Health Care Insider

Nursing can be not only physically and mentally demanding, but also emotionally draining. Nurses must treat their patients with kindness and compassion for long and demanding shifts. Some nurses, however, can burn out on caring for patients. It’s called Compassion Fatigue, and Patricia Morton, former dean of the College of Nursing at University of Utah, explores what causes the condition, warning signs to watch for and steps nurses can take to regain passion for their work.

When discussing the topic of value in health care, you need to ask your patients how they define it. Dr. Michael L. Good, Dean of the University of Florida College of Medicine, talks about their value philosophy. He shares some specific initiatives, how medical schools can train future doctors how to better offer value, and makes a case for adding the concept of "access" to the traditional value equation.

Until recently, neurosurgeons lacked significant data to confidently predict the outcome of a surgery. In recent years, a registry of data gathered from how patients perceive their surgical outcomes is helping physicians—and their patients—have better forecasts for surgical outcomes. Dr. William Couldwell, a specialist in neurosurgery at University of Utah Health, talks about how this is becoming a valuable tool in the field of surgery.

Population health is a new way of approaching health care that emphasizes prevention in a population rather than treatment of an individual. Angie Fagerlin, chair of the Department of Population Health Sciences at University of Utah Health, explains how a population-focused approach could improve overall health and reduce the cost of care.

Health care organizations are utilizing modern electronic methods to find the specific costs of procedures. Dr. Ken Kawamoto, medical information officer at University of Utah Health talks about how this knowledge can help improve their quality of stewardship and patient care.

University of Utah scientists recently revealed a robotic drill that can reduce the most delicate part of brain surgery from more than two hours to just a few moments. The drill has potential to make a big impact on the future of neurosurgery, but what did it take to make this concept a reality? Dr. William Couldwell, one of the scientists behind the new drill, talks about what it took to develop this equipment and what it means for the field.

Divergent thinking and accepting failure as an important part of a learning process are part of what it means to be creative in medicine, according to Dr. Jay Baruch, director of the Concentration in Medical Humanities and Ethics at Brown University. He speaks with Dr. Gretchen Case about how doctors can tap into their own creative senses, why it's so important to do so, and how physicians can use creativity to engage better with patients.

Sometimes a complex health concept is best explained through an analogy — an easily understood comparison of two different ideas. A medical analogy can be an effective communicative tool for any physician. For example, saying “the heart is like a pump” basically helps anyone to understand how the heart works. Dr. Evonne Kaplan-Liss, physician and journalist at Alan Alda Center for Communicating Science at Stony Brooke School of Journalism, says analogies can also help physicians connect with patients. Learn more about what makes for a good medical analogy.

End-of-life care is a difficult topic to discuss—not only for patients and loved ones but also for the physicians who treat them. It’s an important conversation for a doctor to have with their terminal patient, but how can you, as a physician, approach the topic without taking away hope? On this episode of Health Care Insider, Dr. Anna Beck, director of Huntsman Cancer Institute department of Supportive Oncology and Survivorship, discusses the best practices for having end-of-life care and how it can bring a sense of peace and closure to your patients.

Women's health is complicated, and truth is, no physician can be an expert on "all things woman." So how can clinics provide quality, comprehensive health care for women? Dr. Melissa McNeil has worked to develop a comprehensive care clinic for women at the University of Pittsburgh, where she is a Professor of Medicine and Director of the Comprehensive Women's Health Program. Dr. Kirtly Parker Jones talks to Dr. McNeil about the need to unify separated disciplines and create a joint space for internal physicians and OB/GYNs to share expertise and strategies on women's health.

For precision medicine to work, it must include a diversity of people who can access it and take advantage of its benefits–something that’s not guaranteed. We asked Dr. Maya Sabatello, assistant professor of clinical bioethics, Department of Psychiatry, and co-director of the Precision Medicine: Ethics, Politics, and Culture project at Columbia University, to give us an overview of some of the ethics of access issues in personalized medicine. She talks about the importance of collecting diverse data, whose responsibility it is to make sure that happens and how holding people accountable for their health decisions expands the conversation beyond health care.

