COVID-19 and Novel Coronavirus Podcasts

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Episode #105: The Need to Overhaul US Healthcare Payment, with Dr. Ezekiel Emanuel

Welcome to episode #105, Season 4 of Creating a New Healthcare. Today we welcome one of the most prolific and influential healthcare policy experts of our era. Professor Ezekial Emanuel is the Vice Provost for Global Initiatives and Co-Director of the Healthcare Transformation Institute at the University of Pennsylvania. He is also a Special Advisor to the Director General of the World Health Organization. Dr. Emanuel was the founding chair of the Department of Bioethics at the National Institutes of Health. From January 2009 to January 2011 he served as a Special Advisor on Health Policy to the Director of the Office of Management and Budget, and the National Economic Council. He is also a breast oncologist, having earned his MD at Harvard Medical School, completed a residency in Internal Medicine at the Beth Israel Hospital in Boston, and then completed an oncology fellowship at the Dana Farber Cancer Institute, where he was also appointed as faculty. Dr. Emanuel has written and edited 14 books and over 300 articles, and is the world’s most cited bioethicist. He is a frequent contributor to the Atlantic, the New York Times, the Wall Street Journal, and the Washington Post, and regularly appears on television and radio.In this episode, we’ll touch on the following:The fragility of the US employer-based healthcare payment system and how the COVID-19 pandemic is nudging us to a universal payment system.The differences between a universal payment program and a single payer system.An illustration of a capitated primary care trial demonstrating the advantages to providers and patients.What the US can learn from other advanced nations in terms of primary care access and healthcare payment reform.The multi-pronged solutions that Dr. Emanuel recommends to address the insidious institutional racism and the inequities that are embedded in US healthcare deliveryI believe it was H.L. Mencken who said that there are often simple solutions to complex problems, and those simple solutions are typically wrong. Dr. Emanuel does not offer simple solutions to the complex problems in our healthcare system. Instead, he offers thoughtful, studied, and ethical solutions that directly and realistically address the fundamental flaws in our healthcare system. These are serious flaws that leave tens of millions of Americans with no or sub-optimal health insurance, limit access to preventive primary and specialty healthcare for tens of millions of Americans, and create perverse and unethical incentives for providers and health systems that greatly inhibit them from delivering the type of healthcare they would like to offer.Dr. Emanuel is one of the most cited healthcare policy scholars and advisors of our era, as well as one of the most prolific researchers and authors. He is one of the finest healthcare educators and thought-leaders our country has ever produced. It is well worth our time to listen to and study the critically important lessons he is teaching us.Until next time,Be safe and be well.Zeev Neuwirth, MD 
October 22, 2020
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Season 2: It’s a Wrap!

As we wrap Season 2 of SEE YOU NOW we’re listening back through the stories and hearing important themes emerge that include a heightened appreciation for innovation, the role it’s playing in responding to our current public health crises, and how that role is changing and evolving. In the era of COVID-19, the practice, permissions, and norms of innovation have shifted dramatically–it’s also identified and cultivated new leaders.  Season 2 took us across the country finding stories of health innovation, from one coast to the other, from rural settings to urban settings, with nurses who specialize in everything from intensive care, to design, and legislation. While the season highlighted the geographic differences, it also punctuated, and, possibly more importantly, showed just how much we share in common. While we are busy working to bring you more exciting stories in Season 3, we invite you to tune in to some of our favorite moments from Season 2. If you have any favorite episodes or stories of nurses leading innovation across all the frontlines of care, please let us know at [email protected] We’ll be back soon!
October 10, 2020
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Episode #104: Reframing Healthcare – A Moral Imperative, with Dr. Don Berwick

