All of Your Health Information Is Now a Right Not a Privilege – ONC Head Tells Us More

Micky Tripathi

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Marianne O’Hare : Welcome to Conversations on Health Care. This week we
welcome Micky Tripathi , National Coordinator for Health IT at
the Department of Health and Human Services on a new era
for patients who can now digitally access and control all of
their health data .

Dr . Micky Tripathi So that’s what they have and that’s what the, all of these rules
build upon is the patient’s ability to express their right of
access to say I want all of my records.

Marianne O’Hare : Lori Robertson joins us from Fa ctCheck.org and we end with a
bright idea improving health and wellbeing in everyday lives.
Now, here are your hosts, Mark Ma s selli and Margaret Flinter.

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Mark Masselli: You may not have known it but October 6 of this year was
Liberation Day. That ’s Data Liberation Day because that was
the day Americans officially had full access to their health
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data, starting on October 6 health care organizations were
legally required to give patients unrestricted access to their
full health records in digital format.

Margaret Flinter: J oining us today is to talk about these new rules and other
health IT and innovation issues is Micky Tripathi. He is the
National Coordinator for Health IT at the U.S. Department of
Health and Human Services.

Mark Masselli: Well, welcome , Micky to Conversations on Health Care .

Micky Tripathi: Thank you . Thanks for the opportunity to be here .
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Mark Masselli: You know these are new F ederal rules passed under the 21
Century Cures Act and as we know other government
mandates and reall y billions of tax dollars have pushed
forward the use of electronic health records, but on October
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6 , patients really got access to what they wanted. Can you
tell us more that?
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Micky Tripathi: Yeah, the 21 Century Cures Act which was passed in 2016,
yo u know so it’s passed a long time ago, that was signed by
President Obama that gives you a sense of how long ago it was
perhaps with very strong bipartisa n support, you know 98
senators, I think in an equal sort of a proportion on the house
side support an d of course Vice President Biden was you know
very involved in it as well. And the rules that implemented the
one piece that you’re referring to which is related to what’s
called the information blocking, actually went into effect on

Micky Tripathi

th
April 5 , 2021. So th at was the date when provider
organizations, certified technology developers and what are
called health information networks were required to make
available all electronically accessible information to not only
patients but to other authorized parties. So, provider - to -
provider exchange for example or to a payer or to a public
health agency.
th th
The reason October 6 is really important is that on April 5 of
last year was when the rule went into effect and it said
everyone needs to start doing this. But what we did is we said,
let’s phase this a little bit, because we know it’s complicated.
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And so with the 1 Phase, what we said is, what you are
required to minimally make available was kind of a minimum
data set that we call the U.S. Core Data for Interoperab ility .
And for those who feel like you don’t know what that is, I
assure you, you pretty much know what that is, because
whenever you log into a patient portal, what you are actually
seeing is basically defined by ONC regulations.

Then what we said is we w ill give the industry 18 months to
adjust to this. But then 18 months later, and that was October
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6 , it opened up to what’s called Electronic Health Information
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which is what the 21 Century Cures Act called all
electronically accessible information.

So I think as you said, it basically is all of your digital
information that’s required to be made available. That’s you
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know basically the importance of October 6 . It really is a
milestone day for sure.

Margaret Flinter: You know patients are often afraid and anxious I t hink about
their health records, I don’t think they felt they had much
access to them back in the old days of paper records, either.
But that such important information and you know it may
impact whether they feel like they can change provi ders, if
they don’t know whether they can transfer medical records
easily. Do you think this really opens up more options for
patients to kind of t ake control of their healthcare, to switch
providers or specialists or hospitals if they want to and what
do we know from early experience about patient’s willingness
to engage in this process?

Micky Tripathi: Yeah, I mean it’s still very early. You know people aren’t really
used to having this kind of access to their information in
healthcare. You know we are a paper based world, people are
just starting to get used to patient portals for example. And
now as we start to move into the area of APIs as they are
called Application Program Interfaces, you have more A pps

Micky Tripathi

that are developing that you know allow people t o download
their records and bring them into their own hands, like the
Apple Health Record for example.

But I think that is the sort of the hope, is that what th is allows
is a couple of things, one is that patients have the opportunity
to be more directly involved in their care and one of the
choices, they also want to be able to make and this affords
them more the flexibility to do that, is to move from provider
to provider for example, to not be tied to well I am going to
stay here, because they have my r ecords. This allows them the
opportunity to do that.

