Creating a New Healthcare

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be speaking with a colleague of mine, Dr. Ifeyinwa (Ify) Osunkwo, MD, MPH. Dr Ify Osunkwo – or Dr. Ify, as her patients refer to her – is the Director of the Sickle Cell Disease (SCD) Enterprise at Levine Cancer Institute at Atrium Health.  She is a Professor of Medicine at Atrium Health and a Clinical Associate Professor of Medicine at UNC Chapel Hill.  Dr. Ify earned her MD from the University of Nigeria and a Masters in Public Health from Johns Hopkins University.  She completed a pediatric residency at the University of Medicine & Dentistry of NJ, followed by a pediatric hematology-oncology fellowship at Columbia University.  She founded the SCD program at Atrium Health.  This program has been instrumental in improving the quality of life of persons living with SCD in North & South Carolina; and has also demonstrated positive health outcomes in terms of reduced mortality rates, reduced health care costs and hospital readmission rates, and increased patient engagement and satisfaction with care.  Dr Osunkwo has dedicated her career to providing equitable, comprehensive, compassionate and evidence based care for individuals living with SCD.  She serves on numerous national committees for the American Society of Hematology and is the Editor-In-Chief of Hematology News. I felt compelled to share this interview because Dr. Ify is offering a number of humanistic approaches to her patients that are especially important in the COVID-19 era.  They are important from a provider/patient relationship perspective in that they directly address the issues of social isolation, loneliness and anxiety that people with chronic medical conditions are experiencing.  They are important because they address the concrete issue of chronic disease management, which are disproportionately affected by the social distancing and sheltering-in-place public health efforts.  There is little doubt that people with chronic medical conditions and people who are socio-economically vulnerable are impacted upon much more severely than others. I’m posting this interview with the intention and hope that providers from across the country will be inspired by Dr. Ify’s example and adopt these and/or other similar offerings for their patients; and that healthcare systems across the country will support these providers with resources.  All of this is said with the grateful understanding that so many providers and healthcare systems are focused right now on emergency preparedness for the pandemic surge and on treating patients with COVID-19.  What I’m sharing in this interview is what I would call 2nd, 3rd and 4th wave issues – addressing the pandemic’s impact on social determinants of health and on the mental health of patients – which, as Dr. Ify points out, has a significant impact on the course and treatment of chronic disease.  But, these are issues that we need to begin to address now, even as we battle the 1st wave of the pandemic. I’ve known Dr. Ify for a number of years.  She is a wonderful physician who has a refreshing public health perspective that she applies brilliantly in her practice of medicine.  It’s clear that Dr. Ify is incredibly devoted to her patients and is an exemplary role model.  Her accomplishments and her positive impact are also a credit to the Levine Cancer Institute and the Atrium Health system that support her in this critically important, meaningful and innovative work. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Michellene Davis, an Executive Vice President at RWJBarnabas Health – the largest healthcare system in New Jersey.  Michellene leads Social Impact and Community Investment across RWJBarnabas Healthcare.  She oversees the areas of Policy Development, Governmental and External Affairs, Community and Employee Wellness, and Global Health. Ms. Davis is the first woman and first person of color to serve as an Executive Vice President in Barnabas Health system’s history. She is a lawyer and trial litigator who also has extensive experience in senior levels of state government. Michellene is nationally recognized for her contributions to healthcare. In 2018, she received Modern Healthcare’s Top 25 Most Influential Minorities in Healthcare award. This dialogue is filled with more expertise, wisdom, humanity and hope than I could ever begin to describe.  It’s also an eye-opening description and depiction of one of the current epi-centers of the COVID-19 pandemic. Michellene shared her incredible experience and expertise on a range of topics, including: The brave work that healthcare providers & staff are doing in our hospital systems The physical & psychological toll of the COVID-19 ‘battlefield’ on healthcare providers & staff The severely negative and disproportionate impact of COVID-19 on the expanding segment of our population who are socio-economically vulnerable – and the impact that will have on everyone in our society A list of recommendations for the work we must immediately begin, in order to mitigate the ‘2nd wave’ of the pandemic tsunami.  This is not an infectious disease wave, but a tidal wave of repercussions from the social determinants of health – such as lack of income and food, and the lack of a strong national public health infrastructure. