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Register Now for Tomorrow’s Webinar on Innovations in the Primary Care Workforce

Dec 8, 2014, 9:00 AM

At 4 p.m. ET (1 p.m. PT) tomorrow, Tuesday, December 9, 2014, the Robert Wood Johnson Foundation’s LEAP project will hold a webinar on innovations in the primary care workforce, and the project’s new online resource, the Improving Primary Care Team Guide. To join Tom Bodenheimer, MD, MPH, professor, Family & Community Medicine, University of California San Francisco, Lisa Letourneau, MD, MPH, executive director, Maine Quality Counts, and the LEAP Team for this free webinar, register here

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.

Health Data Outside the Doctor’s Office

Dec 2, 2014, 9:46 AM, Posted by Jon White, AHRQ , Karen DeSalvo, HHS/ONC, Michael Painter

A man rides a bike, with a child on a bike kid trailer behind him. "... if a city wants to plan bike infrastructure, they could invest millions in conducting studies into where bike lanes should go, or they instead could quickly access information generated by bikers, such as Map My Ride or Strava, to see where people are actually riding."

Health primarily happens outside the doctor’s office—playing out in the arenas where we live, learn, work and play. In fact, a minority of our overall health is the result of the health care we receive. If we’re to have an accurate picture of health, we need more than what is currently captured in the electronic health record.

That’s why the U.S. Department of Health and Human Services (HHS) asked the distinguished JASON group to bring its considerable analytical power to bear on this problem: how to create a health information system that focuses on the health of individuals, not just the care they receive. JASON is an independent group of scientists and academics that has been advising the Federal government on matters of science and technology for over 50 years.

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Reigniting the Push for Health Equity!

Nov 24, 2014, 1:00 PM, Posted by Daniel Dawes

Daniel E. Dawes, JD, is a health care attorney and executive director of government relations, health policy and external affairs at Morehouse School of Medicine in Atlanta, Georgia; a lecturer of health law and policy at the Satcher Health Leadership Institute; and senior advisor for the Transdisciplinary Collaborative Center for Health Disparities Research. On December 5, the Robert Wood Johnson Foundation (RWJF) will explore this topic further at its first Scholars Forum: Disparities, Resilience, and Building a Culture of Health. Learn more about it.

Scholars Forum 2014 Logo

With growing diversity relative to ethnicity and culture in our country, and with the failure to reduce or eliminate risk factors that can influence health and health outcomes, it is imperative that we identify, develop, promulgate, and implement health laws, policies, and programs that will advance health equity among vulnerable populations, including racial and ethnic minorities.

Daniel Dawes

Every year, the Agency for Healthcare Research and Quality publishes its National Healthcare Quality and Disparities Report, which tracks inequities in health services in the United States. Since the report was first published in 2003, the findings have consistently shown that while we have made improvements in quality, we have not been as successful in reducing disparities in health care. This dichotomy has persisted, despite the fact that health care spending continues to rise. In fact, health care costs have been escalating at an unsustainable rate, reaching an estimated 17.3 percent of our gross domestic product in 2009, according to the Centers for Medicare and Medicaid Services. Despite these high costs, the delivery system remains fragmented and inequities in the quality of health care persist. The impact of disparities in health status and access for racial and ethnic minorities is quite alarming.

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The Imperative to Improve Health Literacy

Nov 19, 2014, 7:59 PM

Joy P. Deupree, PhD, MSN, APRN-BC, is an assistant professor at the University of Alabama (UAB) School of Nursing and a Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellow. She is engaged in community participatory research studies on health literacy. For 12 years, Deupree has taught a campus-wide elective on health literacy and has been a guest lecturer on the topic at the UAB schools of medicine, dentistry and public health. She founded the Alliance of International Nurses for Improved Health Literacy and established a nursing special interest group for the Health Literacy Annual Research Conference.

Joy Deupree

Health literacy is extremely important to building a culture of health. Basic understanding of health care information is essential if people are to live healthy lives, but an alarming number of American adults report poor understanding of health care instructions. 

This year marks the 10-year anniversary of the Institute of Medicine (IOM) report, Health Literacy: A Prescription to End Confusion.While progress has been made, the work has really just begun. We can no longer blame the patient for poor health literacy, and we should keep in mind that limited health literacy affects us as all and contributes to increased health care costs. 

