COVID-19 – The Race to Value Podcast™

Now is the time to embark on a journey towards a brighter and more resilient future. As the U.S. healthcare system grapples with the aftermath of a global pandemic, we find ourselves at a pivotal crossroads. This episode delves deep into the profound changes brought about by the pandemic, examining how it has exposed vulnerabilities in our existing systems and ignited conversations about the need for transformative change. Join us as we navigate this critical juncture, exploring the shifts in healthcare, economy, and societal values that could ultimately lead us to a high-value system that prioritizes well-being and sustainability for all. Get ready to be inspired and informed as we embark on this enlightening exploration of the post-pandemic world.

Joining us in the Race to Value this week is David B. Nash — an American physician, world renowned scholar and public health expert, and Founding Dean Emeritus of the Jefferson College of Population Health. His accolades and achievements in healthcare transformation are innumerable. (The week before this interview was recorded he had received the Lifetime Achievement Award from the American Association for Physician Leadership.) Dr. Nash is also a bestselling author with his new book, “How COVID Crashed This System: A Guide to Fixing American Health Care.”  In this episode, we discuss insights from Dr. Nash’s research on COVID-19’s impact on the healthcare system and how this post-pandemic era can help us transition to a high value health care system.

Episode Bookmarks:

01:30 Introduction to Dr. David Nash, an American physician, world renowned scholar and public health expert, and Founding Dean Emeritus of the Jefferson College of Population Health.

03:30 Have we learned our lessons from the COVID disaster?

05:00 Dr. Nash reflects on his recent experience with Dr. Ashish Jha on the last day of service to our country as the White House COVID-19 Response Coordinator.

05:30 “The office of the presidential response to COVID is now a janitorial closet somewhere in the West Wing of the White House…it is sad.”

06:00 “1.2 million dead from COVID-19 is more than the total of all combat casualties of every war since the Revolutionary War of the United States!”

06:30 “Sadly in the history of our country, when the dying stops, the forgetting begins.”

07:00 PTSD from the pandemic with physicians and healthcare professionals, coupled with societal apathy towards COVID-19 and surging cases in China.

08:00 Medicaid Redetermination as the consequence of the end of the Public Health Emergency and how lost coverage will impact marginalized populations.

09:00 3,000+ people died from 9/11, and we are still taking our shoes off at the airport.  1.2M died from COVID-19, and it is back to business as usual.

09:30 Societal issues (e.g. structural racism, inequality) persist in our country.

10:00 What is the True North for American Healthcare really?  ($4 Trillion in spend with significant amount of low value care, declining life expectancy, low ranking in world health rankings)

10:30 Additional societal measures of a poor performing health system (alcoholism, depression, suicide, opioid abuse).

11:30 How Philadelphia is suffering an exacerbation of  pre-pandemic problems (lack of access, redlining, crime, homelessness, educational disparities).

11:45 There is a 20-year disparity in life expectancy between rich and poor communities in Philadelphia.

13:00 The persistence of health inequities and social injustice since the transatlantic slave trade.

13:30 COVID-19 blasted a searing light on social determinants of health!

14:30 “You can’t have value-based care without equity.” – the costs of health inequities are in the hundreds of billions (see recent JAMA article).

15:00 Employer engagement in health equity transformation.

15:30 “The emergence of the payvider model has given value-based care additional energy.”

17:00 The evolution of medical and nursing education to improve health equity.

18:00 Testing of innovations at scale during the pandemic (e.g. telehealth, hospital-at-home, physical infrastructure changes, novel medical devices).

18:30 The extension of Medicare telehealth flexibilities and the extension of the Acute Hospital Care at Home Program through 2024.

19:00 Bridging the digital divide in Philadelphia through the provision of telehealth services at Jefferson Health.

20:00 The economic incentives that led to the rapid adoption and diffusion of innovation.  What is next for digital health post-pandemic?

20:45 The opportunities for applying precision medicine in cancer care and generative AI in healthcare.

22:00 “Amazon, Walgreens, Walmart, and CVS are the Big 4 disruptors of technology innovation in healthcare. This is where the action is.”

24:00 The existential threat of Artificial Intelligence and the forthcoming technological singularity.

25:00 Personal reflections on the disruption of ChatGPT in healthcare and medical education.