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, On Friday March 27th 2020, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking two questions: (1) How is the COVID-19 pandemic immediately changing the way you’re delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be speaking with Dr. David Shulkin.  Dr. Shulkin served as the 9th Secretary of the US Department of Veterans Affairs, as a member of President Trumps’ cabinet.  Previous to that he served as Under-Secretary for Health, having been appointed by President Obama. Prior to entering the government, Secretary Shulkin was a widely respected healthcare executive.  He has been named as one of the Top 100 Physician Leaders by Becker’s Hospital Review and one of the “50 Most Influential Physician Executives in the Country” by Modern Healthcare and Modern Physician.   Dr. Shulkin is an amazing leader and it’s always a privilege and pleasure to speak with him as he describes the principled-based, data-driven leadership we’ll need in the COVID-19 and post COVID-19 era.  In this dialogue he speaks to a number of issues, including: The renewed recognition of the critical role of government in preparing and maintaining a public health system The need for a more integrated national public healthcare system – that recognizes & addresses the disparities and inequities in healthcare The impact and fall-out of this pandemic on the social determinants of health, which Dr. Shulkin believes could be its most devastating consequence The changes in our daily lives – including some positive ones – such as a sense of kindness and generosity, as well as shared responsibility, adaptiveness and resilience The social awareness and consciousness being raised, especially amongst the younger generations, who may, for years go come, be motivated to enter into public health service These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Dr. Paul Offit, an internationally recognized expert and scientific pioneer in the field of virology and immunology; and the leading virology expert in the U.S.  He is the co-inventor of the rotavirus vaccine recommended for universal use in infants by the CDC, which is credited with saving hundreds of childrens’ lives each day. He is a professor in the division of Infectious Diseases at the Children’s Hospital of Philadelphia, and a professor of Vaccinology at the University of Pennsylvania School of Medicine  (See abbreviated Bio below). My dialogue with Dr. Offit was incredibly hopeful, hugely informative and beyond inspiring.  He is clearly a brilliant medical scientist and a courageous humanitarian. We covered a range of topics including: His perspective on the COVID-19 surge curve and social distancing The 3 major lessons (reframes) he believes we need to learn from this current pandemic His expert thoughts regarding the amount of time it will take to develop a COVID-19 vaccine His views regarding the impact of our public health response on the social determinants of health These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD Paul A. Offit, MD, is Director of the Vaccine Education Center and professor of pediatrics in the Division of Infectious Diseases at Children’s Hospital of Philadelphia.  He is the Maurice R. Hilleman Professor of Vaccinology at the Perelman School of Medicine at the University of Pennsylvania.  Dr. Offit has published more than 150 papers in medical and scientific journals in the areas of rotavirus-specific immune responses and vaccine safety. He is also the co-inventor of the rotavirus vaccine, RotaTeq®, recommended for universal use in infants by the CDC. For this achievement, Dr. Offit received the Luigi Mastroianni and William Osler Awards from the University of Pennsylvania School of Medicine, the Charles Mérieux Award from the National Foundation for Infectious Diseases, and was honored by Bill and Melinda Gates during the launch of their Foundation’s Living Proof Project for global health. In 2009, Dr. Offit received the President’s Certificate for Outstanding Service from the American Academy of Pediatrics. In 2011, he received the David E. Rogers Award from the American Association of Medical Colleges, the Odyssey Award from the Center for Medicine in the Public Interest, and was elected to the Institute of Medicine of the National Academy of Sciences. In 2012, Dr. Offit received the Distinguished Medical Achievement Award from the College of Physicians of Philadelphia and the Drexel Medicine Prize in Translational Medicine from the Drexel University College of Medicine. In 2013, he received the Maxwell Finland award for Outstanding Scientific Achievement from the National Foundation for Infectious Diseases, the Distinguished Alumnus award from the University of Maryland School of Medicine, and the Innovators in Health Award from the Group Health Foundation. In 2014, he was elected to the board of trustees at the College of Physicians in Philadelphia, and in 2015, he was elected to the American Association of Physicians and the American Academy of Arts and Sciences as well as being named as a Fellow for the Pediatric Infectious Diseases Society and the American Academy for the Advancement of Science. In 2016, Dr. Offit received the Franklin Founder Award by the City of Philadelphia, The Porter Prize from the University of Pittsburgh School of Public Health, and the Jonathan E. Rhoads Medal for Distinguished Service to Medicine from The American Philosophical Society. In 2017, he received the Defensor Scientiae Award and an Honorary Doctor of Science degree from The University of the Sciences in Philadelphia.

