Tag Archives: public health

How healthcare providers can empower voters for a healthier democracy

Posted by on

It’s Super Tuesday – a day when voters in 15 states and one U.S. territory go to the polls for the presidential primary election. I’ve written in the past about the importance of exercising your right to vote, voting your values, and highlighted some of the non-partisan “get out the vote” organizations.

This time I want to address the intersection of voting and healthcare, but not from a policy perspective. You can probably guess my views on key policies. But rather from an empowering everyone to vote perspective. Whether you vote in the primary or not, much is at stake in the November general election.

Let me start with a very progressive organization, A Healthier Democracy, that I learned about last year when their CEO, Dr. Alister Martin, spoke at the annual NEHIMSS Chapter Conference. According to their website:

A Healthier Democracy builds platforms for collaboration and community organizing at the intersection of health and civic engagement to maximize collective impact on pressing challenges.

They are home to five high-impact national initiatives. There are two initiatives involving voting that I want to highlight – Vot-ER and Patient Voting: Continue reading →

Healthcare as a right in more progressive countries   

Posted by on

I wasn’t going to write anything this week since my husband and I just returned from an 18-day trip with Road Scholar – The 4 Nordic Capitals. We spent 3-4 days in each – Copenhagen, Oslo, Stockholm, and Helsinki. It was everything I had hoped it would be! But no one hopes for jet lag and feeling like a zombie the first day or two back.

So, on day 2 of re-entry, I was up very early after too short a night’s sleep as my body adjusts to the 7-hour time difference. Why not start writing? I learned so much on the trip and have lots to share in due time. No question that we can learn a lot from these progressive Nordic countries – Denmark, Norway, Sweden, and Finland.

I visited three of these capital cities when we were on a cruise in the Baltic Sea in 2018. But having only 6-8 hours in a port is nothing like immersing yourself for a few days and really learning about the country – their history, political structure, culture, social services, technology, and more.

A day with a Road Scholar tour like this includes a 1-2 hour lecture from the local guide or an outside expert and then guided tours to a variety of sites with usually some free time late afternoon to explore on your own.

Let’s start with how progressive they are. I could start from various angles – a strong focus on sustainability, extensive public transportation infrastructure, free education through the university level, lengthy required maternity/paternity leaves, and of course their healthcare system.

From my lecture notes, here are a few data points I captured on healthcare:

In Finland, healthcare is not completely free but pretty close. Prescriptions are subsidized and you pay a maximum of 700 euro in a year ($769.37 using today’s conversion rate). Think about the people you know in the U.S. who are paying thousands a month for just one critical prescription. Hospitalization is 49 euro a day regardless of what it is for ($53.86 using today’s conversion rate). Think about people in the U.S. who have to declare medical bankruptcy due to hospital bills or deplete their life savings for nursing home care. (A 2015 study by the Kaiser Family Foundation found that medical bills caused 1 million U.S. adults to declare bankruptcy every year and that 26% of Americans aged 18 to 64 struggle to pay medical bills. Medical bankruptcy is almost unheard of outside the U.S.)

In Sweden medical care is free until you are 19 years old and dental care is free until you are 24. For medical care you pay $25 per visit or procedure. After a maximum of $720 per year you don’t pay. (Local guide spoke in dollars vs euros for us).

Yes, people in these countries have high tax rates but their dollars go to services for the entire population. Healthcare is just one example – they truly believe healthcare is a right with every citizen having equal access to services.

More to come on lessons from the Nordic countries in future weeks….

The transformative power of bold leadership in healthcare

Posted by on

With reproductive rights and LGBTQ+ rights under attack in so many states, it was good to see the Summer 2023 Issue of the Brigham magazine in the mail this week. This issue is titled “Care for Every Body – Embracing Inclusive Medicine”. As a former VP and donor to Brigham and Women’s, I receive the paper copy to read. You can access it online here.

The main articles include:

  • Sex & Gender Glossary – essential terms and definitions for understanding sex, gender, and well-being.
  • Pro-Care. Pro-Patient. – describing how the Department of Obstetrics and Gynecology is working toward reproductive justice for all patients. An alarming data point: If all abortions in the U.S. were to stop, 24% more people would die from pregnancy complications and 39% more non-Hispanic Black people would die.
  • Soul Meets Body – describing how the Center for Transgender Health is breaking barriers and providing state-of-the-art, life changing care for trans and gender diverse people. An alarming data point: 46 states have proposed 491 anti-transgender laws in 2023, more than the previous four years combined.
  • Women ≠ Tiny Men – describing how physician-researchers are working to balance the scales for women’s health.

These articles and the programs described represent bold leadership in healthcare and what we should expect from healthcare providers.

