A Global Affairs Media Network
WELLBEING SUMMIT Nutrition and Digital Health 2016 SUMMIT REPORT
Wellbeing Summit 2016
THE WELLBEING SUMMIT BY THE NUMBERS The 2016 Summit utilized two hashtags: #2050Health and #Worldin2050, which generated a rich discussion on the future of health, wellness, digital healthcare, and future of wellbeing.
19.5 MILLION IMPRESSIONS 2,237 TWEETS | 218
CONTRIBUTORS
Twitter data by Brand24, TweetReach, Postano, and Hashtracking.
180 COUNTRIES 19,133 YOUTUBE VIEWS LIVE broadcasting through YouTube to 180 countries. Most views came from the United States, Brazil, and Mexico. Data by YouTube.
200+ ATTENDEES
Over 200 attendees comprised the audience at the Gallup Building in Washington, DC and their makeup was as follows: 27% public sector and policy; 33% private sector; and, 40% civil society, non-profit, and NGOs. COPYRIGHT © 2016, DIPLOMATIC COURIER, A GLOBAL AFFAIRS MEDIA NETWORK™.
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Nutrition and Digital Health
WELCOME
THE FUTURE OF HEALTH & WELLBEING On May 18, 2016, the Diplomatic Courier presented the 2016 Wellbeing Summit titled: “Nutrition and Digital Health” hosted by Gallup in Washington, DC. Over 200 attended the event in person while thousands watched the sessions live on YouTube and the official event website.
Ana C. Rold CEO & Publisher
This year, with the addition of over two dozen thought partners and cocreators spanning the media, civil society, business, and education industries, the discussion kicked into high speed two weeks before the live gathering. On social media, using the hashtags #Worldin2050 and #2050Health we saw global publics and leaders from 180 countries participate in the discussion, which culminated in over 19 million social media impressions the night of May 18. The discussion has lasted until recent days as we continue to unveil articles and editorials focused on health, wellness, nutrition, and the intersection of technology and the future of healthcare. The live sessions, broadcasted principally through YouTube, have generated over 19,133 views. The countries leading with views were the United States, Brazil, and Mexico (in that order). Where did they view? Ever since YouTube started providing this type of data we have followed it with great interest. The majority of viewers—especially those outside of the United States—tend to watch from a desktop or laptop computer. Interestingly, this summit had 28 percent of its viewers joining through mobile, tablet, TV app, or game console—a new trend that we have been anticipating and preparing for. This summer, Diplomatic Courier is launching a brand new video app, which will publish video content on Roku and Apple TV. Engagement on Twitter doubled from last year. We utilized two main hashtags #2050Health and #Worldin2050 and reached 19,579,069 total million impressions. So exactly what was everyone talking about with #2050Health? While #wellbeing, #patient, #digital, and #healthcare, along with #Worldin2050, were somewhat predictable, we noticed that the speakers and organizations took center stage. All of us at Diplomatic Courier would like to express our warmest thanks to Gallup for hosting the 2016 Wellbeing Summit as well as all our Thought Partners and Summit Sponsors: Apollo, Cambridge Holdings, doTERRA, oneC1TY, and the University of Phoenix. We look forward to planning the 2017 Wellbeing Summit with you, which will be held May 2017 in Geneva, Switzerland in collaboration with the World Health Organization (WHO). Ana C. Rold CEO & Publisher Diplomatic Courier
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diplomatic courier magazine presents
The World in 2050 A forum about our future.
The World in 2050 is a series of global summits hosted by diplomatic courier, in collaboration with private and public sector partners. the series was conceived in 2012 when the world reached 7 billion people, with the purpose of convening multi-stakeholders and stimulate discussion and solutions about the future. How will these megatrends, i.e. major global forces such as demographic changes, resource stress, technology, and economic power shifts change our future? Join global publics and thought leaders from 180 countries on a journey of strategic forecasting for a better future.
www.diplomaticourier.com/2050
A Global Affairs Media Network
Nutrition and Digital Health
WELLBEING SUMMIT 2016 | REPORT CONTENTS WELCOME
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The Future of Health and Wellbeing
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Essential Wellness
Ana C. Rold, CEO and Publisher, Diplomatic Courier
Dr. David K. Hill, Chief Medical Officer, Chairman of the Scientific Advisory Committee, doTerra
KEYNOTES
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The States of Health and Wellbeing
Life After Cancer
Dan Witters, Research Director, Gallup-Healthways Wellbeing Index
Dr. Epa Gousopoulos, Physician, Scientist and Spokesperson, Lymphatic Education & Research Network
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Aneesh Chopra, Co-Founder and EVP, Hunch Analytics; First US Chief Technology Officer (2009-2012), The White House
Steve Cox, Vice President, Public Relations, Sodexo North America
The Future of Digital Health
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Healthcare Transformation in the 21st Century Jeff Micklos, Executive Director, Healthcare Transformation Taskforce FIRESIDE INTERVIEW
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Solutions and Innovations in Health Daniella Foster, Director, Science Communications, Mars Symbioscience Dr. Adrian Thompson, Co-Founder,Young Doctors DC LIGHTNING PRESENTATIONS
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In Pursuit of Longevity Jean-Claude Saada, Chairman and Founder, Cambridge Holdings, Inc.
PUBLISHING. Diplomatic Courier magazine is produced by Medauras Global, an independent private publishing firm. The magazine is printed six times a year and publishes a blog and online commentary weekly at www.diplomaticourier.com. EDITORIAL. The articles in Diplomatic Courier both in print and online represent the views of their authors and do not reflect those of the editors and the publishers. While the editors assume responsibility for the selection of the articles, the authors are responsible for the facts and interpretations of their articles. PERMISSIONS. None of the articles can be reproduced without their permission and that of the publishers. For permissions please email the editors at: info@medauras.com with your written request. LEGAL. Copyright Š 2006-2016 Diplomatic Courier and Medauras Global. All rights reserved. No part of this publication can be reproduced without written consent of the publishers. All trademarks that appear in this publication are the property of the respective owners. Any and all companies featured in this publication are contacted by Medauras Global and the Diplomatic Courier to provide advertising and/or services. Every effort has been made to ensure the accuracy of information in this publication, however, Medauras Global and the Diplomatic Courier magazine make no warranties, express or implied in regards to the information, and disclaim all liability for any loss, damages, errors, or omissions.
