Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
Healthcare organizations in Canada are making great strides in promoting safer patient care through engagement and partnership. Now the best of these organizations would like to share their successes and lessons learned with you!
Full details:
https://goo.gl/NukquA
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
At the end of this 90 minute session patient/ family/ advisors/ champions as well as health providers/ leaders/ authorities will leave with at least one practical idea to apply to patient advisor training as a result of their increased understanding of:
Current training programs and models in use across Canada
Training needs of patient advisors at different system levels
Gaps in training needs and ideas on how to fill them
Available supporting resources and leading practices
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
The 2015 Patient Safety Champion Awards are presented by HealthCareCAN and Canadian Patient Safety Institute with support from Patients for Patient Safety Canada.
WATCH: http://bit.ly/1U06qKn
Objectives:
1.Introduce the Measuring and Monitoring of Safety Framework to a Canadian healthcare audience
2.Describe how the framework would work in Canada
Dr. Edward Wagner, Director (Emeritus) MacColl Center, Senior Investigator, Group Health Research Institute addresses the 2014 Weitzman Symposium on The Future of Primary Care
Healthcare organizations in Canada are making great strides in promoting safer patient care through engagement and partnership. Now the best of these organizations would like to share their successes and lessons learned with you!
Full details:
https://goo.gl/NukquA
his is the first in a series of interactive webinars designed to build capacity in the basic principles of knowledge translation and implementation science.
WATCH-ON DEMAND: https://goo.gl/hnp8gi
At the end of this 90 minute session patient/ family/ advisors/ champions as well as health providers/ leaders/ authorities will leave with at least one practical idea to apply to patient advisor training as a result of their increased understanding of:
Current training programs and models in use across Canada
Training needs of patient advisors at different system levels
Gaps in training needs and ideas on how to fill them
Available supporting resources and leading practices
Can we solve the adult primary care shortage without more physicians? CHC Connecticut
Tom Bodenheimer,of the Center for Excellence in Primary Care at UCSF Dep’t of Family and Community Medicine talks about addressing the primary care shortage at the 2014 Weitzman Symposium
The 2015 Patient Safety Champion Awards are presented by HealthCareCAN and Canadian Patient Safety Institute with support from Patients for Patient Safety Canada.
WATCH: http://bit.ly/1U06qKn
Objectives:
1.Introduce the Measuring and Monitoring of Safety Framework to a Canadian healthcare audience
2.Describe how the framework would work in Canada
What do the Canadian Patient Safety Institute (CPSI), the Agency for Healthcare Research & Quality (AHRQ) in the United States, and the Michael Garron Hospital in Toronto have in common? All three organizations have seen the benefits to patient safety when implementing the evidence-based teamwork and communication framework, TeamSTEPPS (Team Strategies and Tools for Effective Performance and Patient Safety).
Full details: https://goo.gl/8Y2PHc
Understanding how the Measurement and Monitoring of Safety Framework can form board understanding and help align strategic and operational approach to patient safety.
Full details: https://goo.gl/XyqTQA
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
Advancing Team-Based Care: Complex Care Management in Primary CareCHC Connecticut
This webinar investigated the ways that team members can contribute to the care of patients with complex medical and/or social needs. The focus was on developing the expanded care team and ensuring ready communication between the core and expanded care teams. Models for effective care management were presented.
This webinar was presented May 5, 2016 3:00 p.m. Eastern Time
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
Patient Engagement Presentation - MPN Network Forum April 18, 2017Alexandra Enns
April 18, 2017
In April we held a Network Forum on engaging policymakers and patients/public effectively and appropriately. We would like to give a warm thanks to both Carolyn Shimmin, Patient Engagement expert of CHI's Knowledge Translation team, and Marcia Thomson, Assistant Deputy Minister of Manitoba Health, Seniors and Active Living for their presentations. Below you can see Carolyn's presentation - to see more of her work on patient engagement and to learn more about knowledge translation at CHI, please check out the blog Knowledge Nudge here. If you would like more information, helpful tools or advice about patient/public engagement in research, please contact Carolyn Shimmin at cshimmin@exchange.hsc.mb.ca
June 27/2017 - SPOR-PIHCI Network presentations from the pre-CAHSPR conference day in Toronto, Ontario
Sharing Practical Advances in Research Knowledge-
Translating Findings to Action from PIHCIN Research
June 23, 2017
At this event, leading health care executives, experts, policymakers, and other thought leaders gathered to conclude a project to develop a guiding framework for providing improved care for people with serious illness. Participants observed the final working session where distinguished panelists discussed innovations in program design and pathways for delivering high quality care to an aging population with chronic illnesses, especially those with declining function and complex care needs. The panelists engaged audience members in Q&A sessions during each panel, as well as at breakout sessions over lunch.
