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>> GOOD AFTERNOON,
EVERYBODY,

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AMOLOL KATHRYN GORDON THE NICHD

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DIRECTOR AND I IT'S GREAT TO SEE

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AN IN-PERSON CROWD AND WELCOME

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EVERYBODY ONLINE.

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TODAY WE ARE A SPECIAL TREAT

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DR. PATIENCE WHITE FROM GEORGE

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WASHINGTON AND I WILL GO THROUGH

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A FEW LOGISTICS BEFORE WE GET

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STARTED.

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SO FIRST OF ALL, THE HOPKINS

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CLOUD CME ACTIVITY CODE IS

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57872.

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AGAIN, 57872.

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THREEZ TEXT THIS CODE TO THE

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JOHNS ON HOPKINS CME CODE THAT'S

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ON OUR SLIDE, IF OUR AV TEAM CAN

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GET US TO THAT NUMBER, THERE YOU

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GO.

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PERFECT.

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THAT WAY YOU CAN RECEIVE CREDIT.

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WE KINDLY REQUEST YOU PROVIDE

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FEEDBACK FROM THE LECTURE SHOWN

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ON THE SLIDE, THOSE APPLYING FOR

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CME, YOU WILL RECEIVE A CME LINK

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VIA E-MAIL AND THE SURVEY WILL

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BE USED TO PROVIDE US WITH

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IMPORTANT FEEDBACK AND I KNOW I

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SPEAK FOR OUR LECTURER, WE

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WELCOME THE FEEDBACK ESPECIALLY

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ON THIS TOPIC.

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SO FOLLOWING THE PRESENTATION,

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QUESTIONS FOR THE SPEAKER, THE

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SPEAKERS, I HAVE A FEW SLIDES AT

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THE END WILL BE TAKEN BY THE

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MICROEN FOCUSED ONS IN THE

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AISLES HERE--MICROPHONES IN THE

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AISLES HERE.

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AT THE END, FEEL FREE TO TYPE

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THOSE IN, WE WILL SEE THOSE AND

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THOSE WILL BE READ, AND WE WILL

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AS TIME PERMITS WE WILL TRY TO

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GET TO ALL OF THEM.

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SO NOW, IT'S MY PLEASURE AND

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PRIVILEGE REALLY, TRUE HONOR TO

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BRUCE DR. PATIENCE WHITE WHO'S A

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THOUGHT LEADER IN THE AREA OF

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HEALTHCARE TRANSITION WHO'S

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ARTICLES I HAVE READ FOR MANY

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YEARS, AND IT'S A REAL PLEASURE

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TO HAVE HER HERE IN PERSON, SHE

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IS PROFESSOR EMERITUS IN

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MEDICINE AND PEDIATRICS AT

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GEORGE WASHINGTON THE UNIVERSITY

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SCHOOL OF MEDICINE AND HEALTH

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SCIENCES.

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SHE'S CO DIRECTOR OF THE

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NATIONAL GUT TRANSITION, IT'S A

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NATIONAL TRUSTEES FOR HEALTHCARE

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TRANSITION IN WASHINGTON D. C.

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DR. WHITE EARNED HER MEDICAL

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DEGREE FROM HARVARD MED SCHOOL

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AND HER MASTERS IN EDUCATION

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FROM GEORGE WASHINGTON,

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COMPLETED HER RESIDENCY IN

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MEDICINE AND FELLOWSHIP IN

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RHEUMATOLOGY AT HARVARD AND THEN

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THROUGHOUT HER CAREER, SHE'S

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BEEN ACTIVE IN ACADEMIC

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MEDICINE, CLINICAL CARE,

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RESEARCH AND PUBLIC POLICY.

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SHE SERVED AS A DIVISION

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DIRECTOR OF AN ADULT AND

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PEDIATRIC RHEUMATOLOGY AS WELL

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AS SOCIALITY DEAN OF FACULTY

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AFFAIRS AT GEORGE WASHINGTON

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SCHOOL OF MEDICINE HEALTH

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SCIENCES.

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SO TODAY SHE AGAIN IS CO

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DIRECTOR OF THE NATIONAL

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ORGANIZATION GUT TRANSITION

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WHICH IS A FEDERALLY FUNDED

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PROGRAM THROUGH THE NATIONAL

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ALLIANCE TO ADVANCE ADOLESCENT

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HEALTH.  AND IT FOCUSES ON THE

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DIFFICULT TRANSITION FROM

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PEDIATRIC TO ADULT HEALTHCARE

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AND IN HER DAY-TO-DAY

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RESPONSIBILITIES SHE ADVISES

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MANY OF US, PROVOIDS HEALTHCARE

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SUPPORT FOR PROVIDERS AND

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NETWORKS THAT IS A SUPPORT THEIR

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PATIENTS AND FAMILIES AS THEY

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CHANGE AND PROGRESS TO ADULT

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CARE.

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SHE'S A PASSIONATE EDUCATOR AS

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YOU WILL SEE, A MENTOR OF

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MEDICAL STUDENTS, OF OLDER

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STUDENTS AND SCIENTISTS, SHE'S

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REALLY DEVOTED HER CAREER TO

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HELPING ALL OF US AND TRYING TO

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IMPROVE HEALTHCARE

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ACCESSIBILITY.

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SINCE 2010, SHE'S BEEN THE LEAD

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AUTHOR ON THE 2023 REAFFIRMATION

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OF THE AMERICAN ACADEMY OF

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PEDIATRICS, AMERICAN ACADEMY OF

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FAMILY PRACTICE, AMERICAN

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COLLEGE OF PHYSICIANS, JOINTS

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ACP STATEMENT, SUPPORTING THE

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HEALTHCARE TRANSEGZ FROM

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ADOLESCENT TO ADULTHOOD IN THE

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HOME AND DEVELOPED THE

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NATIONALLY RECOGNIZED 6 CORE

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ELEMENTS OF TRANSITION AND

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THERE'S AN IMPRESSIVE PAPER

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ONLINE.

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SHE'S AN INCREDIBLE RECIPIENT,

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TUTOR, AND TEACH ARE OF MANY

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NUMEROUS ASHES WARDS.

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ASK BEFORE SHE STARTS I ASKED

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HER TO ADD ON HOW SHE GOT HERE

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AND I THOUGHT IT ESPECIALLY FOR

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TRAINEES AND YOUNG RESEARCHERS

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IN THE AUDIENCE TO IT WILL BE

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INTERESTING FOR YOU TO HEAR A

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TINY BIT ABOUT HER PERSONAL

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STORY.

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SO WITHOUT FURTHER ADO, THANK

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YOU PATIENCE.

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[ APPLAUSE ]

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>> THANK YOU DR. GORDON.

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IT'S A REAL PRIVILEGE FOR ME TO

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BE HERE AND I'M EXCITED THAT YOU

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ARE ALL THINK BEING THIS AS AN

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ISSUE.

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IT'S BEEN PART OF MY LIFE FOR

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MANY, MANY YEARS AND I WILL TELL

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YOU JUST BRIEFLY BECAUSE MANY

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PEOPLE SAY HOW DID YOU GET INTO

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THIS ANYWAY IS SORT OF THETHINKW

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AS A CLINICIAN AND TEACHER ARE

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VERY DIFFERENT WHEN YOU'RE IN

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THE PEDIATRIC SETTING VERSUS--ON

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LOOKING AT THAT QUESTION AND IN

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1980 I PUT MY FIRST ABSTRACT

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TOGETHER, I WAS MENTIONING THIS

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MORNING SO THAT TELLS YOU HOW

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LONG I'VE BEEN INVESTED IN THIS

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AS AN AREA, THE OTHER THYME TIME

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THAT WAS CRUCIAL IN ALL THIS, I

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WENT THROUGH CAREER AND CAN A

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LOT OF RESEARCH AND OTHER

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THINGS, ALWAYS VOLUNTEERING TO

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WORK AROUND IN THE AREA OF

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HEALTHCARE TRANSITION, I HAD A

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FEW IMRANTS FROM THE BUREAU OF

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MATERNAL AND CHILD HEALTH THAT

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ALLOWED ME TO CONTINUE THAT.

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THE OTHER AREA, BESIDES

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EDUCATION IS I'M VERY INTERESTED

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IN ADVOCACY, THAT MAKES SENSE.

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I WILL ADVOCATE FOR YOUNG ADULTS

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AND THOSE KINDS OF THINGS, SO I

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SUDDENLY FOUND MYSELF LUCKILY

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ENOUGH TO BE A ROBERT WOOD

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JOHNSON HEALTH POLICY FELLOW.

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I WORKED ON CAPITAL HILL FOR 2

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YEARS IN THE ANTIFINANCE

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COMMITTEE RIGHT WHEN PART D WAS

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GOING THROUGH AND THE CHANGES IN

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MEDICAID, I WAS VERY INTERESTED

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IN MEDICAID.

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AND I WAS UP THERE IN CAPITOL

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HILL KNOWLEDGING WELL, I GUESS

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MY HELT CARE TRANSITION YEARS

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ARE YOU KNOW STILL--I'M SLUGGING

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ALONG THROUGH THIS AND ALONG

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CAME THE REPORT TO ERR IS HUMAN.

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IT REVOLUTIONIZED THE THINKING

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AND HEALTHCARE DELIVERY SYSTEM

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AND STARTED TALKING ABOUT

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QUALITY AND I LISTENED HARD AND

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THEN BEGAN TALKING ABOUT

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HEALTHCARE TRANSITION AS A

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QUALITY ISSUE AND IT'S TAKEN OFF

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EVER SINCE.

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SO LEARNING CLEARLY HOW TO

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COMMUNICATE WHAT YOU'RE DOING TO

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THE AUDIENCE, YOU'RE TALKING TO,

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MATTERS GREATLY AND I LEARNED

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THAT, THAT WAS SORT OF LIFE

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HAPPENS.

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I WAS ON CAPITOL HILL DOING

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SOMETHING ELSE AND IT TRANSFORM

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THE FIELD I WAS ALWAYS

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INTERESTED IN BUT COULDN'T WORK

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IN AND JUMPING THROUGH THE WIDE

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OPEN WIND O AND SAYING OKAY, I

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WILL DO THIS, I WILL DO THIS AS

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A FULL-TIME CAREER AND I COULD

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BECAUSE IT NOW CHANGED THE

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PLAYING FIELD EMPLOY SO THOSE

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ARE THE 2 THOUGHTS.

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YOU CAN SEE WHY I'M HERE HAVING

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DONE THAT OVER MY CAREER.

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SO TODAY WE WILL TALK ABOUT THE

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AGE GROUP, DO YOU REMEMBER BEING

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18, 19, WHAT YOU WERE DOING

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DURING THAT TIME?

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THINK THROUGH THAT A LITTLE BIT

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AND DID ANYBODY HELP YOU FROM

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MOVING A PEDIATRICIAN TO AN

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INTERNIST, I ASK YOU?

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THEN WE WILL DISCUSS THE KEY

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ISSUES HERE, OUTCOME EVIDENCE

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AND CLINICAL RECOMMENDATIONS

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HERE.

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WE DEVELOPED THESE OVER THE

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YEARS WITH LOTS OF SUPPORT, I

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STAND HERE ON THE SHOULDERS OF

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MANY PEOPLE, PARTICULARLY THE

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MANY PATIENTS AND FAMILIES THAT

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HELPED US THINK THROUGH THIS

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ISSUE.

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I WANT TO GIVE YOU 2 CONCEPTS

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AROUND WHO HAS DONE THIS, HAS

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ACTUALLY PUT HEALTHCARE

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TRANSITION FROM RESEARCH

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STANDPOINT IN SICKLE CELL DEC

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AND THEN AT CHILDREN'S HOSPITAL

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HAS BEEN DOING THIS AND THEN I

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WILL TURN IT OVER TO DR. GORDON

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TO TALK ABOUT THE PROCESS, I'M

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VERY EXCITED ABOUT HERE AT NIH.

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SO WHAT IS IT JUST SO WE GET ON

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THE SAME PAGE HERE?

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IT'S REALLY A PROCESS.

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IT'S VERY IMPORTANT, THAT'S

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MOVING FROM A CHILD TO AN ADULT

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MODEL OF HEALTHCARE.

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NOW YOU MAY CHANGE YOUR

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CLINICIAN OR I MAY NOT IN THAT

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PROCESS, BUT THAT CONCEPT OF

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GOING FROM A CHILD TO AN ADULT

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MODEL OF CARE IS VERY IMPORTANT.

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IT'S SORT OF LIKE, BEING IN

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SCHOOL AND THEN BEING ON THE

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JOB.

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THESE ARE VERY DIFFERENT

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EXPERIENCES AS YOU'RE GROWING UP

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AND THEN WHAT ARE THE GOALS.

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I THINK IT WOULD ALL ADPREE AND

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VERY INVOLVED IN MANAGING OR

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HEALTH KNOWING THEIR OWN

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MEDICATIONS BUT IF YOU DON'T

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KNOW HOW TO USE THE SYSTEM WELL,

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NO MATTER HOW WELL THEY KNOW

259
00:10:22,506 --> 00:10:23,340
ABOUT THEIR DISEASE, THEY WILL

260
00:10:23,340 --> 00:10:27,277
NOT BE ABLE TO SURVIVE IN OUR

261
00:10:27,277 --> 00:10:28,879
COUNTRY IN PARTICULAR I WOULD

262
00:10:28,879 --> 00:10:33,917
SAY AND THEN YOU WANT ORGANIZED

263
00:10:33,917 --> 00:10:36,420
CLINICAL PROCESS, THAT REALLY

264
00:10:36,420 --> 00:10:38,188
HELPS PRACTICES TO REALLY DO THE

265
00:10:38,188 --> 00:10:40,357
WORK OF TRANSITION, SO

266
00:10:40,357 --> 00:10:42,226
TRANSITION IS NOT TRANSFER AND I

267
00:10:42,226 --> 00:10:43,994
THINK THAT'S WHAT MOST PEOPLE

268
00:10:43,994 --> 00:10:47,531
THINK ABOUT HERE, SO TRANSITION

269
00:10:47,531 --> 00:10:48,699
IS PLANNING TRANSFER AND

270
00:10:48,699 --> 00:10:51,335
INTEGRATION INTO THE NEW SYSTEM,

271
00:10:51,335 --> 00:10:52,936
NOW IT MAY ALL HAPPEN IN 1

272
00:10:52,936 --> 00:10:55,205
SYSTEM BUT ALL OF THOSE STEPS,

273
00:10:55,205 --> 00:10:57,074
THIS IS REALLY BASED ON A HUGE

274
00:10:57,074 --> 00:10:58,876
AMOUNT OF TRANSITION LITERATURE

275
00:10:58,876 --> 00:11:01,445
AND SOCIAL MODEL ANDS SO FORTH

276
00:11:01,445 --> 00:11:03,313
SO I WANT TO PUT YOU INTO A

277
00:11:03,313 --> 00:11:08,919
PLANE AND MAKE THE ANALOGY TO

278
00:11:08,919 --> 00:11:09,586
HEALTHCARE TRANSITION.

279
00:11:09,586 --> 00:11:11,521
YOU KNOW YOU'VE ALL BEEN ON

280
00:11:11,521 --> 00:11:13,156
PLANES RECENTLY, YOU GO DUN A

281
00:11:13,156 --> 00:11:14,224
VERY LONG RUNWAY, AND YOU TAKE

282
00:11:14,224 --> 00:11:16,827
OFF, YOU'RE IN THE AIR, IT'S

283
00:11:16,827 --> 00:11:17,561
BUMPY, ACTUALLY, OFTEN,

284
00:11:17,561 --> 00:11:19,129
PARTICULARLY NOW WITH GLOBAL

285
00:11:19,129 --> 00:11:22,933
WARMING AND THEN YOU LAND AND GO

286
00:11:22,933 --> 00:11:23,500
DOWN ALONG RUNWAY.

287
00:11:23,500 --> 00:11:25,636
SO THAT FIRST RUNWAY IS THE

288
00:11:25,636 --> 00:11:27,638
PLANNING PROCESS, UP IN THE AIR,

289
00:11:27,638 --> 00:11:29,773
IS YOUR TRANSFER PROCESS, AND

290
00:11:29,773 --> 00:11:32,609
THEN THAT LONG RUNWAY AFTER, THE

291
00:11:32,609 --> 00:11:35,045
POINT BEING THAT EVERYBODY HAS

292
00:11:35,045 --> 00:11:39,182
SOMETHING TO DO HERE. 

293
00:11:39,182 --> 00:11:40,550
NOBODY FINISHES THE JOB

294
00:11:40,550 --> 00:11:41,485
ACTUALLY, WE'RE ALL WORKING

295
00:11:41,485 --> 00:11:43,153
TOGETHER UNTIL YOU GET OFF THE

296
00:11:43,153 --> 00:11:43,353
PLANE.

297
00:11:43,353 --> 00:11:44,554
I DON'T KNOW WHAT THAT ANALOGY

298
00:11:44,554 --> 00:11:46,657
IS, I DON'T KNOW.

299
00:11:46,657 --> 00:11:48,759
BUT I OFTEN CAN PILOTS, WHAT IS

300
00:11:48,759 --> 00:11:51,295
THE MOST DIFFICULT OR PERHAPS

301
00:11:51,295 --> 00:11:53,030
SCARY, THOUGH I NEVER SAID SCARY

302
00:11:53,030 --> 00:11:54,898
BECAUSE I WAS TOO SCARED TO ASK

303
00:11:54,898 --> 00:12:01,038
AND THEY SAID IT'S THE LANDING.

304
00:12:01,038 --> 00:12:01,972
AND THAT'S MY POINT.

305
00:12:01,972 --> 00:12:04,041
EVERYBODY'S GOING TO FOCUS ON

306
00:12:04,041 --> 00:12:06,209
THIS YOUNG PERSON'S ABILITY TO

307
00:12:06,209 --> 00:12:07,477
LAND IN THE ADULT ENVIRONMENT

308
00:12:07,477 --> 00:12:09,379
AND SURVIVE AND DO WELL AND SO,

309
00:12:09,379 --> 00:12:11,248
AS YOU'RE THINK BEING THAT

310
00:12:11,248 --> 00:12:14,184
PROCESS, THINK ABOUT THAT AS

311
00:12:14,184 --> 00:12:24,494
YOUR SORT OF GOAL.

312
00:12:33,403 --> 00:12:36,440
--I'M LOOKING FROM 12-26 AND

313
00:12:36,440 --> 00:12:38,108
ABOUT 4.1 MILLION TURN 18 THIS

314
00:12:38,108 --> 00:12:41,812
YEAR AND YOU HAVE A LOT OF THEM

315
00:12:41,812 --> 00:12:44,247
IN YOUR SYSTEM.

316
00:12:44,247 --> 00:12:46,416
AND ABOUT 25-35% HAVE CHRONIC

317
00:12:46,416 --> 00:12:46,717
CONDITIONS.

318
00:12:46,717 --> 00:12:48,285
PEOPLE ARE ALWAYS CHOKED AT

319
00:12:48,285 --> 00:12:49,786
THAT, IT'S VERY HIGH IN THE

320
00:12:49,786 --> 00:12:52,356
YOUNG ADULT ENVIRONMENT AND WHY

321
00:12:52,356 --> 00:12:56,259
IS THAT MENTAL HEALTH ISSUES

322
00:12:56,259 --> 00:12:57,294
BEGIN TO SUPPLANT MANY OF THE

323
00:12:57,294 --> 00:12:58,261
OTHER ISSUES THAT ARE GOING ON

324
00:12:58,261 --> 00:13:02,132
IN CHILDHOOD AND YOU CAN SEE, A

325
00:13:02,132 --> 00:13:03,066
LESSER NUMBER HAVE FUNCTIONAL

326
00:13:03,066 --> 00:13:03,567
LIMITATIONS.

