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 introductory episode here.  In this series, I am interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking 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? Our focus this week will be on the rapid transition, or perhaps immersion, of healthcare into a consumer-centric era.  There are very few people I can think of who have a better understanding of this topic than our guest this week.  Kevan Mabbutt is the Senior Vice President and Chief Consumer Officer at Intermountain Healthcare. Kevan has over 2 decades of experience in consumerism. Prior to joining Intermountain in 2017, he was at The Walt Disney Company, where he served as the Global Head of Consumer Insight.  At Disney, Kevan was responsible for leading large international ventures such as the establishment of the first Disney theme park in mainland China.  He brings world-class, product and service-leading consumer experience to healthcare.  I’ve had the great fortune of speaking with and interviewing Kevan numerous times over the past couple of years. If you haven’t had a chance to hear those interviews, I would urge you to listen to Episodes #45 and #52 on the ‘Creating a New Healthcare’ podcast. In this interview, we’ll cover a number of topics including: Why Kevan believes that consumers are now more in the driver’s seat than they were prior to COVID-19. The increased possibility of healthcare systems being disintermediated in the post-COVID era – by lower cost, more convenient competitors and new entrants. The two-fold strategy that Intermountain is taking to accelerate its consumer positioning and combat disintermediation – which includes leveraging its “holistic, end-to-end” integrated ecosystem of care. Some of the key experience attributes Kevan believes that healthcare consumers are seeking – again, catalyzed by the new healthcare experiences we’ve all been exposed to in the COVID-19 pandemic. The three complementary and elegant modules of the ‘Digital Front Door’ that Intermountain is currently deploying – a set of consumer-centric services that well-situate Intermountain now and into the future. Kevan’s passion and expertise in the domain of consumer experience are inspiring and catalyzing.  I have to say that each time I speak with him I am humbled not only by the depth of his knowledge and experience, but also by the core sense of empathy and humanism that drives his work and directs the strategies and tactics that he and his colleagues at Intermountain are deploying. Kevan continuously reminds us of two fundamental consumers – the patients who will have, and deserve to have, increasing consumer choice and power; and the providers and teams whom we must support in their effort to provide the best care possible.  With both sets of customers, Kevan emphasizes the need to reduce friction and create an optimal human-centered experience.  Kevan also emphasizes the need to nurture the trusting relationship between healthcare consumers, providers and integrated systems of care. I hesitate to impose a brand on anyone, but when I think of Kevan Mabbutt, the qualities that come to mind include: generous, thoughtful, balanced, humble, empathetic, data-informed, outcomes-driven, tech-enabled, and consumer-obsessed.  The one quality that stands out the most for me is Kevan’s deep sense of empathy, and his clear intention and track record of operationalizing humanism into the daily experience for patients and providers.  These are qualities that the COVID-19 pandemic reminds us are important and essential to each and every one of us.  These are, in my opinion, the qualities and branding that should be adopted by our healthcare system at large as we, hopefully, enter a time of COVID-19 recovery. 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 introductory episode here.  In this series, I am interviewing future-facing and courageous healthcare leaders and entrepreneurs – asking 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? The episode this week outlines an approach to designing the healthcare consumer experience that, in my opinion, will become a required standard of care.  Our guest is Lee Becker who currently serves as Solutions Principal at Medallia Inc.  Medallia is a pioneering and leading consumer experience management company.  Prior to joining Medallia, Lee served as the Chief of Staff for the Department of Veterans Affairs ‘Customer Experience Office’ and was responsible for transforming the patient experience there.  Lee is a Navy Veteran and former Chief Hospital Corpsman who served in operational capacities and expeditionary platforms providing care to Marines during the Iraq and Afghanistan wars. This is an incredibly instructive and inspiring dialogue in which we discuss: The “whole person” human-centered reframe the VA introduced in its healthcare consumer experience – and how relevant that is to today’s situation, and moving forward during the post-COVID-19 era. The 3 critical components Lee Becker and his colleagues utilized to deploy this holistic reframe of the healthcare consumer experience. The emerging AI-enabled, ‘signal-capture’ technology that transforms how patients can navigate through the healthcare system – again, so on point to the challenges we are currently facing and will continue to encounter in the post-COVID-19 era. Lee brings a unique set of experiences and expertise to bear.  But, even more than his expertise, wisdom and accomplishments, what impresses me most about Lee Becker is his integrity, his palpable sense of purpose and service, and his down-to-earth practicality.  The approaches he (and Medallia) are deploying are so simple and common sensical; but they are not commonplace.  