Health and Wellbeing FORUMS
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Solutions and Innovations in Food Security and Nutrition Chris Bradshaw, Founder and Executive Director, Dreaming Out Loud Julie Kirkwood, Founder, DC UrbanGreens Silke Pietzsch, Technical Director, Action Against Hunger Dr. Constance St. Germain, Executive Dean, Colleges of Humanities and Sciences, University of Phoenix Ayris T. Scales, Member of the Board, DC Social Innovation
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Digital Health and Integrated Care Fadesola Adetosoye, Global Healthcare Solutions Leader, Dell, Inc. Frances Dare, Managin Director,Virtual Health Practice, Accenture David Pittman, eHealth Reporter, Politico Leonard Kish, Co-Founder of Youbase.io; Co-Founder and Principal,Vivaphi
MASTHEAD
READ IT ON
PUBLISHER Ana C. Rold
CREATIVE DIRECTOR Christian Gilliham
ADVISORY BOARD Andrew M. Beato Fumbi Chima Sir Ian Forbes Lisa Gable Mary D. Kane Greg Lebedev Anita McBride
EDITORS Kathryn H. Floyd Michael Kofman Paul Nash
WRITERS Jacob Argue Amar Kakirde Danika Li Winona Roylance Eugenia Witherow
PRESS/MEDIA Press@diplomaticourier.org EDITORIAL Editors@diplomaticourier.org MAILING ADDRESS 1660 L Street, NW, #501 Washington, DC 20036
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Wellbeing Summit 2016 KEYNOTE
Opening Keynote The States of Health and Wellbeing PRESENTER DAN WITTERS, RESEARCH DIRECTOR, GALLUP-HEALTHWAYS WELLBEING INDEX
WELLBEING can be defined in different ways. Gallup and Healthways have focused on the five elements of wellbeing. Dan Witters starts by noting that wellbeing, at the highest level, encompasses all the things that matter to a life well-lived. Therefore, wellbeing goes beyond a physical definition. Witters explains how wellbeing is measured, what wellbeing looks like in the United States today, and how wellbeing can be improved and implemented in our daily lives. THERE ARE FIVE KEY ELEMENTS OF WELLBEING Wellbeing goes beyond physical fitness. It includes purpose, social wellbeing, financial wellbeing, community wellbeing, and physical wellbeing. Each of these elements, in concert with one another, contribute to the definition of wellbeing used by Gallup and Healthways. Purpose equates to liking what you do and being motivated to achieving goals. Purpose should be about having the career that best fits you. Whether you are a stayat-home parent, business manager, student, or retiree, you should have a vocation that is appropriate for who you are as a human being. Your vocation should allow you to use your strengths routinely, and allow you to grow routinely. Social wellbeing concerns supportive relationships and love in your life. Witters expresses that the absence of this vital element serves as a “blindspot in the rearview mirror.” Do you have positive energy from family and friends? Do you take time for trips and vacations? Do you have people in your life that encourage you
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to be healthy – an accountability partner? All of these factors play a large role in an element of your wellbeing that is vital and crucial to a healthy life. Financial wellbeing is about how you manage your wealth and live within your means to build financial security. Though financial wellbeing tends to get better with income, people in low- to moderate-income households can have very good financial wellbeing if they are living within their means appropriately. Community wellbeing is centered around your attachment to your community. Furthermore, community wellbeing includes being content and comfortable in your community, feeling proud of your community. Additionally, you should feel safe and secure in your community, and you should give back to your community. Physical wellbeing is the most multifaceted of the five elements and focuses on physical fitness, mental wellness, and emotional health. Gallup and Healthways receive information on physical wellbeing through selfreported data. Wellbeing in the United States, as Gallup and Healthways defines it, is regionalized. According to Gallup’s Wellbeing Index, wellbeing increases around the Northern plains, the mountainous West, parts of the West, and Alaska and Hawaii. The states in these regions are consistently among the highest rated in terms of the wellbeing index. There are some states that are routinely at the top of the wellbeing index
and some that are routinely at the bottom. These states are categorized as the “Elite 5” and the “Lowest 5.” Elite 5 consists of Hawaii, Minnesota, Colorado, Utah, and Montana. These states are the highest in wellbeing in terms of their average rank. Lowest 5 consists of West Virginia, Kentucky, Mississippi, Ohio, and Arkansas. There is a clear difference in behaviors and lifestyles between the Elite 5 and the Lowest 5 that explains their differences in wellbeing. Witters argues that residents of the Elite 5 states think about and evaluate their lives differently than residents of the Lowest 5 states. The residents of the Elite 5 and the Lowest 5 have many other differences as well. Residents of the Elite 5 have better emotional health. They have lower levels of clinical diagnoses of depression, lower daily stress and sadness, lower rates of obesity thus lower associated diseases – high blood pressure, heart complications, and pain. Additionally, they have lower food and healthcare insecurity, and are more likely to have health insurance. Residents of the Elite 5 behave differently from residents of the Lowest 5. Residents in the higher wellbeing states find a career that is more appropriate for them, have someone who encourages them to make healthy choices in life, smoke less and exercise more, eat healthier and have better access to fresh foods, live within their means, give back to the community in meaningful ways,
Nutrition and Digital Health KEYNOTE
feel safe, feel active and productive daily, and learn new things daily. Holistic wellbeing impacts our performance at work. Compared to employees who are thriving across all five elements, those who are thriving in physical wellbeing alone missed 68% more work days per year due to poor health. Additionally, those who thrive in physical wellbeing alone are three times more likely to file for workers’ compensation claims, five times more likely to report that they would seek out a new employer in the next 12 months, and over twice as many actually changed employers in that 12-month period. Witters argues that holistic wellbeing anchors you to your employers and saves employers replacement costs. He adds that across every outcome that Gallup observes, without exception, those with holistic wellbeing consistently outperform and out-execute those who are physically fit but lack holistic wellbeing.
Witters prescribes wellbeing and wellness programs. Success in these programs necessitates several key factors. Strong and sustained voice for leadership. The leaders should be designated, and should be clear about goals and agendas. Leaders define and talk about wellbeing consistently. There should be a shared and consistent definition of wellbeing between leaders to ensure that the message stays clear and the development of the wellbeing culture can further continue. Lead by example. Witters recommends the bully pulpit – using your power as a leader to establish policy and culture. Members should feel like their leaders genuinely care about their wellbeing. Witters argues that if you feel like your leader authentically cares about your wellbeing, you are more likely to embrace and participate in wellbeing programs and see your wellbeing improve over time. Remember that physical wellness is not the only element that matters. Physical
wellness is better than nothing at all, but all five elements of wellbeing are better than only physical wellbeing. Get the word out. Do not assume that your employees know about the programs you are offering. 40% of employees do not know about programs their employers are offering. The best way to get the word out is through executive leadership. Engage employees. Psychological needs should be met in the form of recognition. Talk about employee accomplishments, incorporate employees’ ideas into initiatives. Employees will be more willing and more likely to participate if they know they will be recognized and their opinions matter. Evaluate the program. Is the program working? You cannot assume the program is working – make sure you focus on programs that are working so that you can further improve them. ■
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Wellbeing Summit 2016 PRESENTATION
Lightning Presentation In Pursuit of Longevity PRESENTER JEAN-CLAUDE SAADA, CHAIRMAN AND FOUNDER, CAMBRIDGE HOLDINGS, INC.
