Dying to Get an Education

Meryl Bloomrosen

Public policy and public health efforts are underway to help assure that people can be healthy where they live, work, and play.  As part of providing education, schools are supposed to protect the health and safety of students.   Various government and non-government organizations (NGOs) offer resources, toolkits and evidence-based resources to help school districts, schools, and school personnel deal with health emergencies, such as life threatening conditions like asthma.  Guidelines indicate that schools should have:  a policy or rule that allows students to carry and use their own asthma medicines; written emergency plan(s) for teachers and staff to follow to take care of a student who has an asthma attack; and standing orders and quick-relief medicines for students’ use.[1] [2]

In the last few days, I read with admiration about middle and high school students setting aside any personal trepidation and potential disciplinary action to help fellow classmates who were having asthma attacks. (more…)

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Food, Health and Public Policy

Meryl Bloomrosen

I am someone who has worked for many years “inside the Beltway” (aka Washington DC), who admittedly wears the “policy wonk” hat, and was a (long distance) caregiver for elderly parents in the last years of their lives, one of whom faced eating related complications and consequences.   Because of these experiences I advocate on behalf of people who live with chronic diseases.  I appreciate more than ever how important it is to comprehensively explore issues related to public health topics such as obesity, food insecurity, food labeling, food literacy, and food shopping.  Indeed, the intersection of social factors, community, education, environment, behavior and health are prominent components of current health policy discussions and activities. [1] [2] [3]

The prominent health policy publication, Health Affairs recently devoted its November 2015 issue to Food and Health.  However, most noticeably and disappointingly absent in the discussions about food and heath were the perspectives, values and needs of people living with the challenges of chronic, life threatening and incurable food related diseases, such as food allergies[4].  Food allergies present significant health burdens for patients and their families and caregivers. Public policies related to food and health must consider diverse patient perspectives and values based on their unique circumstances and life goals. (more…)

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Meet Disruptive Woman to Watch: Tanya Jones

tanya-c-jones2Never underestimate what a memory from one’s youth can set in motion.

At a 2014 Disruptive Women in Health Care forum, Tanya C. Jones talked about her memories of a trip she took with her parents to rural parts of Africa.  What stayed with her were the dire conditions and the realization that people in remote areas with limited access to conventional services and infrastructure needed both skill building and access to modern telecommunications.

Today, as President of Aya Global, a philanthropic advisory practice, this Disruptive Woman to Watch for 2016, is offering strategic guidance to institutions and individuals and helping them reach their philanthropic goals.  Reaching back to her memories of that trip with her parents, she has devoted the last several years to improving the health of women and children in rural communities of Sub-Saharan Africa and South Asia as an implementer, fundraiser and funder. (more…)

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Meet Disruptive Woman to Watch: Carolyn Clancy, MD

clancyWhen the Obama Administration sought top-quality healthcare leaders to assume prominent roles of responsibility in the beleaguered Veterans Administration, it came as no surprise to anyone that Carolyn Clancy, M.D. was one of those tapped to move to the VA.

After a decade as head of the Agency for Healthcare Research and Quality (and we’ll get back to how profoundly she reshaped that organization), this Disruptive Woman to Watch was named VA Interim Undersecretary for Health and then Assistant Deputy Undersecretary for Health before moving into her current role as the Chief Medical Officer for the U.S. Department of Veterans Affairs.

It didn’t take long for her to make an impact on the healthcare our nation provides to its military veterans.  Here’s one example.  Under the previous VA administration, it was reported that certain medical facilities got the nickname “Candy Land” because of their propensity for handing out painkilling medications.  In fact, a report noted that opiate prescriptions had more than quintupled over an eight-year period even as the number of patients declined. (more…)

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A Thoughtful Discussion on Drug Pricing and Innovation

Mary R. Grealy

This post first appeared October 5 on the Prognosis Blog.

There has been a lot of talk of late about the price of prescription drugs.  Most of it, unfortunately, has come in the form of 30-second sound bites, largely driven by one hedge fund investor’s decision to significantly raise the price of a single product.

Determining the correct price for an innovative, life-changing product to achieve both consumer accessibility as well as a return on investment, which is vital to fund future research and development, is a complex topic that warrants a thoughtful discussion, not glib attack lines.

Credit, then, goes to the Washington Post for its lengthy question-and-answer article with Joseph Jimenez, the CEO of Novartis, one of the world’s leading pharmaceutical companies.  In the interview, Jimenez made, I believe, several striking and instructive points.  Among them: (more…)

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In the Operating Room There Are No Politics

Lisa-Suennen-photoThe post below first appeared on Venture Valkyerie on August 23.