What is quality care? It depends on whom you ask. Turns out, patients have much different definitions of quality and successful outcome than doctors and hospitals. Understanding those differences is becoming an important component of doing well in the rankings and becoming a value-driven organization. Making that change, and figuring out how to implement it within the existing system, can be difficult. Get some insights from the chief medical quality officer at University at Utah Health Care, Dr. Robert Pendleton, about what he’s doing to change that paradigm.

Precision medicine is the future of health care because it allows for customized treatment and prevention of disease. However, there are still some very important ethical, technical, social and legal issues that need to be ironed out. We asked Emily Coonrod and Jorge Contrearas to give us an overview of some of the concerns. Learn even more during the Precision Medicine Symposium December 1-2, 2016. It’s free and everyone is welcome. It’s also live streaming and will be archived on Youtube.

When you go to the hospital, you may already be anxious and stressed. Navigating the maze of a large hospital can be frustrating and being lost is the last thing you want to do when seeking treatment. Luckily, at the University of Utah, a new online wayfinding system is being developed that not only helps patients find their way, but also provides useful information about the different departments, clinics and centers. Christopher Strong, a geographic system analyst working on the project speaks about his Imagine Perfect Care statement and how this system can give patients more control over their health care.

Going to the doctor can be a hassle. Taking time off work, driving to the office and sitting in a waiting room can take hours to solve a, sometimes simple, problem. The University of Utah’s Virtual Visit program is using technology to address that issue by conducting a doctor’s visit online. Nate Gladwell, director of Telehealth at University of Utah Health Care talks about the service offered at the U and how it’s a part of imagining perfect health care.

“It is a playground for new ideas,” says Julie Beynon, director of the Imagine Perfect Care Resource Center. The recently opened center is a central hub to house, test and develop ideas to improve health care as we know it. The center focuses on making connections between organizations and providing resources, as well as feedback to help foster innovation in the U of U Health Sciences. Beynon explains the center’s mission and how it can help you get the ball rolling on that new idea.

Through the use of technology, as well as other media and information-gathering initiatives, patients can help doctors better communicate with them and other health care experts. Jean Shipman, director at Spencer S. Eccles Health Sciences Library, shares her Imagine Perfect Care statement and the library’s efforts to empower patients to become active contributors and participants in their own health care.

It seems like a no-brainer: when you are ill or recovering from a procedure, you stay in bed to rest and recover. But new research and practices actually encourage people to get up and moving as soon as possible. This new “Culture of Mobility” is a cultural shift for doctors and patients. At the University of Utah, Dr. Robin Marcus explains how this new approach to recovery may shorten healing time and increase overall patient satisfaction.

University of Utah alum, Dr. Layton Rikkers brings an experienced perspective on the transformation of health care in the United States. He emphasizes the importance of quality care in the business of health, and shares how surgeons have played a big role in bringing shifts in leadership and data-driven innovations to modern medicine.

The health care business is changing, more so in the past five years, than the preceding 20. Expanded roles for providers, alternative payment models and cutting-edge technology are altering the way we do business. But does patient care trump revenue in the emerging models? Dr. John Birkmeyer, the executive vice president of Dartmouth- Hitchcock Medical Center, visits the scope to discuss the strategies being developed to create a sustainable health care organization in modern times that values and prioritizes patient care.

For physicians, a significant amount of data is collected about a patient to better assist with their diagnosis and treatment. Dr. Andrew Bazemore is a physician and director at the Robert Graham Center for Policy Studies in Washington, D.C. He asserts that outside usual patient data collected, information such as education, social support and environment are also crucial to better health care and outcomes. He talks about what steps the industry needs to take to get a more complete understanding of patient health through more information.

Advances in genomics are creating extraordinary opportunities in medicine, but what are the potential consequences of its use to society and the individual? Joshua Shiffman, M.D., a pediatric oncologist at Huntsman Cancer Institute sits down with Wylie Burke, M.D., Ph.D., a professor of bioethics and humanities at the University of Washington to discuss the philosophy behind genomics and offers a perspective on how to use genetic testing responsibly.

