The Pulse: Continuing Childhood Obesity Crisis Requires Population Health Approach

San Diego expert shares collective impact results and community partnership wins

The number of overweight and obese children in the United States has doubled – and quadrupled among adolescents – in the last 30 years. San Diego County is making some strides in combating the epidemic but the rates remain alarming, especially among Hispanic children and those in disadvantaged communities, says Cheryl Moder, founding director of the Childhood Obesity Initiative. Moder shares the latest statistics from San Diego County and the broad-based collaborations she directs in this month’s Pulse podcast.

Employed by the non-profit Community Health Improvement Partners, Moder shares disturbing health consequences – nearly half of children of color born after the year 2000 will develop diabetes in their lifetimes – and the societal costs of the epidemic. “Besides quality of life, the sheer cost is staggering, from direct medical costs to lost productivity.” Forging partnerships to address the epidemic is the most rewarding aspect of her work, Moder says, pointing to seven domains, from healthcare and schools to businesses and community organizations, in which the Initiative is active, educating and promoting programs and policies to reverse the trend.

“If we had planned our neighborhoods in Southern California to promote obesity, we couldn’t have planned them better,” Moder shares, bemoaning abundant access to fast food and sugar-sweetened sodas, a tremendous reliance on automobiles, and a lack of access to healthy, fresh food and to safe exercise opportunities in many San Diego neighborhoods. Moder is encouraged to see cities implementing a tax on soda and other sugar-sweetened drinks, a move she likens to the tobacco control advocacy she did early in her career. For those passionate about ending the obesity epidemic, Moder says, “there are many roles to play, from city planners and decision makers to school administrators and community advocates, not just medical careers.”

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The Pulse: Lung Health Advocate Debra Kelley Takes On Big Tobacco – Again – Through Prop 52

Debra Kelley steered San Diego through major changes in social norms about smoking

Fresh out of graduate school 30 years ago, Debra Kelley began work in San Diego for the American Lung Association. Her first assignment? To help pass a statewide initiative that would establish smoking and no-smoking areas within restaurants. In this month’s Pulse podcast, Kelley shares the results of three decades of advocacy and the remarkable changes she has helped bring about in California, as citizens and governing bodies have come to understand the detriments of smoking and second hand smoke.


“We’ve come a long way, and it is so gratifying to be a part of dramatically changing social norms and saving so many lives,” Kelley says. Today, her work is more apt to be focused on expanding and enforcing smoke-free areas and insuring that emerging tobacco use such as vaping and hookah lounges are subject to the same restrictions as smoking. Auto emissions and climate change are also concerns, as is a major California ballot initiative in November to raise the tax on cigarettes by $2 a pack. The revenue from the proposed initiative will fund prevention programs and medical research related to tobacco-disease as well as help “offset the abysmal rates of reimbursement in California for the 1 in 3 Californians who are on Medi-Cal.”

The tobacco industry spent more than $100 million to defeat the last such initiative, Kelley says. To take on this foe, as well as others she’s faced as director of advocacy at the nonprofit, Kelley describes drawing on a “deep understanding of the political system,” much-in-demand grant writing skills, a comfort with budgets and spreadsheets, as well as ease in public speaking she developed over time.

The Pulse: New wave consultants, Kalish brothers promote emphasis on U.S. food safety

About 48 million Americans, or one in six, get sick from food-borne illnesses each year, 128,000 of them requiring hospitalization, and 3,000 of them dying as a result. Twin brothers Michael and Charlie Kalish bring food-manufacturing, processing, packing, holding and farming experience to this cause, consulting to start-ups and leadership to food businesses to promote a safer food supply chain. Hear how they parlayed a background in cheese making into a thriving food safety consultancy in this month’s Pulse podcast.

Michael and Charlie’s professional experience began in a train tunnel in France, the site of one of Europe’s premier cheese aging facilities where they worked together handling 60 tons of fromage. “Working in these rustic environments, we gained not just a new language but new principles and ways of approaching the manufacturing and holding of safe food,” Michael says.

In 2012, the twins launched their Food Safety Guides consultancy in response to the growing need by industry for food safety expertise and the sweeping changes in U.S. food safety regulations resulting from the Food Safety Modernization Act. They now specialize in working with QA teams in businesses of all sizes to ensure safe food practices. Michael and Charlie have distinguished themselves globally in the food safety field with their innovative approach to food safety system development, engaging training styles, and FSMA expertise. Join them in September when they will offer a  2.5-day FSPCA Preventive Controls for Human Food Training at UC San Diego Extension.

The Pulse: 20 Million people newly insured, 87,000 lives saved: Public policy during pivotal times in healthcare with Rick Kronick

“What do you want to be doing in five years?” That’s the question Pulse podcast guest Rick Kronick’s wife posed to him in 1987, five years before he would fulfill his dream and join the Clinton administration in tackling health care finance reform. Reform itself took much longer to effect, but after a series of career twists and turns, including more than 25 years as a UC San Diego professor, he was appointed by President Obama to help with implementation of the Affordable Care Act (ACA).