IF HEALTH in the United States continues on the path it is currently on, for the first time in modern history, kids are expected to live shorter lives than their parents. In this lightning presentation, chairman and founder of Cambridge Holdings, Inc. Jean-Claude Saada explores some of the lifestyle issues that have created a healthcare crisis in our nation. Saada presents statistics on the reality of what health looks like in modern times, and presents possible solutions to living a healthy, mindful lifestyle. He also brings in interesting analysis on why real-estate developers should have an interest in healthcare, and what is being done to change the picture. Health and healthcare in the United States are rapidly worsening. Despite advances in technology and the increased capabilities of healthcare system today, the average health of adults and children alike in the United States is worse than people realize. Healthcare spending does not necessarily correlate with average health of citizens. The United States spends two times more on healthcare than the average developed country, yet it is last among the 10 most developed countries in healthy lifestyle indicators. These indicators include mortality from previous diseases, infant mortality, and healthy life expectancy at age 60. Obesity kills more than undernourishment. In the United States,
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two-thirds of adults and one-third of kids are overweight or obese. Since 1980, obesity has doubled across the world. Seven out of the top 10 causes of death are associated with chronic, often preventable diseases. Seventy five percent of the $3 trillion healthcare economy is spent on healthcare to treat these diseases. Saada emphasizes that the only way to break the back of healthcare cost is to avoid the necessity of healthcare in the first place. Healthcare costs are rapidly rising with no end in sight. When Saada entered the industry, healthcare costs were already at $500 billion a year (11% of the GDP). Now, it is sitting at $3.2 trillion (19% of the GDP) with only 60 million added into the system. Saada predicts that this curve will continue to escalate unless rapid changes are made Real estate developers have an obligation to be involved with healthcare, and are in a position to make significant improvements \to community health. As a member of the real estate industry, Saada has made steps to become more involved in the development of medical real estate, such as hospitals, medical buildings, and emergency clinics. He believes that the more you enhance the patient experience -the sacrosanct relationship between patient and physician - the better the outcome will be. Real estate developers are in a prime position to spark this change, as they essentially work with blank canvases and can shape something from the ground up.
Real estate has a dangerous impact on health. According to the Environmental Working Group and the Centers for Disease Control and Prevention (CDC), when a baby is born today, they are born with some 200+ toxins and pollutants in the bloodstream. Many of these chemicals are present due to the materials used in real estate. A focus on mindful real estate development may be key to addressing health. For many Americans, 90% of their time is spent indoors, where the air quality can be two to five times worse than the air outside. Saada hopes that by applying the principles of mindful development, real estate developers can begin to focus on cleaning their buildings of toxins. He states that addressing respiratory issues is just as paramount as combating obesity, increasing access to good food, and encouraging exercise. The secret to longevity is to be happy, and to have a sense of purpose. Saada took the lessons he learned from his vibrant and healthy grandmother, who lived to the ripe age of 102, and applied them to his personal and work lives. What he found was that being engaged was paramount to mental wellbeing, which was paramount to overall wellness. Live a simple life full of purpose. A Danish study found that only 10% of longevity is due to genes. The remaining 90% can be attributed to a variety of lifestyle factors that affect physical and mental
Nutrition and Digital Health PRESENTATION
wellbeing. Saada’s grandmother ate in moderation, stayed as active as she could, ate health and fresh food, and spent as much time with her family and friends as possible. Saada summed up all these lifestyle choices by saying, “She had what she needed around her, and she was happy.” Healthcare costs could potentially be a fraction of what they are now. When totaling the healthcare costs of his grandmother over her lifetime, Saada found that they number couldn’t even reach $100,000. If you were to apply this number to all the men, women, and children across the U.S., total healthcare costs would be $320 billion. This is onetenth of the current $32 trillion spent on healthcare annually. High healthcare costs create a substantial burden on the
economy, meaning that individual wellbeing has a more far-reaching impact beyond shortened longevity. Saada isn’t the only one in real estate seeking to make a difference. Through his own efforts, as well as efforts from organizations across the country, Saada relays multiple examples of how mindful development has created positive changes in national health. Together, he hopes that they can target wellness, not healthcare. Real estate organizations have made positive impacts on health, politics, and the environment. Organizations such as Bluezones focus on changing infrastructure and encouraging leaders to push for healthy lifestyle factors. The Urban Land Institute helps build environments that promote healthy design and work to improve urban
corridors for better walkability. Health systems such as Baylor have taken on the mantle of creating neighborhood clinics with cooking education, urban gardens, and community engagement. One project in Nashville, Tennessee is making waves with its innovative design. Dubbed “OneC1ty,” this project takes about 25 acres and develops it into a sustainable and healthy living environment. While approximately 19 acres will be dedicated to a mindful development LEED gold neighborhood, five acres will be made into a totally green and civic environment. The housing community will have open walkways, an irrigation system for recycling water, and windows that capture natural light. In addition, OneC1ty boasts its offerings of culture, art, and music to encourage community interaction. ■
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Wellbeing Summit 2016 FORUM
Forum Solutions and Innovations in Food Security and Nutrition PRESENTERS CHRIS BRADSHAW, FOUNDER AND EXECUTIVE DIRECTOR, DREAMING OUT LOUD JULIE KIRKWOOD, FOUNDER, DC URBANGREENS SILKE PIETZSCH, TECHNICAL DIRECTOR, ACTION AGAINST HUNGER DR. CONSTANCE ST. GERMAIN, EXECUTIVE DEAN, COLLEGES OF HUMANITIES & SCIENCES, UNIVERSITY OF PHOENIX
MODERATOR AYRIS T. SCALES, MEMBER OF THE BOARD, DC SOCIAL INNOVATION
FOOD SECURITY and nutrition are clear issues that affect many people daily. There are many different elements that work together with one another to impact the trajectory of our lives. Among these elements are our environment and community, socioeconomic background, cultural background, and health. The panel examined issues from a microand macro-level, global perspective, and local perspective. Food security plays an important role in education. Globally, 1 in 8 people are malnourished, and approximately 2 billion people in suffer from micronutrient deficiencies. Ninety percent of a child’s brain development happens before the age of five. Any period of malnutrition before the age of two can have negative long-term impacts on a child’s physical and mental development. Additionally, early-childhood experiences lay the foundation for later success in both school and life, making setbacks due to malnutrition detrimental to a child’s future. Malnutrition in early childhood comes with cultural implications as well. Cultural ways of knowing and cultural contexts can be negatively impacted by early-childhood malnutrition. In order incite change in the numbers of those who are malnourished, there must be an initiative in place. However, who the face of this initiative is plays a crucial role in making a positive impact. Bradshaw explains that if the face
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of change is different from the majority of members of that community, then the community is unlikely to feel any impact because of cultural differences. Food security plays an important role in education. The global displacement and migration affects those displaced, as well as the countries who receive them – food availability and nutrition security is a concern. In order to reduce the traumatic mental impact on displaced peoples, Pietzsch explains the importance of providing food that people are familiar with. Refugees who may be displaced to a completely different country have a hard time adjusting to the changes that simply come with being displaced. Action Against Hunger tries to reduce this stress through food and culture. Establishing a culture of wellbeing is vital. It is important to establish good habits in order to establish a culture of wellbeing. DC UrbanGreens operates small farms within urban communities by educating members of the community to run them – jobtraining. Members of the community are then employed by the local neighborhood to create a self-reliant system that provides food, employment, and economic value. A collaborative approach is key to finding solutions. Working together with other organizations
helps in finding solutions to food insecurity. For example, Dreaming Out Loud connects with farmers from Northern Virginia to increase food access for urban communities. Bradshaw notes that it is important to bring a lot of people together in order to find even the smallest of solutions. Partnerships are key. Kirkwood explains that you can reach greater lengths in shorter periods of time based on your partnerships with those who share a common vision. These partnerships can provide organizations with the necessary tools they do not have. Partnerships with refugee communities can open many doors. Within refugee communities, there are many highly educated individuals – doctors, nurses, architects, etc. Action Against Hunger establishes relationships with refugees through members of the community who can help each other. Doctors of the refugee community can help members of their community, and bridge the gap between outside aid and those within the community. Engaging the communities is one of the first steps. Developing relationships with the community comes first. If the community does not trust you, the help you are offering can only go so far. It is important to establish relationships with members of the community. Establishing relationships can take time, but once relationships are established, progress goes up rapidly. ■
