Engaging Patients in Research

Dec 3, 2013, 8:00 AM, Posted by Paul Tarini

What happens when you engage patients in research? That’s a question RWJF is exploring with grants to Sage Bionetworks and PatientsLikeMe to build online, open-source platforms that give patients the opportunity to contribute to and collaborate on research.

Sage Bionetworks’ BRIDGE platform will allow patients to share and track their health data and collaborate on research into diseases and health problems that matter most to them. Three research projects will be piloted on BRIDGE in the coming year, focusing on diabetes, Fanconi anemia and sleeping disorders.

PatientsLikeMe’s Open Research Exchange (ORE) will give researchers and patients a space to work together to develop health outcome measures that better reflect outcomes that are meaningful to patients. After several months building the ORE, PatientsLikeMe is now in testing mode, putting the platform through its paces. But it’s not just an academic exercise. PatientsLikeMe has recruited four researchers to pilot the ORE. These researchers will be providing feedback on the site while working with patients in the PatientsLikeMe network to develop and test an initial set of health outcome measures.

Sage Bionetwork’s Stephen Friend discusses collaboration between patients and researchers

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National League for Nursing Aims to Bridge Gap Between Education and Practice

Nov 27, 2013, 12:00 PM

Beverly Malone, PhD, RN, FAAN, is chief executive officer of the National League for Nursing (NLN). She was recently elected to the Institute of Medicine. Last month, the NLN announced the launch of Accelerating to Practice, a new program designed to help new nurses move more seamlessly from education to practice. It is the inaugural program of the NLN's Center for Academic and Clinical Transitions.

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Human Capital Blog (HCB): Why is Accelerating to Practice needed?

Beverly Malone: We've always known that there is a difference between how nurse educators view graduates of nursing programs and how nursing directors view graduates. But we never knew how deep the divide was. A recent survey showed that 90 percent of educators thought that nurse graduates were doing just fine, but almost 90 percent of directors felt that nurse graduates did not have the skills that were needed to practice. That kind of a divide is not a small one. It has so much to do with how care is delivered, and the League felt compelled to do something about it.

HCB: What explains the divide?

Malone: We don't talk enough to one another. There are some exemplars out there where educators and administrators are on the same wavelength, and they have worked very hard to ensure that graduates are prepared in a way to move quality patient care forward. But overall, that's not the picture throughout the United States.

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Behavior Change: The Motivation Bias

Nov 27, 2013, 7:00 AM, Posted by Pioneer Blog Team

Headshot of BJ Fogg BJ Fogg, director, Stanford Persuasive Tech Lab

Each month, What’s Next Health talks with leading thinkers about the future of health and health care. Recently, we talked with BJ Fogg, director of the Stanford Persuasive Tech Lab, to discuss motivation versus ability, and to better understand which matters more in creating long-term change. In this post, Debra Joy Pérez, former assistant vice president for Research and Evaluation at the Robert Wood Johnson Foundation, who is now working with the Annie E. Casey Foundation, shares her impressions of BJ’s model and how it might impact the work of organizations like ours.

By Debra Joy Pérez

There is something magically simple in how BJ Fogg’s Behavioral Model addresses behavior change. When just three elements coincide—motivation, ability and a trigger—behavior change happens.

From my own experience, I can tell you that BJ’s model can work in developing new and healthy habits. I heard from BJ that immediately after he pees, he does push-ups. He is attaching a new habit he wants to create to an old habit he already has. Every time he relieves himself, he is triggered to perform a simple action that has him looking and feeling healthier. Like BJ, I wanted to improve my health (motivation)—specifically, I wanted to drink more water. My trigger was green tea. I drink a lot of it, so after each cup, I remember to fill the empty cup with water. I’m pleasantly surprised when I see that I’m nearing half a gallon by the middle of the day. It's working.

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A New Holiday Tradition—Tasty Recipes that are Healthy, Too

Nov 26, 2013, 5:01 PM, Posted by Catherine Arnst

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Thanksgiving is almost upon us, ushering in a month-long season of holiday parties, groaning boards of food, favorite family recipes, cookie swaps, and an extra five pounds around the waistline. Instead of just giving in to the excess and making January the month of dieting, perhaps we could make a few adjustments. I’ve asked around the Foundation staff for some healthy holiday recipes instead of the usual green bean casserole and cream-laden sides. Here are some tried and true alternatives, that are kid–friendly as well!