This project was funded by the Gordon & Betty Moore Foundation, and this convening was part of the Project on Advanced Care and Health Policy, a collaboration between the Coalition to Transform Advanced Care (C-TAC) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Learn more on the website: http://petrieflom.law.harvard.edu/events/details/critical-pathways-to-improved-care-for-serious-illness-2
Have you ever struggled to unite a team on an improvement project? Or have you ever been in a situation where lack of communication has hindered your improvement efforts?
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Resi...CHC Connecticut
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Residency Training Programs
Presented by CHC. Inc. and the Weitzman Institute
January 9, 2019 3:00pm (EST)
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
July 12, 2017
This webinar was based on the June 23, 2017 event, "Critical Pathways to Improved Care for Serious Illness: Concluding Convening." At this event, leading health care executives, experts, policymakers, and other thought leaders gathered to conclude a project to develop a guiding framework for providing improved care for people with serious illness. Participants observed the final working session where distinguished panelists discussed innovations in program design and pathways for delivering high quality care to an aging population with chronic illnesses, especially those with declining function and complex care needs. The panelists engaged audience members in Q&A sessions during each panel, as well as at breakout sessions over lunch.
This project was funded by the Gordon & Betty Moore Foundation, and this convening was part of the Project on Advanced Care and Health Policy, a collaboration between the Coalition to Transform Advanced Care (C-TAC) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Learn more on the website: http://petrieflom.law.harvard.edu/events/details/critical-pathways-to-improved-care-for-serious-illness-2.
What do the Canadian Patient Safety Institute (CPSI), the Agency for Healthcare Research & Quality (AHRQ) in the United States, and the Michael Garron Hospital in Toronto have in common? All three organizations have seen the benefits to patient safety when implementing the evidence-based teamwork and communication framework, TeamSTEPPS (Team Strategies and Tools for Effective Performance and Patient Safety).
Full details: https://goo.gl/8Y2PHc
Understanding how the Measurement and Monitoring of Safety Framework can form board understanding and help align strategic and operational approach to patient safety.
Full details: https://goo.gl/XyqTQA
Learn about the new MedRec rebranding strategy and what it means for patients/consumers, and healthcare professionals
2.What’s new with ‘5 Questions to Ask About Your Medications’
3.Hear how organizations are using ‘5 Questions to Ask About Your Medications’ to engage patients and consumers
Advancing Team-Based Care: Complex Care Management in Primary CareCHC Connecticut
This webinar investigated the ways that team members can contribute to the care of patients with complex medical and/or social needs. The focus was on developing the expanded care team and ensuring ready communication between the core and expanded care teams. Models for effective care management were presented.
This webinar was presented May 5, 2016 3:00 p.m. Eastern Time
This webinar will shift the focus from WHAT you are doing with your improvement efforts, instead shedding light on the importance of HOW you are doing it!
Patient Engagement Presentation - MPN Network Forum April 18, 2017Alexandra Enns
April 18, 2017
In April we held a Network Forum on engaging policymakers and patients/public effectively and appropriately. We would like to give a warm thanks to both Carolyn Shimmin, Patient Engagement expert of CHI's Knowledge Translation team, and Marcia Thomson, Assistant Deputy Minister of Manitoba Health, Seniors and Active Living for their presentations. Below you can see Carolyn's presentation - to see more of her work on patient engagement and to learn more about knowledge translation at CHI, please check out the blog Knowledge Nudge here. If you would like more information, helpful tools or advice about patient/public engagement in research, please contact Carolyn Shimmin at cshimmin@exchange.hsc.mb.ca
June 27/2017 - SPOR-PIHCI Network presentations from the pre-CAHSPR conference day in Toronto, Ontario
Sharing Practical Advances in Research Knowledge-
Translating Findings to Action from PIHCIN Research
June 23, 2017
At this event, leading health care executives, experts, policymakers, and other thought leaders gathered to conclude a project to develop a guiding framework for providing improved care for people with serious illness. Participants observed the final working session where distinguished panelists discussed innovations in program design and pathways for delivering high quality care to an aging population with chronic illnesses, especially those with declining function and complex care needs. The panelists engaged audience members in Q&A sessions during each panel, as well as at breakout sessions over lunch.
This project was funded by the Gordon & Betty Moore Foundation, and this convening was part of the Project on Advanced Care and Health Policy, a collaboration between the Coalition to Transform Advanced Care (C-TAC) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Learn more on the website: http://petrieflom.law.harvard.edu/events/details/critical-pathways-to-improved-care-for-serious-illness-2
Have you ever struggled to unite a team on an improvement project? Or have you ever been in a situation where lack of communication has hindered your improvement efforts?
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Resi...CHC Connecticut
Planning, Launching, and Sustaining Accreditation-worthy Postgraduate NP Residency Training Programs
Presented by CHC. Inc. and the Weitzman Institute
January 9, 2019 3:00pm (EST)
Two of the New York metro area’s largest provider organizations will share their experiences leveraging HIE as one of many tools to decrease fragmentation of care and improve patients’ experiences across acute and post-acute care settings for patients undergoing elective surgeries. Representatives from NYULMC and VNSNY will summarize their efforts to redesign more personalized specific care pathways and the central role played by the implementation of real-time data exchange to provide a seamless transfer of clinical data between providers caring for the patient at the time of discharge and throughout the post-acute period.