327
00:13:03,567 --> 00:13:06,770
I JUST WANT TO BRIEFLY MENTION

328
00:13:06,770 --> 00:13:10,207
THAT ACTUALLY, YOUNG PEOPLE FACE

329
00:13:10,207 --> 00:13:12,275
LOTS OF TRANSITIONS HERE AND YOU

330
00:13:12,275 --> 00:13:14,478
KNOW THAT, YOU KNOW, THEY'RE

331
00:13:14,478 --> 00:13:15,212
BECOMING YOUNG ADULTS, THEY'RE

332
00:13:15,212 --> 00:13:17,647
DOING ALL THE THINGS YOUR

333
00:13:17,647 --> 00:13:19,016
PARENTS WISH YOU DIDN'T DO, BUT

334
00:13:19,016 --> 00:13:21,651
I THINK WE ALSO THINK ABOUT WHAT

335
00:13:21,651 --> 00:13:22,719
HAPPENS ABOUT THE SERVICES AS

336
00:13:22,719 --> 00:13:26,056
THEY AGE OUT IN THE PEDIATRIC

337
00:13:26,056 --> 00:13:26,456
ENVIRONMENT.

338
00:13:26,456 --> 00:13:28,425
YOU ALL HAVE THE LUXURY OF

339
00:13:28,425 --> 00:13:29,826
CARING FOR PEOPLE OVER THE AGE

340
00:13:29,826 --> 00:13:31,795
RAINCHL AND NOT HAVE TO WORRY

341
00:13:31,795 --> 00:13:38,435
ABOUT THESE THINGS, BUT ACTUALLY

342
00:13:38,435 --> 00:13:40,771
THE ROLE THAT MEDICAID, SOCIAL

343
00:13:40,771 --> 00:13:42,205
SECURITY, TITLE 5 PLAY HERE IS

344
00:13:42,205 --> 00:13:44,708
POWERFUL AND KNOWING WHETHER

345
00:13:44,708 --> 00:13:47,144
THEY ARE AN SSI RECIPIENT AND

346
00:13:47,144 --> 00:13:49,646
HELPING THEM KNOW THAT AT AGE

347
00:13:49,646 --> 00:13:51,915
1850% OF YOUNG PEOPLE LOSE

348
00:13:51,915 --> 00:13:53,817
SOCIAL SECURITY AND THEREFORE

349
00:13:53,817 --> 00:13:54,384
LOSE MEDICAID.

350
00:13:54,384 --> 00:13:56,286
SO THINKING ABOUT THAT IS A

351
00:13:56,286 --> 00:14:00,991
REALLY IMPORTANT PIECE HERE.

352
00:14:00,991 --> 00:14:02,726
SO HERE'S THE PARENTS VIEW OF

353
00:14:02,726 --> 00:14:05,262
WHAT GOES ON IN TRANSITION.

354
00:14:05,262 --> 00:14:07,230
I ALWAYS FIND IT SORT OF

355
00:14:07,230 --> 00:14:07,731
AMUSING.

356
00:14:07,731 --> 00:14:08,965
THE QUESTION IS PREPEAR TO

357
00:14:08,965 --> 00:14:10,267
TRANSFER AND WHERE THEY'RE

358
00:14:10,267 --> 00:14:10,867
GOING, NOBODY KNOWS.

359
00:14:10,867 --> 00:14:12,536
NOW I HATE TO THINK OF IT THAT

360
00:14:12,536 --> 00:14:14,237
WAY AND WE'RE WORKING VERY HARD

361
00:14:14,237 --> 00:14:16,573
TO CHANGE THAT VISION, BUT I

362
00:14:16,573 --> 00:14:18,542
THINK IT'S--WHENEVER I SHOW THAT

363
00:14:18,542 --> 00:14:21,611
PARENTS JUST NOD AND SAY, YEP,

364
00:14:21,611 --> 00:14:22,079
THAT'S IT.

365
00:14:22,079 --> 00:14:24,548
SO HOW ARE WE DOING?

366
00:14:24,548 --> 00:14:26,883
WE ACTUALLY CHECK-IN EVERY YEAR

367
00:14:26,883 --> 00:14:28,118
THROUGH THE NATIONAL SURVEY OF

368
00:14:28,118 --> 00:14:30,554
CHILDREN'S HEALTH EMPLOY THEY

369
00:14:30,554 --> 00:14:32,355
HAVE MANY QUESTIONS AROUND LOTS

370
00:14:32,355 --> 00:14:33,657
OF AREAS BUT YOU CAN SEE ON THE

371
00:14:33,657 --> 00:14:36,827
RIGHT SIDE OF THIS SLIDE, WHAT

372
00:14:36,827 --> 00:14:39,696
YOUR GENERALLY ASKING, THIS IS

373
00:14:39,696 --> 00:14:42,065
OF PARENTS, OF 12-17 YEAR-OLDS,

374
00:14:42,065 --> 00:14:45,202
THAT'S WHAT THIS NATIONAL SURVEY

375
00:14:45,202 --> 00:14:47,304
IS AND THEIR TIME ALONE ACTIVELY

376
00:14:47,304 --> 00:14:49,706
WORKING TO HELP GAIN SELF-CARE

377
00:14:49,706 --> 00:14:51,842
SKILLS AND DISCUSS THE SHIFT OF

378
00:14:51,842 --> 00:14:53,076
THE ADULT PROVIDER.

379
00:14:53,076 --> 00:14:55,045
NOW SADLY, BUT ACTUALLY, A VERY

380
00:14:55,045 --> 00:14:56,980
POSITIVE THING, WE HAVE A LOT TO

381
00:14:56,980 --> 00:14:57,481
WORK ON.

382
00:14:57,481 --> 00:15:02,719
YOU CAN SEE HERE THE MOST RECENT

383
00:15:02,719 --> 00:15:06,423
DATA IN 2022 SAY 23 OF YOUTH

384
00:15:06,423 --> 00:15:08,125
RECEIVE SPECIAL HEALTHCARE NEEDS

385
00:15:08,125 --> 00:15:08,992
RECEIVE GUIDANCE FROM THE

386
00:15:08,992 --> 00:15:10,794
PARENT'S POINT OF VIEW UNLESS

387
00:15:10,794 --> 00:15:12,129
THOSE THAT DIDN'T HAVE IT.

388
00:15:12,129 --> 00:15:13,497
SO THE MAJORITY OF THE PEOPLE

389
00:15:13,497 --> 00:15:15,932
OUT THERE ARE NOT RECEIVING WHAT

390
00:15:15,932 --> 00:15:21,138
YOU'RE ABOUT TO EMBARK ON, AND I

391
00:15:21,138 --> 00:15:22,472
THINK IT'S REALLY VERY EXCITING

392
00:15:22,472 --> 00:15:26,576
FOR THE MODEL FOR THE REST OF

393
00:15:26,576 --> 00:15:27,177
THE COUNTRY.

394
00:15:27,177 --> 00:15:29,746
THERE ARE A LOT OF QUALITY AND

395
00:15:29,746 --> 00:15:32,015
SAFETY ISSUES, THIS HAS BEEN

396
00:15:32,015 --> 00:15:35,085
DOCUMENTED FOR YEARS IN THE

397
00:15:35,085 --> 00:15:38,588
LITERATURE AND MOST RECENTLY IN

398
00:15:38,588 --> 00:15:40,624
PARTICULAR CERTAIN DISEASES,

399
00:15:40,624 --> 00:15:41,858
SICKLE CELL DISEASE, EPILEPSY,

400
00:15:41,858 --> 00:15:43,393
THE DEATH RATES GO UP

401
00:15:43,393 --> 00:15:44,961
CONSIDERABLY DURING THIS TIME,

402
00:15:44,961 --> 00:15:46,696
SO WE'RE TRYING TO REALLY THINK

403
00:15:46,696 --> 00:15:49,699
ABOUT SOME OF THESE ISSUES, WE

404
00:15:49,699 --> 00:15:50,333
ALL KNOW THAT TEENAGERS DON'T

405
00:15:50,333 --> 00:15:54,304
WANT TO DO WHAT YOU ASK THEM TO

406
00:15:54,304 --> 00:15:57,507
DO, AND SO MEDICATION ADHERENCE,

407
00:15:57,507 --> 00:15:59,376
ADHERENCE TO MEDICAL PROTOCOLS,

408
00:15:59,376 --> 00:16:01,344
WHATEVER IT IS, THERE'S A

409
00:16:01,344 --> 00:16:03,980
CERTAIN BACKGROUND ABOUT BEING A

410
00:16:03,980 --> 00:16:04,347
TEENAGER.

411
00:16:04,347 --> 00:16:07,184
THERE'S A LOT OF DISSATISFACTION

412
00:16:07,184 --> 00:16:09,586
AROUND THIS TIME IN THE MEDICAL

413
00:16:09,586 --> 00:16:14,491
DELIVERY SYSTEM. 

414
00:16:14,491 --> 00:16:17,127
IT'S THE #1 COMPLAINT IN KAISER

415
00:16:17,127 --> 00:16:18,695
IS YOUNG ADULTS AND HOW THEY'RE

416
00:16:18,695 --> 00:16:19,362
HANDLED.

417
00:16:19,362 --> 00:16:21,898
THIS WAS THE BIG SYSTEM TO COME

418
00:16:21,898 --> 00:16:23,233
UP US NATIONALLY AND WORK ON

419
00:16:23,233 --> 00:16:23,733
THIS ISSUE.

420
00:16:23,733 --> 00:16:24,801
COMMUNICATION IN THE HEALTHCARE

421
00:16:24,801 --> 00:16:27,771
DELIVERY IS A LOT OF ISSUES--HAS

422
00:16:27,771 --> 00:16:29,806
A LOT OF ISSUES PARTICULARLY

423
00:16:29,806 --> 00:16:32,776
BETWEEN THE PEDIATRIC AND ADULT

424
00:16:32,776 --> 00:16:37,247
HEALTHCARE DELIVERY SYSTEMS AND

425
00:16:37,247 --> 00:16:38,448
WE'VE KICKOFFS PLAY A BIG ROLE

426
00:16:38,448 --> 00:16:40,550
HERE AND AS YOU KNOW WE TEND TO

427
00:16:40,550 --> 00:16:42,052
FOCUS ON COST PERHAPS OUTSIDE

428
00:16:42,052 --> 00:16:46,489
THE NIH IN THIS ISSUE.

429
00:16:46,489 --> 00:16:48,391
SO, NOW--SO WHAT'S THE EVIDENCE?

430
00:16:48,391 --> 00:16:50,560
, YOU KNOW, REALLY DO YOU NEED

431
00:16:50,560 --> 00:16:51,261
TO DO THIS?

432
00:16:51,261 --> 00:16:54,231
AND THERE'S A LOT OF EVIDENT OUT

433
00:16:54,231 --> 00:16:55,899
THERE NOW, THERE'S A SYSTEMATIC

434
00:16:55,899 --> 00:16:57,367
REVIEW, LOOKING AT IT FROM THE

435
00:16:57,367 --> 00:16:59,035
POINT OF VIEW OF THE TRIPLE AIM

436
00:16:59,035 --> 00:17:02,706
BUT I WILL SHOW YOU EVIDENCE FOR

437
00:17:02,706 --> 00:17:05,742
THE QUADRUPLE AIM, SO THERE'S

438
00:17:05,742 --> 00:17:06,576
STATISTICALLY SIGNIFICANT

439
00:17:06,576 --> 00:17:07,611
IMPROVEMENT IN POPULATION OF

440
00:17:07,611 --> 00:17:09,012
HEALTHNESS EXPERIENCE OF CARE

441
00:17:09,012 --> 00:17:10,914
FOR YOUTH AND FAMILIES AND

442
00:17:10,914 --> 00:17:11,982
UTILIZATION, SO THAT DATA IS OUT

443
00:17:11,982 --> 00:17:14,351
THERE AND IT'S BECAUSE AS A

444
00:17:14,351 --> 00:17:16,152
STANDARDIZED PROCESS, THAT'S

445
00:17:16,152 --> 00:17:18,255
WHAT'S THE BACKGROUND HERE, IS

446
00:17:18,255 --> 00:17:21,091
THAT THERE'S A PROCESS THAT

447
00:17:21,091 --> 00:17:23,159
EVERYBODY FOLLOWS AND YOU GET

448
00:17:23,159 --> 00:17:24,461
BETTER OUTCOME, THAT KIND OF

449
00:17:24,461 --> 00:17:24,761
STRUCTURE.

450
00:17:24,761 --> 00:17:27,597
SO THIS IS A CLINICIAN

451
00:17:27,597 --> 00:17:29,833
EXPERIENCE SURVEY AND 6 SYSTEMS

452
00:17:29,833 --> 00:17:31,468
WHERE WE'RE ASKING GHEE WHIZ, DO

453
00:17:31,468 --> 00:17:34,104
YOU LIKE THAT YOU DID THIS,

454
00:17:34,104 --> 00:17:36,039
THAT'S THE QUEST FROM THE

455
00:17:36,039 --> 00:17:36,773
HEALTHCARE DELIVERY SYSTEM, HOW

456
00:17:36,773 --> 00:17:39,109
WILL I GET THESE PROVIDERS TO DO

457
00:17:39,109 --> 00:17:41,778
IT EMPLOY PROVIDER OR CLINICIAN,

458
00:17:41,778 --> 00:17:44,080
USED BROADLY WHETHER IT'S

459
00:17:44,080 --> 00:17:44,714
NURSES, SOCIAL WORKERS, WHOEVER

460
00:17:44,714 --> 00:17:48,451
IT IS IN THE SYSTEM AND YOU CAN

461
00:17:48,451 --> 00:17:50,520
SEE HERE, WE INVOLVED AN

462
00:17:50,520 --> 00:17:52,389
EVIDENCE-BASED SURVEY AND WE

463
00:17:52,389 --> 00:17:54,224
ASKED--WE GOT A RECENT RESPONSE

464
00:17:54,224 --> 00:17:55,659
RATE, I THOUGHT 31% FROM

465
00:17:55,659 --> 00:17:57,560
CLINICIAN WAS SORT OF

466
00:17:57,560 --> 00:18:00,864
OVERWHELMING, BUT YOU CAN SEE

467
00:18:00,864 --> 00:18:04,034
HERE, THAT THEY THOUGHT A

468
00:18:04,034 --> 00:18:04,634
HEALTHCARE TRANSITION PROCESS

469
00:18:04,634 --> 00:18:05,368
IMPROVES PATIENT EXPERIENCE AND

470
00:18:05,368 --> 00:18:06,803
CLINICIAN EXPERIENCE, I WAS ASH

471
00:18:06,803 --> 00:18:08,938
MAZED ACTUALLY AT THE HIGH

472
00:18:08,938 --> 00:18:10,607
PERCENTAGES THAT WE FOUND HERE.

473
00:18:10,607 --> 00:18:14,377
SO NOW HAVE YOU QUADRUPLE AIM,

474
00:18:14,377 --> 00:18:16,546
REALLY, RESULTS HERE FROM DOING

475
00:18:16,546 --> 00:18:17,547
A PROCESS.

476
00:18:17,547 --> 00:18:19,983
THESE WERE 6 SYSTEMS THAT WERE

477
00:18:19,983 --> 00:18:23,520
IN VERY DIFFERENT PROCESSES, AND

478
00:18:23,520 --> 00:18:24,421
INCORPORATING A STRUCTURED

479
00:18:24,421 --> 00:18:26,222
PROCESS, ALL OF THEM WERE USING

480
00:18:26,222 --> 00:18:30,193
A COMPONENT OF THE 6 CORE

481
00:18:30,193 --> 00:18:30,527
ELEMENTS.

482
00:18:30,527 --> 00:18:32,495
SO SHE MENTIONED THE CLINICAL

483
00:18:32,495 --> 00:18:32,729
REPORT.

484
00:18:32,729 --> 00:18:34,631
THIS HAS BEEN THE WORKS FOR

485
00:18:34,631 --> 00:18:35,799
YEARS, 2011 IS WHEN WE FIRST

486
00:18:35,799 --> 00:18:39,369
CAME TOGETHER AND BEGAN TO TALK

487
00:18:39,369 --> 00:18:42,038
ABOUT HEALTHCARE TRANSITION, IN

488
00:18:42,038 --> 00:18:44,274
2018, WE UPDATED THIS AND VERY

489
00:18:44,274 --> 00:18:48,511
CLEARLY HAD A TARGET OF ALL

490
00:18:48,511 --> 00:18:50,013
YOUTH WITH AN ALGORITHM

491
00:18:50,013 --> 00:18:51,514
STRUCTURE FOR YOUTH WITH SPECIAL

492
00:18:51,514 --> 00:18:54,751
HEALTHCARE NEED ANDS IT COULD

493
00:18:54,751 --> 00:18:56,286
APPLY ACROSS PRIMARY OR

494
00:18:56,286 --> 00:18:59,222
SPECIALTY PRACTICES OR SYSTEMS

495
00:18:59,222 --> 00:19:03,893
HERE AND WE HAD AT THE TABLE

496
00:19:03,893 --> 00:19:05,395
PARENT, YOUTH, NURSING, SOCIAL,

497
00:19:05,395 --> 00:19:07,831
WORK, CLINICIANS FROM ALL THESE

498
00:19:07,831 --> 00:19:08,932
DIFFERENT MEDICAL ASSOCIATIONS

499
00:19:08,932 --> 00:19:11,368
AND DEVELOPED THIS TIMELINE AND

500
00:19:11,368 --> 00:19:13,403
PEOPLE ALWAYS WERE ARGUING,

501
00:19:13,403 --> 00:19:15,672
SHOULD IT BE DEVELOPMENTAL SORT

502
00:19:15,672 --> 00:19:18,274
OF SITUATION THAT MOVES THINGS

503
00:19:18,274 --> 00:19:19,709
ALONG OR SHOULD IT BE AGE?

504
00:19:19,709 --> 00:19:22,278
IT WAS THE PARENTS THAT WERE

505
00:19:22,278 --> 00:19:22,545
CLEAR.

506
00:19:22,545 --> 00:19:24,647
THE COUNTRY'S BUILT ON AGE 18,

507
00:19:24,647 --> 00:19:25,849
BECOMING AN ADULT AND YOU WANT

508
00:19:25,849 --> 00:19:27,684
TO BE SURE YOU'RE AIM THAGOREAN

509
00:19:27,684 --> 00:19:29,319
AND GIVING YOUNG PEOPLE A FAIR

510
00:19:29,319 --> 00:19:31,054
SHOT AT KNOWING THE BALL GAME

511
00:19:31,054 --> 00:19:33,690
THAT'S GOING TO HAPPEN WHEN THEY

512
00:19:33,690 --> 00:19:35,058
TURN 18 HERE.

513
00:19:35,058 --> 00:19:36,926
WE UPDATED IN 2023, SO IT HAS

514
00:19:36,926 --> 00:19:41,464
ALL SORTS OF UPDATED EVIDENCE

515
00:19:41,464 --> 00:19:43,199
AND OTHER THINGS AND CLEARLY, BY

516
00:19:43,199 --> 00:19:45,502
THIS TIME, MOST PEOPLE WERE

517
00:19:45,502 --> 00:19:47,370
BEGINNING TO USE A STRUCTURED

518
00:19:47,370 --> 00:19:49,005
PROCESS THAT WE'RE PUBLISHING

519
00:19:49,005 --> 00:19:52,308
AND USING THE 3 COMPONENTS IN

520
00:19:52,308 --> 00:19:53,610
TRANSITION AND USING QUALITY

521
00:19:53,610 --> 00:19:54,344
IMPROVEMENT APPROACH THAT SEEMED

522
00:19:54,344 --> 00:19:56,546
TO GET THE MOST OUTCOME AND THE

523
00:19:56,546 --> 00:19:59,716
BEST OUTCOME WHEN THEY WERE

524
00:19:59,716 --> 00:20:03,019
DOING THAT EMPLOY .

525
00:20:03,019 --> 00:20:05,789
SO WHAT IS THE 6 CORE ELEMENTS,

526
00:20:05,789 --> 00:20:08,091
I WANT TO BE CLEAR IT'S JUST A

527
00:20:08,091 --> 00:20:08,391
MODEL.

528
00:20:08,391 --> 00:20:10,527
IT'S A ROADMAP FOR A PROCESS,

529
00:20:10,527 --> 00:20:12,095
WHICH YOU WILL TAKE IT IF YOU

530
00:20:12,095 --> 00:20:14,297
WANT IT, DO WITH IT, CUSTOMIZE

531
00:20:14,297 --> 00:20:15,365
IT, THAT'S WHAT PEOPLE DO ALL

532
00:20:15,365 --> 00:20:17,133
OVER THE WORLD AND USING THIS

533
00:20:17,133 --> 00:20:19,669
BACKBONE APPROACH, IT HAS BEEN

534
00:20:19,669 --> 00:20:21,871
TESTED IN QUALITY IMPROVEMENT

535
00:20:21,871 --> 00:20:22,906
LEARNING COLLABORATIVES.