Welcome to Episode #104 (Season 4) of Creating a New Healthcare. I’m delighted to welcome back to this podcast Dr. Don Berwick - one of the leading authorities on healthcare quality & improvement over the past few decades.  Dr. Berwick is President Emeritus and Senior Fellow at the Institute for Healthcare Improvement (IHI), an organization that he co-founded and led as President and CEO for 18 years. In July 2010, President Obama appointed Dr. Berwick to the position of Administrator of the Centers for Medicare and Medicaid Services (CMS), which he held until December 2011. An elected member of the Institute of Medicine (IOM), Dr. Berwick served two terms on the IOM’s governing Council, and was a member of the IOM’s Global Health Board. He served on President Clinton's Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. His body of work & contributions to the field of healthcare quality & safety are unparalleled, including two classics: the 1999 IOM report, ‘To Err is Human’ and the 2001 IOM report, ‘Crossing the Quality Chasm’. In 2005, he was appointed “Honorary Knight Commander of the British Empire” by Queen Elizabeth II, the highest honor awarded by the UK to non-British individuals, in recognition of his work with the British National Health Service. To say that Dr. Berwick brings a seasoned perspective on the current state of our healthcare system and the challenges we face as a nation is, to put it mildly, an understatement. What distinguishes Dr. Berwick even more than his record of accomplishment or his brilliant mind is his tireless reminders of the ethical responsibility we have to attend to the health of the American public - especially for those of us who are providers, administrators, policy makers, health insurance companies, as well as pharmaceutical and device manufacturers. A relevant quote from one of Dr. Berwick’s recent articles underscores this responsibility;  “Fate will not create the new normal; choices will.”  In this episode, we’ll cover a range of topics, including the following:Dr. Berwick’s recent article, Choices for the “New Normal” - which is a call-to-action and a leadership roadmap outlining crucial choices in six critical domains that will play a significant role in determining the future of healthcare delivery.Inequality and Inequity -  the relative lack of social support services provided in the US as compared to other developed nations; which Dr. Berwick describes as “the most notable wake-up call”.An ethical reframing of the social determinants of health, described in his recent article, The Moral Determinants of Health; along with some shocking statistics on inequities related to poverty, hunger, homelessness, social isolation, and the uninsured.The tragic and insidious institutional racism that is embedded in our healthcare delivery system, as well as in other institutions such as our criminal justice system.A critical reframing of healthcare that Dr Berwick refers to as “What Matters to You Medicine”; which he suggests should disrupt and replace the legacy “What’s the Matter With You” paradigm.Dr. Berwick is one of the greatest healthcare humanitarians and transformational leaders of our era. He is the quintessential example of empathic ethical leadership. We need more leaders like this in and around healthcare. Dr. Berwick’s recent publications are seminal. In these articles, he courageously cuts to the stark realities of our healthcare system. He not only lays bare the truth for all to see but also outlines the crucial leadership choices of our time. And even beyond that, he lays out a pathway for positive action. Dr. Berwick writes, speaks & acts with intellectual integrity, academic rigor, and with a disarmingly insightful and honest authenticity - as well as with a powerful voice based in morals and compassion. At times, it’s unsettling, uncomfortable and inconvenient. Make no mistake about it, Dr. Berwick’s message is not an academic treatise. It is a call for ethical action.Until next time, Be safe and be well.Zeev E. Neuwirth, MD
October 7, 2020
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Rebroadcast: Mental Health Pandemic

As September, National Suicide Prevention Month, comes to a close –we wanted to revisit our episode on the Mental Health Pandemic that originally aired in May of 2020 as part of National Nurses Month. Each year during the month of September, the Suicide Prevention Lifeline and other mental health organizations around the world raise awareness of suicide prevention. And on October 10, we will observe World Mental Health Day – a day focused on raising awareness of mental health issues and mobilizing efforts in support of mental health. No one anticipated that 2020, The Year of the Nurse and the Midwife, would see nurses at the center of a novel coronavirus pandemic. But that’s exactly what’s unfolding and nurses are rising to the challenges and demands. Every day, frontline healthcare teams are making impossible choices, risking their health and their family's health, saving lives, and keeping our health systems afloat. The work is exhausting on every dimension and triggering a series of pandemics. COVID-19 will have a mental health impact on everyone. And for those providing the care and making tremendous sacrifices for our communities, the mental health toll will continue on well beyond the pandemic itself. In this special episode of SEE YOU NOW we hear from four healthcare leaders with a different lens on the shared mission of building a healthy, happy, and resilient healthcare workforce. Barbara McLean, clinical nurse specialist and nurse practitioner, Liz Stokes, the director of the ANA Center for Ethics and Human Rights, Judy Davidson, nurse scientist, and Pam Cipriano, the dean of the University of Virginia School of Nursing, share their experience, perspective and wisdom and the urgency of addressing mental health needs now. For additional resources, visit our website at  Contact us at [email protected] 
September 26, 2020
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Episode #103: Rebuilding Trust, A Key Step to Eliminating Healthcare Disparities – with Dr. Mandy Cohen

