Podcasts about Geisinger Health System

Episode Summary: In this episode of SoundPractice, host Mike Sacopulos sits down with Mark Katlic, MD, the chair emeritus of surgery for LifeBridge Health System in Baltimore, Maryland. Katlic opens up about his illustrious career, the creation of the Aging Surgeon Program, and the essential topic of maintaining surgical competence as surgeons age. The Aging Surgeon Program: The program addresses the critical issue of age-related competency in the surgical field. It offers a comprehensive and unbiased evaluation that assesses the physical and cognitive functions of surgeons over the age of 70. Aimed to ensure the ongoing safety and proficiency of aging surgeons, it identifies treatable or reversible conditions that, if addressed, could enhance their functional capacity. By fostering a culture of self-regulation within multidisciplinary surgical teams, the program helps maintain public trust in the healthcare system. Key Points: - The necessity of avoiding a mandatory retirement age, as individual capabilities can vary widely. - The role of strict confidentiality protocols in identifying and addressing issues that might affect a surgeon's performance. - Potential solutions that modify work conditions, allowing experienced surgeons to continue contributing without compromising safety or forcing retirement. About Mark Katlic, MD: Katlic pursued education at Washington and Jefferson College, Johns Hopkins School of Medicine, and Massachusetts General Hospital. His extensive career spans private practice, general and thoracic surgery, and academic positions at Geisinger Health System and LifeBridge Health System. Tune in to this insightful episode to learn how the Aging Surgeon Program is making a difference in the surgical community. Learn more about the American Association for Physician Leadership.

Who is responsible for getting pre authorization? How can pharmacists help doctors? What can the technician do to help expedite prior authorization? Our guests from Geisinger Health System are Kristen Kruszewski, director of pharmacy strategy, Seth Gazes, associate vice president of pharmacy strategy and planning, and Jerry Greskovic, vice president of ambulatory pharmacy services. American Medical Association CXO Todd Unger hosts.

In this insightful episode, Alan sits down with Dan Rockwell, acclaimed author of The Vagrant, seasoned leadership coach, and consultant. Together, they dive into the ways we often stand in our own way, the personal growth practices that can elevate us, and the essential qualities leaders need to embody now more than ever. Packed with practical wisdom, this conversation hits close to home for us at Stay Forth and speaks directly to the heart of meaningful leadership. About Dan Rockwell Dan Rockwell delivered his first presentation at sixteen and has been captivating audiences with his insights and workshops ever since. In 2010, his passion for leadership inspired him to start the Leadership Freak blog, now read in nearly every country and followed by almost 500,000 people across social media. Named among Inc. Magazine's "Top Fifty Leadership and Management Experts" and one of the “Top 100 Great Leadership Speakers,” Dan's work has been widely recognized. The Center for Management and Organization Effectiveness has called Leadership Freak the “most socially shared leadership blog on the Internet.” Dan's reach extends beyond the digital sphere through his keynotes and workshops with an impressive range of clients, including the National Institutes of Health, Home Depot, Ascension Health, Geisinger Health System, and the U.S. Department of Homeland Security. Holding an MBA and degrees in Theology, Pastoral Ministry, and Construction & Design, Dan's diverse background includes owning two businesses and working as a Workforce Development Consultant for Penn State. In this role, he designed courses, mentored instructors, and gave hundreds of presentations to audiences worldwide. Today, he continues his work as a leadership coach and consultant while actively serving in his local community. Dan lives in central Pennsylvania with his wife, his high school sweetheart of over 40 years. Connect with Dan Website: Leadership Freak Book: The Vagrant: Inner Journey of Leadership Parable

In this episode, hosts Dr. Grant Cooper and Dr. Zinovy Meyler engage with renowned cognitive psychologists Christopher Chabris and Daniel Simons to unravel the intricacies of memory, deception, and decision-making. They discuss how vivid but often inaccurate memories form, explore real-life scams including impersonators of the French Minister of Defense, and tackle psychological shortcuts like survivorship bias and confirmation bias. The conversation highlights the influence of AI and deepfakes on deception and offers practical advice to protect against scams, such as the use of family passwords for combating voice cloning. Additionally, they delve into decision-making traps, illustrated through examples like doctors' varied information processing. Through engaging anecdotes and their collaborative research from 'Nobody's Fool,' the episode provides insights into human cognition's limitations and the importance of recognizing and mitigating biases.(00:00) Introduction (04:20) Exploring the Mandela Effect  (06:43) The Fallibility of Memory  (16:15) Survivorship Bias in Decision-Making  (19:58) The Possibility Grid: Understanding Success and Failure  (26:36) Confirmation Bias and Scientific Errors  (38:50) The Time Reversal Heuristic  (39:50) Bias in Scientific Findings  (40:51) The Appeal of Counterintuitive Results  (42:45) Challenges in Replicating Studies  (43:46) The Reality of Social Priming  (46:28) Subliminal Perception and Its Limits  (47:34) Cognitive Training and Its Efficacy  (55:17) Chess Strategies Applied to Life  (57:09) The Importance of Asking Questions  (59:42) Avoiding Deception and Making Better Decisions  (01:04:27) The Role of Information in Decision Making  (01:09:04) ConclusionDaniel Simons and Christopher Chabris are renowned cognitive psychologists best known for their groundbreaking research on attention, perception, and cognitive illusions. Simons, a professor at the University of Illinois, and Chabris, a professor at Geisinger Health System, co-authored the influential book *The Invisible Gorilla*, which explores how our minds can overlook significant details, leading to surprising misconceptions. Their famous "invisible gorilla" experiment demonstrates how people can fail to notice obvious things when focused on specific tasks, revealing the limits of human attention and perception. Both researchers continue to investigate the fascinating ways in which our minds shape our experiences.#podcast #memory #decisionmaking #psychology #deception #mandelaeffect #interview #experts #brainscience #research #mind #cognitivescience #mentalhealth #MemoryStudy #SurvivorshipBiasThanks For WatchingSocials:YouTube: https://www.youtube.com/channel/UCKPNCI1-HBSZmiHNAlAjiIwWebsite: https://www.performanceinitiativepodcast.com/Instagram: https://www.instagram.com/performanceinitiative

Drex dives into the recent Supreme Court decision to overturn the Chevron Doctrine and its profound implications on healthcare cybersecurity regulations. Explore how this ruling could slow down regulatory processes when speed is crucial. Drex also discusses a major data breach involving Geisinger Health System and Nuance Communications, and wraps up with a look into the emerging digital afterlife industry, where generative AI brings back digital versions of the deceased. Remember, Stay a little paranoid.Subscribe: https://www.thisweekhealth.com/subscribe/Linkedin: https://www.linkedin.com/company/ThisWeekHealthTwitter: https://twitter.com/thisweekhealthDonate: Alex's Lemonade Stand: Foundation for Childhood Cancer - https://www.alexslemonade.org/mypage/3173454

Today, you will learn about Geisinger Health System, an healthcare organization based in Pennsylvania.Tune in next week for a closer look at work opportunities in the healthcare sector of the United States.This series is brought to you by Connetics, an AMN Healthcare company. Connetics is a nursing recruitment agency that offers International Nurse Candidates the best placement options for direct-hire positions in the United States' healthcare industry. As one of the leading healthcare recruitment agencies, specializing in international nursing jobs in the United States alongside permanent resident green card acquisition, Connetics partners with healthcare facilities across the US to find the best fit for our healthcare workers. We work personally with each candidate to create a successful, long-term partnership between client and candidate, and our service always comes free of charge to our healthcare workers. If you're thinking about making the step to living and working as a healthcare worker in the USA, then why not enlist the help of one of the top medical staffing agencies? Head over to amnhealthcare.com/international, to find out more.

Let Us Know What You Thought Of The Episode In our latest episode of the Savvy Investor Podcast, we sit down with Dr. Lindsey Duguet from Pennsylvania.  Dr. Lindsey Duguet is a practicing Emergency Medicine Physician and Geisinger Health System's Northeast Regional Emergency Medicine Medical Director.  She began investing in real estate with her husband in 2019 and has scaled from 0 to over 500 units all of which she actively participates in as a general partner. In this podcast we discussed: Dr. Lindsey's double hustle as a full-time doctor and real estate investorTackling the "no time" barrier for personal investmentStrategies for fast-tracking real estate portfolio growth without sacrificing her medical careerThe rough start with 'problem' properties and the takeaways she learntThe role of continuous learning and networking in her successShifting investment focus from single to multi-family properties for sustainable growth& more! Join us for an episode packed with actionable advice for both new and established investors looking to juggle successful investment while maintaining another career.Follow Dr. Lindsey Duguet: https://www.instagram.com/DocduguetLearn More About Our Trusted Partner- Ellements GroupEllements Group offers real estate investors like you the peace of mind that comes from their insightful, full-team approach to financial coaching, holistic financial planning and managing your entire financial picture, not just your portfolio. Would you like to learn more? Visit:https://thesavvyinvestor.ca/ellements-financial-groupSavvy Investor Links: Website: https://thesavvyinvestor.caInstagram: https://www.instagram.com/savvy_investorsYouTube: https://www.youtube.com/@thesavvyinvestorJoin our FREE Savvy Investor Facebook Community:  https://www.facebook.com/groups/341243106757064Disclaimer: The views and advice expressed on this podcast are those of the participants and do not necessarily reflect the opinions or beliefs of the podcast host or affiliated parties. The content is for entertainment purposes only and should not be considered as professional financial, legal, or investment advice. Listeners are encouraged to conduct their own research and consult with qualified professionals before making any financial decisions. The podcast host and producers are not responsible for any actions taken based on the information provided.

Join us for a captivating conversation with Dr. Benjamin Hohmuth, Chief Medical Informatics Officer at Geisinger Health System, as we explore healthcare informatics and leadership. Dr. Hohmuth shares insights into his background, successful projects, top priorities for the next 12 months, and anticipated changes in his role and teams. Tune in for valuable perspectives on leveraging informatics to enhance healthcare delivery.

Join us for a captivating conversation with Dr. Benjamin Hohmuth, Chief Medical Informatics Officer at Geisinger Health System, as we explore healthcare informatics and leadership. Dr. Hohmuth shares insights into his background, successful projects, top priorities for the next 12 months, and anticipated changes in his role and teams. Tune in for valuable perspectives on leveraging informatics to enhance healthcare delivery.

Tune in as Jakob Emerson from Becker's Healthcare interviews Dr. John Bulger, Chief Medical Officer of Geisinger Health Plan, exploring the factors driving member satisfaction, integration with Geisinger Health System, and Medicare Advantage strategies for 2024. Gain insights into recent developments in the healthcare landscape and valuable advice for insurance executives in this engaging conversation.

Tune in as Jakob Emerson from Becker's Healthcare interviews Dr. John Bulger, Chief Medical Officer of Geisinger Health Plan, exploring the factors driving member satisfaction, integration with Geisinger Health System, and Medicare Advantage strategies for 2024. Gain insights into recent developments in the healthcare landscape and valuable advice for insurance executives in this engaging conversation.

Dr. Mark Seeley from Geisinger Health System joins the show for a stimulating discussion on a wide range of topics including his practice as an employed surgeon in a healthcare system with its own health plan and some of the unique opportunities this provides. We discuss the role of surgeons in stewardship of healthcare spending. Dr. Seeley elaborates on his work in education and his recent study evaluating a novel femur osteotomy simulation tool. Articles selected for the lightning round include MRI predictors of residual hip dysplasia 10-years after hip reduction, risks of refracture after operatively treated both bone forearm fractures, and complications of operative treatment for lateral condyle humeral fractures with associated elbow dislocation. Your hosts are Josh Holt from University of Iowa and Julia Sanders from Children's Hospital Colorado. Music by A. A. Aalto.

  Dr. Jason Zaremski is an Associate Professor in the Department of Orthopedics and Rehabilitation at the University of Florida. Dr. Zaremski received his medical degree from Tufts University and then stayed at Tufts to complete his residency in Physical Medicine and Rehabilitation. He is fellowship trained in sports medicine through the Geisinger Health System program in Pennsylvania. He currently serves as a sports medicine physician at the University of Florida and is the Co-medical director for their high school outreach program. He is an elected member of the Board of Directors for the American Medical Society for Sports Medicine. He also has some unique awards he has earned relative to baseball. He received the Arthur Ashe award for leadership and sportsmanship in baseball for Division II and III athletes in 1997 and in 2010 was named a hall of fame catcher for the Emory University all –baseball team.    Connect with The Host! Subscribe to This Podcast Now!       The ultimate success for every podcaster – is FEEDBACK! Be sure to take just a few minutes to tell the hosts of this podcast what YOU think over at Apple Podcasts! It takes only a few minutes but helps the hosts of this program pave the way to future greatness! Not an Apple Podcasts user? No problem! Be sure to check out any of the other many growing podcast directories online to find this and many other podcasts via The Podcaster Matrix!     Housekeeping -- Get the whole story about Dr. Mark and his launch into this program, by listing to his "101" episode that'll get you educated, caught up and in tune with the Doctor that's in the podcast house! Listen Now! -- Interested in being a Guest on The Pediatric Sports Medicine Podcast? Connect with Mark today!   Links from this Episode: -- Dr. Mark Halstead: On the Web -- On X -- Dr. Jason Zaremski: On the Web -- On Z — Dr. Zaremski editorial on weighted balls in Clinical Journal of Sports Medicine https://journals.lww.com/cjsportsmed/Citation/publishahead/Weighted_Ball_Velocity_Throwing_Programs_Are.98972.aspx — Throwers Ten Exercise Handout – Univ of Florida https://www.ortho.ufl.edu/sites/ortho.ufl.edu/files/handouts/Throwers-Ten.pdf — Throwers Ten Exercise Video – Young Athlete Center https://www.youtube.com/watch?v=NEpWHynHssE — Referenced Study in Podcast: Effect of a 6-Week Weighted Baseball Throwing Program on Pitch Velocity, Pitching Arm Biomechanics, Passive Range of Motion, and Injury Rates https://pubmed.ncbi.nlm.nih.gov/29882722/?from_term=weighted+ball+AND+baseball&from_pos=3 — Impact of Ball Weight on Medial Elbow Torque in Youth Baseball Pitchers https://pubmed.ncbi.nlm.nih.gov/31053389/?from_term=weighted+ball&from_pos=5 — Biomechanical Analysis of Weighted-Ball Exercises for Baseball Pitchers https://pubmed.ncbi.nlm.nih.gov/27872403/?from_term=weighted+ball+AND+baseball&from_pos=2 — Roundtable Discussion 1/25/2020 American Sports Medicine Institute: Weighted Ball Throwing Program https://www.youtube.com/watch?v=Npgsp5An43A&feature=youtu.be Calls to the Audience Inside this Episode: -- Be sure to interact with the host, send detailed feedback via our customized form and connect via ALL of our social media platforms! Do that over here now! -- Interested in being a guest inside The Pediatric Sports Medicine Podcast with Dr. Mark? Tell us now! -- Ready to share your business, organization or efforts message with Dr. Mark's focused audience? Let's have a chat! -- Do you have feedback you'd like to share with Dr. Mark from this episode? Share YOUR perspective!   Be an Advertiser/Sponsor for This Program!     Tell Us What You Think: Feedback is the cornerstone and engine of all great podcast. Be sure to chime in with your thoughts, perspective sand more.

In this episode, Chad Lauer and Chad Evans discuss the leadership topic, 'Leading in Crisis.' Our guest is Evan Gajkowski. Evan is a nurse practitioner and the former ECMO coordinator at Geisinger Health System in Pennsylvania. He boasts numerous medical journal publications as first author, as well as many conference presentations, but most importantly, he brings us the practicable experience of leading critical care teams for the sickest patients during the height of the COVID-19 pandemic. His harrowing recounting of compartmentalizing personal emotions to continue to offer calm leadership and compassionate care in the storm offers us insight into the frontlines of an unprecedented challenge to our country, as well as essential lessons in leading during a crisis. As he and our country have emerged from the storm perseverant, Evan continues to be a stalwart in healthcare and his community, leading beyond the hospital as a youth wrestling coach and inspiring young students to pursue careers in medicine. Join us in this emotional episode that inspires us to continue to support and build our community and learn to lead together, even in the toughest of times.

Estás escuchando #JUNTOSRadio ¿Qué es un infarto cerebral?, ¿Quién tiene más riesgo de infarto cerebral?, ¿Qué se debe hacer si alguien cercano tiene síntomas de un infarto? La Dra. Carol Ulloa quien es profesora de neurología en el Centro Médico de la Universidad de Kansas y directora del Centro Integral de Epilepsia del Sistema de Salud de la Universidad de Kansas, nos responde a estas y otras preguntas.   Sobre nuestra invitada:  La Dra. Ulloa estudió medicina en la Universidad de Missouri-Kansas City. Tras completar su residencia en neurología en la Universidad de Boston, se subespecializó en los campos de la neurofisiología clínica y la epilepsia durante una beca de dos años en el New York Presbyterian Hospital-Weill Cornell Medical Center. Se incorporó al cuerpo docente del Geisinger Health System de Pensilvania durante cinco años, donde ocupó el cargo de directora asociada de neurología. Como nativa de Missouri, regresó a sus raíces en el Medio Oeste y se unió al Centro Médico de la Universidad de Kansas en 2015.   La Dra. Ulloa es una neuróloga certificada por la junta con certificación de subespecialidad en epilepsia por la Junta Americana de Neurología y Psiquiatría. Sus principales intereses clínicos son las convulsiones, la epilepsia, la epilepsia intratable, la monitorización EEG por vídeo y las intervenciones quirúrgicas para el tratamiento de la epilepsia. La Dra. Ulloa dirige un equipo multidisciplinar de epileptólogos, neurocirujanos, radiólogos y neuropsicólogos que proporciona una atención integral de vanguardia a los pacientes con epilepsia en el Sistema de Salud de la Universidad de Kansas.  Es miembro de la Sociedad Americana de Epilepsia.    Recursos informativos en español     Biblioteca Nacional de Medicina  https://medlineplus.gov/spanish/stroke.html    Clinica Mayo  https://www.mayoclinic.org/es/diseases-conditions/stroke/symptoms-causes/syc-20350113    Facebook: @juntosKS     Instagram: juntos_ks     YouTube: Juntos KS   Twitter: @juntosKS     Página web: http://juntosks.org         Suscríbete en cualquiera de nuestras plataformas de Podcast: Podbean, Spotify, Amazon Music y Apple Podcast - Juntos Radio          Centro JUNTOS Para Mejorar La Salud Latina     4125 Rainbow Blvd. M.S. 1076,     Kansas City, KS 66160       No tenemos los derechos de autor de la música que aparece en este video. Todos los derechos de la música pertenecen a sus respectivos creadores.   

Introducing our next remarkable guest, Dr. Anjani Mahabashya, a Physician Advisor at Geisinger Health System. In this transformative conversation, Dr. Mahabashya unfolds her unique journey from the world of fashion to the realm of healthcare, emphasizing the profound importance of authenticity, joy, and maintaining a positive attitude.Dr. Mahabashya shares her experiences working with senior citizens, shedding light on the poignant issue of loneliness and the transformative impact of human connection. The conversation unravels the value of being a giver, the art of building healthy communities, and the incredible power of empathy.She discuss the importance of networking, advocating for mental well-being, and the significance of finding a supportive community. Join us for an engaging and uplifting conversation with Dr. Anjani Mahabashya, where we explore the intricacies of personal and community well-being, and the transformative power of compassion. Key Takeaways:Dr. Mahabashya encourages you to become your own cheerleaders, emphasizing the importance of self-care and draping oneself with dignity. Throughout the episode, you will be gifted with insights into personal growth, resilience, and the fulfillment that comes from both self-care and giving back to the community.Contacts:LinkedIn...Book a consultation with Dr. Tomi MitchellClick HERE to schedule a free 30-minute consultation if you'd like support to take the right step towards the great life you deserve.⭐Thank you for listening to our podcast! We would greatly appreciate it if you could take a moment to give us a 5-star review. Your support helps us reach more listeners and continue to bring you high-quality content. Thank you!