• Kathleen Mullaly - Senior Director for Clinical Operations, Department of Network Integration, NYU Langone Medical Center
• Amy Weiss - Director for Strategic Account Development, Integrated Delivery Systems, Visiting Nurse Service of New York (VNSNY)
New York eHealth Collaborative Digital Health Conference
November 18, 2014
July 12, 2017
This webinar was based on the June 23, 2017 event, "Critical Pathways to Improved Care for Serious Illness: Concluding Convening." At this event, leading health care executives, experts, policymakers, and other thought leaders gathered to conclude a project to develop a guiding framework for providing improved care for people with serious illness. Participants observed the final working session where distinguished panelists discussed innovations in program design and pathways for delivering high quality care to an aging population with chronic illnesses, especially those with declining function and complex care needs. The panelists engaged audience members in Q&A sessions during each panel, as well as at breakout sessions over lunch.
This project was funded by the Gordon & Betty Moore Foundation, and this convening was part of the Project on Advanced Care and Health Policy, a collaboration between the Coalition to Transform Advanced Care (C-TAC) and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
Learn more on the website: http://petrieflom.law.harvard.edu/events/details/critical-pathways-to-improved-care-for-serious-illness-2.
Measuring Family Experience of Care Integration to Improve Care Delivery LucilePackardFoundation
The family perception of care integration is essential in identifying opportunities to improve processes of care coordination and care management. This June 15 webinar introduced the Pediatric Integrated Care Survey (PICS), a validated instrument developed by Richard Antonelli, MD, MS, Medical Director of Integrated Care at Boston Children's Hospital, and his team. The instrument assesses family experience of care integration. It asks family respondents to identify the members of their child's/youth's care team and report on their experiences with integration across disciplines, institutions, and communities.
Michigan Hospital Association Governance meetingMary Beth Bolton
Patient centered medical home activities in MI and Nationally and the opportunity to improve quality outcomes by increased access to primary care doctors who outreach members who are missing preventive and chronic care services.
The Patient Centered Primary Care Collaborative has been working for years to build evidence and knowledge about how to improve healthcare by providing a medical "home" for each of us - a place where all our records reside, where the staff know us, etc. This April 2010 by Executive Director Edwina Rogers shows the phenomenal range of results they've produced.
NHS Improving Quality was invited to take part in a recently held event that celebrated the work that is being done in partnership between the Pennine Acute Hospitals NHS Trust and AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP).
Gillian Phazey, Learning and Organisational Development Manager at Pennine Acute Hospitals NHS Trust explains:
'The Learning and Organisational Development and Governance teams at the Pennine Acute Hospitals NHS Trust have been working collaboratively with AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP) to support staff in developing knowledge and skills in this topic. The programme has been specifically designed to support colleagues wanting to gain an introduction to the fundamentals and concepts of quality improvement. So far, two cohorts of staff, from clinical and non-clinical areas of the Trust have completed the programme, and have completed quality improvement projects in their own work area to apply their knowledge. On 17th July a celebration event was held for cohort 2 where staff presented their work in poster or presentation form, the aim of which is to share and spread learning across the Trust. Projects were wide ranging, from introducing new processes to reduce complaints and drug errors, to improving patient experience by implementing new tools and techniques. The day was a great success with the Chief Executive and Chief Nurse in attendance. The Trust is highly supportive of this approach in equipping staff with these important techniques, and the programme supports not only our internal quality agenda and objectives, but more widely responds to the recommendations of the Berwick report. The next cohort is starting in September this year.'
Fiona Thow, Patient Safety Collaborative Delivery Lead at NHS Improving Quality delivered a keynote speech, (link to presentation slides) providing a national perspective on the plans for improving patient safety and took the opportunity to introduce the national safety collaboratives. She also highlighted the need for organisations and individuals to think differently about safety for both patients and staff.
As new payment models emerge that emphasize value over volume, providers are being compelled to look more closely at how to motivate patients—especially those with multiple chronic conditions—to actively manage their care, make better decisions and change behaviors. This editorial webinar will explore the relationships between engagement and improved health outcomes, greater patient satisfaction and better resource utilization. Our panel of experts will share proven strategies for building patients' confidence, disseminating self-management tools and making the best use of your care team.
Edwina Rogers, executive director of Patient-Centered Primary Care Collaborative, began her presentation by highlighting the movement to advance medical homes.