American Public Health Association Meeting & Expo

The IOM report defines health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions.” These skills involve not only reading ability but also numeracy. Failure to develop the necessary skills to manage health care can cost millions of dollars as well as add to human suffering and even cause death.

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Connected Health Approaches to Improve the Health of Veterans

Nov 12, 2014, 1:00 PM, Posted by Mitesh Patel

Mitesh S. Patel, MD, MBA, MS, is an assistant professor of medicine and health care management at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania. He is a staff physician and core investigator at the Center for Health Equity Research and Promotion at the Philadelphia Veterans Administration (VA) Medical Center. Patel is an alumnus of the VA/Robert Wood Johnson Foundation (RWJF) Clinical Scholars Program at the University of Pennsylvania (2012-2014).

Mitesh Patel

Cardiovascular disease is the number one cause of hospitalizations, morbidity and mortality among the veteran population. Building a Culture of Health could address this issue by focusing on individual health behaviors that contribute to risk factors associated with cardiovascular disease such as physical inactivity, diet, obesity, smoking, hyperlipidemia and hypertension.

The current health system is reactive and visit-based. However, veterans spend most of their lives outside of the doctor’s office. They make everyday choices that affect their health such as how often to exercise, what types of food to eat, and whether or not to take their medications.

Connected health is a model for using technology to coordinate care and monitor outcomes remotely. By leveraging connected health approaches, care providers have the opportunity to improve the health of veterans at broader scale and within the setting in which veterans spend most of their time (outside of the health care system). The Veteran’s Health Administration (VHA) is a leader in launching connected health technologies. VHA efforts began in 2003 and included technologies such as My HealtheVet (serving approximately 2 million veterans) and telemedicine (serving about 600,000 veterans).

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Improving Mental Health Care for Veterans is Vital

Nov 12, 2014, 9:00 AM, Posted by Ilse Wiechers

Ilse Wiechers, MD, MPP, MHS is associate director at the Northeast Program Evaluation Center in the Office of Mental Health Operations of the U.S. Department of Veterans Affairs and faculty with the Yale Geriatric Psychiatry Fellowship. She is an alumna of the Yale Robert Wood Johnson Foundation (RWJF)/VA Clinical Scholars Program (2012-2014).

Ilse Wiechers

Health and disease are on a continuum.  We are at a point in time where we are trying to understand the constituents of health, whereas historically our focus has been on understanding disease. It is important to recognize that veterans have unique determinants of health not shared with the rest of the population, such as exposure to combat and prolonged time spent away from social support networks during deployment.

These exposures can put veterans at increased risk for mental health problems, such as posttraumatic stress disorder, depression, and substance use problems. The U.S. Department of Veterans Affairs (VA) has a health care system uniquely positioned to help improve the overall health of veterans because of its expertise in addressing these unique mental health needs.

I have the privilege to serve our nation’s veterans through my work as a geriatric psychiatrist conducting program evaluation for the Office of Mental Health Operations (OMHO) at the VA. My work provides me an opportunity to directly participate in several of the key components of the comprehensive mental health services the VA provides for veterans.

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Let’s Put Veterans in Charge of Their Pain Care

Nov 11, 2014, 9:00 AM, Posted by Erin Krebs

Erin Krebs, MD, MPH, is the women’s health medical director at the Minneapolis VA Health Care System and associate professor of medicine at the University of Minnesota Medical School. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Physician Faculty Scholars program and the RWJF Clinical Scholars program.

Erin Krebs (Veterans Day)

How can we create a Culture of Health that effectively serves veterans? We can put veterans in charge of their pain care.

Chronic pain is an enormous public health problem and a leading cause of disability in the United States. Although 2000-2010 was the “decade of pain control and research” in the United States, plenty of evidence suggests that our usual approaches to managing chronic pain aren’t working. Veterans and other people with chronic pain see many health care providers, yet often describe feeling unheard, poorly understood, and disempowered by their interactions with the health care system.

Evidence supports the effectiveness of a variety of “low tech-high touch” non-pharmacological approaches to pain management, but these approaches are not well aligned with the structure of the U.S. health care system and are often too difficult for people with pain to access. Studies demonstrate that patients with chronic pain are subjected to too many unnecessary diagnostic tests, too many ineffective procedures, and too many high-risk medications.