But I will point out that all of our other rules do require that
providers make that information available, provider to
provider. And so that’s a part of information blocking, is it if a
patient says, I want to go over here to your competitor across
town, that provider who you know you’re leaving is under
information blocking, they would be, you know that would be
an information blocking violation for them to prevent that
information for pulling to the ot her provider even if the
patient wasn’t in the middle of it.

Mark Masselli: You know Micky, I want to go back to your first answer where
it seemed to me that there was a lot of intentionality in the
design of the roll out here, gave everybody in the hospit al and
group practice area 18 months to sort of get ready, but I
understand that some of those hospitals and practice groups
are really pushing back and they are saying they need special
consideration for their infrastructure not being ready for this
new r eality. How is ONC assisting these entities?

Micky Tripathi: Yeah, so first off, we certainly appreciate, you know, the
concerns that they -- that they gave a nd we talked to those
organizations on a regular basis. So, in terms of change being
really hard, if you're a complex hospital system this isn't just
about the information that's in your electronic health record
system ; in a complex, in a hospital system, you have what's in
the electronic health record, but they have all sorts of other
systems that liv e outside of electronic health record systems,
some of which they may have bought, like 10 years ago. And it
was never designed to make information available to like a
patient coming in knocking on the door, saying, “ I'd like that
information. ”

And so the provider organization does need to deal with not
only E pic or Cerner or C linical W orks and what they're able to
make available. But now all of a sudden, it's like, well, that
chemo dosing system that live outside of their systems, for

Micky Tripathi

example, now they hav e to figure out, alright, how will that
information be made available .

Mark Masselli: R emote monitoring devices at home .

Micky Tripathi: A bsolutely , right , a ll of those things could now , you know, are
now required to be made available as long as this i s a part of
what's defin ed as EHI . But I will say that this change has been
coming for a long time, President Obama signed the law in
2016 and we --

Mark Masselli: He has got grey hair now.

Micky Tripathi: Right exactly yeah. And it got delayed like two or thr ee times
due to the pandemic, because we don't have the kind of
interoperability that this rule is designed to direct upon. So at
that point, we just said, y ou know what, we all have to move
forward at this point. We appreciate change i s hard, but now
we a ll just need to get on with it

Margaret Flinter: Well, I was thinking, as you were saying that on a much
smaller scale, remember the ICD - 9 code to ICD - 10 .

Micky Tripathi: Oh yeah.

Margaret Flinter: And I think people ask ed for as many extensions to do that , as
they have and it is just kind of the way it eventually –

Micky Tripathi: That’s understandable.

Margaret Flinter: Of all the concerns that I would suspect we would hear i s the
question from the patient s themselves or the consumers, if
you will about “ well, how are you protecting my personal
medical records from landing where they ought not
led ?”P eople want their providers to have they want
themselves to have them , e verybody's familiar with signing
electronically or with a pen , the HIPPA releases and wh o can
have their records , b ut in this scenario, do you think patients
will continue to feel that they actually own their own health
data? Talk to us a little bit about that . And I wonder about new
concerns about privacy of health records .

Micky Tripathi: Y eah, well, how much time do we have Margaret ? So it's a
huge, huge area that you're putting your finger on here. And
one is just to clarify for everyone that in the United States, you
actually don't own your medical record as an individual. So the
idea of controlling it , you actually don't have the ability to fully
control it. And that's just an artifact of the way we have built
our medical, you know, legal medical record system. P rovider
organizations own the medical record itself, except in one

Micky Tripathi

state, New Hampshire, where the patient does own their
medical record. But one very important thing that patients
have in the United States is they have a right of access to their
records and t hat's what HIPAA grants them, a right of access
to be able to show up at any provider organization, and say, “ I
want all of my records. ” S o that's what they have. And that's
what you know, the all of these rules build upon is the
patient's ability to express that right of access to say I want all
of my records.

One of the thing s that I think from a privacy perspective,
patients need to be very cognizant of is that HIPAA doesn't
protect data outside of the stewardship of organizations that
are regulated by HIPAA. So when your medical record
information is in the hands of a hospit al or a doctor or a health
insurer, HIPAA absolutely covers that information. Alright,
they're not allowed to sell the data, they're not allowed to
make it available to others in an identified form without
permission from the patient, you know, all of thos e things. But
the minute that that information is in your hands as a patient,
meaning you have downloaded that re cord onto your phone,
let's say, that's now your responsibility and HIPAA no longer
protects that.

