My Heroes

Role models who inspire

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Who inspires you? Is it an historical figure, a well-known contemporary figure, or someone you know personally? If you are like me, it is probably a number of people. I pose this question to you during Women’s History Month and must ask myself that same question.

Being on zoom calls from my home office every day, people are quick to notice and comment on the Ruth Bader Ginsburg portrait on the wall. She was truly an inspiring role model and her legacy lives on. The portrait is by a local artist, Taryn Nunez. I bought it at the 2020 Women’s Fund of Rhode Island (WFRI) annual fundraiser and silent auction (all virtual of course). WFRI invests in women and girls through research, advocacy, grant making, and strategic partnerships designed to achieve gender equity through systemic change. I support WFRI both financially and with volunteer time. I love that my RBG art is a conversation starter for both men and women who I “zoom” with. And I often hear stories of their daughters who consider RBG their hero.

I also have a picture on my desk that only I see. It is my mother a few years before she died from cancer. I am now the same age that she was when she died – a rather sobering fact. We grew up in very different times. She did not live long enough to see my life as a wife and mother beyond the first few years nor how my career has evolved. She was widowed in her early 40s and raised the four of us on her own. She inspired me at a young age to be strong, independent, and giving. Volunteer work was something we all did. We did not have much, but we could always help others who had less.

I must admit that growing up I didn’t have female heroes, but I read a lot of biographies of famous women. Continue reading →

What is a “Digital Dog”?

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My colleague, David Muntz, coined the term “digital dog” this week when he described to our StarBridge Advisors team how my two little dogs are so well informed as they walk with me every day while I listen to podcasts. I loved the term and the image!

There is so much great content to listen to. I sometimes feel like my little dogs with their short legs trying to keep up with me as I try to keep up with my two favorite podcasts – This Week in Health IT and In the Bubble. Yes, I subscribe to many more, but these are the top two that I keep up with best I can.

This Week in Health IT is three different weekly shows (each approximately 45 minutes long) – Newsday (Monday), Solution Showcase (Wednesday), and Influencers (Friday). And starting this year Bill Russell decided his audience could benefit from another option so he launched a daily news show on a separate channel – Today in Health IT (shorter at 8-10 minutes each).

I agreed to be one of the rotating co-hosts on Newsday this year. My second episode with Bill was this week – Newsday – Drive-Thru Vaccine Distribution, Reaching the Marginalized, and CIO Priorities. The first topic we covered was the UC Health Mass Vaccination Playbook – a comprehensive resource that is worth downloading. Even if you are already doing similar mass vaccine sites, I am sure there is something to learn from their playbook to refine and improve your own operation. Best practice sharing is what we do in healthcare! Check out the podcast to hear all the stories we discussed.

So that’s my plug for the best podcast series to keep up with what’s happening in health IT.

Turning to my other top podcast, In the Bubble. This is how I stay educated on COVID-19 and all things related. Continue reading →

8 health experts to follow

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In past years, I’ve used the end of the year mark as a way to highlight my most read blogs of the year and encourage you to check them out if you missed them. But who cares about my most read blogs? Instead, I want to amplify the voices of health experts who have educated us throughout this pandemic and who will continue to for many months to come. If you aren’t already following them on social media or listening to their podcasts, I encourage you to do so. They are often interviewed on the major news programs.

Trusting the science, knowing the facts, and maintaining objectivity are critical for all of us to do our part and get safely to the other side of this pandemic.

Here are the experts I recommend you follow in alphabetical order:

Esther Choo, MD, MPH, Co-Founder, Equity Quotient, is an emergency physician and professor at the Oregon Health & Science University. She has been speaking from the front lines of the pandemic since the beginning. She did a podcast series called Doctors’s Log – A Covid-19 Journal in the early months of the pandemic. Twitter: @choo_ek

Laurie Garrett is a Pulitzer Prize winning science journalist and author of several books including “The Coming Plague: Newly Emerging Diseases in a World Out of Balance” and “Betrayal of Trust: The Collapse of Global Public Health”. In 2007, she did a TED talk “Lessons from the 1918 Flu”.  Twitter: @Laurie_Garrett

