Dr. Lisa Simpson, President and CEO of Academy Health

Dr. Lisa Simpson CEO of Academy Health

Mark Masselli: This is Conversations on Healthcare , I am Mark Masselli.

Margaret Flinter: And I am Margaret Flinter.

Mark Masselli: Well Margaret a rare show of agreement from lawmakers in Washington
the Senate has approved a bill that would provide $1.1 billion for research and
preparation for the zika virus. The real concern is what happens when mosquito
population makes landfall in the coming week s , so this is some good news.

Margaret Flinter: And this is largely to support research at t he National Institutes of
Health where they are hard at work to develop a vaccine along with possible treatments
for those who become infected.

Mark Masselli: So far there is no specific treatment for zika other than riding out the
virus symptoms ; rash, fevers, aches and the like , but the threat to pregnant women and
their unborn children is very real. And so far there is not a lot that women can do other
than be ing vigilant around avoiding mosquito bites , not an easy thing to do in certain
parts of this country.

Margaret Flinter: And Dr. Anthony Fauci of the National Institute of Allergy and
Infectious Disease does feel pretty confident though that there will be a workable
vaccine by the end of the year. But for now, we have to brace for mosqui to season and
provoke public health strategies that minimize the population mosquitoes and make
sure that public utilizes mosquito repellents when going outside.

Mark Masselli: It's an example of how scie nce requires diligence and rapid response,
research paradigm so that we can understand the nature of the emerging public health
threats like zika.

Margaret Flinter: And all manner of research is vital to the integrity of robust healthcare
system and toda y our guest is a researcher of another kind. Dr. Lisa Simpson is
President and CEO of AcademyHealth a nonprofit, nonpartisan think tank of
researchers analyzing health systems through the better use of data.

Mark Masselli: AcademyH ealth is taking over t he sponsorship of Health Datapalooza in
Washington, a gathering of health activists dedicated to liberating the data, she will
have much to share with us about his year’s event.

Margaret Flinter : And Lori Robertson stops by, the managing editor of FactCh eck.org ,
always on the hunt for misstatements spoken about health policy in the public domain.

Dr. Lisa Simpson CEO of Academy Health

Mark Masselli: And as always if you have comments , please email us at
[email protected] or find us on Facebook or Twitter ; we love hearing from you.
Margaret Flinter: We will get to our interview with Dr. Lisa Simpson in ju st a moment.
Mark Masselli: But first here is our producer Marianne O'Hare with this week's headline
news.

(Music)

Marianne O'Hare: I'm Marianne O'Hare with these healthcare headlines. Congress has
been acting on a number of some of the bigger threat s to population health in the
country voting to approve $1.1 billion of the President’s $1.9 billion request i n zika
battle , that money slated for accelerated research on vaccines and protections for
pregnant women w ho become infected, scientists are working feverishly to beat the
arrival of the mosquito that carries zika in the US. And the President has also asked for
$1.1 billion to launch an offensive against the opioid addiction problem claiming some
47,000 lives in 2014 alone , Whitehouse Drug Czar Michael Botticelli warning , without
additional resources many more people will die.

The number of uninsured children has dropped significantly across the country
especially in the underserved populations. According to a recent study by the Urban
Institute, the number of children eligible for coverage in CHIP or Medicaid rose to 91%
in 2014 from about 81% in 2008. About four and a half million children are still
uninsured in this country, about two - thirds of them CHI P or Medicaid eligible.

While the medical world scrambles to incorporate the game changing opportunities with
genomics government initiative leading to the mapping of the human genome back in
2008 , n ow the attention has turned to another medical frontier about which little is
known, microbiomes getting much needed infusion of support from the Obama
Administration which just pledged a $121 million to launch a microbiome project . The
bugs that inhabit a person’s body believed to have as much to do with heal th as the
genomic blueprint. The microbiome quest is also being supported by the Bill and
Melinda Gates Foundation. I am Marianne O'Hare with these healthcare headlines.