“I can’t imagine a more exciting way to spend my time. . . I was thrilled with the energy, the commitment, and the meaningfulness of the work,” Kronick says about his three-and-a-half-year stint as deputy assistant secretary within the Department of Health and Human Services. In addition to developing the policies, writing the regulations, and estimating the cost of the insurance exchanges, Kronick wrote issue briefs that were the basis of front-page New York Times’ stories and of arguments submitted to the U.S. Supreme Court in defense of the ACA.

Kronick possesses a PhD in political science, a degree he pursued for 17 years, even while working inside the Beltway.  Once he was appointed as Director for the Agency for Healthcare Research and Quality (AHRQ) in 2014, he put those studies into high gear as he and his staff mobilized political support for the agency when Congress threatened to eliminate it. Over the course of four years, AHRQ’s evidence-based approach to improving safety in hospitals saved 87,000 patients’ lives and almost $20 billion in healthcare costs, he says.

After HHS, Rick was appointed Director for the Agency for Healthcare Research and Quality. Click here to listen to what he has to say about his career and AHRQ’s evidence-based approach to improving safety in hospitals which has saved 87,000 patients’ lives and almost $20 billion in healthcare costs.

The Pulse: The Changing Public Perception and Treatments for Substance Abusers with Jerry Synold

The public perception of substance abuse is changing dramatically, opening up unprecedented opportunities to treat addicts rather than just incarcerating them, says Jerry Synold on this month’s Pulse podcast, drawing on more than 40 years of specialization in drug and alcohol treatment with the U.S. Navy. “The demand [for counselors] has never been greater,” Synold says, with a 22 percent increase anticipated over the next decade. A Master Addiction Counselor who teaches and certifies counselors at UC San Diego Extension, Synold says the shift in attitudes – and an appreciation for the cost savings achieved with drug treatment – has inspired early releases from prison for drug offenders, the establishment of more recovery homes, MediCal reimbursement for treatment, and an overall increase in parity of treatment for substance abuse care with that offered for other medical conditions.


Discussing everything from Prince’s alleged demise from prescription drugs to the legalization of marijuana he says is coming, Synold shares both the enormous challenges and sources of help and hope in his specialty. He says social media and new technologies will change the “recovery of the future,” offering apps that help people connect more easily with counselors and meetings, and sensors that track drug use among parolees. The biggest help will come from effective counselors, Synold says, who are “genuine, empathetic, and have a special ability to create an alliance between themselves and the patient, as is so often true of people in recovery who serve as substance abuse counselors.”

The Pulse: New Medical Society CEO brings business education, advocacy chops to benefit San Diego MD’s

Paul Hegyi spent years working in the state capital, even running for State Assembly himself. Today, he brings more than a decade of legislative experience and a zeal for representing the needs of physicians to San Diego’s Medical Society. In this month’s Pulse podcast, the chief executive officer shares how his focus on polling data and the diverse needs of physicians helped the California Medical Association (CMA) turn around a flagging membership.


Like a seasoned campaigner, Hegyi delved into CMA’s polling data to understand its members. “The doctors in a large medical group such as Sharp Rees Steely have very different priorities than the single ophthalmologist who hangs his own shingle,” Hegyi said. “The data helped us tailor the value we were delivering and change the way we pitched ourselves to different groups.” Membership grew 15 percent during Hegyi’s tenure.

Encouraged to pursue both a marketing certificate and an MBA, Hegyi is excited to implement all that he learned on behalf of San Diego’s physicians in the CEO post he embarked on three months ago. “The thing that doctors want is the ability to take care of patients and to decide the best course of prevention or treatment for their patients,” Hegyi explains. “It’s the best of both worlds for me [to represent them.] I get to do both operations and advocacy – and I get to do it in San Diego.”

The Pulse: Nation’s Alzheimer’s cases and demand for caregiving will soar

Alzheimer’s San Diego’s CEO shares health care, societal and financial implications of the disease

Nearly 5. 3 million Americans are living with Alzheimer’s and other dementias today – and that number will rise to 16 million by the year 2050. The fatal, neuro-degenerative disease’s long duration, costly care, and the absence of a cure or treatment will have dramatic effects on families, health care systems, as well as financial models in the years to come, says this month’s Pulse podcast guest, Mary Ball who serves as the president and chief executive officer of Alzheimer’s San Diego.

“Family members devote an estimated 17.9 billion hours in unpaid hours to the care of loved ones with Alzheimer’s,” Ball says, noting that the cost of memory care units or even in-home health aides is prohibitive for an illness that lasts 8 to 10 years. “We will need a workforce to manage this epidemic, with nurses, doctors, certified nursing assistants, and others who know the signs and symptoms of Alzheimer’s. We need to build capacity within the community with social workers and home health workers to help families engaged in grueling, 24-hour care.”