With the U.S. being the number one in the world for the cost of healthcare and ranked number 37 in the quality category, something needs to change. Rogers discussed the broad stakeholder support and participation for the movement, as well as the incredible volunteer involvement. The four ‘centers’ include: the Center to Promote Public-Payer Implementation, the Center for Multi-Stakeholder Demonstration, the Center for eHealth Information Adoption and Exchange and the Center for Health Benefit Redesign and Implementation. Medical Homes will provide superb access to care, patient engagament in care, clinical information systems, care coordination, team care, patient feedback and publically available information.
Edwards explained that the Obama administration believes the medical homes concept is the best way to approach healthcare reform. The U.S. House of Representatives has showed great support for the movement and is helping develop and allocate funds for a five-year pilot program. She expressed her enthusiasm for the movement and her prediction that the medical home model is certainly the future of health care.
A complete version of Rogers’ presentation on the Patient-Centered Primary Care Collaborative is available online.
PIHCI programmatic grants webinar (en) for circulationAlexandra Enns
These are the slides from CIHR’s webinar providing information for the upcoming PIHCI Network Programmatic Grant funding opportunity.
The complete instructions are on ResearchNet: https://www.researchnet-recherchenet.ca/rnr16/vwOpprtntyDtls.do?prog=2734&view=currentOpps&org=CIHR&type=EXACT&resultCount=25&sort=program&next=1&all=1&masterList=true
Members of the Coleman Supportive Oncology Collaborative including over 169 cancer care providers from 44 institutions came together in person to share lessons from their 3-year project to improve supportive cancer care across the region and to launch the next step in the Coleman Foundation initiative which is to improve patient communication and experience.
Personal protective equipment or PPE has been a major topic of discussion across the nation. The COVID-19 pandemic has exposed major shortages of PPE and health care workers are being asked take care of patients with what some would argue is inadequate protection. The guidelines set by the CDC have changed and recommendations have even gone so far as to approve bandannas as a means for respiratory protection. Some have argued that it is unethical for health care workers to not have adequate protection, while others think it's their duty, protected or not. Adding to this debate has been theft, hoarding and disparate distribution of these critical supplies. During this panel discussion moderator Carmel Shachar, Stephen P. Wood, Christine Mitchell and Dr. Michael Mina explored the ethics of PPE in the COVID-19 pandemic.
March 27, 2020
Each year in low- and middle-income countries thousands of people are detained in hospitals for non-payment of medical bills, despite the fact that such detention is a violation of national and international law. Hospital detention for nonpayment of bills disproportionately affects the most vulnerable people, including post-partum women.
In the US, medical debt manifests itself in other ways, including bankruptcy, litigation to garnish wages, and foregone care. In both contexts, these scandals are the result of failures of financing, priority-setting, and legal oversight.
Without addressing these systemic issues, a "human right to health care" will remain a hollow slogan, as will political promises to achieve universal health coverage.
This event will feature Robert Yates of Chatham House, which has conducted an in-depth investigation of the global phenomenon of hospital detentions. Additional panelists will address manifestations of predatory lending and surprise medical fees in the United States, the ethical imperatives of financing and priority setting for UHC in general, and the implications for thinking about health care as a human right.
For more information, visit our website at: https://petrieflom.law.harvard.edu/events/details/debt-dignity-and-health-care
March 24, 2020
This event will highlight the challenges and opportunities in harnessing artificial intelligence (AI) technologies to serve the needs of individuals with disabilities and dependencies. AI can improve the lives of people with disabilities, such as smart devices supporting people with physical disabilities or sight loss. On the other hand, AI outputs can also reflect discriminatory biases present in the underlying data used to develop the algorithms. While this “garbage in, garbage out” principle is well documented in respect to AI and gender or race, it is understudied in respect to disability or dependencies.
Interdisciplinary panels of legal scholars, ethicists, AI developers, medical and service providers, and advocates with disabilities/ dependencies will explore best practices and guidelines for stakeholders, guided by ethical principles, legal considerations, and the needs of people with disabilities/ dependencies. Participants will seek to articulate clear criteria for developers and medical providers looking to harness the potential of AI to serve individuals with disabilities/ dependencies, including those whose disabilities/ dependencies are the result of aging, injury, or disease, and the caregivers -- including both professionals and unpaid friends and families -- who support some of these individuals.
This webinar was free and open the public.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/artificial-intelligence-and-disability-dependency
March 24, 2020
This event will highlight the challenges and opportunities in harnessing artificial intelligence (AI) technologies to serve the needs of individuals with disabilities and dependencies. AI can improve the lives of people with disabilities, such as smart devices supporting people with physical disabilities or sight loss. On the other hand, AI outputs can also reflect discriminatory biases present in the underlying data used to develop the algorithms. While this “garbage in, garbage out” principle is well documented in respect to AI and gender or race, it is understudied in respect to disability or dependencies.
Interdisciplinary panels of legal scholars, ethicists, AI developers, medical and service providers, and advocates with disabilities/ dependencies will explore best practices and guidelines for stakeholders, guided by ethical principles, legal considerations, and the needs of people with disabilities/ dependencies. Participants will seek to articulate clear criteria for developers and medical providers looking to harness the potential of AI to serve individuals with disabilities/ dependencies, including those whose disabilities/ dependencies are the result of aging, injury, or disease, and the caregivers -- including both professionals and unpaid friends and families -- who support some of these individuals.