(Music)

Mark Masselli: We are speaking today with Dr. Lisa Simpson, President and CEO of
the AcademyHealth which works to improve health and performance of the health

Dr. Lisa Simpson CEO of Academy Health

system by supporting the production and use of evidence to inform policy and practice .
A pediatrician and health policy researcher, Dr. Simpson was deputy director of the
Agency for Healthcare Research and Quality from 1996 to 2002. Dr. Simpson is an
elected member of the Institutes of Medicine and has numerous awards including the
Excellence in Public Service Award from the American Academy of Pediatrics . She
earned her medical degrees at Trinity College in Dublin, Ireland and her master’s from
the University of Hawaii . Dr. Simpson , welcome to Conversations on Healthcare.

Dr. Lisa Simpson: Thank you Mark.

Mark Masselli: You know your organization has just come off an incredible , that the
seventh annual Health Datapalooza , a great gathering of data liberation champions
everywhere. You had Vice President Biden, Secretary Burwell, Todd Park , Susannah
Fox , Karen DeSalvo as well as many patient advocates were there this year promoting
goals in line with your mission at Academy H ealth which is to seek to imp r ove health and
the performance of the health system through use of data. Before we delve into the
work of the Academy we are anxious to hear about the Health Datapalooza, what were
some of the notable highlights?

Dr. Lisa Simpson: Yeah, it was pretty in credible. And I think it's going to be very hard
to top Vice President Joe Biden’s talk , i t was inspiring, moving and he really captivated
the audience and acknowledged the importance of the work of the folks in the audience
but also challenged us to do e ven more to really accelerate the pace of research and
leverage data across the silos that exists. Another highlight for me was that we
achieved the Patients Included certification so there were patients as you noted not just
in the audience but on the pa nels, on the steering committee we had a great Consumer
Shark Tank adaptation. The other thing is this year we have made a real effort to make
sure that we didn’t just talk about Medicare and private sector data but also data at the
state levels and Medic aid and CHIP. And there were a couple of panels that then very
directly took on the issues that influence health, going beyond just healthcare and
looking at social determinants and the environments and how do we bring in the data
across those sectors to help really design strategies that meet people’s needs and lives
where they are.

Margaret Flinter: You know we have always heard that an important function is to bring
IT entrepreneurs together to be hackers in some ways to hack solutions to the problems
that we have of sharing data in a timely fashion , may be you can speak just a little bit
about one or two promis i ng new initiatives that were discussed that might have the
potential for expediting and sharing this trove of health data. And I really appreciate that

Dr. Lisa Simpson CEO of Academy Health

you spoke about also getting data at the state level health and public health, primary
care, tertiary care, community health all works together.

Dr. Lisa Simpson: So I think one , certa inly brand new initiative was the one announced
by Fred Trotter who you know wrote the book Hacking Healthcare and because of his
incredible work in the states, he actually won this year’s Health Data Liberator Award
but he also released a new data set cal led Mr Pup for Medicare referring provider
utilizations but it's really important because it helps understand which provider is
referring patients to which labs and other providers . So now this open data source can
help folks understand referral patterns , may be some hotspots, getting the data out is
just the first step and then all the innovation and creativity of the broader community can
take that data and try to turn it into actual knowledge innovation that helps patients.

Another example from the meet ing was from Phil Payne who talked about a new
platform CIELO that he is developing collaboratively with AcademyHealth where you
can share data and code together for de - identified data in public spaces and also they
are developing a private space for sensi tive data. And it's specifically designed to
promote collaboration and health research and quality improvement s and health
analytics. So it's part of work that we are doing to really promote this culture of open
science and health analytics.

The last one I want to mention is that we also manage a learning community . We
abbreviate it to call it PopCop where we are bringing together leaders at the city health
department and state health department to talk with each other not about just the
trad itional sort of public health datasets or surveillance etc but to actually look at
innovations of bringing in electronic data other kinds of derivative data whether it's
patient reported outcomes or you know your Fitbit to really help enhance the core publ ic
health functions.

Mark Masselli: You know Dr. Simpson you have had a great history of research at
AHRQ back in 1996 and through the years you have seen the technologies and data
streams change, but the principles of quality research remained the same, could you
talk to our listeners about some of the research areas you are focusing on now at
AcademyHealth, how they evolved from your earlier days or quality research?

