Author Archives: Susan Dentzer

Home is My Facebook Page: MHealth’s Potential to Help the Vulnerable

Dec 16, 2014, 12:09 PM, Posted by Susan Dentzer

La Clinica del Pueblo LaClinica del Pueblo, a federally qualified health center in Washington, DC, serves many Latino patients — and relies increasingly on social media to communicate with vulnerable patients about sensitive topics, such as using condoms to help prevent HIV and sexually transmitted diseases.

Say the words “smartphone user” and “app,” and what comes most readily to mind is probably some hipster pulling out his iPhone to book a ride from Uber. But at last week’s mHealth Summit in Washington, D.C., those words were also linked to far different images—of highly vulnerable people seeking and obtaining health care.

Consider:

  • At La Clinica del Pueblo, a federally qualified health center (and previous RWJF grantee) based in Washington, D.C., smartphones and Facebook are key communications channels for reaching hundreds of young gay Latino men and transgender women at risk for HIV. The clinic’s executive director, Alicia Wilson, said on one panel at the mHealth conference that La Clinica’s Facebook page now has about 1,000 followers. “It allows us to spread prevention messages and bring people into care who have been marginalized,” alerting them to free counseling, testing and referral services available through the clinic, Wilson said.
  • A company called Healthvana has a Yelp-like feature that allows people to search for places to get tested for HIV or sexually transmitted diseases. They can also register and set up secure accounts to receive the results from partner testing centers quickly and discretely, along with advice about “actionable next steps” to take should the tests be positive, says CEO and founder Ramin Bastana.
  • Based in Britain, but with a growing presence in the United States, a website and social network called Big White Wall offers a “professionally curated community” for people with psychological issues or mental illness—a virtual space where they can stay anonymous and confide in others; take courses on managing depression and other illnesses; and even have secure consultations with therapists via Skype. Endorsed by England’s National Health Service, and now offered in a “soft launch” phase to enrollees of Kaiser Permanente Northwest, the site demonstrates that “the depth of the need for alternative person-centered health care across the globe is really profound,” says founder Jen Hyatt.

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Seizing Opportunities to Reinvent Public Health

Dec 2, 2014, 10:57 AM, Posted by Susan Dentzer

A doctor talks in a friendly manner to a disabled patient sitting in a wheelchair

“The only thing we know about the future is that it will be different,” wrote the late management guru Peter Drucker.  To the list of society’s sectors that are struggling with that conclusion, add government-funded public health.

State and local health departments face growing challenges, including infectious disease threats such as Ebola and chikungunya; a rising burden of chronic illness; an increasingly diverse population; even the health impact of global warming. At the same time, fiscal constraints accompanying the 2007–2008 recession and its aftermath hammered local, state, and territorial health agencies, which lost nearly 30,000 jobs—6 percent to 12 percent of their total workforces—from 2008 to 2013.

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The “Resilience Dividend” and the Culture of Health

Nov 25, 2014, 8:23 AM, Posted by Susan Dentzer

Red Hook Ikea The Red Hook IKEA after Superstorm Sandy. Credit: Flickr user Ham Hock https://creativecommons.org/licenses/by-nc-nd/2.0/

Red Hook, Brooklyn, is named for its original red clay soil, and the “hook” of land that juts out into Upper New York Bay. Two stores located close to the water there fared very differently during Superstorm Sandy, which ravaged parts of New York and New Jersey in October 2012.

Judith Rodin, president and CEO of the Rockefeller Foundation, recounts the saga in her new book, The Resilience Dividend: Being Strong in a World Where Things Go Wrong.

Ikea, the Swedish household goods chain opened its Red Hook store in 2008, built on pilings with a ground floor garage, an emergency generator, and show rooms and inventory well above ground level. Although its parking lot flooded during the storm, the inventory was untouched, and the store recovered quickly. It functioned as a local office for representatives from the Federal Emergency Management Agency and served as “a neighborhood hub for the distribution of food, clothing, and other supplies,” Rodin writes. The store also “strengthened its neighborhood connections by taking on a new and important role.” 

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Five Takeaways from National Forum on Hospitals, Health Systems and Population Health

Nov 5, 2014, 2:08 PM, Posted by Susan Dentzer

Wake Forest Baptist Medical Center photo

The new faces of population health may be those of Annika Archie, Vernita Frasier, Pecola Blackburn, and Mary Dendy (shown in the photo on the right). They were once part of the cleaning crew at Wake Forest Baptist Medical Center in North Carolina, but their jobs were cut when the hospital outsourced those services to save money. But thanks to a creative initiative on the part of the hospital, they now they have new roles as “Supporters of Health,” serving the hospital’s uninsured, chronically ill patients in proactive ways.

Having come from similar circumstances as their patients, the four women help them cope with a range of needs–from understanding how to take their medications to getting assistance to pay their rent. In just a few months, the supporters helped cut hospital readmission rates for these patients to 2.5 percent, says Gary Gunderson, vice president of faith and health ministries at Wake Forest Baptist. “We gave them training as community health workers,” says Gunderson, “but it was sort of like just giving them a baseball hat”–a formality to acknowledge new roles that they had long played informally.

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The 21st Century Medical School and the “Flipped” Classroom

Sep 30, 2014, 9:30 AM, Posted by Susan Dentzer

Flip the classroom video still

Pity the poor medical student...or at least many students now slogging away in medical schools across the nation.  