If you are in the field of neurotrauma, then we don’t have to hype the significance of the guests on this week’s Health Care Insider. They include: Legendary Neurosurgeon Sir Graham Teasdale, Dr. Michael Fehlings, Dr. Ross Bullock and Dr. Andres Rubiano. Their host, Dr. Greg Hawryluk, director of neurosurgical critical care at University of Utah Health Care, asked their for thoughts on topics including: why neurotrauma is lagging behind other areas of medicine, ICP monitoring, steroids for spinal cord injury, changing behavior and what the future holds.

There’s a lot of talk about culture change in healthcare and how important it is. But how do you actually change it? Professor of biomedical informatics, Nancy Lorenzi takes us through the process she has used successfully at Vanderbilt University.

When it comes to health, we often think of factors like family history and genetics. But there are other, less obvious factors that affect our well-being. Education, public policies, and even what food is available at the local grocery store can impact your health. Ana Marie Lopez, Associate Vice President for Health Equity and Inclusion, joins us on "Health Care Insider" to discuss social determinants and how they impact you.

On this episode of Health Care Insider, we take a look at physician education after medical school. How is it funded and what impacts does it have on patient care? Dr. Brad Poss, the University of Utah’s associate dean of graduate medical education, joins Dr. Kyle Jones to answer these questions and talk about how the university is looking to innovate and improve the system to better service patients.

Gender, age, race, ethnicity and socio-economic status all can affect the quality of care a patient receives. For example, African American women have the overall poorest outcomes with breast cancer, regardless of their access to insurance. In this episode, Dr. Ana Marie Lopez explains how quality of health care in America can vary across demographics and what can be done to insure physicians provide quality health care for everyone.

Health care communicators should always be asking if our messaging methods are achieving the intended objective. In this episode of the Health Care Insider, we examine targeted messages, tailored messages and stories to see which is more effective at getting patients to schedule a colonoscopy appointment. Communication researcher Jakob Jensen explains why his research suggests stories are the best method. He also gives tips on how to best structure your stories to get the behavioral outcome you desire.

One of the latest trends in health care is precision medicine, a medical model aimed to tailor customize care along with medical practices and decisions to the individual patient. Dr. Kyle Bradford Jones talks to Dr. Will Dere, director for the Program for Personalized Health at the University of Utah, about what it takes from medical teams to provide precision medicine, and why it’s important for patients to understand what precision medicine can do for their health care.

Data can be incredibly useful to help inform big decisions—if you keep some key concepts in mind. Walter Douglas is the chief operating officer at the Rutgers New Jersey Medical School. In this short podcast, he shares some of his insight and expertise on what to do and what to avoid when you are putting together a strategic data plan.

Doctors’ instructions can be hard to understand, especially when it’s time for discharge. Most major medical institutions write dismissal summaries at a 10-11th grade reading level. Dr. Martin Zielinski, associate professor of trauma surgery at the Mayo Clinic, says this is too high for most patients. A higher readability level in medical instructions at discharge can result in more callbacks, questions and patient re-admissions. Dr. Zielinski talks with Dr. Kyle Jones about why medical instructions should be at a lower level and how to ensure better communication between patients and physicians.

If you were in charge of the U.S. health care budget, how would you get spending under control? Turns out there are a lot of factors in play beyond economics, including our culture and lifestyles. In this episode of “Help Me Understand Health Care,” Dr. Kyle Bradford Jones asks professor of economics Dr. Norm Waitzman this very question: How can we reduce health care spending and what are the challenges facing us?

Why are health care costs higher in America than anywhere else in the world? If you feel like that’s an overwhelming question and something you’ll never understand, you’re not alone. But don’t give up. Dr. Kyle Bradford Jones asks Dr. Norm Waitzman to explain this complicated issue in a way that we can all better understand what contributes to the problem and what some possible solutions might be.

