Category Archives: Clinical Scholars

May 2 2013
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Human Capital News Roundup: Medication errors affecting children with cancer, particulate matter, the needs of urban communities, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

CBS Evening News profiled RWJF Community Health Leader Roseanna Means, MD, who founded the nonprofit Women of Means in 1988 to provide free medical care to homeless women in the Boston area. Today, 16 volunteer doctors and staff nurses provide care at the city’s shelters to women with unique sensitivities and needs. Read a post Means wrote about her nonprofit for the RWJF Human Capital Blog.

A study led by RWJF Clinical Scholars alumnus Matthew M. Davis, MD, MAPP, finds more than 40 percent of American parents give over-the-counter cough and cold medicines to children under age 4, despite product label warnings to the contrary. Health Day and the Examiner report on the findings.

Helena Hansen, MD, PhD, an alumna of the RWJF Health & Society Scholars program, is the lead author of an analysis that concludes social determinants—rather than changes in the environment or flawed diagnostic criteria—help explain the dramatic rise in the number of Americans diagnosed with mental disorders in recent years. Health Canal and MedPage Today report on the findings.

Forty-seven percent of children with cancer who receive part of their treatment at home have been exposed to at least one medication error, according to a study led by RWJF Physician Faculty Scholars alumna Kathleen E. Walsh, MD, MSc. Those errors had the potential to harm 36 per 100 patients, and actually did cause injury to four per 100, MedPage Today reports.

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Apr 30 2013
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RWJF Scholar Alum Discusses Accountable Care Organizations

Elliott Fisher, MD, MPH, a health policy researcher and alumnus of the Robert Wood Johnson Foundation Clinical Scholars program (1983-1985), was recently named director of the Dartmouth Institute for Health Policy & Clinical Practice. Fisher coined the term “Accountable Care Organization” (ACO). In this Clinical Scholar Health Policy podcast, he discusses the origins of ACOs and the effort to develop them in the nation’s health care system. Watch his interview with RWJF Clinical Scholar Chileshe Nkonde-Price, MD, (2012-2014). The video is republished with permission from the Leonard Davis Institute.

Apr 25 2013
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Human Capital News Roundup: Teen moms and obesity, female lawmakers, HIV prevention, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

A study led by RWJF Clinical Scholar Tammy Chang, MD, MPH, finds that women who had their first child before age 20 are more likely to be obese later in life than those who were not teen moms, Health Day reports. “When clinicians care for teen mothers, we have so many immediate considerations— child care, housing, school, social and financial support—that we may fail to consider the long-term health effects of teen pregnancy,” Chang said. Caroline Richardson, MD, a Clinical Scholars alumna, and Matthew Davis, MD, MAPP, an alumnus and program site co-director at the University of Michigan, co-authored the study with Chang.

RWJF Scholars in Health Policy Research alumnus Craig Volden, PhD, was a guest on MSNBC’s The Cycle to discuss his study published in the American Journal of Political Science. Volden and his colleagues examined the sponsorship histories of 140,000 bills introduced in the U.S. House of Representatives over the last 40 years, and concluded that female lawmakers may be more effective at passing legislation than their male counterparts, particularly during times of party polarization, because they tend to work across party lines.

A study led by RWJF Executive Nurse Fellows alumna Margaret Grey, DrPH, RN, FAAN, finds that Internet-based psycho-educational intervention programs improve outcomes for young patients entering adolescence with type 1 diabetes, Monthly Prescribing Reference reports.

Medical News Today and the MinnPost report on an article written by Gary Taubes, MSE, MS, recipient of an RWJF Investigator Award in Health Policy Research, in The British Medical Journal about the non-profit he co-founded, the Nutrition Science Initiative. The Initiative will fund nutrition and obesity research, which Taubes says has been flawed and inconclusive in the past. Learn more about the Nutrition Science Initiative.

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Apr 18 2013
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Human Capital News Roundup: Conflict resolution strategies, the federal cigarette tax, patient outcomes at Magnet hospitals, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

RWJF/U.S. Department of Veterans Affairs Physician Faculty Scholars alumnus Amal Trivedi, MD, MPH, is co-author of a study that finds older patients are routinely prescribed potentially harmful drugs, particularly in the South. Although the specific reasons for the regional differences are unknown, the researchers hypothesize factors like education, socioeconomic status, and access to quality medical care might be to blame, the New York Times Well Blog reports. NPR and Nurse.com are among the other outlets to report on the findings.

