Anisha Abraham MD, MPH

Many of Medicare's COVID-era telehealth flexibilities are set to expire at the end of 2024, including coverage of audio-only telehealth visits, which may improve access for individuals with limited internet connectivity. In a new JAMA Health Forum paper, we examine recent trends in audio-only telehealth use, and find that certain groups may be disproportionately affected, including low-income patients, people with multiple chronic conditions, and members of racial/ethnic minority groups.

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None of us “enjoyed” the additional authority we needed during a public health emergency, and without this authority we would have struggled even more than we did. We learned a lot about that authority and we reaffirmed what is necessary to protect public health outside of an emergency. The challenge before us now is how do we balance the need for public health authority with the usual rights of citizens during “ordinary” times… This issue of Health Affairs presents an analysis of judicial decisions constraining public health powers during the COVID-19 pandemic -- a must read for my fellow public health leaders… New York State Association of County Health Officials (NYSACHO) https://lnkd.in/gfQsXQTy

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When I read IHME on the cover of the new health financing report announced by Enis in his LinkedIn post of two days ago and after checking 🤔 that Prof. Baris 🤗 is actually one of the authors of the report, obviously and appropriately given his decades long hands-on experience on the matter, I was sure this is another "must read" piece of work that has emerged from the CJL Murray Lab 🧠👏❗ And since I couldn't resist starting to browse right away, please allow me to share with you, attached in the first comment below, together with my brief marks, just one figure from the report that struck me after only a few pages of diving into this paper, that is definitely an important contribution for shaping experts' view on the crucial issue of appropriate generation of resources for the health systems worldwide, in particular in the developing countries, where roughly 83% of the world population lives now, up from 66% in 1950 and 76% in 1990.💡. #InstituteForHeathMetricsAndEvaluation

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This 20-year follow up report reveals that while rates of uninsured have declined, we have not yet reduced health disparities in the United States. Until we recognize the multi-layered impact of community assets, politics/legislation/health policy, systems of care, healthcare provider and individual factors and accordingly implement multi-level approaches with measurable accountability across each layer as well as make visible the invisible, change will continue to move slowly.

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My latest work is out in the American Journal of Preventive Medicine. We explore the relationship between arrest history, minority stress, and health among LGBTQ+ youth across the US. Give it a read, and let me know what you think! https://lnkd.in/ehzDyn59

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Advance care planning conversations save money and increase utilization of specialized end-of-life care (hospice and palliative care). On a personal note, I had been speaking with my in-laws about completing an advance directive. At Christmas one year, we had a direct conversation about the Five Wishes document that they had completed. My Father-in-law Gary was very direct and clear in how he spoke about his wishes; no machines. He fiercely did not want to become depended on others. Gary had a heart attack a year later. He was kept alive on a ventilator until my husband could fly in and say goodbye. We were all so grateful to have had that conversation. There was no second-guessing. He was clear in telling us his wishes and so we were clear in honoring them. ACP conversations are VITAL for practitioners and family members to have in order for people to have the ending they want, or hope for. (Gary died before the launch of The Death Deck or we would have also used it to help have these important conversations).