26:00 The need for clinical rotations of medical residents in retail-based healthcare settings (e.g. Walmart, Oak Street, Walgreens, Iora Health).

27:30 AI should not need to be a threat to physician autonomy.

28:00 The collision of moral and fiduciary responsibility in healthcare.

28:45 Referencing Dr. Nash’s article, “Population Health is the New Public Health” – “The virus exposed a truth that the public health paradigm is outdated and insufficient.”

30:00 Public health spending is $400 per person in the U.S. (compare that to healthcare spending at a rate of $10k per capita).

31:00 Dr. Leana Wen – “Public health saved your life today. You just didn’t know it.”

31:30 The structural, financial, and cultural challenges of public health and why it is not an attractive career trajectory for physicians.

32:30 The leadership needed to fix public health.

33:00 Dr. Nash expresses his concerns about the not-for-profit governance of health systems that overemphasis profit motives.

34:00 Putting C-Suite leaders at personal financial risk for improving population health and health equity. (a controversial idea to find our True North!)

36:30 Reference Don Berwick’s article: “Salve Lucrum: The Existential Threat of Greed in US Health Care”

38:30 Addressing the challenges of pharmaceutical drug shortages.

41:30 The emerging focus on SDOH tools and measures for optimization of provider EHR workflows.

46:30 The Four Horsemen of the Mental Health Apocalypse (e.g. Opioid, Alcoholism, Depression, Suicide) – how COVID-19 and social isolation exacerbated the crisis.

47:30 The PTSD of the younger generation due to their pandemic experiences.

48:00 How life expectancy in Blue Zones is impacted by community relationships and the need to overcome tribalism in the U.S.

48:45 The incontrovertible evidence of how one’s health is affected by the political party of a state’s governor.

49:30 Putting mental health training, research, and payment on par with traditional health services delivery.

51:30 Realigning economic incentives for physicians as the be all, end all starting point for healthcare transformation.

53:00 Dr. Nash provides his perspective on Risant Health (the value-based care merger between Kaiser Permanente and Geisinger).

55:00 Parting thoughts from Dr. Nash on what it will take to heal our country in the post-pandemic era.

As we look around to see what is enduring in our society, it is the work that was accomplished through loving relationships and mutual understanding.  The power of love-driven leadership has the potential to change the world; and in healthcare, it can transform the lives of people undergoing immense suffering. Healthcare leaders must collaborate on solutions to overcome barriers in health equity through a deeply rooted commitment to social justice and love to improve the human condition. Leaders in population health must be willing to step forward – even if it is uncomfortable – to build a community of love that will last forever.

On the Race to Value this week, we interview Geoffrey M. Roche – a leader in healthcare innovation, future-focused strategy, DE&I, and workforce development.  This is a conversation that all healthcare leaders should hear. Geoffrey engaged this interview with utmost authenticity as leader with a willingness to get in “good trouble” for speaking about the issues that many would prefer to ignore or not accept as real.  In this podcast, you will learn about the power of community partnerships in improving health equity to overcome the “political determinants of health” that prevent societal progress. You will also learn about the paramount importance of workforce development and scalable educational solutions in catalyzing a transformation in care delivery and culture change that values the moral imperative of value-based care. The empowerment and education of our workforce holds the key to eliminating workforce burnout and moral injury! And lastly, you will gain perspective on love-driven leadership that can overcome toxic tribalism and hyper-polarization in our society.

Geoffrey is a proponent of love-driven leadership and advocacy for our most vulnerable in society, and his leadership in health equity has been recognized at a national level.  If you need inspiration to overcome the inertia in your health system towards real and impactful change, don’t miss this very important conversation!

Episode Bookmarks:

01:30 Introduction to Geoffrey M. Roche – a leader in healthcare innovation, future-focused strategy, DE&I, and workforce development.

04:00 Collaborating on solutions to overcoming barriers in health equity is informed by a deeply rooted commitment to social justice.

05:30 Geoffrey speaks about his early leadership work at Lehigh Valley Hospital-Pocono taking sojourns into homeless encampments in East Stroudsburg, Pennsylvania.

07:00 Leadership from a Hospital CEO and social justice warrior – how that led to an authentic impact in the population health of underserved communities.

