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Health information technology (health IT), including electronic health records (but much, much more), enables health care providers--from individual clinicians to widely networked health care organizations--to better manage patient care through streamlined sharing of health information. Since 2004, the Office of the National Coordinator for Health Information Technology has led U.S. efforts to deploy advanced health IT in order to improve clinical service delivery and support patient engagement. As a result, nearly every hospitalization and most doctor visits now have a digital footprint, and an extraordinary amount of health data exists that simply didn't a decade ago. The health IT goal now is to foster seamless and secure data sharing to improve the health and care of individuals and populations alike.
In this special Medical Center Hour, Dr. Vindell Washington, National Coordinator for Health Information Technology, introduces this key national initiative and cites the promise and chief challenges for this increasingly central component of our nation's health care system.
A John F. Anderson Memorial Lecture
Southern Appalachia often provides a folksy backstory to our national mythology—a tale of coal miners, moonshining, bluegrass, and ballads. But Appalachia is a real place that figures fundamentally in this country's heritage and destiny.
Its rugged mountains are rich in natural resources while its remote communities are home to some of the nation's most fiercely proud people and most persistent poverty. This region has endowed American culture—and the University of Virginia—with a wealth of gifts and innovations but itself faces staggering difficulties. Embracing Appalachia is challenging, especially now, as the coal industry disappears and crises of poor health, environmental degradation, and poverty deepen.
This Medical Center Hour with West Virginia coalfields native David Gordon probes our particular connections to Appalachia and how the enduring tragedy of this place is a “canary in the coalmine” for the rest of our nation.
Is "healthy Appalachia" possible? What will it take? What must we do?
Co-presented with the Center for Global Health, Institute for the Humanities and Global Cultures (Global South Initiative), Department of Public Health Sciences, and Healthy Appalachia Institute
"Give a [wo]man a mask and [s]he will tell you the truth." –Oscar Wilde
Since 2010, Walter Reed National Military Medical Center's therapeutic arts program has engaged brain-injured and traumatized military veterans in hands-on mask making. Even as they conceal the face, these soldiers' masks vividly reveal secret suffering, declare deeply felt identity and patriotism, signal spiritual wounds and moral strengths, externalize guilt or grief. Making a mask can help its creator to (re)claim identity, and to heal. In this AOA Lecture, physician-educator Mark Stephens and art therapist Melissa Walker discuss the construction of masks as an artful means of recognizing oneself and reflecting on identity, not just for wounded warriors but also for healthcare professionals.
Co-presented with Alpha Omega Alpha national medical honor society, UVA Chapter
What happens when an extroverted six-year-old dog and her introverted human partner enter the local public nursing home as a therapy dog team? This was the question writer Sue Halpern (nervously) asked herself when she and her dog Pransky began their work at the Helen Porter Nursing and Rehabilitation Center in Middlebury VT. In this Medical Center Hour, Halpern revisits the remarkable experiences she and Pransky had over six years with the nursing home residents, experiences that continued even after Pransky's health declined. She also speaks to the increasingly recognized value of introducing therapy animals into medical settings and the significant physical and emotional benefits that follow—for patients, staff, and therapy teams.
A John F. Anderson Memorial Lecture
Thirty-five years after the discovery of AIDS, the story of this disease and the momentous scientific, medical, political, and social changes it occasioned is rich and complicated, even sensational. In 1981, Dr. Michael Gottlieb, a young UCLA immunologist, saw--and published a New England Journal of Medicine article about--a cluster of five cases of immune dysfunction and unusual opportunistic infections in gay men. Not long after, as personal physician to Hollywood actor and AIDS patient Rock Hudson, Dr. Gottlieb became the medical face of this terrifying epidemic.
In this Medical Grand Rounds/Medical Center Hour, Dr. Bruce Hillman, a medical school classmate of Michael Gottlieb, probes the war of egos, money, academic power, and Hollywood clout that advanced AIDS research in its first decade even as it compromised the medical scientist who discovered the disease. Dr. Hillman draws on interviews with Dr. Gottlieb and others to chronicle one of the most important and contentious medical discoveries of our time.