So one of the things I like to keep remindin g everyone and
patients in particular, is you need to be extra vigilant, if you
decide to download that information that's now available to
you, and have it in your hands. And the thing that worries me
is that Margaret or Mark , I'm going to guess that anyt ime you
download an A pp on your phone, you will say, Okay, let's open
the A pp and when it presents to you those user agreements ,
you click through it like ah, j ust y es, yes, yes, yes, yes, fine, just
get me to the A pp, right? That's fine. I mean, do whatev er you
want in every other walk of life, but with your health
information, don't do that. Pay close attention to what those
privacy rules say , b ecause that user agreement could literally
say, we're just going to take your data and sell it in an
identified for u m and because that's no longer protected by
HIPAA, there is nothing against the law.

So that's where the responsibility needs to come in. And just
sorry, the last point is that if a patient is concerned about that,
then what they can do is they can use the A pp that's provided
to them by their provider, for example, like the M y C hart A pp
or a H ealow A pp or A pps that are provided by the provider.
Because if it's provided to you by your provider, it is covered
by HIPAA, even though it's on your phone, you m ay not realize
that it's actually not data on your phone and it's still protected

Micky Tripathi

by HIPAA. And so that's what I would say is that people just
need to be very vigilant about taking data into their own
h ands .

Mark Masselli: I want to sort of pull the thread health data are now among
the most hacked data in the world . And I’m wondering how do
we protect our health information, if more of it is going out to
all of us? And then there's the other side of HIPAA patient
information standards , a re they up to the ta sk in this new era
or do they need to be re - imagined as we think about the
issues around security?

Micky Tripathi: Yeah, so as you point out , if a HIPAA regulated entity, like a
hospital or like a health insurer or a doctor's office, is required
to follow the HIPAA Privacy Rule and the HIPAA Security Rule,
which has all sorts of provisions in there for processes that
you're required to have in place fo r encryption of data, for
multi factor authentication, for any of those systems that we
know, those aren't p erfect, right, we all hear about the
hacking into different healthcare organizations. But even with
that they at least have the requirements related to the HIPAA
Security Rule, which provides a pretty robust set of things that
they're required to do.

Once your data is in the hands of just a vendor that is not
covered by HIPAA, they're not required to follow the HIPAA
Security Rule or the HIPAA Privacy Rule, because they're not
governed by HIPAA. And so that's again the area where we
need to have patient edu cation right now and patient
diligence and vigilance, diligence and vigilance around this,
which is to say, when you have that A pp, there are many
responsible companies who are looking really innovatively and
creatively at developing services that can bene fit fro m being
able to take their data, to help them better manage diabetes,
for example, or to help them with mental health or help them
with management of pregnancy, for example, there are lots of
great A pps out there , but the responsibility is now on yo u to
say --

Mark Masselli: But we're still seeing these big hospitals being hacked all the
time. And so are your security standards up to par in terms of
the ever evolving cyber attacks that are going on?

Micky Tripathi: I think, you know, there's certainl y more that , there's certainly
more that can be done always. And the department is
certainly looking at cyber security at large as well as
specifically in the healthcare sector. But in general, I think one
of the challenges that we all have is that cyber s ecurity is
about people , process, and technology . T he vast majority of

Micky Tripathi

hacking events happen how through emails, phishing, right?

And so that's a bit of a challen ge that you know, that it's not,
it’s not as if you can put a single technology into place , yo u got
to be working all three of those angles to say that's how we
have this kind of cyber security

Margaret Flinter: Well, Micky , I think you are in an incredible position to
continue to move the needle forward on how electronic health
information works t o make things better for us. And certainly
experts have said that one of the ways in which we found we
were not well served during the pandemic was the fact that
most health systems couldn't access data to spot Coronavirus
trends. Are you in the administra tion targeting this as an area
that you can learn from to God forbid we need it in the future
for another pandemic or just to make things better in
health care going forward?

Micky Tripathi: Yeah, absolutely. We are s o we at ONC are doing a huge
amount of w ork with the CDC, on the Data M odernization
Initiative for anyone's interested if you look at, you know, just
Google Data Modernization Initiative, you'll come to the CDC
website, which is , you know, really rethinking the way we
think about the availabilit y of data through the public health
data ecosystem, figuring out how we use C loud infrastructure,
to have much more efficient and effective mobilization of data
for public health needs, that still protects sort of the privacy of
the data from an individual level , as well as from a state level,
because I think one of the things that we need to recognize in
the U . S . is that public health just by the U . S . Constitution is
actually a S tate authority. It's a 10th Amendment of the
Constitution. It's one of the res erve powers that S tates have,
which is public health.