08:00 Serving as Chair of the Commission’s Advisory Board to deal with homelessness – how that taught Geoffrey the “power of partnerships”

08:30 Uniting community stakeholders to eliminate stigmas and facilitate a better understanding of homelessness.

09:30 As a population health leader, you’ve got to be willing to step forward – even if it is uncomfortable. The community of love that you is built will be something you treasure forever.”

10:30 “The Health Equity Tracker” – a tool that aims to give a detailed view of health outcomes by race, ethnicity, sex, socioeconomic status, and other critical factors.

12:00 Geoffrey’s service on The National Health Equity Task Force under the leadership of Dr. Rachel Levine.

12:30 Participating in a national advocacy effort to address the disproportionate health outcomes of the COVID-19 pandemic.

14:30 The Health Equity design sprint led by Karen DeSalvo and Google to examine COVID-19’s impact on vulnerable populations.

15:00 What would it look like if we lived in a society without health disparities? – Geoffrey speaks about the power of data to knock down silos in healthcare that prevent equity.

16:00 The Leadership of David Satcher and Daniel Dawes in addressing disparities through holistic approaches to data, community, intersectionality, policy, healthcare, and SDOH

17:00 “There are so many people that don’t understand why we talk about issues of inequity and health disparities. We have to look through every lens to address this issue systemically.”

18:00 “Speak up, speak out, get in the way. Get in good trouble, necessary trouble, and help redeem the soul of America.” – John Lewis

19:00 How the risk-averse nature of healthcare is a barrier to the adoption of innovative products, treatments, interventions, and technologies that could help transform thousands of lives.

20:30 Board members and trustees of hospitals and health systems need to be educated in value-based care and health equity.

21:30 “If there is one aspect of our U.S. healthcare system that we have not done well, it is the engagement of our governance structure in health equity and value-based care.”

23:00 Geoffrey explains how entrenched organizational inertia within functional departments of health systems stifles innovation to advance equity.

24:15 Overcoming the “Political Determinants of Health” by fostering public-private partnerships.

25:30 The reskilling and upskilling of the workforce to ensure a high-value system will require scalable educational solutions.

26:30 Geoffrey discusses the importance of certificate and microcredential programs to address future workforce needs in value-based care.

27:45 “We have to create a society in healthcare that values the importance of workforce education to advance health equity and population health.”

28:30 “Health systems that do not embrace Competency-Based Education are actually harming their workforce strategy.”

29:00 Overcoming the slow resistance to education to empower healthcare transformation.

30:30 “The education of the healthcare workforce should not be managed by Human Resources.  It should be managed by Strategy and Transformation.”

31:45 The World Economic Forum estimates that, by 2025, 50% of all employees will need reskilling due to the adoption of new technologies and innovations.

33:00 Geoffrey speaks about the need for health systems to partner with Higher Education to develop a collaborative ecosystem for upskilling/reskilling the workforce.

36:00 The intentionality required to think about pathways and pipelines to ensure a diverse healthcare workforce.

36:45 The moral imperative of culturally competent care empowered by an effective DE&I strategy.

37:30 How can Higher Education become an incubator for healthcare system workforce development?

38:00 We are not prepared for the “Baby Boomer tsunami” that will decimate the supply of workers.

39:00 Career mobility is a secret weapon in the ongoing struggle to retain talent.  How can value-based care support workforce strategies for attraction, retention, and mobility?

40:00 Geoffrey explains why talking about the resilience of the healthcare workforce is insufficient in addressing the root causes of burnout and moral injury.

41:00 Engaging the workforce in value-based care is critical in care delivery redesign and cultural transformation.

42:00 Provider and workforce experience is just as important as patient experience.

43:00 Creating a “safe space” where workers are empowered to speak up about issues impacting patient safety.  How workforce fears leads to patient deaths.

44:30 Addressing Health Worker Burnout (35-54% of nurses and physicians and 45-60% of medical students and residents are reporting symptoms of burnout!)

45:30 Researchers estimate that annual burnout-related turnover costs are $9 billion for nurses and $2.6 to $6.3 billion for physicians.

46:30 The need for healthcare leaders to addressing workforce burnout with systems-oriented, organizational-level solutions (not just pizzas, back massages, yoga, and mediation apps)

47:30 Governing Boards need to address workforce burnout as their fiduciary responsibility.

49:00 The need to change nursing shifts and provide opportunities for workforce debriefings to reflect on care processes.

