Innovative Ways to Improve the Care of those with Advanced Illness

December 16, 2016: Care for advanced illness, when chronic conditions move into the last stage, is fragmented, uncoordinated, challenging for patients and families and costly for them and society. Healthcare reform’s triple aim of improving population health, quality of care, and reducing cost is fostering new clinical and payment models for advanced illness. This presentation will focus on these new models and on how policies that promote value-based payment systems can improve care and cost for those with advanced illness.

Dr. Grant is the Director of Policy and Professional Engagement at the Coalition to Transform Advanced Care (CTAC), a palliative care nurse practitioner at the University of Maryland Medical Center, and an Associate Professor at the University of Maryland School of Nursing.  She has a Bachelors and Masters degree in nursing from the Johns Hopkins University and a Doctorate in Nursing Practice from the University of Maryland.


Health Policy at the Ground Level: The Impact of Marketplace Guides on Healthcare Utilization

November 11, 2016: In response to provisions of the Patient Protection and Affordable Care Act (ACA) that became effective in 2014, Christiana Care Health System (CCHS) hired 12 market place guides (MPGs) to assist eligible uninsured individuals with enrollment in insurance and provide referrals to meet patients’ healthcare needs.  Policy experts predicted that new insurance coverage would lead to an increase in healthcare utilization, particularly of emergency services, in spite of overarching market pressures to drive utilization to the lowest-cost environment.  CCHS MPGs had the potential to influence the type and setting of the healthcare services that the newly insured accessed.  This presentation will explore the impact of CCHS MPGs in influencing healthcare utilization within the CCHS network by this subset of patients compared to unassisted Medicaid and uninsured patients in the pre- and post-ACA periods.

Deann Gavney is a part-time student in the Doctor of Public Health (DrPH) in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health.  She is employed full-time as the Division Administrator for Johns Hopkins Rheumatology, where her responsibilities include oversight of the clinical practice, financial performance management, faculty and staff human resource management and recruitment, and sponsored project administration. The DrPH program has been an opportunity to develop a skillset in health outcomes research and consider current topics in public health from a managerial perspective.


Kids Safe and Smokefree: A Multilevel Intervention

October 21, 2016: Low-income and underserved populations have higher smoking rates, greater challenges in quitting smoking, and bear greater tobacco-related morbidity/mortality risk than the general population.  More intensive interventions are needed to address this ongoing public health priority. This presentation will describe a recently completed trial that combined a pediatric systems-level intervention with a pragmatic, individualized intervention.  We will discuss the approach, results and directions for future research and intervention.

Dr. Collins is an Associate Professor and Director of Graduate Studies in the Department of Social and Behavioral Sciences in the College of Public Health at Temple University.  He has conducted four NIH-funded clinical trials focused on child tobacco exposure and adult smoking cessation interventions and has led numerous service projects addressing smoking and addiction in underserved populations. His training is in clinical psychology with a health psychology focus on addictions and chronic disease prevention, but his research is framed in behavioral ecological models that can guide multilevel intervention strategies that integrate treatment methods to address multiple determinants of health behavior change.


Global Surgery 2030: Evidence and Solutions for Achieving Health, Welfare and Economic Development

August 19, 2016: Remarkable gains have been made in global health in the past 25 years, but progress has not been uniform. Mortality and morbidity from common conditions needing surgery have grown in the world's poorest regions, both in real terms and relative to other health gains. At the same time, development of safe, essential, life-saving surgical and anaesthesia care in low-income and middle-income countries (LMICs) has stagnated or regressed. In the absence of surgical care, case-fatality rates are high for common, easily treatable conditions including appendicitis, hernia, fractures, obstructed labour, congenital anomalies, and breast and cervical cancer.

John G. Meara, MD, DMD, MBA is the Kletjian Professor of Global Surgery in the Department of Global Health and Social Medicine, Professor of Surgery at Harvard Medical School, Director of the Program in Global Surgery and Social Change at Harvard Medical School, Plastic Surgeon-in-Chief at Boston Children's Hospital, and Co-Chair of the Lancet Commission on Global Surgery ( He is also the Vice-Chair of the Health Policy Advisory Group for the American College of Surgeons. Since 2008, he has Co-Directed the Paul Farmer Global Surgery Fellowship program in collaboration with Partners In Health.


Delaware Medical Legal Partnership: Attorneys Collaborating with Clinical Teams to Address Social Determinants of Health

August 12, 2016: Patients challenged with social determinants of health are more likely to incur higher health care costs due to their inability to adhere to prescribed medical recommendations and their inefficient use of health care resources. Some of these challenges can be resolved with legal intervention. The Medical-Legal Partnership (MLP) model has demonstrated positive impact on improving health outcomes by addressing civil legal needs of vulnerable populations.  At Christiana Care Health System, a legal team from Community Legal Aid Society, Inc. (CLASI) is collaborating with clinical staff to determine and help resolve patients’ legal needs, which will improve their ability to manage all the determinants of their health. We are conducting an evaluation of the efficacy of the medical-legal collaboration on improved patient outcomes. Process measures describe the type of services needed by patients and how they are delivered by examining how many and types of referrals, hours spent on each referral, source of referral, patient demographics and legal outcome. Outcome measures assess whether the MLP improves patient outcomes in quality of life and perceived stress.