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Wellbeing Summit 2016 PRESENTATION
Lightning Presentation Essential Wellness PRESENTER DR. DAVID K HILL, CHIEF MEDICAL OFFICER, CHAIRMAN OF THE SCIENTIFIC ADVISORY COMMITTEE, DOTERRA
IN THE LAST few years, groundbreaking technological advances in the field of medicine have lead to more effective emergency care and surgical interventions, as well as a stronger grasp on the control and eradication of preventable disease. More and more, people are starting to live longer, but this longevity comes at the price of diminished quality of life in the form of pain and long-term disease. Nowadays, U.S. citizens are fighting heart disease, diabetes, obesity, and cancer at unprecedented rates. While it is easy to point to healthcare as a factor of loss associated with changes you would like to see, in reality it takes entire communities being involved and educated to realize significant changes. Dr. David K Hill of doTERRA believes that some of the limitations of our modern system can be solved through alternative medicine -- primarily essential oils. Seventy percent of the U.S. population has invested in alternative or natural medicine, and 48% of the population has used or is using essential oils to treat themselves. In the words of Dr. Hill, “Essential oils have become part of what is commonly known as preventative care.” He believes that not all great advances in health care have to be tied to new technologies or procedural developments. In this lightning presentation, Dr. Hill addresses the changing definition of health, introduces what essential oils are as well as their history, and addresses concerns regarding the credibility of alternative medicine. The definitions of health and
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healthcare are changing. As medical technologies evolve, the diseases and ailments that our society face evolve alongside it. Nowadays, health has become an adaption to changing needs -- one that has individual definition and requires personalized care to the highest possible degree. Dr. Hill believes that with a continued focus on science and industry standardization, individuals and families can work towards recapturing their health and vitality for themselves. No one thing, including medicine, can be all things to all people. Dr. Hill argued that healthcare workers who are exclusionary of alternative forms of healthcare are as much of a hindrance to health as working in isolation without the assistance of any medicine at all. Essential oils provide an opportunity for collaboration and more sustainable outcomes of health. Modern medicine is an era of discovery, but the current system is still limited. These shortfalls are not attached to specific skills, technologies, or procedures, but instead with the necessary roles of interaction and self-empowerment. Although healthcare workers are acutely aware of these needs, they are extremely limited in their ability to provide to these necessities. There is an element of care better suited for the family and for the personal interaction and understanding that it brings. Essential oils are best suited for home and personal use. Although self-treatment seems basic and fundamental, it is the true element of meeting one’s own expectations
of wellness and personal health routines. Essential oils are not limited to any specific age group or condition, but are most commonly used by young mothers with two to three children. They provide a costeffective, reliable, and intimate alternative to traditional healthcare. Part of being a health-conscious society is that there is no more unknowing acceptance of traditional care. In his years of being a practitioner, the two most important things Dr. Hill learned was that patients never follow the same pattern of illness progression or recovery, and that patient experiences are very real to the patient. Because the information pipeline has extended to all maladies and treatments through the advancement of technology, there has been a convergence of history and modern medicine. A revolving view of health, involving personalized and selfdirected care, is a normal expectation that may define future health practices. What are essential oils, and what is their history? “Essential oils are [...] the elixirs of aroma. It’s what entices us to want to smell a rose. It’s what produces that highly minty and refreshing aroma associated with peppermint.” Essential oils have long had a place in history, with ancient civilizations dating all the way back to the Ancient Egyptians documenting their usage. Essential oils are complex chemistry. Extracted from roots, flowers, and other
Nutrition and Digital Health PRESENTATION
components of various plants, these oils are part of a sophisticated scientific process. How you extract them, when you extract them, and what methods you use to extract, are all influential in determining the chemistry of the essential oil. Certified, pure grade essential oils are becoming a vital part of health redefined. In their unadulterated form, essential oils are aromatic, natural compounds that are fundamentally different than synthetic chemistry. In their purest form, essential oils are devoid of adverse effects. Essential oils are a rapidly growing market. doTERRA is singularly responsible for the rapid market growth of essential oils. This $7.5 billion industry is now considered mainstream. Essential oils are a complex constituency of chemicals
that serve as a basis for pharmacology and modern medicines. Essential oils are an evidence-based scientific industry. It’s more than the individual needs and testimonies of essential oils that validate their usage -- it’s their involvement in an emerging science. Many are quick to dismiss alternative medicines as placebo, but their effects and benefits are very real. Essential oils are part of one of the greatest clinical trials in medical history. As scientists review the recorded uses of essential oils and plant medicines, their apparent benefits grow larger with each study. According to PubMed, over 10,000 studies about the values and effects of essential oils have been published. More and
more top medical facilities are using and recommending essential oils, and physicians are increasingly turning to alternative medicines to achieve full-body, natural health. Research shows that essential oils have benefits for both the most commonplace ailments and the most challenging diseases we face today. Evidence-based research have shown that essential oils have easily dealt with the simplest outcomes of health: lack of sleep, anxiety, and stress relief. Additionally, essential oils have also been found to help deal with difficult issues such as cancer and diabetes. They’re also capable of dealing with the many intricacies of inflammatory diseases that many individuals face today. ■
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Wellbeing Summit 2016 PRESENTATION
Lightning Presentation Life After Cancer PRESENTER DR. EPA GOUSOPOULOS, PHYSICIAN, SCIENTIST AND SPOKESPERSON, LYMPHATIC EDUCATION & RESEARCH NETWORK
FOR MANY, the words “your cancer is in remission,” would be an unrivaled blessing. However for some, the end of their battle with cancer is simply the beginning of another battle. When addressing issues of health and wellbeing, most people are unwilling to talk about the flipside of the coin—disease. In his presentation, Dr. Epa Gousopoulos asks us to imagine ourselves as a 45-65 year old woman who has just beaten breast cancer only to be told that there is a possibility of developing lymphedema. In the Western world, lymphedema is a disease that mainly results from cancer treatment. The presentation covers what lymphedema is, how it affects daily wellbeing, and what the present and future of lymphedema look like. What is lymphedema? Lymphedema is a disease that can either result from genetic predisposition, exposure to disease, or in the case of many Americans, the treatment of cancer. It is an incurable, lifelong disease that has been said to be worse than cancer by affected individuals. Lymphedema is an iatrogenic effect. When something is “iatrogenic,” it means that it resulted from health care treatment and health care officials. Lymphedema is a swelling of the lymph nodes, which happens when your lymphatic system can no longer effectively drain fluid from the tissue. Lymphedema affects the entire body. It is not simple enough to say that lymphedema is a malfunction of the
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lymphatic system. The lymphatic system runs all over the body, including the brain. It affects almost every other bodily system, so it is a crucial player to your overall wellbeing. When addressing health care, the lymphatic system is a pivotal point of treatment for diseases such as hypertension, cardiovascular disease, infectious diseases such as HIV and hepatitis, and cancer metastasis. How does lymphedema affect wellbeing? Wellbeing asks you to quantify how well your life is going. Gousopoulos says that wellbeing includes: physical health, absence of pain, ability to perform what one loves to do, and the feeling of being valued in one’s community. A strong component of one’s wellbeing is feeling a psychological sense of community that leads to a state of empowerment, which inspires action and leads to change. Daily life is completely transformed by lymphedema. For a patient with lymphedema, your day-to-day life often involves long, tiring treatments.You also have to wear expensive compression garments 24/7, which are uncomfortable and often not covered by insurance. These garments are “inconvenient in warm weather, and unfashionable year-round.” If your daily treatments do not go well, you have to use pumps to move the fluid around your body or schedule frequent visits with a therapist to have lymph-draining massages. Even the slightest cut of your
