Category Archives: interview

Paging All Millennials: How to Drive Healthcare Innovation

by Karan Chhabra

Dr. Kapil Parakh is a Johns Hopkins cardiologist and the cofounder of Health for America, a new program aiming to help young people make a difference through healthcare innovation. They run a summer program and yearlong fellowship for recent college graduates from a variety of backgrounds–though all interested in health–and are currently accepting applications (though the deadline is tomorrow!). Dr. Parakh joined us for this interview to tell us more about his organization’s unique model, and to get the word out about this opportunity.

KARAN: What motivated you to found Health for America?logo

DR. PARAKH: The main driving factor behind the vision for Health for America is to harness the power of young people to accelerate community-based innovation to battle chronic disease. According to the CDC, 133 million Americans are affected by chronic disease, accounting for more than 70% of all deaths. We know from reports by the Trust for America’s Health and the Commonwealth Fund that community-based programs targeting chronic disease could reduce disease burden and save lives while saving the system $306 billion over 10 years. Technological advances make this feasible, yet health innovation in the US remains focused on hospital-based care resulting in high costs and poor outcomes.

We have seen young leaders blaze pioneering paths in technology, and our systematic review found that they have limited opportunities to learn about innovation and entrepreneurship in domestic health field. Technology incubators like RockHealth are geared towards youth that have an idea and are looking to launch a company in months. Programs like Global Health Corps and Peace Corps are international; Health Leads offers limited volunteer opportunities while City Year and Code for America are not health focused. We designed a fresh approach that incorporates successful programs but avoids duplication.

Can you tell us about your experience designing a “startup” for heart failure patients within Johns Hopkins? How did that influence what you’re doing now at Health for America?

I am a cardiologist and the Director of Heart Failure at Johns Hopkins Bayview Medical Center. I led the creation of a program to improve the care of patients with heart failure—essentially a startup within a 240 year old institution.

Our program used Lean/Six Sigma to figure out the variance in care, we then used design thinking and brain storming techniques in partnership with IDEO to come up with solutions. Finally, we used Lean Startup to create MVPs and test these solutions. For example, we created new evidence-based order sets to help providers ensure their patients are on all the recommended therapies. We used an iterative process to come up with these order sets to meet the needs of interns and residents as well as hospitalists and cardiologists. Other interventions include the creation of an urgent clinic to address the needs of patients that were not doing well, revised patient education material and new support structures for our patients. The result was that our readmissions rates dropped substantially with better outcomes for our patients and cost savings for the hospital.

These experiences really highlighted the power of these approaches and helped shape the framework we developed at Health for America. The lessons learned helped guide our thinking in terms of the program structure and the role of fellows. We also see Health for America as a mechanism to show host institutions how they can use entrepreneurial approaches to innovate health care delivery.

What are the major differences between Health for America and a startup incubator (Y Combinator, Healthbox, etc.)?

That is a great question. Startup incubators are designed for people who have an idea, a team and need help and mentorship to launch a company. Health for America on the other hand is designed to give young leaders a deep dive into health entrepreneurship without requiring them to come in with their own idea and team. Our goal is to teach fellows the basic tools they need for health innovation and partner them with physicians, community leaders, and private sector organizations so they can experience the process of creating a health solution.

What have you and your team accomplished through Health for America up till now? What are you currently working on?

We are really amazed by the traction Health for America has gained since it was founded in 2012. We have had requests for collaboration from leading institutions from around the country. We were selected as one of 20 winners of the Case Foundation’s Finding Fearless competition out of nearly 1,200 nominations. My co-founder Madhura Bhat was selected as a 2013 SXSW Dewey Winburne Community Service Award recipient. We have been invited to numerous conferences to speak and have had hundreds of potential applicants reach out. We are now working on building upon this exciting start with the launch of our summer program with partners in Washington, DC and Lousiville, KY, which will focus on childhood asthma.

What would your ideal fellow or summer program participant look like? If a reader is interested in applying, how would you recommend they show their interest?