Susan Howard-Smola is a Senior Clinical Researcher at the Value Instistute at Christiana Care Health System. She has doctoral training in public health with an emphasis in program evaluation and qualitative methods and a law degree from the Delaware Law School at the Widener University with a Health Law Certificate. Her research is primarily in the area of population health, program evaluation and health policy.


The Utility of Alternative/Article-Based Metrics (Altmetrics) for Clinical and Public Health Researchers

July 22, 2016: The impact of scientific research is usually measured by journal-based citation metrics such as the Journal Impact Factor and H-Index. Altmetrics (article-based or alternative metrics) offer a complementary way of measuring dissemination and a diversity of impact, of particular relevance to clinical and public health researchers. This presentation will review the strengths and limitations of both journal-based metrics and altmetrics, which will allow clinicians and researchers to understand how altmetrics can increase the dissemination and impact of their work.

Dr. Chisolm is Associate Professor and Vice Chair for Education in the Department of Psychiatry and Behavioral Sciences at Johns Hopkins University. She is co-author of a textbook on psychiatric evaluation and has written more than 70 scientific and clinical articles about substance use and other psychiatric disorders, social media in medicine, and medical education.  Dr. Chisolm is a member of the Miller-Coulson Academy of Clinical Excellence, an Arnold P. Gold Foundation Humanism Scholar, and the recipient of the 2014 Johns Hopkins University Alumni Association Excellence in Teaching Award.


Smoking Cessation and Relapse Prevention during Pregnancy and Continuing Care Postpartum

July 15, 2016: In spite of the well-established negative health implications of tobacco smoking during pregnancy on mother and unborn child, 15.4% of pregnant women report smoking in the past month. Approximately one-third of women who smoke prior to pregnancy quit spontaneously during pregnancy, but up to 60% relapse within the first six months postpartum. This presentation will discuss the strengths and weaknesses of current smoking cessation interventions offered during pregnancy and the need for continuing care postpartum.

Dr. Coleman-Cowger is a Clinical Psychologist and Principal Research Scientist with Battelle’s Public Health Center for Tobacco Research in Baltimore, MD. Her research interests are in women’s health, substance use, mental health, and health disparities. She has published over 30 papers in peer-reviewed journals, holds faculty appointments at the University of Maryland Baltimore and American University, and maintains a collaborative relationship with the American Congress of Obstetricians and Gynecologists (ACOG).


Tools for Studying the Genetic Basis of a Complex Disease

June 24, 2016: Susceptibility to most common diseases is complex, and based on both genetic and environmental risk factors. This presentation will discuss basic concepts and current tools to identify and interpret genetic and epigenetic variation, and pitfalls in associating variants with disease risk.

Dr. Barthold is a pediatric urologist/clinician scientist at Nemours. She completed an American Foundation for Urologic Disease research fellowship under the mentorship of Julianne Imperato-McGinley, an endocrinologist at Cornell University Medical College who pioneered studies of isolated populations with inherited 5-alpha reductase deficiency. Dr. Barthold has been studying testicular descent and cryptorchidism in human populations and animals models for 25 years that have been enhanced by scientific collaborations with individuals at multiple institutions, including those with steroid receptor, muscle and neural development, genomics, genetic epidemiology, bioinformatics and biomedical engineering expertise.


RICH LIFE: Reducing Hypertension Disparities through Health System vs Multilevel Interventions

June 17, 2016: The RICH LIFE Study will help to lower blood pressure and heart disease risk among minority, low income, and rural populations, by comparing standard clinical performance feedback and education for providers and staff to a more comprehensive approach that includes workshops for health system leaders, a structured team approach to care, and access to subspecialists or community support as needed  for patients with hypertension  Finding effective approaches for patients to achieve better heart health helps patients and doctors to make critical decisions on real-world care for high risk patients, and our study combines tested approaches with new ideas in an innovative program that treats patients as whole people, rather than as a disease. Carefully tested interventions that show promise in improving health outcomes will give doctors, insurers, and law makers the confidence to support the widespread use of similar programs in a variety of medical settings and among other at-risk populations.

Dr. Lisa Cooper is the James F. Fries Professor of Medicine  at Johns Hopkins University School of Medicine, Nursing,  and Bloomberg School of Public Health. She is also Vice President, Healthcare Equity, for Johns Hopkins Medicine. A board-certified general internist, social epidemiologist, and health services researcher, Dr. Cooper is an internationally recognized expert on the effectiveness of patient-centered interventions for improving health outcomes and overcoming racial and ethnic disparities in healthcare.


Optimizing Value through Appropriate Use of Invasive Cardiovascular Services

June 3, 2016: The perceived role of invasive cardiac services, especially percutaneous transluminal interventions (PCI), has changed significantly over the past 5-10 years.  New healthcare payment models will apply new pressures to assure that only procedures of high value are performed.  I will review changes in the use of, and perceptions about, invasive cardiac services over the past several decades, and explore how new models of care management may help optimize use of these expensive but useful services.

Dr. Garratt joined Christiana Health System as Associate Director, Center for Heart and Vascular Health in 2015. He also serves as Director, CV Quality and Safety, and as Director, CV Research.  He is highly engaged in the Society for Cardiac Angiography and Intervention (SCAI), a national society with a focus on quality of invasive CV care, participating in numerous activities including Quality, Steering and Executive Committees.