In fact, why not invite any children about the house (or adults who are still kids at heart) to help whip up some of these dishes. Children love to grate, stir, and shake, and the older ones will go at chopping with a vengeance. It’s never too early to teach them to cook, as discussed on this blog a few days ago.

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Empathy and Appreciation for the Impact of the Social Determinants of Health

Nov 26, 2013, 11:00 AM, Posted by Gretchen Hammer

Gretchen Hammer, MPH, is executive director of the Colorado Coalition for the Medically Underserved. She works with local and state health care leaders and policy-makers to improve Colorado’s health care system.

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Healing is both an art and a science. On one hand, clinicians are intensely driven by the quantifiable, the measurable, and the evidence-based algorithms that lead to accurate diagnosis and treatment as well as allow us to develop new innovations in medicine. However, healing is also an art. Patients are not just a collection of systems that can be separated out and managed in isolation of the whole patient. Each patient and their family has a unique set of values, life experiences, and resources that influence their health and ability to heal. Recognizing the wholeness and uniqueness of each patient is where the art of healing begins.

Empathy is defined as “the ability to understand and share the feelings of another.” It takes presence of mind and time to be empathetic. For clinicians, finding the balance between the necessary detachment to allow for good clinical decision making and empathy can challenging.  This balance can be particularly difficult for students and new clinicians.

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“An Educated Consumer is Our Best Customer:” Four Things to Know About Transparency In Health Care Prices, Costs and Quality

Nov 26, 2013, 10:14 AM, Posted by Susan Dentzer

Watch our December 6, 2013, FirstFriday Google+ Hangout archive on transparency in health care.

Panic about high health insurance premiums. Fears about high-cost health-care providers being cut out of health plan networks. Worries that the health plans now available through health insurance exchanges won’t cover the care that patients need.

Welcome to the rollout of Obamacare....right?

Actually, with the exception of the new health insurance exchanges, all of the phenomena described above have a long history. Similar concerns were voiced loudly in the late 1980s and 1990s, when “managed care” in health insurance became a dominant force on the health care and health insurance landscape.

What’s amazing to people who lived through both of these eras—then and now—is how little has changed.  

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Get Out of the Drive-Thru Lane. Learn to Cook!

Nov 22, 2013, 1:32 PM, Posted by Catherine Arnst

A woman and her teenage daughter prepare vegetables in a kitchen.

Some statistics worth pondering: According to the U.S. Bureau of Labor Statistics, the average American spends only 33 minutes a day on food preparation. Just over half of Americans bother to cook every day. On the other hand, 33 percent of children and 41 percent of teenagers eat fast food, every single day.

These fast food children are consuming 126 additional calories, and the teens 310 extra calories, than if they had avoided the chains, says Fast Food Facts 2013, a new report by the Yale Rudd Center for Food Policy & Obesity and funded by RWJF. Most of these children are eating adult meals, too, not the smaller-portioned children’s meals on offer. Not that it would matter, since less than one percent of all kids’ meal served at fast food chains meet recommended nutrition standards.

It’s not much of a stretch to link the lack of home cooking, a diet of fast food, and the fact that a third of U.S. children and adolescents are obese. So, what’s a parent to do? Well for one thing, we could learn to cook.

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Minnesota’s Healthy Communities Conference 2013: Q&A with Paul Mattessich and Ela Rausch

Nov 21, 2013, 2:45 PM

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A conference in St. Paul, Minn., earlier this month examined ideas and emerging examples for building a healthier Minnesota by promoting the integration of health-related programs and community development to address health where we live, learn, work and play. The conference was convened by the Federal Reserve Bank of Minnesota and Wilder Research, the research arm of the Amherst H. Wilder Foundation. The gathering, which was a follow-up to an initial conference on the intersection of health and community development held in Minnesota a year ago, highlighted current successful cross-sector efforts throughout the state.

Elaine Arkin, manager of the Robert Wood Johnson Foundation Commission to Build a Healthier America, was a keynote speaker at the conference. Her remarks included the announcement that the Commission’s recommendations on early childhood and supporting healthy communities will be released in early 2013.

The highlighted projects included a task force on increasing access to healthier foods, often an obstacle in poorer communities; locating needed services alongside senior housing; a stable housing concept for people at risk of homelessness following a hospital stay; and a project underway to give kids living in trailer parks a safe place to play.