skin may result in a bacterial infection called cellulitis, and you will have to endure frequent ER visits to make sure you have not gone into septic shock. Lymphedema affects both your physical and psychological wellbeing. The effects of lymphedema hinder your physical wellbeing and slowly cut away at your psychological health, often making patients feel isolated from their community. For many who have lymphedema, there is usually constant pain, and always discomfort. Everyday capabilities are hindered, and clothes, accessories, and wedding rings do not always fit between the compression garments and the swelling. If you once loved to travel the world, with lymphedema it is no longer possible. High altitudes exacerbate the condition, making travel by plane extremely risky. What is the current state of lymphedema, and what needs to change? The psychological health of many patients with lymphedema is affected because we live in a society that’s not prepared to accommodate patients with these conditions. Those who suffer from lymphedema report feeling ostracized, mocked, depressed, and even suicidal. Changes in advocacy, insurance models, and education are necessary to help alleviate this suffering. Consider the statistics of lymphedema. Twenty to thirty percent of individuals
Nutrition and Digital Health PRESENTATION
who survive breast cancer will develop lymphedema. That number translates to 150 million worldwide, and more than 10 million people in the United States alone that will be affected by lymphedema. This number amounts to more than the cases of multiple sclerosis, muscular dystrophy, AIDS, Parkinson’s, and ALS combined. Advocacy for patients with lymphedema has evolved over the past few years. Lymphedema is often tacked on as an after-note to cancer as an “unfortunate side effect.” When those
who need to be the advocates of changes are the most muted, patients suffer. However, this is changing, as networks such as LE&RN lobby and advocate to make politicians listen. Widespread change at each level of society is necessary. The way to wellbeing for those with lymphatic diseases must include improved services and curative treatments. The current insurance system needs to adapt to include treatments that already exist for lymphedema in order to
alleviate the significant financial burden the disease poses. Additionally, a world campaign to educate the public on the effects of lymphedema is vital to avoiding the psychological damages of the diseases. Identifying new tools, imaging systems, and biomarkers are key to improving healthcare services and overall wellbeing. Luckily, the National Institute of Health has taken an interest in lymphatic research, and Gousopoulos is optimistic that available treatments for those who have lymphedema will be improved in the next few years. ■
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Wellbeing Summit 2016 PRESENTATION
Lightning Presentation Health and Wellbeing PRESENTER STEVE COX, VICE PRESIDENT, PUBLIC RELATIONS, SODEXO NORTH AMERICA
“THE PRIVATE SECTOR solves public problems.” This is the key to Steve Cox’s lightning presentation regarding the increasing societal issues of healthiness and overall wellbeing. Today, America is at a turning point in terms of the way its healthcare system operates. According to the Centers for Disease Control and Prevention (CDC), over half of all adults in the United States have one or more chronic conditions. The American Heart Association for that for diabetes alone, $245 billion of cost is incurred per year in direct medical costs as well as decreased productivity. With healthcare costs on the rise, it’s projected the cost of chronic disease over the next 15 years will be over $42 trillion. Cox explores how incentives drive every action we take, how the private sector will use this tool to solve public problems, and provides an example of this effectiveness through his own employee wellness program.
Incentives operate on three behavioral levels. In order to be most effective, a project needs to align incentives with specific behaviors on an individual, organizational, and communal level. If all three behaviors fail to align, then the project will be a failure. It’s no longer the government’s job to solve public problems. In the absence of the government’s capability to solve problems, the question that arises is “whose job is it?” The issue of public problems is that if you classify them as being everyone’s problem, then they are essentially nobody’s problems. However, Cox argues that if the private sector takes action by meeting incentive thresholds, then these problems can be resolved. A new social economy is emerging. This new economy is based on social outcomes. The currency is public data, reputation, and social impact. Through the usage of incentives, the private sector can tap into these new markets and realize profitability in the form of problem-resolution.
Incentives are the reason people take action. At the beginning of his lightning presentation, Cox presented the following question: “Why does anybody do anything?” His answer was that incentives - financial, moral, and social - are at the base of every action any one individual or organization ever takes. He argues that incentives need to be applied to intractable problems at their most base elements in order to influence behavior.
The private sector is key to resolving public problems. It is absolutely vital to our communities, to our economy, and to our national security and the private sector steps up to do something about the problem of healthcare. Cox introduces the idea of private entities as being wavemakers in the new social economy. The private sector is the driver of the social economy. In the new social market he discussed, Cox presented the economy in
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terms of buyers and sellers. The buyers in this market are buying social impact, and the sellers are selling outcomes and building cross-sector networks. The private sector can work with and around the government. Although the government is no longer at the helm of solving issues such as healthcare, this is primarily due to a lack of capability rather than a lack of motivation. However, this isn’t to say that the government no longer has any stake in public issues. In the future, the government has the capability of operating in a multitude of roles, including funder and research associate, etc. Cox also says that perhaps the government’s only role in the future is to move out of the arena and allow the private sector to do what it can and needs to do. Sodexo has shown the effectiveness of private sector partnerships. Cox’s company Sodexo partnered with Rollins College and the YMCA of Central Florida to create the Communities for Health program. This is a pilot program focused on expanding value, availability, access, and effectiveness of employee wellness programs. Employee wellness programs historically don’t work. According to a study by Gallup, past employee wellness programs have had a meager 20% participation rate. The reason being is that the incentives threshold to participate wasn’t met, and therefore no action was taken. Communities for Health strives to achieve this threshold in
Nutrition and Digital Health PRESENTATION
order to improve engagement, encourage employees to be agents of change, and to tap into community partners among many other goals. Communities for Health operates on a comprehensive systems-based approach. Cox’s program works to engage employees in the workplace and at home, ensuring that people, structures, processes, and incentives are all working together. If a single one
of these four pillars collapses, the entire program fails. Communities for Health triages participants based on their level risk and connects them with lifestyle coaches, peer-to-peer support systems, leverages technology, and strategically uses incentives for the individual, the organization, and the community. Communities for Health is working. In the year that Communities for Health has been in operation, it’s seen tremendous
success. Over half of eligible employees have enrolled in the program, and of these employees, an overwhelming majority have made extensive use of the tools offered to them. Cox believes that the success of the program is because the private sector took action, met incentives, and became actively involved in lifestyle wellness. By taking these principles and expanding them to a nationwide level, Cox argues that issues such as healthcare could eventually be solved. â–
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Wellbeing Summit 2016 KEYNOTE
Keynote The Future of Digital Health PRESENTER ANEESH CHOPRA, CO-FOUNDER AND EVP, HUNCH ANALYTICS; FIRST US CHIEF TECHNOLOGY OFFICER (2009-2012), THE WHITE HOUSE
ANEESH CHOPRA imagines a world where a guardian angel appears on the shoulders of everyone you know. This guardian angel has digital information regarding your health records, and can use this information to provide guidance on maintaining health, responding to health concerns, and making financial and provider decisions. Chopra believes that this vision will be realized in the upcoming round of health care reform. One of the biggest issues with the current healthcare system is a lack of patient-input. By cycling through a process of payment reform, rewarding new medicines, accessing recently published information, and stitching together a patient’s health record, our country would experience an ideal, value-based healthcare delivery system. The speech explores the three ingredients to the success of such a value-based model, discusses areas that need to be addressed in the reform process, and the three main ideas behind an information exchange portfolio. There are three ingredients to the success of a digital healthcare system. Chopra’s vision of a digital healthcare system where each patient receives treatment perfectly tailored to their needs requires the implementation of three key factors: 1) You have to get payment reform right. Payment reform incentives allow the care delivery system to innovate and create technologies and treatments that really work for patients. This in turn allows you to choose providers based on your specific needs.