So we're dealing with you know, 50, really 64 types of
jurisdictions across the country. And so what we're working on
with the CDC is how do you create infrastructure that can
make that more efficient, right . We have lots of C loud
ca pabilities, I mean, you think about the you know what
Netflix does on a day - to - day basis, right , using cloud
infrastructure to make movies available to people all over the
world, how do we take those kinds of technologies and say we
can do that with public health that still allows every S tate to
have the control that they want and need over their data
according to their S tate laws and their S tate cultures and
conventions, but allows us all to benefit from sharing of
infrastruc ture and more interoperability across the system .

Mark Masselli: You know, Micky we've had several of your predecessors on

Micky Tripathi

the show from the early days of the push fo r electronic health
information, Dr. Farzad Mostashari and Aneesh Chopra. And
they talked to us when the notion of easy flow of digital health
data was just an aspirational goal. Maybe you can share with
us what are some of the most dramatic advances to happen
since that time and what do you see is on the horizon? Are we
going to be in the M eta verse with health data at some point?

Micky Tripathi: Yeah, my simple mind has a hard time getting up to the level
of the M etaverse , I’m thinking about how that's going to affect
not only my life, but healthcare. But one of the things that I'm
most excited about in taking this role at this time, is that I'm
able to, you know, build on the great work that Farzad and
Aneesh and Karen DeSalvo and Don Rucker and all my
predecessors did in laying the foundation, right, because it was
a ton of hard work , $40 bill ion in public investment, an equal
amount I’m sure on the private side, and then the sweat
equity of providers and health IT developers getting all these
systems in place, to the point that now we have 97% of
hospitals and over 90% of a mbulatory offices on C ertified
E lectronic H ealth R ecord systems, right. That's a huge
accomplishment in a relatively short time, and it took a ton of
work to get that in place.

Now I have the opportunity to say that's all in place. Now, how
do we think about what it is we wan t to do? So to answer your
question Mark directly, what are the things that you know
already we're able to do? If you think about interoperability,
for example, a lot of people don't appreciate that a lot of
interoperability actually happens today. So the Care of Quality
Network that now exchanges allows exchange of information
across health IT, you know, different EHR vendors, while not
perfect and while it doesn't cover, you know, all of the
hospitals in the country, it covers something like 70% of
hospit als and a large number of ambulatory positions. They do
50 million transactions per day, healthcare transactions per
day. And just to give you a benchmark, the global banking
network Swift, that a lot of us have heard about because of
the Russia - Ukraine cr isis . Swift does 41 million per day.

So just as , and Care Quality alone, doing 50 million that
doesn't even include what E pic does within E pic ’ s own
network care everywhere. And what Commonweal th does
within its own network. So it’s a lot of that baseline
interoperability that's happening today, which is great . Yes we
weren't able to get a lot of data that we want ed to be able to
get during the pandemic. But the information that we were
able to get, for example, on COVID vaccination rates, for

Micky Tripathi

example, all of those things, the immunization registries that ’s
hell of a data, the only way they got that data was from feeds
from EHR systems, right. That's how they got that data , HL7v2
feeds in the background that were pushing that data into
those systems. S o the re's a lot of interoperability that's
happening. But it's not merely good enough, right, we don't
have the kind of interoperability that we want to be able to
have for public health, to have payers be able to have the
interoperability they want , for indivi duals. And I'll just give one
small example , h ere, I am helping my mother who broke her
hip about a month and a half ago -- a nd we're going from
hospital to rehab a mile down the road from each other. They
exchange patients, you know, 10 gazillion times a year, they're
both on very good EHR systems. And right in front of me, they
are printing records out and handing them to the ambulance
driver. And then at the rehab hospital, they're s canning them
in even though they're both on EHRs a nd they're both
connec ted in the back. I know they are. So I’m just like you're
killing me here , y ou're doing this right in front of me.

Margaret Flinter: As your mother is saying, what about me? What about me?

Micky Tripathi: You’re right, exactly. So there's a lot more work t o do. So I
don't want to pretend there isn't. There's a lot more work to
do in interoperability, but a lot is already happening .