Ashish Jha, MD, MPH, is an internationally respected expert on pandemic response and preparedness. He recently left his position as faculty director of the Harvard Global Health Institute and became dean of the Brown University School of Public Health.  His recent interview on In the Bubble with Andy Slavitt, “The Next Three Stages of COVID-19”, is worth checking out. And as I just learned, he also has his own podcast series, “COVID: What Comes Next”. He is a frequent contributor on all the major news outlets. Twitter: @ashishkjha

Vivek Murthy, MD, MBA, has been nominated as the next U.S. Surgeon General, a role he also served in during the Obama Administration.  He is the co-chair of the Biden COVID Task Force. His recent interview on in the Bubble with Andy Slavitt, “Inside the Biden COVID Task Force”, is worth checking out. Twitter: @vivek_murthy

Michael Osterholm, MS, MPH, PhD, is the director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota and is a world-renowned epidemiologist who has spent his career investigating outbreaks. He is a member of the Biden COVID Task Force. Continue reading →

V-Day – With the vaccine comes hope

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The UK administered the first fully tested and approved COVID-19 vaccine this week. The U.S. could be administering the vaccine as early as next week. There is hope!

Projections are that by summer 2021, most everyone in the U.S. who wants a vaccine will be able to get it. There is hope!

The Biden Administration’s health team has been announced. There will be a new reliance on clinicians, scientists, and public health experts. There is hope!

And yet, the challenges are many. To name just a few: overall supply vs demand, distribution logistics and storage, logistics of administering the vaccine, establishing guidelines for prioritized groups to receive it, ensuring both doses are administered at the right time interval, and of course public trust in the vaccine.

As I have read and listened the past week, I have learned how the free market impacts the availability of key components for the manufacturers, that each state can decide on their group priorities after the CDC publishes the guidelines, and that only about 60% of the population say they are willing to take the vaccine.

On a more encouraging note, I have heard how provider organizations have been developing their vaccine administration plan for months and how a leading pharmacy chain is planning to scale administration across their 10,000 locations and has an app ready to go for tracking patients, scheduling appointments, and sending reminders for the second dose.

I encourage you to check out these resources to understand the issues involved:

In the Bubble with Andy Slavitt podcast – Toolkit: Where and When Can I Get the Vaccine? He talks about the science with Dr. David Agus and the logistics with CVS Health’s Tom Moriarty. Together they answer questions from listeners.

Interview with Dr. Atul Gawande in the New Yorker by David Remnick – Atul Gawande on Coronavirus Vaccines and Prospects for Ending the Pandemic. It covers a lot of ground and Dr. Gawande is as insightful here as he is in his regular New Yorker pieces and many books. Continue reading →

Well past time to support our healthcare workers – Part 2

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I knew that Governor Gina Raimondo had announced a two week pause starting November 30th and that there were growing concerns about hospital capacity here in Rhode Island. But when I got this alert pushed to my phone Monday morning like everyone else in the state, it became very real again.

I knew there was discussion about opening a field hospital in Rhode Island. But when I saw that the lead story on one of the national morning news shows was an interview with the field hospital director on opening day December 1st, it became very real again.

I knew that our ED at the largest hospital in the state was at a breaking point as I have been following Dr. Megan Ranney closely on social media in recent weeks. But when I heard her describe what it is like in the ED on this week’s In the Bubble podcast with Andy Slavitt – “Following One Shift in the COVID-19 Unit”, it became very real again. Listening to her describe mentally getting ready for her shift, donning and doffing layers of PPE that is worn the entire shift, assessing and admitting very sick patients, calling families with updates, and heading out the door with her physically exhausted co-workers at the end of a long shift, I came to appreciate even more what our frontline healthcare workers are doing 24×7 in hospitals across the country.

I am not a denialist. Quite the opposite. I have taken this virus seriously since the start. I wear a mask whenever I’m out and can’t be socially distanced. I keep a journal of all our outings and contacts. I have the Crush Covid RI app that includes a location tracker diary for the past 20 days on my phone. I have watched many news stories, read many articles, and listened to many podcasts in the past 9 months. I feel very educated and informed. And at times, I feel very sad – so many stories have brought me to tears.

When I hear about new restrictions in my state, I typically tell my husband no change for us, we’re already living that way.

