Raise the Line

“We don't have a shortage of nurses in this country. We have a shortage of nurses willing to practice in the healthcare environments as they are today,” says Rebecca Love, an educator, innovator and leader who has devoted her career to improving the profession of nursing from multiple angles. She’s currently pursuing one of those efforts as chief clinical officer at IntelyCare, an app which smooths out the scheduling process for nurses looking to pick up extra shifts. “We created a platform that allows nurses more of a credentialing passport to work anywhere they want, when they want to.” Love is also involved in a broader effort to change how nurses are paid, correcting an historical artifact of their services being included in the daily rate of a hospital room instead of being billed as a separate service, as she explains to host Michael Carrese. “Nursing is still the only healthcare profession that does not have a billable service which makes them a cost center to hospitals and as long as that’s the case, healthcare systems are never going to invest in anything to make the lives of nurses better.” Tune in for a powerful perspective shift on one of the biggest challenges facing healthcare today from a leading advocate for the nursing profession.

Mentioned in this episode: https://www.intelycare.com/

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Twenty years ago, health outcomes in Eastern North Carolina lagged behind state averages but those deficits have largely been erased, and Dr. Mike Waldrum, Dean of the Brody School of Medicine at East Carolina University, thinks he knows why. “We’ve done it primarily with a community-based focus and taking students only from North Carolina that we know have a propensity to want to practice medicine in the environments that we're here to serve. That's kind of our sauce,” he tells host Shiv Gaglani. Building on that approach, the university started a rural residency program in recent years, and out of four graduates in its first cohort, two have agreed to stay in the communities in which they trained. And while that kind of incremental progress on the ground level is important, Dr. Waldrum knows change is needed at the system level as well. Some things ECU Health can do on its own, such as implementing a unified electronic medical record across all of its care sites that allows it to model where health needs are and intervene early. But what he sees as the necessary restructuring of how the healthcare system is organized and financed will take a group effort. “We need Medicare, Medicaid, the insurance industry and others as partners in how we transform the system.” Tune in for a thoughtful look at the challenges of improving healthcare in rural communities, and the special role academic “safety-net” health systems play in that effort. 

Mentioned in this episode: https://medicine.ecu.edu/

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If you were to make a word cloud based on this episode of Raise the Line, community would be the most prominent term.  For starters, Dr. Allison Brashear was attracted to Buffalo for its reputation as a welcoming community -- a city of good neighbors, as she puts it -- which reminded her of her roots in the Midwest.  She was also encouraged that the University at Buffalo Jacobs School of Medicine already had a well-established reputation as a community partner.  And, as she tells host Derek Apanovitch, she has seen the impressive strength of the Buffalo community in the wake of the deadly, racially motivated shooting at a supermarket last May. Part of the school’s response to that tragedy has been developing an anti-racist curriculum and focusing students on addressing health inequities. “There's an elective where students can go provide healthcare in the neighborhood, so they actually kind of walk in a patient's shoes... because if you don't understand the social determinants of health of your patient, then you're not going to be able to make a difference.” Brashear adds that the school’s wide variety of partners -- from the VA to community-based primary care clinics -- further enriches the educational experience. “There's a wealth of opportunities to learn here in Buffalo, and that's one of the things that makes it really great.” You’ll also learn about Brashear’s efforts to boost the number of graduates who stay in the region to practice medicine, the University’s research strengths, and her own work as an internationally renowned researcher in several rare neurologic disorders in this in-depth conversation.