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What’s the HEC? Following a long period of advocacy and supported by a trust fund of $1 billion, the Agency for Healthcare Quality and Research (AHRQ) has signaled they will soon release a Notice of Funding  Opportunities (NOFO) for state-based Health Extension Cooperatives. The intention of this NOFO is to demonstrate the effectiveness of state-based healthcare practice transformation support systems. This is similar to the way in which the Dept. of Agriculture has shown decades of success in the Regional Extension Cooperatives (RECs) to support rural farmers. This program comes at a very opportune time as 20+ states are actively engaged in transforming the payments and delivery to primary care. CMMI is promoting state-based payment and primary care delivery reform in their Making Care Primary Program, the AHEAD state-based model, and the recent ACO Flex model. All of these programs require providers to undergo major changes in the way they deliver care, expanding their focus to population health while delivering patient centered comprehensive care. The programs also compel states to look carefully at how the health of their diverse, rural and underserved communities can be maintained and improved over time. Change does not occur spontaneously and none of the hopeful changes in these programs are easy to accomplish. The introduction of HEC resources, regionally distributed within a state, is a powerful way to meet the educational and resource needs of the states and providers as they begin the journey of transformation to high value, whole person equity focused care.  There are a few good examples of the effectiveness of "HEC-like" programs in Vermont’s Blueprint for Health and New Mexico’s Health Extension Regional Organizations. My experience in the Maryland Primary Care Program also demonstrated the essential role of the State Health Department's Program Management Office and regional Care Transformation Organizations providing technical assistance and resources to primary care practices to successfully integrate behavioral health, care management and advanced health information technology in primary care practices across the state. Please take a moment to read the AHRQ notice below: https://lnkd.in/eSTqRpN5 Yours in health- Howard

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Egypt’s #MinistryOfHealth Unveils #PublicPrivatePartnership Plans, But #Doctors Raise Concerns #Egypt's healthcare sector is poised for a shakeup with the government's plan to grant private entities #ConcessionContracts to manage #PublicHospitals. This public-private partnership (#PPP) initiative aims to improve the #LegislativeFramework for #HealthCareInvestment. While some hail this move as a step forward, the #GeneralSyndicateOfDoctors in Egypt has expressed concerns. The Syndicate argues the government should incentivize building new hospitals, not outsourcing management of existing ones. They also question safeguards for worker rights, selection criteria for PPP hospitals, and potential foreign investor influence. The Syndicate proposes #CapacityBuilding and #InfrastructureInvestment to address shortcomings, while advocating for government #Oversight and #FairTreatment of #HealthCareWorkers. They believe a balanced approach will attract private investment in new facilities while preserving #Quality care in existing #Hospitals. #egypt #healthcare #publicprivatepartnership #doctors #investment To learn more, read the article from #TheHieroglyphsOfHealth

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Book Reading Chapter 17. In the pandemic we were led by public health leaders who were hardworking but ignorant. We should do a course correction else we are headed for future mishandling of "pandemics" if we do not put the right leaders at the top. https://lnkd.in/dC9mrGUZ

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The second edition of the Surgeon's Record presented by Commons Clinic! As promised, this article focuses on lessons learned from the Duke University School of Medicine's Collaborative Summit on Health Equity and Value Based Care. Specifically, 7 take-home messages that distill key components of successful specialty-focused VBC with an eye toward health equity. We have yet to solve the equation on value-based care and turn it from high-minded concept to practical reality. In MSK, it's not from a lack of trying (see CJR and BPCI). The future -- as I learned in Durham -- is condition-specific, comprehensive, wrap-around care (global subcapitation if you prefer). It's coordinated, collaborative care backed by data, supported by technology, and (importantly) delivered by people who understand all sides of the clinical, operational, and financial equation. These seven lessons aren't the end, but a good place to start. #medicine #healthcare #health #vbc #valuebasedcare #healthcareinnovation #healthcaretechnology

