Follow on Biologics

Earlier today, I moderated an all day meeting at the National Press Club in Washington DC on a key topic---the policy questions surrounding follow on biologics or FOBs. Biologic drugs, the so called big molecules, include some of the greatest scientific breakthroughs of the last decade. These drugs are giving hope to thousands of patients. They are expensive to create and they do cost more than small molecules or non biologic products. There is an industry out there interested in trying to create a type of "generic product", a FOB. The challenge here is that a FOB is not biologically equivalent to an original innovative product. In addition, the FDA does not have a pathway that makes sense to approve these FOBs. Our program today, with experts from around the nation, demonstrated the need for an urgent policy solution to these issues. We will create a special edition of our journal, Biotechnology Healthcare, that will highlight these findings. For now, pay attention to what happens on Capitol Hill as we struggle with the FOB question. Much more news to follow. Does your institution support the FOBs?? DAVID NASH

The Non Stop Conversation

I feel as though we are in a non stop conversation about reforming our broken health care system and frankly, I think we might be generating more heat than light in the process!! Right now, the process has me perplexed. What is the best way to reach out to the broadest possible audience in order to reach our key stakeholders?? As we plan for and launch the Jefferson School of Population Health, I want our message to come through the cacaphony loud and clear. As a result, of course, I have my BLOG, but this is certainly not enough. You can now view my brand new video on YOU TUBE, you can send me a tweet on twitter (nashpophealth) and you can face book me too. A google search on "School of Population Health" will bring us up immediately and if you put in David B. Nash MD, Google does a good job tracking my publications. In short, we are doing everything we can to get out the message---the message that our system needs a new kind of leader and we are determined to create the educational programs to deliver on that promise. I look forward to hearing from you, DAVID NASH

The Benevolent Perfect Storm

David Ellwood, the Dean of the Kennedy School of Government at Harvard has it right!! We are facing a potential benevolent perfect storm, which is steering students back to public service and to health care specifically. With billions of dollars in the American Recovery and Reinvestment Act, the Stimulus Bill, headed to health care, smart students are headed in the same direction. I am hopeful that the Jefferson School of Population Health will benefit from this newly developing social trend and that this storm will deposit interested and motivated students at our doorstep. We are ready!! We are working hard to organize our faculty and our considerable resources to prepare for this storm and we will be there on Nine Nine Zero Nine----the first day of class. I hope you will join me soon as we begin the journey of preparing a new generation of leaders for the health care industry. Happy Easter and Happy Passover too. I am interested in your views about the Benevolent Perfect Storm, DAVID NASH

CHIME and HIMSS

Each year, the top information technology officers from hospitals around the nation gather for their annual meeting to learn about the latest trends in technology,and the role that technology plays in improving the quality and safety of medical care. The Saturday before the HIMSS meeting, the key leaders gather for their own meeting, the CHIMES conference. I just spoke at the April 4 CHIMES meeting at the giant McCormick Center in Chicago. I told the CIOS that they play a central role in reforming our ailing system. In a nutshell, I view the future of payment as follows---No Outcome--No Income!! That is, we will be paid if we produce the outcomes that are desired, based on the best available medical evidence. This is surely a tall order and I get it. The CIOS get it too, and they know that information about daily practice, readily available at the bedside and in the examining room, will be vital to seeing this vision of NO OUTCOME, NO INCOME come alive. I hope you'll share your views of this vision with me as we work together to reform our broken system. DAVID NASH

NCQA Quality Awards

Every year, the NCQA hosts a major event in Washington D.C. called the Quality Awards Dinner. Typically, the NCQA gives out multiple awards to deserving politicians, providers, and others, who have contributed to the quality agenda at the national level. This year, the dinner was held on Wednesday night March 18th and I attended along with one of my key new faculty members, Dr Susan DesHarnais---she directs our Masters Degree Program in Quality and Safety. The attendees at the dinner, numbering nearly 500, come from all across our industry. I recognized key policy persons from many of the biggest managed care plans in the country, vendors who service the industry and of course, the phamrmaceutical companies too. I was lucky enough to sit at the MedAssurant table, a key firm involved in processing data from managed care companies and helping them to turn that data into useful information to measure and improve quality. For me, the highlight of the evening was the brief talk by Dr Peter Orszag, director of the OMB and a key player in health reform. He reiterated the Obama Administration key message ---create an agenda for Comparative Effectiveness Research, change provider incentives,promote health IT and finally, invest more in prevention and wellness----that sure all sounds good to me!! I am more convinced than ever that our new Jefferson School of Population Health could not have come along at a better, or more challenging time!! Kudos to NCQA on a great event and for their ongoing work in our field. Hope I see you there next year, DAVID NASH

Medical Student Idealism

I just returned from making several presentations at the Annual Meeting of AMSA, the American Medical Student Association, in Washington D.C. Over 1,000 students from across the nation converged on DC for four days of seminars, lobbying, and networking. I feel recharged from the experience as I soaked up some of their idealism and energy!! Even the theme of the meeting ,Take Back our Profession,had a certain positive edginess to it. The students who met with me were focused on leadership, specifically, what are the skill sets necessary to become a leader. We agreed that medical education does not really provide leadership training, at exactly the time that we need it the most. We reviewed the many opportunities that now exist to get a second degree during medical school, such as an MPH or an MBA. Of course, I spent time talking about our new Jefferson School of Population Health and the unique opportunities to pursue a masters degree in health care quality and safety, as well as degrees in public health and health policy. They were intrigued and asked scores of questions about these new programs too. In the end, I came away with a great feeling that there is indeed hope for the future and that some medical students are still idealistic and willing to work for the greater good. I think our new programs will add to the options available and will enhance the leadership model for students.Good leaders prepare the leaders of tomorrow!! AMSA is a good example of this kind of positive role modeling behavior. We should do more to emulate these programs at every medical school. I hope some medical school deans are listening carefully. Thanks for your continued listening too. DAVID NASH

Population Health Colloquium and then some!!

This past week our team from the Jefferson School of Population Health hosted the ninth annual Population Health and Disease Management Colloquium at a beautiful hotel on the river front in Philadelphia. Despite the worst winter storm of the season, and nearly eight inches of snow, we had a full house for three days of learning. What I took away from our meeting is the emerging confluence amongst wellness, prevention, disease management and care coordination. It seems to me that these concepts are fundamental to the pending reform of the health care system and the leaders who were present made a strong case for making reform happen. The American Recovery and Reinvestment Act (ARRA) , otherwise known as the Stimulus Bill, explicitly recognizes these issues and calls for billions of dollars to be spent upgrading the public health infrastructure of the nation and creating a Center for Comparative Effectiveness Analysis. Our conference, and of course, the Jefferson School of Population Health, are part of the answer for health reform. Also this past week I was featured in a story about care coordination in the Philadelphia Inquirer and a radio interview for National Public Radio WHYY in Philadelphia. We are working tirelessly to get the message out that reform can only happen when we rationalize how care is delivered, increase the evidence basis for health care, and change the pernicious incentives as they are currently structured. I hope that our national leadership is up to this tough task. Thanks for your participation, DAVID NASH