This webinar was free and open the public.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/artificial-intelligence-and-disability-dependency
February 14, 2020
On February 14, 2020, Harvard Medical School Center for Bioethics and the Program on Regulation, Therapeutics, and Law (PORTAL) at Brigham and Women's Hospital, in collaboration with the Petrie-Flom Center hosted the monthly health policy consortium on sugar-sweetened beverage excise taxes.
In recent years, some cities have tried to impose soda taxes and other new policies to reduce the obesity epidemic in the US—particularly among children—and its critical impact on society and the health care system. How effective are these policies? What is blocking their uptake? What alternatives should we consider?
For more information visit our website at: https://petrieflom.law.harvard.edu/events/details/soda-taxes-and-other-policy-responses-to-the-american-obesity-epidemic
February 14, 2020
On February 14, 2020, Harvard Medical School Center for Bioethics and the Program on Regulation, Therapeutics, and Law (PORTAL) at Brigham and Women's Hospital, in collaboration with the Petrie-Flom Center hosted the monthly health policy consortium on sugar-sweetened beverage excise taxes.
In recent years, some cities have tried to impose soda taxes and other new policies to reduce the obesity epidemic in the US—particularly among children—and its critical impact on society and the health care system. How effective are these policies? What is blocking their uptake? What alternatives should we consider?
For more information visit our website at: https://petrieflom.law.harvard.edu/events/details/soda-taxes-and-other-policy-responses-to-the-american-obesity-epidemic
October 23, 2019
The future of neuroscience and law will be a computational future, as both fields are increasingly integrating artificial intelligence and machine learning. But what will this future look like? Can AI and digital technologies promote justice, diversity, and inclusion? Or will these technologies replicate, or even exacerbate, existing inequalities and biases? In this lunchtime event, leading experts in artificial intelligence, computational psychiatry, and the law discussed these questions as they explored how AI and digital technologies can advance social good through improved social, psychiatric, and legal interventions.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/computational-justice
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
October 7, 2019
On October 7, 2019, the Harvard Global Health Institute will host a one-day symposium to explore what enabled this visionary program, and to showcase how it has transformed not just the worldwide HIV/AIDS response but global health delivery more broadly.
There are many lessons learned in PEPFAR’s story - from what it took to build a supply chain where there was none, to establishing the use of generic antiretroviral therapies (ARTs) and leveraging human capacity. This event convened the early architects of PEPFAR as well as experts and implementers currently leading the charge. We took a historically informed look at what it will take to stop global transmission, and shared tools useful for others hoping to move the needle on vexing problems in global health.
For more information, visit our website at https://petrieflom.law.harvard.edu/events/details/15-years-of-pepfar
September 10, 2019
Book Talk: Birth Rights and Wrongs: How Medicine and Technology are Remaking Reproduction and the Law
Millions of Americans rely on the likes of birth control, IVF, and genetic testing to make plans as intimate and far-reaching as any over a lifetime. This is no less than the medicine of miracles. It fills empty cradles, frees families from terrible disease, and empowers them to fashion their lives on their own terms. But accidents happen.
Pharmacists mix up pills. Lab techs misread tests. Obstetricians tell women their healthy fetuses would be stillborn. Political and economic forces conspire against regulation. And judges throw up their hands when professionals foist parenthood on people who didn't want it, or childlessness on those who did. Failed abortions, switched donors, and lost embryos may be first-world problems. But these aren't innocent lapses or harmless errors. They're wrongs in need of rights.
At this event, author Dov Fox and an expert panel discussed his book Birth Rights and Wrongs: How Medicine and Technology are Remaking Reproduction and the Law (Oxford University Press, 2019). Panelists explored the ways in which the book seeks to lift the curtain on reproductive negligence, give voice to the lives it upends, and vindicate the interests that advances in medicine and technology bring to full expression. They also examined the book's effort to force citizens and courts to rethink the reproductive controversies of our time, and to equip us to meet the new challenges -- from womb transplants to gene editing -- that lie just over the horizon.
Learn more: https://petrieflom.law.harvard.edu/events/details/book-talk-birth-rights-and-wrongs
September 10, 2019
Book Talk: Birth Rights and Wrongs: How Medicine and Technology are Remaking Reproduction and the Law
Millions of Americans rely on the likes of birth control, IVF, and genetic testing to make plans as intimate and far-reaching as any over a lifetime. This is no less than the medicine of miracles. It fills empty cradles, frees families from terrible disease, and empowers them to fashion their lives on their own terms. But accidents happen.