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing Andrew Parker, the founder & CEO of Papa.  I recently interviewed Andrew and would encourage you to listen to this amazing entrepreneur and amazing new venture.  You can find that dialogue here.  Although I had recently posted that interview, Andrew was one of the first people I thought to reach out to in this limited series because of how critically important and relevant his service is in this time of social distancing, sheltering-in-place, and lockdowns. Papa is  an on-demand service designed to deliver companionship and non-clinical services to seniors and  families. These non-clinical services are delivered through so-called ‘Papa Pals’ who are college age students who assist in a number of ways including household activities, transportation, shopping, filling out forms… Another reason I reached out to Andrew was to learn how Papa had dramatically pivoted its service model to adapt to COVID-19.  It’s such a delight speaking with Andrew. His energy, enthusiasm, and vision; as well as his accomplishments and outcomes with Papa are uplifting, and provide us with tremendous hope for the future. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here.  In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions: (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare?   (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’ll be interviewing two digital innovation superstars from Providence – Sara Vaezy & Maryam Gholami.  Providence is one of the most progressive and innovative integrated delivery systems in the country.  As a result of their long-term investments in healthcare transformation, they are incredibly well prepared for the current situation, and also well prepared to be highly adaptive and agile over the next few months and years.  Lots of lessons to learn from this organization! What you’ll hear in this interview will include: A ‘consumer hub’ which includes a chatbot “Grace” that assesses and navigates patients to appropriate care – and how that’s been adapted for COVID-19. How Providence has pivoted the use of their online ‘on-demand’ platform “Express Care”, which includes ‘virtual video visit’ services that have now also been adapted to deliver chronic disease management in addition to the already existent urgent-care visit use. The greater than 10-fold increase in the number of virtual visits that Providence has been able to scale up to in the past few weeks!  (A fact that is highly illustrative of the rapid shift, Providence has conducted more virtual visits in the first 3 weeks of March 2020 than in the entire year of 2019) The accelerated advances Providence is deploying in home-monitoring of higher risk patients; as well as their focus on the behavioral health of patients and providers. How diligently the Providence digital development and marketing teams are listening to the continuously shifting needs and expectations of their healthcare consumers/patients; and how rapidly they are iterating their products and services to accommodate. Providence is a not-for-profit Catholic health system comprising 51 hospitals as well as 1,085 clinics and other health services, with over 119,000 caregivers serving communities across seven states. Sara Vaezy leads the overall development of the digital strategy, digital partnerships, new business commercialization and business development.   Maryam Gholami is the Chief Product Officer for digital innovations. She leads product development, commercialization, and growth of the consumer digital portfolio. She is also responsible for leading the applications of advanced technologies such as AI and machine learning. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear Friends & Colleagues, Last week, I launched a limited podcast series addressing how the COVID-19 pandemic is reframing American healthcare.  You can find the introduction episode here. In this series, I’ll be interviewing future-facing healthcare leaders and entrepreneurs – to ask two questions:  (1) How is the COVID-19 pandemic immediately changing the way you are delivering healthcare? (2) How will COVID-19 reframe American healthcare for years to come? In this episode, we’re interviewing Dr. Erik Vanderlip, the Chief Medical Officer of Zoom+Care. Zoom+Care is a pioneering healthcare company based in the Pacific Northwest.  It’s mission is to create an innovative, patient-empowered, on-demand health ecosystem for the 21st Century.  At ZOOM+Care, Dr. Vanderlip & his colleagues are integrating behavioral health, urgent care, primary care, telemedicine and specialty care services that utilize advanced chronic care models to engage patients and promote health behavior change. These are unprecedented times, so I hope you find valuable information, guidance, and inspiration in listening to these experts and entrepreneurs share how they are adapting to this pandemic (in real time); and how they’re thinking about and planning for the future. Until next time, be safe and be well, Zeev Neuwirth MD

