1 04:54:55,378 --> 00:00:04,916 GOOD MORNING, EVERYONE. I'M DR. COOTS, I WOULD LIKE TO 2 00:00:04,916 --> 00:00:07,085 CALL THIS BOARD MEETING TO 3 00:00:07,085 --> 00:00:07,452 ORDER. 4 00:00:07,452 --> 00:00:08,954 TODAY MARKS OUR 25th MEETING. 5 00:00:08,954 --> 00:00:10,222 WE WELCOME BOARD MEMBERS 6 00:00:10,222 --> 00:00:10,989 ATTENDING TODAY. 7 00:00:10,989 --> 00:00:15,394 WE HAVE JOINING US IN PERSON 8 00:00:15,394 --> 00:00:20,365 MR. DAVID BAUM, MS. ROYSTER IS 9 00:00:20,365 --> 00:00:26,805 ON THE WAY MR. LACK JESSLY, 10 00:00:26,805 --> 00:00:28,540 STEPHANIE REEL AND DR. NINA 11 00:00:28,540 --> 00:00:28,874 SCHOR. 12 00:00:28,874 --> 00:00:36,782 PARTICIPATING VIA ZOOM DR. CHEN, 13 00:00:36,782 --> 00:00:43,388 DR. CUNNINGHAM, DR. DEVASKAV, 14 00:00:43,388 --> 00:00:44,756 PRICELAG AND STEVE GOLDSTEIN. 15 00:00:44,756 --> 00:00:46,391 WE APPRECIATE HAVING YOU FOR 16 00:00:46,391 --> 00:00:48,193 WHATEVER TIME YOU'RE AVAILABLE 17 00:00:48,193 --> 00:00:50,762 TO GIVE US TODAY. 18 00:00:50,762 --> 00:00:53,632 AS ALWAYS, I'D LIKE TO WELCOME 19 00:00:53,632 --> 00:00:54,966 DOCTORS TABAK AND SCHWETZ IN 20 00:00:54,966 --> 00:00:56,802 PERSON, ALONG WITH MANY OTHER 21 00:00:56,802 --> 00:00:58,370 LEADERS ATTENDING VIA ZOOM. 22 00:00:58,370 --> 00:01:00,005 WE WELCOME COLLEAGUES FROM THE 23 00:01:00,005 --> 00:01:02,140 NIH COMMUNITY AND MEMBERS OF THE 24 00:01:02,140 --> 00:01:04,976 PUBLIC WHO ARE JOINING US IN OUR 25 00:01:04,976 --> 00:01:05,477 LIVE VIDEOCAST SESSION. 26 00:01:05,477 --> 00:01:10,716 I DO HAVE ONE ADMINISTRATIVE 27 00:01:10,716 --> 00:01:12,117 UPDATE, CURRENT CCRH CHARTER WAS 28 00:01:12,117 --> 00:01:13,552 AMENDED RECENTLY AND RECEIVED BY 29 00:01:13,552 --> 00:01:15,187 BOARD MEMBERS EARLIER THIS WEEK 30 00:01:15,187 --> 00:01:16,788 WITH OUR MEETING MATERIALS. 31 00:01:16,788 --> 00:01:18,323 THE AMENDED CHARTER WILL BE 32 00:01:18,323 --> 00:01:21,526 POSTED ON OUR WEBSITE SOON, 33 00:01:21,526 --> 00:01:23,128 MAJOR CHANGE INVOLVED BOARD 34 00:01:23,128 --> 00:01:24,830 FINANCES SO ANNUAL OPERATING 35 00:01:24,830 --> 00:01:29,968 COSTS WILL SUPPORT HONORARIUM 36 00:01:29,968 --> 00:01:31,069 FOR MEMBERS AT MEETINGS 37 00:01:31,069 --> 00:01:31,937 BEGINNING WITH THIS ONE. 38 00:01:31,937 --> 00:01:35,107 I WANT TO TAKE A MOMENT TO 39 00:01:35,107 --> 00:01:36,508 ACKNOWLEDGE THE EXTRAORDINARY 40 00:01:36,508 --> 00:01:43,281 AND ALMOST INCOMPREHENSIBLE 41 00:01:43,281 --> 00:01:45,083 TIMES WE FIND OURSELVES LIVING, 42 00:01:45,083 --> 00:01:47,018 WAR BETWEEN UKRAINE AND RUSSIA 43 00:01:47,018 --> 00:01:51,056 AND FOR TWO WEEKS WATCHING THE 44 00:01:51,056 --> 00:01:53,825 WAR BETWEEN ISRAEL AND HAMAS. 45 00:01:53,825 --> 00:01:56,161 THE PRESIDENT SPOKE TO THE 46 00:01:56,161 --> 00:01:59,030 NATION, AS A FEDERAL BOARD HE 47 00:01:59,030 --> 00:02:00,499 SPEAKS FOR US. 48 00:02:00,499 --> 00:02:02,067 WAR HAS NO WINNERS, ONLY 49 00:02:02,067 --> 00:02:02,334 SURVIVORS. 50 00:02:02,334 --> 00:02:05,170 LET US ALL PRAY FOR PEACE. 51 00:02:05,170 --> 00:02:07,172 AND WITH THAT, I'D LIKE TO GO 52 00:02:07,172 --> 00:02:08,740 AHEAD AND TRANSITION AND MOVE 53 00:02:08,740 --> 00:02:12,511 INTO OF THE MEETING. 54 00:02:12,511 --> 00:02:13,311 WELCOME, DR. TABAK. 55 00:02:13,311 --> 00:02:14,913 WE'LL BEGIN WITH YOUR SLIDES AND 56 00:02:14,913 --> 00:02:16,515 PRESENTATION AND LOOK FORWARD TO 57 00:02:16,515 --> 00:02:17,783 YOUR UPDATE. 58 00:02:17,783 --> 00:02:20,652 >> THANK YOU SO VERY MUCH. 59 00:02:20,652 --> 00:02:25,991 WELCOME HERE IN THE ROOM AND 60 00:02:25,991 --> 00:02:26,658 VIRTUALLY. 61 00:02:26,658 --> 00:02:28,360 25 MEETINGS, WOW. 62 00:02:28,360 --> 00:02:29,027 TIME FLIES. 63 00:02:29,027 --> 00:02:33,165 IF I COULD HAVE THE NEXT SLIDE 64 00:02:33,165 --> 00:02:41,406 PLEASE. 65 00:02:41,406 --> 00:02:41,773 OKAY. 66 00:02:41,773 --> 00:02:44,276 WHAT I'D LIKE TO COVER THIS 67 00:02:44,276 --> 00:02:46,344 MORNING ARE THESE FOUR TOPICS. 68 00:02:46,344 --> 00:02:49,481 A QUICK UPDATE ON SOME 69 00:02:49,481 --> 00:02:50,215 LEADERSHIP CHANGES. 70 00:02:50,215 --> 00:02:54,486 WE ARE IN THE MIDST OF 71 00:02:54,486 --> 00:02:56,922 CONTEMPLATING CHANGES TO THE NIH 72 00:02:56,922 --> 00:02:57,322 MISSION STATEMENT. 73 00:02:57,322 --> 00:02:59,691 I WANTED TO BRING THAT TO THE 74 00:02:59,691 --> 00:03:00,892 BOARD'S ATTENTION. 75 00:03:00,892 --> 00:03:04,563 I ALSO WANTED TO PROVIDE YOU 76 00:03:04,563 --> 00:03:09,835 WITH AN UPDATE ABOUT NIH EFFORTS 77 00:03:09,835 --> 00:03:12,137 TO ADDRESS LONG COVID, BOTH IN 78 00:03:12,137 --> 00:03:13,772 TERMS OF SOME EXTRAMURAL 79 00:03:13,772 --> 00:03:16,775 ACTIVITIES AS WELL AS A QUICK 80 00:03:16,775 --> 00:03:18,543 OVERVIEW OF SOME INTRAMURAL 81 00:03:18,543 --> 00:03:20,612 RESEARCH, ALTHOUGH DR. SCHOR 82 00:03:20,612 --> 00:03:22,681 COULD CERTAINLY AMPLIFY ON ANY 83 00:03:22,681 --> 00:03:24,783 OF THAT. 84 00:03:24,783 --> 00:03:27,552 AND THEN FINALLY, JUST TO ALERT 85 00:03:27,552 --> 00:03:31,289 YOU TO CHANGES TO PEER REVIEW 86 00:03:31,289 --> 00:03:33,592 CRITERIA FOR EXTRAMURAL GRANTS, 87 00:03:33,592 --> 00:03:37,028 ONLY BECAUSE SOME OF YOU ARE 88 00:03:37,028 --> 00:03:39,331 HOME BASED COLLEAGUES WHO MAY 89 00:03:39,331 --> 00:03:40,866 QUESTION WHAT'S GOING, WE WANTED 90 00:03:40,866 --> 00:03:43,502 YOU TO HAVE AN OPPORTUNITY TO 91 00:03:43,502 --> 00:03:44,436 HEAR ABOUT THIS, THAT 92 00:03:44,436 --> 00:03:45,237 INFORMATION WENT LIVE YESTERDAY. 93 00:03:45,237 --> 00:03:48,006 IF I COULD HAVE THE NEXT SLIDE 94 00:03:48,006 --> 00:03:48,640 PLEASE. 95 00:03:48,640 --> 00:03:49,074 AGAIN, NEXT. 96 00:03:49,074 --> 00:03:52,611 SO, I THINK AS YOU ALL KNOW, OUR 97 00:03:52,611 --> 00:03:56,948 NOMINEE FOR THE NIH 98 00:03:56,948 --> 00:03:58,183 DIRECTORSHIP, DR. MONICA 99 00:03:58,183 --> 00:03:59,084 BERTAGNOLLI, CURRENTLY THE 100 00:03:59,084 --> 00:04:03,054 DIRECTOR OF THE NATIONAL CANCER 101 00:04:03,054 --> 00:04:04,956 INSTITUTE, HAD HER HEARING AT 102 00:04:04,956 --> 00:04:09,127 THE SENATE HEALTH COMMITTEE THIS 103 00:04:09,127 --> 00:04:11,196 PAST WEDNESDAY. 104 00:04:11,196 --> 00:04:12,797 THE HEARING WENT VERY WELL. 105 00:04:12,797 --> 00:04:15,934 THE CHAIR OF THE COMMITTEE, 106 00:04:15,934 --> 00:04:19,971 SENATOR SANDERS, INDICATED THAT 107 00:04:19,971 --> 00:04:22,374 THE COMMITTEE WILL VOTE ON THE 108 00:04:22,374 --> 00:04:25,477 NOMINATION NEXT WEDNESDAY, THE 109 00:04:25,477 --> 00:04:26,878 25th OF OCTOBER. 110 00:04:26,878 --> 00:04:30,515 AND OF COURSE OUR HOPE IS THAT 111 00:04:30,515 --> 00:04:35,554 THINGS WILL PROCEED VERY 112 00:04:35,554 --> 00:04:38,156 SMOOTHLY, CULMINATING IN SENATE 113 00:04:38,156 --> 00:04:38,723 CONFIRMATION. 114 00:04:38,723 --> 00:04:43,028 AGAIN, WE HOPE SOMETIME IN EARLY 115 00:04:43,028 --> 00:04:43,295 NOVEMBER. 116 00:04:43,295 --> 00:04:45,497 AND OBVIOUSLY, WE'RE ALL LOOKING 117 00:04:45,497 --> 00:04:51,503 FORWARD TO DR. BERTAGNOLLI'S 118 00:04:51,503 --> 00:04:54,973 TENURE AS NIH DIRECTOR. 119 00:04:54,973 --> 00:04:55,373 NEXT PLEASE. 120 00:04:55,373 --> 00:04:57,642 WE HAVE A NEW DIRECTOR OF THE 121 00:04:57,642 --> 00:05:00,512 NATIONAL INSTITUTE OF ALLERGY 122 00:05:00,512 --> 00:05:06,217 AND INFECTIOUS DISEASES. 123 00:05:06,217 --> 00:05:08,820 DR. JEANNE MARRAZZO FROM 124 00:05:08,820 --> 00:05:10,155 UNIVERSITY OF ALABAMA AT 125 00:05:10,155 --> 00:05:15,694 BIRMINGHAM WHERE SHE HEADED THE 126 00:05:15,694 --> 00:05:17,362 INFECTIOUS DISEASE DIVISION. 127 00:05:17,362 --> 00:05:22,067 SHE IS NOW HERE, HAS HIT THE 128 00:05:22,067 --> 00:05:23,969 GROUND RUNNING. 129 00:05:23,969 --> 00:05:29,941 AND I THINK WILL PROVE TO BE AN 130 00:05:29,941 --> 00:05:32,277 OUTSTANDING LEADER OF NIAID. 131 00:05:32,277 --> 00:05:35,013 IF WE COULD HAVE THE NEXT SLIDE 132 00:05:35,013 --> 00:05:35,714 BEFORE. 133 00:05:35,714 --> 00:05:45,991 I SHOULD SAY WE NEED TO THANK 134 00:05:45,991 --> 00:05:46,891 THE ACTING DIRECTOR. 135 00:05:46,891 --> 00:05:49,427 IT IS NO FUN, I CAN TELL YOU 136 00:05:49,427 --> 00:05:52,063 THAT. 137 00:05:52,063 --> 00:05:54,299 THANKS TO DR. AUCENCLASS FOR 138 00:05:54,299 --> 00:05:55,867 THAT SERVICE. 139 00:05:55,867 --> 00:05:59,838 ON A POSITIVE NOTE, I'M SORRY TO 140 00:05:59,838 --> 00:06:03,341 SAY DR. PATRICIA BRENNAN IS 141 00:06:03,341 --> 00:06:05,677 RETIRED FROM NIH. 142 00:06:05,677 --> 00:06:08,680 PATTI WAS DIRECTOR OF THE 143 00:06:08,680 --> 00:06:10,515 NATIONAL LIBRARY OF MEDICINE BUT 144 00:06:10,515 --> 00:06:13,718 EMERGED AS AN NIH LEADER IN THE 145 00:06:13,718 --> 00:06:16,321 DIGITAL WORKSPACE, IF YOU WILL. 146 00:06:16,321 --> 00:06:20,358 SOME OF US REMEMBER LIBRARIES 147 00:06:20,358 --> 00:06:24,562 WITH DUSTY SHELVES AND BOOKS AND 148 00:06:24,562 --> 00:06:28,767 MICROFICHE AND OTHER INTERESTING 149 00:06:28,767 --> 00:06:29,100 CONTRAPTIONS. 150 00:06:29,100 --> 00:06:32,003 OBVIOUSLY, TODAY'S LIBRARY IS 151 00:06:32,003 --> 00:06:35,273 ALL DIGITAL, AND PATTI IS REALLY 152 00:06:35,273 --> 00:06:42,313 A THOUGHT LEADER IN THIS PART OF 153 00:06:42,313 --> 00:06:42,614 SCIENCE. 154 00:06:42,614 --> 00:06:43,648 AN EVER-INCREASING IMPORTANT 155 00:06:43,648 --> 00:06:44,849 PART OF SCIENCE AND HELPED GUIDE 156 00:06:44,849 --> 00:06:47,986 US IN A NUMBER OF STRATEGIC 157 00:06:47,986 --> 00:06:48,753 WAYS. 158 00:06:48,753 --> 00:06:53,091 SHE WILL BE MISSED GREATLY. 159 00:06:53,091 --> 00:06:54,626 NEXT PLEASE. 160 00:06:54,626 --> 00:06:55,960 SO, DR. STEPHEN SHERRY DREW THE 161 00:06:55,960 --> 00:06:58,029 SHORT STRAW AND WILL BE ACTING 162 00:06:58,029 --> 00:06:58,997 DIRECTOR OF NLM. 163 00:06:58,997 --> 00:07:01,066 STEVE IS WELL KNOWN TO MANY 164 00:07:01,066 --> 00:07:04,836 PEOPLE IN RESEARCH COMMUNITY, 165 00:07:04,836 --> 00:07:06,771 CURRENTLY HEADS THE NCBI, WHICH 166 00:07:06,771 --> 00:07:08,973 IS THE LARGEST REPOSITORY OF 167 00:07:08,973 --> 00:07:13,545 GENOMIC DATA IN THE WORLD, I 168 00:07:13,545 --> 00:07:13,745 GUESS. 