536
00:20:22,906 --> 00:20:24,908
IT'S MEANT TO BE CUSTOMIZED

537
00:20:24,908 --> 00:20:26,810
EMPLOY YOU CUSTOMIZE IT

538
00:20:26,810 --> 00:20:27,877
ACCORDING TO THE COMPLEXITY,

539
00:20:27,877 --> 00:20:29,012
BOTH SOCIAL AND MEDICAL

540
00:20:29,012 --> 00:20:29,646
COMPLEXITY THAT YOU'RE DEALING

541
00:20:29,646 --> 00:20:32,582
WITH AS YOU DO.

542
00:20:32,582 --> 00:20:35,418
AND THAT INTENSITY VARIES,

543
00:20:35,418 --> 00:20:35,885
GREATLY.

544
00:20:35,885 --> 00:20:37,554
IT WILL VARY EACH INTUITY.

545
00:20:37,554 --> 00:20:39,022
IT VARIES ACROSS ALL THE SYSTEMS

546
00:20:39,022 --> 00:20:43,293
THAT I WORK WITH AND IT'S BEEN

547
00:20:43,293 --> 00:20:44,794
NOW APPLIED EVERYWHERE, AT

548
00:20:44,794 --> 00:20:46,563
SCHOOL BASED HEALTH CENTERS,

549
00:20:46,563 --> 00:20:49,299
MENTAL HEALTH, ACROSS MULTIPLE

550
00:20:49,299 --> 00:20:50,433
DIFFERENT SYSTEMS, SO, YOU'RE

551
00:20:50,433 --> 00:20:53,803
HAPPY TO GO TO OUR WEBSITE, AND

552
00:20:53,803 --> 00:20:56,739
DOWNLOAD A LOT OF THESE PAPERS

553
00:20:56,739 --> 00:20:58,508
IF YOU WANT TO, BUT IT'S REALLY

554
00:20:58,508 --> 00:20:59,275
BEEN USED NOW A LOT.

555
00:20:59,275 --> 00:21:01,177
THIS IS OUR WEBSITE, IT GIVES

556
00:21:01,177 --> 00:21:05,315
YOU 3 PACKAGES AND WHAT YOU CAN

557
00:21:05,315 --> 00:21:06,549
DRAW FROM.

558
00:21:06,549 --> 00:21:08,885
SO THERE'S 1 ABOUT YOUNG PEOPLE

559
00:21:08,885 --> 00:21:09,552
LEAVING A PEDIATRICIAN, 1 WHERE

560
00:21:09,552 --> 00:21:11,888
THEY WILL STAY WITH SOMEBODY

561
00:21:11,888 --> 00:21:13,456
THAT TAKES CARE OF THEM OVER THE

562
00:21:13,456 --> 00:21:15,425
LIFE SPAN AND THEN 1 EPITHELIAL

563
00:21:15,425 --> 00:21:17,994
GREATING YOUNG ADULTS INTO ADULT

564
00:21:17,994 --> 00:21:18,761
CARE.

565
00:21:18,761 --> 00:21:19,696
SO IT VARIES WHO YOU ARE AND

566
00:21:19,696 --> 00:21:24,968
WHAT THE YOUNG PERSON IS DOING.

567
00:21:24,968 --> 00:21:27,570
YOU CAN SEE, YOU CAN GET THE

568
00:21:27,570 --> 00:21:28,171
FULL ELEMENTS PACKAGE.

569
00:21:28,171 --> 00:21:31,007
YOU CAN GET IT IN SPANISH, AND

570
00:21:31,007 --> 00:21:32,542
THEREY A FULL IMPLEMENTATION

571
00:21:32,542 --> 00:21:34,744
PACKAGE ASSOCIATE WIDE EACH TO

572
00:21:34,744 --> 00:21:35,311
MAKE THIS EASIER FOR PEOPLE.

573
00:21:35,311 --> 00:21:36,980
SO PEOPLE SAY WELL, WHAT'S MY

574
00:21:36,980 --> 00:21:37,914
ROLE IN THIS PROCESS?

575
00:21:37,914 --> 00:21:41,084
THIS IS A BUSY SLIDE, WE'LL

576
00:21:41,084 --> 00:21:42,886
FOCUS ON THE PEDIATRIC 1 FOR THE

577
00:21:42,886 --> 00:21:45,722
MOMENT HERE, BUT CLEARLY THERE

578
00:21:45,722 --> 00:21:48,391
ARE CORE ELEMENTS ACROSS BOTH

579
00:21:48,391 --> 00:21:49,492
PEDIATRIC AND ADULT.

580
00:21:49,492 --> 00:21:52,295
ADULT SYSTEMS OFTEN SAY, WELL,

581
00:21:52,295 --> 00:21:53,363
JUST FOR--PREPARE THEM AND SEND

582
00:21:53,363 --> 00:21:55,265
THEM TO US NO, NO, NO, THEY HAVE

583
00:21:55,265 --> 00:21:58,768
A LOT THEY HAVE TO DO JUST AS

584
00:21:58,768 --> 00:22:01,237
MUCH AS PEDIATRIC, THOUGH THEY

585
00:22:01,237 --> 00:22:02,605
THINK THEY ARE DOING MORE IN

586
00:22:02,605 --> 00:22:04,140
EVERY SYSTEM I WORK WITH, SO

587
00:22:04,140 --> 00:22:06,643
LET'S JUST QUICKLY THINK ABOUT

588
00:22:06,643 --> 00:22:07,343
THEM HERE.

589
00:22:07,343 --> 00:22:10,880
THIS IS A GENERIC ROADMAP, YOU

590
00:22:10,880 --> 00:22:13,917
WANT TO TELL PEOPLE WHAT YOU'RE

591
00:22:13,917 --> 00:22:14,250
DOING.

592
00:22:14,250 --> 00:22:15,952
THAT'S WHAT THE POLICY IS.

593
00:22:15,952 --> 00:22:17,487
YOU WANT TO TRACK THAT WHAT YOU

594
00:22:17,487 --> 00:22:18,922
SAID YOU WERE GOING TO DO, YOU

595
00:22:18,922 --> 00:22:21,691
ACTUALLY DID AND THIS IS NOTHING

596
00:22:21,691 --> 00:22:23,893
NEW, YOU WANT TO ASSESS THE

597
00:22:23,893 --> 00:22:25,228
SELF-CARE SKILLS, OFFER

598
00:22:25,228 --> 00:22:25,995
EDUCATION, THAT'S READINESS, YOU

599
00:22:25,995 --> 00:22:28,231
WANT TO MAKE A PLAN, SO

600
00:22:28,231 --> 00:22:30,466
EVERYBODY, YOU KNOW YOU WANT TO

601
00:22:30,466 --> 00:22:31,301
SHARE DECISION MAKING, WHATEVER

602
00:22:31,301 --> 00:22:32,802
IT IS, YOU'RE GOING TO DO, YOU

603
00:22:32,802 --> 00:22:35,772
WANT TO BE SURE IT'S WITH

604
00:22:35,772 --> 00:22:37,607
FAMILIES, AND YOUTH, THEN THAT

605
00:22:37,607 --> 00:22:38,975
MOMENT OF TRUTH WHETHER YOU HAVE

606
00:22:38,975 --> 00:22:40,977
A WARM HANDOFF WHICH IS THE

607
00:22:40,977 --> 00:22:45,114
CLASSIC THING BETWEEN THE 2

608
00:22:45,114 --> 00:22:48,151
SYSTEMS OR BETWEEN WHATEVER

609
00:22:48,151 --> 00:22:49,218
YOU'RE BRIDGING A GAP AND THEN

610
00:22:49,218 --> 00:22:51,220
YOU WANT TO ASK, DID I DO A GOOD

611
00:22:51,220 --> 00:22:51,454
JOB?

612
00:22:51,454 --> 00:22:52,989
DID I MEET THE NEEDS OF THE

613
00:22:52,989 --> 00:22:58,761
FAMILIES AND THE SYSTEM THAT I'M

614
00:22:58,761 --> 00:23:00,196
WORKING IN.

615
00:23:00,196 --> 00:23:02,632
SO JUST SO YOU SORT OF THINK

616
00:23:02,632 --> 00:23:06,135
ABOUT WHAT THESE ARE, SO THE

617
00:23:06,135 --> 00:23:07,003
WELCOME OR POLICY CARE GUIDE,

618
00:23:07,003 --> 00:23:09,639
HOWEVER YOU WANT TO DO IT IS

619
00:23:09,639 --> 00:23:10,773
FORMALIZING YOUR APPROACH,

620
00:23:10,773 --> 00:23:12,642
THAT'S THE HARDEST STEP.

621
00:23:12,642 --> 00:23:13,843
EVERYBODY NEEDS TO AGREE FOR

622
00:23:13,843 --> 00:23:15,845
CERTAIN THINGS AND WORKING

623
00:23:15,845 --> 00:23:16,913
TOGETHER TO PULL THAT TOGETHER

624
00:23:16,913 --> 00:23:19,816
SO HAVE YOU A UNIFIED MESSAGE TO

625
00:23:19,816 --> 00:23:22,852
FAMILIES IN YOUTH, FAMILIES FEEL

626
00:23:22,852 --> 00:23:24,554
IT'S VERY HARD IF THEY'RE SEEING

627
00:23:24,554 --> 00:23:26,155
MULTIPLE PROVIDERS IN A SYSTEM,

628
00:23:26,155 --> 00:23:28,591
AND 1 SAYS YOU'RE OUTA HERE AT

629
00:23:28,591 --> 00:23:31,561
18, THE NEXT SAYS YOU NEVER HAVE

630
00:23:31,561 --> 00:23:32,662
TO LEAVE.

631
00:23:32,662 --> 00:23:34,197
AND THEN THEY FIND THEMSELVES

632
00:23:34,197 --> 00:23:35,965
BRIDGING 2 DIFFERENT HUGE

633
00:23:35,965 --> 00:23:37,700
SYSTEMS AND WITH A SYMPTOM

634
00:23:37,700 --> 00:23:39,335
THEY'RE NOT SURE WHERE TO GO.

635
00:23:39,335 --> 00:23:43,306
AND THAT'S WHERE THE MEDICAL

636
00:23:43,306 --> 00:23:43,806
LIABILITY LIES.

637
00:23:43,806 --> 00:23:45,541
THEY NEED TO KNOW WHAT TO DO,

638
00:23:45,541 --> 00:23:49,345
WHO'S MANAGING AND CLEARLY LEAVE

639
00:23:49,345 --> 00:23:50,680
1 SYSTEM FOR ANOTHER.

640
00:23:50,680 --> 00:23:51,748
TRACKING AND MONITORING IS

641
00:23:51,748 --> 00:23:52,548
PRETTY STRAIGHT FORWARD, THERE

642
00:23:52,548 --> 00:23:53,750
ARE MANY WAYS TO DO IT.

643
00:23:53,750 --> 00:23:55,985
YOU HAVE AN EMR, MOST PEOPLE DO

644
00:23:55,985 --> 00:23:59,288
IT THROUGH THAT.

645
00:23:59,288 --> 00:24:00,223
THE READINESS ASSESSMENTS,

646
00:24:00,223 --> 00:24:01,290
PEOPLE LOVE THESE, PEOPLE FOCUS

647
00:24:01,290 --> 00:24:03,026
ON THEM BUT I THINK YOU HAVE TO

648
00:24:03,026 --> 00:24:07,263
THINK THROUGH THAT THEY ARE NOT

649
00:24:07,263 --> 00:24:08,698
EVIDENCE BASED, YOU CAN'T SAY

650
00:24:08,698 --> 00:24:11,968
YOU CORE A HUNDRED AND YOU'RE AN

651
00:24:11,968 --> 00:24:12,969
ADULT, RIGHT?

652
00:24:12,969 --> 00:24:17,040
THAT JUST DOESN'T COMPUTE.

653
00:24:17,040 --> 00:24:18,041
SO THEY'RE A DISCUSSION TOOL.

654
00:24:18,041 --> 00:24:19,642
YOU WANT TO USE IT TO GUIDE YOU

655
00:24:19,642 --> 00:24:21,444
AND HELPING YOUNG PEOPLE GET THE

656
00:24:21,444 --> 00:24:24,981
KILLS AND HEALTH LITERACY THAT

657
00:24:24,981 --> 00:24:28,051
THEY NEED HERE AND NOT GET

658
00:24:28,051 --> 00:24:29,285
INVOLVE BUT SOMEHOW YOU'RE GOING

659
00:24:29,285 --> 00:24:30,987
TO PREDICT THEIR OUTCOME WITH

660
00:24:30,987 --> 00:24:31,421
THIS.

661
00:24:31,421 --> 00:24:37,827
WE DON'T HAVE AN A1C, I WILL SAY

662
00:24:37,827 --> 00:24:38,995
FOR MY ENDOCRINOLOGY, IN THIS,

663
00:24:38,995 --> 00:24:41,197
WE JUST DON'T IN THIS.

664
00:24:41,197 --> 00:24:41,397
RIGHT?

665
00:24:41,397 --> 00:24:42,598
PARENTS WOULD LOVE IF WE HAD A

666
00:24:42,598 --> 00:24:44,500
MEASURE FOR ARK DULT HOOD, THEY

667
00:24:44,500 --> 00:24:45,201
WOULD SAY THANKS.

668
00:24:45,201 --> 00:24:48,805
THEN THE PLANNING, I THINK IT'S

669
00:24:48,805 --> 00:24:51,808
IMPORTANT THAT EVERYBODY SET UP

670
00:24:51,808 --> 00:24:54,143
PRYERITYS THAT ARE IDENTITIES IN

671
00:24:54,143 --> 00:24:55,645
YOUR READINESS ASSESSMENT AND

672
00:24:55,645 --> 00:24:56,479
CLARIFY THE ROLES.

673
00:24:56,479 --> 00:24:57,547
WHAT ARE PARENTS GOING TO DO

674
00:24:57,547 --> 00:24:58,715
HERE IN WHAT IS THE YOUTH GOING

675
00:24:58,715 --> 00:25:01,484
TO DO IN WHAT IS THE PROVIDER

676
00:25:01,484 --> 00:25:02,318
GOING TO DO?

677
00:25:02,318 --> 00:25:04,220
AND OBVIOUSLY DEVELOPING THE

678
00:25:04,220 --> 00:25:06,155
EDUCATION AND THE OTHER KEY

679
00:25:06,155 --> 00:25:10,059
THING IS THE ROLE OF YOU AS A

680
00:25:10,059 --> 00:25:11,427
SPECIALIST VERSUS THEIR PRIMARY

681
00:25:11,427 --> 00:25:12,729
CARE PHYSICIAN AND WE HAVE A

682
00:25:12,729 --> 00:25:15,331
VERY HARD TIME WITH THAT

683
00:25:15,331 --> 00:25:16,699
DISTINCTION IN THIS COUNTRY, BUT

684
00:25:16,699 --> 00:25:17,967
REMEMBER THE ASULT SYSTEMS GOING

685
00:25:17,967 --> 00:25:21,270
TO HAVE THEM FOR 50 YEARS.

686
00:25:21,270 --> 00:25:24,574
YOU HAD THEM FOR 20 OR MAYBE 25.

687
00:25:24,574 --> 00:25:26,109
AND THE PRIMARY CARRY PHYSICIAN

688
00:25:26,109 --> 00:25:29,512
PLAYS A HUGE ROLE IN HELPING

689
00:25:29,512 --> 00:25:32,815
THAT AGING PROCESS THAT WE ALL

690
00:25:32,815 --> 00:25:33,750
DON'T WANT TO ACKNOWLEDGE.

691
00:25:33,750 --> 00:25:35,284
AND THEN OBVIOUSLY TRANSFER,

692
00:25:35,284 --> 00:25:36,619
PUTTING TOGETHER THE

693
00:25:36,619 --> 00:25:38,354
INFORMATION, THE MEDICAL SUMMARY

694
00:25:38,354 --> 00:25:41,023
IS A CRUCIAL COMPONENT HERE, IT

695
00:25:41,023 --> 00:25:42,825
SHOULD BE CONCISE, EVERYBODY CAN

696
00:25:42,825 --> 00:25:44,761
UNDERSTAND THE YOUNG PERSON HAS

697
00:25:44,761 --> 00:25:47,396
IT IN THEIR HANDS WHEN THEY MOVE

698
00:25:47,396 --> 00:25:51,667
AND THEN THERE'S LOTS OF WAYS TO

699
00:25:51,667 --> 00:25:56,939
BRIDGE THE GAP, TELEHEALTH

700
00:25:56,939 --> 00:25:58,407
VISITS, JOINT CLINICS, SPENDING

701
00:25:58,407 --> 00:25:59,509
TIME ON 1 SIDE THEN THE OTHER.

702
00:25:59,509 --> 00:26:00,610
THERE ARE MANY DIFFERENT MODELS

703
00:26:00,610 --> 00:26:02,044
THERE AND THEN BE SURE THAT THEY

704
00:26:02,044 --> 00:26:03,346
ACTUALLY MADE IT, DID THEY SHOW

705
00:26:03,346 --> 00:26:06,916
UP ON THE ADULT WARD LIKE YOU

706
00:26:06,916 --> 00:26:08,217
THOUGHT THAT YOU WERE DPG TO AND

707
00:26:08,217 --> 00:26:10,520
THEN TRY TO OBVIOUSLY

708
00:26:10,520 --> 00:26:11,988
COMMUNICATE WITH ALL THE

709
00:26:11,988 --> 00:26:12,889
CLINICIANS AND COMMUNITY

710
00:26:12,889 --> 00:26:16,459
PARTNERS ABOUT THIS CHANGE AND

711
00:26:16,459 --> 00:26:16,826
WHAT IT MEANS.

712
00:26:16,826 --> 00:26:17,927
SO THERE ARE A LOT OF

713
00:26:17,927 --> 00:26:18,661
MEASUREMENT TOOLS HERE AND I

714
00:26:18,661 --> 00:26:21,097
WANT TO BE SURE THAT THESE

715
00:26:21,097 --> 00:26:24,433
ARE--HAVE BEEN USED WIDELY NOW

716
00:26:24,433 --> 00:26:25,067
IN DIFFERENT SETTINGS DEPENDING

717
00:26:25,067 --> 00:26:26,869
ON WHAT YOU WANT TO DO.

718
00:26:26,869 --> 00:26:29,405
I WILL TALK ABOUT THE CURRENT

719
00:26:29,405 --> 00:26:30,439
ASSESSMENT OF HEALTHCARE

720
00:26:30,439 --> 00:26:32,542
ACTIVITIES, THIS HAS BEEN USED

721
00:26:32,542 --> 00:26:34,010
BROADLY TO ASSESS WHERE PEOPLE

722
00:26:34,010 --> 00:26:36,679
ARE IN THEIR CLINIC, OR IN THEIR

723
00:26:36,679 --> 00:26:36,913
SYSTEM.

724
00:26:36,913 --> 00:26:40,349
IF YOU ARE GOING TO DO A QUALITY

725
00:26:40,349 --> 00:26:43,152
IMPROVEMENT PROJECT, AND NEED A

726
00:26:43,152 --> 00:26:44,687
VERY TIGHT MEASUREMENT AS IS

727
00:26:44,687 --> 00:26:48,057
DONE IN PC ORI GRANTS, THEN YOU

728
00:26:48,057 --> 00:26:48,958
CAN USE THE PROCESS MEASUREMENT

729
00:26:48,958 --> 00:26:50,426
TOOL, THERE'S A LOT OF

730
00:26:50,426 --> 00:26:51,594
VERIFICATION IN THAT, YOU CAN'T

731
00:26:51,594 --> 00:26:52,895
JUST SAY, OH I'M A CERTAIN

732
00:26:52,895 --> 00:26:54,330
LEVEL, YOU HAVE TO ACTUALLY

733
00:26:54,330 --> 00:26:55,932
PROVE IT, SO THAT IT MAKES SENSE

734
00:26:55,932 --> 00:26:58,201
IN YOUR RESEARCH PROJECT AND

735
00:26:58,201 --> 00:27:01,938
THEN SINCE EXPERIENCE IS SUCH A

736
00:27:01,938 --> 00:27:03,573
LARGE PART OF THE QUADRUPLE AIM,

737
00:27:03,573 --> 00:27:06,709
WE HAVE WAYS OF MEASURING

738
00:27:06,709 --> 00:27:08,878
EXPERIENCE BOTH YOUTH PARENTS

739
00:27:08,878 --> 00:27:11,681
AND THE CLINICIAN FEEDBACK

740
00:27:11,681 --> 00:27:12,148
SURVEY.