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2) Governments need to disclose more aggregate information about the performance of the industry. This includes the federal, state, and local levels of governments. By learning about the way that providers practice medicine, patients can make more informed decisions regarding their care. 3) Healthcare information needs to be accessible to providers. Perhaps the most important element of the three, by allowing providers to have access to your health profile, they can more accurately provide the treatment necessary. Currently, electronic health records are locked behind walls and walls of systems and processes. Patient involvement and care provider reform go hand in hand with a digital health future. Not only are there the three ingredients to success to keep in mind, but there also needs to be an alignment of patientinvolvement and provider access. The two current models are either to have the patient control the flow of information, or to allow silos containing multiple facets of a patient’s information to be stitched together by care providers (the enterprise model). Although traditionally used, the enterprise model fails to capture much of the funding and infrastructure necessary to process patient information. The patient is now the heart of the information sharing system. The same way you allow your TV to choose how to display your Netflix profile, Chopra says that you now choose the way that digital health providers use your information. By
allowing patients to take a more active role in their care, you can solve the issue of healthcare. Information exchange is essentially a portfolio of options for a patient to choose from. Care providers need to make significant reforms to how they handle patient information. Currently, providers have access to electronic health records after jumping through hurdles, but this is only one of the many data assets necessary for a system to function. Providers also need to fund up to $1000 per patient per case of remote home monitoring, they have to consume the data that comes out of these home health agencies, they have to process files that CMS makes available, and they have to connect to telemedicine service providers. In addition to all of this, they need to incentivize patients to share their health outcomes in order to close the feedback loop. In the portfolio of information exchange, there are three key ideas. During the Obama Administration, the idea of information exchange was one that became redefined. In addition to these ideas, there also had to be a balance between the opening of information exchange as well as the increased security of this information. Doctors need to be able to securely email another doctor of the patient. This builds a network of care where information and differing methods of treatment can be altered to fit the patient. There needs to be a localized hub for care providers to communicate. This
Nutrition and Digital Health KEYNOTE
hub would ideally allow doctors, hospitals, remote care providers, and patients to connect digitally and allow them to discuss information. The patient needs to actively authorize two previously unfamiliar individuals to connect. This is the only new method of information exchange that will be regulated in the final round of the meaningful use
program. By creating a common open API such as the case of the Argonaut project, you simultaneously open up data while locking it down. When the consumer is actively connecting machines to their accounts, this gives you greater security as each point of access is monitored and approved by the patient. ■
“By allowing patients to take a more active role in their care, you can solve the issue of healthcare. Information exchange is essentially a portfolio of options for a patient to choose from.”
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Wellbeing Summit 2016 INTERVIEW
Fireside Interview Solutions and Innovations in Health INTERVIEWER DANIELLA FOSTER, DIRECTOR, SCIENCE COMMUNICATIONS AND CORPORATE AFFAIRS, MARS SYMBIOSCIENCE INTERVIEWEE DR. ADRIAN THOMPSON, CO-FOUNDER, YOUNG DOCTORS DC
WASHINGTON IS A CITY DIVIDED. While it has the most residents with graduate and professional degrees for its size, it also has some of the lowest high school graduation rates in the country. Adrian Thompson, Co-founder of Young Doctors DC, mentors a group of African-American high school students to encourage them to become doctors and drive authentic community change. Mars Symbioscience Science Communications and Corporate Affairs Director Daniella Foster provided business acumen to the interview. There were a couple of best practices discovered for the successful design, incubation, and growth of a community change model: first, define your population and what you are trying to do. Second, learn from all the steps along the way, not just the outcomes. Finally, to promote patient engagement, medical professionals need to be engaged with the community. Set clear goals about who you are targeting and what you want them to accomplish. Defining your target population is a given in business marketing, but agents of change in the nonprofit sector have a tendency to target too wide a segment for them to handle effectively.