If we had followed the empathetic, humanistic playbook that Lee Becker outlines, our healthcare system would have been much better prepared for the pandemic, and for the recovery in the post-COVID-19 healthcare era.  These ‘whole-person’ human-centered lessons are particularly salient to our present moment in healthcare history, in which the critical importance of emotional, relational and social health are being demonstrated in spades. As Lee points out, if we are going to fully recover from this pandemic, it will require that we take the time to learn these lessons and make the appropriate shifts – particularly the shift from thinking about healthcare consumers only as ‘clinical’ patients – to understanding, engaging and treating them as ‘whole’ people.  The take home point for me is that we must move beyond words and intentions to actually reframing healthcare, or we will find ourselves repeating history over and over again.  As Lee points out, we must, with methodological rigor – redirect our tactics and resources – and deploy the policies, processes, tools & technologies that can make healthcare more engaging, enabling & empathetic for every member of our society. 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 introductory episode here.  In this series, I am interviewing future-facing, courageous healthcare leaders and entrepreneurs – asking 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? The situation is changing rapidly. So, in order to share the remarkable insights from these interviews, as quickly as possible, I’m releasing new episodes as frequently as I can. Our guest this week is Sean Duffy – the co-founder and CEO of Omada Health, one of the leading digital healthcare companies.  I had the good fortune of meeting Sean about 8 years ago, in the early phases of Omada Health.  After a couple of hours of listening to Sean, I was completely enamored with him, his vision and mission, and with the approach he was taking.  It was, and is, breath-taking and brilliant.  Omada Health is based on solid evidence-based medicine. It’s also based on the science of behavior change – which you’ll hear more about in this interview.  I won’t go into any depth providing Sean’s background; but instead, I would urge you to listen to the first interview I posted with Sean on Nov 7, 2017 – I believe is was episode #12 of Creating a New Healthcare.   For those of you who have read my book, Reframing Healthcare, you’ll know that I quote Sean extensively in the book.  Sean and Omada Health have come a long way in the past few years.  Omada Health has come a long way in the past couple of years.  And, as you’ll hear in this interview, Omada has come a long way in the past couple of months during the COVID-19 pandemic. There are numerous critical lessons for the future of US healthcare that emerge from this interview.  The major take home lesson for me is that chronic condition management is more – much more – than a virtual visit or a remote monitoring device.  As Sean points out, it takes a lot of finely tuned and expertly managed instruments, playing all together in sync, from the same symphonic sheet to make meaningful, beautiful and emotionally moving music.  Omada Health has taken a holistic or “whole person” approach, which includes: remote monitoring; 24/7 asynchronous “signal” collection and responsiveness; machine learning and automated responses that enhance customization and personalization of care; expert health coaching and group facilitation; the power of social community to enhance engagement and behavior change; the inclusion of behavioral health monitoring and treatment into its general chronic condition management programs; and advanced motivation and behavior change approaches that include behavioral economic and habit formation techniques. Omada Health has existed in the digital/virtual/remote realm for many years prior to the COVID-19 era.  As a result, they have a vast trove of experience delivering care in this advanced way, and they can innovate at an accelerated pace.  Another major ‘ahah’ for me during this interview was the point Sean made about the data that is being collected.  Omada Health has, for years, been collecting physiologic, emotional and behavioral signals continuously.  As a result, they’re able to, in real time, analyze and understand how the various phases of the pandemic are affecting its clients and the populations they serve.  This has allowed them to rapidly iterate and adjust their care offerings to anticipate and meet their clients’ current and evolving needs during the pandemic.  This capability will contine to serve them and their clients in the post-COVID-19 era.  One example of the “signals” they’ve been able to collect in real time is the marked increase in depression and anxiety, which they’ve  almost immediately responded to by the inclusion of more behavioral health services in their programs. I came away from this interview with a greater appreciation for the work that Omada Health has been doing.  My hope is that healthcare systems across the country take advantage of these ‘representatives from the future’; and collaborate in a way that allows us to collectively leapfrog into a more advanced system of health, that not only delivers better care but also delivers more humanistic care. 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 interview future-facing, courageous, 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 Jay Desai.  Jay is the founder & CEO of PatientPing. PatientPing’s mission is simple: connecting providers to seamlessly coordinate patient care.  