Culture of Health Blog

Zane Gates, MD, is a Robert Wood Johnson Foundation (RWJF) Community Health Leader and medical director of Altoona Regional Partnering for Health Services in Altoona, Pennsylvania. Gates and Patrick Reilly, president of Impact Health Solutions, founded the Empower3 Center for Health program, which is the model for a new health care law in Pennsylvania.

The Commonwealth of Pennsylvania has recently adopted a law to fund community-based clinics that can demonstrate real impact to the community with regard to increased access, reduced costs, lower emergency room (ER) visits, and improved behavioral health outcomes for the low-income working uninsured.  It is modeled on community-based clinics featuring a unique structure that I created along with Patrick Reilly, an insurance consultant from western New York:— Empower3 Center for Health program.

The model we created features an “insurance-less” office concept that allows patients to come in as frequently as needed without worrying about being billed or having any balances to pay. The program has no co-pays, deductibles or balance billing when the patients use the participating community hospital that partners with the program.  Since there is no billing at the point of service, there is more face time with the medical professionals to spend creating a true relationship that focuses on care and provides dignity to the patients seeking quality medical care. The office is open five days a week to provide access to patients as needed. 

Raina Merchant, MD, MSHP, is a Robert Wood Johnson Foundation (RWJF) Clinical Scholars program alumna and an assistant professor at the University of Pennsylvania Department of Emergency Medicine. She recently led the MyHeartMap Challenge, a community improvement initiative and research project to identify and map automated external defibrillators (AEDs) in Philadelphia. Read a post she wrote for the RWJF Human Capital Blog about the Challenge.

Human Capital Blog: Why was it important to collect information about the location of AEDs?

Raina Merchant: Currently there is no comprehensive map or database of where all the AEDs are located—in Philadelphia or really anywhere. So when someone collapses, we have to rely on people remembering where they last saw an AED. In fact, most 911 centers don’t have databases of where AEDs are located. So, the likelihood of being able to find one in an emergency is pretty low, and as a result we have these lifesaving devices that are rarely used. We used the MyHeartMap Challenge, an innovation tournament to have the public find AEDs in Philadelphia, take a photo using a smartphone app, and tag their location so we can make this information available to anyone who needs it.

HCB: How many people or teams participated in the Challenge? How many AEDs were identified?

Merchant: We were really excited about the results. We had more than 330 participants (individuals and teams) who contributed data to the Challenge. They reported more than 1,500 locations of AEDs in the city of Philadelphia. We’re still trying to sort out who exactly participated, but we had representation from schools and health organizations, as well as a lot of individuals who recruited their friends, neighbors and colleagues.  We were worried that people would make up devices, submit false locations or send low-quality pictures, but we were really impressed with the quality of data we received. Every one took this challenge very seriously. The challenge had two winners who were each awarded $9,000 for reporting more than 430 AEDs each. Both winners were also over the age of 40.

Michelle Scott recently graduated from Rowan University and is an intern at the Robert Wood Johnson Foundation (RWJF), working with The Future of Nursing: Campaign for Action.

I had the privilege of attending the Pennsylvania Action Coalition conference in Philadelphia in early June. It was hosted by Julie Fairman, PhD, RN, FAAN, and Afaf Meleis, PhD, DrPS (hon), FAAN, and the co-leads of the Pennsylvania Action Coalition, Betsy Snook, MEd, MSN, RN, and Christine Alichnie, PhD, RN

The conference was held to educate Pennsylvanians about how nurses and other leaders can prepare themselves for these monumental changes in health care as recommended in the Institute of Medicine report The Future of Nursing: Leading Change, Advancing Health. The audience included nurses and other health professionals, business employees, educators and students. It is this diversity that drives the campaign. We need resources to ensure the many campaign supporters can advance its agenda.

The following Q&A was conducted by Michelle Scott, a recent graduate of Rowan University who is an intern at the Robert Wood Johnson Foundation (RWJF), working with The Future of Nursing: Campaign for Action. Scott recently attended a conference to launch the Pennsylvania Action Coalition, and interviewed some students who also participated. Read Scott’s reflections on the conference here.

Question: What do you feel your role as a rising physician will be in the plan to bring nurses and doctors together to work toward improving patient care?

Paul Shay: In health care, there has been a historical hierarchy that places the infallible physician above all other health care providers; however, recent literature has shown that collaborative health care is the best health care. It turns out that doctors aren’t infallible, and every team member, from social worker to nurse to physician, is equally valuable in patient care.

As a rising physician, I would be foolish not to embrace this collaboration in my future practice. I will make a concerted effort to let all of my non-physician colleagues know and feel that they are equal members in our team. Furthermore, it is equally, or arguably more, important that I advocate for other physicians to do the same. And outside of our own practices, we need to support the efforts of nursing organizations such as the Pennsylvania Action Coalition and the Pennsylvania State Nurses Association (PSNA).