But it hit me different this week. Continue reading →

With gratitude – yes, even in 2020

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Difficult as 2020 has been, it is my hope that each of us can find something to be grateful for this Thanksgiving. If you have lost a loved one to COVID, I know that no words can take away your pain and grief. If you are a “long hauler”, I hope that you are finding support from others as you navigate your ongoing health issues. If you have lost your employment due to the economic downturn, I hope you are finding support from your network to find a new job.

Many times, during the past 9 months I have said to my family and friends – I can’t complain, I’m healthy and alive. I never really felt my age, but since March I have been reminded that I am an “elder”. I am overall healthy with no underlying conditions but I’m in that over 65 group. My husband is 4 years older than me and does have some medical conditions. We have been mask wearers since mid-March and do our best to minimize our risks.

I have much to be grateful for. Healthcare workers caring for COVID patients on the front lines and scientists working to develop a vaccine. All those who support them in ways we see and don’t see. And yes, that includes the IT and HTM teams in every health system who provide solutions and systems that the clinicians depend on.

I am also grateful for all the essential workers – at the grocery store, providing public transportation, delivering packages, and the police and firefighters who protect us.

My family are my big rocks. And that has never been truer than this year. I am eternally grateful for them. Continue reading →

Well past time to support our healthcare workers

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Any graph or heat map you look at, one thing is obvious – the coronavirus is out of control and spreading rapidly. New coronavirus cases have jumped by more than a third in the U.S. over the past seven days, according to data from Johns Hopkins University, the fastest pace since late March. Every day since Election Day, more than 100,000 people in the country have tested positive for the virus with a daily record of over 187,957 new cases last Friday per Worldometers.info. We went from 10 million new cases to 11 million in just one week. And we have lost over 250,000 lives.

We saw heartbreaking stories on the news from ICUs in the Northeast during March and April. Then stories from southern states. And now from hospitals in the Midwest. But when you look at the heat maps, the virus is everywhere now.

Listen to any healthcare worker and one more thing is obvious – they are exhausted and burning out. They tell story after story of how hard it is to work 12- and 18-hour shifts caring for COVID patients only to drive home past crowded bars.

We have seen exhausted physicians and nurses share their stories for months. I cannot tell their stories, but I can share them. And I can encourage you to do the same. But more importantly, I can encourage you to take the basic steps needed at this point – messages we have all heard for nearly 9 months now – wear a mask, socially distance, and wash your hands frequently.

This virus is not a hoax. It is not something you can ignore or deny. A story from a nurse in the Dakotas is the latest to go viral. She describes patients who yell at her and say she does not need to wear PPE because they don’t have COVID, right up until they are intubated.

Our healthcare workers truly are heroes, but they are at a breaking point. Our hospitals are at or nearing capacity. There are over 73,000 people hospitalized with COVID, another record since the pandemic started. Field hospitals are opening again in many states. Continue reading →

Make your voice heard, your vote counts!

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Like more than 75 million people, I have already cast my vote. My husband and I were there on the first day of early voting in our state. Millions of voters are willing to stand in long lines to vote. And at a time when new COVID-19 cases are averaging over 72,000 a day.

We are on track for record voter turnout before the election is over. In 2016, about 60% of eligible voters actually voted. Given early voting numbers, the projected 2020 total votes could be record breaking at over 150 million compared to about 135 million in 2016. Voter suppression is real and has taken many forms in this election cycle. It is already too late for mail-in ballots in many states – you will have to take it to a dropbox. And yet, early voting is at a record high.

Yes, I voted for Biden. That should be no surprise if you know me or have read many of my blog posts. I do believe this is the most consequential election in our lifetime. When the votes are counted, it will be either Biden or Trump.