They provide real-time ADT feeds (Admissions, Discharges & Transfers) to providers so they can provide more coordinated and integrated care to their patients. I have first-hand experience with their service, and can’t say enough good things about PatientPing. In our dialogue, we covered a range of topics focusing largely on the flow of patients across the healthcare continuum, especially in the post acute care space.  And, how the infrastructure of the healthcare ecosystem is fundamentally being reframed by the COVID-19 experience. Our discussion included: The impact of COVID-19 on nursing homes and home health services – and the reframing of the so-called ‘post acute care’ domain. How hospitals may become hyper-segmented in the future – the very real possibility of healthcare ‘focus factories’ that have been forecasted by HBS luminaries such as Regina Herzlinger and Clayton Christensen. The reframing of ‘essential services’ including primary care. The radical (overnight) shift from patients being ‘pulled’ into ED’s & hospitals to patients being ‘pushed’ away from hospitals. A major ‘silver-lining’ by-product of this pandemic, which are the rapid regulatory changes coming out of CMS (see link or go to www.cms.gov/newsroom for recent updates) Jay Desai has a brilliant mind and a brilliant heart.  He is an empathetic and innovative entrepreneur, and a brilliant observer and commentator on the changes that are happening, as well as those that are coming in healthcare.  I hope to have the opportunity to speak with him again some time soon. 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? Our guest this week is Dr. Jennifer Schneider, the President of Livongo.  Dr. Schneider previously served as the company’s Chief Medical Officer and is also the author of “Decoding Health Signals: Silicon Valley’s Consumer-First Approach to a New Era of Health.” Livongo is a cutting-edge digital health company that uses advanced remote patient monitoring and machine-learning technologies to empower people with chronic conditions to live healthier lives.  You can hear an initial interview I recorded with Dr. Schneider for episode #72 (Oct 23, 2019) on ‘Creating a New Healthcare’. In this interview, we’ll discuss a number of topics including: The major modalities and approach that Livongo uses to empower patients and providers The specific chronic medical conditions that Livongo is currently managing How Livongo’s approach greatly advances the patient care experience as well as health outcomes – and provides much more customized, personalized care than the current approaches to chronic disease management How Livongo is being deployed to help keep patients with chronic disease safely at home, and away from healthcare facilities during this COVID-19 era Livongo has, for years, been developing a highly sophisticated approach to chronic disease management that has been used by hundreds of healthcare systems and hundreds of thousands of individuals. The unique approach allows patients to receive state-of-the-art chronic disease management without having to be seen in person. What is amazing and elegant about their applications is that it allows for greatly enhanced customization and personalization while also providing immediate responsiveness to remotely monitored biometric signals and personal health needs.  So, care is delivered continuously – when and where the patient needs it, as opposed to the reactive and episodic care provided through the current mode of medical office visits and care management programs. Livongo has been on a trajectory to deliver the type of care that is desperately needed at this point in time, during the COVID-19 pandemic. It enables patients with chronic conditions and complex chronic conditions to be cared for at home and in a highly efficient manner that also reduces the amount of provider time required. This is life saving, as patients with pre-existing chronic conditions are most likely to become infected from the SARS-COV-2 virus, and to have greater morbidities, higher risk of hospitalization, and increased mortality. It’s also life saving for the healthcare system, as the need for provider time is greatly reduced through the use of automated, machine learning technologies. The needs of our healthcare system – and the healthcare market – have caught up with the trajectory that Livongo has been on. I suspect that, once providers and healthcare systems begin to appreciate what Livongo has to offer, we will see this, and similar digital health offerings, become ubiquitous and standard of care for individuals with chronic medical conditions. 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. Our guest this week is Dr. Chris Chen, who is the CEO of ChenMed.  Dr. Chen is a board-certified cardiologist and internal medicine physician. HIs professional journey and the story of ChenMed is a remarkable one – a story of the compassionate redesign of healthcare for the older, the poorer and the sicker.  You can hear more about their story in a previous interview I recorded with Dr. Chen – Episode #38 (May 17, 2018) on ‘Creating a New Healthcare’. There are a number of critically important implications for US healthcare that emerge from this interview.  What’s clear from this conversation is that ChenMed has developed and honed a sophisticated, comprehensive model of care that is allowing it to thrive in the current pandemic – while most other primary and specialty care practices are struggling.  What’s also clear is that this model provides a VIP care experience for those with complex medical and psychosocial conditions, and delivers health and cost outcomes that are superior to the vast majority of provider groups and hospital systems across the country. What’s most critical to take away from this conversation, IMO, is the understanding that the capitated payment model that ChenMed has been built upon has allowed it to develop a proactive, preventive, primary care approach that is best-in-class, resilient, remarkably innovative, and most importantly – relationship-centered and humanistic.  