Dear friends & colleagues, In the three months since the Chinese government notified the WHO of the emergence of a new viral pneumonia, we appear to be on the rising ‘surge curve’ of a pandemic that threatens to overwhelm our healthcare system’s capacity. Despite the stark realities of the present moment and the unknowns that lie ahead, there has been another surge – a surge of humanitarian mission and innovation, of empathy and hope, of teaming and transformation. I am awestruck by the creativity, ingenuity, dedication and collaboration I’ve been witnessing and am privileged to be a part of. It’s difficult to express the gratitude that I and others have for the frontline providers and staff who are seeing patients in the clinics, emergency rooms and hospitals. As I observe the herculean efforts around me, I feel compelled to contribute and use my podcast platform to shed light on how this pandemic is accelerating the reframing of American healthcare… in real time. To that end, I am launching a limited podcast series entitled,‘How COVID-19 is Reframing Healthcare in America’.  In this series, I reach out to interview future-facing healthcare leaders and entrepreneurs, and ask them two questions: (1) How has the COVID-19 pandemic immediately changed the way you are delivering healthcare? (2) How will COVID-19 reframe healthcare in America for years to come? I am awed and inspired by the responses I’ve gotten in the interviews I’ve already begun recording for this series. I can’t wait to share them with you! Friends – I hope you’ll join me in this historic window of opportunity that’s been thrust upon us. The first episode in this limited series is now available for download on the ‘Creating a New Healthcare‘ podcast. I urge you to listen, share, and please reach out with your response. Until next time, be safe and be well. Zeev Neuwirth MD

Dear Friends & Colleagues, This is a timely podcast.  If you are not already a believer that social media is an integral part of our healthcare system and the larger social narrative on illness and health, then I would strongly urge you to listen to this interview. In this episode, I speak with Lisa Bookwalter, the Director Health – Twitter Client Solutions.  Lisa, who joined Twitter this past September, oversees all health client partnerships as well as Twitter’s market positioning in the health space. Prior to joining Twitter, she was a senior director at Healthline Media where she spent the past 9 years creating innovative ways for advertisers to connect with their consumers and clients. In this interview, you’ll hear: The ways in which individual healthcare consumers are using Twitter, nationally and across the globe. How healthcare providers and the medical community are using Twitter. The role Twitter is playing in public health crises, like the current covid19 pandemic. How and why pharmaceutical & device manufacturers are shifting from static websites to engaging consumers on social media channels. How Twitter differs from other social media platforms; and how Twitter is deploying safeguards for their consumers, particularly in the domain of healthcare and health. I was struck by a number of revelations during this interview. First – I really appreciated how Lisa kept pointing out that Twitter is an open platform for authentic human connectivity. As she put it, Twitter is the place people go to tell strangers the truth about themselves. This rang true to me. Unlike Facebook, Twitter is not about connecting with family & friends, or some specifically defined & circumscribed community. It’s an open, global format focused on enabling the sharing of raw experiences, thoughts and issues. It’s the place you go to connect to issues of immediate and timely concern – issues that are enhanced by diverse outreach & participation. Second – Twitter and other social media platforms are rapidly becoming the ‘go-to’ for brands looking to enhance consumer engagement. There is formal advertising on Twitter, but there are also other more organic forms of consumer engagement. The ability to ‘listen’ and understand consumers on Twitter – to receive authentic feedback on products and services seems to be emerging as superior to legacy forms of marketing such as brand websites. Third – Twitter and other social media platforms are rapidly becoming forums not only for conversation, but also for customer service. I was unaware that some companies are already utilizing Twitter for actual customer transactions. During the interview, Lisa gave the example that airlines are leveraging Twitter to allow customers to change their flights. Prior to speaking with Lisa, I hadn’t realized the extent to which Twitter could be used by healthcare consumers (patients) who were seeking information regarding treatment or referrals; and who were also wanting to connect with others who had been or were going through similar situations. During the interview I remarked to Lisa that Twitter has the potential to be the largest and most facile patient support group. It also has the potential to be a highly effective form of behavior change. Social network theory has demonstrated that one of the most powerful motivators for sustained change is the connection to others who are exhibiting specific behaviors. It might be that Twitter and other social media platforms are the next-gen motivational and behavior change tools in our society. I came away from this interview with a much greater sense of how social media can, at an unprecedented scale, transform the healthcare consumers’ experience and healthcare professionals’ capabilities. Lisa Bookwalter’s fundamental premise is that Twitter is about providing people with authentic, meaningful, real-time human connection, on issues that are of immediate importance. If an underlying principle of healthcare is also about human connection, then there is a synergy here I think few of us have yet to fully comprehend. Until Next Time, Be Well. Zeev Neuwirth MD