Why do physicians and hospitals need to be on social media? Simple. That’s where the patients are. It’s part of how they make health care decisions - even which doctor they ultimately see. Dr. Mike Sevilla has become social media expert using it to his advantage for many years. In this interview with Dr. Kyle Bradford Jones, Dr. Sevilla shares how he uses social media to be a more effective physician, lessons he’s learned, and the benefits of having a good social media footprint.

Some children have a lot of medical problems and, consequently, multiple providers. That’s hard for both patients and families to manage. Kids get disjointed care and parents run from place to place, trying to make sure their children are getting the care they need. But what if the payment models were changed so that care could be more family-centered and providers could work in integrated teams? Would providers buy in? And how much more would it cost? Dr. Pamela Peele talks about the UPMC Health Plan experience. (And guess what? Patients did better and it cost less.)

We pay to educate our population so that we can support a strong and robust economy. But how do we protect our investment? What does it cost when people drop out of the economy because they are not healthy enough to work? What does that mean to an employer-driven healthcare marketplace? Is there an economic reason to provide preventive health care or maybe prevention starts earlier at birth? Dr. Pamela Peele, Chief Analytics Officer at the UPMC Health Plan talks about the economic arguments for population health management.

Transitioning from volume to value is a difficult but necessary change. Each hospital has different challenges, cultures, etc., so there is no one-size-fits-all solution. Even so, we can still learn from each other’s experiences. Value University is a program that’s engaging 10 teams from health care organizations across the United States, hosted by The University of Utah and sponsored by the Robert Wood Johnson Foundation. These teams each launch an improvement project at their institution and then share their best practices, success and failures so everyone learns. Dr. Andrew White, Sue Theiler, Jessica Yanny-Moody and Grace Parker at University of Washington Medical Center talk about how they’re responding to health care transformation, share what they’ve learned, and offer their advice for other institutions making the value transition.

Recent studies show that increasing medication prices is the number one health care concern for patients. The increase may mean more money for the companies that manufacture medications, but what about patients? More money spent on research and development equals increased prescription costs. Is that fair? Dr. Kyle Bradford Jones discusses the issue with Director of Drug Information Services at the University of Utah, Dr. Erin Fox. They talk about the causes of increased medication pricing and possible solutions.

Transitioning from volume to value is a difficult but necessary change. Each hospital has different challenges, cultures, etc., so there is no one-size-fits-all solution. Even so, we can still learn from each other’s experiences. Value University is a program that’s engaging 10 teams from health care organizations across the United States, hosted by The University of Utah and sponsored by the Robert Wood Johnson Foundation. These teams each launch an improvement project at their institution and then share their best practices, success and failures so everyone learns. Paula Spencer, program manager of RAM Care at Virginia Commonwealth University Health System, talks about how they’re responding to health care transformation, share what they’ve learned, and offer their advice for other institutions making the value transition.

Transitioning from volume to value is a difficult but necessary change. Each hospital has different challenges, cultures, etc., so there is no one-size-fits-all solution. Even so, we can still learn from each other’s experiences. Value University is a program that’s engaging 10 teams from health care organizations across the United States, hosted by The University of Utah and sponsored by the Robert Wood Johnson Foundation. These teams each launch an improvement project at their institution and then share their best practices, success and failures so everyone learns. Dr. Rob Cina from Medical University of South Carolina Children’s Hospital will talk about how they’re responding to health care transformation, share what they’ve learned, and offer their advice for other institutions making the value transition.

"It’s unlikely we'll see equity between male and female physicians for another 100-150 years,” according to Dr. Carrie Byington. She’s receiving the AAMC's Group on Women in Medicine and Science Individual Award this year for her contribution to creating an inclusive environment at University of Utah Health Care. Listen to this five- minute interview for her insight into the barriers facing women and minority physician-scientists and what we need to do to bring more voices to the conversation.