Pharmacists mix up pills. Lab techs misread tests. Obstetricians tell women their healthy fetuses would be stillborn. Political and economic forces conspire against regulation. And judges throw up their hands when professionals foist parenthood on people who didn't want it, or childlessness on those who did. Failed abortions, switched donors, and lost embryos may be first-world problems. But these aren't innocent lapses or harmless errors. They're wrongs in need of rights.
At this event, author Dov Fox and an expert panel discussed his book Birth Rights and Wrongs: How Medicine and Technology are Remaking Reproduction and the Law (Oxford University Press, 2019). Panelists explored the ways in which the book seeks to lift the curtain on reproductive negligence, give voice to the lives it upends, and vindicate the interests that advances in medicine and technology bring to full expression. They also examined the book's effort to force citizens and courts to rethink the reproductive controversies of our time, and to equip us to meet the new challenges -- from womb transplants to gene editing -- that lie just over the horizon.
Learn more: https://petrieflom.law.harvard.edu/events/details/book-talk-birth-rights-and-wrongs
May 17, 2019
Breakthroughs in genetics have often raised complex ethical and legal questions, which loom ever larger as genetic testing is becoming more commonplace, affordable, and comprehensive and genetic editing becomes poised to be a consumer technology. As genetic technologies become more accessible to individuals, the ethical and legal questions around the consumer use of these technologies become more pressing.
As these questions become more pressing, now is the time to re-consider what ethical and regulatory safeguards should be implemented and discuss the many questions raised by advancements in consumer genetics.
Presentation: Vardit Ravitsky, Associate Professor, Bioethics Programs, Department of Social and Preventive Medicine, School of Public Health, University of Montreal; Director, Ethics and Health Branch, Center for Research on Ethics - Prenatal Genome Sequencing: Ethical and Regulatory Implications for Post-Birth Access to Information
Learn more: https://petrieflom.law.harvard.edu/events/details/2019-petrie-flom-center-annual-conference
May 17, 2019
Breakthroughs in genetics have often raised complex ethical and legal questions, which loom ever larger as genetic testing is becoming more commonplace, affordable, and comprehensive and genetic editing becomes poised to be a consumer technology. As genetic technologies become more accessible to individuals, the ethical and legal questions around the consumer use of these technologies become more pressing.
As these questions become more pressing, now is the time to re-consider what ethical and regulatory safeguards should be implemented and discuss the many questions raised by advancements in consumer genetics.
Presentation: Liza Vertinsky, Associate Professor of Law, Emory University School of Law and Emory Global Health Institute Faculty Fellow (with Yaniv Heled) - Genetic Privacy and Public Figures
Learn more: https://petrieflom.law.harvard.edu/events/details/2019-petrie-flom-center-annual-conference
May 17, 2019
Breakthroughs in genetics have often raised complex ethical and legal questions, which loom ever larger as genetic testing is becoming more commonplace, affordable, and comprehensive and genetic editing becomes poised to be a consumer technology. As genetic technologies become more accessible to individuals, the ethical and legal questions around the consumer use of these technologies become more pressing.
As these questions become more pressing, now is the time to re-consider what ethical and regulatory safeguards should be implemented and discuss the many questions raised by advancements in consumer genetics.
Presentation: Scott Schweikart, Senior Research Associate, Council on Ethical and Judicial Affairs, American Medical Association and Legal Editor, AMA Journal of Ethics - Human Gene Editing: An Ethical Analysis and Arguments for Regulatory Guidance at Both the National and Global Levels
Learn more: https://petrieflom.law.harvard.edu/events/details/2019-petrie-flom-center-annual-conference
May 17, 2019
Breakthroughs in genetics have often raised complex ethical and legal questions, which loom ever larger as genetic testing is becoming more commonplace, affordable, and comprehensive and genetic editing becomes poised to be a consumer technology. As genetic technologies become more accessible to individuals, the ethical and legal questions around the consumer use of these technologies become more pressing.
As these questions become more pressing, now is the time to re-consider what ethical and regulatory safeguards should be implemented and discuss the many questions raised by advancements in consumer genetics.