"There's good news, we're actually seeing signs of a virtuous cycle, we're seeing [workforce] pride in organizations and that leads to people working together better, making the care better, which means the patients are more grateful, which makes people feel even more pride". — Dr. Thomas H. Lee, Professor of Medicine at Harvard Medical School and Chief Medical Officer at Press Ganey.In this episode, Dr. Thomas H. Lee discusses his professional growth, career development, and the core competencies of healthcare leaders. He distinguishes between leadership and management while highlighting their vital roles within complex health organizations. Dr Lee explores clinicians' important contributions to value creation, and the need to hone in on the "value chain". He further develops the idea that people should have choices when it comes to healthcare and we (healthcare providers) should be working hard to be chosen. Dr. Lee underscored the importance of trust-building with patients and staff alike.Follow Dr Thomas H. Lee: Twitter/X, LinkedIn.About the guest: Dr. Thomas Lee is the Chief Medical Officer for Press Ganey and an internist/cardiologist who practices at Brigham and Women's Hospital in Boston, Massachusetts.  He is on the faculty at Harvard Medical School and Harvard School of Public Health and is Editor-in-Chief of NEJM Catalyst and a member of the Editorial Board of The New England Journal of Medicine. He is a member of the Board of Directors of Geisinger Health System and chairs the Board of Geisinger Health Plan. Before joining Press Ganey in 2013, he was Network President for Partners Healthcare System.Additional resources mentioned in the podcast:Book - Healthcare's Path Forward: How Ongoing Crises Are Creating New Standards for ExcellenceBook - HBR's 10 Must Reads On Leadership for HealthcareTurning Doctors into Leaders - Harvard Business ReviewMusic attribution: AudioCoffee from Pixabay.Contact information: If you'd like to get in touch, reach out at jono@clinicalchangemakers.com This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit www.clinicalchangemakers.com

Anyone who makes critical decisions needs to be aware of dual process theory and the heuristics we use and are subject to. Dr. Pat Croskerry, Dr. Christopher Chabris, and Dr. Itiel Dror are all experts in critical thinking about how our minds work. This episode is also available for Yale CME credit (1.0 hour). Dr. Pat Croskerry, MD PhD, is a professor in emergency medicine at Dalhousie University in Halifax, Nova Scotia, Canada. For the past 10 years, he has been Director, Critical Thinking Program, Division of Medical Education, Faculty of Medicine, at that same institution. Trained as an experimental psychologist, Dr. Croskerry went on to become an emergency medicine physician and found himself surprised by the relatively scant amount of attention given to cognitive errors. He is one of the world's foremost experts in safety in emergency medicine and in diagnostic errors. He is humble, honest, and thoughtful; read this interview for more insight into his background and work in the emergency department (https://psnet.ahrq.gov/perspective/conversation-withpat-croskerry-md-phd). Other recent key links to his work include https://www.bmj.com/content/376/bmj-2021-068044/rr-1 and The Cognitive Autopsy (https://www.amazon.com/Cognitive-Autopsy-Analysis-Medical-Decision/dp/0190088745/ref=sr_1_1?crid=2UQIRFBZTX6JH&keywords=croskerry+cognitive+autopsy&qid=1648025342&sprefix=%2Caps%2C109&sr=8-1). Dr. Christopher Chabris, PhD is one of the originators of a famous psychology experiment (link: https://www.youtube.com/watch?v=vJG698U2Mvo); he is currently Professor and Co-director of the Behavior and Decision Sciences Program at Geisinger Health System. His book with Daniel Simons, The Invisible Gorilla (link: http://www.theinvisiblegorilla.com/) is a bestseller that goes into much greater depth on the everyday illusions of attention, memory, confidence, knowledge, cause, and potential; as well as the myth of intuition. Dr. Itiel Dror PhD is a senior cognitive neuroscience researcher at the University College London. He received his PhD in Psychology at Harvard University. He researches information processing involved in perception, judgment, and decision-making. Dr. Dror has dozens of research publications, which have been cited over 10,000 times. His academic theoretical work is complemented with applied worked in healthcare, policing and aviation --to improve human training and decision making. More information and publications are available here. Links to some papers: 1) Short piece from Science, 2) A bit more 'meat' explaining bias sources & fallacies, 3) A 'solution' too, and 4) 'Hot off the press', just published, a new paper on forensic pathology decisions. 

In this episode Alan talks with author of The Vagrant, leadership coach and consultant, Dan Rockwell, about how get in our own way, how we can grow and what we need more of right now in leaders. High practical and very close to our heart at Stay Forth   About Dan DAN ROCKWELL  gave his first presentation at the age of sixteen and has been delivering presentations and workshops ever since. Dan's fascination with leadership led him to launch his Leadership Freak blog in January 2010. Today Leadership Freak is read in virtually every country on the globe, with nearly 500,000 subscribers to its various social media channels. Dan has been named among the “Top Fifty Leadership and Management Experts” and “Top 100 Great Leadership Speakers” by Inc magazine and “Top 30 Leader in Business of 2014” by the American Management Association. His blog has been hailed as “most socially shared leadership blog on the Internet” by Center for Management and Organization Effectiveness. In addition to a devoted online following, the blog's popularity also opened up numerous opportunities to deliver keynotes and workshops. His extensive client list includes: National Institute of Health, Ace Hardware, National Association of Federal Credit Unions, Home Depot, Ascension Health, Executive Women's Conference, Florida Dept. of Transportation, Geisinger Health System, Illinois Association of School Administrators, Lexis Nexis, Allegra Networks, Homeland Security, US Department of Navy, Washington State Department of transportation, and World Leaders Conference. Dan holds an MBA and undergraduate degrees in Theology, Pastoral Ministry, and Construction and Design. He has owned two businesses and spent fifteen years as a Workforce Development Consultant for a Penn State University Special Affiliate, in which capacity he designed courses, hired and mentored instructors, and delivered hundreds of presentations for local, regional, and global organizations. He currently coaches leaders, consults with organizations, and serves in his local church. Dan lives with his high school sweetheart (His wife of over 40 years) and works in central Pennsylvania. Connect with Dan Website: www.leadershipfreak.blog Book: https://www.amazon.com/Vagrant-Inner-Journey-Leadership-Parable-ebook/dp/B0BSMT9CDQ?ref_=ast_author_dp  

IN EPISODE 147: We've all been the target of a scam, fraud, or con - but we also allow ourselves to become the source. In Episode 147, Dan Simons and Christopher Chabris teach us the habits and hooks that make us more susceptible to bad actors and information. You'll learn why people spread misinformation without even realizing it, how our memories play a role in self-deception, the words and phrases that signal potential fraud, and the questions we can ask others and ourselves to stay alert. Even the best of us can fall for frauds - but after listening to Dan and Christopher, you'll be prepared to fight back. ABOUT DAN SIMONS & CHRISTOPHER CHABRIS: Dan Simons is a professor of psychology at the University of Illinois where he heads the Visual Cognition Laboratory. Christopher Chabris is professor and co-director of the Behavioral and Decision Sciences Program at Geisinger Health System and he's also faculty co-director of Geisinger's Behavioral Insights Team. Together, Dan and Christopher have been research collaborators for a quarter century, most notably with their work on the "Invisible Gorilla " experiment, which became a New York Times bestseller. Their latest book is Nobody's Fool: Why We Get Taken In and What We Can Do About It.

How is AI taking form when it comes to helping businesses in healthcare? Dr. Nadia Boutaoui, Founder of NanoNares Inc,  joins us and shares valuable insights and use cases, discussing how AI can improve operations, enhance patient care, and revolutionize personalized medicine.Newsletter: Sign-up for our free daily newsletterMore on this: Episode PageMore on this topic in today's newsletterJoin the discussion: Ask Dr. Nadia and Jordan questions about AI in HealthcareUpcoming Episodes: Check out the upcoming Everyday AI Livestream lineupWebsite: YourEverydayAI.comEmail The Show: info@youreverydayai.comConnect with Jordan on LinkedInTimestamps:[00:00:18] Daily AI news[00:05:55] How AI improves healthcare[00:07:30] AI's role in caring for aging people[00:11:17] Mistrust of AI in healthcare and hallucinations[00:17:14] How AI helps with chronic diseases, cancer, and new drugs[00:19:41] AI's role in healthcare customer service and burnout[00:21:58] Fragmented US health systemTopics Covered in This Episode:- Caring for aging individuals in their homes    - Growing issue with the aging baby boomer population in the US.    - Anticipation of integrating AI technologies for remote healthcare support.- Future of personalized healthcare    - Data monitoring and chatbots trained on personal data for treatment.- Concerns about mistrust of AI and hallucinations    - Inaccurate information provided by language models.    - Need to address concerns as a society.- Using chatbots to answer FAQs and provide personalized responses    - Segmentation of patient population for targeted communication.- AI to identify bottlenecks and improve staff utilization    - Burnout as a significant problem in healthcare.- Supercomputers for personalized treatments in cancer    - DeepMind and IBM Watson using large data sets.    - Collaboration between Regeneron Pharmaceuticals and Geisinger Health System for new drug development.- Human oversight in advanced data analytics and AI    - Human validation of recommendations.- Concerns about data safety and third-party access    - Importance of complying with HIPAA regulationsKeywords:technology, healthcare, regulations, burnout, complexity, cost, training, workflows, safety, compliance, HIPAA, adoption, AI, electronic health records, intervention medicine, prevention, asthma, scheduling, specialists, patient care, aging individuals, diabetes, heart disease, centralized data centers, state laws, federal funding, user feedback, personalization, mistrust, hallucinations, chatbots, genomics, electronic medical records, drug development. Get more out of ChatGPT by learning our PPP method in this live, interactive and free training! Sign up now: https://youreverydayai.com/ppp-registration/

Today we welcome Daniel Simons and Christopher Chabris to the podcast. Daniel Simons is a professor of psychology at the University of Illinois where he heads the Visual Cognition Laboratory. His research explores the limits of awareness and memory, the reasons why we often are unaware of those limits, and the implications for our personal and professional lives.Christopher Chabris is professor and co-director of the Behavioral and Decision Sciences Program at Geisinger Health System. He is also faculty co-director of Geisinger's Behavioral Insights Team. From 2014 to 2017, he wrote a monthly column called GAME ON for The Wall Street Journal. His essays have been published in several media outlets.Daniel and Christopher met at Harvard University in 1997, where they began to collaborate on research. In 2004 they shared the Ig Nobel Prize in Psychology, awarded for The Invisible Gorilla experiment. Together, they co-authored the New York Times bestselling book of the same name. Their latest book is called Nobody's Fool: Why We Get Taken In and What We Can Do About It.In this episode I talk to Daniel and Christopher about scams and how NOT to get scammed! With enough information and persuasion, anybody can fall for a scheme. According to Daniel and Christopher, certain cognitive biases can make us vulnerable to deception. To help us outsmart con artists, they elaborate the different types of scams and how they work, all the while giving us tools to navigate shady situations. Website: dansimons.com & chabris.comTwitter: @profsimons & @cfchabris Topics03:20 Nobody's Fool07:54 Using AI for deception10:13 The truth bias12:42 Fixed belief bias16:40 The possibility grid22:27 Scamming through social media24:21 The Nigerian email scam27:19 Scam baiting29:01 Bernie Madoff's Ponzi scheme 35:16 Are mediums scammers?36:47 Why do people ignore red flags?38:59 The Tinder Swindler and romance scams44:05 Highly successful people get scammed too47:17 When to be skeptical54:37 Accept less, check more

The Art of Charm is brought to you by BetterHelp. Visit betterhelp.com/charm today to get 10% off your first month. Nom Nom delivers fresh dog food with every portion personalized to your  dog's needs, so you can bring out their best. Get 50% off your first two weeks at tryNom.com/artofcharm.  Working out is tough. And finding a workout program that sticks, even tougher. Peloton's classes don't feel like a regular workout class, they feel like entertainment. In fact, you'll be craving your workouts. Get started and download the free Peloton App today. Backed by a leading clinical trial where nine out of ten men experienced healthier and visibly improved skin, Caldera Lab has the tools to unlock your best first impression and confidence! Use code CHARM at calderalab.com for 20% OFF their best products. Factor, America's #1 Ready-To-Eat Meal Kit, can help you fuel up fast with ready-to-eat meals delivered straight to your door. Head to factormeals.com/charm50 to get 50% off your first box. In today's episode, we cover deception and fraud with Chris Chabris. Chris is a research psychologist, Senior Investigator at Geisinger Health System, visiting fellow at the Institute for Advanced Study, and associate professor of Psychology and co-director of the Neuroscience Program at Union College in New York. Scammers and con men are everywhere these days, but how can you recognize when you're being scammed, what behaviors or habits of your own should be aware of that tip you off as a potential victim, and what tactics do scammers, businesses, and governments use on us to get what they want?  What to Listen For Introduction – 0:00 Why are people fascinated by conmen and scammers? How did AJ get scammed in Thailand and what can you learn to avoid being scammed anywhere? How scammers choose their targets – 13:44 What 4 key cognitive habits do scammers exploit in their targets and how can you stop them from exploiting those habits in you? How we help scammers to scam us – 33:50 What do we unconsciously do to help people deceive us? How do people get away with large scale fraud and deception? What are the 4 hooks that businesses and governments use to deceive us? The weapons of scammers – 52:30 How do scammers and con men use words and memories against us? How does your memory deceive you every time you try to remember something? Learn more about your ad choices. Visit megaphone.fm/adchoices

Though he's just coming up on his one-year anniversary, Geisinger Health System CISO Zack Gable sounds like an executive with many more years leading security under his belt. That's because Gable knows his job is about “business enablement,” or empowering clinicians with the tools they need to provide superior patient care, rather than putting the […] Source: Q&A with Geisinger Health System CISO Zack Gable on healthsystemcio.com - healthsystemCIO.com is the sole online-only publication dedicated to exclusively and comprehensively serving the information needs of healthcare CIOs.

Sign up for FREE Health Affairs newsletters.Listen to Health Affairs' Leslie Erdelack and Michael Gerber discuss the newly-announced merger between Kaiser Permanente and Geisinger Health System. They discuss the evolution of value-based care, how mergers may impact patient outcomes and health spending, and how health economists are reacting to the news.Submit to You're A Health Policy Wonk If... Contest (submissions will be taken through May 31, 2023).Related Links: New Mega-deal Highlights Geisinger's Fall, and Raises Concerns About Where Kaiser Is Going Next (Stat News) Have Alternative Payment Models Led To Provider Consolidation? (Health Affairs Forefront) Value-Based Payment As A Tool To Address Excess US Health Spending (Health Affairs) Currently, more than 70 percent of our content is freely available — and we'd like to keep it that way. With your support, we can continue to keep our digital publication Forefront and podcasts free for everyone. Sign up for FREE Health Affairs newsletters.

David Fletcher, Associate Vice President of Telemedicine at Geisinger Health System, reveals the surprises, challenges, and lessons learned from a massive rollout and scaling operation of Geisinger's telemedicine program.

Healthcare Ecosystem–Times They Are A-Changin' with Fahad Rahman, CEO, Lumi Health! Fahad Rahman, CEO, Lumi Health, joins Maureen Shaffer, CEO, Mingletoe, to chat about the rapidly changing healthcare ecosystem for patients, providers, facilities, and especially for medtech startups. Fahad also shared his thoughts on how to think through referral patterns changes, hospital at home, and health equity.

Jeremy Cauwels, MD, chief physician at Sanford Health, and Kenric Maynor, MD, MBA, chair of the Medicine Institute at Geisinger Health System, join us today to discuss innovation in rural health care. American Medical Association CXO Todd Unger hosts. Learn how the AMA is #FightingForDocs and access resources from the AMA Recovery Plan for America's Physicians by visiting: https://www.ama-assn.org/recovery

Episode page with video, transcript, and more Joining us today as our guest is Louis (Lou) A. Shapiro. He is the President and Chief Executive Officer of the Hospital for Special Surgery HSS. He has served in this role since October 2006. Under Lou's leadership, HSS has experienced significant growth, expansion of facilities and recognition as the world leader in its specialty areas of orthopedics, rheumatology and their related disciplines. Lou has more than 30 years of healthcare experience, including as Executive Vice President and Chief Operating Officer of Geisinger Health System in Pennsylvania, and as a leader in the healthcare practice at McKinsey & Company. He began his career at Allegheny General Hospital in Pittsburgh, where he served in a number of capacities. Today we're going to be talking about how the culture at HSS contributes to their habitual excellence, including 13 years being ranked #1 at what they do as a specialty hospital for musculoskeletal care. What's the role of hiring the best of the best and how does a culture help them thrive and stay? What can be learned from the HSS approach that delivers such great value, including incredibly low infection rates. In today's episode, Lou talks with with host Mark Graban, about topics and questions including: Patients being willing to travel to HSS for better care and service (Net Promoter Score of 94) HSS will be celebrating its 160th year anniversary Do other organizations who are losing patients to HSS look to them for how to improve and compete? Why Lou doesn't compare HSS to anybody else Sharing data transparently Culture as strategy Would the HSS management model and culture translate to a general hospital or system? Commitment to culture on top of hiring the very best (and keeping them) Breaking down tradeoffs: better flow, faster care can also be more caring care, higher quality care, safer care Comparing costs - not just per episode, but across the continuum including conservative care The importance of not becoming a commodity Being visible and accessible as a leader "Excellence" as one of the values of the organization and realizing you're not perfect Aiming for and wanting ZERO injuries, infections, complications and ZERO dissatisfied patients

Building CIO Knowledge On a Strong Foundation In this week's 30th Anniversary Podcast episode, Bill Reed engages in a thoughtful discussion with Russ Branzell about CHIME's founding and how CHIME builds CIO knowledge. Bill is a founding Member of CHIME, the 1994 CHIME Board Chair, a CHIME Fellow, and Winner of the 1995 CHIME CIO of the Year award. Through CHIME's programs, materials, conferences, legislative advocacy, and social initiatives (like the Diversity, Equity, and Inclusion initiative and the Opioid Task Force), CHIME strengthens and builds upon CIOs' knowledge and skills. Bill shares lessons learned through his 40 years of experience in health IT. He is currently the executive vice president and partner at Huntzinger Management Group. He also served as CIO of Geisinger Health System, Quantum Health Resources, and Gentiva Health Services. He was president and CEO of AllOne Health Group and executive vice president and COO of Blue Cross of Northeastern Pennsylvania. Through it all, Bill has remained an active Member of CHIME, devoted to the development of knowledge and the advancement of healthcare IT.

If you’re interested in starting a family while living with narcolepsy, this podcast is for you. How might you manage medications or symptoms during pregnancy? What about adoption as an option? We brought together an incredible panel with so much real-life experience and insights, including people with narcolepsy who have walked this journey and an amazing clinician, Dr. Anne Marie Morse, to discuss and share. About Our Guests: DianaAnderson lives with narcolepsy type two and is the mother of a 4-year-old son. She also works full-time in physician assistant education. Emily Barker, PhD is a scientist living with narcolepsy with cataplexy and is the mom of three boys. Emily is also a co-facilitator for the Wake Up Narcolepsy Pregnancy and Parenting peer support group. Ashley Nutter, MEd is the mother of three children and a person living with narcolepsy with cataplexy. Ashley also has a Masters in Education Community Agency Counseling. Katie Williamsen is a mom to one daughter and a web designer living with narcolepsy with cataplexy. Michelle Zagardo is a photographer and teacher living with narcolepsy with cataplexy and the mother of a 6 month old daughter. Dr. Anne Marie Morse, DO is a board-certified and fellowship-trained pediatric neurologist specializing in sleep medicine at Geisinger Health System in Pennsylvania. Download the Pregnancy + Narcolepsy Toolkit for more resources: bit.ly/pregnancy-narcolepsy-toolkit. The Narcolepsy Nerd Alert series invites listeners to dive deeper into specific topics relevant to living with narcolepsy. project-sleep.com/narcolepsy-nerd-alert/

If you’re interested in starting a family while living with narcolepsy, this podcast is for you. How might you manage medications or symptoms during pregnancy? What about adoption as an option? We brought together an incredible panel with so much real-life experience and insights, including people with narcolepsy who have walked this journey and an amazing clinician, Dr. Anne Marie Morse, to discuss and share. About Our Guests: DianaAnderson lives with narcolepsy type two and is the mother of a 4-year-old son. She also works full-time in physician assistant education. Emily Barker, PhD is a scientist living with narcolepsy with cataplexy and is the mom of three boys. Emily is also a co-facilitator for the Wake Up Narcolepsy Pregnancy and Parenting peer support group. Ashley Nutter, MEd is the mother of three children and a person living with narcolepsy with cataplexy. Ashley also has a Masters in Education Community Agency Counseling. Katie Williamsen is a mom to one daughter and a web designer living with narcolepsy with cataplexy. Michelle Zagardo is a photographer and teacher living with narcolepsy with cataplexy and the mother of a 6 month old daughter. Dr. Anne Marie Morse, DO is a board-certified and fellowship-trained pediatric neurologist specializing in sleep medicine at Geisinger Health System in Pennsylvania. Download the Pregnancy + Narcolepsy Toolkit for more resources: bit.ly/pregnancy-narcolepsy-toolkit. The Narcolepsy Nerd Alert series invites listeners to dive deeper into specific topics relevant to living with narcolepsy. project-sleep.com/narcolepsy-nerd-alert/

August 30: Today on TownHall https://www.linkedin.com/in/mark-weisman-md-mba/ (Mark Weisman), CIO and CMIO at https://www.tidalhealth.org/ (TidalHealth) interviews https://www.linkedin.com/in/michaelsuk/ (Michael Suk), Chief Physician Officer, Geisinger System Service and Chair of Musculoskeletal Institute & Department of Orthopaedic Surgeries at https://www.geisinger.org/ (Geisinger Health System) about their lifetime guarantee for certain procedures. How are they able to offer this guarantee to their patients? What supporting technologies help make this guarantee possible? What are some of the challenges in working with a rural population and how do they overcome them? Sign up for our webinar: https://thisweekhealth.com/briefing_campaigns/challenges-and-solutions-to-unmanaged-devices-in-healthcare/ (Challenges and Solutions to Unmanaged Devices in Healthcare) - Thursday September 8, 2022: 1pm ET / 10am PT. If we had to https://thisweekhealth.com/captivate-podcast/securing-healthcares-extended-internet-of-things-xiot-with-medigate/ (troubleshoot just a few devices) every once in a while, our hospital systems would run as smooth as butter, right? But when missing devices, security issues and friction caused by interoperability hits, we can't expect a smooth operation. Our webinar will answer many questions surrounding the devices integral to keeping patients healthy.