Dr. Lisa Simpson: Sure. Historically I think the research community throug hout the
country was very much focused on e ither national surveys or administrative claims data
transactional data. But now we are seeing the opportunity to complement that and
expand it dramatically with other types of data whether it's from electronic h ealth
records or the quantified self and really trying to bring that in so that we have an

Dr. Lisa Simpson CEO of Academy Health

understanding that’s much more in real time. Our goal is really to work with our
members and the community to accelerate everybody’s ability to use these new data
a nd to learn from each other because this is new and complicated , a nd it's really
important to share not just the bright spots and the successes but also the setbacks . So
one the projects that we have right now is working with the Office of the National
Co ordinator, The Community Health Peer Learning Program and that’s looking at data
across sectors. We have 10 geographic communities and 5 subject matter expert
communities all coming together to look at different aspects of population health.

Another init i ative that we have the Electronic Data Methods forum has provided small
grants to researchers to look at such issues as the development of eCQM or Electronic
Clinical Quality Measures again moving from a sort of nonintegrated you know layered
on top quali ty performance measurement enterprise to really seeing quality measures
become a byproduct of clinical workflow.

And then the last example I would like to give you is something that we do a lot of , and
it's really called the Research on Research , and by t hat I mean we look at patterns,
trends and future needs of the field. For example, we manage a dataset for the
National Library of Medicine called HS R Proj which tracks all health services research
funded by over 250 public and private sector organizations . One of the most recent
ones we did looked at disparities research and how has that research as a field
changed over time. In the early part of this past decade, a lot of the research that was
funded was looking at documenting disparities but as the dec ade moved on , we saw
more and more studies addressing, well what do we do about it? The proportion that’s
looking at interventions has actually gone up by 90%. Health services research a
significant portion of it is sort of backward looking and explanato ry which is critical but
increasingly we have got to have interventional and evaluative answer s to this sort of,
well, what works? I look at various aspects of child health care and the last year we
published a study on pediatric hospitalization s for beha vioral health issues, we are just
about have one come out on oral health which is a big big issue particularly for children
on Medicaid and next year we are going to look at re - hospitalizations for children.

Margaret Flinter: Well this is very e xciting in that at AcademyHealth you are looking at
everything from social determinants, organizational structures, technologies, financing
cost, health polic i es all these things that affect health outcomes. But they also have to
affect care delivery syst ems, maybe you could share with our listeners a little bit about
how this work is actually impacting high quality care delivery system.

Dr. Lisa Simpson: We are seeing incredible advances. And in fact I would like to point
you to new journal that we lau nched three years ago as part of our work in the

Dr. Lisa Simpson CEO of Academy Health

Electronic Data Methods forum . It's called eGEMS and it's peer - reviewed and open
access around all these new datasets because we realized that we need to sort of learn
how to learn again and how to use thes e new datasets. And so there a number of
different papers in there , so it's really sort of taking grounded clinical issues and then
saying, well in this new world how do we do this? The other thing that we are seeing is
that more and more delivery system s are saying we need more in - house capability, a
really well - trained researchers but who are really jaz zed [PH] about doing work about
care delivery to day . And so we partnered coming out of the group that we founded
several years ago called the Health Ser vices Research Learning Consortium, we
established the Delivery System Science Fellowship. And this fellowship is a
partnership with 10 leading delivery systems around the country, Mayo, Intermountain
Healthcare, Geisinger , DVA and several others do a nat ional recruitment for really well
qualified health services researchers who then gets selected for one of those delivery
systems and then go work as embedded researchers because this allows them an
opportunity to the trove of data that really exists now in delivery systems settings. We
gather online and we also get them altogether at our annual research meeting , a nd I
think it's really important to sort of start breaking down the silos not just of data but the
silos that have existed between academia and d elivery.

Mark Masselli: We are speaking today with Dr. Lisa Simpson, President and CEO of
AcademyHealth, a national organization serving the needs of health services and policy
research. We were struck by something that Farzad Mostashari said at the Health
Datapalooza that was pretty telling he noted that seven years ago almost no one heard
about electronic health records and you know in so many ways we have come so far
and could you talk about how outcome data, data from electronic healt h records
relatively new tools for research are enhancing your ability to conduct more in - depth
research.