“The strategy that we used this year in engaging people with actual examples...was very effective in really acknowledging that this work is messy, that it does take time and that in order to keep people enthusiastic about it sometimes it does require giving people a pat on the back even just for the small progress that they’ve made,” said Ela Rausch, community development project manager of the Federal Reserve of Minnesota.

Following the conference, NewPublicHealth spoke with Ela Rausch and Paul Mattessich, PhD, Executive Director of Wilder Research.

NewPublicHealth: What were the key goals of this year’s meeting?

Paul Mattessich: The overarching goal is at the national level to bring together public health with community development finance in order to better address health issues, social determinants of health and improved community health. But what we did the first time a year ago was to try to get the two sectors to understand what each other does, what their vocabulary was, how best to work together and to start some networking.

This year the goal was to take the next step and highlight some examples where this cross-sector collaboration occurred, and to use that to try to further that even more and to underscore the fact that the two sectors really do address the same end goal, even though they do it in different ways. And if they team up they can do it more effectively.

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How Do You Transform a Community After a Century of Neglect?

Nov 20, 2013, 1:00 PM

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Bithlo, Fla. is a town of 8,000 that is just 30 minutes outside Orlando and not much farther from the “happiest place on Earth” — but is beset by poverty, illiteracy, unemployment and toxic dumps that have infiltrated the drinking water. The water is so bad that it has eroded many residents’ teeth, making it that much harder for them to find jobs. Streets filled with trash, frequent road deaths and injuries from a lack of transportation options and safe places to walk, and dropping out before 10th grade were all the norm.

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In just a short time, a collection of partners and volunteers have begun to reverse some of the decades-old problems Bithlo has faced. And earlier this week, the town that had been forgotten for almost a century was the scene of a hubbub of activity as hundreds of volunteers descended on the town to continue work on “Transformation Village,” Bithlo’s future main street, which will sport a combination library/coffee shop, schools, shops and many other services, all long missing from Bithlo.

Over the last few months, NewPublicHealth has reported on initiatives of the participating members of Stakeholder Health, formerly known as the Health Systems Learning Group. Stakeholder Health is a learning collaborative made up of 43 organizations, including 36 nonprofit health systems, that share innovative practices aimed at improving health and economic viability of communities.

>>Read more on the Stakeholder Health effort to leverage health care systems to improve community health.

One of the Stakeholder Health members is the Adventist Health System, a not-for-profit health care system that has hospitals across the country. Recently, Adventist’s flagship health care provider, Florida Hospital in Orlando, began supporting United Global Outreach (UGO), a non-profit group aimed at building up communities in need, in their four-year-long effort to transform the town of Bithlo.

NewPublicHealth recently spoke with Tim McKinney, executive vice president of United Global Outreach, and Verbelee Neilsen-Swanson, vice president of community impact at Florida Hospital, about the partnerships and commitment that have gone into Bithlo’s transformation into a town that is looking forward to new housing stock, jobs, stores, better education and improved health outcomes for the its citizens.

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Survey Shows a Shift in Physicians’ Compensation, But Not Their Disappointment

Nov 20, 2013, 1:00 PM

The website Physicians Practice has released its annual Physician Compensation Survey, which for the third straight year shows that a majority of U.S. physicians view the income from their medical practice as “disappointing.” In 2013, 54 percent defined their net income this way, the same number as a year earlier, but 5 percent more than those who took the survey in 2011.

Physicians Practice surveyed 1,474 physicians and staff for the survey, asking about personal income, practice overhead, practice outlook, and other financial issues. For the first time, the survey acknowledged the shift from volume-based reimbursement to value-based reimbursement, asking respondents to share how much of their income is tied to factors other than the number of patients they see.

Thirty-three percent of respondents said a portion of their compensation is tied to value (quality and cost of care provided), with 8.5 percent of that group saying this was the only factor in their pay. Furthermore, 24 percent of respondents said a portion of their compensation was tied specifically to patient satisfaction.

However, productivity remained the dominant factor in physician compensation, with 28 percent of survey respondents saying that their entire compensation package was factored on productivity alone. Another 37 percent said it made up a portion of their annual pay.

See the 2013 Physician Compensation Survey results.
Read coverage of the survey in Becker’s Hospital Review.

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