Mark Masselli: Hope your mom is doing better.

Margaret Flinter: Absolutely.

Micky Tripathi: Yes.

Mark Masselli: I hope you’re a lso handing a note to both of the CEOs of the
organization, telling that story it’s like oh! my G od, your mom
is saying, “I thought you solved this problem, son.”

Margaret Flinter: Exactly.

Micky Tripathi: Like your life’s work and you know we’re still doi ng this, yeah.
Well it was funny because I was talking to one of the vendors,
you know, I was talking to and I just sort of explained that it
was like, wait a minute, and then he called his account
manager, he is like the National Coordinator is in your
ho spital –

Mark Masselli: Like literary it gets down to what you said, you got the
technology, the processes, but the people sometimes just
don’t –

Micky Tripathi: Right, exactly. Yeah and the vendor is like they are connected,

Micky Tripathi

I don’t know why the front desk people don’t realize that they
are connected, you know, that’s the issue, it’s complicated.

Margaret Flinter: Well, there's one issue I'd really like you to comment on.
Health Equity is such a compelling issue for all of us in
healthcare now, and I unders tand your office has just made an
announcement regarding He alth IT E quity. So please fill us and
our audience o n this.

Micky Tripathi: Yeah, sure. So we, you know, we were doing a lot of work in
what we t hink of a s H ealth E quity by design. So, you know,
ba sically the idea is that just in the same way that we think
about privacy by design, safety by design and software
development and in business process, we think that H ealth
E quity ought to be sort of a core design consideration as well.
So thinking first a bout the data as it relates to having social
determinants of health data and other data like sexual
orientation, gender identity, included in the U .S. C ore D ata for
I nteroperability, which is that basic data that needs to be
exchanged, as well as adding additional data elements related
to functional status, for example, disability, and cognitive
status, for example, as you know, other categories of data that
were really important to H ealth E quity, because that has to
start with those pieces . A nd then we hav e some leap awards,
you know, some innovation grants that, that we've just
a warded that help us, you know, move further to, you know,
think about different ways that we can have, you know, better
use of Health Equity and Health Equity related information,
and more fundamental thinking of how do we bake Health
Equity into everything that we do.

So, you know, we're really excited about having that be a part
of the way that people design and think about systems moving
forward, as well as being able to have inn ovation grants to
help people sort of leap forward to the best technologies to
help us move ahead, which is hopefully something that
everyone then will follow.

Mark Masselli: Micky , Margaret, and I want to thank you for joining us today.
Thank you for the knowledge and energy, passion, and
professionalism that you bring to your job. And we want to
thank our audience for being here. You can learn more about
Conversations on Health Care and sign up for our email
updates at www.chcradio.com . Thanks again .

Micky Tripathi: Thank you , I enjoyed it .

Mark Masselli: Really appreciate it .

Micky Tripathi

[Music]

Mark Masselli: At Conversations on Health Care, we want our audience to be
truly in the know when it comes to the facts about health ca re
reform and policy. Lori Robertson is an award winning
journalist and Managing Editor of FactCheck.org, a
nonpartisan , non - profit, consumer advocate for voters that
aim to reduce the level of deception in U . S . politics. Lori, what
have you got for us thi s week?

Lori Robertson: President Joe Biden boasted of a decrease in premiums for
Medicare Part B as the first reduction in more than a decade.
That's true, but he neglected to mention the drop follows a
large increase the prior year, partly due to anticip ated
Alzheimer's drug expenses, which didn't actually materialize.
The seesawing premiums have seniors paying $5.20 cents less
per month for 2023 than they're paying this year, but $16.40
more compared with 2021.

In a September 27 speech, Biden touted prov isions in the
I nflation Reduction Act that will lower prescription drug costs
for some Medicare beneficiaries. The President added that
there was more good news for seniors with Medicare Part B,
which covers physician and outpatient services, “T he
Departme nt of Health and Human Services announced that
the premium for Part B will in fact decrease this year. For years
that fee has gone up. Now for the first time in more than a
decade, it's going to go down .”

I t's technically true. Part B premiums will go down for 2023.
And it's the first time that has happened since 2012. But
there's more to the story. Last year, the Centers for Medicare
and Medicaid Services announced that the monthly Part B
premium would be going up by $21.60. CMS explained that it
was partl y due to COVID 19 expenses and a pandemic related
limit to premium increases the prior year. It also noted
uncertainty around potential Medicare spending on
Alzheimer's drugs, specifically Aduhelm . These types of
physician administered drugs are covered un der Part B, not
Part D, which covers pharmacy prescriptions.