Dr. Lisa Simpson: It's a whole new world. And of course the research community is
adapting and evolving because they are using not just existing robust methods but
developing all kinds of new methods to use these new data streams. But the real
beauty and power of them is the i ncredible richness of clinical details that’s now
available that was never available from the more traditional claims data. So by bringing
in the really rich granular clinical data you can start understanding not just the average
of a population subset bu t really start creating much more specific in - depth PHYNO
[ PH ] types for smaller groups of patient using all the data points to create much more
specific PHYNO types subtypes of patients you are helping to develop predicted
analytics and prospective care m anagement plans that are much more tailored to
individual patients.

Dr. Lisa Simpson CEO of Academy Health

Margaret Flinter: Well Dr. Simpson you are overseeing research in so many of these
big impactful areas certainly CHIP, the Children’s Health Insurance Program, Medicaid,
payment reforms, anything else you would like to say about some of these initiatives
that you are overseeing and the partnerships that you have forged [PH] in order to be
able to address them.

Dr. Lisa Simpson: I am glad you brought up the point partnerships Margaret,
p artnership with our members or organizations who share a passion for improving
health as we do. I earlier had mentioned our ONC work, it's really fascinating , we are
working with these communities to help identify data solutions and really disseminate
edu cational and other resources to support progress on population health. You
mentioned CHIP and Medicaid, so we are delighted for example to have two state
focused networks that we work with in partnership. One of them is the network of
Medicaid medical di rectors and these are the senior most clinicians in each state
Medicaid program. We have worked with them on projects ranging from early elective
deliveries and re - hospitalizations they are tackling high priority issues that they see in
their populations. And you mentioned payment reform, well we are just starting a
project to look at that intersection of payment reform and population health you know
everybody is talking about this move to value not volume that’s easy to say, how do you
actually do that o n the ground to trying to bring the innovation together and then get that
information out to more folks more quickly.

Mark Masselli: Dr. Simpson a big part of the work that you do at AcademyHealth is to
provide nonpartisan analysis of the effectiveness of these health policies and how they
impacted the health as well as the health systems around the country , I am wondering if
you could tell our listeners a little bi t about some of your findings in that area but also
how are you all organize, how are you supported?

Dr. Lisa Simpson: One of the ways we maintain our n eutral brand in Washington
because it can get pretty heated at times you know we have an advocacy role but it's
quite limited. We advocate for science policy but it's about policies related to funding for
research, funding for data and then for the freedom of both at research and data. And
so we don’t weigh in with opinions or taking sides on things like the Affordable Care Act
or MACRA and that allows us to stay focused on the science policy. So we facilitate
their conversation s by bringing the evidence forward. About 18 months ago some
members, some staff in Congress were looking at legislation they w ere drafting on value
based insurance design . And we said, well we have a number of experts in our
membership who have done tremendous studies on this , a nd so we brought them to
Washington and had a you know small closed - door congressional staff conversat ion so
that they could hear directly from the experts at Harvard and elsewhere who are doing

Dr. Lisa Simpson CEO of Academy Health

work on values based insurance design. We do that also with the executive branch.
We just did a workshop yesterday on price transparency bringing in six grantees at the
Robert Wood Johnson Foundation to look at different dimensions of price transparency
to be in a room with seniors leaders in the executive branch to talk about, well what are
we learning about this, when does it work, what are the challenges, reall y making sure
that evidence is part of the policy conversation.

Margaret Flinter: We have been speaking today with Dr. Lisa Simpson, President and
CEO of AcademyHealth serving the needs of health services and policy research
through the better use of dat a. You can learn more about their work by going to
academyhealth.org or follow them on Twitter @AcademyHealth. Dr. Simpson, thank
you so much for joining us today on Conversations on Healthcare.

Dr. Lisa Simpson: Thank you Margaret and Mark, it was a r eal pleasure.

(Music)

Mark Masselli: At Conversations on Healthcare , we want our audience to be truly in the
know when it comes to the facts about healthcare reform and policy. Lori Robertson is
an award - winning journalist and managing editor of FactCheck.org , a nonpartisan,
nonprofit consumer advocate for voters that aim to reduce the level of deception in US
politics. Lori what have you got for us this week?