This episode features Dr. Michael Suk, Chair, Musculoskeletal Institute & Department of Orthopaedic Surgery at Geisinger Health System. Here, he discusses his experience as a White House Fellow under George W. Bush, orthopedic virtual centered care, the importance of being a lifelong learner, and more.

It’s no secret that the prospect of novel narcolepsy treatment options gives hope to many people living with narcolepsy. In this episode, we speak with Dr. Anne Marie Morse to discuss current treatment options, what’s on the horizon in drug development, and how people with narcolepsy can get involved by participating in clinical trials. About Our Guest: Dr. Anne Marie Morse is a board-certified and fellowship-trained pediatric neurologist specializing in sleep medicine at Geisinger Health System in Pennsylvania. She is certified by the American Board of Psychiatry and Neurology in neurology with special qualification in child neurology. Download the New + Upcoming Narcolepsy Treatments Toolkit for more resources: bit.ly/new-upcoming-narcolepsy-treatments The Narcolepsy Nerd Alert series invites listeners to dive deeper into specific topics relevant to living with narcolepsy. https://project-sleep.com/narcolepsy-nerd-alert/

It’s no secret that the prospect of novel narcolepsy treatment options gives hope to many people living with narcolepsy. In this episode, we speak with Dr. Anne Marie Morse to discuss current treatment options, what’s on the horizon in drug development, and how people with narcolepsy can get involved by participating in clinical trials. About Our Guest: Dr. Anne Marie Morse is a board-certified and fellowship-trained pediatric neurologist specializing in sleep medicine at Geisinger Health System in Pennsylvania. She is certified by the American Board of Psychiatry and Neurology in neurology with special qualification in child neurology. Download the New + Upcoming Narcolepsy Treatments Toolkit for more resources: bit.ly/new-upcoming-narcolepsy-treatments The Narcolepsy Nerd Alert series invites listeners to dive deeper into specific topics relevant to living with narcolepsy. https://project-sleep.com/narcolepsy-nerd-alert/

This week, please join author Fabian Eichelmann and Associate Editor Svati Shah as they discuss the article "Deep Lipidomics in Human Plasma: Cardiometabolic Disease Risk and Effect of Dietary Fat Modulation." Dr. Carolyn Lam: Welcome to Circulation on the Run, your weekly podcast, summary and backstage pass to the journal and its editors. We're your co-hosts. I'm Dr. Carolyn Lam, Associate Editor from the National Heart Center and Duke National University of Singapore. Dr. Greg Hundley: And I'm Dr. Greg Hundley, Associate Editor Director at the Pauley Heart Center at VCU Health in Richmond, Virginia. Well, Carolyn, this week's feature, we are going to get into the world of lipidomics and understand how some lipid metabolites may be more predictive of cardiovascular events above and beyond the conventional serum lipoproteins, like HDL and LDL. But before we get to that, how about we grab a cup of coffee and start with some of the other articles in the issue? Would you like to go first? Dr. Carolyn Lam: Sure thing. This first paper is about the basilar artery. Have you ever heard the analogy that the basilar artery is the neurologists' equivalent of our cardiologists' left main coronary artery? Well put, isn't it? Well, that's from the editorial that accompanies this paper, but basically, occlusion of either artery can be fatal without rapid re-perfusion. So that's why the basal artery is the neurologists' left main coronary artery. Re-perfusion therapies for acute basilar artery occlusion include thrombolysis or mechanical endovascular thrombectomy. Dr. Carolyn Lam: In today's issue, Professor Hu from University of Science and Technology of China, and Professor Nogueira from University of Pittsburgh School of Medicine in the US, these are the co-corresponding authors, and their colleagues, reported the outcome of the attention registry of more than 2000 patients with acute basilar artery occlusion who enrolled prospectively and consecutively at 48 sites in China from 2017 to 2021, and followed for the primary outcome of a favorable neurological functional outcome defined as a modified Rankin score of zero to three at 90 days. Dr. Greg Hundley: Wow, Carolyn, I love that analogy. So the basilar artery is kind of similar in the brain to the left main coronary artery in the heart. Whoa, what did they find here? Dr. Carolyn Lam: So, in this nationally representative observational study, the authors found a significant association between endovascular thrombectomy and better functional outcomes and survival at 90 days in patients with acute basilar artery occlusion, and this was compared to chemical thrombolysis. Now, notably, this relationship was modified by the baseline NIH stroke scale. Specifically, patients with baseline NIH stroke scale of 10 or more had an increased rate of favorable outcome when treated with endovascular thrombectomy, whereas no significant beneficial effect was seen in patients with baseline NIH stroke scores of less than 10. Now, all this is discussed in a beautiful editorial by Dr. Hankey, entitled, "Endovascular therapy for acute basilar artery occlusion." Dr. Greg Hundley: Oh, beautifully stated, Carolyn. What a great article. But guess what, Carolyn? I've got a quiz for you. Dr. Carolyn Lam: Uh-oh. Dr. Greg Hundley: This one's open answer, so it's not multiple choice. Can you name a unique feature of zebra fish pertinent to the study of cardiovascular disease? Dr. Carolyn Lam: Okay. Watch me hedge there because, first of all, I'm a daughter of a zoologist. So my dad would have a heart attack if I couldn't say something about the zebra fish. So, what I do know is the zebra fish is an excellent animal model for genetic studies of heart generation, basically development. So, there must be something really cool there about how we can observe that. Dr. Greg Hundley: Excellent, Carolyn. So very well done. As you know, and your dad knows, certain non-mammalian species like zebra fish, have an elevated capacity for innate heart regeneration. Now, understanding how heart regeneration occurs in these contexts can help illuminate cellular molecular events that can be targets for heart failure prevention or treatment, your area of expertise. The epicardium, the mesothelial tissue layer that encompasses the heart, is a dynamic structure that is essential for cardiac regeneration in zebra fish, and these authors, led by Dr. Jinhu Wang from Emory University performed single cell RNA sequencing and identified seven epicardial cell clusters in adult zebra fish, three of which displayed enhanced cell numbers during regeneration. Dr. Carolyn Lam: Oh, interesting, Greg. So did these cell clusters provide some clues that could be applied clinically? Dr. Greg Hundley: Yes. Carolyn. So these authors identified that these subsets of epicardial cells emerge in post embryonic, zebra fish and sponsor regions of active cardio myogenesis during cardiac growth and regeneration. And as the heart achieves its mature structure, these cells facilitate extracellular matrix hyaluronic acid deposition to support formation of the compact muscle layer of the ventricle. These cells associate with the function of the hyaluron and proteoglycan link protein 1 or HAPLN1 paralogue in production and organization of hyaluronic acid containing matrix in cardiac injury sites and thereby enable normal cardiomyocyte proliferation and muscle generation. And so Carolyn, potentially in the future targeting hyaluronic acid regulation by manipulation of HAPLN1 in human epicardial cells could potentially modulate cardiac repair after myocardial infarction. Dr. Carolyn Lam: Well, thanks, Greg. That was awesome. Well, the next paper I want to tell you about is one in which a novel ECG based machine learning approach was used to determine and predict multiple structural heart conditions. So the authors led by Dr. Chen from Department of Translational Data Science and Informatics at the Geisinger Health System in Danville, Pennsylvania. So these colleagues hypothesized that a composite model would yield higher prevalence and positive predictive value to facilitate meaningful recommendations for echocardiography. Dr. Greg Hundley: Oh wow, Carolyn. Machine learning, it's just emerging everywhere these days. So don't we need a large data set to do this? Dr. Carolyn Lam: Absolutely, and listen to how large this is. So using more than 2.2 million ECGs linked to electronic health records and echocardiography reports from almost 500,000 adults between 1984 and 2021, the authors trained machine learning models to predict the presence or absence of any of seven echo confirmed diseases within a year, and the composite model and the composite label that they used included moderate or severe valve disease and reduced ejection fraction. So their composite recommend model where reco is E-C-H-O we used age, sex ECG traces, and had an area under the receive operating curve of 0.91 and a positive predictive value of 42% at 90% sensitivity with a composite label prevalence of 17.9%. Whereas the individual disease models had area under curve ranging from 0.86 to 0.93 and lower positive predictive values from about 1% to 31%. Dr. Carolyn Lam: So in summary, they showed that an ECG based machine learning model using a composite endpoint can identify a high risk population for having undiagnosed clinically significant structural heart disease while outperforming the single disease models and improving practical utility with higher positive predictive values. So this approach may facilitate targeted screening with echo to improve under diagnosis of structural heart disease. Dr. Greg Hundley: Wow, Carolyn, really great article from the world of machine learning. Well, how about we jump to some of the other articles in the issue and I can go first. There are two Research Letters. The first Research Letter comes from Professor Adlam entitled "Pregnancy and Spontaneous Coronary Artery Dissection Lessons from Survivors and Nonsurvivors." And our own Dr. Joe Hill, our Editor-in-Chief also has a Research Letter entitled “Impaired AMP Kinase Signaling in HFpEF Associated Atrial Fibrillation.” Dr. Carolyn Lam: Wow, what an issue filled with great stuff. There's an AHA update by Dr. Churchwell on promoting nutrition security through policies and programs. And there are highlights from the circulation family of journals by our own Molly Klemarczyk, now known as Molly Robbins. I'd love to tell you a little bit about it. The association of new onset AF with cardiovascular outcomes in patients hospitalized with COVID-19 are described in Circ Arrhythmia, and EP. Rates of cardiovascular and cerebral vascular disease mortality among Asian subgroups are presented in Circ CV, Quality and Outcomes. Blood pressure and glycemic control are presented in patients with heart failure in Circ Heart failure. The associations of atrial update with technetium 99 pyrophosphate scans for transthyretin amyloid cardiomyopathy with incident atrial fibrillation and possibly earlier diagnosis of amyloid is presented in Circ Cardiovascular Imaging. Dr. Carolyn Lam: And finally the outcomes associated with larger burdens of residual thrombus after aspiration thrombectomy for STEMI are presented in Circ CV Interventions. Isn't that cool? And finally, we've got an On My Mind paper by Dr. Arany on “It's Time to Offer Genetic Testing to Women with Peripartum Cardiopathy”. So that wraps it up, Greg. Let's go to our feature discussion, shall we? Dr. Greg Hundley: You bet. Dr. Greg Hundley: Welcome listeners to this feature discussion on July 5th, and we are very fortunate today. We have with us Dr. Fabian Eichelmann from the German Institute of Human Nutrition in Potsdam, Germany, and our own associate editor, Dr. Svati Shah from Duke University in Durham, North Carolina. Welcome to you both. Fabian, we're going to start with you. Can you describe for us some of the background information that went into the preparation of your study and what was the hypothesis that you wanted to address? Dr. Fabian Eichelmann : Yeah, sure. So first of all, thanks for the invitation to speak here. So this project was basically comes from a collaboration between us and a group in Redding, UK and we are part of a consortium called FAME, which is short for fatty acid metabolism. And there, we are interested in the health effects of fatty acid metabolism in general. And in this paper that we did, this was particularly cardiometabolic diseases. And I think this is no surprise that we look at lipid metabolism in this context, because there's so many really now also causal factors, lipoproteins, total triglycerides for specific cardiometabolic outcomes. So this is the reason why we wanted to look at it. And through this collaboration, we were also able to harness the potential from two different study designs that I probably will go into later, but which really gave us an opportunity to really generate I think, quite interesting insights. Dr. Greg Hundley: Very nice. And so what was that hypothesis? Dr. Fabian Eichelmann: So the hypothesis was that since the lipid metabolism has formally only been mostly in the clinic, at least been measured by lipoproteins and total triglycerides, for example, but the lipidome of plasma, for example, is really rich. It's really heterogeneous and it contains many different lipid classes and different fatty acids. And through novel technologies and in this case, lipidomics, you can really dive in really deeply and look at this in a specific manner. And then the idea was to really look at this and potentially identify lipids that would be associated or could surface as biomarkers for cardiometabolic diseases and at the same time, if those lipids were also sensitive to a dietary intervention that really tried to modulate the dietary intake of a fat. Dr. Greg Hundley: Very nice. And so how did you set this up? What was your study design and what was your study population? Dr. Fabian Eichelmann: So we had two different study populations for this. So the first one was the EPIC-Potsdam, which is a cohort study, a large scale cohort study here in Potsdam, which started in the nineties. And there, we basically associated baseline concentrations of these lipid measurements with later on occurring incident cardio metabolic outcomes. And in this case, this was type two diabetes and primary CVD and CVD in our case meant myocardial infarction and stroke. And we did that we checked which lipids would be statistically significantly associated after multiple testing with at least one of these outcomes. And then we took those lipids further into intervention trial, which is called the DIVAS trial in Redding, as I said, UK. And there, they had basically a dietary intervention trial that really wanted to assess if the change in the fatty acid proportions in the diet affects the lipids. So there we had the lipidomics measurements at baseline and after four months, and then we compared three different trials to each other. Dr. Greg Hundley: Very nice. And so how many patients did you include and who were these patients? Men and women? And did they have, for example, prior cardiovascular disease? Dr. Fabian Eichelmann: So in EPIC-Potsdam, that's a population based cohort study. All of the participants were drawn from the registries and invited. So these were apparently healthy people. And in those we did these association analyses and those we used the design, which is a case cohort design, which is a sub sample of the whole cohort, which is a really effective way and efficient way of analyzing biomarker projects. And there we had in total 1,262 control participants, and then later on additionally, a 775 type two diabetics and 551 CVD cases. In the DIVAS trial, that was a trial where participants also men and women, which was also the case in EPIC-Potsdam were invited, and they were at a higher risk of at the higher cardiovascular disease risk, which was measured by score, but they didn't have any prior cardiovascular diseases. And those were 113 participants that were randomized to one of these diets. Dr. Greg Hundley: Right. So it sounds like two studies. One, a large case control study and looking at different plasma lipid concentrations in two separate groups. And then the second was a randomized trial, a smaller trial of 113 individuals looking at a dietary intervention. So with that established, tell us your study results. Dr. Fabian Eichelmann: Yeah. So in the first step, as I said, where we associated lip concentrations to later occurring disease, we found from the 282 lipids that we looked at, 69 were really associated to at least one of these outcomes. And interesting here we saw that only eight were associated to both outcomes and 49 were specific to cardiovascular disease and 12 for specific to type two diabetes. And from those 69, we found 19 were also sensitive to the dietary intervention, and what was really striking here was that of these 19, 17 were perfectly in agreement with a suggested beneficial effect, meaning that those lipids that were associated in the EPIC-Potsdam studies on the cohort study with a higher disease risk were reduced by these diets or in the opposite direction, we saw those lipids that were associated with lower risk were increased by these diets. So this was quite a striking observation there. Dr. Greg Hundley: So it sounds like from the lipidomics analysis, there was a construct of certain blood lipid markers that were associated with cardiovascular events, and then in your randomized trial, you were able to modify those by different dietary interventions? Dr. Fabian Eichelmann: Exactly. Dr. Greg Hundley: So listeners, now we're going to turn to our own associate editor, Dr. Svati Shah. And Svati, you see many papers come across your desk. What attracted you to this particular paper and how do we put this study's results in the context with other studies that have been published in really the sphere of lipidomics research? Dr. Svati Shah: Yeah. Thank you, Greg. I just want to point out that this is a really elegant translational study. I think these papers can be very complicated to understand, and I think the authors did a fantastic job of really laying out how you can combine cutting edge what we call omics, using these cutting edge technologies, but applying them to human cohorts with a very strong clinical lens. So it's not just what do we learn about biology, but also what do we learn about biomarkers that might be relevant to how we take care of patients? And that's really one of the biggest things I loved about this study is sort of, you get to have your cake and eat it too. You get to learn about biology, but with a very strong clinical lens towards identifying clinically relevant biomarkers. I think another really important strength of this study, which differentiates it is this sort of use of really cutting edge lipidomics. Dr. Svati Shah: So this is a subset of omics where we're really looking at these granular lipid classes. And some of the clinicians might say, well, we measure cholesterol, why is this different? And you know, Greg, really what lipidomics allows us is a much more granular snapshot of these complex lipid species that are only grossly captured by the cholesterol levels that we would measure normally if we were seeing a patient in clinic. So to be able to get this really granular snapshot of what is happening to lipid biology and how it might relate to cardiovascular events, diabetes, I think is really important. And finally, I think the coolest part about this study is, in other studies we always have a little bit of a hard time with what we call confounders. And what does that mean? That means there may be other things for why you're seeing these biomarkers associated with your disease and those might be uncaptured things, things that you didn't measure in this study. And we call that residual confounding. Dr. Svati Shah: And I think the authors in this study, not only statistically adjusted for those potential confounders, but also importantly, the DIVAS study, where they took the biomarkers that they found from EPIC-Potsdam and said, do they change with the dietary intervention? And in fact, they did find that many of these lipid, these granular lipid species improved, meaning they went in the proper direction in terms of your health with a diet that was higher in unsaturated fats. So really proving not only the potential biology of the benefit of diets enriched in unsaturated fats, but also that these particular biomarkers are modifiable, so they're able to be changed even in this case within 16 weeks with just a dietary intervention. So to me that really was just a beautifully laid out study that highlights really what translational omics and these biomarker studies can do as we think about the clinical care of patients. Dr. Greg Hundley: Very nice. And so it sounds like listeners, moving beyond the lipoproteins, LDL, maybe total cholesterol and these granular lipid species cholesterol esters, free fatty acids, fingo-lipids, glycerophospholipid, et cetera, that's what we were studying in this particular manuscript. So, well, let's turn back to Fabian. And Fabian, what do you see is the next study to really be performed in this sphere of research? Dr. Fabian Eichelmann: I think what would be really interesting and what would really kind of prove what we saw is if you could find a way that an intervention, be it like a drug intervention and not diet because we looked at dietary intervention, that kind of shows the same as we saw, but also that really specifically only alters these lipids and how obviously not really feasible, but if that would be going on for a long enough period, if you also saw these effects that we now saw after four months would also affect the health outcomes instead of just only these proxies. Dr. Greg Hundley: Very nice. And Svati, how about you? What do you see as the next study that might be informative in this sphere of research? Dr. Svati Shah: Yeah. Great question, Greg. I mean, to me, I really think about this gap that we have in actually translating these findings in how we take care of patients. So again, really provocative results here. We have really significant P values, strong effect sizes, biomarkers that are modifiable, but in the paper they show that it adds on top of a clinical model, so what we might use as clinicians in the clinic that these biomarkers may help on top of what we already know about patients. But we really need to implement these findings and study that implementation for how this might in a real world setting actually change outcomes in patients and how we can actually help explain to clinicians how these results might be beneficial for clinical care. Dr. Svati Shah: So on top of what Fabian already said, I think really implementation science is a huge gap in how we take these translational omics discoveries and use them in support of improving patient care. We have lots to learn about these lipid biomarkers and lots more discovery science that can be done. As Fabian said, can we find drugs that might beneficially modified these lipid subspecies? But again, I think this gap in implementation science is really important. Dr. Greg Hundley: Very nice. Well listeners, we want to thank Dr. Fabian Eichelmann from the German Institute of Human Nutrition in Potsdam, Germany, and our own associate editor, Dr. Svati Shah from Duke University in Durham, North Carolina for bringing us these really provocative results, highlighting the identification of several lipids and their association with cardiometabolic disease risk. And then also nested within the same paper, a subset of individuals undergoing a randomized clinical trial demonstrating benefit by a dietary fat intervention, and there possibly supporting the substitution of dietary saturated fatty acids with unsaturated fatty acids perhaps as a potential tool for primary disease prevention. Dr. Greg Hundley: Well, on behalf of Carolyn and myself, we want to wish you a great week and we will catch you next week on the run. Dr. Greg Hundley: This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, please visit ahajournals.org.