741
00:27:12,148 --> 00:27:13,616
NOW IN WORKING WITH YOUTH AND

742
00:27:13,616 --> 00:27:17,220
YOUNG  ADULT FEEDBACK SURVEYS, T

743
00:27:17,220 --> 00:27:19,488
HAS TO BE VERY CONCISE, LESS

744
00:27:19,488 --> 00:27:22,058
THAN 1 PAGE OR THEY WILL NOT

745
00:27:22,058 --> 00:27:24,093
FILL IT OUT.

746
00:27:24,093 --> 00:27:25,127
SO REMEMBER THAT AS YOU'RE

747
00:27:25,127 --> 00:27:27,964
BEGINNING TO THINK ABOUT THIS.

748
00:27:27,964 --> 00:27:30,933
SO THIS GIVES YOU THE CURRENT

749
00:27:30,933 --> 00:27:31,300
ASSESSMENT.

750
00:27:31,300 --> 00:27:31,868
IT'S VERY EASY.

751
00:27:31,868 --> 00:27:34,270
YOU SIT DOWN AND SAY, WHAT LEVEL

752
00:27:34,270 --> 00:27:38,941
AM I AT MY CLINIC WHERE AM I IN

753
00:27:38,941 --> 00:27:40,643
THIS AND YOU KNOW WHAT THE

754
00:27:40,643 --> 00:27:41,644
GOALPOST IS?

755
00:27:41,644 --> 00:27:42,879
THAT'S LEVEL 4.

756
00:27:42,879 --> 00:27:45,047
AND YOU HAVE 6 CORE ELEMENTS AND

757
00:27:45,047 --> 00:27:48,784
THEN 2 AROUND YOUTH AND PARENT

758
00:27:48,784 --> 00:27:49,452
LEADERSHIP.

759
00:27:49,452 --> 00:27:51,020
THIS HAS PROVED VERY HELPFUL.

760
00:27:51,020 --> 00:27:52,521
I WANT TO YOU KNOW ACROSS ALL

761
00:27:52,521 --> 00:27:54,056
THE SYSTEMS I WORKED WITH, THEY

762
00:27:54,056 --> 00:27:59,262
SCORE ABOUT AN AVERAGE OF 1.5 TO

763
00:27:59,262 --> 00:27:59,595
START.

764
00:27:59,595 --> 00:28:02,231
DO THEY MOVE IN ABSOLUTELY BUT

765
00:28:02,231 --> 00:28:04,433
IT'S A WAY OF PROCESS

766
00:28:04,433 --> 00:28:05,501
MEASUREMENT AND I ENCOURAGE YOU

767
00:28:05,501 --> 00:28:07,303
TO THINK ABOUT SOMETHING ABOUT

768
00:28:07,303 --> 00:28:11,440
THAT AS YOU'RE GOING THROUGH

769
00:28:11,440 --> 00:28:11,641
THIS.

770
00:28:11,641 --> 00:28:12,808
SO THIS IS ANOTHER FEEDBACK

771
00:28:12,808 --> 00:28:13,943
SURVEY, I THINK THE MOST

772
00:28:13,943 --> 00:28:16,145
IMPORTANT 1 THAT EVERYBODY

773
00:28:16,145 --> 00:28:18,481
FOCUSES ON OVERALL THIS, IS FOR

774
00:28:18,481 --> 00:28:22,084
YOUTH WHO HAS GONE TO AN ADULT

775
00:28:22,084 --> 00:28:26,689
SYSTEM, OVERALL, HOW REALLY DID

776
00:28:26,689 --> 00:28:29,292
YOU FEEL TO MOVE TO AND TALK TO

777
00:28:29,292 --> 00:28:29,759
OTHER HEALTHCARE.

778
00:28:29,759 --> 00:28:30,626
HOW DID YOU FEEL ABOUT THAT

779
00:28:30,626 --> 00:28:33,629
EMPLOY THAT WAS A QUESTION WE

780
00:28:33,629 --> 00:28:35,064
TESTED HUNDREDS OF TIMES WITH

781
00:28:35,064 --> 00:28:39,035
THE YOUNG PEOPLE AND VARIES,

782
00:28:39,035 --> 00:28:40,236
SOMEWHAT, AND NOT AT ALL.

783
00:28:40,236 --> 00:28:42,672
THAT'S THE WAY THEY WANTED IT

784
00:28:42,672 --> 00:28:45,541
ASKED AND ANSWERED, IT'S BEEN

785
00:28:45,541 --> 00:28:46,609
VERY HELPFUL, THE OTHER SYSTEMS

786
00:28:46,609 --> 00:28:48,678
HAVE BEEN HELPFUL IN CORING THAT

787
00:28:48,678 --> 00:28:50,513
AND ASKING HOW GOOD YOU ARE AS A

788
00:28:50,513 --> 00:28:52,448
CLINICIAN, ET CETERA.

789
00:28:52,448 --> 00:28:55,084
NOW THIS 1 IS A MEDICAL HOME

790
00:28:55,084 --> 00:28:57,253
FEEDBACK SURVEY, IT'S BEEN WELL

791
00:28:57,253 --> 00:29:01,958
VALIDATED AND WE ADAPTED IT FOR

792
00:29:01,958 --> 00:29:03,125
DOING FEEDBACK SURVEYS FOR

793
00:29:03,125 --> 00:29:05,695
CLINICIANS AND THAT'S WHAT WE

794
00:29:05,695 --> 00:29:09,699
USE FOR THE STUDY I PRESENTED TO

795
00:29:09,699 --> 00:29:09,899
YOU.

796
00:29:09,899 --> 00:29:11,367
AS DR. GORDON MENTIONED, WE HAVE

797
00:29:11,367 --> 00:29:12,902
LOTS OF WAYS TO HELP YOU THINK

798
00:29:12,902 --> 00:29:15,771
ABOUT THIS, HOW TO IMPLEMENT THE

799
00:29:15,771 --> 00:29:18,975
6 CORE ELEMENTS, THERE'S A WHOLE

800
00:29:18,975 --> 00:29:20,576
QUALITY IMPROVEMENT PRIMER WITH

801
00:29:20,576 --> 00:29:21,811
ALL EXAMPLES FROM HEALTHCARE

802
00:29:21,811 --> 00:29:25,614
TRANSITION FROM SORT OF THE IHI

803
00:29:25,614 --> 00:29:26,449
BACKBONE AND THEN, I GOT

804
00:29:26,449 --> 00:29:27,917
TOGETHER WITH A LOT OF OUR

805
00:29:27,917 --> 00:29:31,253
SYSTEMS AND WE PUT TOGETHER

806
00:29:31,253 --> 00:29:32,521
THIS--HOW CAN YOU DO THIS?

807
00:29:32,521 --> 00:29:34,757
WHAT ARE SORT OF FAIL SAFE STEPS

808
00:29:34,757 --> 00:29:37,860
YOU WANT TO THINK ABOUT AND

809
00:29:37,860 --> 00:29:40,096
YOU'RE ALREADY WELL PAST STEP 1

810
00:29:40,096 --> 00:29:44,433
HERE WHICH I THINK IS IN STEP 2,

811
00:29:44,433 --> 00:29:47,103
YOU'RE DEVELOPING A PLAN, SO

812
00:29:47,103 --> 00:29:51,440
THIS IS ABOUT I WOULD SAY--12

813
00:29:51,440 --> 00:29:53,042
BIG SYSTEMS ALL AGREED THAT

814
00:29:53,042 --> 00:29:55,311
WITHOUT THESE, YOU HAVE A VERY

815
00:29:55,311 --> 00:29:58,080
HARD TIME MAKING IT HAPPEN OVER

816
00:29:58,080 --> 00:29:59,648
A PERIOD OF TIME.

817
00:29:59,648 --> 00:30:01,517
WE HAVE A LOT OF RESOURCES FOR

818
00:30:01,517 --> 00:30:04,153
YOUTH AND YOUNG ADULTS AND YOU

819
00:30:04,153 --> 00:30:07,123
CAN SEE HERE MOST OF THEM HAVE

820
00:30:07,123 --> 00:30:09,091
BEEN SET UP WITH YOUNG ADULTS

821
00:30:09,091 --> 00:30:10,760
AND THERE'S A QUICK VIDEO, YOU

822
00:30:10,760 --> 00:30:13,162
CAN SEE IN THE UPPER RIGHT HAND

823
00:30:13,162 --> 00:30:14,563
CORNER MADE BY YOUNG ADULTS

824
00:30:14,563 --> 00:30:17,199
ABOUT WHAT IS THIS WHOLE THING

825
00:30:17,199 --> 00:30:18,634
OF HEALTHCARE TRANSITION ANYWAY,

826
00:30:18,634 --> 00:30:20,669
SO I ENCOURAGE YOU TO SEND YOUNG

827
00:30:20,669 --> 00:30:22,538
PEOPLE TO THIS PART OF WEBSITE

828
00:30:22,538 --> 00:30:25,474
TO HAVE A ELECTRIC AT SOME OF

829
00:30:25,474 --> 00:30:26,442
THESE RESOURCES.

830
00:30:26,442 --> 00:30:28,010
--LOOK AT SOME OF THESE

831
00:30:28,010 --> 00:30:28,377
RESOURCES.

832
00:30:28,377 --> 00:30:29,678
SO NOW LET'S LOOK AT 2 PROGRAMS

833
00:30:29,678 --> 00:30:31,447
AND WHAT THEY DID, THE FIRST 1

834
00:30:31,447 --> 00:30:36,719
IS GOING TO BE A MULTISPECIALTY

835
00:30:36,719 --> 00:30:37,686
MULTISITE PROJECT.

836
00:30:37,686 --> 00:30:39,588
THIS A RESEARCH PROJECT FUNDED

837
00:30:39,588 --> 00:30:41,257
BY PC ORI FUNDED OVER 5 YEARS

838
00:30:41,257 --> 00:30:44,026
AND IT WAS GIVEN TO ATRIUM FOR

839
00:30:44,026 --> 00:30:45,961
YOUTH WITH SICKLE CELL DISEASE.

840
00:30:45,961 --> 00:30:48,030
I AM ONLY PRESENTING THE

841
00:30:48,030 --> 00:30:50,366
TRANSITION PROCESS, THERE ARE

842
00:30:50,366 --> 00:30:51,801
LOTS OF COMPONENTS TO THIS, IN

843
00:30:51,801 --> 00:30:54,737
THE MIDDLE OF THIS COVID

844
00:30:54,737 --> 00:30:55,004
HAPPENED.

845
00:30:55,004 --> 00:30:56,806
SO DID THEY GET ALL THE NUMBER

846
00:30:56,806 --> 00:30:58,207
OF PEOPLE THEY WANTED IN THE

847
00:30:58,207 --> 00:30:58,674
STUDY?

848
00:30:58,674 --> 00:30:58,841
NO.

849
00:30:58,841 --> 00:31:00,142
WE WERE TALKING ABOUT THAL

850
00:31:00,142 --> 00:31:02,144
MORNING, HOW DO YOU CONVINCE

851
00:31:02,144 --> 00:31:04,180
PEOPLE TO DO WHATEVER PILOT YOU

852
00:31:04,180 --> 00:31:05,748
WANTED TO DO, YOU KNOW THIS.

853
00:31:05,748 --> 00:31:07,483
OUT THERE IT WAS VERY HARD

854
00:31:07,483 --> 00:31:07,883
DURING THIS TIME.

855
00:31:07,883 --> 00:31:08,350
SO THESE, THE PROCESS

856
00:31:08,350 --> 00:31:09,151
MEASUREMENT TOOL, THE TOP CORE

857
00:31:09,151 --> 00:31:16,759
IS A HUNDRED, JUST ON TO REMIND

858
00:31:16,759 --> 00:31:21,964
YOU, AND THEY DID SORT OF A QI

859
00:31:21,964 --> 00:31:22,565
PROCESS BIANNUAL SITE VISITS,

860
00:31:22,565 --> 00:31:23,132
ANNUAL CONFERENCES, AND THEY

861
00:31:23,132 --> 00:31:28,304
WANTED THEM TO REACH 90, AT A

862
00:31:28,304 --> 00:31:28,737
LEVEL 90.

863
00:31:28,737 --> 00:31:30,139
THAT'S A HUGE, YOU WILL SEE

864
00:31:30,139 --> 00:31:30,739
THAT'S A BIG LEFT AT HOW FAST

865
00:31:30,739 --> 00:31:32,441
THEY GOT THERE IN THE 5 YEAR

866
00:31:32,441 --> 00:31:33,142
PROCESS, RIGHT?

867
00:31:33,142 --> 00:31:34,076
THEY DID OUTCOME MEASURE WANTS,

868
00:31:34,076 --> 00:31:36,745
THEY ARE NOW LOOKING AT THE

869
00:31:36,745 --> 00:31:37,713
DATA, DECREASED MORTALITY RATES,

870
00:31:37,713 --> 00:31:40,249
THAT WILL BE TOUGH IN THE MIDDLE

871
00:31:40,249 --> 00:31:40,516
OF COVID.

872
00:31:40,516 --> 00:31:44,320
THEY LOST A LOT OF THEIR PEASHS

873
00:31:44,320 --> 00:31:45,488
DURING THAT TIME EMPLOY LOST TO

874
00:31:45,488 --> 00:31:46,589
FOLLOW UP, ER VISITS, THOSE

875
00:31:46,589 --> 00:31:47,089
KINDS OF THINGS.

876
00:31:47,089 --> 00:31:50,192
THIS WILL BE HARD TO INTERPRET

877
00:31:50,192 --> 00:31:51,360
BUT I THINK THEIR PATIENT

878
00:31:51,360 --> 00:31:54,730
SATISFACTION WILL PROBABLY COME

879
00:31:54,730 --> 00:31:56,532
OUT ON TOP HERE.

880
00:31:56,532 --> 00:31:58,701
IT LOOKS SO, ALREADY.

881
00:31:58,701 --> 00:32:00,269
SO HERE THEY ARE, THIS IS AT 20

882
00:32:00,269 --> 00:32:04,140
MONTHS, THEY DID PRETTY WELL,

883
00:32:04,140 --> 00:32:07,042
REALLY BOTH THE PEDIATRIC AND

884
00:32:07,042 --> 00:32:10,246
ADULT CLINICS, YOU SEE THEM

885
00:32:10,246 --> 00:32:13,749
SITES A-N, THERE WERE 14 SITES

886
00:32:13,749 --> 00:32:14,583
ACROSS THE SOUTHEAST, VERY

887
00:32:14,583 --> 00:32:15,384
DIFFERENT, SOME SMALL, SOME

888
00:32:15,384 --> 00:32:21,390
LARGE, AND YOU COULD SEE THAT

889
00:32:21,390 --> 00:32:23,025
THE ADULT CLINICIANS WERE A

890
00:32:23,025 --> 00:32:24,827
LITTLE BIT BEHIND IN THIS

891
00:32:24,827 --> 00:32:31,300
MEASUREMENT AT 24 MONTHS BUT

892
00:32:31,300 --> 00:32:32,835
OVERALL, EVERYBODY GOT THERE.

893
00:32:32,835 --> 00:32:36,372
AND THAT WAS AT 54 MONTHS.

894
00:32:36,372 --> 00:32:37,006
SO IT DOES TAKE TIME, WHAT DO WE

895
00:32:37,006 --> 00:32:37,306
LEARN HERE?

896
00:32:37,306 --> 00:32:37,940
WE LEARN THAT IT'S 18 MONTHS TO

897
00:32:37,940 --> 00:32:38,607
REALLY GET IT UP AND RUNNING IN

898
00:32:38,607 --> 00:32:41,544
A LARNL SYSTEM AND YOU HAVE TO

899
00:32:41,544 --> 00:32:44,914
THINK ABOUT THAT AND THAT

900
00:32:44,914 --> 00:32:48,150
EVERYBODY WANTS A QUICK TURN

901
00:32:48,150 --> 00:32:48,384
AROUND.

902
00:32:48,384 --> 00:32:52,321
IT'S JUST CHANGING PRACTICE AND

903
00:32:52,321 --> 00:32:58,727
HARD SO YOU SEE, THEY WENT FROM

904
00:32:58,727 --> 00:33:02,064
19 TO 97, IT WAS QUITE

905
00:33:02,064 --> 00:33:02,631
IMPRESSIVE ACTUALLY IN THAT

906
00:33:02,631 --> 00:33:02,865
PROCESS.

907
00:33:02,865 --> 00:33:03,399
SO NOW LET'S TALK ABOUT

908
00:33:03,399 --> 00:33:03,999
CHILDREN'S MERCY KANSAS CITY.

909
00:33:03,999 --> 00:33:04,500
THIS IS A NOT FOR PROFIT

910
00:33:04,500 --> 00:33:11,674
PEDIATRIC ACADEMIC HEALTHCARE

911
00:33:11,674 --> 00:33:11,907
SYSTEM.

912
00:33:11,907 --> 00:33:12,508
HUGE SYSTEM, 700 MEDICAL STAFF

913
00:33:12,508 --> 00:33:13,776
MEMBERS, AND ABOUT A HUNDRED AND

914
00:33:13,776 --> 00:33:14,743
50,000 UNIQUE VISITS, SO YOU GET

915
00:33:14,743 --> 00:33:16,745
THE SENSE OF THE SIZE OF THIS

916
00:33:16,745 --> 00:33:19,315
AND THEY WANTED TO DO THIS, THEY

917
00:33:19,315 --> 00:33:23,786
PUT IT IN THEIR STRATEGIC PLAN

918
00:33:23,786 --> 00:33:26,222
IN 2015, AND THEY BEGAN SORT OF

919
00:33:26,222 --> 00:33:26,922
THINKING ABOUT WELL, HOW MANY

920
00:33:26,922 --> 00:33:27,790
PATIENTS ARE ACTUALLY--WERE OVER

921
00:33:27,790 --> 00:33:32,494
12 IN WHO DO WE NEED TO TARGET.

922
00:33:32,494 --> 00:33:38,467
YOU CAN SEE IT'S A LARGE NUMBER

923
00:33:38,467 --> 00:33:39,068
IN THAT SYSTEM, IT'S ACTUALLY

924
00:33:39,068 --> 00:33:39,635
GROWN BECAUSE WE'RE DOING A

925
00:33:39,635 --> 00:33:40,269
GREAT JOB IN PEDIATRICS, PEOPLE

926
00:33:40,269 --> 00:33:40,836
ARE SURVIVING AND THEN THEY

927
00:33:40,836 --> 00:33:41,503
ACTUALLY LOOKED AT THE NUMBER OF

928
00:33:41,503 --> 00:33:45,674
YOUNG ADULTS OVER THE AGE OF 25

929
00:33:45,674 --> 00:33:48,677
SITTING IN THE SYSTEM AND IT

930
00:33:48,677 --> 00:33:49,078
SHOCKED EVERYBODY.

931
00:33:49,078 --> 00:33:51,714
SO THAT WAS WHAT BEGAN TO BE THE

932
00:33:51,714 --> 00:33:52,381
MOTIVATING FACTOR, THE WEIGHT

933
00:33:52,381 --> 00:33:55,718
TIMES FOR NEW PATIENT VISITS

934
00:33:55,718 --> 00:33:57,953
WERE TOO LONG, 2 YEARS IN SOME

935
00:33:57,953 --> 00:33:58,220
INSTANCES.

