“There is no single more powerful concept” in transforming health care than transparency—that is, accurate information for everybody about the costs, quality, and other aspects of health care—according to former US Senate Majority Leader and Robert Wood Johnson Foundation Board Member Bill Frist at the Second National Summit on Transparency in Health Care Costs, Prices, and Quality. Not only is shining the spotlight on costs and quality the key to making health care markets work, Frist said, but it’s also central to delivering the vaunted Triple Aim of better health, better health care, and lower costs. Here are our key takeaways reflecting how much transparency discussions have advanced since the first RWJF sponsored summit in 2013:
Mar 4, 2015, 11:16 AM, Posted by Susan Dentzer
We can all play a role in helping children grow up at a healthy weight, including the U.S. Soccer Foundation. Their work is helping make strides in reducing childhood obesity rates. Here's how.
Washington, D.C.’s Shaw neighborhood is named after Colonel Robert Gould Shaw, who commanded the famed 54th Massachusetts Volunteer Infantry, the all-black regiment that fought for the Union during the Civil War. Today, the multi-ethnic neighborhood is home to the U Street Corridor, a revived commercial district known in the early 1900s as “Black Broadway"; Ben’s Chili Bowl, a celebrated city landmark; and Seaton Elementary, a public school whose students are mainly Hispanic, African-American, and Asian.
It’s also home to the young goalie of Seaton’s soccer team, sixth grader Kevin Alvarez.
Like many kids in his neighborhood, Kevin, age 13, never played sports until recently, and was seriously overweight. Then his school was fortunate to become home to Soccer for Success®, a program managed locally by DC SCORES, a Washington, D.C., nonprofit.
Feb 19, 2015, 2:21 PM, Posted by Susan Dentzer
For the second year running, more women than men have signed up for coverage in health insurance marketplaces during open enrollment under the Affordable Care Act. According to the Department of Health and Human Services, enrollment ran 56 percent female, 44 percent male, during last year’s open enrollment season; preliminary data from this year shows enrollment at 55 percent female, 45 percent male—a 10 percentage point difference.
What gives? An HHS spokeswoman says the department can’t explain most of the differential. Females make up about 51 percent of the U.S. population, but there is no real evidence that, prior to ACA implementation, they were disproportionately more likely to be uninsured than men—and in fact, some evidence indicates that they were less likely to be uninsured than males.
What is clear that many women were highly motivated to obtain coverage under the health reform law—most likely because they want it, and need it.
Roadmaps Out of Fantasyland: RWJF’s Outbreaks Report and the National Health Preparedness Security Index
Jan 30, 2015, 5:47 PM, Posted by Susan Dentzer
“When you hear hoofbeats, think of horses, not zebras,” the late Theodore Woodward, a professor at the University of Maryland School of Medicine, cautioned his students in the 1940s. Woodward’s warning is still invoked to discourage doctors from making rare medical diagnoses for sick patients, when more common ones are usually the cause.
And while many Americans have worried about contracting Ebola—in viral terms, a kind of “zebra”—more commonplace microbial “horses,” such as influenza and measles viruses, continue to pose far greater threats. For instance, a large multistate measles outbreak has been traced to Disneyland theme parks in California—while this year’s strain of seasonal flu has turned out to be severe and widespread.
One obvious conclusion is that many microbes remain a harmful health menace, expected to kill hundreds of thousands of Americans this year. Another—speaking of Disneyland—is that much of America appears to live in a kind of fantasyland, thinking that it is protected against infectious disease.
Jan 16, 2015, 1:25 PM, Posted by Susan Dentzer
In his new book, The Patient Will See You Now, Eric Topol, MD, invokes the famed Arabian folk tale One Thousand and One Nights, in which the poor woodcutter Ali Baba utters "Open Sesame" to unseal the cave where thieves have a treasure of gold coins. Topol asks "whether we, like Ali Baba, can breech the gate that keeps us from [health and health care] data, to a new world of openness and transparency."
It's worth remembering that, in the folk tale, Ali Baba does get rich — but after fighting over the gold, almost everybody else ends up dead.
So how do we ensure that the story of increasingly open health data has a more universally happy ending?
It won’t be easy, and Topol acknowledges the quandaries of dealing with the "gold" — the enormous flow of health data already under way.
Among the issues:
Jan 7, 2015, 1:48 PM, Posted by Susan Dentzer
It’s 2015, the year that Marty McFly, the fictional character in the 1989 hit movie "Back to the Future II," visits by time traveling into the future in a souped-up DeLorean automobile. Predictably, most of the technologies the film foreshadowed haven’t been invented as of the real 2015—not the “hover board” that Marty glides along on, nor the self-lacing sneakers, nor (of course) the time travel.
But plenty else has been invented or discovered in the last 30 years, revolutionizing much of our lives, including our health and health care. If you want to feel as exhilarated, and maybe even as disoriented, as Marty did after fast-forwarding to 2015, read Dr. Eric Topol’s new book, The Patient Will See You Now: The Future of Medicine Is In Your Hands.
Dec 16, 2014, 12:09 PM, Posted by Susan Dentzer
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.
- 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.
Dec 2, 2014, 10:57 AM, Posted by Susan Dentzer
“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.
Nov 25, 2014, 8:23 AM, Posted by Susan Dentzer
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.”
Nov 5, 2014, 2:08 PM, Posted by Susan Dentzer
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.