The drug had been approved by the Food and Drug
Administration in June 2021 t hrough an accelerated approval
process that was criticized by health experts. At the time the
drug was supposed to cos t $56,000 a year. Several months
later, the drug ’ s manufacturer dropped the price by about
half. Then in January of this year, CMS proposed that Medicare
cover Aduhelm only for seniors in clinical trials, citing
questions about whether the drugs benefits o utweigh the

Micky Tripathi

risks. CMS said that lower than expected expenses on
Aduhelm and other services caused excess reserves for Part B.
It announced the monthly premium for next year would be
$164.90 o r about five bucks less than seniors are paying this
year.

And t hat's my fact check for this week. I'm Laurie Robertson
Managing Editor of factcheck.org .

Margaret Flinter: FactCheck.org is committed to factual accuracy from the
country’s major political players and is a project of the
Annenberg Public Policy Center at the University of
Pennsylvania. If you have a fact that you’d like check, email us
at www.chc.radio.com . We’ll have FactCheck.org’s Lori
Robertson check it out for you here on Conversations on Health Care.

[Music]

M argaret Flinter: Each week Conversations highlights a bright idea about how to
make wellness a part of our communities and everyday lives.
Louisville, Kentucky has consistently been on a T op 20 list of
U.S. cities you don't want to live in if you have a lu ng disorder .
S urrounded by the nation's leading rubber manufacturing
entities and nestled in the Ohio River Valley, t his is a city that
has grappled with pollution. Several years ago, the city's newly
hired Chief of Innovation made a decision to tackle the issue.

Ted Smith: I wondered if there was something we might be able to do ,
new and different. Maybe the risk is concentrated in certain
places a nd if we knew where the risk was concentrated, if that
were true, maybe there would be something we could do
a bout it.

Margaret Flinter: And through his work in public health research , Ted Smith had
learned of a tech enabled smart inhaler that when synced to a
person's phone, acted like a GPS for whenever that person
needed to use their rescue inhalers .

Ted Smith: E ssentially to put a GPS transponder on top of your inhaled
medication so that when you took a puff of your medication, it
would take a snapshot of what time it was and where you
were. And that kind of real - time monitoring of asthma events,
especially those rescue inhaler attacks, is really high value
signal, and you're capturing it in real - time.

Margaret Flinter: Smith dubbed the program AIR Louisville and tracked 1100
participants over the course of a year. He said they were able
to chart environmental tr iggers in any given area where an
asthma attack occurred and chart rea l- time data on the

Micky Tripathi

conditions and the location, giving them some great public
health epidemiology data.

Ted Smith: We ended up with a very high sp ecial resolution map of the
burden of asthma in Louisville, Kentucky and then that led us
to explore where those little micro areas are that are
problematic and what we might be able to do about it.

Margaret Flinter: More importantly, the smart inhalers gave users a feedback
loop of information which allowed them to better manage
their exposure to known asthma triggers.

Ted Smith: One part of the use of the technology is the surveillance. But
another part of the technology is the feedback loop to the user
who learns how poorly controlled or not t heir asthma is or
how adherent they are with the medication they're supposed
to be taking daily. And there is an immediate effect, people
end up getting better control of their respiratory disease .

Margaret Flinter: R eliance on emergency inhalers dropped 7 8% among
participants and the city was now armed with data that could
help them devise pollution mitigation strategies .

Ted Smith: W ith the harder problem that I think the rest of the country
has, which is our ambient air quality standards are still not lo w
enough and people are exposed to levels of pollution that we
are going to have to work hard to figure out how to remove .

Margaret Flinter: A tech enabled smart inhaler that gathers meaningful data
that informs public health officials how they might reduc e the
burden of asthma health costs while teaching asthma sufferers
to better control their disease and stay healthier. Now that's a
bright idea.

[Music]

Mark Masselli: I'm Mark Masselli.

Margaret Flinter: And I'm Margaret Flinter.

Mark Masselli: Peace and h ealth .

[Music]

Marianne O’Hare: Conversations on Health Care i s recorded in the knowledge
and technology center studios in Middletown, Connecticut,
and is brought to you by the Community Health Center , now
celebrating 50 years of providing quality care t o the
underser ved where healthcare is a right, not a privilege ,
www.chc1.com and www.chcradio.com .