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UM takes a global look at health care

Kathleen Sebelius, U.S. Secretary of Health and Human Services, addressed the challenges facing the nation's health care system.

A registered nurse and health care administrator in one of Miami’s poorest neighborhoods, Deborah George has helped treat and counsel patients with all types of medical conditions: diabetics who don’t follow their daily regimen of insulin shots, pregnant teenagers, and HIV-positive patients.

“We see the uninsured and the underinsured,” explained George, administrative affairs/chief medical officer at the Jessie Trice Community Health Center in Miami’s Liberty City. “We see a high percentage of patients with diabetes and cardiovascular disease, and we get patients with a lack of appropriate access to health education.”

Confronting and dealing with such challenges almost every day is one of the reasons George decided to attend the University of Miami’s Global Business Forum, a three-day conference held January 12-14 that brought together influential leaders from the public and private sectors to discuss everything from the economics of health care and medical technology to the aging population, hospital design, and delivery systems.

George was particularly interested in hearing the remarks Secretary of Health and Human Services Kathleen Sebelius delivered during the opening keynote session on the second day of the conference, titled “The Business of Health Care: Defining the Future” and organized by UM’s School of Business Administration.

“Listening to her was like seeing a mirror image of what we’re doing in our own community,” said George, referring to a plan described by Sebelius to bring the patient-centered “medical home” model to more U.S. states. George said Jessie Trice is preparing an application to become such a home, a new approach to improving patient health in which a primary-care physician heads up a team—with strong patient involvement—that provides continuous and coordinated care throughout a patient’s lifetime.


FDA Commissioner Margaret A. Hamburg, left, discussed the role and challenges of her agency during a conversation with UM President Donna E. Shalala.

From medical homes to medical devices, UM’s Global Business Forum covered the gamut, addressing a range of issues in some 30 panel discussions where CEOs, industry analysts, public policy makers, physicians, nurses, and others explored and exchanged ideas. Every UM college and school was involved in the forum as well as units like the Arnold Center for Confluent Studies, The Launch Pad, and the Lowe Art Museum.

“The future of health care is front and center on our national stage right now, and the Global Business Forum couldn’t have been timelier,” UM President Donna E. Shalala said during welcoming remarks.

In addition to Secretary Sebelius, other keynote speakers during the forum included FDA Commissioner Margaret Hamburg; James Forbes, global principal investments executive for Bank of America Merrill Lynch; and Arthur Agatston, developer of The South Beach Diet.

Troyen Brennan, executive vice president and chief medical officer for CVS Caremark, and Jeffrey Immelt, chairman and CEO of General Electric Company, closed out the forum on January 14.

The forum opened January 12 with a panel discussion on “Harnessing the Power of Art to Improve Health Outcomes” at which panelists discussed art-based methods for training students to be more observant caregivers and healers.

“It’s often our eyes that open our minds,” said panelist Abigail Housen, co-founder of Visual Thinking Strategies (VTS) and former professor of the Massachusetts College of Art. The skills required to study a painting, for example—entering the realm of ambiguity, looking longer and deeper, entertaining multiple possibilities—are also important in the health care field, she noted.

Jeffrey Immelt, chairman and CEO of GE, called for greater consumer-driven health care.

“Art appears to be translatable into a clinical setting,” said panelist Sherrill H. Hayes, professor and chair of the Department of Physical Therapy at the Miller School of Medicine. Hayes collaborated with co-moderator Hope Torrents, school programs coordinator of the Lowe Art Museum, on a VTS-based curriculum for her doctor of physical therapy students. Citing the success of their experience at the Lowe, as well as other non-UM studies, Hayes said this kind of guided art workshop can increase accuracy in observation and communication skills as well as teamwork, empathy, and awareness in high-achieving students.

Panelist Alex J. Mechaber, associate professor of medicine and senior associate dean for undergraduate medical education, commended the Global Business Forum for opening its 2011 conference with “quite an innovative panel.” “The Miller School recognizes the importance of the humanities and includes them in the curriculum,” he said, adding that two years ago the school launched its ethics and humanities pathway, which incorporates art, economics, film, philosophy, and theater.”


With Secretary Sebelius and FDA Commissioner Margaret Hamburg speaking back to back at UM’s Gusman Concert Hall on January 13, the forum kicked into high gear, providing attendees with frank and critical discussion on issues of national importance.

A panel on "Commercializing Medical Devices: A View from the Trenches" was held at the School of Business Administration.