Just as the Winter 2022 Issue titled “Standing Tall for Justice – Cultivating Equity and Inclusion in Medicine” was bold leadership as it covered racial equity in healthcare. And just as Michael Dowling, President and CEO at Northwell Health in New York, regularly shows us what bold leadership means. He doesn’t shy away from controversial issues as he addresses the issue of gun violence and calls for civility and decency in our public discourse.

Dr. Robert Higgins, President, Brigham and Women’s Hospital and EVP, Mass General Brigham comments in the introduction to the Summer 20223 Issue – “While forging the road toward a more inclusive healthcare systems is not an easy or immediately achievable goal, it is a vital commitment we must make. Our sense of humanity depends on it.”

Are you uncomfortable being a bold leader? Do you embrace or shy away from the DEI discussion? The DEI Committee of CHIME is hosting a webinar this Friday, June 30, at 12PM EDT that I highly recommend. It is titled “DE&I in Healthcare 2.0 – Getting Comfortable Being Uncomfortable in a Safe Space Zone”. Please follow this link to register if you want to learn how to stay DEI focused in an anti-DEI climate.

In a recent podcast interview, I was asked about some of the unique challenges and opportunities of being a CIO in the healthcare sector compared to other industries. I commented on how being in healthcare is mission driven and how we can make a difference in people’s lives. Leaders of our nation’s leading healthcare systems being willing to address the difficult issues and care for every person is one of the reasons I am passionate about working in healthcare.

What we do matters.

Related Posts:

Leadership means being bold and taking on the tough issues

Towards a more civil society

When is enough enough?

The healing power of humanity

 

ACP – addressing the digital divide

Posted by on

“We need to advance health equity in a sustainable way – not with charity care and not performative health equity”, said Dr. Alister Martin, ED physician and CEO of A Healthier Democracy in the closing keynote at the annual NEHIMSS chapter conference last week. One of the many initiatives of A Healthier Democracy is Link Health which focuses on connecting patients to the Affordable Connectivity Program (ACP) to close the digital divide.

Listening to Dr. Martin last Thursday, I decided to use this week’s blog post to amplify this important initiative and help raise awareness among health IT leaders about the ACP and its importance for healthcare. As they say, timing is everything. June 14-22 is the ACP White House Week of Action and June 16 is the ACP Healthcare Day of Action.

Here’s some background on the ACP taken from the Link Health website:

COVID-19 Accelerated A Massive Shift To Telehealth.

The COVID-19 pandemic ushered in widespread acceptance of telehealth and other digital innovations in medicine and dramatically increased the use of telehealth as an intervention to reach patients.  A recent HHS study shows a 63-fold increase in Medicare telehealth utilization and 32-fold increase in behavioral health care through telehealth triggered by the pandemic.

Access To Broadband Internet Is A Social Determinant Of Health.

Despite widespread internet usage in the United States, 15–24% of Americans lack broadband internet connection, a foundational requirement for telehealth and the bevy of other services that underpin the social determinants of health. In fact, access to broadband internet has been considered a “super” social determinant of health (SDoH).

The Affordable Connectivity Program Expands Broadband Access But Needs Help From Healthcare.

The Bipartisan Infrastructure Law created the Affordable Connectivity Program which provides a subsidy of up to $30/month for lower-income households ($75/month for households on tribal lands) on participating internet service plans and a one-time $100 subsidy for a connected device. 51.6 million households are eligible for the ACP, yet only 25% have enrolled. 38 million more households are potentially missing out on money to pay their internet bill. Importantly, only 13% of patients with Medicaid have signed up for the ACP.

Link Health is partnering with the White House, Civic Nation, and leading healthcare organizations on the ACP Week of Action to leverage the health sector to connect patients to the ACP and close the digital divide. There are resources at this site if you are ready to be part of the action and amplify the message through your organization and in your community. Continue reading →

Leadership means being bold and taking on the tough issues

Posted by on

As a leader, do you shy away from issues that may be considered too controversial or too political? What if those issues are at the core of delivering healthcare to your community and supporting your team? In our current political environment with the level of discourse so negative and uncivil, it can be hard to take a stand on something. But true leaders do just that.

Michael Dowling, President and CEO at Northwell Health in New York, is the kind of leader who doesn’t shy away from controversial issues. He should be a role model for all of us. I have mentioned him in previous posts on the need for civility and on preventing gun violence. This week I want to highlight his unwavering commitment and national leadership to prevent gun violence.

Under Dowling’s leadership, Northwell Health hosted the 4th Annual Gun Violence Prevention Forum this week. It was an in-person event in New York but open for virtual registration. I can’t tell how many were in the room but in his opening remarks he said there were over 2000 registered virtually.