How to build wealth by investing in our children is how Antwan Williams finds value. He stresses the importance of learning the value of saving and writing down your goals through his new Children's book Mansa Little Reminders. Antwan also spends a lot of time on Strategic growth initiatives as a healthcare executive to understand the underlying financial impact on his community.  He brings a genuine optimistic spirit to challenge the status quo and cares about people.  The oldest of ten, he leads the way to impact more communities beyond his own. Antwan believes in  Self-reflecting to better understand what he wants in life. He puts in the research to become a high-performing healthcare executive and forever learner. Antwan D. Williams is an Author, leader in healthcare, and servant to the community.  His book, Mansa's Little Reminders, is a financial literacy gem for kids everywhere. Antwan is currently with Henry Ford Health as Vice President of Operations with the Wyandotte Hospital. He is also co-founder of The Advancement League. A membership ecosystem known for career development, community impact, and their annual Young Health Leader Summit. Before serving in his current role, Antwan served as Executive Administrator for Allied Health and Support Services for Winnie Palmer Hospital for Women and Babies and the Arnold Palmer Hospital for Children at Orlando Health.Originally from St. Petersburg, Florida, Antwan joined Orlando Health from the Geisinger Health System in Danville, Pennsylvania, where he directed numerous service line initiatives, including serving as the Executive leading the systems' emergency departments across the 12-hospital campus portfolio.Antwan earned his Bachelor of Science in business management at Florida State University and his Master's degree in health services administration at the University of Central Florida.https://www.henryford.com/www.5starbdm.com

How good are you at paying attention? Test yourself with this experiment (link: https://www.youtube.com/watch?v=vJG698U2Mvo), one of the most famous psychology experiments. Christopher Chabris, PhD is one of the originators of this experiment; he is currently Professor and Co-director of the Behavior and Decision Sciences Program at Geisinger Health System. His book with Daniel Simons, The Invisible Gorilla (link: http://www.theinvisiblegorilla.com/) is a bestseller that goes into much greater depth on the everyday illusions of attention, memory, confidence, knowledge, cause, and potential; as well as the myth of intuition. 

Attorney and author Dennis Hursh helps physicians navigate their employment contracts. He describes his shock early on in his career when he saw the lopsided language in the contracts offered to his highly trained physician clients. He points out that no hospital executive would ever agree to such contractual language for themselves.A sampling of items Mr. Hursh considers “insane”:- 24 hour call shifts (and by the way, you will work the next day, too)- The employer will decide if you're disabled and has the right to terminate you if you can't do the job- No paycheck for you if you can't navigate their complex credentialing process by your start date AND they reserve the right to terminate you if you aren't fully credentialed by your start date- Punitive non-compete clauses (a.k.a., restrictive covenants) that wreak professional and personal havoc rather than simply limit the loss of patients who might follow you when you leave- “Brutal” provisions in the contract that the administration promises they won't enforce (but nonetheless they won't remove the language)- Low starting pay with a promise (but no contractual language) of partnership to come- “Integration” documents that provide explanations and promises related to the formal contract (but alas, they are not enforceable unless they are in the formal contract)In this episode, Mr. Hursh exposes the risks lurking in several areas typically included in physician employment contracts (beware if these points are not explicitly addressed!):CREDENTIALING: Flexibility can be built into the contract to allow a physician to begin a narrower scope of work if certain hospital credentials or other privileges are still delayed at the start date.RESTRICTIVE COVENANTS (noncompete clauses): This refers to contractual language that prohibits a departing physician from practicing within a specified distance of the former employer for some period of time. Mr. Hursh draws attention to several issues regarding the distance that is specified and what is being measured: Is it the distance between the physician's previous office and the office with the future employer? From a specific hospital or the organizational headquarters? Or from any of the employer's sites anywhere?MALPRACTICE INSURANCE: He describes the critical difference between Occurrence vs. Claims-Made insurance policies. Red alert if the contract simply says “malpractice insurance is provided.” If you don't know the difference you could be saddled with expensive “tail insurance” when you hightail it out of there.COMPENSATION, CALL, DUTY HOURS and LOCATION: Ambiguity is not the physician's friend when it comes to an employment contract. Exquisite clarity about compensation and call is critical. If your future employer thinks full-time means 40 jam-packed patient-contact hours then, in reality, you could end up with a 60-hour workweek. Similarly, it's critical to have clarity and security about your office and hospital location.Mr. Hursh advises physicians to hire an attorney who has experience working with physician agreements and who has the needed resources (e.g., MGMA database, up-to-date Stark regulations). An advantage of hiring an attorney is that shelling out the money for an attorney signals that the physician is taking the offer seriously. Also, contractual challenges can be raised by the attorney so that the physician doesn't have to directly challenge a potential employer.Also in this episode:•We discuss my guest's article “Are Hospitals Evil? A Physician Contract Attorney Explains”•How hospitals protect themselves while circumventing the bans on Corporate Practice of Medicine•The Business School Mindset (BSM) and its many manifestations in healthcare systems•How disdain for physicians leaks out in the language, action, and inaction of management •Patient care and collegiality are harmed when competition is the primary motivator Meet Dennis Hursh, Esq.Dennis Hursh, a veteran physicians' lawyer, with over 35 years of health-law experience is a frequent lecturer on physician contracts to residency and fellowship programs, and has spoken at events sponsored by the White Coat Investor, the Pennsylvania Medical Society, the Hershey Medical Center, UPMC, Geisinger Health System, the Pennsylvania Society of Cardiology, the WellSpan Health System, the Hospital of the University of Pennsylvania, and the American Podiatry Association. A former contributing editor to Physicians News Digest, Dennis has authored several published articles on physician contractual matters, and has literally “written the book” on physician employment agreement negotiation - “The Final Hurdle - A Physicians' Guide to Negotiating a Fair Employment Agreement”.Dennis represents physicians in all 50 states in reviewing and negotiating employment agreements to protect physicians in one of the biggest transactions of their careers.Dennis has also published information you may find useful in his Physician Contracts Blog, at: https://pahealthlaw.com/physician-contracts-blog/Website: https://pahealthlaw.com/Book: The Final Hurdle: A Physician's Guide to Negotiating a Fair Employment Agreement

Buzz Stewart, CEO and co-founder of Medcurio, speaks with host Dr. M Christine Stock, Managing Director of Medical Affairs at Health2047. Buzz has been using healthcare data in real-time for more than two decades with healthcare organizations such as Geisinger Health System and Sutter Health. They discuss Buzz's journey of founding and selling several healthcare startups and how ridiculously difficult it is to access healthcare data.

Clinical psychologist Dr. Scott Anderson discusses how parents can best support their kids with mental health disorders. Scott R. Anderson, Ph.D., received his Ph.D. in Psychology (clinical track) from Virginia Tech. Dr. Anderson completed his predoctoral internship with the United States Air Force in San Antonio, Texas. For three years he worked with military children and families stationed in the United Kingdom before completing a postdoctoral fellowship in integrated primary care at Geisinger Health System in 2017. Dr. Anderson has had extensive training in and experience with behavioral interventions, parent management strategies, and consultation with schools and medical providers. He specializes in using evidence-based treatments and evidence-informed strategies in addressing a variety of behavioral health concerns, including Attention-Deficit/Hyperactivity Disorder (ADHD), high-functioning Autism Spectrum Disorders, sleep problems, disruptive behaviors, and anxiety disorders. Dr. Anderson joined the Developmental–Behavioral Pediatrics Program at Rochester Regional Health in 2017, where he is currently a part-time staff psychologist. In 2018, Dr. Anderson started a part-time private practice in Bath, NY. The intention was for this to be a small “side-hustle” to keep him from getting bored, but this practice has expanded to the point that it is now his primary focus!

Did you know that in the U.S 1 in 10 babies are born preterm? November is Prematurity Awareness Month. I speak to Dr. James Cook, Director of Newborn Services for Geisinger Health System and a member of the March of Dimes Market Board in Philadelphia about the work of the organization which helps fund research on preventing prematurity and provides resources to the health of moms and babies.www.marchofdimes.org

Breaches and ransomware infections are hitting healthcare hard alongside the critical supply chain that helps keep healthcare operations running. The federal government has been issuing a flurry of guidance, executive orders, draft regulations, diplomacy, and more to try to kickstart our national response to the cyber crisis. We are calling in the cavalry, but will it help?  In this episode of The CyberPHIx, we hear from Steve Dunkle, Chief Information Security Officer for Geisinger Health System.   Steve is one of the country's leading cybersecurity healthcare leaders and we get his perspective on some of these federal updates and proposed changes to see how they fare in terms of providing meaningful support and guidance for healthcare organizations.  We discuss new federal and standards guidance and related trends including:  NIST's “Bad Practices” cybersecurity guide for end-of-life devices, default passwords, and single-factor authentication  Ransomware guidance from the NSA, FBI, and CISA on stopransomware.gov  Third-party risk and supply chain risk guidance and pending regulations  Strategies for CISO executive success include a focus on customer service, strategic thinking and planning, networking, and continuous learning Incident response and cyber-resilience guidance  OCR enforcement focus areas and HIPAA Security Rule compliance 

For the past several months, Healthcare IT News Features Editor Bill Siwicki has been writing a series on lessons learned from the COVID-19 pandemic for hospitals throughout the US. For this installment of HIMSSCast, Bill and host Jonah Comstock are joined by Paul Coyne, NP,  clinical practice and chief nursing informatics officer at the Hospital for Special Surgery, and Joe Fisne, associate chief information officer at Geisinger Health System, to discuss some of the biggest learnings to come out of the series.This podcast is brought to you by Zoom and is a companion to 'Telehealth is here to stay', episode 1 of our Workplace Re-entry series.Talking pointsHow COVID taught us how fast we can innovateThe importance of video conferencing, internally as well as externallyPhysician collaboration and rapid prototypingHow COVID-19 aligned priorities within hospitalsAn unexpected lesson: Hospital HR systems need improvementComfortable vs uncomfortable innovationThe future of telehealth utilizationMore about this episodeHealth IT Lessons Learned During the COVID-19 Era (Bill's series)Hospital IT leaders talk lessons learned from a tough pandemic yearWhat does the 'after COVID-19' business look like? IT leaders weigh inCIOs plan on refined telehealth, faster deployments, more collaborative toolsHow IT leaders are reimagining and repurposing technologies to handle new challengesBurnout in the Age of COVID-19 (Bill's previous series)

Learn about the six-year integrated plastic surgery residency program at Geisinger Health System, in Danville, Pennsylvania, with Dr. Ashley Jordan and Dr. Emma Dahmus. Recorded in May 2021. Contact Information: Dr. Jordan - ajordan2@geisinger.edu Dr. Dahmus - edahmus@geisinger.edu