169 00:07:13,745 --> 00:07:17,415 AND HE'S GRACIOUSLY AGREED TO 170 00:07:17,415 --> 00:07:20,351 STEP IN WHILE WE PUT TOGETHER A 171 00:07:20,351 --> 00:07:23,888 SEARCH AND SO FORTH. 172 00:07:23,888 --> 00:07:26,057 NEXT PLEASE. 173 00:07:26,057 --> 00:07:29,661 LAUREN HIGGINS, ACTING DIRECTOR 174 00:07:29,661 --> 00:07:31,830 OF THE LEGISLATIVE POLICY AND 175 00:07:31,830 --> 00:07:33,431 ANALYSIS OFFICE, IS VERY HAPPY 176 00:07:33,431 --> 00:07:38,069 TODAY, BECAUSE THIS IS HER LAST 177 00:07:38,069 --> 00:07:46,111 DAY AS ACTING DIRECTOR, AS KATE 178 00:07:46,111 --> 00:07:47,912 KLIMCZAK WILL BE JOINING MONDAY 179 00:07:47,912 --> 00:07:49,614 AS NEW ASSOCIATE DIRECTOR FOR 180 00:07:49,614 --> 00:07:50,982 LEGISLATIVE POLICY AND ANALYSIS, 181 00:07:50,982 --> 00:07:54,152 SHE COMES FROM THE FDA BUT 182 00:07:54,152 --> 00:07:59,557 ACTUALLY HAD BEEN AT NIH FOR A 183 00:07:59,557 --> 00:08:01,025 TIME PRIOR TO THAT SO WE'VE 184 00:08:01,025 --> 00:08:03,394 STOLEN HER BACK IN THE FDA. 185 00:08:03,394 --> 00:08:06,498 THIS HAPPENS ALL THE TIME AMONG 186 00:08:06,498 --> 00:08:09,334 SIBLING ORGANIZATIONS IN HHS BUT 187 00:08:09,334 --> 00:08:14,739 WONDERFUL TO HAVE KATE REJOINING 188 00:08:14,739 --> 00:08:15,940 NIH. 189 00:08:15,940 --> 00:08:16,407 NEXT PLEASE. 190 00:08:16,407 --> 00:08:19,644 ALSO, I'D LIKE TO LET YOU KNOW 191 00:08:19,644 --> 00:08:21,479 THAT WE'VE RECENTLY APPOINTED A 192 00:08:21,479 --> 00:08:26,117 NEW DIRECTOR OF THE OFFICE OF 193 00:08:26,117 --> 00:08:27,986 NUTRITION RESEARCH, DR. ANDREW 194 00:08:27,986 --> 00:08:28,486 BREMER. 195 00:08:28,486 --> 00:08:31,523 DREW IS AN EXPERT IN THIS 196 00:08:31,523 --> 00:08:32,056 DOMAIN. 197 00:08:32,056 --> 00:08:35,160 THIS IS SOMETHING THAT FRANKLY 198 00:08:35,160 --> 00:08:37,428 NEEDS A REFRESH AT NIH. 199 00:08:37,428 --> 00:08:40,732 WE THINK THERE'S MUCH MORE THAT 200 00:08:40,732 --> 00:08:42,600 CAN BE DONE IN THIS SPACE, 201 00:08:42,600 --> 00:08:45,603 SOMETHING THAT ACTUALLY CAME UP 202 00:08:45,603 --> 00:08:47,972 AT DR. BERTAGNOLLI'S HEARING ON 203 00:08:47,972 --> 00:08:50,742 WEDNESDAY ABOUT THE NEED TO DO 204 00:08:50,742 --> 00:08:53,211 MORE IN NUTRITIONAL SCIENCE. 205 00:08:53,211 --> 00:08:57,715 AND WE'RE VERY GRATEFUL FOR DREW 206 00:08:57,715 --> 00:08:58,950 TO ACCEPT THE PERMANENT 207 00:08:58,950 --> 00:08:59,450 POSITION. 208 00:08:59,450 --> 00:09:03,454 THIS OFFICE IS LOCATED WITHIN 209 00:09:03,454 --> 00:09:07,258 WHAT WE FINALLY REFER TO AS 210 00:09:07,258 --> 00:09:08,159 DPCPSI, A VERY LARGE DIVISION 211 00:09:08,159 --> 00:09:11,062 WITHIN THE OFFICE OF THE 212 00:09:11,062 --> 00:09:12,664 DIRECTOR, AND IT INCLUDES 213 00:09:12,664 --> 00:09:14,866 STRATEGIC PLANNING AND RESEARCH 214 00:09:14,866 --> 00:09:15,800 EFFORTS AND OTHER ORGANIZATIONS 215 00:09:15,800 --> 00:09:18,803 IN THERE THAT YOU MIGHT KNOW AS 216 00:09:18,803 --> 00:09:20,505 OFFICE OF RESEARCH ON WOMEN'S 217 00:09:20,505 --> 00:09:21,573 HEALTH AND OFFICE OF AIDS 218 00:09:21,573 --> 00:09:22,974 RESEARCH AND SO FORTH. 219 00:09:22,974 --> 00:09:27,879 THERE ARE MANY -- I THINK IT'S 220 00:09:27,879 --> 00:09:28,246 14 OFFICES. 221 00:09:28,246 --> 00:09:30,915 SO DREW WILL BE THE DIRECTOR OF 222 00:09:30,915 --> 00:09:34,485 THE OFFICE OF NUTRITION 223 00:09:34,485 --> 00:09:35,453 RESEARCH. 224 00:09:35,453 --> 00:09:37,755 NEXT PLEASE. 225 00:09:37,755 --> 00:09:39,891 SO, I'D LIKE TO NOW GO TO THE 226 00:09:39,891 --> 00:09:42,694 NEXT TOPIC, THANKED IS ABOUT THE 227 00:09:42,694 --> 00:09:43,928 NIH MISSION STATEMENT. 228 00:09:43,928 --> 00:09:46,531 AND THE SUBPLOT OF THIS IS WORDS 229 00:09:46,531 --> 00:09:46,831 MATTER. 230 00:09:46,831 --> 00:09:49,434 SO IF I COULD HAVE THE NEXT 231 00:09:49,434 --> 00:09:50,301 SLIDE PLEASE. 232 00:09:50,301 --> 00:09:52,971 ON YOUR LEFT IS THE CURRENT NIH 233 00:09:52,971 --> 00:09:53,371 MISSION STATEMENT. 234 00:09:53,371 --> 00:09:55,139 I THINK MANY OF ARE YOU FAMILIAR 235 00:09:55,139 --> 00:09:56,140 WITH THIS. 236 00:09:56,140 --> 00:09:57,508 THE MISSION IS TO SEEK 237 00:09:57,508 --> 00:09:58,776 FUNDAMENTAL KNOWLEDGE ABOUT THE 238 00:09:58,776 --> 00:10:01,112 NATURE AND BEHAVIOR OF LIVING 239 00:10:01,112 --> 00:10:03,915 SYSTEMS, AND APPLICATION OF THAT 240 00:10:03,915 --> 00:10:05,683 KNOWLEDGE TO ENHANCE HEALTH, 241 00:10:05,683 --> 00:10:07,986 LENGTHEN LIFE, REDUCE ILLNESS 242 00:10:07,986 --> 00:10:10,989 AND DISABILITY. 243 00:10:10,989 --> 00:10:12,557 WE'VE HIGHLIGHTED TO ENHANCE 244 00:10:12,557 --> 00:10:14,726 HEALTH AND LENGTHEN LIFE AND 245 00:10:14,726 --> 00:10:17,762 REDUCE ILLNESS AND DISABILITY 246 00:10:17,762 --> 00:10:20,431 FOR THE FOLLOWING REASONS. 247 00:10:20,431 --> 00:10:23,101 FIRST, MANY PEOPLE HAVE POINTED 248 00:10:23,101 --> 00:10:26,237 OUT TO US THAT WE NEVER TALK 249 00:10:26,237 --> 00:10:28,239 ABOUT PREVENTION IN THE MISSION 250 00:10:28,239 --> 00:10:28,806 STATEMENT. 251 00:10:28,806 --> 00:10:29,974 AND THIS SEEMS ODD BECAUSE OF 252 00:10:29,974 --> 00:10:32,243 COURSE SO MUCH OF WHAT WE 253 00:10:32,243 --> 00:10:35,813 UNDERSTAND ABOUT MEDICINE IS THE 254 00:10:35,813 --> 00:10:38,583 NEED TO PREVENT BEFORE DISEASE 255 00:10:38,583 --> 00:10:40,551 BEGINS, AND IT'S OBVIOUSLY THE 256 00:10:40,551 --> 00:10:46,090 BEST WAY OF COMBATING IT. 257 00:10:46,090 --> 00:10:51,396 AND ALSO, MANY MEMBERS OF THE 258 00:10:51,396 --> 00:10:55,366 DISABILITY COMMUNITY WHICH IS A 259 00:10:55,366 --> 00:10:56,234 VERY HETEROGENEOUS COMMUNITY 260 00:10:56,234 --> 00:11:02,307 POINTED OUT TO US THAT FOR SOME, 261 00:11:02,307 --> 00:11:05,343 THEY DON'T REQUIRE A REDRESS OF 262 00:11:05,343 --> 00:11:07,045 THEIR DISABILITY BECAUSE THAT'S 263 00:11:07,045 --> 00:11:08,346 WHO THEY ARE. 264 00:11:08,346 --> 00:11:11,816 I THINK THE BEST WAY I CAN 265 00:11:11,816 --> 00:11:13,818 DESCRIBE THIS IS IN MY 266 00:11:13,818 --> 00:11:15,687 INTERACTIONS WITH PEOPLE FROM 267 00:11:15,687 --> 00:11:17,188 PARTS OF THE DEAF COMMUNITY, 268 00:11:17,188 --> 00:11:22,994 WHEN I WAS IN UNIVERSITY OF 269 00:11:22,994 --> 00:11:23,695 ROCHESTER, OUR NEIGHBORING 270 00:11:23,695 --> 00:11:25,196 INSTITUTION R I.T. IS THE HOME 271 00:11:25,196 --> 00:11:29,133 OF ONE OF THE TWO VERY LARGE 272 00:11:29,133 --> 00:11:35,373 COLLEGES FOR THE DEAF, NTID, AND 273 00:11:35,373 --> 00:11:37,342 INDIVIDUALS THERE REFUSE SUCH 274 00:11:37,342 --> 00:11:39,177 THINGS AS COCHLEAR IMPLANTS 275 00:11:39,177 --> 00:11:41,045 BECAUSE THEY FEEL THAT BEING 276 00:11:41,045 --> 00:11:42,680 DEAF IS PART OF WHO THEY ARE, 277 00:11:42,680 --> 00:11:44,615 AND THEY DON'T NEED TO BE, 278 00:11:44,615 --> 00:11:46,317 QUOTE, FIXED. 279 00:11:46,317 --> 00:11:49,420 THIS IS NOT A UNIVERSAL VIEW BY 280 00:11:49,420 --> 00:11:51,756 ALL MEMBERS OF DISABILITY 281 00:11:51,756 --> 00:11:52,890 COMMUNITIES, IT'S VERY 282 00:11:52,890 --> 00:11:53,358 HETEROGENEOUS. 283 00:11:53,358 --> 00:11:56,160 BUT AT LEAST WE HAVE HEARD A 284 00:11:56,160 --> 00:11:58,162 GREAT DEAL FROM THE INDIVIDUALS 285 00:11:58,162 --> 00:12:02,133 WHO FEEL THIS WAY, AND VIEW OUR 286 00:12:02,133 --> 00:12:06,237 CURRENT STATEMENT AS BEING 287 00:12:06,237 --> 00:12:06,637 ABLEIST. 288 00:12:06,637 --> 00:12:11,542 SO, WE HAVE A PROPOSED REVISION, 289 00:12:11,542 --> 00:12:15,179 AND IT IS PROPOSED. 290 00:12:15,179 --> 00:12:16,914 AND SO THE BEGINNING PART 291 00:12:16,914 --> 00:12:19,317 REMAINS THE SAME BUT IT ENDS 292 00:12:19,317 --> 00:12:22,186 WITH "TO APPLY THAT KNOWLEDGE TO 293 00:12:22,186 --> 00:12:24,155 OPTIMIZE HEALTH AND PREVENT OR 294 00:12:24,155 --> 00:12:28,626 REDUCE ILLNESS FOR ALL PEOPLE." 295 00:12:28,626 --> 00:12:32,530 AND SO, OBVIOUSLY I THINK WHAT 296 00:12:32,530 --> 00:12:35,500 WOULD BE COMPLETELY 297 00:12:35,500 --> 00:12:38,236 NON-CONTENTIOUS IS INSERTING " 298 00:12:38,236 --> 00:12:39,370 PREVENT" BECAUSE HOPEFULLY 299 00:12:39,370 --> 00:12:42,240 EVERYBODY AGREES WITH THAT BUT 300 00:12:42,240 --> 00:12:43,374 WE'VE REMOVED "DISABILITY." 301 00:12:43,374 --> 00:12:45,176 IF I COULD HAVE THE NEXT SLIDE 302 00:12:45,176 --> 00:12:45,576 PLEASE. 303 00:12:45,576 --> 00:12:47,779 AGAIN, WE'VE REMOVED IT FROM THE 304 00:12:47,779 --> 00:12:51,049 DRAFT BECAUSE WE HAVE A REQUEST 305 00:12:51,049 --> 00:12:54,052 FOR INFORMATION OUT NOW INVITING 306 00:12:54,052 --> 00:12:56,687 PUBLIC COMMENT ON OUR MISSION 307 00:12:56,687 --> 00:12:59,724 STATEMENT AND THE PROPOSED 308 00:12:59,724 --> 00:13:00,958 CHANGE. 309 00:13:00,958 --> 00:13:01,893 AND SPECIFIC INFORMATION IS ON 310 00:13:01,893 --> 00:13:03,528 THE LOWER LEFT. 311 00:13:03,528 --> 00:13:07,965 THIS IS OPEN UNTIL NOVEMBER 24. 312 00:13:07,965 --> 00:13:12,770 WE HAVE ALREADY RECEIVED A GREAT 313 00:13:12,770 --> 00:13:15,606 DEAL OF FEEDBACK. 314 00:13:15,606 --> 00:13:17,208 AGAIN, NOT TO BIAS THINGS IN ANY 315 00:13:17,208 --> 00:13:19,777 WAY, ONE WAY OR THE OTHER, THUS 316 00:13:19,777 --> 00:13:23,081 FAR MOST PEOPLE FEEL THAT THE 317 00:13:23,081 --> 00:13:24,682 REVISION IS A REASONABLE ONE, 318 00:13:24,682 --> 00:13:26,584 BUT, AGAIN, WE NEED TO ALLOW 319 00:13:26,584 --> 00:13:29,353 THIS TO RUN THE FULL COURSE AND 320 00:13:29,353 --> 00:13:32,390 GET AS MANY PEOPLE'S INPUT AS 321 00:13:32,390 --> 00:13:32,857 POSSIBLE. 322 00:13:32,857 --> 00:13:35,059 SO I WANTED TO ALERT YOU TO ALL 323 00:13:35,059 --> 00:13:35,560 OF THIS. 324 00:13:35,560 --> 00:13:37,662 SOMEBODY MAY ASK YOU ABOUT THIS. 325 00:13:37,662 --> 00:13:42,467 YOU YOURSELF MAY HAVE VIEWS ON 326 00:13:42,467 --> 00:13:42,800 THIS. 327 00:13:42,800 --> 00:13:45,503 AND CERTAINLY WE ARE VERY 328 00:13:45,503 --> 00:13:46,604 INTERESTED IN ANY FEEDBACK, 329 00:13:46,604 --> 00:13:49,607 EITHER YOU OR ANY COLLEAGUES 330 00:13:49,607 --> 00:13:52,143 THAT YOU HAVE, ARE WILLING TO 331 00:13:52,143 --> 00:13:52,577 OFFER. 