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Determine what kind of change you want to see accomplished. The first step in accomplishing a goal is to create it, being specific about what merits success or failure. Whether the change being sought after is on a macro or micro level, reflecting on who you want to affect and how you want to affect them is helpful in discovering the best way to make progress. Target a segment you can handle. Starting off with a population that is manageable is key. Getting too big too soon can spell disaster for any program. Thompson’s work with Young Doctors DC has taught him that keeping in close contact with the people you are trying to affect, in his case African-American high school boys, is the best way to create meaningful change in their lives. Mentorship requires a close relationship, and having a close relationship is only possible if you keep numbers low. Have a plan to scale. Even though Young Doctors DC is based on mentorships and therefore requires low student-todoctor ratios Thompson believes it can scale. Although his focus is currently on Washington, D.C., especially Wards 7 and 8, he has plans to take the program to New York and Los Angeles soon. Moreover, Thompson is expanding his pipeline to include youth who are not yet in high school, or are already in college. Knowing
how you plan to grow your idea will help you to make decisions early on in the process, when operations are smaller. Find partnerships to help you along the way. Look for organizations that share your vision, and try to connect. These partners may provide financial assistance, share advice from their experience in the industry, or work with you at events. Change does not happen in a vacuum; having partners enables your organization to advance at a rate impossible individually. Partnerships with the public and private sectors encourage cooperation and growth. Focus on the journey, not just the destination. Create benchmarks to measure your progress by to better understand what is working and what is not. Setting benchmarks keeps the organization focused. There are less African-American men applying to medical schools now than there was in 1978, so Young Doctors DC’s first goal is to get the number of African-American medical school applicants from Washington, D.C. up to where they previously were. This is a goal that can be easily measured and, once accomplished, will show that the practices they employ have been effective and are worth using more broadly. Conversely, if the
Nutrition and Digital Health INTERVIEW
goal is not met within an agreed upon period, new strategies will need to be formed. Considering only the outcomes can give a misleading result.Young Doctors DC’s mission is to invest in youth and help expose them to careers in healthcare. The most logical outcome metric would be to see how many students ended up in the medical field, but that information alone would not tell the whole story. The mentorship these young men receive, even if it does not lead to a medical career, is important in their development as father figures are not always present for them. The exposure to professionals across the city who look like them can encourage them that with hard work, they too can be successful. Moreover, hearing people they trust talk to them about the importance of healthcare can enable them to be
ambassadors to their communities, which tend to have low levels of participation. Patient engagement is aided by cooperating with community members. Low participation levels can be countered by engaging with the community where they are. Being a part of the community creates relationships built on trust. Thompson is convinced that if the number of African-American doctors increases, the amount of patient engagement with these community’s residents will also increase. That is the crux of the community focused approach provided by Young Doctors DC. Thompson’s experience has shown him that large portions of the community feel that no one cares about them, that they are being left behind, but when an African-American doctor connects with them, they are able to trust him and
consequently have better health outcomes. Going to churches and other places communities naturally gather can assist in preventative care. There is an aversion to going to the doctor’s office among certain communities that makes preventable diseases and treatable injuries go untreated. There is a physiological response to seeing someone in a white physician’s coat—a fact Thompson used to advantage with a white coat ceremony for the graduates of his program—that lowers confidence and increases defensiveness. Going out into the community, where patients are confident and feel in charge, can be an effective way to get them involved in preventative health measures. One of the things Young Doctors DC does is to supervise its students while they take the blood pressure of members of their community, countering the narrative of cultural distrust in physicians. ■
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Wellbeing Summit 2016 FORUM
Forum Digital Health and Integrated Care PRESENTERS FADESOLA ADETOSOYE, GLOBAL HEALTHCARE SOLUTIONS LEADER, DELL, INC. FRANCES DARE, MANAGING DIRECTOR, VIRTUAL HEALTH PRACTICE, ACCENTURE DAVID PITTMAN, EHEALTH REPORTER, POLITICO
MODERATOR LEONARD KISH, CO-FOUNDER AND COO OF YOUBASE.IO, CO-FOUNDER AND PRINCIPAL, VIVAPHI
HEALTHCARE IS BETTER than it used to be. For the system to provide quality, equitable care at a lower percentage of Gross Domestic Product (GDP), however, new solutions—such as digital health and integrated care—will have to become more prominent. Leonard Kish, Co-founder and COO of YouBase.io, as well as Co-founder and Principal at VivaPhi, led a panel on the discussion of what these new strategies might look like. Kish was joined by the following experts: Fadesola Adetosoye, Global Health Solutions Leader at Dell, Inc.; Frances Dare, Managing Director of Virtual Health Practice at Accenture; and David Pittman, an eHealth reporter at Politico. There were a number of critical insights that the panel developed: first, doctor’s visits in the future will utilize telemedicine, but never get rid of in-person interactions. Second, patients can be intimidated by doctors, but will share information more openly with virtual characters or anonymously on online platforms. Third, electronic health records need to be more accessible to patients and transferrable among health networks. Lastly, for these solutions to be truly disruptive, these must considerably cut the cost of care. Telemedicine has the potential to change the way doctors see patients. In order to increase the productivity of preventive care, interactions outside the office may have to be an added possibility.
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Through telemedicine, doctors can quickly address patient inquiries without requiring the waiting time—and cost—of an inperson appointment. Telemedicine can fill a gap in the current healthcare system. Patients may have certain ailment that they are unsure how to handle, but are not willing to pay to see a doctor about. Telemedicine may be able to address these quick inquiries with greater convenience for the patient. Telemedicine can cut costs. By skipping all of the standard procedures of an annual check-up and focusing on what the problem is, patients receive care only to the items that trouble them. Moreover, as a means to proliferating preventive care, telemedicine can reduce expensive visits to the emergency room by picking up the signs of disease early. Telemedicine could become the gateway to the rest of the healthcare system.Were a patient to have a problem that he believed needed professional treatment, in the future he may first contact a doctor electronically before being moved through the rest of the system, if necessary. Through digital technology, a doctor can make a summary judgement about whether there is a simple prescription he can give, if the patient needs to come into a physical location to be checked out more thoroughly, or to go directly to a specialist, or the emergency room. In-person interactions will remain a key part of how health is managed. While telemedicine is helpful to solving the problems of the healthcare system, it is not
a replacement to physically being in a room with a doctor. No matter how innovative we become orhow many great technologies we develop, a doctor’s touch will always be needed. For example, traumatic injuries will never go away entirely, and there is no conceivable way to perform surgery without having a doctor in a room with a patient. Anonymous care via the Internet makes patients more open about their problems. Online, anonymous care can reduce patient misrepresentation of symptoms. Physician’s white lab coats establish hierarchy that intimidates patients. The authority that is represented in the physician’s attire and forcing the patient to wait long periods of time in a vulnerable position has been shown to affect the information patients are willing to provide. Some information, although important for a physician to know about her patient, is withheld due to embarrassment, among other reasons. Research has shown that patients will input about 20 percent more information when on an online platform than they would when faced with the dominant doctor figure. Anonymity has great promise in treating mental health patients. A medical team at the University of California’s San Diego campus has developed a digital mental health “coach” that can read nonverbals and help the patient without the perceived intrusion they may feel as a result of talking to a person. In essence the patient answers questions from a virtual character—behind
Nutrition and Digital Health FORUM
which is a trained psychiatrist—who can see them while not being seen. The results thus far have been positive. Second, in the United Kingdom, an online platform known as the Big White Wall has been very successful in dealing with mental health. Big White Wall is a clinically curated, anonymous social forum where people with depression, stress, and anxiety can support each other. Participants that are judged to be suicidal or otherwise in need can get live therapy from trained professionals. Electronic health records are a source of contention. There is disagreement over how much access patients should have to their record. Patients want access to their full electronic health record and to be able to input anything they want, while physicians only want patients to see an extract and only feel comfortable with them inputting demographics. With more access to analytical tools, patients might better understand what their healthcare status is. While doctors fear that patients will misunderstand the information the information in their file and consequently make poor choices, patients feel that it is their right to know all the information that is being stored on them and see a refusal to release them as unjust.