Welcome to episode #103, Season 4 of Creating a New Healthcare. In this episode we are welcoming back to the podcast Dr. Mandy Cohen, the Secretary for the North Carolina Department of Health & Human Services. Dr. Cohen and her administration have been critical in responding to the current pandemic. Over the past 3 1/2 years, they have also been hard at work, developing and deploying a cutting-edge, state-wide approach to addressing the Social Determinants of Health - a critical national issue whose importance has been magnified by the pandemic.  In this episode, we’ll cover:3 major lessons that the COVID-19 pandemic has taught us: (1) equity, (2) system-ness and (3) care beyond walls. How Dr. Cohen and the NC DHHS adopted “an equity lens” in deploying targeted programs and policies to create a more equitable healthcare system.The progress in “health opportunity” programs such as the NCCARE360 closed-loop referral program.The central importance of Community Health Workers in building a ‘bridge of trust’ to creating better health.   For me, there were three profound take-aways from this episode:As we were discussing the importance and necessity of collecting data on racial disparities and inequities in healthcare, Dr. Cohen paraphrased a mutual colleague - Dr. Mark Smith, the founding president and former CEO of the California Health Care Foundation. The lesson she shared is the cautionary note that one should not admire a problem too much at the expense of doing something about it. We should not wait around for perfect or publishable data before taking action. Heeding this advice, she is “full tilt” on deploying resources to assist traditionally marginalized populations - in particular, the Black and Latinx populations.Governor Roy Cooper has been fiercely promoting the importance of Medicaid expansion - which has become even more critically important due to the stressors of the pandemic on factors such as employment. There are currently 2.2 million people on Medicaid in NC, which accounts for about one-fifth of the entire NC population.  1.5 million of those individuals are children, which accounts for one out of every three children in NC.  If we accepted federal funding and expanded Medicaid in NC, it would provide insurance coverage for another 600,000 people - covering COVID-19 testing, behavioral health treatment, early childhood development programs, life-saving medical care and so on. As Dr. Cohen puts it - the fact that we are one of only twelve states in the entire country that has not yet expanded Medicaid is a “black eye” on the NC commonwealth. There was another profound ‘aha’ moment that happened during this interview that I don’t think I’ll ever forget. As we were discussing the 'community health work' (CHW) program she and her team are deploying, Dr. Cohen punctuated the key role that community health workers serve in the healthcare ecosystem. It's well known that Community Health Workers serve to provide navigation and coordination of clinical care, and that they assist with social services and social agency. But, from Dr. Cohen’s perspective, their key core function is really about rebuilding trust. It’s about meeting people where they are, and starting to rebuild a bridge that has been broken. She went on to say that we have to acknowledge that we have a “trust deficit” in communities of historically marginalized people. More explicitly, Black and Latinx communities have been left out and let down by our healthcare system. And, some of the current health inequities are likely due to the fact that people don’t seek healthcare because they don’t believe they will be heard, listened to, and appropriately cared for. The “trust deficit” is based on decades of lived and learned negative experiences, and is supported by decades of published research. Dr. Cohen is a knowledgeable, forward-thinking, empathetic and highly competent public health leader. She has a definite bias to action - deploying programs that achieve measurable positive health outcomes for individuals and communities. Under her leadership, the NC DHHS is keenly focused on addressing the long-standing and systemic ‘dis-trust’ in our healthcare system, which to my mind may be the single most important ‘dis-ease’ we need to tackle if we are to achieve our full potential as a state, and as a nation.Until next time, be safe and be well.Zeev Neuwirth, MD
September 23, 2020
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The Path to a Timely, Safe and Effective COVID-19 Vaccine

In this episode, Dr. Paul Offit and Dr. Margaret Trexler Hessen discuss the scientific underpinnings of vaccine development and get up to speed on the advanced COVID-19 vaccine candidates. They also speak about the realistic expectations for the COVID-19 vaccine and how hygienic measures will remain an important component of controlling the virus. Dr. Offit is the Maurice R. Hilleman Chair of Vaccinology and Professor of Pediatrics at the Perelman School of Medicine at the University of Pennsylvania. He is also the Director of the Vaccine Education Center at the Children’s Hospital of Philadelphia. Dr. Offit co-invented the RotaTeq vaccine and is co-editor of Elsevier’s reference book, Plotkin’s Vaccines. Hosted by: Margaret Trexler Hessen, MD, FACP, FSHEA, Director, Point of Care, Digital Content, Elsevier Clinical Solutions Learn more on Elsevier's Website | Health Podcast Network Follow on Twitter | Facebook | LinkedIn | YouTube
September 21, 2020
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Sensing Health

Across the globe, millions of people are experiencing the challenges, complexities, and costs of caring for elderly family members—these challenges have been amplified and complicated by the COVID-19 pandemic. AARP recently reported that 48 million Americans, mostly women, care for another adult and now, checking in on our elder loved ones in a physically distanced manner requires even greater creativity and innovation. In this episode, we meet nurse innovator Joshua Littlejohn MPH, MSN, RN, and entrepreneur Gabriela Sabaté, MBA, MHCI, who are experimenting and innovating with technologies that connect data to transform how we not only provide care remotely, but also how we approach and use hackathons as a way to crowdsource ideas and introduce new innovations.  For more additional resources visit our website at  Contact us at [email protected] 
September 19, 2020
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3M CEO Mike Roman