Most spend the first two years of medical school cramming their heads with facts about the functions of cells, organ systems, and other aspects of the human body. Having contact with real patients—the reason most students went to medical school in the first place—is quite limited until the third year, when clinical clerkships begin.

Meanwhile, medical knowledge is exploding, doubling every five years, and taxing the human brain’s capacity for processing and recall. Today’s medical students know that one day, they’ll be most likely to practice medicine with the aid of “cognitive computing” systems like IBM’s Watson, which has already “learned” as much as a second-year med student, and is helping clinicians at the Mayo Clinic, Memorial Sloan-Kettering Cancer Center, and other institutions process reams of medical information to make clinical decisions. 

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Living Out Their Salad Days: Shaping Healthier Environments for Kids in the Nation’s Schools

Sep 2, 2014, 10:59 AM, Posted by Susan Dentzer

A school lunchroom full of hundreds of young children, happily slurping up ... salad.

If you’re someone who’s ever struggled to get kids to eat their vegetables, it sounds like an impossible dream.

But this is reality at Anne Frank Elementary School, the largest in Philadelphia, with 1,200 students from kindergarten through fifth grade. Serving salads was the brainchild of Anne Frank principal Mickey Komins, who had the salads brought in from a local high school cafeteria.

Along with the after-school Zumba and kickboxing classes that the school now sponsors for kids, parents, and staff, healthier food offerings are among the innovations that earned Anne Frank an award from the Alliance for a Healthier Generation. The Alliance, a Robert Wood Johnson Foundation grantee, is a nonprofit founded by the American Heart Association and the Clinton Foundation to help stem the tide of childhood obesity. It’s at the vanguard of a growing national movement to turn schools into healthier environments, and offer kids fundamental lifelong lessons about maintaining their health.

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Building the Information-Rich Culture of Health

Aug 20, 2014, 10:36 AM, Posted by Michael Painter, Susan Dentzer

Reform by the Numbers Visual

What if your mother wanted to take some ibuprofen for her arthritis, but didn’t know if it would interact adversely with her other medications?

No problem, right?

She could whip out her smartphone and launch an app that connected to her local health information exchange. Within fractions of a second, the exchange would verify her identity, locate the computer storing her electronic health record (EHR), and shoot an answer back to her.

This scenario is just one example of the many ways that having timely access to health information could contribute to health. It could, that is, if the nation had an agreed-upon way to organize data about health and health care in ways that made it easily accessible and usable while still secure and protected.

But for now, we don’t.

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Advanced Practice Nursing: Providing Care and Promoting Health

Jul 29, 2014, 10:50 AM, Posted by Susan Dentzer

Check out an August 1 Google+ Hangout with the Campaign for Action and RWJF.

The U.S. population is growing, getting older and suffering from more chronic disease. Thanks to the Affordable Care Act (ACA), more people are gaining health coverage and the means to obtain care. And there’s a widespread view that the country faces a drastic shortage of doctors—and primary care providers in particular.

So why are so many states seemingly determined not to let advanced practice registered nurses deliver the primary care they specifically trained to provide—and help millions of patients in the process?

Across the country, 31 states impose varying limits on the ability of nurse practitioners (one of the four types of advanced practice registered nurses) to evaluate patients; diagnose, order and interpret diagnostic tests; and to initiate and manage many treatments, including prescribing medications.

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Putting a Female Face on the Need for a Culture of Health

Jul 25, 2014, 11:29 AM, Posted by Susan Dentzer

A doctor examines a patient.  An image appears on a computer monitor.

Statistics are “human beings with the tears washed away,” an old saying goes. Sadly, the tears behind one set of statistics, showing that women’s life expectancy has been falling in just under half of U.S. counties, have rarely garnered much notice.

How to put a face on this story, to help mobilize corrective action?

Progress toward that end was made last week, when the Robert Wood Johnson Foundation teamed up with Women’s Policy, Inc, a nonprofit, nonpartisan organization that seeks to inform policy-making on women’s issues, to sponsor a briefing on that subject on Capitol Hill. About 75 people, including several female members of Congress, gathered in the Rayburn House Office Building to learn what is driving the widespread trend of poorer female health. (Watch the webcast by clicking here).

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Promoting A “Green” Culture of Health: Instead of Wasting Food, Getting it to Those Who Need It

Jun 25, 2014, 3:54 PM, Posted by Susan Dentzer

Mercer Street Friends Food Bank Warehouse Trenton

“A mind is a terrible thing to waste,” goes an old slogan of the United Negro College Fund. Another terrible thing to waste is healthy food.

That’s especially true in a nation where 1 in 7 U.S. households are “food insecure”—that is, they lack consistent, dependable access, typically for financial reasons, to “enough food for active, healthy living,” as a U.S. Department of Agriculture report puts it. About 1 in 10 U.S. households have food-insecure children—an equally appalling reality in a country that wastes an estimated 30 to 40 percent of its food supply, or a whopping 133 billion pounds of food in 2010 alone.

In California’s Orange County, however, a solution is at hand—and there’s no reason it couldn’t take hold and spread nationwide. Since 2012, the Waste Not Orange County Coalition, a public-private partnership, has worked to boost donations to local food pantries of surplus healthy food from local restaurants, grocery stores and other facilities. The organization was formed out of the realization that enough food was tossed out every day to feed the nearly 380,000 local residents—almost half of them children—who are deemed food insecure.

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