936
00:33:58,220 --> 00:34:01,390
AS YOU KNOW THAT, TRY TO GET

937
00:34:01,390 --> 00:34:04,827
SOMEBODY IN FOR AN AUTISM

938
00:34:04,827 --> 00:34:07,329
EVALUATION OUT THERE, MENTAL

939
00:34:07,329 --> 00:34:09,598
HEALTH, YOU KNOW THIS, IN THE

940
00:34:09,598 --> 00:34:15,904
SYSTEMS OUT THERE, THEY REALIZED

941
00:34:15,904 --> 00:34:24,313
THAT THEIR BEAN COUNTERS IT'S

942
00:34:24,313 --> 00:34:24,880
BETTER THAT HAVE THEM FOR 21

943
00:34:24,880 --> 00:34:25,514
YEARS THAN THE OTHER 4, SO THERE

944
00:34:25,514 --> 00:34:26,148
WAS A FINANCIAL MOTIVATOR HERE,

945
00:34:26,148 --> 00:34:26,749
I HATE TO MENTION IT BUT THOSE

946
00:34:26,749 --> 00:34:27,383
ARE THE FACTS WHEN WE GET PEOPLE

947
00:34:27,383 --> 00:34:27,816
TO THINK ABOUT THIS.

948
00:34:27,816 --> 00:34:28,384
THEY GOT ENGAGEMENT EARLY ON

949
00:34:28,384 --> 00:34:29,018
FROM CONSUMERS, THEY CREATED A

950
00:34:29,018 --> 00:34:32,921
COMMITTEE WITH WORK GROUPS.

951
00:34:32,921 --> 00:34:34,123
PARTICULARLY THEY HAD H. I.T. AT

952
00:34:34,123 --> 00:34:37,893
THE TABLE, THEY WORKED WITH

953
00:34:37,893 --> 00:34:39,028
CERNER AND THEY GOT CERNER

954
00:34:39,028 --> 00:34:43,632
INTERESTED IN IT FROM A GENERAL

955
00:34:43,632 --> 00:34:44,533
STANDPOINT, THEY HAD EDUCATORS

956
00:34:44,533 --> 00:34:47,536
IN MARKETING AND OUTCOME, NOW

957
00:34:47,536 --> 00:34:50,072
THE MARKETING BECAME A VERY

958
00:34:50,072 --> 00:34:51,507
IMPORTANT COMPONENT OF THIS,

959
00:34:51,507 --> 00:34:58,480
MARKETING IT TO FAMILIES, AND TO

960
00:34:58,480 --> 00:34:59,081
CLINICIANS AS THEY BEGAN THIS

961
00:34:59,081 --> 00:34:59,682
PROCESS AND THEY HAD TO MAKE A

962
00:34:59,682 --> 00:35:06,655
LOT OF INFRASTRUCTURE CHANGE

963
00:35:06,655 --> 00:35:13,729
ANDS THEY CHOSE THE PROCESS AND

964
00:35:13,729 --> 00:35:14,363
INCORPORATED IT INTO THE SYSTEM,

965
00:35:14,363 --> 00:35:14,897
UNIVERSAL CLINIC FLOW, AND

966
00:35:14,897 --> 00:35:15,531
ENGAGE THE MEDICAL DIRECTORS AND

967
00:35:15,531 --> 00:35:16,165
STAFFS OF CLINICS, SO THERE WAS

968
00:35:16,165 --> 00:35:16,765
A CHAMPION IN EVERY CLINIC AND

969
00:35:16,765 --> 00:35:17,599
THEY ROLLED THEM IN OVER A 4

970
00:35:17,599 --> 00:35:17,900
YEAR PERIOD.

971
00:35:17,900 --> 00:35:18,534
SO THEY HAD A PILOT OF A FEW AND

972
00:35:18,534 --> 00:35:21,670
THEN THEY ROLLED IT OUT ACROSS

973
00:35:21,670 --> 00:35:27,309
THE INSTITUTION AND THE

974
00:35:27,309 --> 00:35:27,910
OUTPATIENT SETTING.

975
00:35:27,910 --> 00:35:29,445
SO WHAT DID THEY DO, THEY GAVE A

976
00:35:29,445 --> 00:35:30,112
POLICY TO ALL 14 YEAR-OLDS THAT

977
00:35:30,112 --> 00:35:32,915
TOLD THEM WHEN THEY WERE GOING

978
00:35:32,915 --> 00:35:33,782
TO BE LEAVING THE INSTITUTION

979
00:35:33,782 --> 00:35:35,351
AND EVERYBODY HAD TO AGREE ON

980
00:35:35,351 --> 00:35:37,219
IT, THAT WAS THE DEAL.

981
00:35:37,219 --> 00:35:40,489
THEY DID A READINESS ASSESSMENT,

982
00:35:40,489 --> 00:35:44,760
HAD A GOAL SETTING PROCESS ANDA

983
00:35:44,760 --> 00:35:49,298
I DISCUSSION, THAT TURNED OUT TO

984
00:35:49,298 --> 00:35:49,865
BE THE MOST IMPORTANT FOLLOW

985
00:35:49,865 --> 00:35:50,432
THROUGH THEY FIGURED OUT IN

986
00:35:50,432 --> 00:35:50,766
THEIR SYSTEM.

987
00:35:50,766 --> 00:35:54,470
THEY'VE BEEN AT THIS NOW FOR

988
00:35:54,470 --> 00:35:58,941
ABOUT 8 YEARS, THEY DO A LOT OF

989
00:35:58,941 --> 00:36:00,409
REPORTS BACK TO CLINICS ABOUT

990
00:36:00,409 --> 00:36:02,044
MEASURING THEIR SUCCESS IN THAT

991
00:36:02,044 --> 00:36:04,380
DISCUSSION AS WELL AS MISSED

992
00:36:04,380 --> 00:36:04,713
OPPORTUNITIES.

993
00:36:04,713 --> 00:36:08,617
OOPS THEY FORGOT TO TALK ABOUT

994
00:36:08,617 --> 00:36:11,387
IT ALTOGETHER IN A VISIT.

995
00:36:11,387 --> 00:36:15,324
THEY HAVE MEDICAL SUMMARY

996
00:36:15,324 --> 00:36:17,025
TEMPLATE THAT PEOPLE CAN TWEAK

997
00:36:17,025 --> 00:36:18,293
AND THEN THEY HAVE A TRANSFER

998
00:36:18,293 --> 00:36:19,061
ORDER AND DATE.

999
00:36:19,061 --> 00:36:21,730
SO IF SOMEBODY CALLS BACK TO THE

1000
00:36:21,730 --> 00:36:22,297
INSTITUTION, THEY HAVE BEEN

1001
00:36:22,297 --> 00:36:22,931
TRANSFERRED, THEY'RE EAR MARKED

1002
00:36:22,931 --> 00:36:23,532
SO THEY ASK WHY YOU'RE CALLING

1003
00:36:23,532 --> 00:36:24,199
BACK, WHAT HAPPENED SO THEY'RE

1004
00:36:24,199 --> 00:36:25,033
VERY CLEAR THAT WHEN THEY LEAVE

1005
00:36:25,033 --> 00:36:27,336
THE SYSTEM, THEY HAVE LEFT THE

1006
00:36:27,336 --> 00:36:28,370
SYSTEM UNLESS THERE'S AN

1007
00:36:28,370 --> 00:36:30,773
EMERGENCY OF SOME SORT, RIGHT?

1008
00:36:30,773 --> 00:36:33,709
AS I SAID, IT CHAMPIONS AND THEY

1009
00:36:33,709 --> 00:36:43,152
HAD 3 ADULT HOSPITALS THAT THEY

1010
00:36:43,152 --> 00:36:45,421
HAD ON SPEED DIAL BECAUSE

1011
00:36:45,421 --> 00:36:50,459
GETTING AN ADULT ON SPEED DIAL

1012
00:36:50,459 --> 00:36:50,793
AND VERY HARD.

1013
00:36:50,793 --> 00:36:51,260
SO FIRST CARE CAN THEN

1014
00:36:51,260 --> 00:36:51,860
SUBSEQUENT SPECIAL CARE OUT OF

1015
00:36:51,860 --> 00:36:52,428
THIS PARTICULAR INSTITUTION

1016
00:36:52,428 --> 00:36:52,928
EMPLOY THEY HAVE A VERY

1017
00:36:52,928 --> 00:36:53,529
EDUCATION PROCESS, YOU CAN SEE

1018
00:36:53,529 --> 00:36:55,697
I'M PUTTING THINGS UP THERE,

1019
00:36:55,697 --> 00:36:57,332
THEY HAVE THEIR GOALS, YOUNG

1020
00:36:57,332 --> 00:36:59,168
PEOPLE CHOOSE A GOAL FOR A YEAR,

1021
00:36:59,168 --> 00:37:04,473
THERE'S A LOT OF INFORMATION IN

1022
00:37:04,473 --> 00:37:07,142
THEIR EMR DEVELOPED BY THE

1023
00:37:07,142 --> 00:37:08,844
SYSTEM THAT YOU CAN USE TO HELP

1024
00:37:08,844 --> 00:37:10,746
THEM THINK ABOUT COMPLETING THAT

1025
00:37:10,746 --> 00:37:14,950
GOAL, AND MAKES IT EASIER FOR

1026
00:37:14,950 --> 00:37:15,217
EVERYBODY.

1027
00:37:15,217 --> 00:37:15,851
NOBODY'S REINVENTING THE WHEEL,

1028
00:37:15,851 --> 00:37:17,619
ALL THAT INFORMATION IS THERE.

1029
00:37:17,619 --> 00:37:18,220
THEY HAD INVOLVEMENT AND STILL

1030
00:37:18,220 --> 00:37:19,087
HAVE INVOLVEMENT OF BOTH THEIR

1031
00:37:19,087 --> 00:37:21,256
PARENT ADVISORY COUNCIL AND

1032
00:37:21,256 --> 00:37:22,257
THEIR TEEN ADVISORY COUNCIL.

1033
00:37:22,257 --> 00:37:26,261
THEY HAVE THEM IN EACH CLINIC.

1034
00:37:26,261 --> 00:37:28,130
SO EVERYBODY IS IN A FEEDBACK

1035
00:37:28,130 --> 00:37:29,765
LOOP, ONCE THEY'RE UP AND

1036
00:37:29,765 --> 00:37:30,899
RUNNING, THEY GET FEEDBACK FROM

1037
00:37:30,899 --> 00:37:33,435
THIS GROUP WHO ARE OBVIOUSLY

1038
00:37:33,435 --> 00:37:35,637
GETTING THEIR CARE IN THAT

1039
00:37:35,637 --> 00:37:36,038
PARTICULAR CLINIC.

1040
00:37:36,038 --> 00:37:38,173
SO WHAT ARE THE OUTCOMES IN

1041
00:37:38,173 --> 00:37:41,410
WELL, THEY WANTED TO KNOW THE #

1042
00:37:41,410 --> 00:37:43,512
OF YOUTH RECEIVING TRANSITION

1043
00:37:43,512 --> 00:37:44,079
READINESS ASSESSMENTS, DOING

1044
00:37:44,079 --> 00:37:54,523
GOAL SETTING AND RECEIVING

1045
00:37:56,091 --> 00:37:56,592
HEALTHCARE EDUCATION IN THAT

1046
00:37:56,592 --> 00:37:56,792
ORDER.

1047
00:37:56,792 --> 00:37:57,392
SO THEY HAVE A DASHBOARD THAT

1048
00:37:57,392 --> 00:37:58,393
GOES UP EVERY 6 MONTHS AND

1049
00:37:58,393 --> 00:38:02,965
REPORTED EVERY YEAR DOWN TO THE

1050
00:38:02,965 --> 00:38:04,366
INDIVIDUAL CLINICIAN ABOUT WHO'S

1051
00:38:04,366 --> 00:38:11,106
DOING IT.

1052
00:38:11,106 --> 00:38:11,507
THERE ARE SPECIFIC

1053
00:38:11,507 --> 00:38:12,140
IMPLEMENTATION SURVEYS THEY USE

1054
00:38:12,140 --> 00:38:12,674
ON CURRENT ASSESSMENT AND

1055
00:38:12,674 --> 00:38:13,275
FEEDBACK SURVEYS FOR YOUTH AND

1056
00:38:13,275 --> 00:38:13,876
FAMILIES 6 MONTHS AFTER THEY

1057
00:38:13,876 --> 00:38:14,576
LEAVE THE INSTITUTION AND THEY

1058
00:38:14,576 --> 00:38:18,247
HAVE A BONUS SYSTEM IN THEIR

1059
00:38:18,247 --> 00:38:20,115
COMPENSATION SYSTEM, HOW WELL

1060
00:38:20,115 --> 00:38:21,984
YOU DO MATTERS IN A SMALL WAY,

1061
00:38:21,984 --> 00:38:22,584
THAT'S NEW AND IT'S BEEN VERY

1062
00:38:22,584 --> 00:38:25,621
INTERESTING TO SEE, HOW MUCH IT

1063
00:38:25,621 --> 00:38:26,154
CHANGED THE UPTAKE OR NOT.

1064
00:38:26,154 --> 00:38:26,788
IT DEPENDED ON THE DIVISION, IT

1065
00:38:26,788 --> 00:38:27,789
WAS I THINK FASCINATING WHEN YOU

1066
00:38:27,789 --> 00:38:28,557
THINK ABOUT IT.

1067
00:38:28,557 --> 00:38:32,160
YOU CAN SEE IN 2016 THEY HAD 9

1068
00:38:32,160 --> 00:38:33,362
DIVISIONS IN THEIR CURRENT

1069
00:38:33,362 --> 00:38:34,963
ASSESSMENT OF THE TOP IS 32,

1070
00:38:34,963 --> 00:38:39,434
JUST TO REMIND YOU ON THE

1071
00:38:39,434 --> 00:38:40,135
CURRENT ASSESSMENT AND THEN IN

1072
00:38:40,135 --> 00:38:44,806
2019 THEY HAD NEARLY ALL 15

1073
00:38:44,806 --> 00:38:46,542
DIVISION ANDS THEY HAD A MARKED

1074
00:38:46,542 --> 00:38:47,876
INCREASE ACROSS THE BOARD IF ALL

1075
00:38:47,876 --> 00:38:50,746
OF THEM.

1076
00:38:50,746 --> 00:38:52,147
NOW THIS PRACTICE PLAN, CAN YOU

1077
00:38:52,147 --> 00:38:53,015
SEE IF YOU'RE AT LEAST 10% ARE

1078
00:38:53,015 --> 00:38:59,454
MEETING THE PAIRED METRIC OF

1079
00:38:59,454 --> 00:39:05,260
DOING THE READINESS ASSESSMENT

1080
00:39:05,260 --> 00:39:09,364
AND AS THE TEAR CLOSE OFF SO

1081
00:39:09,364 --> 00:39:09,865
THAT'S A PAIRING METRIC.

1082
00:39:09,865 --> 00:39:10,465
SO WHAT ARE THE KEY FEATURES,

1083
00:39:10,465 --> 00:39:14,736
I'M GOING TO WRAP UP AND LET

1084
00:39:14,736 --> 00:39:18,740
DR. GORDON TALK TO YOU ABOUT

1085
00:39:18,740 --> 00:39:21,143
YOUR POTENTIAL EXCITING PLANS.

1086
00:39:21,143 --> 00:39:23,178
SO SENIOR LEADERSHIP ENGAGEMENT

1087
00:39:23,178 --> 00:39:26,315
OF KEY PLAYERS, AND OUT THERE,

1088
00:39:26,315 --> 00:39:28,684
IN THE GENERAL PROCESS IT'S

1089
00:39:28,684 --> 00:39:30,052
REALLY IMPORTANT POINT AS A

1090
00:39:30,052 --> 00:39:33,589
CHILDREN'S HOSPITAL TO HAVE

1091
00:39:33,589 --> 00:39:34,756
ADULT CLINICIANS ON THESE

1092
00:39:34,756 --> 00:39:35,591
COMMITTEES, ALTHOUGH MANY OF

1093
00:39:35,591 --> 00:39:36,191
THEM WILL NOT BE AT THE

1094
00:39:36,191 --> 00:39:36,858
INSTITUTIONS, THEY GET THEM FROM

1095
00:39:36,858 --> 00:39:45,100
THEIR PAIRED INSTITUTIONS ACROSS

1096
00:39:45,100 --> 00:39:45,734
THE WAY SO THAT EVERYBODY SERVED

1097
00:39:45,734 --> 00:39:46,335
IS INFORMED ALONG THE PROCESS

1098
00:39:46,335 --> 00:39:47,069
AND OBVIOUSLY YOUTH AND

1099
00:39:47,069 --> 00:39:47,669
FAMILIES, METHODOLOGY, NOW YOU

1100
00:39:47,669 --> 00:39:54,810
HAVE WANT TO HAVE MEASURABLE

1101
00:39:54,810 --> 00:39:55,410
AIMS AND EVERYBODY AGREE WHAT

1102
00:39:55,410 --> 00:39:55,844
SUCCESS LOOKS LIKE.

1103
00:39:55,844 --> 00:39:56,478
YOU'RE A RESEARCH INSTITUTION, I

1104
00:39:56,478 --> 00:40:00,983
WISH WE HAD AN A1C THAT WOULD

1105
00:40:00,983 --> 00:40:03,552
SAY THAT WOULD SAY, I HAVE DONE

1106
00:40:03,552 --> 00:40:03,719
IT.

1107
00:40:03,719 --> 00:40:04,252
THIS TEST, IT'S A QUALITY

1108
00:40:04,252 --> 00:40:04,853
IMPROVEMENT PROCESS, SO IT'S

1109
00:40:04,853 --> 00:40:05,487
GOING TO BE A LOT OF THINGS YOU

1110
00:40:05,487 --> 00:40:06,088
HAVE TO LIVE WITH THAT AREN'T

1111
00:40:06,088 --> 00:40:10,325
GOING TO BE MEASURED TO THE

1112
00:40:10,325 --> 00:40:10,726
P-VALUE HERE.

1113
00:40:10,726 --> 00:40:16,932
AND OBVIOUSLY HARD WIRING INTO

1114
00:40:16,932 --> 00:40:22,104
THE PROCESS THROUGH YOUR EHRV1,

1115
00:40:22,104 --> 00:40:25,907
USING SOME KIND OF PROCESS AS A

1116
00:40:25,907 --> 00:40:26,508
BACKBONE, IT'S GOT TRANSITION

1117
00:40:26,508 --> 00:40:28,377
AND THERE ARE OTHER 1S OUT

1118
00:40:28,377 --> 00:40:34,082
THERE, ASK OBVIOUSLY CONNECTING

1119
00:40:34,082 --> 00:40:41,423
REGIONAL LEGAL AND NATIONALLY, I

1120
00:40:41,423 --> 00:40:41,923
WILL TELL YOU HOW YOU'RE

1121
00:40:41,923 --> 00:40:42,724
CONNECTED NATIONALLY AND THROUGH

1122
00:40:42,724 --> 00:40:47,329
OUR LEARNING COLLABORATIVE, AND

1123
00:40:47,329 --> 00:40:49,031
VUBSLY HEARING SUCCESS AND

1124
00:40:49,031 --> 00:40:49,665
LESSONINGS LEARNED PUBLISH WHAT

1125
00:40:49,665 --> 00:40:49,965
YOU LEARNED.

1126
00:40:49,965 --> 00:40:50,632
YOU ALL KNOW IT DIDN'T HAPPEN IF

1127
00:40:50,632 --> 00:40:51,099
YOU DIDN'T PUBLISH IT.

1128
00:40:51,099 --> 00:40:51,767
SO I'M HAMMERING ON THE GROUP TO

1129
00:40:51,767 --> 00:40:52,000
DO THAT.

1130
00:40:52,000 --> 00:40:58,674
SO THERE'S A LOT OF IF HE

1131
00:40:58,674 --> 00:41:02,177
EVERRER, I MUST ADMIT, ONCE

1132
00:41:02,177 --> 00:41:03,612
ERR HUMAN CAME OUT, WE BEBAN TO

1133
00:41:03,612 --> 00:41:04,046
MESSAGE DIFFERENTLY.

1134
00:41:04,046 --> 00:41:07,149
THERE USED TO BE 1 PUBLICATION A

1135
00:41:07,149 --> 00:41:07,749
MONTH AND NOW WE HAVE 30-50,

1136
00:41:07,749 --> 00:41:08,250
IT'S HARD TO GET PAPERS

1137
00:41:08,250 --> 00:41:08,884
PUBLISHED, WHICH IS CRAZY, BUT

1138
00:41:08,884 --> 00:41:09,618
IT'S--IT'S A GOING MOVEMENT OUT

1139
00:41:09,618 --> 00:41:17,459
THERE BUT ACTUALLY WHERE ARE WE?