We are really looking for passionate changemakers from a variety of backgrounds including the fields of technology, computer science, art, design and health. You don’t have to be a pre-med or public health major and anyone with an interest in health is welcome to apply. We evaluate applications based on aptitude, creativity, integrity, teamwork and leadership and are hoping for a nice mix of applicants so that we can benefit from their diverse backgrounds and experiences. For more information, and to apply, I would encourage readers to visit our summer program’s webpage.

Karan is a first-year student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.

Follow him on Twitter @KRChhabra or subscribe to the blog.

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Helping Your Doctor Help You (Part II of II)

by Karan Chhabra

Ubel critical_decisions_cover

This is the second in a two-part interview with Dr. Peter Ubel, a physician, behavioral scientist, and author of the book Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices TogetherMissed Part I? It’s right here

KARAN: You referred to patient education earlier, not just in terms of treatment information but also the types of questions to be asking. But what about the former? Our generation is definitely comfortable using technology to look up health information, and we get a ton of information through news, magazines, and the general media. But not all of it’s good. So how do you recommend people sift through the good and bad information out there, when they’re trying to inform themselves before a visit to the doctor.

DR. UBEL: Of course, the education system should help people learn how to objectively look at things and help them when things go over their heads.

But the other thing I’d say is, print out and bring in the stuff that you see online, show it to your doctor, and let them tell you what’s right or wrong about it. Then they’ll know what you care about more than they did before, which is really valuable. Your doctor shouldn’t be threatened when you bring these materials in; they should be happy that you’re helping focus the visit on the topics you care about. If you’ve got misconceptions that are affecting the way you’re behaving, like what pills you’re taking or not taking, the doctor should be happy to have a chance to address those misconceptions.

So: print it out; bring it in.

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Helping Your Doctor Help You (Part I of II)

by Karan Chhabra

Ubel critical_decisions_cover

Dr. Peter Ubel is a physician and behavioral scientist at Duke, as well as an author and personal mentor/hero. I recently read his latest book, Critical Decisions: How You and Your Doctor Can Make the Right Medical Choices Together, and recommend it highly to anyone interested in making the right medical decisions—either as a patient or a practitioner. I spent a lot of time with the topic when I wrote my Honors thesis, but Dr. Ubel‘s book beats everything else I’ve read at dissecting the psychological and historical quirks that make decision-making such a complicated issue. In addition, it offers a lot of concrete advice on how to do the decision-making dance better.

Dr. Ubel and I had this interview to elaborate on how his book applies to the Millennial generation and our unique medical needs. Because the conversation was so chock-full of decision-making goodness, we had to split it up into two parts—the second half can be found here.

KARAN: Though I hope our readers all read your book, for those who haven’t just yet, I want to start with an example that touches on the issues it discusses. I recently got a bad ankle sprain. The following week, I went to a local orthopedic surgeon for it. He was a very old-school doctor; before even talking about treatment options at all, he was getting his stuff out to give me a cortisone shot for my ankle. I was still trying to give him my history and symptoms and I had to stop to ask what he was doing. It was a little scary; I had no desire to get a shot, and from whatever little I know, I think cortisone might’ve even hurt more than it helped. But I’m obviously not residency-trained in orthopedic surgery, so I didn’t feel right questioning his opinion. So while I have seen how the patient autonomy movement has affected the way doctors are ethically trained, which you discuss in your book, I still think there are a lot of doctors who fit the old mold. As a patient, especially a young and inexperienced patient, it’s difficult sometimes to know how to respond.

DR. UBEL: I don’t think this is an old/young issue. If anything, people tend to think their older patients are more deferential than the younger ones. Most people in their 20s are more into the “consumer” mindset than older people who grew up in the “doctor knows best” era. But when you are young, the age difference between you and the doctor is bigger, so that could make it harder to be assertive when interacting with your doctor. But patients ought to feel they can assert themselves because, even for mundane issues, any time there’s more than one way to go about it, the patient deserves to know what their alternatives are and to be a partner in the decision. So what happened to you is not the best possible medical care. Whether the doctor made the right choice, that’s one thing. But if he didn’t say “One thing we could do is this, but you should know, there are other alternative. For example, if you don’t want to get a shot, we could just give it time, etc.” If the physician didn’t speak to you that way, that’s a problem.

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