Study strengthens links between red meat and heart disease Queen Mary University (UK), 15 April 2021 An observational study in nearly 20,000 individuals has found that greater intake of red and processed meat is associated with worse heart function. The research is presented at ESC Preventive Cardiology 2021, an online scientific congress of the European Society of Cardiology (ESC).1 "Previous studies have shown links between greater red meat consumption and increased risk of heart attacks or dying from heart disease," said study author Dr. Zahra Raisi-Estabragh of Queen Mary University of London, UK.2,3 "For the first time, we examined the relationships between meat consumption and imaging measures of heart health. This may help us to understand the mechanisms underlying the previously observed connections with cardiovascular disease." The study included 19,408 participants of the UK Biobank.4 The researchers examined associations of self-reported intake of red and processed meat with heart anatomy and function. Three types of heart measures were analysed. First, cardiovascular magnetic resonance (CMR) assessments of heart function used in clinical practice such as volume of the ventricles and measures of the pumping function of the ventricles. Second, novel CMR radiomics used in research to extract detailed information from heart images such as shape and texture (which indicates health of the heart muscle). Third, elasticity of the blood vessels (stretchy arteries are healthier). The analysis was adjusted for other factors that might influence the relationship including age, sex, deprivation, education, smoking, alcohol, exercise, high blood pressure, high cholesterol, diabetes, and body mass index (BMI) as a measure of obesity. The researchers found that greater intake of red and processed meat was associated with worse imaging measures of heart health, across all measures studied. Specifically, individuals with higher meat intake had smaller ventricles, poorer heart function, and stiffer arteries - all markers of worse cardiovascular health. As a comparison, the researchers also tested the relationships between heart imaging measures and intake of oily fish, which has previously been linked with better heart health. They found that as the amount of oily fish consumption rose, heart function improved, and arteries were stretchier. Dr. Raisi-Estabragh said: "The findings support prior observations linking red and processed meat consumption with heart disease and provide unique insights into links with heart and vascular structure and function." The associations between imaging measures of heart health and meat intake were only partially explained by high blood pressure, high cholesterol, diabetes, and obesity. "It has been suggested that these factors could be the reason for the observed relationship between meat and heart disease," said Dr. Raisi-Estabragh. "For example, it is possible that greater red meat intake leads to raised blood cholesterol and this in turn causes heart disease. Our study suggests that these four factors do play a role in the links between meat intake and heart health, but they are not the full story." She noted that the study did not look into alternative mechanisms. But she said: "There is some evidence that red meat alters the gut microbiome, leading to higher levels of certain metabolites in the blood, which have in turn been linked to greater risk of heart disease." Dr. Raisi-Estabragh said: "This was an observational study and causation cannot be assumed. But in general, it seems sensible to limit intake of red and processed meat for heart health reasons."     More Fruits and Veggies Improves Sleep for Young Adults University of Michigan, April 15, 2021 Eating more fruits and vegetables can help young adults, especially young women, sleep better, a new study shows Young adults who reported eating less than five servings of fruits and vegetables per day reported a high prevalence of chronic insomnia symptoms, with over one-third reporting difficulties with falling asleep or maintaining sleep at least three times per week for three months or longer. Women who increased their fruit and vegetable intake by three or more servings over a three-month period were more than twice as likely to experience an improvement in these insomnia symptoms, according to the study in the Sleep Health Journal. “We were very excited to see that a fairly simple dietary intervention, such as encouraging an increase in fruit and vegetable consumption, could make such an impact on sleep,” says lead author Erica Jansen, research assistant professor of nutritional sciences at the University of Michigan’s School of Public Health. “We know from other literature that improving sleep improves overall quality of life and many other health outcomes, so the benefits likely extend beyond the sleep changes.” Jansen and senior author Gwen Alexander, a researcher in the public health sciences department at Henry Ford Health System, and colleagues analyzed data of more than 1,400 participants compiled by Detroit-based Henry Ford and the more rural Geisinger Health System headquartered in Danville, Pennsylvania. “From my health educator perspective, our study shows a link between dietary choices and improved sleep for young people who wish to improve their overall health and well-being,” Alexander says. “Our study was unique in that it investigated an understudied population of generally healthy young adults. Future research designed for this population has great potential to lead to better health habits.” Eligible young adults included those ages 21-30, who received any medical care at the centers and who reported eating less than five servings of fruits and vegetables per day. Researchers randomized the participants into one of three groups: one had an untailored web-based program to encourage higher fruits and vegetables consumption; the second had an age-targeted tailored web-based program; and the third group also included personalized e-coaching support. Young adults who increased their fruit and vegetable consumption by at least three servings experienced modest improvements in sleep latency (time to fall asleep) and insomnia over a three-month period, compared to participants with no change or smaller increases in fruits and vegetable intake, although there were no differences in sleep duration. Women who increased their fruit and vegetable intake by three or more servings reported a four-minute shorter time, on average, to fall asleep at follow-up, and twofold higher odds of improvement in insomnia symptoms. “What is unique about our study is that we were able to see that as fruit and vegetable intake changed, insomnia-related sleep characteristics also changed,” Jansen says. “We still cannot rule out that sleep characteristics changed first, which in turn caused a change in fruit and vegetable intake, but since the participants were part of a trial to increase fruit and vegetable intake, it is more likely the other way around. The participants were not told to change anything about their sleep habits.” The researchers hope the findings will be incorporated into other sleep hygiene principles, which include things like maintaining a consistent bedtime and rise time, eliminating screens prior to going to bed, sleeping in a dark, cool environment, and not drinking caffeine or alcohol before bed. Additional coauthors are from the University of South Carolina School of Medicine and the Henry Ford Health System.     Multivits, omega-3, probiotics, vitamin D may lessen risk of positive COVID-19 test British Medical Journal, April 20, 2021 Taking multivitamins, omega-3, probiotics or vitamin D supplements may lessen the risk of testing positive for SARS-CoV-2, the virus responsible for COVID-19 infection—at least among women—indicates a large population study, published online in the journal BMJ Nutrition Prevention & Health. But taking any of vitamin C, zinc, or garlic supplements wasn't associated with a lower risk of testing positive for the virus, the findings show. There has been plenty of celebrity endorsement of the use of dietary supplements to both ward off and treat COVID-19 infection since the start of the pandemic, note the researchers. In the UK alone, market share rose by 19.5% in the period leading up to the first national 'lockdown' on March 23 last year, with sales of vitamin C rising by 110% and those of multivits by 93%. Similarly, zinc supplement sales rose by 415% in the first week of March, at the height of COVID-19 fears in the U.S.. Dietary supplements can help to support a healthy immune system, but whether specific supplements might be associated with a lower risk of catching SARS-CoV-2 isn't known. In a bid to plug this knowledge gap, the researchers drew on adult users of the COVID-19 Symptom Study app to see if regular supplement users were less likely to test positive for SARS-CoV-2. The app was launched in the UK, the US, and Sweden in March 2020 to capture self-reported information on the evolution of the pandemic. Initially, it recorded the location, age and core health risk factors of its users. But as time went on, subscribers were asked to provide daily updates on a range of issues, including symptoms, coronavirus test results, and healthcare. People without obvious symptoms were also encouraged to use it. For the purposes of this study, the researchers analysed information supplied by 372,720 UK subscribers to the app about their regular use of dietary supplements throughout May, June, and July 2020 during the first wave of the pandemic as well as any coronavirus swab test results. Between May and July,175,652 UK subscribers regularly took dietary supplements;197,068 didn't. Around two thirds (67%) were women and over half were overweight (BMI of 27). In all, 23,521 people tested positive for SARS-CoV-2 and 349,199 tested negative between May and July. Taking probiotics, omega-3 fatty acids, multivits or vitamin D was associated with a lower risk of SARS-CoV-2 infection: by 14%, 12%, 13% and 9%, respectively, after accounting for potentially influential factors, including underlying conditions and usual diet. No such effects were observed among those taking vitamin C, zinc, or garlic supplements. And when the researchers looked specifically at sex, age and weight (BMI), the protective associations for probiotics, omega-3 fatty acids, multivits and vitamin D were observed only in women of all ages and weights. No such clear associations were seen in men. Despite some differences, the same overall patterns were mirrored in both the US (45,757) and Swedish (27,373) subscribers. The equivalent figures for the US and Sweden were a reduced risk of:18% and 37%, respectively for probiotics; 21% and 16%, respectively, for omega-3 fatty acids; 12% and 22%, respectively for multivits; and 24% and 19%, respectively, for vitamin D supplements. This is an observational study, and as such, can't establish cause. The researchers also acknowledge several limitations, including that the study relied on self reported data and a self selected group. No information was collected on supplement doses or ingredients either. But although the observed effects were modest, they were significant, note the researchers, who call for large clinical trials to inform evidence-based therapeutic recommendations. "We know that a range of micronutrients, including vitamin D, are essential for a healthy functioning immune system. This, in turn, is key to prevention of, and recovery from, infections. "But to date, there is little convincing evidence that taking nutritional supplements has any therapeutic value beyond maintaining the body's normal immune response," comments Professor Sumantra Ray, Executive Director, NNEdPro Global Centre for Nutrition and Health, which co-owns the journal. "What's more, this study wasn't primarily designed to answer questions about the role of nutritional supplements in COVID-19. This is still an emerging area of research that warrants further rigorous study before firm conclusions can be drawn about whether specific nutritional supplements might lessen the risk of COVID-19 infection," he cautions.   Vitamin D deficiency may impair muscle function Garvan Institute of Medical Research (Australia), April 16, 2021 Vitamin D deficiency may impair muscle function due to a reduction in energy production in the muscles, according to a mouse study published in the Journal of Endocrinology. Vitamin D deficient mice were found to have impaired muscle mitochondrial function, which may have implications for muscle function, performance and recovery. This may suggest that preventing vitamin D deficiency in older adults could help maintain better muscle strength and function and reduce age related muscle deterioration, but further studies are needed to confirm this.  Vitamin D is a hormone well known to be important for maintaining bone health and preventing rickets and osteoporosis. In recent years, vitamin D deficiency has been reported to be as prevalent as 40% in European populations and linked to increased risk for several conditions, including COVID-19, cancer and diabetes. Although these studies report association rather than causation, the benefits of vitamin D supplementation are now a major subject of health debate. Multiple studies have also linked low vitamin D levels to poor muscle strength, particularly in older people. Skeletal muscle enables us to move voluntarily and perform everyday activities. It is essential that they have enough energy to power these movements. Specialised organs in cells, called mitochondria, convert nutrients in to energy to meet this demand. Previous studies indicate that impaired muscle strength in people with vitamin D deficiency may be linked to impaired muscle mitochondrial function. Determining the role of vitamin D in muscle performance of older people is also difficult, as they may suffer from a number of pre-existing health conditions that can also affect their vitamin D status. Therefore, previous studies have been unable to determine how vitamin D may directly affect muscle performance. Dr Andrew Philp and his team at the Garvan Institute of Medical Research in Australia, and collaborating universities, used a mouse model to determine the effects of diet-induced vitamin D deficiency on skeletal muscle mitochondrial function in young, male mice. Mice were either fed a diet with normal quantities of vitamin D, or with no vitamin D to induce deficiency, for a period of 3 months. A typical vitamin D level for humans is 40-50 nmol.L-1, and acute vitamin D deficiency is diagnosed when levels drop below 12 nmol.L-1. On average, the mice in this study had vitamin D levels of 30 nmol.L1, with diet-induced vitamin D deficiency leading to levels of just 3 nmol.L-1. Although this level was more extreme than typically observed in people, it is still within the clinically-recognised range. Tissue and blood samples were collected monthly to quantify vitamin D and calcium concentrations and to assess markers of muscle mitochondrial function and number. After 3 months of diet-induced vitamin D deficiency skeletal muscle mitochondrial function was found to be impaired by up to 37%. This was not due to a reduced number of mitochondria or a reduction in muscle mass. "Our results show there is a clear link between vitamin D deficiency and oxidative capacity in skeletal muscle. They suggest that vitamin D deficiency decreases mitochondrial function, as opposed to reducing the number of mitochondria in skeletal muscle." Dr Philp comments. "We are particularly interested to examine whether this reduction in mitochondrial function may be a cause of age related loss in skeletal muscle mass and function." These findings suggest that vitamin D deficiency may impair mitochondrial function and reduce the amount of energy produced in the muscles, which may lead to poor muscle function. Therefore, preventing vitamin D deficiency in older people may help maintain muscle performance and reduce the risk of muscle related diseases, such as sarcopenia. However, further studies that investigate the direct effect of vitamin D deficiency on muscle function and strength are necessary to confirm this. Whilst this study indicates that vitamin D deficiency can alter mitochondrial function in skeletal muscle, Dr Philp and his team were unable to determine precisely how this process occurred. Therefore, their future work aims to establish how vitamin D deficiency alters mitochondrial control and function in skeletal muscle.     Psychedelic experience may not be required for psilocybin's antidepressant-like benefits So-called 'magic mushroom' drug seems to work through multiple brain mechanisms for its different effects University of Maryland School of Medicine, April 16, 2021 University of Maryland School of Medicine (UMSOM) researchers have shown that psilocybin--the active chemical in "magic mushrooms"-- still works its antidepressant-like actions, at least in mice, even when the psychedelic experience is blocked. The new findings suggest that psychedelic drugs work in multiple ways in the brain and it may be possible to deliver the fast-acting antidepressant therapeutic benefit without requiring daylong guided therapy sessions. A version of the drug without, or with less of, the psychedelic effects could loosen restrictions on who could receive the therapy, and lower costs, making the benefits of psilocybin more available to more people in need. In all clinical trials performed to date, the person treated with psilocybin remains under the care of a guide, who keeps the person calm and reassures them during their daylong experience. This can include hallucinations, altered perception of time and space, and intense emotional and spiritual encounters.  Researchers in the field have long attributed psilocybin's effectiveness to the intense psychedelic experience.  "We do not understand the mechanisms that underlie the antidepressant actions of psilocybin and the role that the profound psychedelic experience during these sessions plays in the therapeutic benefits," says Scott Thompson, Ph.D., Professor and Chair, Department of Physiology at UMSOM and senior author of the study. "The psychedelic experience is incredibly powerful and can be life-changing, but that could be too much for some people or not appropriate."  Several barriers prevent the wide-spread use of psychedelic compounds. For example, there is fear that the psychedelic experience may promote psychosis in people who are predisposed to severe mental disorders, like bipolar disorder and schizophrenia, so the clinical therapy sessions performed to-date have been limited to a highly selected screened group without a family history of these disorders.  Dr. Thompson adds that there may also be an equity issue because not everyone can take several days off work to prepare and engage in the experience. The costs of staffing a facility with at least one trained guide per treated person per day and a private space may also be prohibitive to all but a few. He says it is conceivable that a depression treatment derived from psilocybin could be developed without the psychedelic effects so people can take it safely at home without requiring a full day in a care facility. For their study, led by UMSOM MD/PhD student Natalie Hesselgrave, the team used a mouse model of depression in which mice were stressed for several hours a day over 2-3 weeks. Because researchers cannot measure mouse moods, they measure their ability to work for rewards, such as choosing to drink sugar water over plain water. People suffering from depression lose the feeling of pleasure for rewarding events. Similarly, stressed mice no longer preferred sugar water over plain water. However, 24 hours after a dose of psilocybin, the stressed mice regained their preference for the sugar water, demonstrating that the drug restored the mice's pleasure response.  Psilocybin exerts its effects in people by binding to and turning on receptors for the chemical messenger serotonin. One of these receptors, the serotonin 2A receptor, is known to be responsible for the psychedelic response. To see if the psychedelic effects of psilocybin were needed for the anti-depressive benefits, the researchers treated the stressed mice with psilocybin together with a drug, ketanserin, which binds to the serotonin 2A receptor and keeps it from being turned on. The researchers found that the stressed mice regained their preference for the sugar water in response to psilocybin, even without the activation of the psychedelic receptor. "These findings show that activation of the receptor causing the psychedelic effect isn't absolutely required for the antidepressant benefits, at least in mice," says Dr. Thompson, "but the same experiment needs to be performed in depressed human subjects." He says his team plans to investigate which of the 13 other serotonin receptors are the ones responsible for the antidepressant actions. "This new study has interesting implications, and shows that more basic research is needed in animals to reveal the mechanisms for how these drugs work, so that treatments for these devastating disorders can be developed" says Albert E. Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, University of Maryland Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.   Tea compound promotes formation of osteoblasts under inflammatory environment and increases bone mass First Affiliated Hospital of Soochow University (China), April 7, 2021   According to news originating from Suzhou, People’s Republic of China, the research stated, “Postmenopausal osteoporosis is a disease of bone mass reduction and structural changes due to estrogen deficiency, which can eventually lead to increased pain and fracture risk.” Our news correspondents obtained a quote from the research from First Affiliated Hospital of Soochow University: “Chronic inflammatory microenvironment leading to the decreased activation of osteoblasts and inhibition of bone formation is an important pathological factor that leads to osteoporosis. Theaflavin-3,3’-digallate (TFDG) is an extract of black tea, which has potential anti-inflammatory and antiviral effects. In our study, we found that TFDG significantly increased the bone mass of ovariectomized (OVX) mice by micro-CT analysis. Compared with OVX mice, TFDG reduced the release of proinflammatory cytokines and increased the expression of osteogenic markers in vivo. In vitro experiments demonstrated that TFDG could promote the formation of osteoblasts in inflammatory environment and enhance their mineralization ability. In this process, TFDG activated MAPK, Wnt/b-Catenin and BMP/Smad signaling pathways inhibited by TNF-a, and then promoted the transcription of osteogenic related factors including Runx2 and Osterix, promoting the differentiation and maturation of osteoblasts eventually.” According to the news reporters, the research concluded: “In general, our study confirmed that TFDG was able to promote osteoblast differentiation under inflammatory environment, enhance its mineralization ability, and ultimately increase bone mass in ovariectomized mice. These results suggested that TFDG might have the potential to be a more effective treatment of postmenopausal osteoporosis.”     Patients who are overweight or obese at risk of more severe COVID-19   Murdoch Children's Research Institute and University of Queensland, April 16, 2021   Patients who are overweight or obese have more severe COVID-19 and are highly likely to require invasive respiratory support, according to a new international study.  The research, led by the Murdoch Children's Research Institute (MCRI) and The University of Queensland and published in Diabetes Care, found obese or overweight patients are at high risk for having worse COVID-19 outcomes. They are also more likely to require oxygen and invasive mechanical ventilation compared to those with a healthy weight.  MCRI researcher Dr Danielle Longmore said the findings, which highlighted the relationship between obesity and increased COVID-19 disease burden, showed the need to urgently introduce strategies to address the complex socio-economic drivers of obesity, and public policy measures such as restrictions on junk food advertising.  "Although taking steps to address obesity in the short-term is unlikely to have an immediate impact in the COVID-19 pandemic, it will likely reduce the disease burden in future viral pandemics and reduce risks of complications like heart disease and stroke," she said. The study looked at hospitalised SARS-CoV-2 patients from 18 hospitals in 11 countries including China, America, Italy, South Africa and The Netherlands.  Among the 7244 patients aged 18 years and over, 34.8 per cent were overweight and 30.8 per cent were obese.  COVID-19 patients with obesity were more likely to require oxygen and had a 73 per cent greater chance of needing invasive mechanical ventilation. Similar but more modest results were seen in overweight patients. No link was found between being overweight or obese and dying in hospital from COVID-19.  Cardiovascular and pre-existing respiratory diseases were associated with increased odds of in-hospital deaths but not a greater risk for needing oxygen and mechanical ventilation. For patients with pre-existing diabetes, there was increased odds of needing invasive respiratory support, but no additionally increase in risk in those with obesity and diabetes.  Men were at an increased risk of severe COVID-19 outcomes and needing invasive mechanical ventilation. In those aged over 65 years, there was an increased chance of requiring oxygen and higher rates of in-hospital deaths. The University of Queensland's Dr Kirsty Short, who co-led the research, said almost 40 per cent of the global population was overweight or obese.  "Obesity is associated with numerous poor health outcomes, including increased risk of cardiometabolic and respiratory disease and more severe viral disease including influenza, dengue and SARS-CoV-1," she said.  Dr Short said while previous reports indicated that obesity was an important risk factor in the severity of COVID-19, almost all this data had been collected from single sites and many regions were not represented. Moreover, there was a limited amount of evidence available about the effects of being overweight or obese on COVID-19 severity.  "Given the large scale of this study we have conclusively shown that being overweight or obese are independent risk factors for worse outcomes in adults hospitalised with COVID-19," she said. MCRI Professor David Burgner, who co-led the research, said the data would help inform immunisation prioritisation for higher-risk groups. "At the moment, the World Health Organization has not had enough high-quality data to include being overweight or obese as a risk factor for severe COVID-19 disease. Our study should help inform decisions about which higher-risk groups should be vaccinated as a priority," he said.   Neuroprotective Herbs for the Management of Alzheimer’s Disease University of Central Florida and University of California, Los Angeles   Background—Alzheimer’s disease (AD) is a multifactorial, progressive, neurodegenerative disease that is characterized by memory loss, personality changes, and a decline in cognitive function. While the exact cause of AD is still unclear, recent studies point to lifestyle, diet, environmental, and genetic factors as contributors to disease progression. The pharmaceutical approaches developed to date do not alter disease progression. More than two hundred promising drug candidates have failed clinical trials in the past decade, suggesting that the disease and its causes may be highly complex. Medicinal plants and herbal remedies are now gaining more interest as complementary and alternative interventions and are a valuable source for developing drug candidates for AD. Indeed, several scientific studies have described the use of various medicinal plants and their principal phytochemicals for the treatment of AD. This article reviews a subset of herbs for their anti-inflammatory, antioxidant, and cognitive-enhancing effects. Methods—This article systematically reviews recent studies that have investigated the role of neuroprotective herbs and their bioactive compounds for dementia associated with Alzheimer’s disease and pre-Alzheimer’s disease. PubMed Central, Scopus, and Google Scholar databases of articles were collected, and abstracts were reviewed for relevance to the subject matter. Conclusions—Medicinal plants have great potential as part of an overall program in the prevention and treatment of cognitive decline associated with AD. It is hoped that these medicinal plants can be used in drug discovery programs for identifying safe and efficacious small molecules for AD.   1.1. Ashwagandha (Withania somnifera) Ashwagandha, commonly called Indian ginseng or winter cherry, is one of the most prominent herbs prescribed as a brain rejuvenator for AD. It is prescribed to increase energy, improve overall health and longevity, and as a nerve tonic [86]. Ashwagandha has been shown to possess antioxidant activity, free radical scavenging activity, as well as an ability to support a healthy immune system [87]. Ashwagandha contains several bioactive compounds of great interest, such as ergostane-type steroidal lactones, including withanolides A-Y, dehydrowithanolide-R, withasomniferin-A, withasomidienone, withasomniferols A-C, withaferin A, withanone, and others. Other constituents include the phytosterols sitoindosides VII-X and beta-sitosterol and alkaloids [86,88]. A subset of these components has been shown to scavenge free radicals generated during the initiation and progression of AD. Molecular modeling studies showed that withanamides A and C uniquely bind to the active motif of Aβ25-35 and prevent fibril formation. Furthermore, these compounds protected PC-12 cells and rat neuronal cells from β-amyloid-induced cell death [89,90,91]. Treatment with the methanol extract of ashwagandha triggered neurite outgrowth in a dose- and time-dependent manner in human neuroblastoma cells [29], and, in another study involving cultured rat cortical neurons, treatment with Aβ peptide induced axonal and dendritic atrophy and loss of pre-and postsynaptic stimuli [92]. Subsequent treatment with withanolide A induced significant regeneration of both axons and dendrites and restored the pre- and post-synapses in the cultured cortical neurons. In vivo, withanolide A inhibited Aβ(25–35)-induced degeneration of axons, dendrites, and synapses in the cerebral cortex and hippocampus and also restored Aβ-peptide-induced memory deficits in mice [93]. The in vivo ameliorative effects were maintained even after the discontinuation of the drug administration. Aqueous extracts of ashwagandha increased acetylcholine (ACh) content and choline acetyl transferase activity in rats, which might partly explain the cognition-enhancing and memory-improving effects [29,94,95]. Treatment with the root extract caused the upregulation of the low-density lipoprotein receptor-related protein, which enhanced the Aβ clearance and reversed the AD pathology in middle-aged and old APP/PS1 mice [96]. Oral administration of a semi-purified extract of ashwagandha reversed behavioral deficits and blocked the accumulation of Aβ peptides in an APP/PS1 mouse model of AD. This therapeutic effect of ashwagandha was mediated by the liver low-density lipoprotein receptor-related protein [96]. Using an AD model of Drosophila melanogaster, researchers noted that treatment with ashwagandha mitigated Aβ toxicity and also promoted longevity [97]. Despite the extensive literature on the therapeutic effects of ashwagandha, there are limited data on its clinical use for cognitive impairment [98]. In a prospective, randomized, double-blind, placebo-controlled pilot study involving 50 subjects with mild cognitive impairment, subjects were treated with either ashwagandha root extract (300 mg twice daily) or placebo for eight weeks. After eight weeks of study, the ashwagandha treatment group demonstrated significant improvements in both immediate and general memory tests compared to the placebo group. Furthermore, the treatment group showed significant improvement in executive function, sustained attention, and information-processing speed [99]. These studies lend credence to ashwagandha’s role in enhancing memory and improving executive function in people with SCI or MCI. 1.2. Brahmi (Bacopa monnieri) Brahmi, or Bacopa monnieri (Bm), is a perennial creeper medicinal plant found in the damp and marshy wetlands of Southern and Eastern India, Australia, Europe, Africa, Asia, and North and South America. In the Ayurvedic system of medicine, Bm is recommended for mental stress, memory loss, epilepsy, insomnia, and asthma [34,36]. The bioactive phytochemicals present in this plant include saponins, bacopasides III, IV, V, bacosides A and B, bacosaponins A, B, C, D, E, and F, alkaloids, sterols, betulic acid, polyphenols, and sulfhydryl compounds, which may be responsible for the neuroprotective roles of the plant. Both in vitro and in vivo studies show that these phytochemicals have an antioxidant and free radical scavenging action by blocking lipid peroxidation in several areas of the brain [36,100,101,102]. Bm acts by reducing divalent metals, scavenging reactive oxygen species, decreasing the formation of lipid peroxides, and inhibiting lipoxygenase activity [103]. Numerous studies have also shown Bm’s role in memory and intellect [33,56,100,104,105,106]. To determine the neuroprotective effect of Bm in a rat model of AD, researchers tested an alcoholic extract of Bm at doses of 20, 40, and 80 mg/kg for a period of 2 weeks before and 1 week after the intracerebroventricular (icv) administration of ethylcholine aziridinium ion (AF64A). Spatial memory was tested using the Morris water maze (MWM), and the cholinergic neuron density was determined using histological techniques. The researchers showed that Bm extract improved the escape latency time in the MWM test and blocked the reduction of cholinergic neuron densities [35]. Another group reported the reversal of colchicine-induced cognitive deficits by a standardized extract of Bm. In addition to reversing colchicine-triggered cognitive impairment, the Bm extract also attenuated colchicine-induced oxidative damage by decreasing the protein carbonyl levels and restoring the activities of the antioxidant enzymes [107]. Most of the studies exploring the cognitive-enhancing effects of Bm in humans focused on normal, aged individuals. In a double-blind, randomized, placebo-controlled trial on 35 individuals aged above 55 years, subjects received either 125 mg of Bm extract or a placebo twice a day for a period of 12 weeks, followed by a placebo period of another four weeks. Subjects underwent a battery of memory tests, including general information, orientation, mental control, logical memory, digit forward, digit backward, visual reproduction, and paired association learning. Subjects were scored on each sub-test, and total memory score was calculated by adding the score of all subtests. A significant improvement was observed in mental control, logical memory, and paired association learning in Bm-treated patients compared to the placebo group at 8 and 12 weeks after initiation of the trial [37]. The results suggested the use of Bm in the treatment of age-associated memory impairment. Ten subjects were given 500 mg of Sideritis extract, 320 mg Bm extract, or a combination using a crossover design. Sideritis extract is rich in a variety of flavonoids and has been shown to improve cognition in animal models of AD [108]. The Attention d2 Test is a neuropsychological measure of selective and sustained attention and visual scanning speed. Assessment tests revealed that Sideritis extract combined with a low-dose Bm extract resulted in improvement in the d2 concentration test score [109]. A similar effect of Bm alone was observed only after repetitive dosing, suggesting that the long-term memory effects seen with repetitive dosing of Bm may be a promising therapeutic option for subjects suffering from MCI [109]. In another prospective, non-comparative, multicenter trial involving 104 subjects who suffered from MCI, Bm extract in combination with astaxanthin, phosphatidylserine, and vitamin E was given for 60 days. The tested combination formula was well tolerated. Cognitive and mnemonic performance was assessed with validated instruments including Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-cog) and Clock-Drawing Test (CDT) that can assess the risk of MCI progression to AD. Researchers noted significant improvements in ADAS-cog and CDT scores [110]. The observed sixty-day improvements in ADAS-cog and CDT were statistically significant as compared with baseline values. Memory is affected by several factors, including focus and attention, neurotransmitters, hormones, trophic factors, cyclic AMP, ion channels, protein transcription, synapse formation, and nutrients. Some of these processes can be modulated by Bm extract alone or in combination with other compounds. The abovementioned study design is similar to our therapeutic program for people with SCI and MCI, where Bm is administered in combination with other nutraceuticals and cogniceuticals [15,111]. 1.3. Cat’s Claw (Uncaria tomentosa) Cat’s claw (CC) is a tropical vine with hooked thorns that resemble the claws of a cat and is mainly recommended for its potential role in the treatment of AD and pre-AD. It is found mainly in the Amazon rainforest and other areas of South and Central America. This medicinal plant contains oxindole alkaloids, polyphenols (flavonoids, proanthocyanidins, and tannins), glycosides, pentacyclic alkaloids, and sterols [38,39]. CC is known for its immune-modulating and anti-inflammatory effects and for its role as a free radical scavenger. Based on in vitro studies, the anti-inflammatory effect of CC is attributed to its ability to inhibit iNOS gene expression, nitrate formation, cell death, PGE2 production, and the activation of NF-κB and TNF-α [45]. Using a transgenic mouse model of Alzheimer’s disease, a significant reduction in the Aβ load (by 59%) and plaque number (by 78%) in the hippocampus and cortex was observed after treating 8-month-old mice with the CC extract for 14 days [44]. CC extract also caused a significant reduction in astrocytosis and microgliosis, and it improved hippocampus-dependent memory. Some of the components in the CC extract crossed the blood–brain barrier (BBB) and entered the brain parenchyma following intravenous injection [44]. Pre-clinical studies suggest that CC extract inhibits the formation of plaques and tangles, reduces astrocytosis and microgliosis and improves memory in mouse models of AD [43,44]. CC extract not only prevented the formation and aggregation of Aβ fibrils and tau protein paired helical filaments, but it also facilitated the disaggregation of preformed fibrils and tau protein tangles [43,44]. While proanthocyanidin B2 was identified as the primary phytochemical with plaque-and tangle-dissolving activity, other polyphenols present in the CC extract also possess plaque-reducing activity [44]. Based on pre-clinical studies, Cat’s claw may be effective for memory loss and cognitive decline associated with AD, although no studies have been carried out in humans. 1.4. Ginkgo Biloba Ginkgo biloba (Gb) has been in the spotlight primarily for its potential role in treating AD. Gb also appears promising as a therapeutic agent for several other chronic and acute forms of diseases. The main pharmacologically active groups of compounds are flavonoids and terpenoids. Almost all clinical studies use Gb extract that contains a combination of flavonoid glycosides, terpene lactones, and ginkgolic acids [50]. Gb extract has shown beneficial effects in treating Alzheimer’s, cardiovascular diseases, cancer, tinnitus, and other age-associated conditions [49,50]. The suggested mechanisms of the Gb extract are its antioxidant effect, anti-platelet activating factor activity for vascular diseases, inhibition of β-amyloid peptide aggregation in AD, and decreased expression of peripheral benzodiazepine receptor for stress alleviation [48,49,50]. Gb is popular as a treatment for early-stage AD and vascular dementia. Gb extract reverses β-amyloid and NO-induced toxicity in vitro and reduces apoptosis both in vitro and in vivo [112,113,114]. Treatment with Gb extract enhanced memory retention in young and old rats and improved short-term memory in mice [49,115]. Several studies indicate that ginkgo delays the progression of AD and is as effective as the cholinesterase inhibitors for treating AD. A modest improvement in cognitive function was observed in AD subjects in various randomized, double-blind, placebo-controlled trials [116,117,118]. Gb extract also improves ADLs among AD individuals and is preferred over other AD medications because of its negligible adverse effects [119,120]. 1.5. Gotu Kola (Centella asiatica) Considered both a nutraceutical and cogniceutical, Gotu kola (Gk) is a staple in Chinese, Indonesian, and Ayurvedic medicine [57]. This medicinal plant is used to strengthen the brain, heal skin issues, and promote liver and kidney health. Gk is considered a rejuvenating herb for nerve and brain cells as it is believed to promote intelligence and improve memory [54,55,56,57]. In vitro studies using various Gk plant derivatives (asiaticosides, asiatic acid, madecassoside, and madasiatic acid) showed that these compounds were capable of blocking H2O