50:00 Healthcare workers should be treated like athletes and given breaks (rest brings about higher performance).

51:45 Referencing Chris Lowney’s book “Heroic Leadership”

52:15 Geoffrey shares his insights on the importance of love-driven leadership and the importance of authenticity and mentorship.

53:30 The culture of bullying in the medical profession needs to be overcome with love-driven leadership.

54:00 Mentorship programs that provide love, guidance, and inspiration.

55:00 Leaders that do not proactively seek out opportunities as a mentor – “It is time for them to go!”

55:45 Cultural awareness of the need for belongingness and inclusion and why leadership is not about titles.

56:45 Toxic tribalism and hyper-polarization on major societal issues impacting public health…issues like mass shootings, climate change, abortion rights, and gender-affirming care models.

58:00 “If you don’t advocate on these issues, you will further exacerbate the trajectory of health disparities.”

59:00 Advocacy for marginalized populations goes back to the origins of our healthcare system. Getting into “good trouble” is the right thing to do.

The COVID pandemic has taken the lives of 1 million Americans in two years (more than twice the amount of Americans who lost their lives in WWII in four years).  This grim statistic came about because of a fundamentally broken, fragmented, expensive, inequitable, and occasionally unsafe healthcare system.  If the mission of our $4 trillion healthcare system is to improve health and prevent death from disease, we could look to no greater example of failure than the COVID-19 pandemic.

Global pandemics are always horrific, but they also represent wonderful opportunities to learn by taking advantages of the crises invoked. The COVID crash of American healthcare is not unlike an airline crash.  Failure to learn and overcome our structural and cultural flaws will have calamitous results.  The airplane (American healthcare) will continue to crash again and again.  We would never tolerate these failures in aviation, but why do we accept them when it comes to healthcare?  The answer ultimately comes down to misalignment of financial incentives (fee-for-service medicine) and cultural headwinds related to structural racism, American exceptionalism, lack of trust, and tribalism.

On this week’s episode of Race to Value, we interview Dr. David Nash about his new book co-written with Charles Wohlforth, “How COVID Crashed the System: A Guide to Fixing American Health Care.”  Dr. David Nash is among the world’s most respected experts on health care accountability, quality, and leadership. He is the founder of the Jefferson College of Population Health in Philadelphia and remains its founding dean emeritus.  In this interview, we do a deep dive on his new book explaining what went wrong as it relates to COVID and health care delivery.  This is a must-listen podcast as you will hear the unfiltered truth about the pandemic from the nation’s foremost prophet of population health.  This podcast will make you angry and sad, but it will also leave you with optimism for the future of value-based care and population health management.  We can get better and do better by those we serve – we can win this Race to Value.

Episode Bookmarks:

01:30 The opportunity to learn and take advantage of the COVID-19 pandemic so we may heal a broken healthcare system

03:00 Introduction to Dr. David Nash, one of the world’s most respected experts on health care accountability and population health

05:00 America’s COVID crash and the realization of a broken, fragmented, expensive, inequitable, and occasionally unsafe healthcare system

07:00 Dr. Nash provides perspective on the 1 million American citizens that died

08:00 “Half a million Americans died fighting WWII over a period of 4 years, and it is mind boggling to see how COVID-19 killed twice as many in half the time.”

08:30 Recognition of the fragility of the healthcare system pre-pandemic

08:45 “If the mission of a $4 trillion a year healthcare system is to improve health, we are not doing such a good job.”

09:00 The Four Horses of the Pre-Pandemic Healthcare Apocalypse: 1) Depression, 2) Opioid Abuse, 3) Alcoholism, 4) Suicide Ideation

09:30 “The Baby Boomer Generation is going to end up living longer than the Millennial Generation if we don’t do something about our healthcare system.”

10:30 Investigating the COVID crash like we would an airplane crash

11:00 “The pandemic shined a spotlight on structural failures, social determinants of failures, and the failure of our healthcare system to have a clear mission to improve health.”