What’s also critical to take away from this conversation is the understanding that the predominant fee-for-service payment model has: (1) decimated primary care; (2) led to severe disparities; and (3) limited the ability of well-meaning professionals to deliver the type of compassionate, competent care they were trained to and want to deliver.  What I realized during the course of this conversation is that you can’t put a CPT code on ‘caring’ – and that is the fundamental flaw with fee-for-service payment in primary care.  Another important lesson to be gleaned from this interview is that fee-for-service payment has rendered our system of healthcare fragile, vulnerable, and inequitable – all of which have been revealed and exacerbated by the COVID-19 pandemic. It will be important to translate these understandings into meaningful action. Healthcare leaders must (in the aftermath of the pandemic surge) address this issue of payment; and push for a more rapid conversion to value-based payment models. This will not only serve our patients and our public health; but also allow providers and healthcare systems to be less vulnerable in the future. This is not the only fix, by any means. It’s apparent that there are other reframes that need to occur, such as redesigns in clinical care models – in the use of virtual & digital health technologies; in the use of remote patient monitoring; in the use of data analytics & machine learning; in the deployment of other less costly, more accessible approaches to healthcare; and in the adoption of a consumer-centric mindset.  It’s apparent that our business models and operational approaches will require reframing as well.  Having said all that, payment is still the fundamental “but” that has prevented us from unleashing the tremendous value locked up in our healthcare system for the past many decades.  If this pandemic has taught us nothing else, it’s taught us that we must remove the fee-for-service “but” from our primary care and public healthcare lexicon. In ‘Reframing Healthcare’ I wrote, “It’s clear that the current predominant system of payment – fee-for-service – provides a perverse incentive to do more” [unnecessary, costly and potentially harmful testing, procedures & surgeries]. What’s also now clear to me is that fee-for-service payment provides a perverse incentive to do less – less caring & compassion, less proactive outreach, less prevention, less equitable care, less of all the right things that we would want for ourselves, our families, our communities, and our patients. The need to transition out of fee-for-service should be one of the first lessons discussed, and one of the first set of responses deployed in the post COVID-19 era. 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? Our guest this week is Dr. Anthony Slonim, President and Chief Executive Officer of Renown Health in Reno, NV.  Over the last four years, he and his colleagues have created one of the most innovative and progressive health services organizations in the country. Dr. Slonim is a nationally recognized thought leader. Modern Healthcare has named him one of the “50 Most Influential Clinical Executives” of 2019. He has also been named a “Physician Leader to Know” every year, since 2014, on the Becker’s Hospital Review. A board-certified pediatric intensive care doctor by training, Dr. Slonim has authored more than 15 textbooks and published more than 60 academic journal articles. Before joining Renown Health, Dr. Slonim served in executive leadership roles at Barnabas Health in NJ, Carilion Clinic in VA and Children’s National Medical Center in DC. Dr. Slonim currently chairs the American Hospital Association’s Systems Council, representing more than 300 integrated health systems nationwide. In this interview, we’ll cover a number of topics including: How the public health mindset/model is augmenting and perhaps superseding the medical mindset/model in the COVID-19 era How the current pandemic is pushing many more Americans into an existence of extreme scarcity, and the economic effect on the social determinants of health and health outcomes How Renown Health’s unique approach and operating structure – which is focused on prevention and health as well as healthcare – have prepared and positioned it to address the current situation. The escalation of behavioral and mental health conditions – a lesser talked about consequence of the pandemic, which can easily overwhelm our healthcare system, unless we find new ways to assist people. How we must use this opportunity to methodically, systematically and cautiously reframe our approach – to be prepared for not only the shock waves of this current crisis; but to be prepared for future such events by focusing on health and establishing a prepared public healthcare system. The importance of leadership at this point in time, especially at a time of widespread uncertainty and anxiety, which can cause individuals and organizations to recede into a vegetatitve mode of self-preservation. Dr. Slonim is an exceptional CEO.  In addition to being a seasoned HC executive, he is a seasoned physician and an expert in public health. In a previous interview we conducted I mentioned that we needed more CEO’s with these sorts of credentials. That was true then, but even more so now, in this COVID-19 era.  Our interview ended up going into a discourse on the type of intentional leadership that will be required in this time crisis and its aftermath. He has a perspective that I hope others leaders can be inspired by and benefit from. 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 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