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Navigating Rejection and Recognition: Insights from 40 Years of Climate and Health Data at Hajj We are proud to announce our two pivotal studies published in Environmental Health Perspectives (https://lnkd.in/dkm-29DW) and the Journal of Travel Medicine (https://lnkd.in/dXE_es3W), shedding light on the health risks faced by pilgrims in Mecca. The latter study specifically highlights the escalating climate-related health risks for Hajj pilgrims, utilizing a comprehensive 40-year dataset. Our findings demonstrate a strong correlation between rising temperatures and the incidence of heatstroke and heat exhaustion among over two million annual pilgrims from 180 countries, underscoring the representativity and generalizability of our work. Despite the critical implications of our research, it was initially rejected—sometimes within just a few hours—by prestigious journals like Lancet Public Health, Planetary Health and Nature Climate Change, without explanations or opportunities for peer review. This swift dismissal reflects a troubling bias within scientific publishing, where innovative research that deviates from conventional Western-focused narratives or challenges established scientific domains often faces undue resistance or disregard. The relevance of our study has been dramatically underscored by the tragic events of this year's pilgrimage, where temperatures soared above 50°C, resulting in numerous fatalities. These alarming conditions have drawn significant attention from major global media outlets, including CNN, BBC, and The Washington Post, with more than 17 news outlets such as MSN and The New York Times citing our work (https://lnkd.in/dBcRxPr9). This widespread media interest confirms the initial bias of these journals. As the senior author of this study, I am compelled to advocate not only for the robustness and relevance of our findings but also for a shift in the scientific community towards more equitable and inclusive publishing practices. We must ensure that all relevant science, regardless of origin, is given a fair platform to influence global health strategies effectively. The existential challenge of climate change concerns all of humanity, not just the few who control prestigious journals and organizations. #NatureClimateChange #LancetPublicHealth #LancetPlanetaryHealth #ResearchBias #ScienceAdvocacy #AcademicPublishing

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Do sign up and find out more about the standards how they developed and how they can help us all in our simulation practices

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An analysis of the US Primary Care Workforce Within this review by HRSA in Nov 23 startling comparison’s are highlighted in Table 7, life expectancy rates in OECD countries. https://lnkd.in/gS-qW_gS Focusing on poor US maternal/infant outcomes, decades of research on safe care provided by midwives is demonstrated at the highest levels of evidence, meta-analysis and systematic review. One only needs to search Cochrane database. “Women or their babies who received midwife continuity of care models compared to those receiving other models of care were less likely to experience a caesarean section or instrumental vaginal delivery, and may be less likely to experience an episiotomy. They were more likely to experience a spontaneous vaginal birth.” https://lnkd.in/gPWsuz34 Combine the workforce shortage with increasing costs of all health care, we can only imagine population health life expectancy data five years from now. The US spends more than any other high income country, yet population health indicators are worse? “On average, other large, wealthy countries spend about half as much per person on health as the U.S.” https://lnkd.in/gv4M7R-g If barriers to full integration of a diverse, inter-professional workforce — practicing to the full scope of their education, training and licensure — within a system of collegial care and seamless transfer were adopted — it is doubtless lives would be saved and life expectancy would increase in our country. #GrowMidwives #WhoIsListening #wecanandmustdobetter

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From this excellent NEJM review by Bell et al on the effects of heat on health: https://lnkd.in/em_AHnUq "Being a member of a marginalized racial or ethnic group or having low socioeconomic status is a key factor affecting risk, but several other factors also increase the risk of adverse health effects, including social isolation, extremes of age, coexisting conditions, and medications." Addressing drivers of health, like utilities access, is critical to improve #HealthEquity and the overall health of our nation. The Physicians Foundation Let’s Take 5 campaign supports physicians to meet their patients’ needs. #SDOH

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Show me some progress for 40% of the population in 2621 counties lowest in health care workforce forever with just 25% of the primary care workforce paid less to the tune of less than 20% of primary care spending. This works out to less than 50 billion. Show me at least 10 billion more on the way to the 100 billion plus needed so that these practices can have sufficient team members and health professionals to integrate, coordinate, and do patient centered are. I want proof of funding changes - no promises, no articles, no reports Don't care if this goes to CHCS, small practices, medium size practices, whatever - but anything less is a violation of CMS guidelines, health equity, and Belmont principles that we must apply to health care design the same as with physicians and human subject researchers.