11:30 American exceptionalism and the hubris of political leadership

13:30 Failures of government: lack of communication, lack of understanding, and a lack of transparency

14:30 Early warnings from Italy in early December 2019 telling us that the pandemic was coming

15:00 President Trump’s pathetic goal to re-open the economy by Easter Sunday 2020

15:30 Failure at all levels of government (ex: White House, FDA, CDC, HHS)

16:00 “The Greatest Failure of Leadership in Our Time” (Referencing NEJM Editorial, Oct. 2020)

16:30 The passage of Medicare in 1965 led to a divergence of healthcare and public health due to economic incentives to overbuild hospitals and overutilize medical procedures

18:00 40-50 years of underfunding our Public Health infrastructure at the expense of a $4T healthcare industry

18:30 1/4th of all healthcare spending is wasteful and of no value (Referencing JAMA Article, Oct. 2019 from Will Shrank, et al.)

19:00 Reallocating wasteful healthcare spending to fund public health and community health workers?

19:30 The Power of Determinants of Health (i.e. Zip Code, Credit Score, Structural Racism, Inadequate Education, Gun Violence)

20:00 1-in-4 people in Philadelphia live in poverty (and half of them are in “deep poverty”)

21:00 African Americans have 7-8X higher mortality from COVID-19 than white populations

22:00 Fee-for-service medical practices that faced revenue disruption, laying off healthcare workers and facing bankruptcy

22:30 Hospital leaders that rallied together during the pandemic

23:30 Complex cases of cardiac disease, orthopedics, neurosurgery, and cancer keep hospitals in business

24:00 Dr. Nash’s shares the story of his physician daughter who wore a garbage bag to work because her hospital did not have an adequate PPE supply

24:30 “This airplane (healthcare) is going to crash again and again.  We would never tolerate this in aviation.”

25:00 The vulnerability that was created by American exceptionalism

27:00 Balancing patriotism and pro-capitalist views with the recognition of flawed aspects of our American culture

27:30 “Rugged individualism” and the lack of trust in government leadership

28:00 Social sciences research showing how other countries have stronger communities and trust their governments more (Referencing “Bowling Alone: The Collapse and Revival of American Community”)

29:00 State governors that refused mandates for masking and prior evidence of vaccination

29:30 Advocates for non-evidence based treatment (ex: Ivermectin)

30:00 “American culture led to a toxic witches brew of over-confidence.”

30:30 The invention of mRNA technology at Penn years ago led to COVID-19 vaccines by Moderna and Pfizer

31:00 Population health outcomes that are worst in the world juxtaposed to medical research that is the best in the world!

32:00 Life expectancy was already dropping in the U.S. in the time preceding the pandemic

32:30 The harmful culture of “hero worship”

33:00 Medical mistrust in the African American community stemming from the Tuskegee experiments

34:00 Lack of trust, deep racism, rugged individualism, and the over-reliance on science created a “cultural headwind” that prolonged suffering and cost American lives

35:00 The difficulties in understanding that mask wearing protects others (Why care about others in a tribal culture?)

36:00 Health inequities in African and Latin American communities

37:00 Dr. Nash reflect on his sadness for why safety net hospitals are even needed (“the only country in the western world without universal healthcare coverage and universal access to care.”)

38:00 Lack of primary care coupled with structural failures leading to poor healthcare outcomes in minority populations

39:00 “If you are poor in America, you are almost by definition ill health.”

40:00 Dr. Nash shares his optimism for the future of value-based care and population health management

42:00 Private sector innovation led by entrepreneurs (Referencing Dr. Stephen Klasko and “Health Assurance”)

44:00 Should we also be optimistic about public health?

45:00 “Public health saved your life today — you just don’t know it.” (referencing Dr. Leana Wen and her book, “Lifelines”)

46:00 Spending on public health = $400 per capita (compared to $11k per capita for the healthcare system!)

47:00 “We have to put public health on the same pedestal that we put sub-specialty medicine, requiring us to go deep into the medical training system.”

48:00 The misalignment of societal benefit and financial rewards leading to poor emphasis on public health infrastructure

50:00 “Reevaluating our mission may lead us to have a better appreciation for the power of Public Health.”

51:00 The financial stressors on fee-for-service healthcare during the pandemic leading to CARES Act relief payments

56:00 Dr. Nash provides perspective on “Bright Spots” in the healthcare industry (Payviders, disruptive primary care companies, bundled payment models)

58:00 “When we change economic incentives by aligning them towards health, we improve clinical outcomes, reduce waste, and improve patient satisfaction.”