In her remarks, Sebelius, the 21st secretary of the agency charged with keeping Americans healthy, addressed issues across the spectrum health care, saying that strategies such as the adoption of electronic medical records, the introduction of farmers markets and bike paths to underserved communities, and increased training of new primary care physicians can help improve health care.

In the face of forthcoming congressional action to possibly repeal President Obama’s health care reform package, Sebelius said citizens, employers, providers, and scholars must realize what would happen if the nation maintained the health care system in place before the passage of the law. People, she said, are beginning to realize and understand the benefits of the new law, noting one component of the act allows young adults to remain on their parents’ or guardians’ health plan until age 26.

Hamburg, whose remarks took on the form of a conversation with President Shalala, warned about the possible pitfalls of acquiring medications from unknown sources via the Internet. She also detailed one of her agency’s strategies to curtail tobacco by updating warning labels on tobacco product packaging with larger and more graphic labels.

The day also brought more panels. At “Neurologic Music Therapy: A Bridge between Art and Science,” the role of music in re-educating the injured or diseased human brain was discussed. Presented by the Frost School of Music and College of Arts and Sciences, the panel offered data and video of therapy sessions to demonstrate music’s ability to access and drive critical regions of core function in the brain related to movement, cognition, and speech and language production.

“Music is a biological language of the brain,” said Michael Thaut, a professor of music and of neuroscience at Colorado State University, where he directs the Center for Biomedical Research in Music. Neurologic Music Therapy, NMT, is an evidence-based approach being used for patients with brain injury, autism spectrum disorders, Parkinson’s, and other problems of the central nervous system—often with quicker results than other standard therapies, Thaut noted. With 1,500 trained neurologic music therapists in 22 countries, including at UM, NMT is gaining prominence and is a reimbursable health service akin to other types of physical therapy, added Thaut.

UM students volunteered at the forum to help the event run seamlessly.

One video clip he showed demonstrated how the wobbly gait of a patient suffering from ataxia, or severe lack of coordination, was almost immediately steadied when a metronome was added to the process. “Music engages central cognitive centers and connects and networks them in a very effective way,” explained Thaut.


Also on the second day of the forum, keynote speaker James D. Forbes shared his vision for the future of health care. Welcomed by President Shalala and introduced by his longtime business associate Miguel “Mike” Fernandez, a UM trustee and chair of MBF Healthcare Partners, Forbes spent about 45 minutes outlining a sunny forecast for the business of health care.

“The state of the industry is quite healthy,” said Forbes, global principal investments executive for Bank of America Merrill Lynch, noting that even in 2009, at its lowest growth in 50 years, health care was still 4 percent ahead of the GDP, a key indicator for investors.

Forbes, global head of healthcare investment banking at Merrill Lynch from 2002 to 2008, has helped companies raise over $50 billion in financing in the past five years and has been involved in over $80 billion of mergers and acquisition transactions, including initiating and being the lead advisor to the consortium in the $33 billion leveraged buyout of hospital owner HCA, on whose board he currently serves, among others.

“I think you’re going to see a lot of buyouts in the next few years,” said Forbes, a big believer in the power of a top management team to turn even mediocre companies around. He said buyout figures could reach as high as $5 billion to $10 billion compared to last year’s highest figure of $3 billion.

James D. Forbes, global principal investments executive, Bank of America Merrill Lynch, delivered a forecast on the future of health care during a Global Business Forum luncheon on the Foote University Green.

One key fact steering his bullishness on health care is the baby boomer generation. The first wave of those 74 million Americans born between 1946 and 1964 are turning 65 this year, he explained, making them eligible for Medicare. This “inexorable” increase in Medicare utilization excites investors like Forbes who foresee those individuals beginning to double or even triple their use of health care services.


Remarks by Brennan and Immelt capped the three-day forum. Brennan, who earned medical and law degrees from Yale, said better and smarter use of technology and empowering consumers with more information so they can make wiser choices can both help control health care costs and improve care. He said the industry must solve the troubling problem of too many patients not taking their medications, noting that up to 70 percent of hospital readmissions are due to noncompliance.

Immelt also called for a greater focus on consumer-driven health care, and he outlined five key points to improving the industry: get consumers to be accountable for their health, focus on chronic health, implement technology at lower costs, harness the power of information, and improve efficiency in health care delivery.

“We’re going to be working on health care for the rest of our lives,” Immelt said. “Big business has the most to lose if we don’t get it right.”

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