Presentation: Emily Qian, Genetic Counselor, Veritas Genetics (with Magalie Leduc, Rebecca Hodges, Bryan Cosca, Ryan Durigan, Laurie McCright, Doug Flood, and Birgit Funke) - Physician-Mediated Elective Whole Genome Sequencing Tests: Impacts on Informed Consent
Learn more: https://petrieflom.law.harvard.edu/events/details/2019-petrie-flom-center-annual-conference
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Critical Pathways to Improved Care for Serious Illness
1. Critical Pathways to Improving Care for
Serious Illness
Roundtable Discussion on Care Model Framework
March 10, 2017
Petrie-Flom/ C-TAC Project on Advanced Care and Health Policy
Funded by the Gordon and Betty Moore Foundation
10. White Paper Scan
Organizations Terminology Identification Components
Providers Outcomes
Payment
Models
CRITICAL PATHWAYS TO IMPROVING CARE FOR SERIOUS
ILLNESS
10
11. White Paper Author
Organizations
Coalition to Transform Advanced Care
(C-TAC)
Health Care Transformation Task Force
(HCTTF)
Center to Advance Palliative Care (CAPC)
Common Practice
Institute for Healthcare Improvement
(IHI)
The Conversation Project (TCP)
RAND Health
American Hospital Association (AHA)
National Academy of Social Insurance
National Consensus Project for Palliative
Care
SeniorBridge
Agency for Healthcare Quality and
Research (AHRQ)
Mathematica
Robert Wood Johnson Foundation
(RWJF)
Center for Health Care Strategies
Health Industry Forum
National Academy of Medicine
CRITICAL PATHWAYS TO IMPROVING CARE FOR SERIOUS
ILLNESS
11
16. Common Triggering Criteria
Advanced Cancer
Dementia
Diagnoses
Serious Mental Illness
Cognitive Impairment
Behavioral Health
Assistance with ADLs
Caregiver Burden
Functional Impairments
Poverty
Access to Care
Social Vulnerability
Palliative Care
Hospice
Prognosis
Prior Use and Costs
Risk Screening: “Would you be surprised?”
Risk
CRITICAL PATHWAYS TO IMPROVING CARE FOR SERIOUS
ILLNESS
16
21. Outcomes
Utilization
• ED visits
• Inpatient Admissions
• ICU stays
Costs
• Total Spending
• Cost-benefit analysis
Process Measures
• Documentation of ACP
discussion
• Completion of pain
assessment
Patient Reported
Outcomes
• QOL
• Satisfaction with care
CRITICAL PATHWAYS TO IMPROVING CARE FOR SERIOUS
ILLNESS
21
22. Payment Structures
Shared Risk/
Shared Savings
Value or
Population-
Based
Strategies in
FFS Models
CRITICAL PATHWAYS TO IMPROVING CARE FOR SERIOUS
ILLNESS
22
23. Observations on current efforts
to provide quality
serious illness care
Kathleen Kerr
Kathleen.kerr@sbcglobal.net
415-439-9789
24. Objective
Observations culled from…
• Multiple CHCF initiatives related to community-based PC
– Payer-provider partnerships
– Expanding access to PC in safety net systems
– Expanding access to PC in rural areas
– SB1004 implementation support
• GBM assignment
– Identification of 100 serious illness programs
– 14 case profiles
• Mr. B
Share observations about the current state of serious
illness care, to inform improvement efforts
Critical Pathways to Improving Care for
Serious Illness
24
25. Patient population for GBM work
• Poor prognosis and are likely in the last stage
of life (which could last for years)
• Experience functional impairment
• At risk for cycling in and out of the hospital in
absence of additional supports
Critical Pathways to Improving Care for
Serious Illness
25
26. Essential (ideal) elements of serious illness programs
Team-based
approach
Goal-based
approach
Concordant
care
Comprehensive
care
Coordinated
services
Transition
supports
Home-based
care
Rapid access to
services
Family-oriented
care
Caregiver
support
Measurement
Critical Pathways to Improving Care for
Serious Illness
26
27. Core (observed) serious illness program services
(in addition to concurrent access to disease-directed care)
1. Pain and symptom management
2. Medication management and reconciliation
3. Medical information / prognostication support
4. Goals of care & advance care planning discussions, and assistance with
documentation
5. Case management / care coordination
6. Transition support
7. Psycho-emotional support for patients
8. Emotional support for family caregivers
9. Spiritual care
10. Referrals to community resources for assistance with social and practical
needs (or provide such services directly)
11. 24 / 7 service or strategies to ensure expanded access
12. Bereavement support or referrals
27
Critical Pathways to Improving Care for
Serious Illness
28. 1. Several types of organizations sponsor serious
illness programs
Health
systems
Medical
groups
Health plans
Hospice & PC
organizations
Specialty
organizations
Partnerships
Critical Pathways to Improving Care for
Serious Illness
28
29. 2. Core services offered via a wide range of
interventions
Home-based
primary care
Specialty geriatric
services
Specialty
palliative care
Specialty care
units
Care
management
services
Navigation /
coaching
programs
Transition
management
programs
Structured ACP
programs
Social supports
and services
Spiritual care
programs
Support programs
for families /
caregivers
Complementary
and integrative
medicine services
Hospice
Critical Pathways to Improving Care for
Serious Illness
29
30. 3. Variation abounds (which might be OK)
• Eligible/target patients
• Strategies for identifying patient population
• Scope of service
• Care settings
• When engage, frequency of contact, length of service
• Staffing (which disciplines) and staffing ratios
• Training requirements
• Use of lay staff and volunteers
• Degree of integration with primary / specialty services
(referring providers)
• Metrics
• Payment models and payment amount
• Number of customers