Jennifer Bumgardner is president of BIC Healthcare Solutions and has spent more than 20 years, forming and executing innovative healthcare strategic business building and marketing communication solutions. She has worked for or with multiple nationally and internationally renowned health care organizations including Medical College of Georgia, Wake Forest University Baptist Medical Center and Mission Health System in North Carolina, Geisinger Health System in Pennsylvania and, most recently, Johns Hopkins Health System in Maryland.Jennifer developed and executed unique, award-winning business development and marketing solutions for many industries, including financial services, education, healthcare, entertainment and retail services. Specific to healthcare, her expertise includes expediting new physician productivity time to increase overall net revenue production, extrapolating and interpreting market analytics and epidemiology data to pinpoint areas of opportunity for current business advancement and future expansion, proving ROI and cost savings tied directly to measurable tactics, leading and developing a team of top notch physician liaisons, and building “out of the box” solutions designed to meet system priorities within the healthcare space.She earned a BA in Marketing from Bloomsburg University of Pennsylvania. When not engaged in creating best in class healthcare business solutions for my clients, Jennifer enjoys running, reading, gourmet cooking and spending time with my husbandand two children.You can reach Jennifer through her website or through LinkedIn at linkedin.com/in/jennifer-bumgardner-bichs.******************************************************************************************If you'd like to talk to Terry McDougall about coaching or being a guest on Marketing Mambo, here's how you can reach her:https://www.terrybmcdougall.comhttps://www.linkedin.com/in/terrybmcdougallTerry@Terrybmcdougall.comHer book Winning the Game of Work: Career Happiness and Success on Your Own Terms is available at Amazon. 

Humana recently came out with their Value-based Care Report. The subhead is Physician Progress and Patient Outcomes. It’s a very fancy report with a lot of pages and graphics, and this impressive format definitely caught the attention of some of our industry. I read one blog post really keying in on one sort of depressing aspect of the report, namely, that Humana’s value-based care (VBC) program saved a rounding error of 0.4% over their non-VBC program. I wanted to get an expert’s take on this report and the reaction to the report and could think of no better person than Steve Blumberg, who has worked in value-based care delivery on the provider and on the payer side. Steve Blumberg, MBA, is the VP of practice transformation for GuideWell Health, a subsidiary of GuideWell. This Humana report, if you’d like to see it for yourself, can be found at digital.humana.com/VBCReport.  You can learn more at guidewell.com. Steven Blumberg serves as vice president, practice transformation, for GuideWell Health. In this role, he is responsible for developing and implementing strategies for the further establishment of a high-quality, economically effective clinical system across Florida. He also provides guidance on value-based care and population health models. Prior to joining GuideWell in June 2019, Blumberg served as vice president for value-based care at Baptist Health South Florida, where he led the strategy and implementation for Baptist’s population health and value-based care efforts. Prior to that, he was senior vice president and executive director of AtlantiCare Health Solutions, the New Jersey division of the Geisinger Health System, where he was responsible for population health, the organization’s provider physician group, and home care and hospice continuum services. Earlier in his career, he was chief planning and business development officer at UHealth–The University of Miami Health System. Blumberg also held leadership roles at UF Health–Shands Healthcare and Baptist Health Jacksonville. Blumberg has been active in community and professional organizations, including serving on the boards of the Ronald McDonald House, Community Hospice, and the Northeast Florida Health Planning Council. He has also served nationally on the Premier Population Health Steering Group and on the National Institute of Standards and Technology’s Baldrige Board of Examiners. Blumberg holds a bachelor’s degree in business administration and marketing from the University of Florida and a Master of Business Administration from Florida State University. He is a fellow of the American College of Healthcare Executives. 02:11 Does value-based care really reduce cost, according to the Humana report? 03:02 Why we should look at outcomes and not just raw costs. 04:06 Is the impact of a value-based model that much better than a fee-for-service model during COVID? 04:38 “At the end of the day, I think … the lack of a cost difference is notable, but one must think there’s more to it than that.” 05:44 “You have to look at these things over time.” 06:02 “I think in health care we’ve been looking for the ‘what will save 10%’ solutions … and there’s just no such animal.” You can learn more at guidewell.com. Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth Does value-based care really reduce cost, according to the Humana report? Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth Why we should look at outcomes and not just raw costs. Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth Is the impact of a value-based model that much better than a fee-for-service model during COVID? Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “At the end of the day, I think … the lack of a cost difference is notable, but one must think there’s more to it than that.” Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “You have to look at these things over time.” Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “I think in health care we’ve been looking for the ‘what will save 10%’ solutions … and there’s just no such animal.” Steve Blumberg of @_GuideWell discusses the 2020 Humana Value-based Care Report on our #healthcare #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth

In this health care podcast, I speak with Steve Blumberg, VP of practice transformation for GuideWell Health, a subsidiary of GuideWell. How’s this for an interesting career trajectory? Steve spent the last decade working on population health and value-based care delivery ... on the provider side. Recently, he transferred over to the payer side, working for GuideWell Health, which is the health services arm of GuideWell, which is part of a family of companies including Florida Blue. So, a payer, in other words. I wanted to find out a bunch of things from Steve, but the main one is this: How do—if they, in fact, do—payviders improve care for patients? Or what does it take for an organizational structure to drive Triple Aim results? Going into this conversation, here is what I was thinking about: Payviders have access to longitudinal data (potentially) that siloed entities will certainly not. They also have a goal to keep care affordable in a really real way, especially if the patient/member/client is on the ACA (Affordable Care Act) marketplace and shopping for premiums. My big concern with payviders, though, is whether they’re an “HMO in drag,” as they say. On the other hand, payers and providers, in the most cynical sense, have wildly divergent goals. Search #medtwitter any day of the week—you will find a galaxy of tweets wherein doctors complain about payers—to just get a tiny sense of those wildly divergent goals. Do separate payers working with separate providers offer a kind of check and balance? A historical knock on this hypothesis is the inarguably crappy outcomes for chronic conditions that US patients have the privilege of paying comparatively ridiculous sums for. I couldn’t tell you whether those crappy outcomes are a result of the separateness of payers and providers or some other factor, but so it is. Here’s the short version of one of Steve’s main points: It’s not about control. It’s about connection. It’s about being able to connect with patients over their continuum of care. It’s also about how consumers and employers are increasingly trading out choice and broad networks for an assurance of quality. You can learn more at guidewell.com. Steven Blumberg serves as vice president, practice transformation, for GuideWell Health. In this role, he is responsible for developing and implementing strategies for the further establishment of a high-quality, economically effective clinical system across Florida. He also provides guidance on value-based care and population health models. Prior to joining GuideWell in June 2019, Blumberg served as vice president for value-based care at Baptist Health South Florida, where he led the strategy and implementation for Baptist’s population health and value-based care efforts. Prior to that, he was senior vice president and executive director of AtlantiCare Health Solutions, the New Jersey division of the Geisinger Health System, where he was responsible for population health, the organization’s provider physician group, and home care and hospice continuum services. Earlier in his career, he was chief planning and business development officer at UHealth–The University of Miami Health System. Blumberg also held leadership roles at UF Health–Shands Healthcare and Baptist Health Jacksonville. Blumberg has been active in community and professional organizations, including serving on the boards of the Ronald McDonald House, Community Hospice, and the Northeast Florida Health Planning Council. He has also served nationally on the Premier Population Health Steering Group and on the National Institute of Standards and Technology’s Baldrige Board of Examiners. Blumberg holds a bachelor’s degree in business administration and marketing from the University of Florida and a Master of Business Administration from Florida State University. He is a fellow of the American College of Healthcare Executives. 03:30 How does thinking like a payer change the way you build out a primary care provider practice? 04:37 “When I was on the provider side, I definitely worried about the total cost of care … but making the products affordable was … someone else’s concern.” 09:12 How would you define practice transformation? 13:29 “We’re curating networks.” 16:56 “If they come to the market, they’ll be hard to ignore.” 17:38 How integrated is the physicians network? 18:35 “Control isn’t the right word … it is the connection with the patient … that’s where we think the most effective primary care takes place.” 18:59 Where does attempting team-based care fall apart the most? 21:25 Are employers trading out for an assurance of quality? You can learn more at guidewell.com. Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth How does thinking like a payer change the way you build out a primary care provider practice? Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “When I was on the provider side, I definitely worried about the total cost of care … but making the products affordable was … someone else’s concern.” Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth How would you define practice transformation? Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “We’re curating networks.” Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “If they come to the market, they’ll be hard to ignore.” Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth How integrated is the physicians network? Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth “Control isn’t the right word … it is the connection with the patient … that’s where we think the most effective primary care takes place.” Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth Where does attempting team-based care fall apart the most? Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth Are employers trading out for an assurance of quality? Steve Blumberg of @_GuideWell discusses #healthcare transformation on our #podcast. #healthcarepodcast #healthcaretransformation #payer #pophealth

-- This episode’s Community Champion Sponsor is Ensemble Health Partners. To learn more about their inspiring work: https://www.ensemblehp.com/ (CLICK HERE) -- For months, all of us have been personally or professionally battling COVID-19, or both.  This global public health crisis has inflicted terrible physical, mental, emotional, financial, and spiritual strain on billions of people around the world.   Yet, during these challenging times, another crippling disease has taken root across our nation- we are now facing an infodemic that is, unfortunately, impacting some of our friends, colleagues, and loved ones.  To confront the issue of disinformation during this pandemic, I asked Susan Dentzer to join us to shed light on this critically important issue.  For ten years, Susan was the former on-air Health Correspondent for the PBS NewsHour. Additionally, she was the editor-in-chief of the policy journal Health Affairs and is currently a Senior Policy Fellow for the Robert J. Margolis Center for Health Policy at Duke University.  I’m grateful to have Susan on our podcast to confront the infodemic scourge plaguing many of our communities and the opportunity to learn from her how we can work together to move the health of the nation forward. Work that must be based on facts and science. Let’s go!  Episode Highlights: Susan’s storied career, including PBS NewsHour On-Air Health Correspondent Uncertainty of facts during the pandemic Politics and COVID-19 Impact of misinformation to our society, nation, and the world Susan’s current work with the Robert J Margolis Center for Health Policy at Duke University About our Guest:  Susan Dentzer is Senior Policy Fellow for the Robert J. Margolis Center for Health Policy at Duke University.  Based in Washington, DC, where the center’s research team is located, she focuses on the COVID-19 pandemic response; health system transformation, such as through telehealth; biopharmaceutical policy; health care issues in the 2020 elections,  and other key health policy issues.   Dentzer is one of the nation's most respected health and health policy thought leaders and a frequent speaker and commentator on television and radio, including PBS and NPR, and an author of commentaries and analyses in print publications such as Modern Healthcare.  She was also the editor and lead author of the book Health Care Without Walls: A Roadmap for Reinventing U.S. Health Care, available on Amazon.com. From March 2016 to February 2018, Dentzer was President and Chief Executive Officer of NEHI, the Network for Excellence in Health Innovation, a nonprofit, nonpartisan organization then composed of more than 80 stakeholder organizations from across all key sectors of health and health care.  From 2013 to 2016, she was a senior policy adviser to the Robert Wood Johnson Foundation, the nation’s largest philanthropy focused on health and health care in the United States, and before that, was the editor-in-chief of the policy journal Health Affairs. From 1998 to 2008, she was the on-air Health Correspondent for the PBS NewsHour. Dentzer wrote and hosted the 2015 PBS documentary, Reinventing American Healthcare, focusing on the innovations pioneered by the Geisinger Health System and spread to health systems across the nation.  Dentzer is an elected member of the National Academy of Medicine (formerly the Institute of Medicine) and also serves on the Board on Population Health and Public Health Practice of the National Academies of Science, Medicine, and Engineering. She is an elected member of the Council on Foreign Relations; a fellow of the National Academy of Social Insurance; and a fellow of the Hastings Center, a nonpartisan bioethics research institute. She is also a member of the Board of Directors of the International Rescue Committee, a leading global humanitarian organization; a member of the board of directors of... Support this podcast

In this episode, David Smith, MTP Project Executive, speaks with Dr. Jaewon Ryu, CEO at Geisinger, about how Geisinger innovated care and education for their patients. Dr. Ryu discusses the success of using Geisinger's Recovery at Home model to provide care to Medicare and dual-eligible patients and how the health system uses grassroots outreach for risk mitigation and education. Learn more about Recovery at Home, 65 Forward, and other innovations launched by Geisinger to better care for their patient population.

“I think it's an enormous gift to pursue medicine and particularly academic medicine,” says former philosophy major Dr. Steven Scheinman, a distinguished researcher in the genetics of inherited kidney disease and dean of the Geisinger Commonwealth School of Medicine. The school in its current form is only a few years old, having not had a clinical system partner prior to 2017 when it aligned with the highly-ranked Geisinger Health System. Scheinman is thrilled with the learning opportunities the partnership is providing due to the health system’s emphasis on prevention and primary care. Forward-thinking programs in home care, geriatrics, whole genome screening and pharmacy innovation provide a rich grounding in population health for learners, and a generous scholarship program aimed at boosting primary care underscores the school’s commitment to a health management approach. But, as Scheinman enthusiastically says to host Shiv Gaglani, “Wait, there’s more!” Their expansive conversation also includes an overview of COVID’s impact on learning -- including a new “e-ICU” program and how med students will make better use of their 4th year. Speaking of which, Scheinman also shares valuable insights from his perch as Board Chair of the National Residency Match Program.

On this episode we are joined by John Oast, Manager, Security at Geisinger Health System. John shares insights on addressing challenges related to the management of forensic patients. John shares how his team manages up to 20 forensic patients on a daily basis, from planning, to documentation and training. We'll also learn about John's passion outside of security which has led to a  YouTube Channel with over 1,600 videos and 13.5 thousand subscribers. Thank you to our sponsors: 3D Network Technology, Genetec, The Change Execution Group and 360 Life Transformations. Special Mentions: IAHSS, Scott Bitting, Alan Lynch and John Maffey.

This week on The Healthcare Security Cast we are celebrating our Healthcare Heroes for IAHSS Healthcare Security and Safety Week. Canada's Recognition Expert, Sarah McVanel shares her recognition tip of the day and Chris Littlefield of Beyond Thank You, shares his tip of the day to create a culture of appreciation.  On today's show we're joined by Scott Hemingway, John Oast, Brendan Riley, Radford Garrison, Lenton Bailey and Kelvin Owens. Thanks you to our sponsors: 3D Network Technology, Genetec, The Change Execution Group and 360 LIFE TRANSFORMATIONS Special Mentions: Shane Miller, Mike Arlage, Marvin Lands, Frank Taromina, David Freeman, Carl Hoops, Peter Huey and Jose Mendez. Organizations Represented: Signature Healthcare, Geisinger Health System, Lowell General Hospital (Circle Health), MultiCare Health System and Truman Medical Centers

Christopher F. Chabris, PhD is an American research psychologist and currently a Senior Investigator at Geisinger Health System. Dr. Chabris and Dr Simons are co-authors of the book titled Invisible Gorillas.  Dr. Stephey and Dr Chabris will be discussing the topic of in-attentional blindness and how our intuitions deceive us. http://theinvisiblegorilla.com http://www.brainspan.com/ Get a FREE audio book download of The Invisible Gorilla at  www.audibletrial.com/InBound The Move Look & Listen Podcast is brought to you in part, by Audible - get a FREE audiobook download and 30-day free trial at www.audibletrial.com/InBound Douglas W. Stephey, O.D., M.S. 208 West Badillo St Covina, CA 91723 Phone: 626-332-4510 Website: http://bit.ly/DouglasWStepheyWebsite Videos: http://bit.ly/DrStepheyOptometryVideos If interested in producing a podcast of your own, like the The Move Look & Listen Podcast, contact Tim Edwards at Tim@InBoundPodcasting.com InBound Digital Media - Marketing Videos/Social Media Ad Campaigns  http://bit.ly/InBoundDigitalMedia Follow Tim Edwards Cicciarelli & InBound Digital Media https://www.instagram.com/inbounddigitalmedia/ tim@inboundfilms.com 310-844-1983

We are excited for every New Normal episode but this one is really special. Emily LaFeir and Becky Miller from Geisinger Health System talk with Shannon Curran about how they pivoted immediately to track remote employees and emergency fund access and what life looks like in a post-COVID-19 world. They directly support the front-lines, and Quick Base is grateful to partner with them to improve every workflow to make tracking seamless.https://www.quickbase.com#TheNewNormal videos are updated every week and featured on our social channels:LinkedIn: https://www.linkedin.com/company/2845325Twitter: https://twitter.com/QuickBaseFacebook: https://www.facebook.com/quickbase/

Russ Branzell talks with John Kravitz, CHCIO, Chair, CHIME Board; Corporate CIO Geisinger Health System. In this segment, John talks about how healthcare has changed in these unprecedented times, and how health IT leaders and organizations are adapting to better meet the needs of the patients and the organization.

Hear from the experts in our conversations on a rare genetic disease: Lynch Syndrome. We cover Lynch Syndrome diagnosis, new treatment options, and how to connect with the Lynch Syndrome community. Experts in this episode include: *Heather Rocha, a Genetic Counselor at Geisinger Medical Center in Danville, Pennsylvania. *Dr. Julie Woods, MD, a Medical Oncologist at Geisinger Medical Center in Danville, Pennsylvania. *Dr. Julie Hergenrather, PhD, Psychologist at the Geisinger Health System in Danville, Pennsylvania. More resources and information for you: raredisease.com/lynch

Megan Epler, Program Manager of the Autism & Developmental Medicine Institute at Geisinger Health System, and Donna Pedillo, Director of Outreach & Fundraising at The Campus Theatre, speaking with VIA's Fiona Powell about a sensory-friendly showing of "Abominable" at The Campus Theatre, 413 Market Street in Lewisburg on Sunday, January 26, 2020, at 2:00 p.m., sponsored by ADMI's SPARK study. Admission is free. www.GeisingerADMI.org.

John Oast, Manager of Security, Geisinger Health System.

Those of us watching every shift in the level of adoption of genomic medicine have our eyes closely glued to Geisinger Health System in Pennsylvania. Adam Buchanan is the Co-Director of Geisinger’s MyCode Genomic Screening and Counseling program, and today we talk to him about the rationale of making genomic screening part of routine medical care.