I rarely tread into the political, but during this time of extreme political rhetoric bordering on insanity, I have seen two things in the last week that brought home what is such an important and ironic point. The first was this poster, which I happened across in the lobby of the American Heart Association’s national headquarters:Screen Shot 2015-08-23 at 12.04.01 PM

It’s a poster that I suspect was created during a time of debate about the ACA, focusing as it does on lifetime limits on benefits, which were eliminated with passage of the ACA. The focus of the poster, of course, is how important it is to write policy by starting with patient needs and putting politics aside.

The other item that got me to this particular blog post was a Huffington Post story today about candidate Rand Paul, who happens to be an opthamologist. The article talks about how, while other candidates were at the Iowa State Fair giving farm kids helicopter rides and eating meat on sticks, Dr. Paul was giving free cataract surgeries to Haitians. The quote that caught my attention was this, “In the operating room there are no politics,” according to the candidate. I’m sure his visit to Haiti was timed for political reasons, but the words still matter because they are right. (more…)

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How Many More Annas Must Die?

anna gunnIt’s been over a year since my older sister Anna died, so I choke up less readily while speaking about it.  The raw anger is less, but the frustration of losing someone to a preventable medical mistake will always remain with me.   Anna was five years older than me, my only sister, and the one I often turned to for advice. We were close despite living 600+ miles apart.  She was smart and insightful; she was at ease in most social situations. I, on the other hand, was the nerdy kid sister who loved science, who became a physician in my early 40’s.

In 2012, Anna’s world turned upside down when she was diagnosed with bone marrow failure (myelodysplastic syndrome) at 58.  This disease stemmed from her previous treatment for breast cancer. At the time of diagnosis, everything else in her life seemed to be going well.  She loved being a (single) mom; she had a wonderful job; and they had just adopted an adorable Lab. She actually felt great. (more…)

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American Hospitals Need to Stop Offering Fast Food, Quick!

heather farthingBan on Hospital Smoking: A Model

In the 1950′s the Journal of the American Medical Association (JAMA) published what was, at the time, an incredibly surprising finding: smoking is detrimental to health1. By 1964, the Surgeon General had publically acknowledged the linkage between smoking and cancer and, by the seventies, the smoking-cancer relationship was standard curricula in U.S. medical schools 2. Despite both medical and public awareness, however, hospital policy lagged behind the science; most healthcare centers had little to no official regulation regarding smoking in their facilities2. Reducing Smoking in Hospitals. A time for Action, published in a 1985 issue of the JAMA, declared a forceful criticism of this oversight:

Six years later, the Joint Commission: Accreditation of Healthcare Organizations (JCAHO) ordered that all American hospitals be smoke free by the end of 19934. Today, American hospitals are plagued by a bad case of déjà vu. This time the paradox is not the presence of the cigarette at the bedside, but rather the burgers, the fries, and the soft drinks.

What’s Wrong With Fast Food? (more…)

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Sixth White House Conference on Aging: Now It’s Time to Do More. A Lot More.

Anne-Montgomery-PortraitThe post below first ran on Altarum Institute’s Health Policy Forum.

Around the country, people at more than 700 “watch parties” gathered to tune into a livestream of the White House Conference on Aging (WHCOA) on Monday, July 13. Hosted by the White House in the East Wing and the Eisenhower Executive Office Building with an invited audience of about 200 attendees, the sixth WHCOA featured more than two dozen speakers, most notably President Obama. They heard about many accomplishments, a few shortcomings, and a commitment to taking forward some solutions—but not enough. Striking a tone that was both optimistic and pragmatic, the President observed that even as challenges for health care programs and for individual retirement security are “becoming more urgent” due to the sheer size of the Baby Boomer cohort, older adults are “living longer and living healthier. We’re seeing people break athletic records—in their 60s,” he noted with a smile.

Turning to policy, the President called on attendees, policymakers, and citizens to keep Medicare, Medicaid, the Older Americans Act (OAA), and Social Security robust and available, not only for current seniors but also for younger generations. “For Medicare,” he noted, “that means we’ve got to keep slowing the growth of health care costs.” While no blueprint was presented at the conference for how to accomplish this, the Obama Administration waded into these controversial waters last January with an announcement by U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell that the agency would attempt to shift half of all fee-for-service Medicare payments by the end of 2018 to “alternative payment models.” (more…)

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New initiative focused on mental health in the workplace

MHFA_Facebook_AThe National Council for Behavioral Health in collaboration with Aetna, a major health insurance provider, has launched a new initiative to create healthier work environments through Mental Health First Aid training. The purpose of this initiative is to raise awareness of mental health issues in the workplace and to change the perceptions of mental health and substance use problems for employees.

Mental Health First Aid is a skills-based, in-person training that helps increase literacy around mental illness and substance use and better equips managers and employees to safely, respectfully and effectively address mental health and substance use concerns before they become performance problems. It also provides resources so employees know where to go for help for themselves or a colleague. (more…)

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Over-Reliance on Tests: Why Physicians Must Learn to Trust Themselves & Their Patients

Val Jones, MD

The post below ran yesterday on Better Health.