Critical Pathways to Improving Care for
Serious Illness
30
33. System-based programs cross settings
and service lines
AllinaHealth Abbott Northwestern Hospital – Minneapolis
Full array of primary and specialty services, home health and case
management plus …
• specialty palliative care available in multiple settings
• embedded specialty geriatric care in transitional care units, nursing
homes and assisted living communities
• medical home for individuals with complex conditions
• advance care planning classes offered at multiple clinics
• lay navigator program (LifeCourse)
• hospice care
Variation across markets, campuses within markets, and
accessibility depending on disease, age, insurance
Critical Pathways to Improving Care for
Serious Illness
33
34. Multi-organization efforts are common
• Funding, plus support from Clinical Analytics, Case
Managers, Social Workers, pt transportation costsHPSJ
• Primary and specialty care, plus inpatient and clinic-based
palliative care
San Joaquin General
Hospital
• Home-based palliative care, with ability to transition to
hospice as appropriate
Community Palliative &
Hospice Care
• Home-based palliative care, with ability to transition to
hospice as appropriateHospice of San Joaquin
• Telephonic case management, analytics to identify patients,
and "feet on the street" (member engagement)Axispoint Health
• Mental health services
Beacon Behavioral
Health
Multi-organization network for a rural, poor county
Critical Pathways to Improving Care for
Serious Illness
34
35. 5. Safety-net programs have distinct challenges
Critical Pathways to Improving Care for
Serious Illness
35
36. Palliative care focus areas
Patient
& Family
Symptom
Manage-
ment
Info about
Prognosis,
Options
Assess
Values &
Translate
into Medical
Choices
Spiritual
support
Psycho-
social
support
Critical Pathways to Improving Care for
Serious Illness
36
37. Patient
& Family
Symptom
Manage-
ment
Info about
Prognosis,
Options
Assess
Values &
Translate
into Medical
Choices
Spiritual
support
Mental Health Care
Companionship
Caregiver issues
Access to food
Transportation
Housing & Physical safety
Legal support
Financial support
Safety-net palliative care focus areas
Critical Pathways to Improving Care for
Serious Illness
37
38. 6. Rural programs have distinct challenges
• Distance / geography
• Less than optimal voice / data connectivity
• Opioid epidemic / other substance abuse
• Poverty
• Older, isolated population
• Few available providers
#1
#2
#3
Total travel time between visit 1-2
and visit 2-3 = 4 minutes
Implications for ….
• Clinical model / scope
• Staffing-training /
partnerships
• Caseload
• Cost of care, potential impact
Critical Pathways to Improving Care for
Serious Illness
38
39. 7. Multiple funding options … but not universally available
• Support from parent organization (quality/operational
value, loss leader, mission)
• Traditional FFS billings
• Hospice benefit
• Health plan contracts (multiple business lines)
• Serve MA/ MA SNP / Medicaid Managed Care population
• Serve ACO population (Medicare and commercial)
• Serve global/full capitation population (PACE)
• CMS demonstrations/Innovation programs: IAH, Oncology
Care Model / ESRD Care Model, CCTP, MCCM, CPC+
Terrific reference: CAPC’s Payment Primer: What to know about payment for
palliative care delivery (https://www.capc.org/topics/payment/)
Critical Pathways to Improving Care for
Serious Illness
39
40. 8. Funding doesn’t solve all problems
• Workforce
– “It has been difficult to achieve rapid scale of our model
and ramp up services to cover a larger geography.
Workforce shortages and competition in the market for
talented palliative care providers continues to be a
challenge.”
• Rescue and repair
– “About 90% of patients referred to Transitions do not know
that their diseases are terminal.”
• Willing referring providers
– “Let’s see what the cath results are and if there is nothing
more we can do then I’ll refer to palliative care”
• Willing patients
– Must be … open to more support, open to strangers in the
home, able to get to clinic, can afford co-pays, etc.
Critical Pathways to Improving Care for
Serious Illness
40
41. Dying in America: Improving Quality and Honoring
Individual Preferences Near the End of Life
IOM (Institute of Medicine). 2014. Dying in America: Improving quality
and honoring individual preferences near the end of life. Washington,
DC: The National Academies Press.
Turns out they were on to something …
Five improvement /focus areas
1. Delivery of person-centered, family-
oriented EOL care
2. Clinician-patient communication and
ACP
3. Professional education and
development
4. Policies and payment systems
5. Public education and engagement
42. Food for thought
1. Many types of providers / sponsors … consider getting input from all
2. Range of patient and family needs/preferences requires a suite of
interventions … not just one thing, and often not just one
organization
3. There are particular challenges when delivering care in the safety-
net and to rural populations; these may impact staffing and training,
care model, program costs, expected impact, and more
4. Some success with existing funding options, but program scope and
design often limited by what gets paid for
5. Consider focus on integration / coordination / education as
solutions to workforce issues, and to promote buy-in from patients
and providers
6. While there are many challenges, there are also are many promising
programs and practices operating currently (it’s probably okay to be
a little optimistic)
Critical Pathways to Improving Care for
Serious Illness
42