Fierce Healthcare reports on a study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholar Kelly Doran, MD, that finds frequent use of the emergency department at Veterans Health Administration facilities is often due to “severely compromised life circumstances,” rather than poor access to outpatient health care. The study raises questions about the degree to which increasing access to outpatient care, as the Affordable Care Act aims to do, will reduce emergency department use.

Manish K. Sethi, MD, a health policy associate at the RWJF Center for Health Policy at Meharry Medical College, spoke to the Leaf Chronicle about a program he started at Cameron College Prep Middle School in Nashville to teach teens conflict resolution strategies in an effort to reduce violence in the Nashville area. Read a Q&A with Sethi about the program.

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Apr 11 2013
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Human Capital News Roundup: Lead exposure from soil, breast cancer mortality, climate change, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

Asthmapolis, founded and directed by RWJF Health & Society Scholars alumnus David Van Sickle, PhD, MA, has secured a $5 million investment that will be used to expand operations and further enhance its product, the Milwaukee Business Journal  and Journal-Sentinel report. The company has engineered a GPS-enabled asthma inhaler called the Spiroscout, which sends a signal with the time and location to a remote server every time a patient uses it, allowing patients and providers to track and analyze the onset of asthma symptoms. Read more about Asthmapolis here and here.

Health & Society Scholar Sammy Zahran, PhD, is co-author of a study that finds that children in Detroit are being exposed to lead from an overlooked source: contaminated soil. Zahran and his team examined seasonal fluctuations in children’s blood lead levels and found that levels were highest in the summertime, when contaminated soil turns into airborne dust. The researchers were able to rule out exposure to lead-based paint as the main source of the contamination, NPR’s Shots Blog reports, because blood lead levels were lower in the winter, when children are more likely to be indoors.

A study from the Center for Climate Change Communication at George Mason University, which is directed by RWJF Investigator Awards in Health Policy Research recipient Edward W. Maibach, PhD, MPH, finds a majority of Republicans and Republican-leaning Independents think action should be taken to address climate change, United Press International reports. The New York Times Dot Earth Blog also reported on the findings.

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Apr 8 2013
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‘Patient-Centered’ Medicine and Health Care Reform: Optimistic Visions Without A Coherent Blueprint

Benjamin Roman, MD, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholar in residence at the University of Pennsylvania and a senior fellow at the Leonard Davis Institute of Health Economics. This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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The term “patient-centered" has become something of a mantra in the nation’s current health reform efforts. There’s widespread agreement—at least in theory—that putting the patient at the center of everything is important but, as demonstrated in discussions at the recent AcademyHealth National Health Policy Conference, there is no exact blueprint for how to accomplish that.

Patient-centeredness means many things to many different people, but at its core are issues of shared decision-making and balancing how much the patient should really be in the driver’s seat. Patients want more information, but too much is overwhelming. They want to be nudged to do the right thing for their health, but not nagged. They want to choose health care wisely, but they don’t necessarily want less. Doctors want to involve patients in decision-making but don’t know how, or what evidence to use for the discussion.

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Apr 5 2013
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Spending Money to Save Money in Health Care

Ashok Reddy, MD, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholar in residence at the University of Pennsylvania and a senior fellow at the Leonard Davis Institute of Health Economics.  This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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With the debate about the fiscal cliff and the sequester hanging so heavily over Washington, it was no surprise that congressional staffers at the AcademyHealth National Health Policy Conference seemed so exclusively focused on cutting health care spending. Some estimated that 30 percent of the $2.5 trillion spent on health care may provide little value; finding interventions that provide high-value care is a top priority that tends to obscure any other possibilities.

In this prevailing atmosphere of stark fiscal reality and gridlocked politics it can be hard to gain traction for the idea that investing in programs that prevent chronic diseases would ultimately decrease the costly long-term expenditures driven by those diseases. But that’s where traction is needed.

Take diabetes for instance. One estimate has the medical treatments for people with diabetes costing 2.4 times more than expenditures that would be incurred by the same group in the absence of diabetes. By preventing the development of diabetes in an individual you decrease the risk of heart attack, kidney failure and amputated extremities.