58:30 “The pessimist sees difficulty in every opportunity. The optimist sees opportunity in every difficulty”. – Winston Churchill

61:00 Dr. Nash’s parting thoughts on applying lessons learned to find a path to healing

63:00 “When the dying stops, the forgetting begins — that is our culture.  How COVID Crashed the System is all about prolonging the conversation.”

64:00 Preorders now available for Dr. Nash’s new book at Rowman and Amazon with a release date planned for September 2022

Healthcare costs due to Chronic Obstructive Pulmonary Disease (COPD) is in excess of $32 billion due to high rates of re-hospitalizations and ED visits, complex and inefficient clinical pathways during transitions of care, and intensive resource burden on clinical and administrative staff. The average cost per COPD patient readmission in the U.S. typically falls between $9,000 and $12,000. Unlike other high cost chronic conditions like CHF and diabetes, it seems that many ACOs are not as purposeful in their targeting of COPD as part of their population health playbook. This is a massive unmet need with many COPD patients experiencing fragmented and inconsistent care that drives poor clinical outcomes and high economic burden. Consequently, COPD now represents the 3rd leading cause of death and the 5th most costly chronic disease in the US. What is it about this particular chronic condition that makes it so less prone for population health management with ACOs and other risk-bearing entities?  Why is this chronic disease so universally undiagnosed? How can we implement chronic care management programs that actually make an impact on patient lung health and clinical outcomes?

For anyone that wants to know more about “Effective COPD Management to Achieve Value-Based Care Goals”, look no further than this week’s episode with Dr. MeiLan Han. She is Professor and Chief of Pulmonary and Critical Care Medicine at the University of Michigan who is widely known for her expertise on Chronic Obstructive Pulmonary Disease. Dr. Han is a leading pulmonologist, researcher, lung health advocate, consultant, and national volunteer spokesperson for the American Lung Association. She is also the author of the new book, “Breathing Lessons: A Doctor’s Guide to Lung Health.”

Episode Bookmarks:

01:30 Introduction to Dr. MeiLan Han (pulmonologist, COPD researcher, lung health advocate, author, and speaker)

05:30 Origins in rural, small town America that led to a career in pulmonary medicine and research

07:00 “Many people that have lung damage and don’t know it. We don’t do a good job of diagnosing lung disease in this country.”

07:30 Only half of the 25-30M Americans with COPD even have a diagnosis!

08:00 Undiagnosed lung disease led to server morbidity and increased mortality during COVID-19 pandemic

08:30 Research continues to be under-funded due to lack of awareness of lung health importance

09:20 11M Americans suffering from long-haul COVID

09:40 Societal threats to lung health (ex: air pollution, hazardous chemicals, plastic microparticles in lungs)

10:00 “The pandemic was a golden opportunity to raise awareness for lung health, but now people are starting not to listen.”

12:00 The impact of race and socioeconomic status on COVID death rates, and overall poor lung health in marginalized communities

13:30 COPD is more common in rural communities where there is less access to care

14:20 Virtual care is not a perfect solution in areas where there is a “digital divide”

16:00 Half of adult Americans have at least one chronic condition and more than two thirds of Medicare patients have two or more.

17:00 Ambulatory Care Sensitive Conditions as an opportunity for ACOs to achieve cost savings

18:30 The challenges of developing and implementing COPD Quality Improvement Measures

19:00 Difficulties in collecting data from spirometry and PFTs in the Electronic Medical Record

20:00 Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations and the difficulties of tracking symptoms and exacerbations

22:00 The lack of reporting requirements on COPD has limited progress of health systems and EHR companies

23:00 The relative ease of collecting Blood Pressure and A1c results and why capturing data related to COPD is so much more difficult

24:45 Diagnosis gaps of COPD in the early stages due to “therapeutic nihilism”

26:15 Lack of spirometry testing possibly due to the fact that smoking cessation is already such a big part of healthcare

27:00 More studies needed to demonstrate the absolute necessity of early COPD intervention

27:45 Managing patients with lung health exacerbations that don’t yet qualify for a COPD diagnosis

29:00 “Perfect is the enemy of good in assessing lung health screening results.”