332 00:13:52,577 --> 00:13:59,350 IF I COULD HAVE THE NEXT SLIDE 333 00:13:59,350 --> 00:13:59,617 PLEASE. 334 00:13:59,617 --> 00:14:00,852 I'D LIKE TO TOUCH UPON EFFORTS 335 00:14:00,852 --> 00:14:02,854 NIH IS TAKING WITH REGARD TO 336 00:14:02,854 --> 00:14:05,623 LONG COVID. 337 00:14:05,623 --> 00:14:07,592 NEXT PLEASE. 338 00:14:07,592 --> 00:14:12,930 SO, WITHIN THE EXTRAMURAL SPACE, 339 00:14:12,930 --> 00:14:14,899 NIH HAS A MULTI-FACETED PROGRAM 340 00:14:14,899 --> 00:14:18,970 OF ACRONYM OF WHICH IS 341 00:14:18,970 --> 00:14:20,505 "ReCOVer," RESEARCHING COVID 342 00:14:20,505 --> 00:14:23,040 TO ENHANCE RECOVERY. 343 00:14:23,040 --> 00:14:24,142 THE GOAL AS I'M SURE YOU CAN 344 00:14:24,142 --> 00:14:28,846 FIGURE OUT WOULD BE TO 345 00:14:28,846 --> 00:14:30,248 UNDERSTAND LONG COVID, ALLOW US 346 00:14:30,248 --> 00:14:32,416 TO BE ABLE TO PREDICT, TREAT, 347 00:14:32,416 --> 00:14:34,252 AND PREVENT THIS. 348 00:14:34,252 --> 00:14:36,621 THE SCIENTIFIC AIMS ARE ON THE 349 00:14:36,621 --> 00:14:38,156 LEFT. 350 00:14:38,156 --> 00:14:41,459 REALLY TO UNDERSTAND THE 351 00:14:41,459 --> 00:14:43,327 BIOLOGY, DEFINE RISK FACTORS, 352 00:14:43,327 --> 00:14:45,496 UNDERSTAND HOW THE DISEASE 353 00:14:45,496 --> 00:14:48,566 PROGRESSES, AND IT'S A VERY 354 00:14:48,566 --> 00:14:50,168 HETEROGENEOUS SET OF CONDITIONS 355 00:14:50,168 --> 00:14:50,601 INDEED. 356 00:14:50,601 --> 00:14:53,437 AND THEN OBVIOUSLY TO IDENTIFY 357 00:14:53,437 --> 00:14:55,039 THE INTERVENTIONS TO TREAT AND 358 00:14:55,039 --> 00:14:55,840 PREVENT THIS. 359 00:14:55,840 --> 00:14:57,675 NOW, THE PRINCIPLES THAT HAVE 360 00:14:57,675 --> 00:15:00,278 BEEN GUIDING THIS EFFORT ARE 361 00:15:00,278 --> 00:15:02,947 OUTLINED ON THE RIGHT-HAND SIDE 362 00:15:02,947 --> 00:15:04,081 OF THE SLIDE. 363 00:15:04,081 --> 00:15:08,886 THIS IS, I BELIEVE, ONE OF THE 364 00:15:08,886 --> 00:15:11,022 MOST PATIENT-CENTRIC STUDIES NIH 365 00:15:11,022 --> 00:15:13,491 HAS EVER EMBARKED ON. 366 00:15:13,491 --> 00:15:15,459 THE PARTICIPANTS ARE VIEWED AS 367 00:15:15,459 --> 00:15:16,661 OUR TRUE PARTNERS. 368 00:15:16,661 --> 00:15:22,934 THEY ARE ENGAGED WITH US AS WE 369 00:15:22,934 --> 00:15:26,304 DEFINE AND DEVELOP PROTOCOLS. 370 00:15:26,304 --> 00:15:28,339 WE DEBATE THE METHODOLOGIES IN 371 00:15:28,339 --> 00:15:28,773 CERTAIN INSTANCES. 372 00:15:28,773 --> 00:15:32,210 MANY OF THE PATIENTS AND/OR 373 00:15:32,210 --> 00:15:33,945 THEIR ADVOCATES ARE EXPERTS AND 374 00:15:33,945 --> 00:15:36,881 HAVE MUCH TO BRING TO THE TABLE 375 00:15:36,881 --> 00:15:38,182 IN THIS DISCUSSION. 376 00:15:38,182 --> 00:15:41,319 AND THE OTHER PART OF THIS IN 377 00:15:41,319 --> 00:15:43,287 TERMS OF GUIDING PRINCIPLES IS 378 00:15:43,287 --> 00:15:46,290 THAT WE'RE APPROACHING THIS WITH 379 00:15:46,290 --> 00:15:49,427 AN ADAPTIVE PLATFORM, MEANING 380 00:15:49,427 --> 00:15:52,530 THAT IF SOMETHING EMERGES THAT 381 00:15:52,530 --> 00:15:55,366 HAD NOT BEEN ANTICIPATED, THIS 382 00:15:55,366 --> 00:15:57,068 PLATFORM AND I'LL SHARE WITH YOU 383 00:15:57,068 --> 00:16:00,538 IN A MOMENT IT'S A SERIES OF 384 00:16:00,538 --> 00:16:01,772 NESTED STUDIES, IS FLEXIBLE 385 00:16:01,772 --> 00:16:06,410 ENOUGH SO THAT WE CAN TAKE ON 386 00:16:06,410 --> 00:16:08,679 NEW APPROACHES BASED UPON ANY 387 00:16:08,679 --> 00:16:09,714 EMERGENT SCIENCE. 388 00:16:09,714 --> 00:16:10,848 AND NEW THINGS ARE BEING LEARNED 389 00:16:10,848 --> 00:16:13,251 ALL THE TIME. 390 00:16:13,251 --> 00:16:16,887 JUST EARLIER THIS WEEK, THERE 391 00:16:16,887 --> 00:16:19,724 WAS A RATHER COMPLEX PUBLICATION 392 00:16:19,724 --> 00:16:21,892 IN "CELL," SUGGESTING THAT 393 00:16:21,892 --> 00:16:25,896 LEVELS OF SEROTONIN MAY HAVE 394 00:16:25,896 --> 00:16:27,298 SOME UNDERLYING INVOLVEMENT, AT 395 00:16:27,298 --> 00:16:31,269 LEAST FOR SUBSET OF PATIENTS. 396 00:16:31,269 --> 00:16:34,772 AND THAT SEEMS TO BE A COMMON 397 00:16:34,772 --> 00:16:35,039 THEME. 398 00:16:35,039 --> 00:16:36,741 WE FIND THINGS, BUT THEY APPEAR 399 00:16:36,741 --> 00:16:41,245 TO RELATE TO ONLY SUBSETS OF 400 00:16:41,245 --> 00:16:46,717 PATIENTS AND NOT EVERYBODY. 401 00:16:46,717 --> 00:16:49,253 NOW, TRUTHFULLY, THIS TYPE OF 402 00:16:49,253 --> 00:16:51,455 CONDITION IS NOT NEW. 403 00:16:51,455 --> 00:16:53,291 POST SEQUELAE OF VIRAL 404 00:16:53,291 --> 00:16:54,659 INFECTIONS HAVE BEEN KNOWN FOR A 405 00:16:54,659 --> 00:16:56,794 LONG, LONG TIME, BUT IN THIS 406 00:16:56,794 --> 00:16:59,797 INSTANCE WE MAY KNOW MORE ABOUT 407 00:16:59,797 --> 00:17:03,100 THIS THAN ANY OTHER VIRAL 408 00:17:03,100 --> 00:17:04,969 INFECTION IN THE PAST. 409 00:17:04,969 --> 00:17:07,238 NOW, OF COURSE, THE VIRUS IS NOT 410 00:17:07,238 --> 00:17:10,441 THE SAME VIRUS AS THE ANCESTRAL 411 00:17:10,441 --> 00:17:10,675 STRAIN. 412 00:17:10,675 --> 00:17:12,109 IT'S BEEN MUTATING. 413 00:17:12,109 --> 00:17:16,247 SO WE HAVE MOVING TARGETS, AND 414 00:17:16,247 --> 00:17:20,117 WE HAVE TO ADAPT TO 415 00:17:20,117 --> 00:17:24,588 UNDERSTANDING WHAT IS HAPPENING 416 00:17:24,588 --> 00:17:26,223 IN TERMS OF PATIENT RESPONSE TO 417 00:17:26,223 --> 00:17:28,392 THE VIRUS, DIFFERENT VIRUSES 418 00:17:28,392 --> 00:17:29,260 ALONG THE WAY, AND SO FORTH. 419 00:17:29,260 --> 00:17:35,566 SO IF I COULD HAVE THE NEXT 420 00:17:35,566 --> 00:17:36,634 SLIDE PLEASE. 421 00:17:36,634 --> 00:17:41,772 OH, IF YOU -- WHAT IS IT? 422 00:17:41,772 --> 00:17:43,974 IT'S POST-ACUTE -- I DON'T 423 00:17:43,974 --> 00:17:44,342 REMEMBER. 424 00:17:44,342 --> 00:17:45,810 I HATE ACRONYMS. 425 00:17:45,810 --> 00:17:46,744 DOES ANYBODY KNOW? 426 00:17:46,744 --> 00:17:49,113 DO YOU KNOW? 427 00:17:49,113 --> 00:17:50,281 POST-ACUTE SEQUELAE -- I'M 428 00:17:50,281 --> 00:17:52,917 SORRY, I'LL LOOK IT UP, I'LL 429 00:17:52,917 --> 00:17:55,986 FIND IT. 430 00:17:55,986 --> 00:17:56,387 SEQUELAE OF COVID. 431 00:17:56,387 --> 00:17:57,688 THANK YOU. 432 00:17:57,688 --> 00:18:00,091 IT'S BEEN DECODED BY DR. SCHOR, 433 00:18:00,091 --> 00:18:00,825 THANK YOU. 434 00:18:00,825 --> 00:18:03,794 I CALL IT LONG COVID BUT YES, 435 00:18:03,794 --> 00:18:09,800 PASSING IS POST -- -- PASC 436 00:18:09,800 --> 00:18:11,035 IS -- RIGHT, APOLOGIES FOR NOT 437 00:18:11,035 --> 00:18:12,436 DEFINING IT. 438 00:18:12,436 --> 00:18:14,872 THIS OF COURSE IS I THINK 439 00:18:14,872 --> 00:18:16,107 SELF-EVIDENT. 440 00:18:16,107 --> 00:18:18,809 THE APPROACH REQUIRES A 441 00:18:18,809 --> 00:18:19,744 MULTI-DISCIPLINARY APPROACH, 442 00:18:19,744 --> 00:18:20,411 VIRTUALLY EVERY ORGAN SYSTEM IN 443 00:18:20,411 --> 00:18:22,480 THE BODY HAS BEEN AFFECTED, BEEN 444 00:18:22,480 --> 00:18:24,415 REPORTED TO BE AFFECTED. 445 00:18:24,415 --> 00:18:26,584 NOT EVERYBODY SYSTEM AFFECTED IN 446 00:18:26,584 --> 00:18:27,918 EVERY PATIENT, BUT RATHER THERE 447 00:18:27,918 --> 00:18:31,389 ARE SUBSETS OF SYSTEMS THAT 448 00:18:31,389 --> 00:18:37,094 APPEAR TO BE AFFECTED. 449 00:18:37,094 --> 00:18:39,930 SOME MAY RELATE TO WHICH VARIANT 450 00:18:39,930 --> 00:18:41,565 YOU WERE INFECTED WITH, IN PART 451 00:18:41,565 --> 00:18:48,339 NO DOUBT RELATES TO HOW YOUR OWN 452 00:18:48,339 --> 00:18:49,774 BODY RESPONDS, FOR EXAMPLE, HOW 453 00:18:49,774 --> 00:18:50,708 YOUR IMMUNE SYSTEM RESPONDS, SO 454 00:18:50,708 --> 00:18:52,643 WE NEED TO DEAL WITH A VERY WIDE 455 00:18:52,643 --> 00:18:54,912 RANGE OF THINGS. 456 00:18:54,912 --> 00:18:57,481 NEXT PLEASE. 457 00:18:57,481 --> 00:18:59,683 SO, WE NOW HAVE FIVE CLINICAL 458 00:18:59,683 --> 00:19:04,188 TRIALS PLANNED, TWO OF WHICH ARE 459 00:19:04,188 --> 00:19:06,924 ALREADY ENROLLING, THE FIRST TO 460 00:19:06,924 --> 00:19:12,163 TEST WHETHER OR NOT REDUCTION OF 461 00:19:12,163 --> 00:19:18,602 VIRAL LOAD CAN PLAY A ROLE IN 462 00:19:18,602 --> 00:19:19,470 RECOVERY. 463 00:19:19,470 --> 00:19:20,838 THE SECOND, TO ASCERTAIN 464 00:19:20,838 --> 00:19:23,474 APPROACHES TO DEAL WITH SOME OF 465 00:19:23,474 --> 00:19:24,408 THE NEUROLOGICAL AND COGNITIVE 466 00:19:24,408 --> 00:19:26,877 DYSFUNCTIONS THAT HAVE BEEN 467 00:19:26,877 --> 00:19:27,611 REPORTED. 468 00:19:27,611 --> 00:19:30,247 YET TO START ENROLLING BUT WILL 469 00:19:30,247 --> 00:19:32,016 BE ENROLLING SOON ARE EFFORTS TO 470 00:19:32,016 --> 00:19:36,654 SEE IF WE CAN INTERVENE FOR THE 471 00:19:36,654 --> 00:19:38,456 VARIOUS AUTONOMIC DYSFUNCTIONS 472 00:19:38,456 --> 00:19:39,790 THAT ARE REPORTED, THE SLEEP 473 00:19:39,790 --> 00:19:42,259 DISORDERS THAT HAVE BEEN 474 00:19:42,259 --> 00:19:44,528 REPORTED, AND FINALLY ISSUES 475 00:19:44,528 --> 00:19:51,802 RELATED TO EXERCISE AND 476 00:19:51,802 --> 00:19:52,303 TOLERANCE. 477 00:19:52,303 --> 00:19:55,206 THE LAST CATEGORY OF EFFORT IS 478 00:19:55,206 --> 00:19:58,275 THE ONE THAT SOME PATIENTS AND 479 00:19:58,275 --> 00:20:01,345 THEIR ADVOCATES ARE PARTICULARLY 480 00:20:01,345 --> 00:20:03,147 CONCERNED ABOUT. 481 00:20:03,147 --> 00:20:05,649 THE SIMILARITIES BETWEEN LONG 482 00:20:05,649 --> 00:20:09,220 COVID AND CHRONIC FATIGUE 483 00:20:09,220 --> 00:20:10,921 SYNDROME ARE QUITE APPARENT. 484 00:20:10,921 --> 00:20:17,695 AND AT LEAST IN A SUBSET OF 485 00:20:17,695 --> 00:20:19,763 CHRONIC FATIGUE SYNDROME 486 00:20:19,763 --> 00:20:21,165 PATIENTS, EXERCISE CAN WORSEN 487 00:20:21,165 --> 00:20:21,999 THEIR CONDITION. 