I met my newly admitted patient in the quiet of his private room. He was frail, elderly, and coughing up gobs of green phlegm. His nasal cannula had stepped its way across his cheek during his paroxsysms and was pointed at his right eye. Although the room was uncomfortably warm, he was shivering and asking for more blankets. I could hear his chest rattling across the room.

The young hospitalist dutifully ordered a chest X-Ray (which showed nothing of particular interest) and reported to me that the patient was fine as he was afebrile and his radiology studies were unremarkable. He would stop by and check in on him in the morning.

I shook my head in wonderment. One look at this man and you could tell he was teetering on the verge of sepsis, with a dangerous and rather nasty pneumonia on physical exam, complicated by dehydration. I started antibiotics at once, oxygen via face mask, IV fluids and drew labs to follow his white count and renal function. He perked up nicely as we averted catastrophe overnight. By the time the hospitalist arrived the next day, the patient was looking significantly better. The hospitalist left a note in the EMR about a chest cold and zipped off to see his other new consults. (more…)

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Let Freedom Ring

Regina Holliday

The following post ran on May 3 on Regina Holliday’s Medical Advocacy Blog.

This winter was hard for me. Winter always is.  In my mind, I walk through yesteryears and live through the months I lost my husband Fred.

I had a bad cough in January and February just like I had in 2009.  My cough was pertussis this time, not a chest cold.  This time it was my ribs that broke from explosive coughs, instead from metastasis as Fred’s had.

This winter I felt I had to finish my memoir, so while coughed I wrote.  I tied together the story that I have been working on for five years.  This past week it became available on Amazon and it is called The Writing on the Wall.   I had wondered why I felt so frantic about quickly finishing my book on the importance of patient data access, but I have learned not to question such feelings.  I just act on them.

Then I went to HIMSS15 in Chicago.  Then I heard CMS (Centers for Medicare & Medicaid Services) was considering cutting a key measure that affected patients in Meaningful Use Stage 2.  Facilities and Providers complained that they were not able to ensure 5% of patients would view, download or transmit their data in the Meaningful Use Stage 2 reporting window.  Anyway, they assured CMS, patients did not want access anyway.  So CMS proposed gutting the legislation, removing the 5% requirement and replacing it with literally “1” patient. (more…)

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Saving AHRQ: Hope on the Horizon

Whitney Bowman-Zatzkin

You likely felt the ground shake a bit this week when the House Appropriations Committee released its FY16 funding language.

Right there in Section 266 on page 94, the language proposed the termination of the Agency for Healthcare Research and Quality (AHRQ):


With all of the attention lately about the desires in Congress to invest in research to advance the discovery of treatments for diseases – with hearings, news articles, and patients making trips to DC to be in the headlines across the country – this news came as quite a blow to many in the health research arena.

There is hope on the horizon. (more…)

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Making Research Work Better for Key Audiences

Tim_HeadshotWhen we translate research so that it’s most helpful to policymakers, what steps do we take to ensure the findings actually resonate? This question was at the center of the Disruptive Women in Health Care event on Tuesday, June 2nd, “A Disruptive Health Services MashUp – Moving Research into Policy,” where panelists gave answers ranging from increasing engagement with policymakers, to using simpler language to describe research findings and to even writing a song.

The program during Health Datapalooza 2015 at the Mariott Wardman Park in Washington, DC, featured panelists Lauren Radomski, MPP, Senior Manager, AcademyHealth; Alicia Wilson, Executive Director, La Clínica del Pueblo; and Wen Dombrowski, MD, MBA, Aging, Technology, Social Media Advisor, Resonate Health. Each panelist shared insights into how she and their organizations are reforming the way research is communicated.

“The ability to translate and disseminate research, and all of this information among us here and among stakeholders and other audiences outside of this room and outside of DC is the dream,” said Robin Strongin, Founder of Disruptive Women in Health Care, setting the stage for the panel discussion. (more…)

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“What If 1 Million Americans Asked for Medical Records on the Same Day?”

Jane Sarasohn-Kahn

farzadThe following post ran yesterday on Health Populi, see the original post here.

This was not a theoretical question Dr. Farzad Mostashari, former head of the Office of the National Coordinator of Health IT in the Department of Health and Human Services, asked yesterday at the closing keynote of Day 1 of the Patient Engagement Forum.

Dr. Mostashari issued a challenged to the community of mischief-makers in health/tech patient advocacy: tell everyone you know to contact their doctors — by phone, email, patient portal, or in-person, on one designated day which he called a “Day of Action.”

Health IT journalist Neil Versel (disclosure: also a long-time friend in the field) covered this news story here in MedCity News.

In the meantime, here is my (abridged) transcript of Dr. M’s talk, thanks to my note-taking skills. My own words are between carrots <> to provide additional context. (more…)

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