This week we’re joined by Brian Ebersol and Eileen Everhart of Geisinger Health System in Pennsylvania. They talk about how health care is about more than just patient care at hospitals and how transportation and wellbeing figures into planning for treating the whole person.

Health systems continue to expand their reach, so it is important to consolidate resources and programs.  Offering cohesive educational resources to patients can be part of the consolidation.  Jessica Sember received her MSN with a specialization of Leadership and Organizational Development.  Jessica's nursing career has been within women's health.  She has had various roles in labor and delivery, childbirth education, and as a lactation consultant.  She is currently the perinatal education coordinator for her health system.  Listen and learn as we discuss coordinated education and some tips for success in standardizing materials, improving marketing for classes and the importance of communication among staff. Listen and Learn: How health systems benefit from offering coordinated education across the organization What challenges need to be faced when setting up a coordinated education program Ways that increase cohesiveness among the education staff How consistent curriculum and material make a difference to patients, staff and providers Jessica can be reached for more information at jnsember@geisinger.edu.   Related Products from InJoy: Understanding Curriculums

Health systems continue to expand their reach, so it is important to consolidate resources and programs.  Offering cohesive educational resources to patients can be part of the consolidation.  Jessica Sember received her MSN with a specialization of Leadership and Organizational Development.  Jessica's nursing career has been within women's health.  She has had various roles in labor and delivery, childbirth education, and as a lactation consultant.  She is currently the perinatal education coordinator for her health system.  Listen and learn as we discuss coordinated education and some tips for success in standardizing materials, improving marketing for classes and the importance of communication among staff. Listen and Learn: How health systems benefit from offering coordinated education across the organization What challenges need to be faced when setting up a coordinated education program Ways that increase cohesiveness among the education staff How consistent curriculum and material make a difference to patients, staff and providers Jessica can be reached for more information at jnsember@geisinger.edu.   Related Products from InJoy: Understanding Curriculums

In this episode, we are joined by cognitive psychologist, Christopher Chabris, who is perhaps best known for his collaborative research on the Ig Nobel prize-winning ‘Gorillas in Our Midst' experiment and his subsequent popular psychology book, The Invisible Gorilla. Chris is an Associate Professor of Psychology at Union College in New York and a Senior Investigator at Geisinger Health System. Why Chris believes companies often fail the test of inattentional blindness during the product design phase. Why our attention is more limited than we think and how learning self-control can help us to take in more information. Why we overvalue confidence and how we can work to recognize and overcome our own cognitive biases. Key Takeaways and Learnings Inattentional blindness: the surprising facts on how limited our attention is. Illusion of attention: why we think we pay more attention to things than we actually do. Human cognitive architecture: how understanding the limitations and foibles of the human mind can lead to successful product and technology design. Links and Resources Mentioned in this Episode Get in touch with Christopher via email or Twitter Christopher's website The Invisible Gorilla: How Our Intuitions Deceive Us, a book by Christopher Chabris Invisible Gorilla, Facebook page Gorillas in Our Midst, scientific paper Selective Attention test, YouTube video of the experiment Ulric Neisser, the father of Cognitive Psychology A Deadly Wandering: A Mystery, a Landmark Investigation, and the Astonishing Science of Attention in the Digital Age, a book by Matt Richtel 65% of Americans believe they are above average in intelligence, a study by Patrick R. Heck, Daniel J. Simons and Christopher F. Chabris Zen and the Art of Motorcycle Maintenance: An Inquiry into Values, a book by Robert M Pirsig Superforecasting: The Art and Science of Prediction, a book by Philip E. Tetlock and Dan Gardner Everything Is Obvious: How Common Sense Fails Us, a book by Duncan J. Watts Thinking, Fast and Slow, a book by Daniel Kahneman Innovaton Ecosystem Episode 070 – The Return on Investment of Mental Models with Robert Hagstrom Innovaton Ecosystem Episode 078 – Human Innovation, Smart Machines with Ed Hess

Geisinger Health System has made headlines for offering free genetic screenings and money-back guarantees to its patients. CEO David Feinberg tells Eric Topol how it all works.

Improving blood product utilization not only impacts patient outcomes, it can also yield significant cost savings. In this CAP Case Example, Geisinger Health System’s Medical Director for Transfusion Medicine, Dr. Amanda Haynes, explains how she spearheaded a blood product utilization improvement program that resulted in more than $1 million in savings in 2015. Read more about Geisinger's initiative in this CAP Case Example: https://capatholo.gy/2HmlXVm.

HHS Secretary Alex Azar laid out an ambitious plan to promote value-based care this week, pledging that there's "no turning back" when it comes to reforming how hospitals and doctors get paid. What does it all mean? Karen Murphy's in position to know: She's the Chief Innovation Officer at Geisinger Health System, but she also previously worked in the Obama administration, helping to oversee value-based care efforts, and served as Pennsylvania's Secretary of Health too. Karen discussed how value-based care is playing out at the provider level, what she makes of Azar's comments on value-based care and medical marijuana, what Geisinger is doing on the biggest public health challenges and why she thinks every health care worker needs to do a stint in government. (Starts at the 18:20 mark.) But first: POLITICO's Sarah Karlin-Smith and Rachana Pradhan joined Dan Diamond to discuss the latest Trump administration changes to Medicaid, the most recent developments related to the opioid crisis and HHS' evolving communication strategy (Starts at the 1:50 mark). We'd appreciate your help: Please share PULSE CHECK and rate us on your favorite podcast app! Have questions, suggestions or feedback? Email ddiamond@politico.com. Referenced on the podcast: Sarah's story on Donald Trump's suggestion of using the death penalty to stop the opioid epidemic: https://www.politico.com/story/2018/03/01/donald-trump-death-penalty-suggestion-opioid-crisis-376176 HHS Secretary Alex Azar's remarks on value-based care: https://www.hhs.gov/about/leadership/secretary/speeches/2018-speeches/remarks-on-value-based-transformation-to-the-federation-of-american-hospitals.html Penn professors Lawton Burns and Mark Pauly's article on value-based care: https://www.milbank.org/quarterly/articles/transformation-health-care-industry-curb-enthusiasm/

Dr ANJALI Hooda is probably the only functional medicine doctor in India,She is specialist in obesity management,gut health and developing a healthy life-style. She has plethora of qualifications and degrees: * MBBS, PGIMS, Rohtak, Haryana, India. * MD in Internal Medicine, Lincoln Medical Center an affiliate of Weill Cornell Medical College, New York, NY, USA. * Fellowship in Obesity Medicine and Clinical Nutrition, Geisinger Health System, Danville, PA, USA. * Trained in Bio-Identical Hormone Replacement Therapy (BHRT) with Dr. Neal Rouzier, MD. * Trained in Functional Medicine and accredited by The Institute for Functional Medicine (IFM), USA * Obesity, Advanced Metabolic & Functional Medicine Specialist Her style of consultation makes us rethink about the way medicine and healthcare has been done in this country.She is among very few doctors who says meditation is the solution of many lifestyle issues and food is actually the real medicine. In this episode we talked about * What exactly gut is? * Gut health and the reasons we are getting multiple gut issues? * Leaky gut syndrome and the preventions? * Irritable bowl syndrome and SIBO. * Gluten sensitivity and lactose intolerance in Indian population. * Childhood obesity. * Metabolic syndrome and diabetes. * Food is medicine. **For more check show notes at www.roadtorevamp.com.** For more information and appointments check her website **www.doctoranjali.com.** You can follow her on facebook where she is regularly doing fb live to educate and teach masses for free in diet and nutrition. **https://www.facebook.com/DoctorAnjali/** There is much more to share about her and functional medicine.We are going to do this very soon on our website and facebook page. **https://www.facebook.com/RoadToRevamp/**

To raise awareness for February Heart Month, I am joined by Amy Sturm, a cardiovascular genetic counselor. She has 15 years of experience in cardiovascular genetics, personalized genomics, research, and education. Amy is the Director of Cardiovascular Genomic Counseling and Professor at Geisinger Health System's Genomic Medicine Institute. There she provides leadership for the scaling up of genomic counseling efforts in the MyCode Community Health Initiative. She serves as the President-elect and the Cardiovascular Genetics Expert at National Society of Genetic Counselors (NSGC). Amy also works with The Familial Hypercholesterolemia Foundation and The Sudden Arrhythmia Death Syndromes (SADS) Foundation on their important advocacy work, research, and medical education programs.  On this episode, we discuss…..Roles of a cardiovascular genetic counselorInherited cardiovascular diseasesFamilial HypercholesterolemiaLong QT SyndromeRed flags for an inherited cardiovascular disorder in a family historyGenetic testing including the cascade screening methodPreventative treatments for patients with a positive testingImportance of testing childrenNotifying at-risk relatives of patients  To learn more from Amy, follow her on Twitter and read a few of her blog posts below: Am I at Risk for Heart Disease?Familial Hypercholesterolemia: The Common, Inherited Cause of Heart Disease Rarely Talked About Curious about the patient perspective in cardiac genetic testing process with a genetic counselor? One of her patients also wrote about his genetic testing experience guided by Amy. Stay updated on new episodes and activities of DNA Today via Twitter, Instagram, Facebook and iTunes. Questions/inquiries can be sent to info@DNApodcast.com.

Carol Kneier, Registered Dietitian, Nutritionist, & Certified Diabetes Educator; talks to Frank Andrews about Geisinger Health System's decision to eliminate the sale of sugar sweetened drinks from its locations.

Date: February 24, 2011 Featuring: Rick Gilfillan, MD, Acting Director, Center for Medicare and Medicaid Innovation Most of us are familiar with the various demonstration projects the Centers for Medicare & Medicaid Services (CMS) has sponsored over the years. This year CMS is taking the notion of figuring out “what works” when it comes to better patient care to an entirely new level, with the launch of the Innovation Center at CMS. Rick Gilfillan, fresh from helping to redesign payment methods at the Geisinger Health System to align with quality outcomes — and gaining national recognition as a result — is now applying his passion for improvement to the country as a whole. As the Innovation Center ramps up, Dr. Gilfillan is eager to keep everyone up to date with what’s on the broader agenda and what’s most immediately in store. WIHI host Madge Kaplan talks with Dr. Gilfillan, who explains the strategy behind the Innovation Center and the prospects for seeding much more robust work with both new payment and service delivery models. Dr. Gilfillan is not alone in believing that a lot of great models exist already. The challenge comes in first harnessing these best practices and then spreading them. It’s this last issue that he has been hearing about in spades; the need to diffuse new models quickly and effectively has never been greater and requires a national learning network and infrastructure that currently doesn’t exist, but can be created.

Date: November 1, 2012 Featuring: Tom Delbanco, MD, Richard and Florence Koplow–James Tullis Professor of General Medicine and Primary Care, Harvard Medical School Robert D. Harrington, MD, Professor of Medicine, University of Washington; Medical Director, Harborview Medical Center HIV clinic; Associate Section Chief of Infectious Diseases, Harborview Medical Center Richard Martin, MD, FAAFP, Department Director of Community Practice Service Lines (CPSL), Scranton and Monroe Counties; Director of Care Continuum, Geisinger Health System Michael Meltsner, AB, JD, Matthews Distinguished University Professor of Law, Northeastern University School of Law, Boston, MA Some changes in medicine are easier to contemplate than others. For a long time the notion that patients should be able to view what doctors write about them, following a visit, was unthinkable. It was a kind of “patient don’t ask, doctor don’t tell” policy. However, the growth of electronic health records, increased pressure for transparency, and the need to improve communication and understanding between patients and providers in every way possible are all tugging at information once considered off limits.Despite the fear that “physician notes” have a tendency to be brief, even glib, and might unintentionally insult or alarm the reader, some health systems, like Dartmouth Hitchcock, have been successfully offering patients easier access to these notes, along with the entire electronic health record, for several years. [See the December 2009 WIHI: OpenNotes and the Electronic Medical Record.]Still many more health systems have been on the fence, waiting for evidence that there’s value in doing so — and that the benefits outweigh the risks. Now that evidence seems to have arrived, and this WIHI digs into the experience of more than 13,000 patients and 100 primary care doctors who were part of a pilot study.The findings appear in the October 2, 2012, issue of the Annals of Internal Medicine, reporting on a one-year experiment with what have come to be called “open notes” at three major health care organizations: Beth Israel Deaconess Medical Center (BIDMC) in Massachusetts, Geisinger Health System in Pennsylvania, and Harborview Medical Center in the state of Washington.WIHI host Madge Kaplan welcomes lead author of the study, Dr. Tom Delbanco, one of the key innovators behind OpenNotes and their trial use at BIDMC, and two clinicians who helped lead the pilots at Geisinger and Harborview. By making notes accessible to patients in their own practices, both these clinicians came to better understand shared decision making and the ways in which transparency, rather than offend, increases trust. Michael Meltsner shares what mattered to him when he faced serious illness. A distinguished law professor, Meltsner’s “A Patient’s View of OpenNotes” also appears in Annals, and captures the brave new world of patient expectations and the need to level the playing field.

Chromosomal microarray technology (CMA) facilitates the genetic diagnosis of intellectual disabilities, autism spectrum disorder, and congenital abnormalities in children. Previously, G-band karyotyping was the test performed for this purpose but it could only identify very large chromosomal abnormalities and was not very sensitive. Being a molecular rather than microscopic technique, CMA is far more sensitive for identifying genetic abnormalities and is now the test of choice. We interview David H. Ledbetter, MD, and Christa Lese Martin, PhD, from Geisinger Health System, authors of this JAMA Insights article. Articles discussed in this episode: Chromosomal Microarray Testing for Children With Unexplained Neurodevelopmental Disorders New Approaches to Molecular Diagnosis

Marc Williams of Geisinger Health System speaks to CHI on May 19th, 2017. Dr. Williams will be speaking during the Clinical NGS Assays: Applications and Interpretation meeting at the Next Generation Diagnostic Summit, August 15th to the 18th in Washington D.C. Topics include implementation of NGS in routine car, challenges to overcome and exciting applications of NGS. For more information, please visit http://www.NextGenerationDx.com/NGS-Diagnostics/

Debra Weinrich speaks with Dr. Greg Burke, the Chief Patient Experience Officer at Geisinger Health System. Deb and Dr. Burke discuss the Geisinger's trademarked ProvenExperience program, the theories behind the program and its evolution. 