488 00:20:21,999 --> 00:20:26,437 AND SO THEY HAVE EXPRESSED 489 00:20:26,437 --> 00:20:30,674 CONCERN ABOUT THIS. 490 00:20:30,674 --> 00:20:32,209 OTHER EXPERTS HAVE INDICATED 491 00:20:32,209 --> 00:20:34,812 THAT SUPERVISED EXERCISE CAN BE 492 00:20:34,812 --> 00:20:36,881 POTENTIALLY BENEFICIAL, AND SO 493 00:20:36,881 --> 00:20:38,249 WE'RE WORKING WITH A NUMBER OF 494 00:20:38,249 --> 00:20:41,785 GROUPS TO COME UP WITH THE 495 00:20:41,785 --> 00:20:44,922 CORRECT APPROACH FOR THIS LAST 496 00:20:44,922 --> 00:20:45,723 CATEGORY. 497 00:20:45,723 --> 00:20:47,091 NEXT PLEASE. 498 00:20:47,091 --> 00:20:50,394 I'LL JUST FLIP THROUGH THE 499 00:20:50,394 --> 00:20:52,663 INTRAMURAL EFFORT QUICKLY, WE 500 00:20:52,663 --> 00:20:54,498 WANT YOU TO KNOW THE INTRAMURAL 501 00:20:54,498 --> 00:20:56,166 PROGRAM IS ENGAGED. 502 00:20:56,166 --> 00:20:57,067 PLEASE, NINA, IF THERE'S 503 00:20:57,067 --> 00:20:58,035 COMMENTARY WOULD YOU LIKE TO 504 00:20:58,035 --> 00:20:59,036 ADD, JUMP IN. 505 00:20:59,036 --> 00:21:00,271 NEXT PLEASE. 506 00:21:00,271 --> 00:21:02,740 THERE'S A LONGITUDINAL STUDY BY 507 00:21:02,740 --> 00:21:06,877 NIAID THAT'S BEEN ONGOING SINCE 508 00:21:06,877 --> 00:21:08,412 JUNE OF 2020. 509 00:21:08,412 --> 00:21:11,081 AND THESE ARE IMPORTANT BECAUSE 510 00:21:11,081 --> 00:21:16,020 WE'RE GETTING A SENSE OF HOW THE 511 00:21:16,020 --> 00:21:18,322 DISEASE PROGRESSES. 512 00:21:18,322 --> 00:21:19,056 HIGH BURDEN OF PERSISTENT 513 00:21:19,056 --> 00:21:24,228 SYMPTOMS BUT AS OF NOW, NO 514 00:21:24,228 --> 00:21:26,330 SPECIFIC CAUSE. 515 00:21:26,330 --> 00:21:31,535 THERE'S A COVID ARC STUDY, THEY 516 00:21:31,535 --> 00:21:42,079 WROTE OUT THE ACRONYM, ACUTE, 517 00:21:42,079 --> 00:21:42,813 RECOVERY, CONVALESCENS STUDY. 518 00:21:42,813 --> 00:21:46,951 THE HOPE IS IF YOU LOOK AT THE 519 00:21:46,951 --> 00:21:48,419 MOST SEVERE YOU GAIN SOME 520 00:21:48,419 --> 00:21:50,521 INSIGHT. 521 00:21:50,521 --> 00:21:53,357 NEXT PLEASE. 522 00:21:53,357 --> 00:21:56,093 AGAIN, ONE STUDY HAS ASKED ARE 523 00:21:56,093 --> 00:21:57,595 THERE ASSOCIATIONS BETWEEN 524 00:21:57,595 --> 00:21:58,162 NEUROLOGIC SYSTEMS AND 525 00:21:58,162 --> 00:22:01,031 STRUCTURAL CHANGES IN THE BRAIN. 526 00:22:01,031 --> 00:22:02,066 NINA, YOU SHOULD BE TALKING 527 00:22:02,066 --> 00:22:03,334 ABOUT THE BRAIN, NOT ME. 528 00:22:03,334 --> 00:22:06,837 IF YOU COULD SEE IN THE LOWER 529 00:22:06,837 --> 00:22:08,806 LEFT, THERE ARE A NUMBER OF 530 00:22:08,806 --> 00:22:11,208 POST-COVID SYMPTOMS IN PATIENTS. 531 00:22:11,208 --> 00:22:15,479 THEY LOOKED AT ABOUT 100 FOLKS, 532 00:22:15,479 --> 00:22:20,384 TOGETHER WITH IMAGING STUDIES. 533 00:22:20,384 --> 00:22:23,153 AND INTERESTINGLY, THE PLASMA 534 00:22:23,153 --> 00:22:26,190 PROTEIN PROFILE IS QUITE 535 00:22:26,190 --> 00:22:29,093 ALTERED, AND, AGAIN, I GUESS 536 00:22:29,093 --> 00:22:32,363 MAYBE THAT SHOULDN'T BE 537 00:22:32,363 --> 00:22:33,163 SURPRISING FOR AN INFECTIOUS 538 00:22:33,163 --> 00:22:35,399 PROCESS BUT MAYBE THERE ARE SOME 539 00:22:35,399 --> 00:22:37,768 CLUES THERE THAT COULD SERVE 540 00:22:37,768 --> 00:22:41,405 ULTIMATELY AT BIOMARKERS, FOR 541 00:22:41,405 --> 00:22:41,639 EXAMPLE. 542 00:22:41,639 --> 00:22:44,708 AND YET AFTER NINE MONTHS AFTER 543 00:22:44,708 --> 00:22:48,879 COVID, FOLKS WITH NO PULMONARY 544 00:22:48,879 --> 00:22:50,848 SYMPTOMS, YOU KNOW, DIDN'T SHOW 545 00:22:50,848 --> 00:22:52,149 CHANGES IN THIS. 546 00:22:52,149 --> 00:22:56,353 SO, AGAIN, ALL OF THIS JUST 547 00:22:56,353 --> 00:22:58,756 UNDERSCORES THE TREMENDOUS 548 00:22:58,756 --> 00:23:00,391 HETEROGENEITY THAT WE'RE 549 00:23:00,391 --> 00:23:03,527 OBSERVING IN THESE PATIENTS. 550 00:23:03,527 --> 00:23:04,728 NEXT PLEASE. 551 00:23:04,728 --> 00:23:09,767 AND, AGAIN, NINDS HAS BEEN DOING 552 00:23:09,767 --> 00:23:11,201 AN OBSERVATIONAL STUDY WITH 553 00:23:11,201 --> 00:23:13,771 INDIVIDUALS WHO HAVE PERSISTENT 554 00:23:13,771 --> 00:23:16,240 NEUROLOGIC SYMPTOMS. 555 00:23:16,240 --> 00:23:18,776 THEY HAVE ALSO STUDIED THE 556 00:23:18,776 --> 00:23:21,812 BRAINS OF INDIVIDUALS WHO HAVE 557 00:23:21,812 --> 00:23:24,114 DIED, AND HAVE SHOWN DAMAGE TO 558 00:23:24,114 --> 00:23:27,851 THE BRAIN THAT THEY BELIEVE IS 559 00:23:27,851 --> 00:23:30,888 CAUSED BY INFLAMMATION, 560 00:23:30,888 --> 00:23:32,523 ESPECIALLY AROUND BLOOD VESSELS, 561 00:23:32,523 --> 00:23:35,626 AND NIAAA AND NINR HAVE BEEN 562 00:23:35,626 --> 00:23:36,960 LOOKING AT THE OLFACTORY 563 00:23:36,960 --> 00:23:38,395 IMPAIRMENT THAT IS ASSOCIATED 564 00:23:38,395 --> 00:23:42,199 WITH A MORE LASTING SET OF 565 00:23:42,199 --> 00:23:43,167 SYMPTOMS. 566 00:23:43,167 --> 00:23:45,035 SO, AGAIN, VERY HETEROGENEOUS 567 00:23:45,035 --> 00:23:47,104 BUT WE WILL EVENTUALLY MAKE 568 00:23:47,104 --> 00:23:49,773 SENSE OUT OF THIS, WITH THE 569 00:23:49,773 --> 00:23:51,108 EXTRAMURAL EFFORTS AND 570 00:23:51,108 --> 00:23:51,542 INTRAMURAL EFFORTS. 571 00:23:51,542 --> 00:23:53,744 LET ME JUST PAUSE. 572 00:23:53,744 --> 00:23:55,546 NINA, ANYTHING TO ADD THAT YOU 573 00:23:55,546 --> 00:23:57,114 THINK WOULD BE HELPFUL? 574 00:23:57,114 --> 00:24:01,118 >> YEAH, I THINK THE ONLY THING 575 00:24:01,118 --> 00:24:02,119 TO UNDERSCORE THE HETEROGENEITY 576 00:24:02,119 --> 00:24:07,725 YOU TALK ABOUT IS IN SOME 577 00:24:07,725 --> 00:24:09,526 PATIENTS WHO CAN ACTUALLY 578 00:24:09,526 --> 00:24:11,328 IDENTIFY THAT VIRUS PERSISTS IN 579 00:24:11,328 --> 00:24:12,896 THE CENTRAL NERVOUS SYSTEM AND 580 00:24:12,896 --> 00:24:15,199 IN MOST PATIENTS YOU DON'T FIND 581 00:24:15,199 --> 00:24:17,201 PERSISTENCE OF THE VIRUS BUT YOU 582 00:24:17,201 --> 00:24:23,807 FIND AS YOU MENTIONED THE 583 00:24:23,807 --> 00:24:24,808 VASCULITIY CHANGES, AND 584 00:24:24,808 --> 00:24:26,176 SYMPTOMOLOGYICALLY THOSE 585 00:24:26,176 --> 00:24:27,277 PATIENTS CAN LOOK THE SAME. 586 00:24:27,277 --> 00:24:36,653 AND SO IT'S A REAL CHALLENGE . 587 00:24:36,653 --> 00:24:37,421 >> THANK YOU. 588 00:24:37,421 --> 00:24:39,423 THIS SHOWS THE VALUE OF DOING 589 00:24:39,423 --> 00:24:42,326 THINGS INTRAMURALLY AND 590 00:24:42,326 --> 00:24:43,594 EXTRAMURALLY. 591 00:24:43,594 --> 00:24:47,064 THE INTRAMURAL CAN PIVOT 592 00:24:47,064 --> 00:24:48,632 RAPIDLY, LONG-TERM STUDIES MORE 593 00:24:48,632 --> 00:24:51,101 EASILY, SO THERE ARE MANY 594 00:24:51,101 --> 00:24:52,202 ADVANTAGES TO HAVING RESEARCH 595 00:24:52,202 --> 00:24:54,238 CONDUCTED IN THE EXTRAMURAL 596 00:24:54,238 --> 00:24:54,872 COMMUNITY AND INTRAMURALLY. 597 00:24:54,872 --> 00:24:57,274 IF I COULD HAVE THE NEXT SLIDE 598 00:24:57,274 --> 00:25:00,210 PLEASE. 599 00:25:00,210 --> 00:25:02,179 I'M GOING TO FINISH WITH CHANGE 600 00:25:02,179 --> 00:25:04,281 TO PEER REVIEW CRITERIA IN CASE 601 00:25:04,281 --> 00:25:06,316 SOMEBODY ASKS YOU ABOUT THAT. 602 00:25:06,316 --> 00:25:11,021 AND SO IF I COULD HAVE THE NEXT 603 00:25:11,021 --> 00:25:15,392 SLIDE PLEASE. 604 00:25:15,392 --> 00:25:17,394 OUR CURRENT GRANT REVIEW 605 00:25:17,394 --> 00:25:19,329 CRITERIA SCORES EACH APPLICATION 606 00:25:19,329 --> 00:25:20,864 BY FIVE DIFFERENT CRITERIA. 607 00:25:20,864 --> 00:25:22,633 THAT IS, THERE'S AN INDIVIDUAL 608 00:25:22,633 --> 00:25:24,635 SCORE PROVIDED BY STUDY SECTION 609 00:25:24,635 --> 00:25:28,105 MEMBERS, ON THE SIGNIFICANCE OF 610 00:25:28,105 --> 00:25:29,473 THE WORK, INVESTIGATORS 611 00:25:29,473 --> 00:25:30,841 CONDUCTING THE WORK, INNOVATION 612 00:25:30,841 --> 00:25:32,709 OF THE WORK, APPROACH OF THE 613 00:25:32,709 --> 00:25:35,813 WORK, AND THEN THE ENVIRONMENT 614 00:25:35,813 --> 00:25:40,517 IN WHICH THE WORK IS TO BE 615 00:25:40,517 --> 00:25:41,385 CONDUCTED. 616 00:25:41,385 --> 00:25:43,287 WE'RE CHANGING THIS NOW SO THAT 617 00:25:43,287 --> 00:25:45,589 ONLY FACTORS 1 AND 2 ARE GOING 618 00:25:45,589 --> 00:25:46,523 TO BE SCORED. 619 00:25:46,523 --> 00:25:51,795 THE IMPORTANCE OF THE WORK AND 620 00:25:51,795 --> 00:25:53,363 RIGOR AND FEASIBILITY. 621 00:25:53,363 --> 00:25:55,999 NOT SCORED BUT EVALUATED FOR 622 00:25:55,999 --> 00:25:58,035 SUFFICIENCY ONLY WILL BE THE 623 00:25:58,035 --> 00:25:59,603 INVESTIGATORS AND THE 624 00:25:59,603 --> 00:26:00,737 ENVIRONMENT. 625 00:26:00,737 --> 00:26:03,473 IN OTHER WORDS, THE REPUTATION 626 00:26:03,473 --> 00:26:05,342 OF THE INVESTIGATOR AND 627 00:26:05,342 --> 00:26:06,944 REPUTATION OF THE ORGANIZATION 628 00:26:06,944 --> 00:26:09,179 THAT THEY WORK SHOULDN'T 629 00:26:09,179 --> 00:26:10,781 CONTRIBUTE TO THE SCORE. 630 00:26:10,781 --> 00:26:14,318 IT'S EITHER ADEQUATE OR NOT 631 00:26:14,318 --> 00:26:15,052 ADEQUATE. 632 00:26:15,052 --> 00:26:18,622 WHAT WE HAVE FOUND OVER THE 633 00:26:18,622 --> 00:26:22,492 YEARS IS THAT EITHER ON PURPOSE 634 00:26:22,492 --> 00:26:29,533 BUT MORE OFTEN THAN NOT IN A 635 00:26:29,533 --> 00:26:31,869 SORT OF NOT-REALIZING FASHION 636 00:26:31,869 --> 00:26:33,003 PEOPLE WERE PROVIDING FOR WEIGHT 637 00:26:33,003 --> 00:26:35,505 TO THE FACT THAT SOMEBODY IS 638 00:26:35,505 --> 00:26:36,773 FAMOUS OR THE INSTITUTION THAT 639 00:26:36,773 --> 00:26:40,911 THEY WORK AT IS FAMOUS. 640 00:26:40,911 --> 00:26:43,080 CENTRIFUGES WORK JUST AS WELL AT 641 00:26:43,080 --> 00:26:44,715 CITY COLLEGE OF NEW YORK AS THEY 642 00:26:44,715 --> 00:26:45,682 DO AT HARVARD. 643 00:26:45,682 --> 00:26:49,086 I REALLY DO BELIEVE THAT. 644 00:26:49,086 --> 00:26:53,257 SO, THIS NEW FRAMEWORK WILL 645 00:26:53,257 --> 00:26:55,325 START, STARTING JANUARY 25th, 646 00:26:55,325 --> 00:26:56,426 2025, OVERWHELMINGLY THE 647 00:26:56,426 --> 00:26:58,095 RESEARCH COMMUNITY IS VERY 648 00:26:58,095 --> 00:26:59,630 PLEASED WITH THIS. 649 00:26:59,630 --> 00:27:01,832 WE'VE DONE EXTENSIVE OUTREACH ON 650 00:27:01,832 --> 00:27:02,032 THIS. 651 00:27:02,032 --> 00:27:03,333 SO STAY TUNED. 