Mentioned in this episode: medicine.buffalo.edu/atp1a3

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“We thought it was the end of psychedelic research, and the great dreams we had were for some future generation,” says Dr. Bill Richards, referring to the 1970s when the Nixon administration criminalized psychedelic compounds.  At that point, he could not have imagined there would once again be the thriving interest in psychedelics for both therapeutic and non-clinical purposes that we see today. On this episode of Raise the Line with host Shiv Gaglani, we take a unique, multi-generational look at psychedelic research with two guests who happen to be related to each other. Dr. Bill Richards' extraordinary contributions to the field started sixty years ago and he was instrumental in helping Dr. Roland Griffiths reignite psychedelic research in 1999 at Johns Hopkins University after decades of dormancy. His son, Dr. Brian Richards, has made his own significant mark in the space, contributing to some of the original research administering psilocybin with cancer patients and healthy normal adults. He also teaches and mentors students at the California Institute for Integral Studies, the leading psychedelic medicine certificate program worldwide. They’re currently colleagues working with cancer patients at Sunstone Therapies, a company focused on defining the standards for optimal delivery of psychedelic-assisted therapy. You’ll hear about the range of patient experiences they’ve witnessed, the critical role of therapists who guide the sessions, what it’s like to work together and whether they think the US is ready to integrate psychedelics into medical care, among many other dimensions to this fascinating issue. 

Mentioned in this episode:

https://www.sunstonetherapies.com/

Sacred Knowledge by William A. Richards

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“After an hour in this machine, I learned more about my health than the health system had told me my entire life.” That’s our Raise the Line guest Andrew Lacy describing a full body MRI scan he underwent several years ago in Canada that sparked the idea for the company he subsequently founded, Prenuvo, which uses advanced MRI technology for preventive screenings. Growing curiosity about the state of his health as middle age approached had prompted Lacy to undergo a diagnostic gauntlet: colonoscopy, genetic screening, blood tests and more. But he didn’t get the comprehensive answer he was seeking until the MRI. “Seeing the results of that scan felt like I was seeing the future of healthcare. From that moment on, my mission was to figure out how can I take this and bring it to the world,” says Lacy, a serial entrepreneur, investor and advisor in a wide range of industries. He has taken big steps toward fulfilling that mission by raising $70 million to establish scanning centers in nine locations in North America with plans for many more. Prenuvo’s MRI technology candetect solid cancer at Stage 1 as well as 500 other medical conditions, and has already proven to be invaluable for many clients, as he tells host Shiv Gaglani. “There's a potential to have a lifesaving diagnosis in one out of every twenty people who are scanned.”  Tune in to learn how Prenuvo is hoping to deepen our understanding of aging and early disease progression, shift the healthcare system toward a prevention-first model and help people take control of their own health. 

Mentioned in this episode: https://www.prenuvo.com/
Use this promo code for a $300 discount on a whole-body scan: OSMOSIS

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When Tracy Dixon-Salazar was a young mother of two she described herself as a mediocre high school student with no real academic or career ambitions. Today, she has a PhD in Neurobiology and Neurosciences, is credited with uncovering the genetic driver of a rare form of childhood-onset epilepsy, and she also identified the first precision therapy for it. Unfortunately, the spark for this remarkable change of course was her daughter Savannah’s battle with Lennox-Gastaut Syndrome (LGS) which caused hundreds of seizures a day, stopped her cognitive development and nearly killed her several times.  It all started thirty years ago at a time when the condition was poorly understood. “Nobody really knew what to do with this kid so I realized I had to fight, I had to become her advocate. You'll do anything for your babies and so I had to become educated,” she explains to host Michael Carrese. Dixon-Salazar moved on from her academic life several years ago to become a full-time advocate as executive director of the LGS Foundation where she works with over 200 gene-specific advocacy groups for rare diseases. “It gives me so much hope. The ability for patients to have a voice in the whole process has changed. Now patients have a platform.” Don’t miss this incredible story of a mother’s persistence that changed the prevailing dogma about epilepsy and LGS and ushered in new approaches to treatment that have affected many children beyond Savannah. 

Mentioned in this episode: https://www.lgsfoundation.org/

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“There's never been a better time to do what we do in our fields and the future of life sciences is so incredibly bright,” says Dr. Lloyd Minor. From his perch as dean of Stanford University School of Medicine, Minor sees the convergence of biomedicine, information science and technology dramatically increasing the pace of discovery-driven science and translational science. As a result of observing and contributing to the culture of discovery at Stanford, and based on his own groundbreaking work as a physician-scientist in otolaryngology, Minor has distilled the necessary elements of innovation into what he calls the “Four Cs of Innovation” -- combination, collaboration, chance, and culture.  “A culture of inquiry and collaboration is so important to making scientific advances that benefit patients and there is a level of collaboration and cohesiveness here that I think is very, very conducive to interdisciplinary scholarship,” he tells Raise the Line host Shiv Gaglani. But Minor acknowledges that this time of unprecedented change and new technology in healthcare has been stressful for providers, which informs his approach to leadership. “There's never been a more important time for empathy in leadership and for leaders to be engaged listeners.” Tune in for a fascinating look at how academic medicine is both driving change and adapting to it, how Stanford is applying precision medicine for preventive health and the importance of balancing the opportunities and risks of AI in healthcare. 