Interorganizational sharing of electronic health records are required by HIPAA regulations. HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996. It was passed to give patients their rights to their records, but a lot of providers are using them to hide behind. Sharing information about their patients with their competitors can be bad for business, so providers make it unnecessarily difficult to do; however, this negatively affects the patient, who has to spend time reiterating information, and wastes the time of the medical professional, which translates into lost money for the healthcare system on the whole. Doctors and patients alike have pointed to electronic health records as a problem and, if utilized effectively, a way to cut down on certain costs. The Obama Administration is trying to educate doctors and patients what their rights are. Health and Human Services (HHS), tasked with protecting the health of all Americans and providing essential human services, is the federal department in charge of this objective. New protocols are being developed at HHS that attempt to make it easier for doctors and patients to get the information they need from their electronic health record. Transfer of health data from one entity to the next is what HIPAA was designed to do, and HHS is
holding parties accountable if they do not. HHS has the ability to make substantial change happen without the need for legislation, making these new developments more likely to actually take place. Healthcare costs must go down if digital health is to be worthwhile. In the end it comes down to the economic arguments. With each new technology, each new way of delivering care, the bottom line is really what matters. The increase in technology does not always mean a decrease in the cost of care. In fact, some of the most expensive parts of the healthcare system (i.e. CAT-scans) are very technologically advanced. Cost-benefit analysis must be run on each of these digital health products to ensure that their implementation will either lower the cost of care, or provide care at the same cost more efficiently. Digital Health measures have great potential to disrupt the medical industry, but they will not be enough on their own. With 17 cents on the dollar being spent on healthcare in America, there is a systemic problem that cannot be addressed by new technology alone. Technology is enabling medicine to advance at great rates, but the hill is too high to climb on its own; nonetheless, the progress being made has been dynamic, and the expert panelists were optimistic about the future. â–
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Wellbeing Summit 2016 KEYNOTE
Keynote Healthcare Transformation in the 21st Century PRESENTER JEFF MICKLOS, EXECUTIVE DIRECTOR, HEALTHCARE TRANSFORMATION TASKFORCE
HEALTHCARE COSTS in the United States are much higher than any other country as a percentage of Gross Domestic Product (GDP), but there are still many who are not covered, or not adequately covered. The Healthcare Transformation Task Force is a consortium that brings together patients, payers, providers, and purchasers to align private and public sector efforts to clear the way for a sweeping transformation of the U.S. healthcare system. The director of the program, Jeff Micklos, delivered the Closing Keynote speech in which he summarized the progress that has been made thus far, and what lessons have been learned. Here are a few of the key points: first, new delivery systems need to be considered. Second, all the players in the healthcare system need to be accountable to each other. Finally, technology and data are critically important to managing care effectively. Innovative delivery systems have the potential to create change. Various payment models are being tested in both the public and private sectors. Person centered care is the way forward. The healthcare industry needs to think about individuals before they become patients. Whenever disease can be prevented, copious amounts of research has shown that it is more cost effective to deal with the problem in its early stages than it is to treat it after it has advanced further. Being person-centric needs to be balanced from the front-end and the back-end to ensure satisfactory treatment. Presently the
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data being analyzed are metrics like patient satisfaction, which have a back-end bias; for care to have a real-time effect, patients need to have the ability to input goals, preferences, etc. before they are treated. New ways of delivering care are a big part of the Affordable Care Act and how providers are reinventing their systems. The Affordable Care Act (ACA) does more than just insure the uninsured; it has changed how care is provided. One significant change under the law is the way that Medicare pays for physician services, bringing together the ability to pay based on the quality of services provided, the clinical practice improvement components, and the use of health technology. ACA also created the Centers for Medicare and Medicaid Innovation, which were granted 10 billion dollars of funding. The Innovation Center, as it is also known, is testing a vast array of innovative payment models directed at accomplishing the Triple Aim: high quality care, at a lower cost, to create better population health. The goal is to find a model that can be utilized on the federal level to substantively change the healthcare arena for the better. Much of the reform that is taking place today is being driven by the private sector advancing public goals. The ingenuity of the private sector in cutting costs while maintaining efficiency can help their bottom line, but it also helps the system as a whole be more effective. Private sector innovation equals, if not surpasses, the innovation of federal programs. Political differences should not undo the progress that is being made. From a macro
policy set, Micklos has confidence that everything is going in the right direction, but the details need to continue to be optimized. With a new administration coming in 2016, the politically charged subsidies and mandates of the Affordable Care Act ought to be separated from health care delivery transformation and innovation, which should not be interfered with regardless of political affiliation. Healthcare providers need to be accountable to each other, and patients need to be accountable to the system. Keeping costs down is a systemic effort, and all parts of the system need to do their part if significant progress is to be made. Value over volume is a new emphasis in healthcare. Payment for services that focus on good outcomes, as opposed to the number of services provided, can lower costs while maintaining quality. It is a core principle to everything that is going on in delivery transformation. The effective case care management programs are critical to taking care of the 20 percent of the population that contributes to about 80 percent of the cost. Physicians and providers do not get paid solely for what they provide anymore: there is a benchmark for the care that they provide to patients that they are going to be adjudicated against. The Healthcare Transformation Task Force is promoting value-based care. The Task Force is uniquely situated to help this movement forward because its membership is composed of the four P’s: the providers, the patients, the political
Nutrition and Digital Health KEYNOTE
players, and the purchasers/employers. They are the first group to bring all the stakeholders together to talk about model development, like-minded goals, and potential partnerships. To be a member of the Task Force, a business must commit to transferring 75 percent to value-based care arrangements that hit Triple Aim goals by 2020. They have been able to move the net percentage of their members up from 30 percent to 41 percent in the last year, so they believe they will be able to reach their goal by the end of the decade. Doctor shortages are a major problem, but it can be solved. The number of doctors in the United States is below the number needed to be able to treat everyone who needs care in a timely manner. Medical schools have been offering incentives for their students to pursue primary care for decades now, and yet these shortages persist. Although the American Medical Association (AMA) has been blamed for instituting measures that keep the number of physicians low, it has been taking steps to reverse its policy. However, even with the persistence of the doctor shortage, mid-level practitioners—like physician assistants and nurse practitioners—are helping to fill the void in care, performing tasks that do not require the full expertise of a physician.
There must be a balance between a patient feeling secure in their ability to make health payments, while also having skin in the game to reduce costs. There is an increasing amount of patient cost-sharing under many new plans (i.e. high deductible plans). The more that an individual has in the game, the more judicious they will be with their delivery of healthcare services, but if one goes too far in the opposite direction, the disincentive to get healthcare services—especially preventive care—will lead to greater costs in the long run. There is a sweet spot somewhere in between that minimizes the overall cost burden on the system. Technology and data are transformative when used properly. As with any aspect of the healthcare system, data and technology must undergo cost-benefit analyses. Electronic health records need to expand their range. A lot of time and money has been spent over the last 15 years to transfer from paper records to digital records. Thus far most of the work has been focused on getting health systems to be able to talk to themselves, but the ultimate goal is be able to plug into the larger world. The interoperability of these systems is still a real world concern. Technological and business
reasons have been a challenge for advancing electronic health records into this second realm, but there is opportunity for that to shift in the near future. Medical innovation must undergo costbenefit analysis, too. America is always innovating new medical devices, new drug therapies, and so on, but they must be balanced from a cost perspective. With the cost of creating a new drug and bringing it to market being so high, it would be imprudent to take off the table as a potential source of excess within the healthcare system. Likewise, medical devices improve the accuracy of measurements, but medical professionals need to judge whether the sometimes minor increases in accuracy justify the massive increases in costs. Data is not enough by itself. Data is information, and information by itself is not necessarily helpful. It is how data is used, how it is understood, that creates knowledge and wisdom. There are huge amounts of data, and the quantity is growing at an accelerating pace. Data requires time and resources to collect and analyze, which may or may not be spent in a more productive manner. Even so, the practical application of data has the ability to modernize care. ■
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WELLBEING SUMMIT 2016 Nutrition and Digital Health Gallup Building | Washington, DC May 18, 2016