Friday, April 16, 2010

Iowa Public Radio Interview

I, along with HMP (Health Management and Policy) research collaborator Dr. Peter Damiano, were special guests on an episode of Iowa Public Radio The Exchange recently, discussing changes that will be occurring in healthcare with the reform that was recently passed. To listen, click the link below.

Thursday, April 15, 2010

Adding the Executive Branch to the Portfolio

I have enjoyed the opportunity to serve on the National Advisory Committee on Rural Health and Human Services for the past two years. The committee advises the Secretary of Health and Human Services, currently Kathleen Sebelius, regarding rural health and human services issues. Physicians, nurse practitioners, academics, policy folks, retired bureaucrats, association types, and a couple hospital administrators among others serve on the committee. It is staffed by the Office of Rural Health Policy…a truly amazing group of folks. We meet three times per year – once in Washington, D.C. The other two meetings are field trips to rural America. We develop a two to three topic report annually for the Secretary on issues we believe are important to rural communities. We also write comment letters and white papers on issues of interest when time is of the essence.

When I was asked to serve on this committee, I thought it might be an interesting opportunity to get involved in the executive branch of government. Most of my work in the past has been on the legislative side of things. It has been interesting getting a better understanding of the depth and breadth of our government. I am continuously amazed how truly gigantic it really is.

The most recent meeting was in D.C. in late February. At the time, we thought we would be focused on healthcare reform as a done deal and what impact the new legislation would have on the rural areas of our country. We talked instead about bundled payments and accountability of care organizations, regulatory issues that affect rural health and human services issues, and stimulus funding for implementation of the electronic health record. We also spent time discussing the epidemic of childhood obesity, especially as it relates to rural America.

One of the highlights of this meeting was a discussion with Mary Wakefield, director of the Health Resources and Services Administration. What a ball of fire she is. And coming from North Dakota, she is someone who can really relate to the rural nature of our committee.

When I am in D.C., I try to make it to Capitol Hill. I met with staffers in both Senator Harkin and Grassley’s office as well as the health aide in Congressman Boswell’s office. I am always impressed with how bright and committed these folks are to doing the work to keep their bosses in the know on important issues facing their constituents. I’m preparing to head to Washington next week for more meetings with our elected officials.

I’m looking forward to thanking our leaders for their efforts to fix our Medicare “tweener” hospital challenges. After several years of advocating for “tweener” hospitals, we have some legislation that improves the inequitable Medicare payment levels for middle-sized rural hospitals like GRMC. So many of us fought for this change and I want to acknowledge the Iowa Congressional delegation for their efforts to make sure this was written into the bill and just as importantly stayed in the bill as it was written into law.

I digress…back to my committee work. It is easy sometimes to lose heart, given how slowly some things in government move. Yet, when one is able to influence the process by making sure we are telling the story of how legislation and regulation impact the people we are dedicated to serving, it can be rewarding. I remind myself that I am a member of a “special interest group,” that is, someone who advocates for the special interests of the patients and families we are privileged to serve. I believe government works best when “we, the people” get involved.

This is going to be a particularly interesting year for our committee, given the changes coming in the delivery of healthcare and human services, but also because the committee is coming to Iowa in September on one of its field trips. I can’t wait to show off our state to the rest of the committee.

(By the way…Jesse Jackson was on my plane ride home from DC to Chicago…you never know who you might run into. I didn’t get a chance to talk with him…he was riding up front!)

The postings on this site are my own and don’t necessarily represent GRMC’s positions, strategies, or opinions.

Thursday, April 8, 2010

The Heart of Grinnell

For more than a decade, Grinnell Regional Medical Center has been a leader in promoting health improvement for our employees and the community. We continuously look for the best ways to encourage and provide opportunities for exercise. We have provided pathways for reducing or eliminating the use of tobacco. We have provided classes on proper nutrition and maintaining a healthy weight and we have looked for the best ways to help people manage the stress in their lives. We have also been a national leader in the provision of hospital-based integrated health, which has contributed to our success with improved health and healing.

A little over two years ago, working with a group of colleagues from Grinnell and some new friends from HeartMath®, we doodled on the back of a napkin a simple vision of a healthy community, something we call “The Heart of Grinnell.” The focus of this project is stress.

Stress has become epidemic in our society. Last year the Journal of the American Medical Association published an article about a study that indicated workplace stress was a greater risk for cardiovascular disease than smoking or high cholesterol. There is little doubt that stress and its effects is a major underlying cause of many chronic diseases that plague our society.

Until our discovery of HeartMath®, our focus was on recommending relaxation techniques to manage stress such as exercise, massage, yoga, therapy, prayer, and meditation. De-cluttering our lives can also impact our stress levels. The problem with most of these approaches to reducing stress is they occur after the fact, not in the heat of the moment or when stressful situations have taken control of our emotions. HeartMath® is a scientifically proven technique that has been developed to be an effective way to manage stress at the time stress is impacting us—just-in-time stress relief, if you will.

Stress is really caused by our emotional response to the environment around us. The toxic impact of stress affects us in many ways physically, emotionally and mentally. If unchecked, stress can impact our health, our relationships and our productivity. The techniques are based on the long-established connection between the mind, body, and spirit, recognizing that one’s state of mind impacts the body’s autonomic nervous system (ANS) that controls our breathing and heart-rate variability. HeartMath® provides the tools to lessen the physiological effects of stress.

GRMC received a $240,000 grant through the Centers for Disease Control and Prevention last year through efforts from Senator Tom Harkin. The concept of our project is simple: look for opportunities to teach the HeartMath® technique to as many community members as possible and then over time study the impact on the overall health of the community. Through the use of pilot projects at Grinnell College, police and firefighters, the Grinnell Newburg School District, Brownell’s, and the Grinnell Ministerial Association, we hope to demonstrate the healthful impact of effective stress management on overall community health status. From that point, the goal is to extend HeartMath® further into the community spurred on through the proven benefits of the pilot projects.

Seventy-five percent of all GRMC staff members have been trained in the HeartMath® technique and the initial impact has been very beneficial. The Institute of HeartMath® has hundreds of other studies which have proven the benefits of this technique, primarily focused on single organizations. What’s unique about The Heart of Grinnell project is its focus on the entire community.

We have discovered, when we are able to control our emotional response to the stressors around us, we often can maintain other healthy behaviors such as diet and exercise which sometimes suffer when we get stressed. So, HeartMath® has become a central focus in our overall health and fitness program.

Our vision to create optimal health in our community is the focus of The Heart of Grinnell project. Of course we are interested in improving physical health such as decreasing cardiovascular disease and diabetes, but we are also thinking about health in a much broader perspective. By decreasing the stress in our community can we improve productivity and relationships as well? So we intend to measure the number of domestic abuse calls to the police station, absenteeism in our employers, and test scores in our schools.

It is a bold initiative. We are excited about it. The more people exposed to HeartMath® and the amazing benefits of stress reduction, the more this vision is beginning to take hold.

We will keep you posted as our vision unfolds….