they guided me through the topline on digital health information use among U.S. adults in 2011.

The 56 million US adults who access data via electronic health records (EHRs) was a surprise to me, and to this trio, as well — so much so that they revisited the study methodology and samples to ensure that this was not a statistical anomaly. It’s not. But as with all numbers, it’s insightful to know what lies beneath the raw stat.

The big number to consider here is 24% of U.S. adults who are accessing their personal health information (PHI) from their physicians’ EHRs. In this case, the 56 million tend to be younger, better educated (more with college education), higher internet adoption, and more likely to own smartphones and tablet computers. They are also more likely to observe a physician doing digital activities during the consult – such as seeing the doctor entering information into the EHR.

What’s common among those consumers interacting with their EHR-borne health information is that they are more frequent online health information seekers than people who are non-users of their EHR data: three times more likely. (more…)