Session 17 Dr. Fred Weiss is a Radiologist by training who did a Fellowship in Pain Medicine. However, he's going to share with us today what he likes least about the specialty, part of the reason he's not currently practicing Pain Medicine. Let's jump right in and learn about Pain Medicine! [01:38] Residency and Fellowship Fred is currently an emergency radiologist at Geisinger Health System in Danville although he previously practiced as a Pain Medicine physician in Florida. Finishing his last fellowship in 2014, he's been practicing as an attending for about two years now. He actually did two fellowships, one was a half and half fellowship in Neuroradiology and Musculoskeletal Radiology, and the second was in Pain Medicine in University of Pennsylvania. Prior to medical school, Fred was a physical therapist and he really enjoyed the musculoskeletal system and the nervous system, finding those were the easiest for him to understand, digest, and put into practice. During rotations, Fred enjoyed all the subspecialties affiliated with pain but didn't actually see himself as a surgeon although he liked interventional radiology-type procedures. So it was a matter of choosing a base specialty for going into Pain, doing neuro and musculoskeletal procedures the most. [03:45] Traits of a Good Pain Doctor Fred underscores patience as a major key to becoming a good Pain Medicine physician, along with compassion since you mostly see patients with chronic pain as a Pain doctor. Although right now, Fred admits that the best trait to have is patience with a political system and medical system we're currently in with all the complications going on with opioids where a lot of physicians feel like they have targets on their back. More so, pain physicians feel that the most because they're prescribing opioids considering the country is going through a national opioid epidemic right now. [05:05] The National Opioid Epidemic During interviews for attending jobs, Fred sees a lot of diversity in the way people practice pain medicine. There are those that practice only interventional procedures such as injections, epidurals, facet injections, Neuro Blocks, spinal cord assimilators, etc. On the opposite end of the spectrum, there are those that only prescribe pain medications and when you only do this type, there are only a few classes of medications being prescribed including opioids. And there are those people doing things in moderate amounts of injections and pain medications. There's a lot of heterogeneity in the way people practice and there are people who abuse these medications and seek them while there are those who really need it and those who don't. Fred finds how difficult it is not just on a day-to-day basis, but also, on a patient-to-patient basis to figure out who's a good candidate for certain medications and for certain procedures, and who would respond to what. [06:46] Ways to Get into Pain Medicine In the physical therapy world, Fred's specialty was manual therapy as he enjoyed putting his hands on someone to make them feel better either for mobilization or for therapy purposes, similar to osteopathic medicine. It drew him toward that especially that he found success in those sort of techniques so he wanted to carry it over to the Pain Medicine field. To some extent, he was fairly successful in getting patients off pain medications by simply using manual therapy techniques and other modalities. Fred is not an osteopathic physician. He actually applied to nine osteopathic medical schools and got rejected from all of them. Instead, he got accepted to an allopathic school. When he was in medical school, there were a limited number of specialties eligible for Pain Medicine Fellowship such as Anesthesiology, Physical Medicine, Neurology, and Psychiatry where he has done rotations in all of those. When he did his rotation in Radiology and met an interventional radiologist who did a bit of pain management procedures, he decided to go into Radiology, then do Interventional Radiology, and do the pain part of it. But when he went into Radiology while doing interventional rotations, he found that the only part of it that he enjoyed were the pain procedures. So he wanted to do a Fellowship in Pain Medicine. Along the way, he met his mentor who is a neuroradiologist and a neuro interventional radiologist at UC San Diego, who was actually the first radiologist to become board-certified in Pain Medicine. What he actually did was apply for fellowship in UC San Diego where he was already part of the faculty, completed the fellowship, and was able to be boarded under the American Board of Psychiatry and Neurology. The institution then sponsored him for the exam to get certified. A few years later, another physician did the same thing but he was sponsored by the American Board of Physical Medicine and Rehab. However, there was a lot of political change happening in the field of pain management around the time he applied. The Anesthesiology board was simultaneously closing and opening options and required physicians to have their primary boards sponsoring the examination. Consequently, Fred appealed to the American Board of Radiology (ABR) and had multiple organizations rally around this and lobby for pain medicine to become an official subspecialty of Radiology since many of the procedures were even invented by radiologists. So he wrote an 80-page application for the ABR and then to be submitted to the American Board of Medical Specialties (ABMS) and were successful in getting Pain Medicine to become an official subspecialty for Radiology. Other boards that applied included the American Board of Emergency Medicine and the American Board of Family Medicine. As a result, pain medicine is now an official subspecialty of those skills as well. [12:12] Types of Patients Pain Medicine physicians treat patients across the board from the developmental spectrum treating patients, children and adults alike. When he was in Florida, Fred was treating mostly 80-year-old females with back pain and neck pain as the most common issues. The youngest patient he has treated was a eight-year-old for a chronic pain, biomechanical issue due to pes planus (flat feet) where he gave her a few exercises (incorporated with martial arts exercises being a black belt himself) and prescribed no medications. She was pain free after a month. [14:40] A Typical Day: Clinics and Procedures Fred's typical day depends on whether it's a clinic day or procedure day. If mixed, he would see about 15-20 patients between 8am -12pm. Then do a 10-minute follow-up on someone he did facet injections previously. Other patient are those with chronic regional pain syndrome where he would do regional blocks or ultrasound-guided like stellate ganglion block. He also treats chronic ankle pain where he injects joins with ultrasound guidance. Fred describes his typical day as similar to sports medicine clinic day. On his procedure, he would usually have epidurals, facet injections, nerve blocks that are image-guided under fluoroscopy. His nurses would then bring patients in from the waiting room to have them prepped and ready to go and doing procedure after procedure. Fred also adds how patients would cry and give you a hug after they've treated you and they're pain-free which is very rewarding for him. Fred performs procedures on 60%-70% of his patients since a lot of patients will respond to physical therapy. Being a physical therapist, he has a general idea of who responds well to it or who may need a little push like an injection to give them temporary relief in order to be able to tolerate more physical therapy. While there are also patients who flat-out refuse to go through physical therapy which he finds pretty challenging. He further explains that injections are only temporary for the vast majority of patients and what helps long-term is physical therapy and rehabilitation. This is reflected in the newest guidelines where physical therapy and exercise modalities are the first line of defense rather than prescribing opioids or doing injections. Fred remembers one of his deans who taught in primary care class that there is no evidence for physical therapy prescribed for back pains and now it's come to a complete 180 degrees which he thinks as much more appropriate. [19:05] The Role of Injections With a lot of theories on how injections work, Fred points out that reducing inflammation is one of them. He also adds being a radiologist poses an advantage who are able to figure out what types of patients can respond really well to steroids coming from a perspective of decreasing inflammation. However, most of the time, physicians don't see much inflammation going on but there is remodeling or irritation of bone-on-bone arthritis and those patients respond to a combination of local anesthetics and steroid since the steroid will allow the local anesthetic to last longer, where the duration of which varies from patient to patient. One of the challenges they have in pain medicine is really figuring out who is going to respond the best and the most to the procedures that we do for the best bang for their buck. Fred can actually figure things out based on what he can see on the MRI. [21:23] Taking Calls and Work-Life Balance For outpatient pain, you don't take any calls. In the practice he was in, he would take calls Mon-Fri/8-5 and no call on weekends. If patients had issues, they were instructed to call the emergency room or the primary care doctor and follow up during daytime hours with their office if the issue is really urgent. As pain doctor, your work-life balance basically depends on your practice setting. If you're just opening a private practice, you will be developing your practice so you have to put your heart, soul, gut, and time so you probably won't have any vacation. But on a typical steady state, you get to have your 3-4 weeks of vacation per year, work Mon-Fri, 8-5, and no call on weekends. [23:10] Different Pain Fellowships and Matching Fred explains that the process for fellowships is unifying more and more every year where it's the same umbrella and category of fellowships, largely housed in Anesthesiology academic programs throughout the country, with only six or seven are currently in Physical Medicine and only one or two in the Neurology department. Everyone is applying for those fellowships and depending on the department, there is some bias as to whether it's calculated or not in terms of taking a certain number of anesthesiology or PM&R residents for their program. For instance, for anesthesiology, you can apply to any program and that's fine but if you're in PM&R, only a certain of spots are allotted for some fellowships. Moreover, Fred describes matching as very competitive in that back in 2015, 65% of those who applied ended up matching which means 35% did not match, quite a large percentage of people. [25:18] How to be a Competitive Applicant If you're in Anesthesiology, Pain Medicine is already built into your program where you will be doing a couple months of it irregardless. In order to be a competitive applicant, you have to go in rotations, work hard, show some interest, and a get as much hands-on as you can. Ask for it. Sometimes you even have to beg for the fellows to give up their procedures or work directly with the attending to do some procedures. Other ways to be competitive is to get involved in research and doing a presentation for society meetings to show some initiative and to show the attending physicians that you're willing to put a little extra work in it as there is really not that much work to put in. If you're a PM&R resident, seek out pain doctors who are fellowship-trained for this process. Get to know them and get their tips. Get their connections. A lot of times, it's not necessarily what you know but who you know. So really network as much as you can. Fred gives the same advice to the Anesthesiology resident to put an extra effort to do a little bit of research and get to know the people in your department and work with them. [27:05] Pain Medicine Subspecialities and Boards As part of the training, you basically do some hospice palliative care training so you can work in that type of setting. So you can also do a subspecialty in Cancer Pain, which is a lot of opioid management but nothing to worry about patients getting chronically addicted because they really won't live that long so it's really just for palliative care. The procedures tend to be more complicated with cancer pain patients. Additionally, opioids don't have a complete effect for relieving their pain so they have to get intrathecal opioid pain pumps, another type of procedure which is very effective in cancer pain. Just like any board exam prep, you're going to have to study and work hard. But because only a few people talk about pain medicine boards in general, there's this fear about them. For those in pain fellowships right now, Fred suggests that it's almost identical to the process of taking the in-training exam. So if you did well on the in-training exam, you're going to do well on the boards. There are books available online (some for free) that you can download and do those questions. There are also question banks online that you can practice on but they are fairly expensive and Fred thinks they're only marginally useful. Overall, you can do this easily with just a free book. [30:08] Primary Care and Other Specialties What Fred wants to communicate to, not just primary care physicians, but also to all fields referring to pain medicine, that pain medicine does not equal opioids. Pain medicine equals a comprehensive management for pain that's both behavioral, procedural, medical, and rehab. Fred often encountered patients who'd say they've been referred to him by their primary care doctor because it's illegal for them to prescribe it. The truth is that it's never illegal for a primary care doctor to prescribe opioids but the bottom line is that opioid care is not good pain care. It requires procedures and rehab and other types of medications that are much better for pain. Therefore, if you're going to refer to Pain Medicine, Fred believes that patients need to have a clear expectation of what to think and what they're going to receive on the first day and it's certainly not going to be a controlled substance. Other specialties Pain Medicine works the closest with include Neurology, Neurosurgery (for nerve blocks), Orthopedics (for chronic knee pain), and Primary Care referrals. [32:30] Special Opportunities Outside of Clinical Medicine As in any field, you can do medico legal consulting as well as present for various pharmaceutical companies but there could be a lot of ethical issues involved so you want to make sure you're not only pushing the drug but that it also works for your patients. Several pain doctors also open their own surgical centers. [33:33] The Emotional Aspect of Pain Medicine Going in from radiology which is really cognitively challenging throughout the day, Fred finds pain medicine as less cognitively challenging because you have already practiced patterns for step-by-step management so the cognitive aspect is not there as much as the emotional aspect. It is very emotionally challenging throughout the day. 20% of Fred's patients do really well, while some do neutral, a chunk of them just don't get better. What Fred wished he would have known before entering this field is how emotionally taxing the practice can be throughout the day as you will be seeing a lot of patients crying and feeling hopeless. And on top of the chronic pain, patients also have financial issues and even on top of that is the absence of physical therapy practices that took Medicaid. In fact, a lot of the procedures he offered that he thought would be best for patients were not covered since the organization he worked for did not believe in free care so he was not allowed to provide those procedures. In the end, his patients were stuck taking medications they didn't want to take because that was the only option they had, some stuck with opioid medications because that was the only class of medications that their insurance company or Medicaid would cover. Sadly, a fairly large part of our country has been addicted to prescription opioid medications. This is one of the reasons Fred went back to the practice of Radiology because he didn't believe in this process that is self-feeding and defeating at the same time, making the problem worse than better. On the other hand, what Fred likes the most about Pain Medicine is seeing his patients get better especially when he's able to bring the two skill sets of Radiology and Pain Medicine together. Patient get better with the right diagnosis and the right directed targeted treatment. If he had to do it over again, Fred would still have chosen Pain Medicine despite all the political issues being that it's a fantastic and rewarding field because it challenges you on every level. [38:44] The Future of Pain Medicine What Fred sees on the horizon is more technology dedicated to things like spinal cord stimulation, a device implanted subcutaneously that create electronic bursts to block pain signals. These types of technologies would come forward in the algorithm of treating patients earlier with higher end procedural intervention rather than doing medications, steroids, and local anesthetics on a frequent basis. Stem cell therapy is another thing that he sees having a lot of potential. As more research comes out, there's going to be niche indications for certain types of stem cells to be injected into various nerves, joints, and tendons that will stimulate healing. [40:25] Final Words of Wisdom If you really want to do this despite the political climate, go for it. At the end of the day, you're going to be extremely well-rewarded for the work that you do. The patients are going to love you and get tons of Christmas cards and hugs. It's a very rewarding field but it takes a lot from you cognitively, emotionally, and physically but at the end of the day, it's well worth it. Links: ryan@medicalschoolhq.net Geisinger Health System

Click here for tedhart.com He lectures around the world but now is here for you. From the latest in charity news, technology, fundraising and social networking, Ted Hart and his guests help you maneuver through this economic downturn in the charitable sector to greater levels of efficiency and fundraising success. PAGE 2 GUEST EXPERT: Anthony Alonso, President of Advantage Plus has over 25 years of experience in direct marketing. He is often called upon as an industry leader to speak on telephone, planned giving and social media marketing. His experience ranges in the education, health care, social services and arts markets. Over the last twenty-five years, Mr. Alonso has had the honor of working with prestigious institutions, such as the United States Naval Academy Foundation, the United States Military Academy Association of Graduates, the United States Merchant Marine Academy Alumni Association, The Betty Ford Center, Geisinger Health System, Rocky Mountain Health System, Oxford University, The London School of Economics, Dartmouth College, Advocate Health Foundation, The Hill School and countless Catholic organizations. Mr. Alonso served three terms on the AFP Foundation Board, was a founding member of the AFP Industry Partners Council and is currently an officer of the New Jersey Chapter board of AFP. Mr. Alonso has volunteered his time to his Catholic preparatory high school where he was a board member and contributor. He has provided pro-bono calling services to a myriad of organizations including the AFP Foundation for Philanthropy. It is Mr. Alonso’s expertise that has led his clients to successfully raise over $250 million within the last five years.

Mike Murray and the crew over at Geisinger are making the implementation of genomic medicine look down right easy. In today’s interview, Mike explains GenomeFIRST Medicine, a program at the Geisinger Health System in Pennsylvania to offer care “that is based on an individual’s DNA sequence.” The healthcare provider boasts its own biobank and has partnered up with Regeneron’s Genome Center to offer exome screening to self selected patients. As of DNA Day last year, April 25th 2016, 100,000 recruits had signed up.

Geisinger Health System, recognized as one of the better-run health care systems, created xG Health to export the model it used to earn the recognition. CEO Earl P. Steinberg explains how xG Health is successfully deploying Geisinger’s tried-and-true methods to help other health systems.

Today we are fortunate to welcome Dr. Kenneth E. Wood, current Associate Chief Compliance Officer for the University of Maryland Medical Center as well as the new Director of the Maryland Critical Care Network. Dr. Wood just recently joined us from the Geisinger Health System, where he was the Chief Medical Officer as well as the Director of the IAA Geisinger Center for Healthcare Systems Re-Engineering. AND before that he was the Director of Critical Care Medicine and the and Program Director for the Pulmonary and Critical Care Fellowship at the University of Wisconsin.... Needless to say, he has spent a majority of his life making medicine run like an efficient machine. However, today Dr. Wood explains the real issue plaguing our society. Quite simply, the United States health care system is failing to do its most fundamental duty: take care of it's people. This is a lecture I assure you cannot be watched just once...

Joining me for episode #230 is Paul DeChant, MD, MBA to talk about reducing burnout, especially physician burnout, through Lean. Paul (see his bio here) is the former CEO of Sutter Gould Medical Foundation, a 300-physician multispecialty medical group in California's Central Valley. Before that, he had stints at organizations including Geisinger Health System and the Palo Alto Medical Foundation. He is now a consultant and executive coach for Simpler Healthcare. For a link to this episode, refer people to www.leanblog.org/230. In the podcast, we talk about questions and topics including: Tell us about your career... how did you get involved in healthcare leadership and how did you get exposed to Lean? What problems or opportunities were you trying to address with Lean? How did you see your role and participation as CEO? As a physician leader? You recently wrote a blog post "why is physician engagement even an issue?" How would you describe the current state of life for an MD before Lean? Can Lean help prevent burnout for MDs or others? Is there a point where somebody gets "too burned out" and can't be turned?

When one hospital comes up with an application that improves operations and patient outcomes, they might want to share that program with other hospitals. But as two health systems recently discovered, it’s not always as easy as it sounds. Dr. Wendy Chapman, Chair of the Biomedical Informatics Department at the University of Utah, is joined by Dr. Alistaire Erskine, the Chief Clinical Informatics Officer for Geisinger Health System in Pennsylvania and Dr. Stan Huff, the Chief Medical Information Officer at Intermountain Healthcare in Utah. In this podcast, they discuss innovations in information and how sharing can be improved among health systems.

Host: Howard Levy, MD, PhD Guest: David H. Ledbetter, PhD, FACMG From the ASHG Meeting in San Diego, Dr. Howard Levy is joined by Dr. David Ledbetter, Executive Vice President and Chief Scientific Officer at Geisinger Health System. Dr. Ledbetter shares his career story as an internationally recognized researcher in the advancement of medical genomics, and the initiatives he is leading at Geisinger to bring genomic sequencing to primary care settings for improved risk assessments and better patient outcomes.

Dr. Vivian Lee interviews Dr. John Bulger, chief quality officer for the Geisinger Health System, about the start of the ProvenCare initiative, which began with the idea that if incentives for physicians, hospitals and payers are aligned, patients can receive better quality care at a lower cost. Dr. Bulger and his team started with “warrantied” heart surgery as a case study to the concept. In this interview, he discusses what his team learned from the results of the experiment and how they changed procedures and philosophies to achieve better care for patients.

Depression affects more than 350 million people, and all too often causes a loved one to take his or her own life.Contrary to popular belief, depression is very prevalent in society and has been on the rise in the past decade, causing many of its victims to tragically end their lives. In fact, Suicide Awareness Voices of Education (SAVE) reports that suicide takes the lives of nearly 30,000 Americans annually.At some point in your life you may encounter hard times which cause you to feel down in the dumps. However, there is a difference between feeling sad and suffering from depression. Depression is a serious medical disorder that causes tenacious feelings of sadness, hopelessness and helplessness. It can interfere with your daily tasks and can lead to suicide.According to the National Institute of Mental Health, there are two types of depression: major depression and persistent depressive disorder. Major depression consists of severe symptoms such as persistent sadness, inability to eat, sleep, enjoy life and thoughts of suicide. Persistent depressive disorder is characterized by a depressed mood that lasts for at least two years.What are the signs you should be looking for if you think someone you know is suffering from depression?Depression might be thrown around loosely in daily conversations, but there are some serious symptoms and warning signs you should be aware of. Symptoms include constantly being sad, a loss of pleasure in what used to bring joy, changes in sleep and appetite, loss of energy and motivation, problems with memory or concentration, and a preoccupation with dying.Unfortunately, depression and mental illness are often stigmatized, which could make it harder to talk openly and seek help. However, SAVE recommends that instead of instilling negativity, you should openly start a sensitive dialogue by asking your loved one questions about how he or she is feeling.What are some of the treatment options available for depression?There are several options that involve medications, psychotherapy and self-care. Oftentimes a combination of taking antidepressants, talking to a professional and changing up your diet or exercise routine can be used together to help ease symptoms of depression.What else can be done to heal, help and prevent depression and suicide?If you or a loved one is battling depression or having thoughts of suicide, you are not alone. Reach out to your doctor or the National Suicide Prevention Lifeline at 1-800-273-8255.Chief of Psychiatry and the psychiatry residency program director for Geisinger Health System, Dr. Marie Ruevem, discusses why depression is a misunderstood yet very prevalent illness, as well as signs of depression and the types of treatment options available.

Depression affects more than 350 million people, and all too often causes a loved one to take his or her own life.Contrary to popular belief, depression is very prevalent in society and has been on the rise in the past decade, causing many of its victims to tragically end their lives. In fact, Suicide Awareness Voices of Education (SAVE) reports that suicide takes the lives of nearly 30,000 Americans annually.At some point in your life you may encounter hard times which cause you to feel down in the dumps. However, there is a difference between feeling sad and suffering from depression. Depression is a serious medical disorder that causes tenacious feelings of sadness, hopelessness and helplessness. It can interfere with your daily tasks and can lead to suicide.According to the National Institute of Mental Health, there are two types of depression: major depression and persistent depressive disorder. Major depression consists of severe symptoms such as persistent sadness, inability to eat, sleep, enjoy life and thoughts of suicide. Persistent depressive disorder is characterized by a depressed mood that lasts for at least two years.What are the signs you should be looking for if you think someone you know is suffering from depression?Depression might be thrown around loosely in daily conversations, but there are some serious symptoms and warning signs you should be aware of. Symptoms include constantly being sad, a loss of pleasure in what used to bring joy, changes in sleep and appetite, loss of energy and motivation, problems with memory or concentration, and a preoccupation with dying.Unfortunately, depression and mental illness are often stigmatized, which could make it harder to talk openly and seek help. However, SAVE recommends that instead of instilling negativity, you should openly start a sensitive dialogue by asking your loved one questions about how he or she is feeling.What are some of the treatment options available for depression?There are several options that involve medications, psychotherapy and self-care. Oftentimes a combination of taking antidepressants, talking to a professional and changing up your diet or exercise routine can be used together to help ease symptoms of depression.What else can be done to heal, help and prevent depression and suicide?If you or a loved one is battling depression or having thoughts of suicide, you are not alone. Reach out to your doctor or the National Suicide Prevention Lifeline at 1-800-273-8255.Chief of Psychiatry and the psychiatry residency program director for Geisinger Health System, Dr. Marie Ruevem, discusses why depression is a misunderstood yet very prevalent illness, as well as signs of depression and the types of treatment options available.

Stewart Gandolf interviews Susan Alcorn, CCO, Geisinger Health System. Stewart and Susan discuss self promotion, and proving marketing value to management. Read our blog on this podcast here: https://healthcaresuccess.com/blog/podcast-interview/the-pride-of-shameless-self-promotion-make-them-feel-theyd-be-doomed-without-you.html

Workflow rehearsals of key practice protocols ensure that the entire care team --- including the embedded case manager --- is prepared in advance, notes Robert Fortini, vice president and chief clinical officer at Bon Secours Health System. Fortini describes two workflows "rehearsed" by Bon Secours care teams, details the embedded case manager's contribution to medication compliance in the practice, and explains key steps that precede the case manager hiring process. Robert Fortini explained how Bon Secours has adapted the Geisinger Health System embedded case manager model to meet the needs of its own population during "Embedded Case Management in the Primary Care Practice: Program Design and Results," a 45-minute webinar on August 10, 2011.

Dr. Syed Amiry is a leading dermatology expert in the field of general dermatology and has over 6 years of experience in cosmetic dermatology. He is Board Certified by the American Board of Dermatology and received his Medical Degree at AT Still University in Kirksville, MO. His Medical School training included traditional Medical School Teaching as well as a Holistic Osteopathic Philosophy of Integrating Mind and Body. Dr Amiry completed his Dermatology residency at Geisinger Health System in Pennsylvania where he was honored as Chief Resident. He completed specialized training (only 13 programs in the country) in Cosmetic, Laser and Skin Cancer Surgery (Mohs) at Dermatology Associates of San Diego under the guidance of world-renowned dermatologists Dr. Fitzpatrick, Dr. Goldman, Dr. Tse and Dr Butterwick.Tonight Dr. Amiry joins Dr Howard Liebowitz M.D. and co-host Kelly Pappas to discuss his work.Dr. Liebowitz is internationally recognized for his expertise in combining the most effective treatments offered by advanced science with foundational natural and functional medicine. He believes that by replacing missing hormones (hormone balancing and replacement), removing toxic chemicals, providing essential nutrients, a low glycemic diet, adequate rest, and proper exercise, the natural healing ability of the body will result in restoring optimal health at any age.To receive his free monthly newsletter, click here.

Co-locating healthcare case managers in care settings can improve communication with patients as they move through the continuum of care, says Jan Van der Mei, regional director of continuum case management for Sutter Health Sacramento Sierra Region. Ms. Van der Mei describes the major issues that case managers face while helping patients navigate the Sutter system, as well as the key role of case managers in reducing hospital readmissions. Ms. Van der Mei is one of five contributors to the "Guide to Patient-Centered Case Management," a 110-page resource of best practices in identifying, stratifying and monitoring individuals for case management. It documents the returns generated by targeted case management interventions in place at Geisinger Health System and other organizations, and the Q and A chapter answers more than 50 questions on patient-centered case management.

Host: Jack Lewin, MD Guest: Glenn Steele, MD, PhD At some point during the health reform debate, you've probably heard President Obama and others recognize the work of the Geisinger Health System. Through a variety of mechanisms -- among others, charging a flat fee for certain surgical procedures and other high-volume episodes of care, and working hard to integrate services -- Geisinger has been able to bend that all-important cost curve, while also improving the quality of the care they provide. Host Dr. Jack Lewin welcomes the physician executive who has overseen this prolonged period of successful innovation, Geisinger President and CEO Dr. Glenn Steele. On a grand scale, how feasible would it be to leverage the innovations developed at Geisinger across the various markets for health care around the United States?

Host: Jack Lewin, MD Guest: Glenn Steele, MD, PhD At some point during the health reform debate, you've probably heard President Obama and others recognize the work of the Geisinger Health System. Through a variety of mechanisms -- among others, charging a flat fee for certain surgical procedures and other high-volume episodes of care, and working hard to integrate services -- Geisinger has been able to bend that all-important cost curve, while also improving the quality of the care they provide. Host Dr. Jack Lewin welcomes the physician executive who has overseen this prolonged period of successful innovation, Geisinger President and CEO Dr. Glenn Steele. On a grand scale, how feasible would it be to leverage the innovations developed at Geisinger across the various markets for health care around the United States?

Guest: Alfred Casale, MD Host: Bruce Japsen As President Barack Obama touts what is right and wrong with the nation's healthcare system, hardly a week goes by when you don't hear him or one of this surrogates mentioning Geisinger Health System. So what does Mr. Obama see in this large Pennsylvania based medical care provider? Dr. Alfred Casale, director of Cardiothoracic Surgery at Geisinger Health System tells host Bruce Japsen about the Pennsylvania system's years of experience measuring quality and improving patient care to keep costs low.