September 17, 2020
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Isolation and the Brain

September 15, 2020
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Campaign for Health

Around the globe, nurses are actively innovating to improve the health, safety, and wellbeing of citizens, environments, and entire communities in settings that some might not have considered—our state legislatures. The link between nursing, politics, and innovation might not seem obvious, but for the nurses who have ushered in meaningful legislation—the relationship is a natural one. In this wide-ranging conversation with Delaware Lt. Gov, Bethany Hall-Long, we discover how nurses involved with legislation at the local, state, and federal level is innovation. For additional resources, visit our website at  Contact us at [email protected] 
September 11, 2020
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The Swedish Strategy

September 10, 2020
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Episode 102: What NASA can teach us about social isolation & loneliness

Dear Friends & Colleagues,Welcome back to the Fall 2020 season of ‘Creating a New Healthcare’.  We are now entering the 4th year of our podcast, with over 250,000 downloads this year to date!  It’s clear that the issue of reframing healthcare has never been more important than it is at this moment.  So, if you find value in listening to the podcast, I would urge you to share it with friends and colleagues.  There is so much going on in the world right now. It’s a time of great uncertainty, volatility, distress - and opportunity.   One of the unintended consequences of the sheltering-at-home and social-distancing - necessary to combat COVID-19 - is the devastating isolation, loneliness and despair it has wreaked across the US population.  Research, prior to the pandemic, informs us that somewhere between 40 - 50% of the population experiences social isolation or loneliness.  I strongly suspect that the pandemic has raised those numbers significantly.  We also know that it’s not just the elderly.  The second most affected segment of the population are college age adults.  We desperately need a national solution to address social isolation and loneliness. So, what can NASA teach us about social isolation & loneliness?  And, why is Humana, a major healthcare insurance company, collaborating with NASA to address social isolation?To answer those questions, we’ll be joined today by two distinguished experts in this area - Dr. Will Shrank,  the Chief Medical Officer at Humana; and Dr. Gary Strangman - a psychologist and researcher from the Massachusetts General Hospital (MGH).  Dr. Strangman is the Director of a “Neural Systems Group” at MGH and has also been working closely with NASA over the past 2 decades - currently as the Innovation Specialist for NASA’s Translational Research Institute for Space Health (TRISH).In this interview, we’ll dive into the following:The physiologic and psychologic impact of social isolation on astronauts and the types of solutions NASA is exploring to deal with this.Some of the similarities between space travel & sheltering-at-home in the era of COVID-19.Startling statistics on the impact of social isolation on Humana’s senior members, and the types of initiatives they’ve been deploying to combat it.Next steps for the collaboration between Humana and TRISH.During the interview it becomes abundantly apparent that Gary Strangman and Will Shrank are superstars in their respective fields.  The fact that Humana is collaborating with NASA’s Translational Institute for Space Health speaks volumes about the intense focus, commitment and highly innovative approach Humana is taking to better understand and combat the epidemic of social isolation.  Humana and TRISH are also collaborating, alongside others, in a public health awareness campaign, called ‘Far from Alone’.  This program addresses health-related social needs and promotes understandings of loneliness and social isolation - issues that are exacerbated by the Coronavirus pandemic. I recently read a quote from Atul Gawande that provides a meaningful context to the work that Dr. Shrank and Dr. Strangman, and their respective organizations, are engaged in.  “We’ve been wrong about what our job is in medicine. We think our job is to ensure health and survival.  But really it is larger than that. It is to enable well-being. And well-being is about the reasons one wishes to be alive." Until Next Time,Be Safe & Be Well.Zeev Neuwirth MD 
September 9, 2020
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Myth Busters

During the crisis phase of the COVID-19 pandemic, healthcare, like every other sector of the US economy, was forced to cease non-essential activities. Which meant canceling thousands of elective procedures and in-person visits, halting a wide-ranging set of business operations, and shifting thousands of employees to work from home and redeploying many to new roles. The profound disruption was both astounding and revealing and offered a rare opportunity to innovate swiftly at the enterprise level. In this episode, Karen Murphy, PhD, RN, executive VP, chief innovation officer and founder of the Steele Institute for Health Innovation at Geisinger offers the thirty thousand foot view of enterprise-level innovation at a scale and pace that was once thought of as too hard, too risky, and just not possible.   For additional resources visit:  Contact us at [email protected] 
September 4, 2020
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Nursing Home Heroes

September 3, 2020
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Covid on Campus

September 1, 2020
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