652 00:27:03,333 --> 00:27:05,102 AND WITH THAT I APOLOGIZE FOR 653 00:27:05,102 --> 00:27:07,037 BEING A LITTLE OVER, BUT I WILL 654 00:27:07,037 --> 00:27:10,540 STOP THERE AND TURN IT BACK TO 655 00:27:10,540 --> 00:27:10,807 THE CHAIR. 656 00:27:10,807 --> 00:27:12,943 >> THANKS VERY MUCH, DR. TABAK. 657 00:27:12,943 --> 00:27:14,278 REALLY APPRECIATE THAT 658 00:27:14,278 --> 00:27:14,845 PRESENTATION TODAY. 659 00:27:14,845 --> 00:27:15,779 ALL RIGHT. 660 00:27:15,779 --> 00:27:18,649 NEXT UP WE'LL HAVE THE 661 00:27:18,649 --> 00:27:23,921 PRESENTATION OF THE CLINICAL 662 00:27:23,921 --> 00:27:25,322 CENTER CEO, DR. GILMAN. 663 00:27:25,322 --> 00:27:26,857 >> THANK YOU. 664 00:27:26,857 --> 00:27:29,393 THANKS TO ALL OF YOU FOR BEING 665 00:27:29,393 --> 00:27:29,726 HERE. 666 00:27:29,726 --> 00:27:35,132 IT'S BAD WHEN YOU START WITH NO 667 00:27:35,132 --> 00:27:37,734 VOICE. 668 00:27:37,734 --> 00:27:39,202 OKAY. 669 00:27:39,202 --> 00:27:47,778 HERE WE GO. 670 00:27:47,778 --> 00:27:49,212 671 00:27:49,212 --> 00:27:50,514 AGAIN, THANKS FOR BEING HERE. 672 00:27:50,514 --> 00:27:53,317 LET'S GO TO THE NEXT SLIDE AND I 673 00:27:53,317 --> 00:27:56,820 DO WANT TO ACKNOWLEDGE A COUPLE 674 00:27:56,820 --> 00:27:59,289 ACCOMPLISHMENTS OF OUR CHAIR, 675 00:27:59,289 --> 00:28:02,459 DR. COOTS IS NOW A MEMBER OF THE 676 00:28:02,459 --> 00:28:04,027 AMERICAN HOSPITAL ASSOCIATION TO 677 00:28:04,027 --> 00:28:09,299 THE BOARD OF TRUSTEES AND WAS 678 00:28:09,299 --> 00:28:10,300 RECOGNIZED BY BECKER'S HEALTH 679 00:28:10,300 --> 00:28:12,836 CARE AS ONE OF THE TOP PHYSICIAN 680 00:28:12,836 --> 00:28:16,740 LEADERS IN THE COUNTRY, SO IN 681 00:28:16,740 --> 00:28:21,545 THESE ACCOMPLISHMENTS HE BRINGS 682 00:28:21,545 --> 00:28:22,346 FURTHER ACKNOWLEDGMENT AND 683 00:28:22,346 --> 00:28:29,486 GRAVITAS TO OUR BOARD AND WE'RE 684 00:28:29,486 --> 00:28:30,253 GRATEFUL FOR THAT. 685 00:28:30,253 --> 00:28:32,189 AFTER A COUPLE YEARS WE FINALLY 686 00:28:32,189 --> 00:28:37,694 HAVE A CHIEF NURSING OFFICER, 687 00:28:37,694 --> 00:28:40,831 DR. JORDAN ASCENDED TO THIS 688 00:28:40,831 --> 00:28:41,431 POSITION IN JULY 2023, SHE HAD 689 00:28:41,431 --> 00:28:43,600 BEEN DOING THE WORK TWO YEARS 690 00:28:43,600 --> 00:28:47,471 BEFORE WE COULD REMOVE THE 691 00:28:47,471 --> 00:28:51,475 "ACTING" FROM THE TITLE. 692 00:28:51,475 --> 00:28:53,877 AND I WON'T -- WE'RE GLAD THAT 693 00:28:53,877 --> 00:28:56,213 THE TWO YEARS OF WAITING IS 694 00:28:56,213 --> 00:28:57,614 FINALLY OVER. 695 00:28:57,614 --> 00:29:03,387 WE SAW SOME RECOGNITION DURING 696 00:29:03,387 --> 00:29:06,456 THE SEARCH PROCESS THAT THE 697 00:29:06,456 --> 00:29:08,325 DEPARTMENT WAS BEGINNING TO 698 00:29:08,325 --> 00:29:10,794 BETTER UNDERSTAND THE IMPORTANCE 699 00:29:10,794 --> 00:29:15,565 OF NURSE EXECUTIVES AND NURSE 700 00:29:15,565 --> 00:29:17,067 LEADERS, WITH SOME CHANGES OR 701 00:29:17,067 --> 00:29:18,602 PROPOSED CHANGES AND POLICIES 702 00:29:18,602 --> 00:29:19,903 RELATED TO COMPENSATION AND 703 00:29:19,903 --> 00:29:23,306 OTHER ISSUES, BUT WE'RE VERY 704 00:29:23,306 --> 00:29:26,610 GLAD THAT WE HAVE BARBARA 705 00:29:26,610 --> 00:29:33,784 PERMANENTLY INSTALLED HERE NOW. 706 00:29:33,784 --> 00:29:34,551 NEXT SLIDE. 707 00:29:34,551 --> 00:29:36,653 WE'VE HAD SOME VERY GOOD 708 00:29:36,653 --> 00:29:39,689 CLINICAL CENTER GRAND ROUNDS 709 00:29:39,689 --> 00:29:41,958 PRESENTATIONS. 710 00:29:41,958 --> 00:29:48,031 I WENT OVER IN THE PAST, THE 711 00:29:48,031 --> 00:29:49,666 ADVANCES WE MADE AND MEDICAL 712 00:29:49,666 --> 00:29:52,736 SIMULATION PROGRAM AND HOW 713 00:29:52,736 --> 00:29:55,605 IMPORTANT SIMULATION IS TO A 714 00:29:55,605 --> 00:29:57,007 HOSPITAL WHERE ALMOST EVERYTHING 715 00:29:57,007 --> 00:30:00,410 IS PLANNED IN ADVANCE, SO YOU 716 00:30:00,410 --> 00:30:03,613 CAN ACTUALLY PRACTICE, YOU CAN 717 00:30:03,613 --> 00:30:05,682 ACTUALLY SIMULATE, BUT SO MANY 718 00:30:05,682 --> 00:30:08,118 THINGS ARE SORT OF LOW VOLUME, 719 00:30:08,118 --> 00:30:09,453 HIGH COMPLEXITY, AND THEREFORE 720 00:30:09,453 --> 00:30:11,254 KIND OF HIGH RISK. 721 00:30:11,254 --> 00:30:15,158 AND SO SIMULATION IS VERY 722 00:30:15,158 --> 00:30:15,425 IMPORTANT. 723 00:30:15,425 --> 00:30:17,894 SO DURING HEALTHCARE SIMULATION 724 00:30:17,894 --> 00:30:23,300 WE DID HAVE PRESENTATION BY DR. 725 00:30:23,300 --> 00:30:27,337 MARY FEY, PRINCIPAL FACULTY, 726 00:30:27,337 --> 00:30:29,239 ACADEMIC NURSE CONSULTANT AT 727 00:30:29,239 --> 00:30:30,674 HARVARD CENTER FOR MEDICAL 728 00:30:30,674 --> 00:30:31,108 SIMULATION. 729 00:30:31,108 --> 00:30:34,244 I LEARNED A LOT MORE ABOUT BEES 730 00:30:34,244 --> 00:30:35,979 THAN I KNEW BEFORE. 731 00:30:35,979 --> 00:30:38,281 TURNS OUT THAT BEES ARE SORT OF 732 00:30:38,281 --> 00:30:39,149 HAVE AN INTERESTING PARADIGM TO 733 00:30:39,149 --> 00:30:42,886 THE KIND OF LEARNING THAT TAKES 734 00:30:42,886 --> 00:30:45,222 PLACE DURING SIMULATION. 735 00:30:45,222 --> 00:30:48,091 ONE OF OUR FACULTY MEMBERS, A 736 00:30:48,091 --> 00:30:48,725 CRITICAL CARE MEDICINE DOCTOR, 737 00:30:48,725 --> 00:30:52,229 WHO HAS BEEN IN THE SIMULATION 738 00:30:52,229 --> 00:30:54,731 WORLD LONG AND DEEP FOR AN 739 00:30:54,731 --> 00:30:57,667 EXTENDED PERIOD OF TIME ASKED 740 00:30:57,667 --> 00:31:02,739 THE QUESTION ABOUT HOW, YOU 741 00:31:02,739 --> 00:31:04,374 KNOW, ABOUT DEALING WITH PEOPLE 742 00:31:04,374 --> 00:31:06,676 WORLD RENOWNED EXPERTS AND COME 743 00:31:06,676 --> 00:31:09,379 TO THE SIM LAB AND THEY ARE NOT 744 00:31:09,379 --> 00:31:11,948 SURE WHY THEY ARE THERE, WHY 745 00:31:11,948 --> 00:31:14,684 THEY HAVE TO DO THAT. 746 00:31:14,684 --> 00:31:17,521 AND SO THE HIGHLIGHTED QUOTE 747 00:31:17,521 --> 00:31:20,123 THERE I THOUGHT WAS HER 748 00:31:20,123 --> 00:31:22,659 RESPONSE, AND WAS A GOOD LESSON 749 00:31:22,659 --> 00:31:25,395 FOR ALL OF US, AND WE ALL SHOULD 750 00:31:25,395 --> 00:31:31,234 GET UP AND GO TO THE SIM LAB 751 00:31:31,234 --> 00:31:33,470 WITH THE IDEA WE'RE GOING TO 752 00:31:33,470 --> 00:31:35,605 LEAVE AT LEAST 1% BETTER. 753 00:31:35,605 --> 00:31:37,307 YOU COULD TAKE SIM LAB OUT AND 754 00:31:37,307 --> 00:31:39,509 ADD THE CEO OFFICE AND DO THE 755 00:31:39,509 --> 00:31:40,410 SAME THING. 756 00:31:40,410 --> 00:31:42,279 I VERY MUCH ENJOYED THAT 757 00:31:42,279 --> 00:31:42,846 PRESENTATION. 758 00:31:42,846 --> 00:31:45,182 BY THE WAY, YOU CAN WATCH -- WE 759 00:31:45,182 --> 00:31:46,983 CAN MAKE IT POSSIBLE FOR YOU TO 760 00:31:46,983 --> 00:31:51,254 SEE THESE. 761 00:31:51,254 --> 00:31:52,155 NEXT SLIDE. 762 00:31:52,155 --> 00:31:53,557 WE TALKED ABOUT THE 763 00:31:53,557 --> 00:31:54,958 GROUNDBREAKING FOR THE SURGERY 764 00:31:54,958 --> 00:31:56,159 RADIOLOGY LABORATORY MEDICINE 765 00:31:56,159 --> 00:31:56,660 WING. 766 00:31:56,660 --> 00:32:00,263 WE HAD A FEW DAYS OF RAIN IN 767 00:32:00,263 --> 00:32:01,898 SEPTEMBER, AND SO THIS IS WHAT 768 00:32:01,898 --> 00:32:04,134 OUR HOLE LOOKED LIKE THEN. 769 00:32:04,134 --> 00:32:08,972 IT'S PRETTY MUCH DRIED OUT NOW. 770 00:32:08,972 --> 00:32:11,374 IT'S ONE OF THE MORE ENJOYABLE 771 00:32:11,374 --> 00:32:14,511 PARTS OF MY DAY, TO GO OVER TO 772 00:32:14,511 --> 00:32:16,479 THE STAIRWELL ON THE NORTHWEST 773 00:32:16,479 --> 00:32:22,852 CORNER OF CLINICAL CENTER, GO TO 774 00:32:22,852 --> 00:32:25,255 THE FIFTH OR SIXTH FLOOR AND 775 00:32:25,255 --> 00:32:27,057 WATCH THE PROJECT, WATCH THEM 776 00:32:27,057 --> 00:32:27,991 MOVE DIRT. 777 00:32:27,991 --> 00:32:30,794 YOU CAN ACTUALLY USE THE STOP 778 00:32:30,794 --> 00:32:32,829 WATCH FUNCTION AND TIME HOW 779 00:32:32,829 --> 00:32:35,765 OFTEN A DUMP TRUCK FULL OF DIRT 780 00:32:35,765 --> 00:32:37,400 LEAVES THE CAMPUS AS THEY ARE 781 00:32:37,400 --> 00:32:40,237 DOING THIS. 782 00:32:40,237 --> 00:32:42,172 WHAT THEY SAID WAS RIGHT, EVERY 783 00:32:42,172 --> 00:32:43,773 THREE MINUTES WHEN THEY ARE 784 00:32:43,773 --> 00:32:44,574 GOING. 785 00:32:44,574 --> 00:32:47,844 SO, IT IS MAKING PROGRESS. 786 00:32:47,844 --> 00:32:52,115 WE DID HAVE SOME VISITORS FROM 787 00:32:52,115 --> 00:32:52,983 THE SENATE HEALTH COMMITTEE 788 00:32:52,983 --> 00:32:56,686 EARLIER THIS WEEK WHO WANTED TO 789 00:32:56,686 --> 00:32:57,387 SEE THE PROJECT. 790 00:32:57,387 --> 00:32:59,289 I THINK THE OFFICE OF RESEARCH 791 00:32:59,289 --> 00:33:02,158 FACILITIES DID A GREAT JOB 792 00:33:02,158 --> 00:33:03,126 PROVIDING THE GROUND-LEVEL VIEW 793 00:33:03,126 --> 00:33:06,930 BUT I MADE SURE THEY HAD A FIFTH 794 00:33:06,930 --> 00:33:08,365 FLOOR VIEW THAT I REGARD AS SORT 795 00:33:08,365 --> 00:33:09,866 OF SPECIAL TO THOSE OF US WHO 796 00:33:09,866 --> 00:33:11,468 WORK IN THE CLINICAL CENTER. 797 00:33:11,468 --> 00:33:15,772 AND SO THERE WE ARE. 798 00:33:15,772 --> 00:33:17,274 NEXT SLIDE. 799 00:33:17,274 --> 00:33:19,342 WE ACTUALLY HAD TO ADJUST THIS 800 00:33:19,342 --> 00:33:20,777 SLIDE BECAUSE WE SAID WE 801 00:33:20,777 --> 00:33:22,145 UNVEILED IT ON THE 7th OF 802 00:33:22,145 --> 00:33:25,048 SEPTEMBER BUT IT TURNS OUT WE 803 00:33:25,048 --> 00:33:26,750 DIDN'T UNVEIL IT ON THE 7th. 804 00:33:26,750 --> 00:33:27,751 THERE WAS SOMETHING THAT 805 00:33:27,751 --> 00:33:29,386 HAPPENED AND WE WEREN'T ABLE TO 806 00:33:29,386 --> 00:33:32,355 DO IT THAT DAY. 807 00:33:32,355 --> 00:33:35,158 NEXT TIME YOU VISIT THE CLINICAL 808 00:33:35,158 --> 00:33:37,961 CENTER I HOPE YOU'LL STOP BY AND 809 00:33:37,961 --> 00:33:40,497 VIEW THIS STRIKING EXHIBIT THAT 810 00:33:40,497 --> 00:33:42,399 HONORS THE NOBEL PRIZE WINNER, 811 00:33:42,399 --> 00:33:45,568 ONE OF THE THREE NOBEL PRIZE 812 00:33:45,568 --> 00:33:48,038 WINNERS FOR 2020 IN PHYSIOLOGY 813 00:33:48,038 --> 00:33:50,807 AND MEDICINE FOR HELPING TO 814 00:33:50,807 --> 00:33:55,278 DISCOVER THE HEPATITIS C VIRUS 815 00:33:55,278 --> 00:33:57,714 AND YOU'LL SEE A COUPLE OF VERY 816 00:33:57,714 --> 00:33:59,749 INTERESTING THINGS, FIRST OF ALL 817 00:33:59,749 --> 00:34:01,985 THAT DR. ALTER SHARES THE 818 00:34:01,985 --> 00:34:04,120 EXHIBIT WITH A WHOLE HOST OF 819 00:34:04,120 --> 00:34:05,889 PEOPLE THAT HELPED HIM ALONG THE 820 00:34:05,889 --> 00:34:09,459 WAY DO THIS PROJECT. 