His opening comments were inspiring. He said we were gathered to learn, to share, to strengthen our commitment to work together in unison, and to hold hands as we march down the road bending the curve of gun violence. He challenged us to each rethink and reimagine the obligation and responsibility of leadership. As health systems, to ask who are we, what do we stand for and believe in. He said we need to inspire others that this is health. That we can’t improve health unless we go upstream. And that health is more than medicine. Whether inside the organization or outside, to take on difficult topics. To make sure others get involved and feel bad about not doing so. He talked about the progress made. He reminded us that big issues and big successes are the result of a constellation of small things. And he encouraged us to be optimistic, that people follow optimistic leaders. He asked us to be proud, committed and fearlessly optimistic.

He talked about the National Health Care CEO Council on Gun Violence Prevention and Safety taking the pledge to prioritize the health and safety of our communities. 50 health system CEOs have signed the pledge and are united to fight gun violence. He talked about how even a few years ago he couldn’t get anyone to sign something like this. The response he got back then was it’s too political, their board wouldn’t like it, there were NRA members on their board, and so on. 50 is progress and we can hope that in the future it will be hundreds. Continue reading →

When is enough enough?

Posted by on

We are all asking when is it enough? Parents of young children are struggling with how to talk to their children, how to keep them safe. The mass shootings in Buffalo and Uvalde are the latest horrific examples of gun violence and hate in this country.

I have been struggling to find the right words. There are none. Yes, thoughts and prayers for all the victims, their families, and communities are needed. May they find the strength to carry on in the very difficult days ahead. But what’s needed in this country is action and policy change, not just more thoughts and prayers.

I read two pieces that have helped me to express what I’m feeling.

Michael Dowling, President and CEO of Northwell Health, is a progressive voice amongst healthcare executives. He doesn’t shy away from taking a stand on difficult issues and very clearly names gun violence as a public health issue. Under his leadership, Northwell established The Gun Violence Prevention Learning Collaborative for Health Systems and Hospitals, a grassroots initiative that gives healthcare professionals the space to have open dialogue about the impact of gun violence, share best practices and collectively take action. This piece in Becker’s Hospital Review describes his call to action – “Michael Dowling: ‘Every single US hospital leader should be screaming about what an abomination this is’”.

Arika Lycan posted on LinkedIn a piece that frames not just the murder of innocent elementary school children but all the ways that our rights are under attack – “Who is going to do something about this?!” I am, You are, We are.” Arika is a consistent voice for social justice. I am grateful to be collaborating with them and the entire CHIME Diversity, Equity, and Inclusion Committee to continue to educate and raise awareness with our health IT colleagues.

We can’t let Buffalo and Uvalde move out of the news cycle and be forgotten. We need to speak up, show up, donate our time and money, and vote for candidates at all levels of government who support our values. The 2022 mid-term elections are consequential. Know what candidates stand for and vote your values. And consider volunteering some of your time to do phone / text banks for critical House and Senate races in other states.

I admit that I don’t have anything truly new to say today. I have written numerous posts after similar events rocked us to the core, and I have said it all before. So, I’m sharing my “Hate has no place” post again. If you don’t want to read it again or even for the first time – here’s my bottom-line message:

We must speak up for love and justice every chance we can. We must challenge those who hate and divide us as a people. And we must vote for the kind of leaders that we are willing to trust the future of our children and grandchildren to. Please join me.

Hate has no place (written August, 2019)

The most recent horrific mass shootings are not due to video games, the Internet, nor mental illness. There are more guns in the United States than people. Let that sink in.

Hate speech, racism, and white supremacy exist and are tolerated by some of our elected leaders who are supposed to keep us all safe. Let that sink in.

This is not who we want to be as a country. It is time for responsible, moral leaders to act. Continue reading →

Know someone interested in a nursing career?

Posted by on

As National Nurses Week comes to an end, let’s continue to recognize the work nurses do in so many different settings each and every day. The theme for International Nurses Day 2022 is “Nurses: A Voice to Lead – Invest in nursing and respect rights to secure global health”. And let’s encourage young people who are interested in a nursing career to learn more about the many paths they could take. I’m hoping my readers who are already established in their own careers will share this post with the young people they know who may be considering a nursing career.

I’ve worked in healthcare IT for 40 years now. During that time, I have been fortunate to work with amazing nurses in both leadership and staff roles. There are so many different paths a nurse can take in their career. Here are the stories of a few nurses I know well.