Lori Robertson: Well the zika virus is still in the news as Congress considers President
Obama’s $1.9 billion request for emergency funds to combat the virus . We found
misleading claims in some senators’ statements in favor it , Sen ator Heidi Heitkamp from
North Dakota said , z ika will be everywhere in the United States . Senator Marco Rubio
similarly said, i t can be in any state in the country . Health exp erts proj ect local clusters
of z ika cases in some states not widespread transmission. There are now 45 countries
and territories worldwide with active z ika transmission according to the C enters for
Disease C ontrol and Prevention. Scientists believe z ika spreads in three ways : through
mosquito bites, via sexual contact with a male, or from mother to child during
pregnancy. Why won't it spread widely in the US? Tom Frieden head of the CDC has
said that zika primarily spreads through the bite of certai n mosquitoes in places that
don’t have air - conditioning or screens. Denise Jamieson, chief of the women’s health
and fertility branch of the CDC also has said, that experience with other diseases
carried by the same mosquitoes shows that the continental U S would likely to see a
small number of cases .

Dr. Lisa Simpson CEO of Academy Health

The CDC provides maps for the estimated ranges of the mosquitoes that can transmit
zika showing that the mosquitoes primarily thrive in the southern states and Puerto
Rico . In order for an outbreak to occur , says the CDC, People infected with z ika must
enter the US and the mosquitoes that transmit the virus must bite an infected person
during the first week of infection , and then infected mosquito must live long enough for
the virus to multiply and for it to bite another person . Public health officials don’t believe
it will be everywhere in the United States of America . The CDC reported 658 locally
acquired cases in US territories primarily Puerto Rico . The continental US has seen
zero locally acquired cases and 472 travel related ones , a nd that’s my fact check for this
week, I am Lori Robertson managing editor of FactCheck.org.

Margaret Flinter: FactCheck.org is committed to factual accuracy from the country's
major political pla yers and is a project of the Annenberg Public Policy Center at the
University of Pennsylvania. If you have a fact, that you would like checked, email us at
www.chcradio.com . We will have FactCheck.org's Lori Robertson check it out for you
here on Conversations on Healthcare.

(Music)

Margaret Flinter : Each week Conversations highlights a bright idea about how to make
wellness a part of our communities and everyday lives. Each year more than 1 million
babies die at birth and another 3 million die within the first few weeks of life, often from
prevent able causes , a nd when babies are born prematurely the risks escalate.
Newborns and particular ly preemies have a considerable amount of difficulty regulating
their own body temperature and without access to incubators babies in the Third World
often succumb to hypothermia , t hat got former Stanford MBA student Jane Ch e n
thinking, how do we develop a low - cost solution to the problem?

Jane Ch e n: My team and I realized what was needed was a local solution , s omething
that could work without electricity t hat was simple enough for a mother or a midwife to
use. We needed something that was portable, something that could be sterilized and
be used across multiple babies and something ultra low - cost compared to the $ 20,000
that an incubator in the US costs.

M argaret Flinter: Speaking at a recent Ted Talk, Ch e n said that they developed a
cocoon like device called simply Embrace , a thermal body wrap that encases the baby
and helps regulate body temperature for up to 6 hours.

Jane Ch e n: It looks like a small s leeping bag for a baby , i t’s waterproof , t here is no
se a ms inside so you can sterilize it very easily b ut the magic is in this pouch of wax.
This is a phase change material. It’s a wax - like substance with the melting point of

Dr. Lisa Simpson CEO of Academy Health

human body temperature , 37 degrees Celsius. You can melt this simply using hot water
and then when it melts , it’s able to maintain one constant temperature for 4 to 6 hours at
a time after which you simply reheat the pouch, and it creates a warm micro
environment for the baby.

Margaret Flinter: And Ch e n and her developers have managed to keep the cost of the
Embrace baby warmer at around $ 25 per unit. Since launching the product in 2010,
they estimate that over 150,000 babies’ lives may have been saved with the device
which i s easy to sterilize and design ed for multiple uses. The Embrace infant w armer
has earned numerous international awards for design and efficacy, a low cost, high
tech , portable temperature regulator, designed to regulate preemie ’s body temperatures
to ensu re that they not only survive premature birth but ultimately thrive as well. Now
that’s a bright idea.

(Music)

Margaret Flinter: This is Conversations on Healthcare, I am Margaret Flinter.

Mark Masselli: And I am Mark Masselli, peace and health.

Con versations on Healthcare, broadcast from the campus of WESU at Wesleyan
University, streaming live at www.wesufm.org and brought to you by the Community
Health Center.