Medical Grand Rounds/History of the Health Sciences Lecture
Co-presented with the Department of Medicine and the History of the Health Sciences Lecture Series of Historical Collections, Claude Moore Health Sciences Library
Deborah Salem Smith's acclaimed play Love alone is the story of what happens after a routine medical procedure goes tragically wrong. A medical malpractice lawsuit ensues, and the lives of both the patient's family and the doctor charged with her care are transformed. The play tracks the fallout in both homes. It is a portrait of how each family grieves and heals. These questions were central in the construction of the plot: Is forgiveness a single act or a daily act? Is it unconditional? Who has the right to forgive? Does forgiveness require remorse or an apology by the offender? Do lawsuits empower victims and thus aid the grieving process, or do they disrupt grieving? Does proving negligence make a victim more prepared to forgive? What does a lawsuit mean for the doctor sued, and for his or her personal journey of recovering from the unexpected death of a patient? George Bernard Shaw famously quipped, "We have not lost faith, but we have transferred it from God to the medical profession." What are the implications and burdens of such faith? This Medical Center Hour explores Love Alone with the playwright and local actors but also with a physician who has written on doctors' efforts to deal with their own mistakes.
A John F. Anderson Memorial Lecture
In this Medical Center Hour, award-winning journalist Meera Subramanian explores the human and global health implications of India’s ravaged environmental landscape. Her new book, A River Runs Again: India's Natural World in Crisis, investigates five environmental crises by profiling ordinary people and micro-enterprises determined to guide India and its burgeoning population into a healthier future. An organic farmer revives dead land; villagers resuscitate a river run dry; cook-stove designers seek a smokeless fire; biologists bring vultures back from the brink of extinction; and, in one of India’s poorest states, a bold young woman teaches adolescent girls the fundamentals of sexual health. In these individual stories resides hope for a nation and its people and the potential for a sustainable and more prosperous world.
A John F. Anderson Memorial Lecture/Exploring the Global South
Co-presented with the Center for Global Health, Institute for the Humanities and Global Cultures (Global South Initiative), Department of Public Health Sciences, and Virginia Quarterly Review
Where you live in a particular U.S. city determines your predicted life expectancy. Neighborhood is destiny, in a way. For example, in New Orleans, there is a twenty-five-year difference in life expectancy from one parish to another only three miles away. This pattern of great gaps in health status, even over short distances, repeats itself in New York, Chicago, the Bay Area, and many other American cities, with harsh consequences.
In 2005, Tulsa, Oklahoma was one of the first cities to recognize such dramatic neighborhood variations in life expectancy, with a fourteen-year difference in life expectancy between north Tulsa and midtown—and to take action. In this presentation, Dr. Gerard Clancy describes specific initiatives and lessons learned on the ten-year journey, from 2005 to 2015, to reverse these health disparities and improve the health of the people in north Tulsa. The successes of the past decade have inspired a new ten-year initiative in Tulsa focused on mental health system improvements.
Co-presented with the Brodie Medical Education Award Committee, the Academy of Distinguished Educators, and the Department of Medicine
Many personal, social, organizational, and regulatory factors in health care today contribute to clinicians experiencing burnout, a chronic stress syndrome characterized by exhaustion, depersonalization, and feelings of inadequacy. When severe, these symptoms are often accompanied and exacerbated by depression—and sometimes lead to suicide. In this combined Medical Center Hour and Medical Grand Rounds, Dean Gianakos MD FACP will not teach techniques to fortify personal resilience in the face of incipient burnout or offer strategies to reduce the inefficiencies of practice. Rather, using poems and stories, he will open a dialogue on how health professionals can emotionally support one another, initiate crucial conversations, and reduce the isolation that too often characterizes medical practice.
Co-presented with the Department of Medicine, UVA
In the spotlight for years now, health care that is truly equitable and patient-centered and delivered by a diverse, well-integrated team remains a goal—in most sites, it's not yet everyday reality. Individuals and institutions—including health professional schools as well as centers of clinical practice—continue to work toward this goal. But this effort cannot depend just on recruiting more diverse learners, reorganizing clinical environments, or deploying didactics aimed at eliminating biased attitudes and behaviors. Rather, it’s a matter of redesigning health professional education—curriculum, assessment strategies, learning environments—to prepare a thoroughly diverse workforce ready to counter health disparities. To actually realize diversity’s benefits, we must eschew a colorblind philosophy and embrace principles of equity pedagogy.
In this Medical Center Hour, Dr. Catherine Lucey explores equity pedagogy and how it may help to counter the structural racism and inequitable learning environments of traditional medical school. Such a fundamental change in our pedagogy may be necessary to improve health outcomes for patients of all cultures, colors, creeds, and means and, along the way, establish work environments where clinicians, teachers, and scientists of many backgrounds and professional preparations can all flourish.
A John F. Anderson Memorial Lecture / Medical Education Grand Rounds
Co-presented with the Office of Medical Education