San Diego is a hotbed of Alzheimer’s research, and Ball names UC San Diego among a dozen prestigious organizations that are collaborating to generate treatments and cures as well as preventive measures. Both diagnosed patients and healthy, asymptomatic people are being recruited for clinical trials, as researchers pursue the hope that lies in identifying and understanding Alzheimer’s telltale plaques and tangles in the brain.

Dr. Rodney Hood: Offering a powerful prescription for the neediest patients and the healthcare system

Data-driven hot spotting can help eliminate racial, ethnic health disparities

The Affordable Healthcare Act may have improved access to health care but some races and ethnicities continue to experience implicit bias, structural barriers, and poorer health outcomes than other groups. In this month’s Pulse podcast, Dr. Rodney Hood, a board-certified internist and the managing director of CareView Medical Group in San Diego, shares his career path, research, and community health initiatives that dramatically improve patient outcomes while saving health care systems millions of dollars.

 

 

“Looking at life expectancy, we know that the average adult lives 78 years,” says Dr. Hood. “But when we delve deeper, we find that Asians have the longest life expectancy, Hispanics next longest, whites then natives, and African Americans have the shortest.” Dr. Hood has devoted his career to serving multicultural and under-served patients in Southeast San Diego and to getting clinicians, nurses, health workers, and administrators into the community where they can better understand and meet the needs of diverse patients.

In the podcast, he shares the results of research conducted with a prestigious grant from the Center for Medicare and Medicaid Innovation, “hot-spotting” in at-risk communities with need-based interventions. Serving 60 patients over three years, the interventions saved the health care system saved $4 million dollars and the physician group $200,000.

Dr. Hood and the Multicultural Health Foundation he cofounded continue to partner with for-profit health care systems to demonstrate the model’s potential savings, a portion of which he advocates setting aside for “wellness initiatives.”

Listen in as Dr. Hood gives insight into the challenges facing his patients and some innovative strategies for improving patient care.

To listen to previous episodes of the Pulse, visit our archives page on UCTV’s Career Channel.

The Pulse: What would you fund with $3 million?

AHF leader discusses non-traditional grant recipients and their methods

 

Nancy Sasaki, executive director of Alliance Healthcare Foundation, touts innovation for entrenched problems among needy populations

If you had $3 million to devote to improving the health of vulnerable citizens of San Diego and Imperial County each year, what would you fund?

Would you bring children in an asthma-inducing area of Imperial County indoors to play — and use the space to teach parents seeking re-unification with their children how to play with their kids? Would you mobilize San Diego’s college students to care for and feed the homeless? Or expose high-risk youth from the urban core to outdoor sports like surfing and snowboarding?

In this month’s Pulse podcast, executive director of Alliance Healthcare Foundation (AHF) Nancy Sasaki shares how she and the board of AHF select their annual grant recipients, and details how she came to lead the organization.

 

A beloved middle-school science teacher inspired Sasaki to dedicate her life to health care management, a field in which she says “learning never stops.”

Where did she gain the business acumen she needed to run a foundation with a $74 million endowment? “I attended classes and workshops,” Sasaki explains. “And then I was hired to conduct the turnaround of a Planned Parenthood in Hawaii with the largest debt of any such affiliate at the time.”

Four-and-a-half years ago, Sasaki joined Alliance, which she says often awards grants to organizations run by demonstrated leaders, “folks who never take ‘no’ for an answer and are always looking for innovative solutions to the problems they are trying to solve.”

Hear more about how leaders are cultivated in healthcare on this month’s podcast, What Would You Fund With $3 million?

To listen to previous episodes of the Pulse, visit our archives page on UCTV’s Career Channel.

Kaiser Permanente’s Brady reimagines health care via information technology

Area chief information officer details how to break into health care field from outside

James Brady, the area chief information officer at Kaiser Permanente Orange County, knows how intimidating the jump can be — the jump into health-care information technology from outside the field.

Brady did it himself 13 years ago, parlaying his tech experience and educational background into a health-care career that now finds him overseeing information technology initiatives that affect nearly a half-million Kaiser members.

Named “CIO of the Year 2015” by The Los Angeles Business Journal, Brady reveals on this month’s Pulse podcast how to overcome the barrier of job descriptions that “call for more than five years [of] electronic medical record experience, which most applicants from outside health care cannot fulfill.”

 

Kaiser “has a very robust internship program,” Brady says, sharing the company’s philosophy of “building long-term relationships with people who are truly interested in being a part of the Kaiser Permanente family.”

The rise in consumerism, the entrance of new players and partners in health-care delivery (think of Walgreens health clinics), and the transformative effect of mobile technology continues to challenge health-care providers to reimagine the delivery of care.

At the most successful health-care systems, Brady says, “information officers are now part of the senior leadership teams, and have a place at the table so they are part of the strategic-planning sessions.”

Learn more about Brady’s big jump — the career rise he credits to his extensive post-secondary education, and his work with professional associations — and federal health-care policy innovations as well, in this month’s podcast, From IT to Health IT: James Brady Talks About Making the Leap.

To listen to previous episodes of the Pulse, visit our archives page on UCTV’s Career Channel.