The number of undecided voters is at a record low. If you are one of those undecided voters or leaning towards Trump despite all your concerns, I offer up a few statements for your consideration from some unlikely sources on why they also support Biden:

  • Former Republican Party Chairman, Michael Steele has endorsed Biden. He clearly and thoughtfully articulates his position as a longtime Republican in a recent podcast “My Country Matters: Why I am Endorsing Biden”. In the last few minutes of it, he talks about leadership, decency, and character. He quotes Dr. Martin Luther King, Jr. in saying “Our lives begin to end the day we become silent about things that matter.”
  • A conservative New Hampshire newspaper, The Union Leader, has not endorsed a Democrat for President in a 100 years. Their editorial “Our Choice is Joe Biden” says “We have found Mr. Biden to be a caring, compassionate and professional public servant. He has repeatedly expressed his desire to be a president for all of America, and we take him at his word. Joe Biden may not be the president we want, but in 2020 he is the president we desperately need. He will be a president to bring people together and right the ship of state.”
  • The CEO of Expensify, David Barrett, has publicly endorsed Biden in an email to 10M customers entitled “Protect democracy, vote for Biden”. In his opening he says, “That’s right, I’m saying a vote for Trump, a vote for a third-party candidate, or simply not voting at all — they’re all the same, and they all mean — I care more about my favorite issue than democracy. I believe Trump winning is more important than democracy. I am comfortable standing aside and allowing democracy to be methodically dismantled, in plain sight.” His full email is included in this Business News article.

I saw a story of a 102-year-old woman born before women had the right to vote who said this is the most consequential election in her life as she cast her vote. If she can get out and vote, so can you.

Don’t sit this one out. Make a plan to vote and help your family and friends make a plan. Make your voice heard. Every vote matters. This election must be decided at the ballot box by your vote, not the courts.

Resources and Related Posts:

I Will Vote

When We All Vote

Fair Fight

Vote your values

Forward together

12 more days – forward together

When healthcare becomes personal

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When you get a call that your husband has been taken to the ER by ambulance, it is hard not to think the worst. I got that call last Wednesday. The good news is that by late Friday night Tom was OK’d for discharge from the hospital. But we still do not have the answers needed. More tests and results should help us better understand what happened and why it happened so together with his PCP and specialists we can develop a go forward plan.

I have worked in healthcare for over 35 years. Our family has dealt with various minor health issues and been able to access the best healthcare available. I have the utmost respect and gratitude for health professionals and all they do.

Through this experience I have seen healthcare through the patient and family lens in a different way. I have several takeaways worth sharing.

Emergency resources – Know when to call your PCP, go to the nearest urgent care center, call 911 or head right to the hospital ER. Minutes can matter.

Friends and family – I can’t say enough here. Tom was visiting a friend when the incident started. She took him to the closest Urgent Care, they called an ambulance fairly quickly and he was taken to the closest ER. The friend reached out to another friend thinking that person might know how to contact me. Fortunately, he did. We are setting up the Emergency Contact feature on our phones for the future. On the first call with the ED physician, I did a 3-way with my daughter who is a nurse practitioner. I wanted her in the loop from the start – to help interpret what I was being told, help educate me, and advocate for Tom.

Clinician in the family – If you are fortunate as we are to have a clinician in your family, let them help you. They are invaluable. Listen to them, loop them in on calls to ask all the right questions, and let them educate you. Our daughter spent ½ hour on the phone with the attending physician before Tom was discharged while I drove to get him. She then explained it all to me and started doing more research on her own.

Accessible and Integrated EHR – Now we are in my domain. Continue reading →

COVID-19: The good, the bad, the different

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When it comes to COVID-19, there is little good. But every report that reflects progress is good news. Whether it is progress in how best to treat hospitalized patients, progress towards a vaccine, or the number of new cases, hospitalizations and deaths trending downward. I saw one of those reports just a few days ago when Shereef Elnahal, President and CEO, University Hospital in Newark, New Jersey shared their good news on social media:

“We made it.

For the first time since the #covid19 pandemic started, University Hospital has ZERO patients with coronavirus in house.

After over 1,000 discharges, leading northern NJ’s regional response, and folks in the City of Newark wearing masks, socially distancing, and getting tested, we hit a milestone that we’ve been hoping for since a time when almost every patient in our hospital had coronavirus.

So proud!”

There are probably many more hospital leaders in the Northeast who can finally report this same good news. And they have reason to be very proud of what they and their teams have done for their communities.

But there is plenty of bad. A health crisis with nearly 200,000 deaths and a projection that there could be over 400,000 deaths by the end of the year. An economic crisis with millions unemployed.

Another evolving bad news story is what we are learning about the “long-haulers”. These are people who had COVID-19 and months later report a variety of long-term symptoms. Continue reading →