You Say You Want A (Health Care) Revolution? Create The Health System You Want To Work In

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As a child of the 1960s, I'm no stranger to revolutions. Along with many others, I advocated for civil rights and women's empowerment, and waged the War on Poverty. We endeavored to make the world more compassionate and equitable—something that every generation has the opportunity, and, I believe, the responsibility, to do.

The Jewish Healthcare Foundation (JHF) and its supporting organizations, the Pittsburgh Regional Health Initiative (PRHI) and Health Careers Futures (HCF), channel that same kind of activist energy to create what we call "the army" of the health care revolution. Through fellowship, internship, and champions programs, we have engaged more than 900 health professionals from multiple disciplines who are advocates for high-quality, error-free, and patient-focused health care. Equipped with Lean-based quality improvement training, coalition-building skills, and a grounding in systems thinking (which portrays the health care system as a complex entity consisting of many multidisciplinary, interdependent parts), they're reshaping our health system on the front lines.

But, as proud as we are of this battalion, we realize that it's not enough. Not when up to 250,000 Americans die annually from preventable medical errors. Not when we squander 30 percent or more of total health care spending because of poor care coordination, medical errors, overtreatment, and other forms of waste. Not when the US health system provides evidence-based care about half of the time. And not with health care discussions in Washington, D.C., moving glacially and taking on a combative Game of Thrones tone. We need a larger army of reform-minded leaders across the United States, one capable of making systemic change. Otherwise, our health system will continue to underperform, cannibalize the economy, and discourage health professionals who already experience higher burnout rates than workers in other fields do.

Recruiting More Revolutionaries

To fortify that army, we launched the Health Activist Network in the spring of 2017. The Health Activist Network empowers health professionals to create the health system they want to work in by accelerating health policy, as well as care delivery, improvements. Through this network, health professionals connect, collaborate, and take action with one another through an online platform, attend in-person and virtual events, learn from national health reform advisers, and receive the tools and training to lead improvements in their work settings. The PRHI manages the Health Activist Network, with funding from the DSF Charitable Foundation and the JHF.

We kicked things off in April 2017 with the first event in our speakers' series, which featured Community Catalyst Executive Director Rob Restuccia, who explained that his early-career experiences as a surgical unit orderly at a safety-net hospital motivated him to fight for expanded health coverage and consumer rights.

During the summer of 2017, Health Quality Advisors LLC President Mike Millenson was the speaker. He described how he was awakened to the US health system's inequalities and errors as a reporter and was motivated to author Demanding Medical Excellence: Doctors and Accountability for the Information Age.

This fall, Margo Wootan, vice president of nutrition for the Center for Science in the Public Interest (CSPI), offered advice on building coalitions and taking on industry groups with deep pockets and a team of lobbyists—she and the CSPI have used these strategies to empower consumers with nutritional information on food labels and in restaurants, give kids greater access to healthy foods in schools, and curb junk food advertising.

Finally, health policy and financing expert Bruce Vladeck provided his take on why the United States spends more on health care than any other developed nation, yet underperforms on population health measures. Vladeck is a former director of the Health Care Financing Administration (now called the Centers for Medicare and Medicaid Services [CMS]).

We have also had virtual events, with Health Activist Network members submitting their questions to social media savants Vineet Arora, an associate professor of medicine at the University of Chicago Medicine, and Neel Shah, an assistant professor at Harvard Medical School and director of the Delivery Decisions Initiative at Ariadne Labs. Arora and Shah are among the nationally and internationally recognized leaders who are contributing to the Health Activist Network as health reform advisers. The list also includes Stuart Altman, the Sol C. Chaikin Professor of National Health Policy, Brandeis University; Ann Hwang, director of the Center for Consumer Engagement in Health Innovation at Community Catalyst; Mike Millenson; and Bruce Vladeck.

Creating Savvy Health Activists

In the fall of 2017, we also launched a more intensive, combined fellowship/Health Activist Network program to help burgeoning health activists learn how to change perspectives, practices, and policies. More than twenty-five students and young health professionals each selected a health issue that stokes their passion, and we're providing them with training, education, and a stipend to tackle the issue at a grassroots level. The fellows are analyzing the components of past successful activist campaigns—including HIV/AIDS awareness and treatment, the Susan G. Komen Race for the Cure series, and Mothers Against Drunk Driving (MADD)—and then crafting a strategy to create their own movement.

The fellows are partnering with professionals who have backgrounds in consumer advocacy, investigative reporting, communications/public relations, and policy, as well as local organizations that work on the ground to address the fellows' selected health issues. The fellows come from a constellation of disciplines, including health care administration, education, social work, nursing, pharmacy, physical and occupational therapy, psychology, public health, public policy, health care ethics, and law.

The health issues that stoke their passion are just as varied. They're working to address challenges that include preventing and managing chronic health conditions in minority communities; improving youth health literacy; boosting access to nutritious foods in underserved neighborhoods; making technology more accessible for people with disabilities; and bridging the gap between medical and social services with community health workers.

The goal is to help activist-minded health professionals channel their concerns and frustrations in a positive manner—to move from noise to strategy and success.

Early-career health professionals may feel like a cog in a gargantuan unchangeable machine. That feeling, if left untreated, can devolve into cynicism and disillusionment. It can lead to higher rates of job turnover, and subsequently poorer care coordination and patient outcomes.

With the Health Activist Network, we want to show young professionals that they control the lever. We want to harness the passion that guided them toward the medical field in the first place and use it for real-world improvements in the communities where they work and live. If you say you want a health care revolution, we don't want to "change your head"—we want to help you make it happen.

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Sunday, May 26, 2019