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The market for digital health technologies has exploded in recent years, and this interest is reflected in National Institute of Mental Health (NIMH)’s #SBIR and #STTR portfolio. NIMH is supporting a range of projects in this space, including research to develop devices and software applications that can help increase mental health care access, quality, and personalization: https://lnkd.in/g76yw9ra #mentalhealth #smallbusiness #funding

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UPDATE 1 of 6👆🏽of the OCI Foundation's VLSS SOCIAL MEDIA CONTEST (Correct as of 07.35 AM, 30/04/2024; Nigerian Time). BAUCHI (34.0%; 10,788), soars to the top spot, with KWARA (25.0%; 1,225) and GOMBE (23.0%; 1,515) rounding up the Top 3 in the first 24 hours. No State is eligible for a win, yet. IMPORTANT NOTES: 1. To Vote, follow this link: https://lnkd.in/eTXQyvYh. 2. A balanced approach on all VLSS components gives more points than a very high score in one component. 3. We strongly recommend that contestants should target all of the Views (20%), Like (20%), Share (30%) and Subscribe (30%), not just the views. 4. To win easily, see where the points are, and watch some winning strategies here: https://lnkd.in/gJB8v6EF. 5. This all ends at midnight on Saturday, May 4, 2024. Results will be announced within 48 hours after that, to allow for updates on the Subscription Scores (data on this lags by 48 hours from TikTok) All others (Views, Likes and Shares) will be frozen at this time. 6. A minimum of 60% VLSS Percentage Score AND a Top 3 finish are needed for the main 50k rewards. 7. If there is a tie in the PERCENTAGE VLSS SCORE, the RAW VLSS SCORES are used to separate contestants. We Rise, By Lifting Others Admin, OCI Foundation

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I am pleased to announce that I will be lead guest editing a special collection titled "Towards Universal Cancer Care: Addressing Global Delivery Disparity and Financial Toxicity," to be published in INQUIRY: The Journal of Health Care Organization, Provision, and Financing (Sage). This collection explores the challenges and solutions in cancer care delivery and the financial toxicity associated with them across both the global North and South. This initiative provides an extensive analysis of how various health systems address cancer burdens, covering topics like epidemiological trends, comparative analyses of treatment models, and systemic contributors to financial toxicity. It also explores innovative financial strategies, patient and caregiver narratives, the role of technology in enhancing care accessibility, and the integration of patient-centered care to improve oncological outcomes. Co-guest edited by Manmeet Ahluwalia, MD, MBA, FASCO, and Anwaar Saeed, both distinguished leaders in their respective fields: Manmeet Ahluwalia, MD, MBA, FASCO, Fernandez Family Endowed Chair in Cancer Research, serves as the Chief Scientific Officer, Chief of Medical Oncology, and Deputy Director at Miami Cancer Institute (MCI), Baptist Health South Florida. His career highlights include transforming the Burkhardt Brain Tumor and Neuro-Oncology Center into a leading center for brain tumor trials as its head at the Cleveland Clinic. Currently, Dr. Ahluwalia leads cutting-edge research in AI-based radiomics in glioblastoma with a substantial NIH R01 grant of $3.9 million and oversees a NIH PO1 grant exceeding $10 million focused on gender-specific differences in glioblastoma. His work has notably altered neuro-oncology practices across the U.S. Anwaar Saeed, MD, is an Associate Professor of Medicine and leads the Gastrointestinal (GI) Medical Oncology Program at the University of Pittsburgh, UPMC, and UPMC Hillman Cancer Center. As the Vice Chair of the Colorectal Cancer Committee of the NSABP Foundation, she specializes in immune modulatory approaches in gastric, esophageal, and colorectal cancers. Dr. Saeed has authored over 150 peer-reviewed publications and led more than 40 clinical trials focusing on innovative immunotherapy combinations, including the ongoing phase I/II CAMILLA multicohort study. She is also gearing up to chair a national trial under SWOG/intergroup NCI targeting advanced gastric & esophageal adenocarcinoma with a novel chemo-immunotherapy regimen. Submissions are now open through December 12, 2024. For submission guidelines, please visit: https://lnkd.in/dkyGDZie For further queries, I may be reached directly. We look forward to your contributions to this important discourse in global health.

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