Nancy Hanrahan, PhD, RN, CS, FAAN, is associate professor and faculty member of the Center for Health Outcomes and Policy Research at the Penn School of Nursing. She is a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar alumna. As a health systems researcher, she develops innovative models that promote an integrated mind/body approach to mental and physical health care.

At a time when there is an urgent need for innovative solutions to health care challenges, educators have a responsibility to prepare a generation of students who can think outside the box. The Inaugural Game Solutions for Healthcare Symposium at the University of Pennsylvania School of Nursing showcases such transformative learning experiences.

At this event, students from nursing and other schools within the University of Pennsylvania show what happens when you “mix-it-up” and work together to build innovative games and applications that target specific health care problems. More than 60 undergraduate students, staff and faculty participated in the game projects from five different schools at Penn. Teams included students from nursing, engineering, computer science, law, medicine and business. Nursing students defined a health care problem and then a team of engineers, or computer scientists, developed a technological solution.

By Raina Merchant, MD, MSHP, Robert Wood Johnson Foundation Clinical Scholars program alumna and assistant professor, University of Pennsylvania Department of Emergency Medicine

If the person next to you went into cardiac arrest, would you know what to do? Would you know where to find an automated external defibrillator (AED) to shock and restart their heart? Millions of public places across the United States have AEDs that can save lives – airports, casinos, churches, gyms and schools, among them – but most people don’t know where they’re located. Every second counts when someone’s heart stops beating, and time spent searching for an AED is time wasted in increasing the chances of survival.

Surprisingly, no one knows where all of the country’s AEDs are located. Requirements for AED reporting and registration vary widely by state, and no comprehensive map of their locations has ever been compiled. As a result, 911 dispatchers aren’t always able to direct callers to an AED in an emergency, and callers have no good way of quickly locating one on their own.

This week, I launched the MyHeartMap Challenge with a multidisciplinary team from the University of Pennsylvania. This pilot study will use social media and social networking tools to gather this critical public health data and create searchable maps of Philadelphia’s AEDs that can be used by health professionals and the general public.

The first step of our challenge is a Philadelphia-based community-wide contest. We’re asking Philadelphians to find and photograph AEDs over the next six weeks, and submit the photo and location to us via a mobile app or our website. You can also participate if you don’t live in Philadelphia by finding a creative way to use your social network or harness crowdsourcing.

By Linda Wright Moore

RWJF Senior Communications Officer

Attending the 36th annual convention of the National Association of Black Journalists (NABJ) last week in Philadelphia provided an opportunity to reflect on the many challenges facing reporters and the news industry in the 21st century. It was also a personal trip down my professional memory lane.

At the start of my career, as a television reporter and anchor, I attended my first NABJ annual meeting in New Orleans in 1983. The organization was small back then – just a few hundred members. We all knew each other by name. Fast forward to 2011, and I was happy to connect with old friends, including founders of the organization.

The group has grown dramatically to 3,000 members, and more than 2,500 people attended the Philadelphia gathering. The profession of journalism and newsgathering has also been transformed in response to tectonic shifts in the way we gather and disseminate information. Consider: “publisher” used to define an institution that had capacity to print a book, newspaper or magazine. Now, it’s anyone with a laptop, an Internet connection and something to say.

But don’t be fooled. The explosive growth of information and ease of access to it do not mean that journalism is a dying craft. In this 21st century age of information overload – where opinion, conjecture and even fiction can masquerade as fact – the ability to find credible, engaging, reliable sources of news and information is more valuable than ever. A free press is still the cornerstone of democracy – enabling us to make informed decisions about political leaders and policies. And we also rely on media to keep us informed about issues and policies affecting every aspect of our lives, including our health and health care.

At the Robert Wood Johnson Foundation (RWJF) booth at the NABJ Career Fair & Exhibition, we provided an array of information about Foundation programs – touching on the work of every team: Childhood Obesity, Coverage, Pioneer, Public Health, Quality/Equality, Vulnerable Populations and Human Capital. We distributed the first edition of the Human Capital Expert Resource Guide, which highlights the work and expertise of selected RWJF scholars, fellows and leaders with a focus on issues of concern to Black and Latino communities. We hope it will be a useful source of experts to interview for reporters developing stories around health and health care issues. Take a look and let us know how we can make future editions more useful for journalists and other researchers.

In this month’s RWJF Clinical Scholars Health Policy Podcast former RWJF Clinical Scholar Donald Schwarz, M.D., M.B.A., (University of Pennsylvania, 1985-1987), Philadelphia Health Commissioner and Deputy Mayor for Health and Opportunity, discusses his work combating the childhood obesity epidemic in Philadelphia, touching on that effort’s controversial soda tax. In his conversation with podcast series host, Matthew Press, M.D., Schwarz also talks about the impact of health care reform at the city health level, and the learning curve required to transition from a career in academia to government service.

Read more about the RWJF Clinical Scholars program. For an overview of RWJF scholar and fellow opportunities, visit www.RWJFLeaders.org.

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