821 00:34:09,459 --> 00:34:12,028 AND THAT'S REALLY, REALLY 822 00:34:12,028 --> 00:34:12,295 IMPORTANT. 823 00:34:12,295 --> 00:34:13,897 AND SO WE'RE STILL IN THE 824 00:34:13,897 --> 00:34:18,134 PROCESS OF GETTING THE UNVEILING 825 00:34:18,134 --> 00:34:20,036 SCHEDULED, BUT I THINK WE ARE 826 00:34:20,036 --> 00:34:21,504 GOING TO GET IT DONE SOMETIME IN 827 00:34:21,504 --> 00:34:22,972 THE NEXT FEW WEEKS. 828 00:34:22,972 --> 00:34:25,275 NEXT SLIDE. 829 00:34:25,275 --> 00:34:30,146 LAST WEEK WE HAD A VERY 830 00:34:30,146 --> 00:34:34,017 INTERESTING -- A FORMER NIH 831 00:34:34,017 --> 00:34:35,118 PHYSICIAN-SCIENTIST DR. 832 00:34:35,118 --> 00:34:39,489 BERNSTEIN LATE IN LIFE 833 00:34:39,489 --> 00:34:45,028 DISCOVERED HIS ARTISTIC BEND AND 834 00:34:45,028 --> 00:34:46,496 BEGAN DOING WOOD SCULPTURES, AND 835 00:34:46,496 --> 00:34:48,531 HE FIRST STARTED TRYING TO DO IT 836 00:34:48,531 --> 00:34:50,900 WITH SORT OF HAMMER AND CHISEL. 837 00:34:50,900 --> 00:34:53,570 THEN HE FIGURED OUT HE HE 838 00:34:53,570 --> 00:34:55,705 COULDN'T GET MUCH DONE UNTIL HE 839 00:34:55,705 --> 00:34:59,275 STARTED USING A CHAINSAW. 840 00:34:59,275 --> 00:35:00,510 SO WE DEDICATED LAST FRIDAY 841 00:35:00,510 --> 00:35:03,346 THESE TWO SCULPTURES THAT ARE 842 00:35:03,346 --> 00:35:05,148 JUST OUTSIDE OUR 7th FLOOR 843 00:35:05,148 --> 00:35:07,784 CHAPEL AND DR. BERNSTEIN PASSED 844 00:35:07,784 --> 00:35:13,390 AWAY A FEW YEARS AGO BUT WE HAD 845 00:35:13,390 --> 00:35:15,125 HIS WIDOW AND SOME OTHER OF HIS 846 00:35:15,125 --> 00:35:16,593 FRIENDS AND HER FRIENDS THERE 847 00:35:16,593 --> 00:35:18,595 WITH US. 848 00:35:18,595 --> 00:35:22,866 AND WE HAD A VERY NICE INSPIRING 849 00:35:22,866 --> 00:35:27,103 DAY IN THE AFTERNOON AT THE 850 00:35:27,103 --> 00:35:27,570 CHAPEL. 851 00:35:27,570 --> 00:35:28,938 NEXT SLIDE. 852 00:35:28,938 --> 00:35:30,940 WE HAVE HAD A PRESENTATION, IT 853 00:35:30,940 --> 00:35:34,077 WASN'T PART OF GRAND ROUNDS, BY 854 00:35:34,077 --> 00:35:36,112 DR. EARNEST GRANT, PAST 855 00:35:36,112 --> 00:35:37,947 PRESIDENT OF THE ANA, THE TOPIC 856 00:35:37,947 --> 00:35:47,824 WAS ABOUT MEN IN NURSING IT WAS 857 00:35:47,824 --> 00:35:49,526 ORGANIZEDDED BY CLINICAL CENTER 858 00:35:49,526 --> 00:35:56,466 NURSING DEPARTMENT, ALSO PART OF 859 00:35:56,466 --> 00:35:57,801 OUR DIVERSITY, EQUITY, 860 00:35:57,801 --> 00:35:59,102 INCLUSION, AND ACCESSIBILITY 861 00:35:59,102 --> 00:36:02,138 PROGRAMS BESIDES DR. GRANT WE 862 00:36:02,138 --> 00:36:06,376 HAD A SERIES OF OUR MALE NURSES, 863 00:36:06,376 --> 00:36:09,946 A PANEL THAT PARTICIPATED IN THE 864 00:36:09,946 --> 00:36:14,184 PROGRAM WITH SOME REALLY, REALLY 865 00:36:14,184 --> 00:36:15,919 INSPIRING STORIES AND IT WAS -- 866 00:36:15,919 --> 00:36:19,456 THIS WAS WELL ATTENDED, WELL 867 00:36:19,456 --> 00:36:20,924 RECEIVED, AND WE'RE VERY HAPPY 868 00:36:20,924 --> 00:36:26,830 WE WERE ABLE TO HOST DR. GRANT 869 00:36:26,830 --> 00:36:27,130 VIRTUALLY. 870 00:36:27,130 --> 00:36:27,764 NEXT SLIDE. 871 00:36:27,764 --> 00:36:30,133 LAST BUT NOT LEAST, NO STRANGER 872 00:36:30,133 --> 00:36:32,335 TO THE LAST BOARD BUT MAYBE KIND 873 00:36:32,335 --> 00:36:36,239 OF UNKNOWN TO THIS PARTICULAR 874 00:36:36,239 --> 00:36:37,807 BOARD, WE HAD DR. DAVID 875 00:36:37,807 --> 00:36:40,410 HENDERSON, WHO WAS THE LONGTIME 876 00:36:40,410 --> 00:36:43,313 HOSPITAL EPIDEMIOLOGIST AT THE 877 00:36:43,313 --> 00:36:44,681 CLINICAL CENTER, DEPUTY DIRECTOR 878 00:36:44,681 --> 00:36:47,217 FOR CLINICAL CARE, WHAT WE NOW 879 00:36:47,217 --> 00:36:50,086 CALL THE CHIEF MEDICAL OFFICER, 880 00:36:50,086 --> 00:36:51,287 TALKING ABOUT THE COVID-19 881 00:36:51,287 --> 00:36:53,823 PANDEMIC, LOOKING BACK AND 882 00:36:53,823 --> 00:36:55,358 LOOKING FORWARD, REALLY TALKING 883 00:36:55,358 --> 00:36:56,459 ABOUT THE SPECIFICS RELATED TO 884 00:36:56,459 --> 00:37:00,663 OUR HOSPITAL RESPONSE. 885 00:37:00,663 --> 00:37:02,532 DAVID WAS ALSO THE PRESIDENT OF 886 00:37:02,532 --> 00:37:04,067 THE SOCIETY OF HOSPITAL 887 00:37:04,067 --> 00:37:06,936 EPIDEMIOLOGISTS OF AMERICA, 888 00:37:06,936 --> 00:37:09,072 ACTUALLY THE YEAR OF HIS 889 00:37:09,072 --> 00:37:09,672 PRESIDENCY COINCIDED WITH THE 890 00:37:09,672 --> 00:37:12,008 FIRST YEAR OF THE PANDEMIC, AND 891 00:37:12,008 --> 00:37:14,277 SO DAVID FOR THE LAST THREE 892 00:37:14,277 --> 00:37:17,013 YEARS HAS BEEN PARTICIPATING IN 893 00:37:17,013 --> 00:37:20,650 WEEKLY PHONE CALLS WITH HOSPITAL 894 00:37:20,650 --> 00:37:24,287 EPIDEMIOLOGISTS ALL AROUND THE 895 00:37:24,287 --> 00:37:25,421 COUNTRY, AND HELPED ADVISE. 896 00:37:25,421 --> 00:37:27,724 DAVID STEPPED DOWN FROM CHIEF 897 00:37:27,724 --> 00:37:30,660 MEDICAL OFFICER POSITION AT THE 898 00:37:30,660 --> 00:37:35,532 END OF 2019 BUT WE HAVE HAD HIS 899 00:37:35,532 --> 00:37:36,733 SERVICES RETAINED ON CONTRACT 900 00:37:36,733 --> 00:37:39,435 DURING ALL OF THE TIME SINCE. 901 00:37:39,435 --> 00:37:43,106 SO WE'VE HAD SOME EXCELLENT, 902 00:37:43,106 --> 00:37:45,441 EXCELLENT INPUT. 903 00:37:45,441 --> 00:37:45,742 NEXT SLIDE. 904 00:37:45,742 --> 00:37:48,678 THIS IS WHAT ACTIVITY LOOKS 905 00:37:48,678 --> 00:37:49,879 LIKE. 906 00:37:49,879 --> 00:37:51,014 YOU CAN SEE 2022 AND 2023 LOOK 907 00:37:51,014 --> 00:37:52,315 ABOUT THE SAME. 908 00:37:52,315 --> 00:37:56,019 SEPTEMBER WAS A LITTLE LOWER 909 00:37:56,019 --> 00:38:00,290 THAN I THOUGHT, BUT IT IS IN 910 00:38:00,290 --> 00:38:02,759 ESSENCE THE 2022 AND 2023 IN 911 00:38:02,759 --> 00:38:05,261 TERMS OF INPATIENT AVERAGE DAILY 912 00:38:05,261 --> 00:38:07,196 CENSUS WAS PRETTY STABLE, AND 913 00:38:07,196 --> 00:38:09,732 WE'RE STILL BELOW THE THREE-YEAR 914 00:38:09,732 --> 00:38:12,769 AVERAGE SO 19 AND PART OF 20 915 00:38:12,769 --> 00:38:14,804 WOULD HAVE BEEN PRE-PANDEMIC. 916 00:38:14,804 --> 00:38:15,238 NEXT SLIDE. 917 00:38:15,238 --> 00:38:16,773 THIS IS WHAT IT LOOKS LIKE IN 918 00:38:16,773 --> 00:38:18,708 TERMS OF NUMBERS. 919 00:38:18,708 --> 00:38:20,743 SO FOR THE YEAR, ADMISSIONS WERE 920 00:38:20,743 --> 00:38:24,814 UP 7% BUT OUR LENGTH OF STAY WAS 921 00:38:24,814 --> 00:38:25,014 DOWN. 922 00:38:25,014 --> 00:38:27,350 GETTING PEOPLE OUT OF THE 923 00:38:27,350 --> 00:38:28,851 HOSPITAL A DAY SOONER IS BETTER 924 00:38:28,851 --> 00:38:30,420 FOR THEM THAN HAVING THEM IN THE 925 00:38:30,420 --> 00:38:32,121 HOSPITAL A DAY LONGER THAN THEY 926 00:38:32,121 --> 00:38:33,523 NEED TO BE. 927 00:38:33,523 --> 00:38:35,325 SO INPATIENT DAYS ARE BASICALLY 928 00:38:35,325 --> 00:38:38,061 THE SAME AS THEY WERE IN 2022, 929 00:38:38,061 --> 00:38:39,862 AND CENSUS AS I SAID IS THE 930 00:38:39,862 --> 00:38:40,296 SAME. 931 00:38:40,296 --> 00:38:42,165 IT'S GOOD TO SEE OUTPATIENT 932 00:38:42,165 --> 00:38:44,667 VISITS GO UP BY 8% AND ALL OF 933 00:38:44,667 --> 00:38:46,135 THAT'S BEEN IN CLINIC VISITS, 934 00:38:46,135 --> 00:38:52,075 NOT IN DAY HOSPITAL VISITS. 935 00:38:52,075 --> 00:38:54,477 ALTHOUGH OUR DAY HOSPITAL STAYED 936 00:38:54,477 --> 00:38:55,411 FAIRLY BUSY. 937 00:38:55,411 --> 00:38:56,746 7% INCREASE IN INPATIENTS, WHICH 938 00:38:56,746 --> 00:39:01,317 IS ALSO GOOD. 939 00:39:01,317 --> 00:39:02,685 NEXT SLIDE. 940 00:39:02,685 --> 00:39:05,321 THE HOSPITAL AREAS THAT HAVE 941 00:39:05,321 --> 00:39:06,322 GONE UP NATIONAL CANCER 942 00:39:06,322 --> 00:39:10,460 INSTITUTE A COUPLE OF THEIR 943 00:39:10,460 --> 00:39:12,695 PROTOCOLS AND SINCE WE HAVE -- 944 00:39:12,695 --> 00:39:15,465 WE'RE BASICALLY BACK TO RUNNING 945 00:39:15,465 --> 00:39:16,499 THE CLINICAL CENTER LIKE WE WERE 946 00:39:16,499 --> 00:39:17,767 PRE-PANDEMIC, THAT IS WE DON'T 947 00:39:17,767 --> 00:39:23,940 HAVE AN AREA SET ASIDE FOR 948 00:39:23,940 --> 00:39:27,577 COVID-19 TESTING FOR THE STAFF. 949 00:39:27,577 --> 00:39:30,813 WE ARE ABLE TO BEGIN USING THE 950 00:39:30,813 --> 00:39:36,786 METABOLIC WARD AGAIN, SO THE 951 00:39:36,786 --> 00:39:38,321 NATIONAL INSTITUTE FOR DIABETES, 952 00:39:38,321 --> 00:39:39,789 DIGESTIVE DISORDERS AND KIDNEY 953 00:39:39,789 --> 00:39:42,425 DISEASE, ONE OR TWO OF THEIR 954 00:39:42,425 --> 00:39:43,059 VERY BUSY METABOLIC RESEARCHERS 955 00:39:43,059 --> 00:39:46,496 HAS BEEN ABLE TO USE THE 956 00:39:46,496 --> 00:39:47,897 INPATIENT UNIT AS WELL. 957 00:39:47,897 --> 00:39:51,167 THAT ONE -- THOSE ARE THE AREAS 958 00:39:51,167 --> 00:39:52,769 THAT HAVE GONE UP SINCE THE LAST 959 00:39:52,769 --> 00:39:56,939 TIME WE LOOKED AT THE NUMBERS. 960 00:39:56,939 --> 00:39:57,407 AGAIN, IN TELEHEALTH, 961 00:39:57,407 --> 00:40:00,443 APPROXIMATELY 10% OF OUR VISITS 962 00:40:00,443 --> 00:40:01,978 ARE TELEHEALTH VISITS. 963 00:40:01,978 --> 00:40:03,946 SOMEPLACE AROUND 600 PER MONTH, 964 00:40:03,946 --> 00:40:08,151 THAT'S ROUGHLY TWO DAYS OF 965 00:40:08,151 --> 00:40:10,086 OUTPATIENT VISITS PER MONTH BY 966 00:40:10,086 --> 00:40:11,854 TELEHEALTH IN TERMS OF THE 967 00:40:11,854 --> 00:40:12,221 NUMBERS. 968 00:40:12,221 --> 00:40:13,756 AND SO IN AN AVERAGE MONTH THAT 969 00:40:13,756 --> 00:40:16,893 WOULD BE ABOUT 10% OF OUR 970 00:40:16,893 --> 00:40:20,496 VISITS, OUR TELEHEALTH VISITS 971 00:40:20,496 --> 00:40:20,663 NOW. 972 00:40:20,663 --> 00:40:21,464 NEXT SLIDE. 973 00:40:21,464 --> 00:40:23,933 WE CONTINUE TO FOCUS ON 974 00:40:23,933 --> 00:40:25,668 DIVERSITY, EQUITY, INCLUSION, 975 00:40:25,668 --> 00:40:28,738 AND ACCESSIBILITY. 