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PopHealth Week: New Look, New Syndication Times

Gregg Masters and I recently updated PopHealth Week to include a new look and new syndication times with HealthCareNow Radio. The weekly show still features the same great guests exploring all things population health and now you can listen to it syndicated on HealthCareNow Radio at 5:30 am, 1:30 pm and 9:30 pm Eastern Time.  Take a look, here’s the new logo:

 

PopHealth Week Banner Asset 15 (2)@3000px

You can follow @PopHealthWeek on twitter and look for the show tweet so you’ll know who’s on. Here’s an example:

Dr. Steve J. Schienman

And if you can’t listen to the broadcast on HealthcareNow Radio,  you can catch prior episodes anytime you’d like right here.

Thanks for reading and I hope you’ll tune in to PopHealth Week.

Coming up soon another fun project… PopHealth Minute.

 

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A Frustrating Day at a Community Health Improvement Program

A few months ago, I attended a community health annual event associated with one of the many initiatives started by a large organization to bring together groups and begin implementing programs to improve the health of the community.

 

At this particular event after a couple of years of meetings and work, there were a number of presentations by the organization, community groups, the local government and a review of work done to date. It was a Kumbaya moment. Near the end of the day when people were asking questions, a gentleman next to me stood up, he worked in one of the poorest neighborhoods in the city and oversaw a local effort in that community.

He said and I’m paraphrasing.

 

I look at our community and see it has the exact same issues today we had 50 years ago. Nothing has changed, nothing has been done and we look just the same. You tell us to exercise but we have no sidewalks, no parks, the nearest gym is 3 miles away, we have no transportation, no access to healthy foods…

and well you know the rest of the issues he raised. He was clearly frustrated and has every right to be.

At that point a young woman stood up, Continue reading

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Presentation on Population Health at the Leading Healthcare Organizations Conference in Kuwait

Looking forward to presenting on Population Heath and conducting a workshop on Developing a Population Health Management Program for persons with Diabetes at this years Leading Healthcare Organizations Conference February 3 and 4th in Kuwait City, Kuwait.

Here is a link to the brochure.

vigor title page

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The Continuing Errors of the Wellbeing/Wellness Industry: Notes from a recent conference.

At some point the industry needs to come up with some way to police itself. Why?  I recently attended a meeting of the key companies and leaders in the wellbeing industry. Here were some statistics presented by a large corporation during a panel that included one of the Senior Executive’s of the company offering the employer their wellness service:

Incentives Associated with the Company Wellness Program

Annual Physician Visit –  $100

So why are they incenting employees to get an annual visit? Amongst the many screenings recommended by the USPSTF it gives it an A Grade to annual screening for adults aged 40 years or older and for those who are at increased risk for high blood pressure. Adults aged 18 to 39 years with normal blood pressure (<130/85 mm Hg) who do not have other risk factors should be re-screened every 3 to 5 years.

Health Risk Appraisal (HRA) $100

I believe this one is fine.

Annual Biometric Screenings $300

Again this is over-testing and not recommended annually. Per the USPSTF various biometric screens such as abnormal blood glucose a typical screening included in these gets a B Grade. The USPSTF recommends screening for abnormal blood glucose as part of cardiovascular risk assessment in adults aged 40 to 70 years who are overweight or obese.

Both the annual physician office visit and the annual biometric screening are not recommended for many in the younger age categoris or those with no known risk factors.  So why would the conference, the company and the senior population health executive offer up this information as an example of an excellent program?

Then they presented a slide on outcomes:

82% of all continuously enrolled maintained or improved their health continuum status.

This one is just bogus as presented, but let’s go through it.

  1. Selection bias, by only measuring those who enrolled and then were continuously enrolled (2 out of 3 strikes) selection bias is all over this one. See the Illinois Workplace Wellness Study.
  2. How many didn’t enroll at all?
  3. How many enrolled, but quit?
  4. What was the definition of maintain or improved health?
    1. Might it have been one measure and others got worse?
  5. What was the net overall change in risk a la Dee Edington (Natural Flow) or perhaps the movements for each of the individual health measures?

Again as a Wellbeing expert why would the vendor allow their client to put this slide up?

The weight loss program they ran offered by one of the well-recognized national vendors had 2,600 participants who lost 9,226 lbs during the year.  Wow an average of 3 lbs! Was that at 12 months? How many gained versus lost weight during the period? How many dropped out?

And the next line showed a weight loss challenge at 12 weeks. In which over 1,300 participants had lost about 12,000 lbs or about 10 lbs each.  Again these weight loss challenges have not been shown to create sustainable weight loss.   How did they look at the end of the year?

But to add insult to injury, this presentation was the final one of the day that began with a nationally recognized academic who when asked which is the best weight loss program, gave this answer:

“any weight loss program can show weight loss over 3-6 months, but a year or two later they gain it back and often gain back more.”

So they started the day honestly and finished it a little less so, to put it nicely. But the bigger issue is:

Isn’t part of our job as experts to inform and educate clients to do what works, what is evidence based and report on what’s meaningful and real? ”

Why would you let one of your clients present this at a major national conference. And then while you are on the stage, tout it as success and look the other way. And, if this is a reflection on your program, one allowing excess testing, inappropriate visits and the reporting of meaningless results what does it say about your program?

Come on, we can and must do better.

 

 

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John D. Bower School of Population Health

JDB LogoI’m honored to have been appointed as Graduate Faculty at the John D. Bower School of Population Health at the University of Mississippi Medical Center.

The School is one of the few schools of Population Health in the nation and “their mission is to educate leaders who will transform health care delivery and the health of Mississippians.

This really resonated with me as I had previously done work in Mississippi when Specialty Disease Management Services Inc. (SDM) was involved in the Medicaid disease management initiative as a subcontractor to McKesson Health Solutions.  SDM provided on the ground RNs and community care coordinators located throughout the state seeking to improve the health and care for Medicaid beneficiaries with asthma, diabetes heart failure and COPD. I also have in-laws in Leland, Mississippi in the heart of the Delta.

beech,-bettina1The school is led by Dr. Bettina Beech, their Dean, who is a dynamo building the school and truly working to embed the schools expertise into the state by getting involved in programs to leverage population health in an effort to improve the health of all Mississippians.  Her areas of scientific inquiry focus on the role of nutritional factors in the primary and secondary prevention of obesity and type 2 diabetes, with a particular focus on child health disparities.

The School has three departments, Continue reading

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