My favorite nurse and the one I am most proud of is my oldest daughter, Katie Killinger. She decided to go into nursing after she graduated from college with a degree in Hospitality Administration / Management. When she first mentioned that she was thinking of nursing, I was very supportive and told her she’d have many potential paths as her career progressed. She went to Regis College in the Boston area in a combined undergrad/grad program. After two years she earned her Bachelor of Nursing degree and sat for the nursing boards. After the third year she had her master’s degree as a Family Nurse Practitioner. Her early nursing experience included staff nurse positions on the cardiac surgery step-down unit and then the cardiac surgery ICU at Brigham and Women’s Hospital (BWH). One of her first nurse practitioner (NP) positions was supporting two division chiefs as the NP and Coordinator of the Atrial Fibrillation Program at Mass General Hospital. For the past 10 years she has been the Chief NP of the Orthopedic/Spine Surgery Service at Brigham and Women’s Faulkner Hospital. Who knows what her future holds – I know from our many conversations that maintaining a balance between clinical and administrative time is something she considers for the long-term.

My second favorite nurse is my sister, Mary Sheehan. She and her husband, Tim, both attended a two-year associate degree nursing program and then went on to get their bachelors and advanced degrees. Continue reading →

End of year thoughts and advice for 2022

Posted by on

We are entering the third year of this pandemic. Vaccines have been available for over a year – a turning point we anxiously waited for as 2020 came to an end. But 2021 was not the turnaround year we had hoped for. Over 840,000 people have lost their lives in our country since the start of the pandemic – the majority of people who died of COVID since this summer were not vaccinated. Anti-vaxxers proudly proclaim their resistance and misinformation continues to spread. Our health system and healthcare workers are under incredible strain. Hospital leaders are pleading with their communities to get vaccinated and boosted.

It is hard to be optimistic at times.

Those who can continue to work remotely. Kids are in classrooms and used to wearing masks with parents and grandparents viewing school holiday concerts over Zoom. Families cautiously gathered over the holidays or changed plans at the last moment.

We crave normalcy and getting out in the world to do the things we enjoy – spending time with family and friends. live music, sports events, travel and more.

We tend to look ahead to the new year with hopes and dreams of a better year. We ask ourselves how can things get worse? We make resolutions.

David Muntz, my StarBridge Advisors colleague, recently wrote a blog post, “12 Steps to Prepare for 2022 – Big Challenges – Bigger Opportunities” that was far more than just a professional health IT perspective and advice. As this year comes to an end, I leave you with a few excerpts from his steps 1 and 12: Continue reading →

COVID-19 – listen to the experts

Posted by on

Dr. Anthony Fauci may be a household name for your family. But what about Andy Slavitt?  He is a policy expert who served in the Obama administration first to save health.gov and then as acting administrator of the Centers for Medicare and Medicaid Services. During the pandemic he provided reliable, relatable information and education with his daily tweets at @ASlavitt and award-winning “In the Bubble with Andy Slavitt” podcast.  He quickly became a household name with my family and a trusted resource. Many trusted him and looked to him for insight.

He served as President Biden’s Senior Advisor on COVID-19 for the first 120 days of the new administration. He is now back from the White House and in his chair on the renamed podcast – “In the Bubble with Andy Slavitt: Our Shot”.  As the podcast description says, “Just as he took us through the pandemic, this 10-week series called Our Shot is about leading us out. It’s an insider’s guide for getting closure on what happened, how we emerge, and what must come next.”

Busy as my schedule is, I am trying to keep up with this new series. So far, I have heard his interviews with CDC Director, Dr. Rochelle Walensky, and President Biden’s Press Secretary, Jen Psaki. And I am halfway through Andy’s just released book written primarily prior to his recent stint in the Biden Administration. His book, “Preventable – The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S Coronavirus Response”, is a must read. Not just to understand what happened but how do we prevent it from happening again.

While COVID-19 may seem to be behind us, it is not when you consider the variants and the percent of the population not yet fully vaccinated. Continue reading →

Systems at scale and optimized workflow

Posted by on

IT teams work at scale all the time supporting thousands of users. Workflow optimization is often a goal for new systems. The mass vaccination sites and events are at scale and depend on an optimized, efficient workflow. With over 2 million doses a day being administered now in the U.S., these sites and events are becoming more prevalent and will continue over the next several months. While there was much publicity of the problems in the vaccine rollout early on, there have been many improvements in the tools to find vaccine locations and schedule appointments, and the administering of shots. In part that has been due to improved technology and better workflow design.

Two health systems doing mass vaccination sites/events have shared their playbooks in recent weeks for others to learn from. UCHealth in Denver is offering a playbook, “COVID-19 Mass Vaccination Drive-Through Playbook”. It is a 59 page comprehensive and very detailed playbook covering organizational structure and partner involvement, pre-event planning, contingency planning, patient communication, staff, provider and agency recruitment, vaccine storage and handling, and media communications. The Atrium Health playbook is a higher-level guide for leaders – “A Leader’s Guide to Safer, Faster and More Equitable Community Vaccination Events”. Both are valuable tools whether you are in the planning stage or tweaking your current operation.

To build on these tools, I recommend checking out two recent interviews that Bill Russell did at This Week in Health IT.

Continue reading →