976 00:40:28,738 --> 00:40:37,647 THIS ANNUALLY WE HAVE TO -- WE 977 00:40:37,647 --> 00:40:39,082 COMMUNICATE WITH NIH, EDI AND 978 00:40:39,082 --> 00:40:40,383 OTHERS WITH REGARD TO OUR 979 00:40:40,383 --> 00:40:43,453 PROGRESS OR LACK THEREOF ON OUR 980 00:40:43,453 --> 00:40:46,422 RACIAL, ETHNIC, AND EQUITY PLAN. 981 00:40:46,422 --> 00:40:53,229 THIS YEAR WAS DONE A LITTLE BIT 982 00:40:53,229 --> 00:40:53,629 DIFFERENTLY. 983 00:40:53,629 --> 00:40:55,164 WE SELF-ASSESSED, AND IT IS AND 984 00:40:55,164 --> 00:40:57,900 HAS BEEN SUBMITTED BUT WE HAVE 985 00:40:57,900 --> 00:41:00,369 TO DOCUMENT OUR ASSESSMENT. 986 00:41:00,369 --> 00:41:01,104 IT'S NOT COMPLETELY 987 00:41:01,104 --> 00:41:02,438 SELF-ASSESSED. 988 00:41:02,438 --> 00:41:06,809 HOW DID YOU DO ON THIS PRIORITY 989 00:41:06,809 --> 00:41:08,111 THAT YOU ESTABLISHED, AND SO -- 990 00:41:08,111 --> 00:41:09,846 AND THEN YOU PROVIDE SOME 991 00:41:09,846 --> 00:41:12,115 DOCUMENTATION, AND THEN THEY 992 00:41:12,115 --> 00:41:13,216 LOOK AT OUR SELF-ASSESSMENT AND 993 00:41:13,216 --> 00:41:17,720 WILL GIVE US SOME FEEDBACK. 994 00:41:17,720 --> 00:41:25,528 WE DID INTRODUCE A NEW 995 00:41:25,528 --> 00:41:27,363 INITIATIVE WHICH IS THE PROGRAM 996 00:41:27,363 --> 00:41:30,967 AND WE DID GET THE CLINICAL 997 00:41:30,967 --> 00:41:32,101 CENTER NURSING DEPARTMENT 998 00:41:32,101 --> 00:41:34,170 HIRING, INTERVIEW POLICY KICKED 999 00:41:34,170 --> 00:41:34,504 OFF. 1000 00:41:34,504 --> 00:41:38,107 WE CONTINUE TO OFFER GROUND 1001 00:41:38,107 --> 00:41:40,543 WATER TRAINING ON A REGULAR 1002 00:41:40,543 --> 00:41:42,979 BASIS, AND OUR CLINICAL CENTER 1003 00:41:42,979 --> 00:41:43,813 DIVERSITY, EQUITY, INCLUSION, 1004 00:41:43,813 --> 00:41:44,714 AND ACCESSIBILITY ADVISORY 1005 00:41:44,714 --> 00:41:46,916 COMMITTEE HAS BECOME MORE ACTIVE 1006 00:41:46,916 --> 00:41:49,118 DURING THE COURSE OF THE YEAR. 1007 00:41:49,118 --> 00:41:52,588 WE'RE STILL WORKING OUT OUR 1008 00:41:52,588 --> 00:41:56,592 AWARDS PROGRAM, AND WE ARE STILL 1009 00:41:56,592 --> 00:42:01,264 WORKING OUT ACCESSIBILITY 1010 00:42:01,264 --> 00:42:03,266 PROGRAM TO FOCUS ON THE A OF 1011 00:42:03,266 --> 00:42:07,170 DIIA. -- DEIA. 1012 00:42:07,170 --> 00:42:09,705 WE DID OBSERVE THREE NATIONAL 1013 00:42:09,705 --> 00:42:13,309 RECOGNITIONS INDICATED THERE. 1014 00:42:13,309 --> 00:42:14,143 NEXT SLIDE. 1015 00:42:14,143 --> 00:42:20,550 THESE ARE -- DR. TABAK SORT OF 1016 00:42:20,550 --> 00:42:23,886 ALLUDED TO HOW WE ARE BEGINNING 1017 00:42:23,886 --> 00:42:25,955 TO THINK DIFFERENTLY ABOUT 1018 00:42:25,955 --> 00:42:28,858 DISABILITY, AND WE'RE BEGINNING 1019 00:42:28,858 --> 00:42:29,926 TO THINK ABOUT DISABILITY 1020 00:42:29,926 --> 00:42:32,762 DEPARTING FROM THE MEDICAL MODEL 1021 00:42:32,762 --> 00:42:35,631 OF DISABILITY, AND GETTING MUCH 1022 00:42:35,631 --> 00:42:41,504 MORE TO A SOCIAL OR SOCIETAL 1023 00:42:41,504 --> 00:42:45,842 MODEL, TRYING TO COUNTERACT OUR 1024 00:42:45,842 --> 00:42:48,711 TENDENCIES SOMETIMES THAT ARE 1025 00:42:48,711 --> 00:42:53,783 OVERT AND SOMETIMES MORE 1026 00:42:53,783 --> 00:42:54,383 SUBCONSCIOUS TOWARD ABLEISM. 1027 00:42:54,383 --> 00:42:58,154 AND SO WE HAD A VERY NICE 1028 00:42:58,154 --> 00:43:00,857 PRESENTATION BY DAVID RICE FROM 1029 00:43:00,857 --> 00:43:08,064 THE NIH STAFF, AND THIS -- 1030 00:43:08,064 --> 00:43:10,600 THE -- WE'VE HAD TWO OR THREE 1031 00:43:10,600 --> 00:43:17,773 PROGRAMS INCLUDING ONE DANCE 1032 00:43:17,773 --> 00:43:22,278 PROGRAM ON -- TO WORK ON THE -- 1033 00:43:22,278 --> 00:43:23,446 OUR SPANISH LATINX GROUPS AND 1034 00:43:23,446 --> 00:43:25,348 THEN I ALREADY TALKED ABOUT THE 1035 00:43:25,348 --> 00:43:29,352 MEN IN NURSING FORUM. 1036 00:43:29,352 --> 00:43:32,088 NEXT SLIDE. 1037 00:43:32,088 --> 00:43:33,155 DR. COLLEEN HADIGAN, CHIEF 1038 00:43:33,155 --> 00:43:34,190 MEDICAL OFFICER, HAS BEEN 1039 00:43:34,190 --> 00:43:35,725 WORKING ON LOOKING AT THE DATA 1040 00:43:35,725 --> 00:43:37,994 THAT WE HAVE AVAILABLE TO US TO 1041 00:43:37,994 --> 00:43:40,363 LOOK AT HEALTH DISPARITIES. 1042 00:43:40,363 --> 00:43:42,365 AND COLLEEN HAS BEGUN GOING OVER 1043 00:43:42,365 --> 00:43:46,102 SOME OF THE EARLY DATA THAT WE 1044 00:43:46,102 --> 00:43:48,437 HAVE WITH ME, AND WE'VE 1045 00:43:48,437 --> 00:43:50,239 IDENTIFIED SOME AREAS TO DO A 1046 00:43:50,239 --> 00:43:53,042 DEEPER DIVE AND WE'LL BE BACK TO 1047 00:43:53,042 --> 00:43:54,210 DISCUSS THAT DATA A LITTLE BIT 1048 00:43:54,210 --> 00:44:00,683 MORE AFTER THE FIRST OF THE 1049 00:44:00,683 --> 00:44:01,617 YEAR. 1050 00:44:01,617 --> 00:44:03,686 BECAUSE WE DON'T TALK ABOUT 1051 00:44:03,686 --> 00:44:05,187 COVERED LIVES, WE'RE NOT A 1052 00:44:05,187 --> 00:44:08,157 HEALTH SYSTEM, IT'S BEEN A 1053 00:44:08,157 --> 00:44:09,191 LITTLE BIT HARDER TO IDENTIFY 1054 00:44:09,191 --> 00:44:13,462 HOW TO LOOK AT OUR DATA BUT 1055 00:44:13,462 --> 00:44:17,166 COLLEEN WORKING WITH SOME OF OUR 1056 00:44:17,166 --> 00:44:18,968 INFORMATION MANAGEMENT 1057 00:44:18,968 --> 00:44:20,202 INFORMATION TECHNOLOGY FOLKS AND 1058 00:44:20,202 --> 00:44:21,737 OTHERS, WE'VE BEEN ABLE TO DRILL 1059 00:44:21,737 --> 00:44:24,006 DOWN AND LOOK AT A FEW THINGS 1060 00:44:24,006 --> 00:44:27,777 AND I THINK GIVEN THE IMPORTANCE 1061 00:44:27,777 --> 00:44:28,744 OF THE FOCUS ON HEALTH 1062 00:44:28,744 --> 00:44:29,712 DISPARITIES I THINK WE'LL BE 1063 00:44:29,712 --> 00:44:31,314 ABLE TO COME BACK TO THE BOARD 1064 00:44:31,314 --> 00:44:32,581 AFTER THE FIRST OF THE YEAR AND 1065 00:44:32,581 --> 00:44:40,389 TALK ABOUT MORE OF THOSE THINGS. 1066 00:44:40,389 --> 00:44:42,658 ALSO, THE TWO GROUPS THAT ASK 1067 00:44:42,658 --> 00:44:44,961 FOR WHAT WE'RE DOING ON A 1068 00:44:44,961 --> 00:44:47,463 REGULAR BASIS ARE ACGME WHO LOOK 1069 00:44:47,463 --> 00:44:51,534 AT OUR TRAINING PROGRAMS, AND 1070 00:44:51,534 --> 00:44:53,602 ALSO THE JOINT COMMISSION, SO 1071 00:44:53,602 --> 00:44:57,540 THIS WILL -- COLLEEN'S WORK WILL 1072 00:44:57,540 --> 00:44:59,175 GO MAKE A SIGNIFICANT DENT IN 1073 00:44:59,175 --> 00:45:01,577 THE PROGRESS THAT THOSE GROUPS 1074 00:45:01,577 --> 00:45:04,580 EXPECT TO SEE I THINK. 1075 00:45:04,580 --> 00:45:06,215 NEXT SLIDE. 1076 00:45:06,215 --> 00:45:08,951 YOU ALL HAVE RECEIVED CLINICAL 1077 00:45:08,951 --> 00:45:10,920 CENTER QUARTERLY REPORT, AS WE 1078 00:45:10,920 --> 00:45:13,756 PROVIDE PRIOR TO EVERY MEETING. 1079 00:45:13,756 --> 00:45:15,091 AFTER THIS MEETING THE REPORT 1080 00:45:15,091 --> 00:45:17,893 WILL BE POSTED ON THE CLINICAL 1081 00:45:17,893 --> 00:45:19,962 CENTER WEBSITE FOR PUBLIC 1082 00:45:19,962 --> 00:45:20,296 VIEWING. 1083 00:45:20,296 --> 00:45:23,866 AND DR. LANG IS HERE TO ANSWER 1084 00:45:23,866 --> 00:45:26,002 ANY QUESTIONS THAT YOU MIGHT 1085 00:45:26,002 --> 00:45:28,137 HAVE ABOUT THOSE METRICS. 1086 00:45:28,137 --> 00:45:31,640 I THINK THIS QUARTER FOR THE 1087 00:45:31,640 --> 00:45:34,343 FIRST TIME WE'RE BACK TO 1088 00:45:34,343 --> 00:45:38,681 REPORTING THE RESULTS OF OUR 1089 00:45:38,681 --> 00:45:40,983 PRESS GANEY PATIENT SATISFACTION 1090 00:45:40,983 --> 00:45:42,351 MEMBERS WHICH CONTINUE TO LOOK 1091 00:45:42,351 --> 00:45:46,088 REALLY GOOD, SO IN AGGREGATE OUR 1092 00:45:46,088 --> 00:45:49,091 NUMBERS LOOK VERY GOOD. 1093 00:45:49,091 --> 00:45:51,327 WE STILL FIND PLENTY OF 1094 00:45:51,327 --> 00:45:52,028 OPPORTUNITY FOR IMPROVEMENT AS 1095 00:45:52,028 --> 00:45:55,064 WE SIT DOWN AND TALK WITH 1096 00:45:55,064 --> 00:45:56,198 PATIENTS AND FAMILIES WHO DIDN'T 1097 00:45:56,198 --> 00:45:59,835 HAVE A VERY GOOD EXPERIENCE, AND 1098 00:45:59,835 --> 00:46:02,772 THERE ARE -- PART OF THE PRESS 1099 00:46:02,772 --> 00:46:05,408 GANEY SURVEY IS THE OPPORTUNITY 1100 00:46:05,408 --> 00:46:07,043 TO PROVIDE NARRATIVE COMMENTS 1101 00:46:07,043 --> 00:46:10,446 THAT COME BACK TO US AND DR. 1102 00:46:10,446 --> 00:46:12,648 HADIGAN AND OTHERS MEET ON A 1103 00:46:12,648 --> 00:46:16,886 WEEKLY BASIS TO GO OVER THE 1104 00:46:16,886 --> 00:46:18,320 NARRATIVE COMMENTS AND DECIDE 1105 00:46:18,320 --> 00:46:21,090 WHAT WE MIGHT DO THAT WOULD MAKE 1106 00:46:21,090 --> 00:46:23,359 THE PATIENT EXPERIENCE EVEN 1107 00:46:23,359 --> 00:46:24,460 BETTER. 1108 00:46:24,460 --> 00:46:25,227 NEXT SLIDE. 1109 00:46:25,227 --> 00:46:28,731 WE DO, IF WE CAN EVER STOP DOING 1110 00:46:28,731 --> 00:46:30,866 SURVEYS FOR OTHER PEOPLE, WE 1111 00:46:30,866 --> 00:46:36,739 LIKE TO FEEL THAT THE PATIENT 1112 00:46:36,739 --> 00:46:37,673 SAFETY -- SURVEY OF PATIENT 1113 00:46:37,673 --> 00:46:39,542 CULTURE, EVERY TIME WE GET READY 1114 00:46:39,542 --> 00:46:41,510 TO SEND OUR SURVEY OUT WE FIND 1115 00:46:41,510 --> 00:46:44,447 SOMEBODY ELSE IS IN FRONT OF US 1116 00:46:44,447 --> 00:46:46,916 WITH A SURVEY AND SO BUT THIS IS 1117 00:46:46,916 --> 00:46:57,093 VERY IMPORTANT FOR US. 1118 00:46:57,093 --> 00:47:01,964 WE DID THIS IN 2021, IS THAT -- 1119 00:47:01,964 --> 00:47:03,599 2021? 1120 00:47:03,599 --> 00:47:05,101 2020, DID IT IN 2017. 1121 00:47:05,101 --> 00:47:07,269 IT'S NOT EXACTLY THE SAME 1122 00:47:07,269 --> 00:47:08,804 SURVEY, IT'S THE SURVEY WE GET 1123 00:47:08,804 --> 00:47:10,339 FROM AHRQ BUT IT'S NOT EXACTLY 1124 00:47:10,339 --> 00:47:14,076 THE SAME SURVEY BUT IT DOES 1125 00:47:14,076 --> 00:47:16,445 PROVIDE SOME WAY TO COMPARE HOW 1126 00:47:16,445 --> 00:47:18,948 WE'RE MAKING PROGRESS. 1127 00:47:18,948 --> 00:47:21,417 BETWEEN 2017 AND 2020 WE DID 1128 00:47:21,417 --> 00:47:22,585 MAKE SOME SIGNIFICANT PROGRESS. 1129 00:47:22,585 --> 00:47:24,987 WE DO HAVE THE RESULTS OF OUR 1130 00:47:24,987 --> 00:47:25,988 FEDERAL EMPLOYEE VIEWPOINT 1131 00:47:25,988 --> 00:47:26,455 SURVEY. 1132 00:47:26,455 --> 00:47:30,025 WE HAVE SOME OF THE RESULTS. 