1140
00:41:17,459 --> 00:41:20,095
THIS IS WHERE WE ARE, WE'RE

1141
00:41:20,095 --> 00:41:20,662
BUILD THE TRACKS AS WE GO,

1142
00:41:20,662 --> 00:41:26,702
WELCOME TO THIS WONDERFUL

1143
00:41:26,702 --> 00:41:27,502
MILIEU, OF THIS BIG CHANGE THAT

1144
00:41:27,502 --> 00:41:28,136
DOES MAKE A BIG DIFFERENCE AND

1145
00:41:28,136 --> 00:41:29,504
JUST TO LET YOU KNOW, WE'RE VERY

1146
00:41:29,504 --> 00:41:35,610
EXCITED THAT THE IN, IH WILL BE

1147
00:41:35,610 --> 00:41:37,112
REJOINING THE LEARNING

1148
00:41:37,112 --> 00:41:37,379
COMMUNITY.

1149
00:41:37,379 --> 00:41:39,748
SO THIS HAS BEEN GOING ON FOR

1150
00:41:39,748 --> 00:41:42,117
ABOUT 10 YEARS, ONCE A MONTH

1151
00:41:42,117 --> 00:41:44,352
I'VE HAD ANYWHERE BETWEEN 8 AND

1152
00:41:44,352 --> 00:41:45,754
15 HEALTH SYSTEMS COMING IN, I'M

1153
00:41:45,754 --> 00:41:46,388
AMAZED WE'RE TILL DOING IT, THEY

1154
00:41:46,388 --> 00:41:50,025
STILL WANT IT, AND YOU CAN SEE

1155
00:41:50,025 --> 00:41:51,860
WHO'S CURRENTLY ON IT, A BIG

1156
00:41:51,860 --> 00:42:00,736
VARIETY OF PEOPLE WHETHER IT'S

1157
00:42:00,736 --> 00:42:02,304
AN FQHC, UNIVERSITY, AND BIG

1158
00:42:02,304 --> 00:42:05,107
SYSTEMS THAT ARE PART OF THIS

1159
00:42:05,107 --> 00:42:08,310
THAT COME, THEY PRESENT WHAT

1160
00:42:08,310 --> 00:42:13,482
THEY'RE DOING, PEOPLE ASK A LOT

1161
00:42:13,482 --> 00:42:18,120
OF LOT OF LEARNING COMMUNITY AND

1162
00:42:18,120 --> 00:42:18,754
WE PUBLISH PAPER S, WE'RE GOING

1163
00:42:18,754 --> 00:42:19,354
TO A TRANSITION CONFREN, THERE

1164
00:42:19,354 --> 00:42:19,921
WILL BE 9 PRESENTATIONS FROM

1165
00:42:19,921 --> 00:42:20,689
THESE GROUPS AND THEY'RE MOVING

1166
00:42:20,689 --> 00:42:21,289
HAVING ABILITY TO COLLABORATE

1167
00:42:21,289 --> 00:42:22,691
ACROSS DIFFERENT SYSTEMS TO

1168
00:42:22,691 --> 00:42:25,761
LEARN THE BEST PRACTICES ARE.

1169
00:42:25,761 --> 00:42:27,896
SO I AM GOING TO CONCLUDE.

1170
00:42:27,896 --> 00:42:32,200
I THINK IT IS A MAJOR CONCERN

1171
00:42:32,200 --> 00:42:33,502
HEALTHCARE TRANSITION, SO I'M

1172
00:42:33,502 --> 00:42:39,274
GLAD YOU ARE GOING TO BE JOINING

1173
00:42:39,274 --> 00:42:39,875
IN THIS PROCESS, AND I THINK A

1174
00:42:39,875 --> 00:42:40,509
STANDARDIZED PROCESS IS THE WAY

1175
00:42:40,509 --> 00:42:41,576
YOU HAVE TO GO TO IMPROVE

1176
00:42:41,576 --> 00:42:41,877
OUTCOMES.

1177
00:42:41,877 --> 00:42:47,682
I DON'T THINK THAT'S A QUESTION

1178
00:42:47,682 --> 00:42:50,418
ANYMORE.

1179
00:42:50,418 --> 00:42:53,822
COMMUNITY PARTNERSHIPS,

1180
00:42:53,822 --> 00:42:56,858
REMEMBER, YOU'RE A LEADER IN

1181
00:42:56,858 --> 00:42:57,192
THIS COUNTRY.

1182
00:42:57,192 --> 00:42:59,561
THE PEOPLE YOU INTERFACE WITH

1183
00:42:59,561 --> 00:43:00,896
OUT THERE ARE--YOU HAVE AN

1184
00:43:00,896 --> 00:43:04,132
OBLIGATION AS A ROLE MODEL, YOU

1185
00:43:04,132 --> 00:43:04,800
KNOW THAT AND SO I THINK THIS IS

1186
00:43:04,800 --> 00:43:05,400
EXCITING THAT YOU ARE GOING TO

1187
00:43:05,400 --> 00:43:05,967
TAKE THIS ON AND OBVIOUSLY,

1188
00:43:05,967 --> 00:43:06,835
THESE QUALITY SYSTEM

1189
00:43:06,835 --> 00:43:07,602
IMPROVEMENTS CAN IMPROVE HEALTH

1190
00:43:07,602 --> 00:43:08,236
OUTCOMES TO BECOME ADULTS THAT

1191
00:43:08,236 --> 00:43:09,404
ARE MORE HEALTH YEAR AND ENGAGED

1192
00:43:09,404 --> 00:43:10,572
AND THAT'S REALLY THE BOTTOM

1193
00:43:10,572 --> 00:43:11,540
LINE OF WHAT WE WANT.

1194
00:43:11,540 --> 00:43:13,041
SO I WANT TO THANK YOU FOR

1195
00:43:13,041 --> 00:43:13,575
INVITING ME.

1196
00:43:13,575 --> 00:43:17,746
I HOPE YOU'RE NOT LIKE EITHER OF

1197
00:43:17,746 --> 00:43:23,919
THESE PICTURES HERE, BUT I THANK

1198
00:43:23,919 --> 00:43:24,953
THE INVITATION, THE OBVIOUSLY

1199
00:43:24,953 --> 00:43:25,554
THE MANY PEOPLE THAT MADE IT

1200
00:43:25,554 --> 00:43:26,188
POSSIBLE FOR THE NATIONAL CENTER

1201
00:43:26,188 --> 00:43:35,530
TO REALLY MOVE AS IT HAS AND ALL

1202
00:43:35,530 --> 00:43:35,897
OF MY PATIENTS.

1203
00:43:35,897 --> 00:43:36,431
SO I WILL TURN IT OVER TO

1204
00:43:36,431 --> 00:43:36,731
DR. GORDON.

1205
00:43:36,731 --> 00:43:45,173
[ APPLAUSE ]

1206
00:43:45,173 --> 00:43:45,774
>> THANK YOU SO MUCH FOR
THE

1207
00:43:45,774 --> 00:43:52,080
OPPORTUNITY TO TALK AND THANK

1208
00:43:52,080 --> 00:44:02,557
YOU FOR SHARING THE PODIUM.

1209
00:44:07,562 --> 00:44:12,834
THIS IS SUCH AN IMPORTANT TOPIC.

1210
00:44:12,834 --> 00:44:13,435
SO OUR GOAL TO THEM WE'VE BEEN

1211
00:44:13,435 --> 00:44:14,035
THINKING FOR THE PAST 3 MONTHS

1212
00:44:14,035 --> 00:44:14,636
OR SO ABOUT HOW DO WE IMPROVE

1213
00:44:14,636 --> 00:44:15,270
DISEASE KNOWLEDGE OF ADOLESCENT

1214
00:44:15,270 --> 00:44:15,837
IN ADULTS OR AYA, OR DO WE

1215
00:44:15,837 --> 00:44:16,905
DECREASE VARIABILITY, AND THIS

1216
00:44:16,905 --> 00:44:19,741
IS IMPORTANT ALL OF OUR PATIENTS

1217
00:44:19,741 --> 00:44:21,977
CENTER ON RESEARCH PROTOCOLS SO

1218
00:44:21,977 --> 00:44:24,145
THIS IS ALSO IMPORTANT FOR THE

1219
00:44:24,145 --> 00:44:25,113
ENTIRETY OF OUR RESEARCH AND

1220
00:44:25,113 --> 00:44:27,382
THEN HOW DO WE HELP THEM PREPARE

1221
00:44:27,382 --> 00:44:30,118
FOR THAT IMPORTANT MILESTONE AT

1222
00:44:30,118 --> 00:44:31,119
18 YEARS?

1223
00:44:31,119 --> 00:44:37,692
AT 18 YEARS THEY'RE GOING TO

1224
00:44:37,692 --> 00:44:39,628
HAVE TO RESIGN, THE FAMILY HAS

1225
00:44:39,628 --> 00:44:40,695
TO RECONSENT BUT THIS TIME THE

1226
00:44:40,695 --> 00:44:41,296
PARTIC PLAN TO ANALYZE BY AGE

1227
00:44:41,296 --> 00:44:47,469
HAS TO SIGN AS AN ADULT.

1228
00:44:47,469 --> 00:44:48,303
--PARTICIPANT HAS TO SIGN AS AN

1229
00:44:48,303 --> 00:44:48,970
ADULT.

1230
00:44:48,970 --> 00:44:51,106
SO WE ARE ABOUT TO LAUNCH WITH A

1231
00:44:51,106 --> 00:44:52,707
LITTLE HELP FROM OUR FRIEND HERE

1232
00:44:52,707 --> 00:44:53,341
TO THE RIGHT, A QYQA PROJECT AS

1233
00:44:53,341 --> 00:44:53,975
A PILOT, OUR ULTIMATE GOAL IS TO

1234
00:44:53,975 --> 00:44:54,542
GO THROUGHOUT THE CLINICAL

1235
00:44:54,542 --> 00:45:02,951
CENTER, WE WILL BE ASSESSING

1236
00:45:02,951 --> 00:45:03,551
METRICS RELATED AND KNOWLEDGE

1237
00:45:03,551 --> 00:45:09,824
OUR PATIENTS HAVE OF THEIR OWN

1238
00:45:09,824 --> 00:45:14,429
DISEASE, KNOWLEDGE AROUND WHAT

1239
00:45:14,429 --> 00:45:16,298
MEDICATIONS THEY TAKE, KNOWLEDGE

1240
00:45:16,298 --> 00:45:17,032
AROUND SELF-CARE, LIFE KILLS,

1241
00:45:17,032 --> 00:45:20,869
AND THEN AT THE SAME TIME WE'RE

1242
00:45:20,869 --> 00:45:21,303
GOING TO TALK ABOUT

1243
00:45:21,303 --> 00:45:21,870
SATISFACTION, SO HOW DOES IT

1244
00:45:21,870 --> 00:45:23,338
FEEL AS A PATIENT TO GO THROUGH

1245
00:45:23,338 --> 00:45:23,838
THIS PROCESS, WHAT ABOUT

1246
00:45:23,838 --> 00:45:24,439
PATIENTS OR GUARDIANS AND THEN

1247
00:45:24,439 --> 00:45:27,242
US AS CLINICIANS, HOW DO WE FEEL

1248
00:45:27,242 --> 00:45:29,177
ABOUT HOW IT'S GOING AND WHETHER

1249
00:45:29,177 --> 00:45:31,313
OUR MESSAGES ARE GETTING ACROSS.

1250
00:45:31,313 --> 00:45:31,880
WE ARE GOING TO BE PREPARING

1251
00:45:31,880 --> 00:45:33,481
MATERIALS ON THE ADULT UNITS, WE

1252
00:45:33,481 --> 00:45:36,151
WILL GIVE OUR PATIENTS THE

1253
00:45:36,151 --> 00:45:38,353
OPPORTUNITIES TO VISIT THOSE

1254
00:45:38,353 --> 00:45:39,821
UNITS ULTIMATELY AND AS

1255
00:45:39,821 --> 00:45:41,423
DR. WHITE HAS TALKED ABOUT,

1256
00:45:41,423 --> 00:45:42,691
RIGHT BEFORE AGE 18, THEY WILL

1257
00:45:42,691 --> 00:45:50,732
HAVE THE CHANCE TO MEET THE NEW

1258
00:45:50,732 --> 00:45:52,701
PROVIDER AND HAVE A WARM

1259
00:45:52,701 --> 00:45:53,468
HANDOFF.

1260
00:45:53,468 --> 00:45:55,837
SO HERE WE GO, SO WE ARE GOING

1261
00:45:55,837 --> 00:45:57,138
TO, IF I CAN GET THIS TO WORK,

1262
00:45:57,138 --> 00:46:00,208
WE ARE GOING TO LAUNCH A PILOT

1263
00:46:00,208 --> 00:46:05,080
WITH 5 ICs INITIALLY, THESE

1264
00:46:05,080 --> 00:46:06,514
ARE ICs WHO HAVE BEEN THINKING

1265
00:46:06,514 --> 00:46:07,949
ABOUT TRANITION, THEY'VE DONE

1266
00:46:07,949 --> 00:46:08,550
PRELIMINARY WORK OR THEY HAVE

1267
00:46:08,550 --> 00:46:10,852
BEEN ORGANIZING THEMSELVES IN A

1268
00:46:10,852 --> 00:46:11,353
WAY, THEY RECOGNIZE IT'S

1269
00:46:11,353 --> 00:46:12,354
IMPORTANT FOR THEIR PATIENTS SO

1270
00:46:12,354 --> 00:46:13,154
THEY'RE ALREADY ENGAGED.

1271
00:46:13,154 --> 00:46:16,491
WE WILL TEST RESOURCES AND A

1272
00:46:16,491 --> 00:46:16,958
TRANSITION TOOL KIT.

1273
00:46:16,958 --> 00:46:21,162
WE SPENT A COUPLE HOURS THIS

1274
00:46:21,162 --> 00:46:22,764
MORNING THINKING ABOUT THE TOOL

1275
00:46:22,764 --> 00:46:25,667
KIT, WHAT'S IN IT, THE LEADERS,

1276
00:46:25,667 --> 00:46:26,735
MATERIALS, WHEN DO WE START,

1277
00:46:26,735 --> 00:46:28,603
WHEN DO WE ROLL IT OUT AND

1278
00:46:28,603 --> 00:46:29,170
CLINICIAN TEAM ANDS FAMILIES

1279
00:46:29,170 --> 00:46:30,472
WILL REVIEW THE HELPFULNESS OF

1280
00:46:30,472 --> 00:46:31,873
THIS RESOURCES AND THEN WE'RE IN

1281
00:46:31,873 --> 00:46:36,911
THE PROCESS OF DEFINING METRICS

1282
00:46:36,911 --> 00:46:37,212
OF SUCCESS.

1283
00:46:37,212 --> 00:46:39,180
WHAT DOES SUCCESS LOOK LIKE?

1284
00:46:39,180 --> 00:46:40,515
WE WILL ESTABLISH A COHESIVE

1285
00:46:40,515 --> 00:46:43,985
TRANSITION OF CARE LETTER FOR

1286
00:46:43,985 --> 00:46:44,753
PATIENTS, FOR THEIR FAMILIES,

1287
00:46:44,753 --> 00:46:45,387
THEY'RE GOING TO SEE IT AT THE

1288
00:46:45,387 --> 00:46:46,354
BEGENERATEDDING AND THEN THEY'RE

1289
00:46:46,354 --> 00:46:48,289
GOING TO SEE IT AGAIN AS THEY GO

1290
00:46:48,289 --> 00:46:53,528
THROUGH THE PROCESS, AND IT ALSO

1291
00:46:53,528 --> 00:46:54,529
ACKNOWLEDGES WHAT DIFFERENCES

1292
00:46:54,529 --> 00:46:56,598
THEY MIGHT ENCOUNTER AND

1293
00:46:56,598 --> 00:46:57,432
CHALLENGES, WE'LL CREATE A FACT

1294
00:46:57,432 --> 00:46:58,066
SHEET ABOUT THE ADULT UNITS TO

1295
00:46:58,066 --> 00:46:59,934
GIVE TO OUR PEDIATRIC PATIENTS.

1296
00:46:59,934 --> 00:47:02,971
WE WILL FOLLOW THESE METRICS

1297
00:47:02,971 --> 00:47:04,205
ALONG A TIMELINE EMPLOY OUR GOAL

1298
00:47:04,205 --> 00:47:05,874
NOW IS OVER A YEAR AND WE WILL

1299
00:47:05,874 --> 00:47:07,942
BE MAKING SURE WE WILL COME TO

1300
00:47:07,942 --> 00:47:08,743
CONSENSUS ON THAT ASK ULTIMATELY

1301
00:47:08,743 --> 00:47:11,713
THERE WILL BE A TOUR OF THE

1302
00:47:11,713 --> 00:47:14,682
ADULT UNIT, THE WARM HANDOFF,

1303
00:47:14,682 --> 00:47:15,350
AND THEN OUR GOAL IS THAT SIGN

1304
00:47:15,350 --> 00:47:19,154
OUT TO THE NEW ADULT CLINICIAN.

1305
00:47:19,154 --> 00:47:22,190
I COME TO THIS PERSONALLY AS A

1306
00:47:22,190 --> 00:47:22,857
PEDIATRIC EBD O CRINOLOGYIST AND

1307
00:47:22,857 --> 00:47:23,491
I'VE HAD TROUBLE OVER THE YEARS

1308
00:47:23,491 --> 00:47:24,492
GETTING MY PATIENTS OVER THE

1309
00:47:24,492 --> 00:47:29,197
BRIDGE AND I REALIZE NOW, WE

1310
00:47:29,197 --> 00:47:31,466
DIDN'T DO ENOUGH OF OUR HOME

1311
00:47:31,466 --> 00:47:32,033
WORK BEFORE HAND AS GOOD

1312
00:47:32,033 --> 00:47:35,003
INTENTIONED BUT WE NEEDED TO DO

1313
00:47:35,003 --> 00:47:36,171
MORE BACKGROUND WORK.

1314
00:47:36,171 --> 00:47:37,605
SO I'D REALLY LIKE TO

1315
00:47:37,605 --> 00:47:40,575
ACKNOWLEDGE AND THANK MY GREAT

1316
00:47:40,575 --> 00:47:41,109
COMMITTEE.

1317
00:47:41,109 --> 00:47:48,616
IT TAKES A VILLAGE TO DO THIS

1318
00:47:48,616 --> 00:47:50,351
WORK AND THIS HAS BEEN SUCH A

1319
00:47:50,351 --> 00:47:51,986
PLEASURE TO WORK WITH ALL OF

1320
00:47:51,986 --> 00:47:56,925
YOU, AGAIN WHAT I PRESENT TODAY

1321
00:47:56,925 --> 00:47:57,559
IS REALLY THE CULMINATION OF ALL

1322
00:47:57,559 --> 00:47:58,193
OF OUR EFFORTS AND I HOPE WE CAN

1323
00:47:58,193 --> 00:47:58,827
COME BACK AGAIN MAYBE IN A YEAR

1324
00:47:58,827 --> 00:47:59,394
OR SO AFTER WE COMPLETE THE

1325
00:47:59,394 --> 00:48:00,028
PILOT AND SHOW OFF WHAT WE'VE

1326
00:48:00,028 --> 00:48:00,695
DONE AND WITH THE ULTIMATE GOAL

1327
00:48:00,695 --> 00:48:02,797
TO BE ABLE TO GO THROUGHOUT THE

1328
00:48:02,797 --> 00:48:03,264
CLINICAL CENTER.

1329
00:48:03,264 --> 00:48:06,000
SO THAT IS WHAT I HAVE AND I

1330
00:48:06,000 --> 00:48:07,769
WILL HAVE DR. WHITE COME UP AND

1331
00:48:07,769 --> 00:48:15,944
WE WILL BE HAPPY TO TO ANSWER

1332
00:48:15,944 --> 00:48:16,277
ANY QUESTIONS.

1333
00:48:16,277 --> 00:48:26,588
THANK YOU SO MUCH.

1334
00:48:38,266 --> 00:48:38,600
>> WONDERFUL TALK.

1335
00:48:38,600 --> 00:48:39,067
APPRECIATE THIS A LOT.