It is true that, so far, research in cost-effectiveness analyses has not shown that prevention reduces medical costs. Besides childhood vaccination and flu shots for the elderly, few health care services ‘save money.’ A 2010 Health Affairs article calculated that if 90 percent of the U.S. population used proven preventive services, it would save only 0.2 percent of health care spending.

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Apr 4 2013
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Human Capital News Roundup: Weight loss programs, cybersecurity policy, employees who smoke, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

A study led by RWJF/U.S. Department of Veterans Affairs Clinical Scholars alumnus Jeffrey Kullgren, MD, MPH, finds that weight loss programs motivate patients to lose more weight when they offer financial prizes in group competitions, rather than individual rewards. MedPage Today and Medscape [registration required] report on the findings.

Healthcare Finance News reports on a study co-authored by RWJF Investigator Award in Health Policy Research recipient Mark A. Hall, JD, that finds insurers subject to the medical loss ratio requirements in 2011 spent less than one percent of premium revenue on quality improvements (0.74%) or rebates (0.35%). The researchers write that “current market forces do not strongly reward insurers’ investments in this area.”

In a post on the New York Times’ Room for Debate blog about prenuptial agreements, Investigator Award recipient Celeste Watkins-Hayes, PhD, writes: “There is no doubt that women need to be savvy about protecting their assets and ensuring that their contributions and hard work are valued, even in marriage. But prenups can only protect a certain demographic. What is needed is a comprehensive strengthening of all women’s safety nets through access to jobs that build wealth, increased financial literacy and a better infrastructure for raising children with or without a significant other.”

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Apr 3 2013
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Electronic Health Records Interoperability: Friend or Foe

Zachary Meisel, MD, MPH, MSc, is an emergency physician, assistant professor of emergency medicine at the University of Pennsylvania's Perelman School of Medicine, a Robert Wood Johnson Foundation (RWJF) Clinical Scholar, a senior fellow at the Leonard Davis Institute of Health Economics, and a columnist on health care issues for Time.com. This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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The standing-room-only crowd at the AcademyHealth National Health Policy Conference’s “Life After HITECH: Health IT Policy 2.0” session was a testament to the big stakes, high emotion and dramatic clinical implications that characterize every aspect of the electronic health records debate.

The session, moderated by former National Coordinator for Health Information Technology David Blumenthal, was one of the liveliest of the entire conference. It impaneled current National Health Information Technology (HIT) Coordinator Farzad Mostashari along with Christine Bechtel, who sits on the Government Accountability Office’s Health IT Policy Committee, and Paul Tang, the chief innovation and technology officer at the Palo Alto Medical Foundation.

Patient Privacy Issue

One issue was the national push for universal electronic health records (EHR) systems—a drive now fueled by HITECH Act funding but tangled in many discussions about unintended consequences. The first and most prominent has pivoted around worries related to patient privacy.

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Mar 29 2013
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Facing What May Be the Affordable Care Act’s Ultimate Challenge: The Gap Separating Evidence from the Policy-Makers Who Need It

David Grande, MD, MPA, is an assistant professor of medicine at the University of Pennsylvania's Perelman School of Medicine, a senior fellow at the Leonard Davis Institute of Health Economics, associate director of the Robert Wood Johnson Foundation (RWJF) Clinical Scholars program and an alumnus of the RWJF Health & Society Scholars program. This is part of a series of essays, reprinted from the Leonard Davis Institute of Health Economics’ eMagazine, in which scholars who attended the recent AcademyHealth National Health Policy Conference reflect on the experience.

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It’s a time of unprecedented upheaval in U.S. health care. Big changes are bursting through on virtually every front. Legislators and administrators in Washington and 50 state capitals struggle daily to reinvent their health care systems even as they lack an exact blueprint for the new things they’re supposed to be building.

This was nowhere more evident than at the recent AcademyHealth National Health Policy Conference, where state and federal officials and interest groups lined up to present long lists of policy questions that confront them as they grapple with implementation of the Affordable Care Act and mounting public budgetary pressures.

Managing 'Churn'

For instance, in the “Opportunities & Challenges for State Officials” session, New Mexico’s Medicaid Director Julie Weinberg described the unknowns surrounding how “churn” between private and public coverage will change and how new Medicaid eligibility standards will impact enrollment processes.

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