Mentioned in this episode: https://med.stanford.edu/

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Educating someone to be a nurse, physician or allied health professional is obviously a complex process for learners, faculty and administrators. Today, our new Raise the Line co-host (and Osmosis COO) Derek Apanovitch takes a look at tools that help all of those stakeholders visualize the overall curriculum, where a student is on their learning path, and how they are performing. Our guide is Andrew Dos-Santos a veteran of healthcare and higher education IT who has launched the edtech company Fenix Alma Solutions to apply the insights he’s gained in his long career. “Over the last twenty years working so closely with faculty and staff it became clear that disconnected, disparate systems weren't the answer, and this is the landscape most institutions are still working within.” Fenix Alma, and its curriculum management platform VidaNovaVLE, provides the ability to see both the big picture and a granular view to ensure that educators and learners can target where performance improvements should be made. As a unified platform, it also gives administrators the ability to connect the data needed to answer critical questions about what is being taught at what level, what is being assessed, and how are learners doing. 

“We are trying to breathe new life into this health sciences education technology space.” Tune in to learn about customizing content for students, integrating with external content providers such as Osmosis, and how AI might benefit health sciences education. 

Mentioned in this episode: https://fenixalma.com/

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The failure of patients to take their medications as prescribed costs the U.S. healthcare system more than $500 billion a year, not to mention the adverse health outcomes it causes. Today’s Raise the Line guest, Sebastian Seiguer, co-founded and leads a company called Scene Health that is tackling this problem with a system that combines video technology, clinical coaching and validated interventions to improve medication adherence rates. Based on evidence gathered in multiple clinical trials, the Centers for Disease Control recently concluded that using asynchronous video is equivalent to an in-person Directly Observed Therapy - the current gold standard for adherence. “It’s an incredible thing. It's the first time in healthcare that an asynchronous video appointment is being treated the same as an in-person appointment,” Seiguer tells host Shiv Gaglani. Scene Health is currently supporting patients across multiple chronic and infectious conditions, including diabetes, asthma, opioid use disorder, tuberculosis and hypertension. Check out this enlightening conversation to learn why adherence is so low in the first place, how Scene Health is educating patients on how and why their medications work, and other applications for this approach.

Mentioned in this episode: https://www.scene.health/

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To the uninitiated, interoperability may sound like a surgical term, but it actually refers to how IT systems and other technologies communicate with each other. The goal, of course, is seamless communication to improve efficiency and quality of care, but that's obviously a big challenge. Today on Raise the Line, we dive into this important issue with two people who come at it from different professional perspectives, but who share that goal. Oh, and they also happen to be brothers!  Jake Engle is a Senior Director at Oracle Cerner, a supplier of health information technology used at thousands of facilities worldwide. His brother, Dr. Sam Engle, is a pediatric endocrinologist at Children’s Wisconsin. On the patient care side, Dr. Engle talks about the value of having a complete patient history in hand prior to appointments to maximize the efficiency of the time spent, but also to avoid doing duplicate tests. “Especially with kids, you never want to have to repeat labs if you don't need to. I feel very strongly about that.” From the tech side, Jake Engle addresses the challenge of trying to synthesize data from multiple sources such as EHRs, insurance records, public health databases or commercial products focused on one niche of healthcare. “I think the healthcare systems are a bit late to the game and it's much a more complicated game.” You’ll also learn about efforts to make it easier for patients to access their health data, the need for data standards in the industry and how their personal relationship contributes to this work.  

If you like this podcast, please share it on your social channels. You can also subscribe to the series and check out all of our episodes at www.osmosis.org/podcast