1336
00:48:39,067 --> 00:48:40,034
A LOT SEEMS TO BE FOCUSED ON THE

1337
00:48:40,034 --> 00:48:42,137
CLINICIAN IN THE CENTER, AND A

1338
00:48:42,137 --> 00:48:42,737
LOT OF THIS FROM THE WEBSITES

1339
00:48:42,737 --> 00:48:43,371
ARE THERE OTHER METHODS SUCH AS

1340
00:48:43,371 --> 00:48:43,972
LIFE SKILLS DOING THAT NOT IN

1341
00:48:43,972 --> 00:48:44,606
THE CLINICAL SETTING BUT IN THE

1342
00:48:44,606 --> 00:48:47,108
OUTSIDE ACADEMIC SETTING SO WHEN

1343
00:48:47,108 --> 00:48:48,276
WE HAD ISSUES ABOUT FINANCIAL

1344
00:48:48,276 --> 00:48:50,712
LITERACY WE SET UP CENTERS WHERE

1345
00:48:50,712 --> 00:48:54,182
SCHOOLS DID FIELD TRIPS TO LEARN

1346
00:48:54,182 --> 00:48:55,884
FINANCIAL LITERACY SAY FOR

1347
00:48:55,884 --> 00:48:56,818
CODING, IS THIS SOMETHING WE

1348
00:48:56,818 --> 00:48:57,585
NEED AN INDIVIDUAL TOUCH IN THE

1349
00:48:57,585 --> 00:49:00,488
CLINIC OR SOMETHING WE CAN DO

1350
00:49:00,488 --> 00:49:01,055
MORE GLOBALLY OUT IN THE

1351
00:49:01,055 --> 00:49:01,556
COMMUNITY AS AN ACADEMIC

1352
00:49:01,556 --> 00:49:07,295
EXERCISE FOR CHILDREN

1353
00:49:07,295 --> 00:49:07,595
EVERYWHERE?

1354
00:49:07,595 --> 00:49:08,830
>> THANK YOU IF ARE THAT

1355
00:49:08,830 --> 00:49:09,097
QUESTION.

1356
00:49:09,097 --> 00:49:09,831
SO THERE'S ALWAYS A QUESTION

1357
00:49:09,831 --> 00:49:13,735
ABOUT HOW YOU DEFINE THE

1358
00:49:13,735 --> 00:49:15,203
TRANSITIONS, ARE YOU GOING TO

1359
00:49:15,203 --> 00:49:16,604
LOOK AT ALL OF THEM, RIGHT?

1360
00:49:16,604 --> 00:49:18,806
ARE YOU GOING TO LOOK AT

1361
00:49:18,806 --> 00:49:19,407
INDEPENDENT LIVING WORKFORCE,

1362
00:49:19,407 --> 00:49:20,008
PARTICIPATION AS FINANCIAL LIT

1363
00:49:20,008 --> 00:49:23,978
RASY, HOWEVER YOU WANT TO

1364
00:49:23,978 --> 00:49:26,781
DO--FINANCIAL LITERACY, HOWEVER

1365
00:49:26,781 --> 00:49:27,182
YOU WANT TO DO IT.

1366
00:49:27,182 --> 00:49:27,815
SO SOME INSTITUTIONS OR HEALTH

1367
00:49:27,815 --> 00:49:28,316
SYSTEMS HAVE A READINESS

1368
00:49:28,316 --> 00:49:30,785
ASSESSMENT THAT HAS HELPED PLUS

1369
00:49:30,785 --> 00:49:31,786
ALL OF THOSE AND THEREFORE ALL

1370
00:49:31,786 --> 00:49:40,895
THAT INFORMATION HAS TO BE

1371
00:49:40,895 --> 00:49:43,565
AVAILABLE FOR THE CLINICIANS TO

1372
00:49:43,565 --> 00:49:46,734
DISCUSS IT, SO FOR EXAMPLE,

1373
00:49:46,734 --> 00:49:50,838
MERCY, ASSOCIATED WITH 2 STATES,

1374
00:49:50,838 --> 00:49:51,873
1 BROADENED MEDICAID, 1 DIDN'T.

1375
00:49:51,873 --> 00:49:53,708
THEY HAVE TO HAVE A LOT OF

1376
00:49:53,708 --> 00:49:54,809
INFORMATION FOR JUST HEALTH

1377
00:49:54,809 --> 00:49:55,410
INSURANCE ACROSS THE BOARD.

1378
00:49:55,410 --> 00:49:59,781
SO YES, THERE ARE SOME

1379
00:49:59,781 --> 00:50:08,690
INSTITUTIONS THAT TAKE IT SORT

1380
00:50:08,690 --> 00:50:09,290
OF MORE WHOLISTICALLY AND THEN

1381
00:50:09,290 --> 00:50:09,924
SOME INSTITUTIONS THAT ARE JUST

1382
00:50:09,924 --> 00:50:10,391
FOCUSING ON HEALTHCARE

1383
00:50:10,391 --> 00:50:10,692
TRANSITION.

1384
00:50:10,692 --> 00:50:11,326
SO YOU DECIDE WHAT YOU'RE GOING

1385
00:50:11,326 --> 00:50:11,526
TO DO.

1386
00:50:11,526 --> 00:50:12,126
NOW THOSE THAT ARE JUST DOING

1387
00:50:12,126 --> 00:50:12,760
HEALTHCARE TRANSITION, OBVIOUSLY

1388
00:50:12,760 --> 00:50:13,294
ARE GOING TO ASK QUESTIONS

1389
00:50:13,294 --> 00:50:14,929
AROUND THEIR CAPACITY, KNOWING

1390
00:50:14,929 --> 00:50:16,130
ABOUT THEIR INSURANCE, WHAT THEY

1391
00:50:16,130 --> 00:50:18,967
SHOULD DO, SO THEY CAN ACTUALLY

1392
00:50:18,967 --> 00:50:20,068
GET THEIR HEALTHCARE TRANSITION

1393
00:50:20,068 --> 00:50:22,036
BECAUSE SO HAVING THAT KIND OF

1394
00:50:22,036 --> 00:50:23,371
INFORMATION AND EXTREMELY

1395
00:50:23,371 --> 00:50:30,645
HELPFUL AND NOBODY'S ASKING THE

1396
00:50:30,645 --> 00:50:34,115
CLINICIAN TO JUST KNOW

1397
00:50:34,115 --> 00:50:34,616
EVERYTHING.

1398
00:50:34,616 --> 00:50:35,216
YOU CAN'T.

1399
00:50:35,216 --> 00:50:36,751
BUT THE INSTITUTION THAT'S

1400
00:50:36,751 --> 00:50:39,854
WORKING CAN PUT THIS INFORMATION

1401
00:50:39,854 --> 00:50:46,461
TOGETHER ABOUT HOW TO CALL AND

1402
00:50:46,461 --> 00:50:46,761
ASK NUMBERS.

1403
00:50:46,761 --> 00:50:47,395
I HOPE I ANSWERED YOUR QUESTIONS

1404
00:50:47,395 --> 00:50:48,029
BECAUSE CERTAINLY THERE'S A LOT

1405
00:50:48,029 --> 00:50:48,663
OF INFORMATION OUT THERE TO HELP

1406
00:50:48,663 --> 00:50:49,264
PEOPLE TBAIN THE KNOWLEDGE AND

1407
00:50:49,264 --> 00:50:49,831
OTHER ASPECTS OF THEIR LIFE

1408
00:50:49,831 --> 00:50:50,498
WHETHER IT'S THROUGH SCHOOLS, ET

1409
00:50:50,498 --> 00:50:57,472
CETERA AND SO THE HELT CARE

1410
00:50:57,472 --> 00:51:05,079
DELIVERY SYSTEM DOESN'T DO IT

1411
00:51:05,079 --> 00:51:05,246
ALL.

1412
00:51:05,246 --> 00:51:06,914
>> YOU KNOW 1 ARK DITIONAL

1413
00:51:06,914 --> 00:51:07,448
POINT, THANK YOU, IS WE'RE

1414
00:51:07,448 --> 00:51:08,016
TRYING TO THINK ABOUT HOW WE

1415
00:51:08,016 --> 00:51:08,616
PREPARE THE YOUNG PERSON TO GO

1416
00:51:08,616 --> 00:51:08,816
HOME.

1417
00:51:08,816 --> 00:51:14,155
SO THEY COME TO THE CLINICAL

1418
00:51:14,155 --> 00:51:15,123
CENTER, TRANSITION ACROSS THE

1419
00:51:15,123 --> 00:51:15,990
CLINICAL CENTER, BUT ALSO WHAT

1420
00:51:15,990 --> 00:51:16,591
COMMUNICATION HAPPENS PRIMARY

1421
00:51:16,591 --> 00:51:21,829
CARE DOCTOR, THE PRIMARY

1422
00:51:21,829 --> 00:51:22,397
SUBCOMMERCIALIST AT HOME, SO

1423
00:51:22,397 --> 00:51:22,997
THAT'S PART OF OUR FRAMEWORK,

1424
00:51:22,997 --> 00:51:23,264
OUR MODEL.

1425
00:51:23,264 --> 00:51:23,865
>> DR. WHITE, THANK YOU
VERY

1426
00:51:23,865 --> 00:51:24,499
MUCH FOR THE SUPERB PRESENTATION

1427
00:51:24,499 --> 00:51:25,133
AND FOR YOUR WORK AND LEADERSHIP

1428
00:51:25,133 --> 00:51:25,767
IN THIS FIELD AND F DR. GORDON,

1429
00:51:25,767 --> 00:51:28,970
THANK YOU FOR LEADING THE

1430
00:51:28,970 --> 00:51:29,337
INITIATIVE HERE.

1431
00:51:29,337 --> 00:51:35,043
WE HAVE A COUPLE QUESTIONS FROM

1432
00:51:35,043 --> 00:51:37,679
THE VIDEOCAST AUDIENCE, THE

1433
00:51:37,679 --> 00:51:39,947
FIRST IS PLEASE DESCRIBE AS AN

1434
00:51:39,947 --> 00:51:46,688
EXAMPLE THE TRANSITION OF AN

1435
00:51:46,688 --> 00:51:47,288
ADOLESCENT WHO AT AGE 18 WITH

1436
00:51:47,288 --> 00:51:47,822
DIABETES MAY LOSE SUPPORT.

1437
00:51:47,822 --> 00:51:48,356
HOW DOES YOUR ORGANIZATION

1438
00:51:48,356 --> 00:51:48,923
APPROACH THIS COMBINATION OF

1439
00:51:48,923 --> 00:51:50,925
CLINICAL CARE,A , ACCESS AND POY

1440
00:51:50,925 --> 00:51:51,959
ISSUES?

1441
00:51:51,959 --> 00:51:53,795
NWHAT AN INCREDIBLY WONDERFUL

1442
00:51:53,795 --> 00:51:56,030
AND DIFFICULT QUESTION TO

1443
00:51:56,030 --> 00:51:56,964
ANSWER.

1444
00:51:56,964 --> 00:52:06,774
YOU KNOW, NOT EVERY STATE HAS

1445
00:52:06,774 --> 00:52:09,077
EXPANDED MEDICAID.

1446
00:52:09,077 --> 00:52:10,445
IN THOSE STATES SADLY THERE'S

1447
00:52:10,445 --> 00:52:11,079
NOT A LOT OF OPTIONS HERE, WE'RE

1448
00:52:11,079 --> 00:52:11,713
VERY AWARE AND HAVE INFORMATION

1449
00:52:11,713 --> 00:52:12,080
ABOUT EACHITATE.

1450
00:52:12,080 --> 00:52:19,120
WE JUST CAN A REPORT CALLED THE

1451
00:52:19,120 --> 00:52:29,030
AGING OUT PROCESS WHERE WE

1452
00:52:29,030 --> 00:52:29,597
OUTLINED ALL THE ISSUES THAT

1453
00:52:29,597 --> 00:52:30,198
HAPPEN AT AGE 18 AND WHERE YOU

1454
00:52:30,198 --> 00:52:30,765
CAN POTENTIALLY GO FOR MORE

1455
00:52:30,765 --> 00:52:31,366
INFORMATION BUT SADLY, A YOUNG

1456
00:52:31,366 --> 00:52:31,866
PERSON WITH DIABETES WHO

1457
00:52:31,866 --> 00:52:32,500
ACTUALLY IS IN A STATE THAT DID

1458
00:52:32,500 --> 00:52:33,201
NOT EXPAND MEDICAID IS IN A LOT

1459
00:52:33,201 --> 00:52:38,740
OF TROUBLE AND WE WORK HARD AT

1460
00:52:38,740 --> 00:52:40,041
MANY OF SOME AREAS AND CERTAINLY

1461
00:52:40,041 --> 00:52:40,608
THE DIABETES ASSOCIATION AND

1462
00:52:40,608 --> 00:52:43,511
MANY OF THE PATIENT AND DRUG

1463
00:52:43,511 --> 00:52:44,178
COMPANIES, AS MUCH AS YOU MAY OR

1464
00:52:44,178 --> 00:52:46,347
MAY NOT LIKE THEM ARE TRYING TO

1465
00:52:46,347 --> 00:52:48,149
FILL THE GAP, BUT IT'S A MAJOR

1466
00:52:48,149 --> 00:52:56,357
HOLE IN OUR DELIVERY SYSTEM AND

1467
00:52:56,357 --> 00:53:00,495
WE CERTAINLY AS A SMALL NATIONAL

1468
00:53:00,495 --> 00:53:02,897
CENTER CAN'T CHANGE THAT BUT WE

1469
00:53:02,897 --> 00:53:11,339
CAN CERTAINLY POINT IT OUT.

1470
00:53:11,339 --> 00:53:11,706
>> THANK YOU.

1471
00:53:11,706 --> 00:53:13,808
HOW ARE TEENS WANTING TO LEARN?

1472
00:53:13,808 --> 00:53:14,342
ONLINE, VERSUS IN PERSON,

1473
00:53:14,342 --> 00:53:14,942
MEETING WITH TEENS GOING THRU

1474
00:53:14,942 --> 00:53:15,576
THE SAME PROCESS, ALSO CHILDREN

1475
00:53:15,576 --> 00:53:16,177
INVOLVED IN THE PROJECT HERE?

1476
00:53:16,177 --> 00:53:16,844
>> YOU KNOW THE QUESTION
IS I

1477
00:53:16,844 --> 00:53:17,912
THINK WE'RE GOING TO LEARN,

1478
00:53:17,912 --> 00:53:19,080
WE'RE GOING TO LEARN.

1479
00:53:19,080 --> 00:53:26,254
WE'RE STILL KIND OF BATTING

1480
00:53:26,254 --> 00:53:27,455
AROUND DIFFERENT OPTIONS, EVEN

1481
00:53:27,455 --> 00:53:31,926
HOW MUCH IS THE PATIENT GOING TO

1482
00:53:31,926 --> 00:53:37,532
FILL OUT VERSUS THEIR PARENTS,

1483
00:53:37,532 --> 00:53:38,166
VERSUS THE CLINICIAN ASKING THE

1484
00:53:38,166 --> 00:53:38,666
QUESTIONS TO MORE OF AN

1485
00:53:38,666 --> 00:53:39,300
INTERVIEW, MANY OF OUR PEDIATRIC

1486
00:53:39,300 --> 00:53:45,473
PATIENTS ARE SERVED BY THE

1487
00:53:45,473 --> 00:53:52,113
WONDERFUL PARENTS AND WE WILL BE

1488
00:53:52,113 --> 00:53:55,483
PARTNERING WITH THEM AND IT'S A

1489
00:53:55,483 --> 00:53:56,050
GOOD THOUGHT TO HAVE THEM BE

1490
00:53:56,050 --> 00:53:56,684
PART OF THE MODEL WE'RE THINKING

1491
00:53:56,684 --> 00:53:56,884
ABOUT.

1492
00:53:56,884 --> 00:53:57,452
AND I WOULD GUESS AND AS THE

1493
00:53:57,452 --> 00:53:58,085
MOTHER OF 2 YOUNG ADULTS HAVING

1494
00:53:58,085 --> 00:53:58,686
ZOOM TECHNOLOGY INVOLVED WOULD

1495
00:53:58,686 --> 00:54:00,354
MAKE IT MORE ATTRACTIVE TO THE

1496
00:54:00,354 --> 00:54:00,788
YOUNG PEOPLE EMPLOY.

1497
00:54:00,788 --> 00:54:01,522
>> YEAH, IT'S SUCH AN

1498
00:54:01,522 --> 00:54:01,989
INTERESTING QUESTION.

1499
00:54:01,989 --> 00:54:02,590
I THINK EVERY SYSTEM HAS SENT

1500
00:54:02,590 --> 00:54:03,758
OUT A SURVEY, WHAT'S THE SECOND

1501
00:54:03,758 --> 00:54:04,559
WORLD WAR ARE?

1502
00:54:04,559 --> 00:54:06,661
A THIRD, A THIRD, A THIRD AND

1503
00:54:06,661 --> 00:54:08,296
INTERESTINGLY ENOUGH, COVID WAS

1504
00:54:08,296 --> 00:54:12,366
EBS SIGHTING, NOW MANY OF THEM

1505
00:54:12,366 --> 00:54:13,534
WANT TO COME BACK TO THE CLINIC

1506
00:54:13,534 --> 00:54:14,435
BECAUSE THEY GET OUT OF SCHOOL,

1507
00:54:14,435 --> 00:54:15,470
THERE'S ALL SORTS OF MOTIVATION

1508
00:54:15,470 --> 00:54:15,870
HERE.

1509
00:54:15,870 --> 00:54:16,771
SO I THINK OFFERING HOWEVER YOU

1510
00:54:16,771 --> 00:54:18,606
CAN DO IT TO GET THE INFORMATION

1511
00:54:18,606 --> 00:54:26,981
YOU NEED IS PROBABLY THE BEST

1512
00:54:26,981 --> 00:54:27,815
WAY.

1513
00:54:27,815 --> 00:54:30,852
THERE'S NO 1 WAY, I GUESS?

1514
00:54:30,852 --> 00:54:31,486
YOU KNOW WE'RE ALL DIFFERENT AND

1515
00:54:31,486 --> 00:54:34,889
TEENAGERS ARE ALL DIFFERENT.

1516
00:54:34,889 --> 00:54:35,823
>> I HAVE MORE QUESTIONS
FORLET

1517
00:54:35,823 --> 00:54:38,493
VIDEOCAST BUT IF YOU HAVE

1518
00:54:38,493 --> 00:54:41,028
IN-PERSON, I WILL KEEP GOING BUT

1519
00:54:41,028 --> 00:54:42,263
IF YOU HAVE QUESTIONS HERE FOR

1520
00:54:42,263 --> 00:54:44,198
IN-PERSON, MOVE ME OVER.

1521
00:54:44,198 --> 00:54:48,736
>> GREAT TALK, WE FIND 
DOCTORS

1522
00:54:48,736 --> 00:54:50,771
WHO CAN HELP WITH ADULT PATIENTS

1523
00:54:50,771 --> 00:54:53,608
AND HELPING WITH COGNITIVE

1524
00:54:53,608 --> 00:54:55,042
DISABILITIES.

1525
00:54:55,042 --> 00:54:55,643
>> WELL YOU'RE A VERY
SMART

1526
00:54:55,643 --> 00:54:56,711
AUDIENCE AS YOU WOULD SUSPECT

1527
00:54:56,711 --> 00:54:58,012
EMPLOY THESE ARE CRUCIAL ISSUES

1528
00:54:58,012 --> 00:55:07,021
HERE, I THINK THE MOST DIFFICULT

1529
00:55:07,021 --> 00:55:11,025
GROUP TO MANAGE TRANSITION IS

1530
00:55:11,025 --> 00:55:13,427
THOSE WITH COGNITIVE

1531
00:55:13,427 --> 00:55:16,063
DIFFICULTIES IN PARTICULARLY THE

1532
00:55:16,063 --> 00:55:16,697
MIND FIELD OF SUPPORTED DECISION

1533
00:55:16,697 --> 00:55:17,331
MAKING VERSUS GUARDIANSHIP WITH

1534
00:55:17,331 --> 00:55:19,500
FAMILIES AND SO FORTH SO I THINK

1535
00:55:19,500 --> 00:55:21,369
THAT WE HAVE A LOT OF

1536
00:55:21,369 --> 00:55:23,604
INFORMATION ABOUT IT BUT WE'RE

1537
00:55:23,604 --> 00:55:24,772
WORKING NOW, THERE'S A NEW

1538
00:55:24,772 --> 00:55:25,339
NATIONAL CENTER TO WORK ARK

1539
00:55:25,339 --> 00:55:27,542
ROUND AUTISM AND EPILEPSY, SO I

1540
00:55:27,542 --> 00:55:28,342
THINK THEY'RE GOING TO FOCUS A

1541
00:55:28,342 --> 00:55:29,544
LOT ON THAT PARTICULAR ISSUE.