30:30 COPD costs total $32 billion due to excessive rates of re-hospitalizations and ED visits

33:00 How limited diagnoses hinder the impact of Chronic Care Management programs to more effectively manage COPD patients

35:00 Engaging patients through medication optimization and suggested use of inhalers and how virtual care can help

36:00 The use of social workers and respiratory therapists to manage COPD on interdisciplinary care teams

36:30 The challenges of Pulmonary Rehabilitation, especially in a virtual setting

39:30 The opportunity to use remote patient monitoring of cardiorespiratory parameters for patients with COPD

42:00 Physicians being overwhelmed with data and how that may hinder adoption of RPM

43:00 The limited reduction impact of the Hospital Readmissions Reduction Program (HRRP) on COPD readmissions

45:00 Dr. Han speaks about the limited number of health system success stories in lowering COPD readmissions

46:00 Disease exacerbations are one-third of COPD readmissions (as opposed to comorbidities and psychosocial issues)

48:00 The impact of climate change and greenhouse gas emissions on people’s lung health

49:00 Children’s lung health impacted by schools being placed by highways and the excess deaths of COVID-19 due to air pollution from wildfires

50:00 The responsibility of the health sector to minimize its role as a contributor to greenhouse gases

51:00 Recommendations for patients in assessing indoor and outdoor pollution

52:30 COPD and Lower Respiratory infections as the leading causes of death globally (but they receive limited grant funding for research)

53:30 Referencing Dr. Han’s book, “Breathing Lessons: A Doctor’s Guide to Your Lungs”

54:30 “Our society doesn’t focus on keeping lungs healthy – we instead focus on diagnoses.  This is why lung disease was the #1 cause of death in the US last year.”

56:00 The need for health policy and public health funding for promoting improved lung health

We are pleased to release a special bonus episode and do our part to address the nation’s concerns around the pandemic and the COVID vaccine. As it stands right now, around 164 million people, or 50% of the total U.S. population, have now been fully vaccinated. Ultimately, with a large portion of the U.S. population still unvaccinated, it seems that COVID-19 is not going to disappear soon. The U.S. will continue to see outbreaks of the virus in communities with low vaccine uptake.

Our guest is Dr. Rodney Rohde, a virologist and clinical laboratory expert with 30 years of experience in Public health, virology, and zoonotic disease, and is a Professor in the College of Health Professions and Associate Director for the Texas State University Translational Health Research Center. This episode is for anyone who wants to hear a scientific discussion about SARS-CoV-2/COVID-19 to combat misinformation that is out there about the pandemic.

Episode Bookmarks:

04:30 Dr. Rohde shares a brief overview of the medical laboratory profession and the Clinical Laboratory Science degree programs

08:30  The impact of the pandemic on the medical laboratory staffing crisis

09:50 Dr. Rohde speaks about the importance of laboratory medicine in improving value-based care and health equity

13:00 Did SARS-CoV-2 originate from a laboratory leak at the Wuhan Institute of Virology?  Or did the virus originate from a zoonotic spillover event?

18:15 Referencing Dr. Rohde’s recent article discussing how the US is split between the vaccinated and unvaccinated – and how the deaths and hospitalizations reflect this divide

20:00 Dr. Rohde discusses how “99.5% of all the people dying from COVID-19 in the U.S. are unvaccinated” and how to understand breakthrough infections happening with the vaccinated

22:30 How to eradicate a virus and why current immunization rates will not support disease eradication

24:50 “Viruses, especially RNA viruses, are the most diabolical microbes on the planet.”

25:30 Viral mutations that create infectious variants and the opportunism of infection

28:20 The global achievement of smallpox eradication

28:50 Dr. Rohde explains vaccine efficacy and what people should ask their physicians if debating whether or not to receive the vaccine

31:00 The low of mRNA vaccines

34:00 Dr. Rohde explains what the Delta variant is and provides a scientific overview of viral mutations

37:00 The changing pathology of the virus and how younger, unvaccinated people are now being affected by the Delta variant

38:00 Booster shots for immunocompromised individuals and the likelihood of boosters for the general population

39:20 The transmissibility of the Delta variant. what the R-naught number means in understanding viral contagion, and how Delta variant compares to Ebola transmission

45:00 Referencing the COVID-19 thought leadership and insights from Scott Gottlieb, Tom Frieden, and Peter Hotez

46:20 The three-year cycle of unchecked pandemics, the development of herd immunity, and the potential for an endemic transition in 2022

47:50 The significance of the landmark scientific achievement of developing a mRNA vaccine technology (the first time in history!)