Why is inclusion important to the future of health care? Because, to solve the problems facing academic medicine, we need make it possible for everyone to contribute. Why is inclusion important to Dr. Carrie Byington? Listen to this brief interview and you’ll understand. It’s an inspiration to anyone that feels like they don’t belong or have anything to say that matters. Dr. Byington is the winner of the GWIMS (Group on Women in Medicine and Science) Individual Award. She shares how her journey to becoming a doctor and a leader in academic medicine has driven her desire to make inclusion a priority. Posted yesterday at 12:58pm

Transitioning from volume to value is a difficult but necessary change. Each hospital has different challenges, cultures, etc., so there is no one-size-fits-all solution. Even so, we can still learn from each other’s experiences. Value University is a program that’s engaging 10 teams from health care organizations across the United States, hosted by The University of Utah and sponsored by the Robert Wood Johnson Foundation. These teams each launch an improvement project at their institution and then share their best practices, success and failures so everyone learns. Francis Fullam and Dr. Suparna Dutta at Rush University Medical College will talk about how they’re responding to health care transformation, share what they’ve learned, and offer their advice for other institutions making the value transition.

Transitioning from volume to value is a difficult but necessary change. Each hospital has different challenges, cultures, etc., so there is no one-size-fits-all solution. Even so, we can still learn from each other’s experiences. Value University is a program that’s engaging 10 teams from health care organizations across the United States, hosted by The University of Utah and sponsored by the Robert Wood Johnson Foundation. These teams each launch an improvement project at their institution and then share their best practices, success and failures so everyone learns. Lisa Ishii at Johns Hopkins Medicine will talk about how they’re responding to health care transformation, share what they’ve learned, and offer their advice for other institutions making the value transition.

The United States needs more primary care physicians and team-based medical care to better serve patients. Primary Care Progress is a group that promotes the need for primary care teams of doctors, nurses and pharmacists and educates medical students on their benefits. Karen Gunning holds a doctorate of pharmacy (Pharm.D.) and is supervisor of the PCP chapter at the University of Utah School of Medicine. In this podcast, she and family physician Dr. Kyle Bradford Jones talk about how learning about the benefits of team-based care in med school can prepare students for success in practice and treating their patients for their whole careers.

Fifty years after Medicare was signed into law, about 50 million elderly and disabled Americans use it to help pay for their health care. The public has long supported Medicare, but physicians and many politicians were skeptical of it in the beginning. But Medicare has actually saved money for just about everyone. Dr. Kyle Bradford Jones talks about how Medicare came about, who qualifies, and how it works.

President Lindon B. Johnson signed Medicaid into law in 1965, providing government-subsidized health care to those who can’t afford it. How has it changed since then? Family physician Dr. Kyle Bradford Jones gives a quick history lesson in how Medicaid has provided care for poor individuals and families in the past and more recently, including an ongoing debate some states are having about expanding Medicaid.

Primary care is not emphasized in the U.S. health system—the current health care model is not designed to help people with multiple chronic conditions, especially those who also have mental health problems. Dr. Kyle Bradford Jones says Patient-Centered Medical Home (PCMH) models are the solution. Dr. Jones talks about the University of Utah’s Neurobehavior HOME Program, a type of PCMH, and how it is helping in the delivery of health care for people with chronic and complicated medical problems.

Has your employer created a fitness center or handed out FitBits? Many companies are beginning to offer incentives to employees who participate in wellness programs. In this podcast, Dr. Kyle Bradford Jones discusses how these programs benefit employers and employees, and how you can take full advantage of them to make yourself healthier and possibly put some extra cash in your pocket.

Many health care organizations in the United States don’t know what their own services actually cost. This is one of the reasons the U.S. spends more than twice as much on health care as other developed countries. In this podcast, Dr. Kyle Bradford Jones is joined by Dr. Bob Pendleton, Chief Medical Quality officer for the University of Utah, to discuss how the University of Utah Hospital went about finding out what the health services cost. The hospital’s strategy can be a model for other health systems all over the country.

As health spending increases, health care systems are moving toward payment models that reward value over volume. Brigitte Nettesheim is principal of the consulting firm The Chartis Group. In this podcast, she speaks about emerging payment models and the roles physicians and academic medical centers have in leading the way with value-driven care.