1542
00:55:29,544 --> 00:55:31,579
WE HAVE A WEBSITE THAT DEALS

1543
00:55:31,579 --> 00:55:37,718
WITH YOUTH WITH INTELLECTUAL AND

1544
00:55:37,718 --> 00:55:38,886
DEVELOPMENTAL DISABILITIES ABOUT

1545
00:55:38,886 --> 00:55:42,723
THIS AS WELL.

1546
00:55:42,723 --> 00:55:48,129
SO I THINK THE QUESTION THAT WAS

1547
00:55:48,129 --> 00:55:51,732
ASKED IS WHERE ARE THE ADULT

1548
00:55:51,732 --> 00:55:57,572
PROVIDERS AND THIS IS A VERY

1549
00:55:57,572 --> 00:55:58,172
DIFFERENT QUESTION, WE'VE DONE

1550
00:55:58,172 --> 00:55:58,773
FOR YEARS IN PEDIATRICS THAT

1551
00:55:58,773 --> 00:55:59,373
THEY'RE GOING TO PROBABLY GROW

1552
00:55:59,373 --> 00:55:59,974
UP BUT WE REALLY DIDN'T THINK

1553
00:55:59,974 --> 00:56:00,408
ABOUT IT VERY MUCH.

1554
00:56:00,408 --> 00:56:00,942
I INCLUDE MYSELF IN THAT.

1555
00:56:00,942 --> 00:56:01,609
SO NOW WE'RE SUDDENLY LOOKING AT

1556
00:56:01,609 --> 00:56:02,376
THE ADULT SYSTEM THAT'S UNDER

1557
00:56:02,376 --> 00:56:02,910
HUGE STRAIN JUST TO FIND A

1558
00:56:02,910 --> 00:56:03,544
PRIMARY CARE PHYSICIAN IS HARD.

1559
00:56:03,544 --> 00:56:04,946
SO YOU HAVE TO BE CREATIVE IN

1560
00:56:04,946 --> 00:56:08,082
YOUR MODELS AND MANY SYSTEMS

1561
00:56:08,082 --> 00:56:09,250
FINALLY LOCATE A PRIMARY CARE

1562
00:56:09,250 --> 00:56:11,986
PHYSICIAN ON THE ADULT SIDE BUT

1563
00:56:11,986 --> 00:56:14,255
TILL COME BACK YEARLY TO THE

1564
00:56:14,255 --> 00:56:20,995
PEDIATRIC GROUP AS A

1565
00:56:20,995 --> 00:56:21,329
CONSULTATION.

1566
00:56:21,329 --> 00:56:22,763
THAT'S A VERY DIFFERENT MIND SET

1567
00:56:22,763 --> 00:56:24,565
THAN WHERE THEY'VE BEEN.

1568
00:56:24,565 --> 00:56:26,067
SO WORKING THAT OUT, ALLOWS

1569
00:56:26,067 --> 00:56:26,901
EVERYBODY TO GET THE LONG-TERM

1570
00:56:26,901 --> 00:56:27,602
OUTCOME THAT THEY'RE ANXIOUS TO

1571
00:56:27,602 --> 00:56:38,145
SEE BUT STILL HAVE THEM GET THE

1572
00:56:42,083 --> 00:56:49,890
HEALTHCARE THEY NEED AS GROWING

1573
00:56:49,890 --> 00:56:50,524
UP AND BECOMING OLDER SO THAT'S

1574
00:56:50,524 --> 00:56:51,158
JUST 1 MODEL BUT THERE ARE MANY

1575
00:56:51,158 --> 00:56:51,759
AS THEY'RE TRYING TO PINCH HIT

1576
00:56:51,759 --> 00:56:52,360
WITH ALL THESE ISSUES AROUND,

1577
00:56:52,360 --> 00:56:54,729
THERE ISN'T, WELL, WHY WOULD

1578
00:56:54,729 --> 00:56:57,765
THERE BE SOME OF THESE ADULT

1579
00:56:57,765 --> 00:57:00,868
PROVIDERS THAT THESE PEOPLE ARE

1580
00:57:00,868 --> 00:57:01,435
JUST SURVIVING, THAT WE JUST

1581
00:57:01,435 --> 00:57:01,936
LEARN IT THAT THEY ARE.

1582
00:57:01,936 --> 00:57:02,570
>> ANOTHER INTERESTING
POINT I

1583
00:57:02,570 --> 00:57:03,037
THINK WE WILL HAVE THE

1584
00:57:03,037 --> 00:57:03,638
OPPORTUNITY TO THINK ABOUT IS

1585
00:57:03,638 --> 00:57:04,205
HOW IT VARIES BY DIAGNOSIS.

1586
00:57:04,205 --> 00:57:04,772
SO 1 MODEL, THERE MIGHT BE A

1587
00:57:04,772 --> 00:57:05,439
MODEL THAT'S ADOPTED MORE WITH 1

1588
00:57:05,439 --> 00:57:06,907
VERSUS ANOTHER AND KIND OF BY

1589
00:57:06,907 --> 00:57:12,747
IC, BY DISEASE CATEGORY, SO

1590
00:57:12,747 --> 00:57:15,916
WE'LL SEE.

1591
00:57:15,916 --> 00:57:17,418
NGREAT.

1592
00:57:17,418 --> 00:57:17,685
THANK YOU.

1593
00:57:17,685 --> 00:57:18,819
THAT'S ACTUALLY ALL I HAVE FOR

1594
00:57:18,819 --> 00:57:19,920
THE VIDEOCAST AUDIENCE, I DON'T

1595
00:57:19,920 --> 00:57:20,588
KNOW IF ANYONE HAS ANYTHING? 

1596
00:57:20,588 --> 00:57:20,921
OH, PLEASE DO?

1597
00:57:20,921 --> 00:57:21,555
>> HI, THANK YOU SO MUCH
FOR

1598
00:57:21,555 --> 00:57:31,666
YOUR TALK AND THANK YOU

1599
00:57:31,666 --> 00:57:33,734
DR. GORDON FOR INFORMING US ON

1600
00:57:33,734 --> 00:57:39,206
THE EFFORTS AT NIH, I KNOW THAT

1601
00:57:39,206 --> 00:57:39,707
A LOT OF THIS WORK VERY

1602
00:57:39,707 --> 00:57:40,174
IMPORTANTLY FOCUSES ON

1603
00:57:40,174 --> 00:57:40,775
TRANSITION INTO MEDICAL HOME.

1604
00:57:40,775 --> 00:57:41,342
I'M WONDERING IF THERE'S ANY

1605
00:57:41,342 --> 00:57:41,942
RESEARCH OR ESTABLISHMENT BEST

1606
00:57:41,942 --> 00:57:44,578
PRACTICES IN TERMS OF

1607
00:57:44,578 --> 00:57:46,781
ADOLESCENTS AND YOUNG ADULTS

1608
00:57:46,781 --> 00:57:50,718
WITH SPECIAL HEALTHCARE NEEDS IN

1609
00:57:50,718 --> 00:57:54,789
THIS WINDOW WHO EXPERIENCE ACUTE

1610
00:57:54,789 --> 00:57:57,124
INSULTS OR HEALTH NEEDS

1611
00:57:57,124 --> 00:58:00,594
REQUIRING ADMISSION TO THE

1612
00:58:00,594 --> 00:58:01,228
HOSPITAL OR EVEN ADMISSION TO AN

1613
00:58:01,228 --> 00:58:01,662
INTENSIVE CARE UNIT.

1614
00:58:01,662 --> 00:58:02,263
I THINK DR. GORDON BROUGHT UP

1615
00:58:02,263 --> 00:58:02,763
VARIABLE PRACTICE ACROSS

1616
00:58:02,763 --> 00:58:04,965
PEDIATRIC AND ADULT SETTINGS I

1617
00:58:04,965 --> 00:58:06,133
THINK CLINICALLY I HAVE SEEN

1618
00:58:06,133 --> 00:58:08,669
THAT IN MY TRAIN AND I AM

1619
00:58:08,669 --> 00:58:10,171
WONDERING IT THERE ANY EFFORTS

1620
00:58:10,171 --> 00:58:12,173
THAT ARE FOCUSED ON POTENTIALLY

1621
00:58:12,173 --> 00:58:13,908
STANDARDIZING CARE OR AT LEAST

1622
00:58:13,908 --> 00:58:15,876
INVESTIGATING THAT IN THE

1623
00:58:15,876 --> 00:58:21,716
IN-PATIENT OR ICU SETTING?

1624
00:58:21,716 --> 00:58:22,917
>> SO ABSOLUTELY.

1625
00:58:22,917 --> 00:58:30,124
IT'S BEEN A CHALLENGE BECAUSE

1626
00:58:30,124 --> 00:58:33,894
YOU KNOW YOU HAVE SOME YOUNG

1627
00:58:33,894 --> 00:58:38,666
PEOPLE THAT ARE NEVER GOING TO

1628
00:58:38,666 --> 00:58:40,468
GET OVER 60-POUND ANDS THEY'RE

1629
00:58:40,468 --> 00:58:42,002
SUDDENLY IN AN ADULT SETTING, DO

1630
00:58:42,002 --> 00:58:45,406
THEY HAVE THE EQUIPMENT.

1631
00:58:45,406 --> 00:58:46,006
SO COVID ACTUALLY SPEARHEADED

1632
00:58:46,006 --> 00:58:46,941
THIS, RIGHT, SUDDENLY THERE WERE

1633
00:58:46,941 --> 00:58:48,309
ADULT PATIENTS SITTING IN

1634
00:58:48,309 --> 00:58:48,943
PEDIATRIC WARD ANDS VICE VERSA

1635
00:58:48,943 --> 00:58:49,577
DEPENDING ON WHAT WAS HAPPENING

1636
00:58:49,577 --> 00:58:50,211
IN THAT O THEY DEVELOPED A BROWP

1637
00:58:50,211 --> 00:58:50,845
ACROSS THE COUNTRY BEGINNING TO

1638
00:58:50,845 --> 00:58:51,445
TALK ABOUT IT AND SO THE

1639
00:58:51,445 --> 00:58:52,313
HOSPITALLISTS IS VERY INTERESTED

1640
00:58:52,313 --> 00:58:53,647
IN THIS, THEY'RE IN THE VERY

1641
00:58:53,647 --> 00:58:55,883
BEGINNINGS OF THIS PROCESS, BUT

1642
00:58:55,883 --> 00:58:56,183
ABSOLUTELY.

1643
00:58:56,183 --> 00:58:58,119
A LOT OF TIMES WHEN A SYSTEM

1644
00:58:58,119 --> 00:58:59,553
COMES TO ME, I SAY, ALL RIGHT,

1645
00:58:59,553 --> 00:59:01,088
YOU'RE GOING TO HAVE TO DECIDE

1646
00:59:01,088 --> 00:59:02,523
WHICH OF YOUR PEDIATRIC

1647
00:59:02,523 --> 00:59:10,731
PROVIDERS ARE GOING TO GET ADULT

1648
00:59:10,731 --> 00:59:15,402
HOSPITAL PRIVILEGES, AND THAT

1649
00:59:15,402 --> 00:59:16,670
QUESTION COMPLETELY FLABBERGASTS

1650
00:59:16,670 --> 00:59:17,638
THEM UNTIL THEY BEGIN TO PEEL IT

1651
00:59:17,638 --> 00:59:18,172
AWAY AND REALIZE WHAT THAT

1652
00:59:18,172 --> 00:59:18,806
MEANS, AND SO I THINK A LOT OF

1653
00:59:18,806 --> 00:59:22,176
THIS IS THEY'RE JUST BEGINNING

1654
00:59:22,176 --> 00:59:23,410
TO THINK IT THROUGH.

1655
00:59:23,410 --> 00:59:29,583
WE DO KNOW THAT IF YOU--IF YOU

1656
00:59:29,583 --> 00:59:34,355
DON'T HAVE AN OUTPATIENT PROCESS

1657
00:59:34,355 --> 00:59:38,759
GOING ON, THERE WAS A SURVEY, OF

1658
00:59:38,759 --> 00:59:42,096
A LOT OF CHILDREN'S HOSPITALS

1659
00:59:42,096 --> 00:59:42,630
DONE BY SOME CANADIANS OF

1660
00:59:42,630 --> 00:59:43,264
AMERICAN HOSPITALS, AND THAT IF

1661
00:59:43,264 --> 00:59:43,831
YOU DON'T HAVE AN OUTPATIENT

1662
00:59:43,831 --> 00:59:44,465
PROCESS GOING ON, THE IN-PATIENT

1663
00:59:44,465 --> 00:59:44,832
CAN'T HANDLE IT.

1664
00:59:44,832 --> 00:59:45,466
IN OTHER WORDS, THE LAST THING

1665
00:59:45,466 --> 00:59:46,066
YOU WANT TO DO AFTER SOMEBODY

1666
00:59:46,066 --> 00:59:46,700
GOT OUT OF THE ICU IS YOU NEED

1667
00:59:46,700 --> 00:59:47,368
TO ACTUALLY LEAVE THE CHILDREN'S

1668
00:59:47,368 --> 00:59:48,402
HOSPITAL, THAT'S NOT GOING TO

1669
00:59:48,402 --> 00:59:48,769
FLY WELL.

1670
00:59:48,769 --> 00:59:50,404
SO I THINK THEY ARE RECOMMENDING

1671
00:59:50,404 --> 00:59:54,775
THAT YOU GET THE OUTPATIENT

1672
00:59:54,775 --> 00:59:56,877
PROCESS IN TOW HERE AND THE

1673
00:59:56,877 --> 01:00:02,183
IN-PATIENT THEN SUPPORTS THAT

1674
01:00:02,183 --> 01:00:02,616
PROCESS.

1675
01:00:02,616 --> 01:00:04,552
AND LOTS OF INSTITUTIONS ARE

1676
01:00:04,552 --> 01:00:07,822
BEGINNING TO SAY, PARTICULARLY

1677
01:00:07,822 --> 01:00:08,989
IN DECS LIKE SICKLE CELL

1678
01:00:08,989 --> 01:00:09,456
DISEASE, WHERE THEY'RE

1679
01:00:09,456 --> 01:00:10,090
ADMISSIONS ARE COMING OR THEIR

1680
01:00:10,090 --> 01:00:11,192
VISITS ARE COMMON AND THE

1681
01:00:11,192 --> 01:00:20,234
DIFFERENCES IN HOW PEOPLE HANDLE

1682
01:00:20,234 --> 01:00:22,503
PAIN MANAGEMENT, IS GETTING

1683
01:00:22,503 --> 01:00:24,038
THESE GROUPS TOGETHER AND TRYING

1684
01:00:24,038 --> 01:00:28,475
TO FIGURE OUT HOW TO COMMUNICATE

1685
01:00:28,475 --> 01:00:29,777
WHO THIS PERSON IS, THEY'RE NOT

1686
01:00:29,777 --> 01:00:31,812
A DRUG SEEKER, THERE'S ALL SORTS

1687
01:00:31,812 --> 01:00:32,413
OF STATE INVOLVEMENT, STATE

1688
01:00:32,413 --> 01:00:33,013
MEDICAID, LICENSING, ALL SORTS

1689
01:00:33,013 --> 01:00:33,647
OF THINGS THAT ARE BEGINNING TO

1690
01:00:33,647 --> 01:00:37,218
COALESCE AROUND THIS IN

1691
01:00:37,218 --> 01:00:40,187
PARTICULAR, SYSTEMS THAT ARE

1692
01:00:40,187 --> 01:00:40,855
BEGINNING TO ADDRESS IT SO IT'S

1693
01:00:40,855 --> 01:00:41,655
A VERY GREAT QUESTION.

1694
01:00:41,655 --> 01:00:42,089
THANK YOU AND IT'S A

1695
01:00:42,089 --> 01:00:43,057
BEGENERATEDDING PROCESS BUT

1696
01:00:43,057 --> 01:00:50,331
THEY'RE FAR BEHIND THE

1697
01:00:50,331 --> 01:00:52,666
OUTPATIENT PROCESS ONGOING.

1698
01:00:52,666 --> 01:00:52,967
NTHANK YOU.

1699
01:00:52,967 --> 01:00:53,801
THANK YOU ALSO FOR THE QUESTION,

1700
01:00:53,801 --> 01:00:54,435
MY LAST COMMENT BECAUSE I SEE

1701
01:00:54,435 --> 01:00:55,202
IT'S 1:00 O'CLOCK, THERE IS A

1702
01:00:55,202 --> 01:00:57,004
PEDIATRIC TRANSLATIONAL RESEARCH

1703
01:00:57,004 --> 01:00:58,672
TEEJIC PLAN FOR THE NIH CLINICAL

1704
01:00:58,672 --> 01:01:00,574
TRUSTEES AND I'VE BEEN DELIGHTED

1705
01:01:00,574 --> 01:01:03,477
TO BE ASKED TO BE PART OF THAT,

1706
01:01:03,477 --> 01:01:04,078
SO WE'RE REALLY TACKLING WHAT

1707
01:01:04,078 --> 01:01:04,745
YOU ASKED AND THINKING ABOUT HOW

1708
01:01:04,745 --> 01:01:11,051
TO MAKE THE CLINICAL CENTER SAFE

1709
01:01:11,051 --> 01:01:14,755
AND HOW TO AVOID THOSE

1710
01:01:14,755 --> 01:01:15,489
DEVIATIONS IN CARE.

1711
01:01:15,489 --> 01:01:25,266
THE DEVIATIONS DON'T HELP THE

1712
01:01:25,266 --> 01:01:25,833
RESEARCH PROTOCOLS, DR. BEBY

1713
01:01:25,833 --> 01:01:26,400
MERK, I THINK HER PEDIATRIC

1714
01:01:26,400 --> 01:01:26,967
HOSPITAL SERVICE HAS REALLY

1715
01:01:26,967 --> 01:01:27,601
HELPED US A LOT AND THE ICU, THE

1716
01:01:27,601 --> 01:01:28,235
PEDIATRIC BEDS SO WE DON'T HAVE

1717
01:01:28,235 --> 01:01:28,903
TO SEND EVERYTHING TO CHILDREN'S

1718
01:01:28,903 --> 01:01:35,409
NATIONAL OR OTHER HOSPITALS.

1719
01:01:35,409 --> 01:01:36,877
WELL, THANK YOU AGAIN TO

1720
01:01:36,877 --> 01:01:37,511
DR. WHITE AND TO ALL OF YOU FOR

1721
01:01:37,511 --> 01:01:37,745
COMING.

1722
01:01:37,745 --> 01:01:38,112
>> THANK YOU. 

1723
01:01:38,112 --> 01:01:38,512
>> [ APPLAUSE ]

1724
01:01:38,512 --> 01:01:39,013
>> I AM VERY EXCITED.

1725
01:01:39,013 --> 01:01:44,351
I THINK YOU WILL DO GREAT

1726
01:01:44,351 --> 01:01:44,885
THINGS.

1727
01:01:44,885 --> 01:01:48,956
>> THANKS FOR BEING HERE
AGAIN

1728
01:01:48,956 --> 01:01:59,099
TODAY. 

1729
01:32:37,136 --> 01:32:38,403
 TOC7

1730
01:32:38,403 --> 01:32:41,940
1:33 P.M.

1731
01:32:41,940 --> 01:32:52,017
TEST

1732
01:33:17,810 --> 01:33:21,580
TOC7

1733
01:33:21,580 --> 01:33:25,651
1:33 P.M.

1734
01:33:25,651 --> 01:33:35,727
TEST

1735
01:59:06,790 --> 01:59:07,725
TOC7

1736
01:59:07,725 --> 01:59:10,761
1:59 P.M.

1737
01:59:10,761 --> 01:59:20,838
TEST