50:00 Viewing public health as part of our public defense and why we need to learn that one lesson from this pandemic!

Our nation has lost more than 300,000 people from COVID-19.  It is the latest sign of a generational tragedy – one still unfolding in every corner of the country.  As we head into the Christmas holiday, refusal to acknowledge the severity of the pandemic by acting irresponsibly will result in countless more deaths from the virus.

Our nation is at stake, and this week’s Race to Value guest, Dr. Brent Staton wants to share a personal message of love and hope for a brighter tomorrow.  His featured podcast episode (recorded with Dr. Ty Webb) on how the Cumberland Center for Healthcare Innovation is “Building Economic Strength in Rural Communities” was released earlier this week.  After recording that episode, he contracted COVID-19.  We invited him back for a Bonus episode to share a message of God’s love in serving others by taking the pandemic seriously during this upcoming holiday season.  Dr. Staton recorded this episode while hooked up to oxygen battling this terrible disease.

This pandemic is real.  If Dr. Staton’s message saves just one life, his service to his community, and the world as a whole, will have been realized.

Episode Bookmarks:

0:00   Update on the COVID crisis and Dr. Staton’s personal battle with the illness

1:30 “As an American nation, we need to re-focus on unity and protecting one another”

2:30 Complications with COVID-19, Influenza B, and underlying asthma

2:50 Due to a flu vaccine shortage, Dr. Staton gave his own personal dose to a patient (and then ended up contracting the flu)

3:10 How Dr. Staton contracted COVID-19 from a patient during a 15-second interaction

4:30 Serving Others:  Practicing medicine with a servant’s heart and Dr. Staton’s plea for his community to wear a mask as the ultimate gesture of servanthood and love for others

4:45 Health Inequities:  Dr. Staton has access to care during COVID that all Americans should have.

6:20 Dr. Staton is in his late 40’s and was in excellent health prior to his COVID infection.

7:30 Post-COVID complications after recovery

7:50 Misinformation on COVID from the media and the Internet.  “We can’t continue down a pathway of mistrust.”

9:15 Dr. Staton provides perspective on the unnecessary deaths he has seen due to COVID

9:50 Pandemic deniers, and the culture of fear and misunderstanding in our nation

11:00 The worst case scenario if people don’t begin taking the pandemic serious during the Christmas holidays

12:00 Appropriate mask wearing protocol

13:00 What a COVID infection really feels like (“a torture chamber”)

14:10 The truth about mask wearing and vaccine efficacy

15:10 “The disrespect for other human life” by those who refuse to wear masks

15:30 Trusting Dr. Fauci and public health officials, an update on the vaccine research, and misunderstanding of herd immunity

17:10 Using the God-given gift of a human brain and loving others as we get through the pandemic

18:20 Spiritual reflection on death and how we can preserve life by re-focusing on a pandemic plan, mask wearing, and social distancing

19:50 The end of the pandemic will take another year to reach and what Dr. Staton is seeing in the data from other countries

21:50 Treatment with monoclonal antibodies

23:20 The ultimate goal of CCHI is to serve patients in our community

24:00 World War II as a lesson for the unity needed in our nation to defeat COVID-19

27:10 Getting back to the basics (“wash your hands, social distance, love your neighbor, wear your mask, and take care of yourself appropriately”)

The Rio Grande Valley, located in the southernmost tip of Texas along the US-Mexico border, has become a new epicenter for COVID-19 over the last month.  Death rates are also over five times higher than the rest of Texas because more than 60-percent of residents are diabetic or prediabetic and more than 90-percent of the population is Latino. To compound the situation, the Valley was also impacted by the landfall of Hurricane Hanna on July 25th creating mass flooding, infrastructure stress, and home displacement in the local community.

The Valley needs our prayers and support.  In this bonus episode to the Race to Value podcast, Edwin Estevez provides an update on how the RGV community is dealing with this current public health crisis.  If interested in helping out the Rio Grande Valley community, please contact Edwin at [email protected].  Resources to community benefits organizations provide relief to the Valley are also listed below.

http://www.foodbankrgv.com/

https://www.redcross.org/local/texas/central-and-south-texas/volunteer.html

https://www.salvationarmytexas.org/mcallen/