Dear Friends & Colleagues, Every day in the US, 11,000 people turn 65 years old. By 2023 it’s estimated that there will be nearly 55 million seniors in the US, and by 2030, seniors will make up over 20% of the US population. The literature informs us that social isolation & loneliness is rampant – affecting over half of seniors. The literature also informs us that social isolation contributes to many unwanted outcomes, including: (1) depression and an overall sense of unhealthiness, (2) poor medication adherence; (3) increases in ED utilization & hospital admissions. This problem is fueled by the fact that there are simply not enough healthcare professionals to provide the care seniors need, especially with growing shortages in primary care and nursing. And even if we had enough trained professionals, the costs would be unmanageable and unsustainable. There needs to be another solution – a reframing of healthcare and the healthcare workforce for senior care. Here is where Papa enters the picture. Papa is an automated, on-demand service that assigns college-age students to spend time with seniors. The students, called Papa Pals, are carefully selected and provide seniors with companionship, non-clinical assistance at home, and transportation to local destinations such as the supermarket, pharmacy, and doctor’s office. And, as you’ll hear, Papa has expanded its services to non-seniors like postpartum women and family caregivers of older adults. Our guest this week is Andrew Parker, the founder & CEO of Papa. He started Papa to support his grandfather, whom he called Papa. Andrew has led Papa to raise over $13M in capital and expanded the service nationwide to support health plans, employers, and health systems. Prior to Papa, Andrew was an early employee at MDLIVE, one of the nation’s largest telehealth companies, where he ran health systems sales and product to bring the solution to over 30 million Americans. In this interview, you’ll hear: The significant problem of social isolation & loneliness, and the negative impact it has on healthcare utilization, costs and overall health and health outcomes. How senior healthcare consumers are actually using Papa services, and why Medicare Advantage insurers are paying for this as a benefit in their products. Some of the specific health metrics and outcomes Papa is measuring and improving. How Andrew conceives of Papa as a new cloud-based healthcare delivery system – what he terms “pre-care”. How Papa has expanded its services from “grandkids-on-demand” to “family-on demand”. I had to listen to this interview a couple of times before I began to understand the enormity of what Andrew Parker is doing with Papa. He is reframing the American healthcare workforce. Prior to Papa, we relied solely on professionals such as nurses, social workers, paramedics, community health workers and care managers to provide in-home services. Papa has increased the healthcare workforce by literally tens of millions of people, simply by tapping college-age individuals. Andrew and his colleagues are creating “a new type of healthcare provider” and leading us to rethink what it means to be a healthcare provider. Papa is a next-gen approach to the triple-aim. It’s a practical & innovative approach to solving for the social-determinants-of-health such as food insecurity and transportation. Parker is, in his own words, creating a new “cloud-based healthcare delivery system”.  This could not be accomplished without cutting-edge, cloud-based, digital technology and analytics. Without “the tech platform”, Papa would remain a local, community-based, largely manual, excel-spreadsheet type of enterprise. With the tech platform, it’s become an enterprise that delivers outstanding care and customer service that is convenient, personalized, highly responsive, cost-effective, and scale-able. Despite the reliance on technology (or maybe because of the reliance on advanced cloud-based technology), the Papa approach is incredibly empathetic and humanistic. It reminds us that healthcare is fundamentally about trusting, healing relationships. Andrew initiated this approach as a way to take care of his own grandfather.  The origin of this company – the authentic and empathetic mission of taking care of Papa – infuses everything Andrew and his colleagues are doing. It’s an inspiring purpose, and a service that is desperately needed in our country and across the globe. Until Next Time, Be Well. Zeev Neuwirth MD