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Big (Box) Medicine?

Nov 6, 2014, 4:55 PM, Posted by Michael Painter

Lucy in the chocolate factory

Let’s see a show of hands. Who among us, doctor, nurse, patient, family member, wants to give or get health care inspired by a factory—Cheesecake or any other?

Anyone?

I didn’t think so.

True confession: I have never actually eaten at a Cheesecake Factory (hereinafter referred to as the Factory). My wife, Mary, and I did enter one once. We were returning from a summer driving vacation. Dinnertime arrived, and we found ourselves at a mall walking into a busy Factory.

It seemed popular. The wait was long—really long. We got our light-up-wait-for-your-table device. We perused the menu. There was a lot there. Portions seemed gigantic. We looked at each other and, almost without speaking, walked back to the hostess, returned our waiting device and left.

You got me—I cannot say 100 percent that I wouldn’t love Factory food. We were so close that one time!

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Quotable Quotes About Nursing, November 2014

Nov 6, 2014, 1:00 PM

This is part of the November 2014 issue of Sharing Nursing’s Knowledge.

“As a nurse, I understand the risk that I take every day to go to work, and he’s no different than any other patient that I’ve provided care for. So I wasn’t going to say, ‘No, I’m not going to provide care for him. I didn’t allow fear to paralyze me. I got myself together. I’d done what I needed to get myself prepared mentally, emotionally, physically, and went in there.”
--Sidia Rose, a nurse at Texas Health Presbyterian Hospital, Treating Ebola: Inside the First U.S. Diagnosis, 60 Minutes, CBS News, Oct. 26, 2014

“...I grabbed a tissue and I wiped his eyes and I said, ‘You’re going to be okay. You just get the rest that you need. Let us do the rest for you.’ And it wasn’t 15 minutes later I couldn’t find a pulse. And I lost him. And it was the worst day of my life. This man that we cared for, that fought just as hard with us, lost his fight. And his family couldn’t be there. And we were the last three people to see him alive. And I was the last to leave the room. And I held him in my arms. He was alone.”
--John Mulligan, a nurse at Texas Health Presbyterian Hospital, Treating Ebola: Inside the First U.S. Diagnosis, 60 Minutes, CBS News, Oct. 26, 2014

“Someone asked a nurse, what do you make? I make sure your seriously ill father is cared for. I make sure that when you’re incontinent you’re cared for. It’s this everyday, profound yet intimate work that people do. People don’t understand it. It requires incredible cognitive and emotional intellect to do it. You are with someone at the most difficult and challenging and joyous moments of their lives.”
--Diana Mason, PhD, RN, FAAN, professor, Hunter-Bellevue School of Nursing and president, American Academy of Nursing, Nurses Want to Know How Safe is Safe Enough With Ebola, NPR.org, Oct. 14, 2014

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With New Apps, Product Recall Information is Just a Consumer’s Touch Away

Oct 31, 2014, 11:40 AM

The U.S. Consumer Product Safety Commission (CPSC) awarded prizes this week for four new online applications to help consumers track product recalls. Earlier this year, the CPSC challenged developers to create apps to help consumers track recall announcements and safety incidents involving consumer products. Nine developers submitted proposals, using the CPSC’s SaferProducts.gov website.

The CPSC’s research finds that recalls impact both consumers who purchase new products and consumers who purchase products—such as cribs and high chairs, whose safety standards change over the years—at yard sales and thrift stores. The products’ bar codes can be used by some of the apps to determine whether there has been a recall. Others check user emails for information on products purchased online.

The four new apps:

  • Safety Checker usually needs just three fields filled in or the bar code scanned to find recall data. The app works with iOS and Android devices.
  • Recall Pro uses Google Chrome to help consumers find recall information before making an online purchase.
  • The “Slice” app checks purchases via email inboxes against the CPSC’s recall list and is available for iOS and Android users.
  • Total Recall 101 checks a user’s email inbox and archives for references to purchased products, including product receipts and conversations with friends (but emails remain private to the user). The app matches products against the CPSC’s recall list and alerts users to any problems.

>>Bonus Link: Injuries cause tens of thousands of deaths in the United States each year. Find more information on product safety advice from the CPSC.

This commentary originally appeared on the RWJF New Public Health blog.