1133 00:47:30,025 --> 00:47:32,561 WE KNOW WE SET A RECORD FOR 1134 00:47:32,561 --> 00:47:35,097 PARTICIPATION, OUR OFFICIAL 1135 00:47:35,097 --> 00:47:37,133 PARTICIPATION RATE IS .4 1136 00:47:37,133 --> 00:47:38,334 PERCENTAGE POINTS ABOVE WHERE IT 1137 00:47:38,334 --> 00:47:40,202 WAS LAST YEAR WHEN WE DID IT, SO 1138 00:47:40,202 --> 00:47:43,005 WE SET A NEW RECORD BUT NOT BY 1139 00:47:43,005 --> 00:47:44,440 VERY MUCH, IT'S STILL BELOW WHAT 1140 00:47:44,440 --> 00:47:46,842 WE REALLY WANTED TO DO. 1141 00:47:46,842 --> 00:47:50,379 WE'VE SEEN -- I'VE SEEN THE 1142 00:47:50,379 --> 00:47:51,847 PARTICIPATION PATIENT RATE BY 1143 00:47:51,847 --> 00:47:53,048 GROUPS IN CLINICAL CENTER BUT 1144 00:47:53,048 --> 00:47:54,116 DON'T HAVE THE DETAILED 1145 00:47:54,116 --> 00:47:55,184 BREAKOUT. 1146 00:47:55,184 --> 00:47:56,919 WHEN WE HAVE THAT WE'LL PROBABLY 1147 00:47:56,919 --> 00:47:58,187 BE BACK. THAT WILL PROBABLY 1148 00:47:58,187 --> 00:47:59,522 ALSO BE ON THE AGENDA AFTER THE 1149 00:47:59,522 --> 00:48:05,060 FIRST PART OF THE YEAR. 1150 00:48:05,060 --> 00:48:05,928 NEXT SLIDE. 1151 00:48:05,928 --> 00:48:09,532 SO, THIS IS MORE DETAIL ON THE 1152 00:48:09,532 --> 00:48:11,367 SURVEY FROM AHRQ. 1153 00:48:11,367 --> 00:48:15,004 THE AGENCY FOR HEALTH CARE 1154 00:48:15,004 --> 00:48:16,172 RESEARCH AND QUALITY, LAST 1155 00:48:16,172 --> 00:48:17,740 ADMINISTERED IN 2020. 1156 00:48:17,740 --> 00:48:21,777 THIS HAS A LITTLE DIFFERENT BEND 1157 00:48:21,777 --> 00:48:23,379 BECAUSE THERE'S MORE FOCUS ON 1158 00:48:23,379 --> 00:48:24,280 BOTH PHYSICAL AND PSYCHOLOGICAL 1159 00:48:24,280 --> 00:48:27,583 SAFETY OF THE STAFF. 1160 00:48:27,583 --> 00:48:28,117 NEXT SLIDE. 1161 00:48:28,117 --> 00:48:29,919 SO, THESE ARE THE TOPICS THAT 1162 00:48:29,919 --> 00:48:36,926 ARE COVERED IN THE SURVEY. 1163 00:48:36,926 --> 00:48:38,794 NEXT SLIDE. 1164 00:48:38,794 --> 00:48:41,797 AND WORKPLACE SAFETY 1165 00:48:41,797 --> 00:48:42,531 SUPPLEMENTAL SET. 1166 00:48:42,531 --> 00:48:44,333 AND THESE ARE STILL APPLICABLE 1167 00:48:44,333 --> 00:48:47,002 TO US ALTHOUGH A FEW ARE LESS 1168 00:48:47,002 --> 00:48:49,071 APPLICABLE TO US. 1169 00:48:49,071 --> 00:48:51,640 WE ARE -- IN TERMS OF PHYSICAL 1170 00:48:51,640 --> 00:48:54,376 SAFETY WE ARE BEHIND A FENCE 1171 00:48:54,376 --> 00:48:57,179 WITH GATES AND GUARDS, AND 1172 00:48:57,179 --> 00:48:59,381 IT'S -- THAT WILL MAKE A BIG 1173 00:48:59,381 --> 00:49:01,116 DIFFERENCE THAN IF YOU WERE AT A 1174 00:49:01,116 --> 00:49:05,187 HOSPITAL IN THE MIDDLE OF A BIG 1175 00:49:05,187 --> 00:49:07,623 CITY THAT I WAS DOWNTOWN THE 1176 00:49:07,623 --> 00:49:08,490 NIGHT BEFORE LAST FOR THE 1177 00:49:08,490 --> 00:49:11,660 FOUNDATION FOR THE NIH AWARDS 1178 00:49:11,660 --> 00:49:15,297 BANQUET, WALKED BY THE GEORGE 1179 00:49:15,297 --> 00:49:16,665 WASHINGTON HOSPITAL AND IT'S 1180 00:49:16,665 --> 00:49:18,133 RIGHT THERE IN THE MIDDLE OF 1181 00:49:18,133 --> 00:49:19,969 TOWN, A LOT OF THINGS COULD GO 1182 00:49:19,969 --> 00:49:23,239 ON AROUND THERE THAT PROBABLY 1183 00:49:23,239 --> 00:49:24,807 ARE VERY UNLIKELY TO TAKE PLACE 1184 00:49:24,807 --> 00:49:26,642 IN OUR -- BUT IT DOESN'T MEAN 1185 00:49:26,642 --> 00:49:31,313 OUR STAFF DON'T HAVE CONCERNS 1186 00:49:31,313 --> 00:49:33,282 ABOUT THEIR SAFETY. 1187 00:49:33,282 --> 00:49:37,119 SO-- NEXT SLIDE. 1188 00:49:37,119 --> 00:49:38,621 SO, THIS IS 2024. 1189 00:49:38,621 --> 00:49:40,289 I SORT OF GAVE ADVANCE NOTICE OF 1190 00:49:40,289 --> 00:49:40,789 THIS. 1191 00:49:40,789 --> 00:49:45,894 WE THINK THIS WILL BE AN AUSTERE 1192 00:49:45,894 --> 00:49:46,395 YEAR. 1193 00:49:46,395 --> 00:49:48,063 OUR JOB IS TO HOLD THE GAINS 1194 00:49:48,063 --> 00:49:50,266 WE'VE MADE IN TERMS OF PATIENT 1195 00:49:50,266 --> 00:49:51,100 SAFETY, PATIENT EXPERIENCE, 1196 00:49:51,100 --> 00:49:53,769 PATIENT CARE DURING THE COURSE 1197 00:49:53,769 --> 00:49:55,237 OF THE LAST FEW YEARS. 1198 00:49:55,237 --> 00:49:58,907 WE HAVE NO PLANS FOR NEW BRIGHT 1199 00:49:58,907 --> 00:50:02,611 SHINY OBJECTS, AND WE WILL NEED 1200 00:50:02,611 --> 00:50:03,345 OBVIOUSLY TO PIVOT TO THE 1201 00:50:03,345 --> 00:50:08,217 PRIORITIES OF THE NEW NIH 1202 00:50:08,217 --> 00:50:08,584 LEADERSHIP. 1203 00:50:08,584 --> 00:50:10,052 DR. BERTAGNOLLI HAS BEEN THE 1204 00:50:10,052 --> 00:50:12,254 CHAIR OF THE CLINICAL CENTER 1205 00:50:12,254 --> 00:50:14,657 GOVERNING BOARD SO I HAVE HAD A 1206 00:50:14,657 --> 00:50:18,927 LOT OF CONTACT AND A LOT OF 1207 00:50:18,927 --> 00:50:20,462 COMMUNICATION WITH DR. 1208 00:50:20,462 --> 00:50:20,963 BERTAGNOLLI. 1209 00:50:20,963 --> 00:50:25,134 SHE OBVIOUSLY COMES FROM A 1210 00:50:25,134 --> 00:50:27,536 CLINICAL MEDICINE CANCER SURGERY 1211 00:50:27,536 --> 00:50:29,405 BACKGROUND, SO AS A FORMER 1212 00:50:29,405 --> 00:50:33,309 CLINICIAN MYSELF WHO STILL 1213 00:50:33,309 --> 00:50:35,210 THINKS LIKE A CLINICIAN I THINK 1214 00:50:35,210 --> 00:50:37,046 OUR ABILITY TO COMMUNICATION IS 1215 00:50:37,046 --> 00:50:39,915 IMPORTANT. 1216 00:50:39,915 --> 00:50:41,417 I'M STARTING TO WRITE DOWN SOME 1217 00:50:41,417 --> 00:50:42,885 THINGS I HEAR HER SAY THAT I 1218 00:50:42,885 --> 00:50:45,921 KNOW WE'RE GOING TO HEAR OVER 1219 00:50:45,921 --> 00:50:49,091 AND OVER AGAIN, AND I THINK SO 1220 00:50:49,091 --> 00:50:53,429 WE'RE LOOKING FORWARD AS DR. 1221 00:50:53,429 --> 00:50:54,930 TABAK INDICATED THAT -- AND DR. 1222 00:50:54,930 --> 00:50:59,868 TABAK IS A HUGE SUPPORTER OF THE 1223 00:50:59,868 --> 00:51:01,270 CLINICAL CENTER, AND I WOULD BE 1224 00:51:01,270 --> 00:51:04,640 REMISS IF I DIDN'T TELL YOU THAT 1225 00:51:04,640 --> 00:51:08,043 I'VE BEEN ENJOYED MY 6 1/2 YEARS 1226 00:51:08,043 --> 00:51:09,545 AT THE NIH IN PART BECAUSE I 1227 00:51:09,545 --> 00:51:12,815 KNEW I HAD A FRIEND IN THE 1228 00:51:12,815 --> 00:51:15,684 CLINICAL CENTER IN THE DEPUTY'S 1229 00:51:15,684 --> 00:51:16,585 OFFICE, DEPUTY DIRECTOR'S 1230 00:51:16,585 --> 00:51:20,389 OFFICE, AND IN THE ACTING 1231 00:51:20,389 --> 00:51:21,590 DIRECTOR'S OFFICE. 1232 00:51:21,590 --> 00:51:23,692 WE DID HAVE SOME EXTRA MONEY 1233 00:51:23,692 --> 00:51:26,628 LAST YEAR AND WE HAVE TWO 1234 00:51:26,628 --> 00:51:27,963 PROJECTS UNDERWAY, ONE IS A 1235 00:51:27,963 --> 00:51:29,598 PROJECT TO SEE WHETHER WE CAN 1236 00:51:29,598 --> 00:51:31,800 GET A BETTER ASSESSMENT OF 1237 00:51:31,800 --> 00:51:34,837 NURSING WORKLOAD MANAGEMENT. 1238 00:51:34,837 --> 00:51:36,171 OUR PATIENTS ARE A LITTLE 1239 00:51:36,171 --> 00:51:40,342 DIFFERENT AND A LITTLE MORE 1240 00:51:40,342 --> 00:51:40,576 COMPLEX. 1241 00:51:40,576 --> 00:51:43,445 THE NUMBER OF INFUSIONS OR IV 1242 00:51:43,445 --> 00:51:46,215 ADMINISTRATIONS FOR SOME OF OUR 1243 00:51:46,215 --> 00:51:47,082 MORE COMPLEX PROTOCOLS MEAN THAT 1244 00:51:47,082 --> 00:51:51,086 THERE'S A TREMENDOUS AMOUNT OF 1245 00:51:51,086 --> 00:51:52,421 NURSING WORKLOAD AND WORK HOURS 1246 00:51:52,421 --> 00:51:54,022 AND TRYING TO QUANTIFY TO MAKE 1247 00:51:54,022 --> 00:51:56,058 SURE WE HAVE THE RIGHT NUMBER OF 1248 00:51:56,058 --> 00:51:58,660 STAFF FOR THE RIGHT NUMBER OF 1249 00:51:58,660 --> 00:52:04,633 PATIENTS WITH THE RIGHT ACUITY 1250 00:52:04,633 --> 00:52:05,501 IS REALLY IMPORTANT. 1251 00:52:05,501 --> 00:52:09,071 THERE ARE ALWAYS SOME OTHER 1252 00:52:09,071 --> 00:52:10,205 PRIORITIES LIKE IF WE HAVE 1253 00:52:10,205 --> 00:52:14,276 ANOTHER YEAR LIKE WE HAD IN 2018 1254 00:52:14,276 --> 00:52:18,514 THE COST OF PHARMACY MEDICATIONS 1255 00:52:18,514 --> 00:52:20,949 TOOK OFF, THAT'S A BIG PROBLEM. 1256 00:52:20,949 --> 00:52:22,785 BUDGET HAS BEEN APPROVED BY THE 1257 00:52:22,785 --> 00:52:24,453 CLINICAL CENTER GOVERNING BOARD. 1258 00:52:24,453 --> 00:52:27,289 IT STILL HAS TO GO THROUGH THE 1259 00:52:27,289 --> 00:52:29,258 NIH STEERING COMMITTEE AND 1260 00:52:29,258 --> 00:52:32,861 FINALLY THE FULL BODY OF 1261 00:52:32,861 --> 00:52:36,098 INSTITUTE DIRECTORS, AND BUT 1262 00:52:36,098 --> 00:52:36,465 WE'RE HOPEFUL. 1263 00:52:36,465 --> 00:52:37,666 NEXT SLIDE. 1264 00:52:37,666 --> 00:52:39,668 SO, THIS IS THE AGENDA FOR 1265 00:52:39,668 --> 00:52:40,436 TODAY. 1266 00:52:40,436 --> 00:52:42,070 YOU'VE ALREADY HEARD FROM DR. 1267 00:52:42,070 --> 00:52:43,672 COOTS AND DR. TABAK AND ME. 1268 00:52:43,672 --> 00:52:47,009 I'LL BE FOLLOWED IN A FEW 1269 00:52:47,009 --> 00:52:49,611 MINUTES BY JACK SHERN. 1270 00:52:49,611 --> 00:52:50,612 JACK IS A PEDIATRIC ONCOLOGIST 1271 00:52:50,612 --> 00:52:52,648 BY TRAINING AND HE WILL GET THE 1272 00:52:52,648 --> 00:52:54,883 MORNING OFF TO A GOOD START 1273 00:52:54,883 --> 00:52:57,553 TALKING ABOUT CAMP FANTASTIC AND 1274 00:52:57,553 --> 00:53:01,757 WHAT THE CLINICAL CENTER DOES TO 1275 00:53:01,757 --> 00:53:02,991 FACILITATE THE CAMP FANTASTIC. 1276 00:53:02,991 --> 00:53:06,495 DR. JORDAN, WE'RE IN OUR MAGNET 1277 00:53:06,495 --> 00:53:09,264 WINDOW, WE'VE SUBMITTED 1278 00:53:09,264 --> 00:53:10,632 APPLICATION, COLLECTING ALL THE 1279 00:53:10,632 --> 00:53:12,067 DOCUMENTATION FOR THE MAGNET 1280 00:53:12,067 --> 00:53:12,935 VISIT NEXT YEAR. 1281 00:53:12,935 --> 00:53:15,771 DR. JORDAN WILL PROVIDE THAT. 1282 00:53:15,771 --> 00:53:17,005 JON McKEEBY IS HERE, JON IS 1283 00:53:17,005 --> 00:53:19,107 GOING TO TALK ABOUT WHERE WE ARE 1284 00:53:19,107 --> 00:53:20,175 WITH OUR ELECTRONIC HEALTH 1285 00:53:20,175 --> 00:53:24,613 RECORD AND OUR EFFORTS TO 1286 00:53:24,613 --> 00:53:26,148 PROCURE A NEW ELECTRONIC HEALTH 1287 00:53:26,148 --> 00:53:27,516 RECORD. 1288 00:53:27,516 --> 00:53:30,219 THE PRESENTATION WILL COME AS NO 1289 00:53:30,219 --> 00:53:33,255 SURPRISE TO BOARD MEMBER 1290 00:53:33,255 --> 00:53:35,424 STEPHANIE REEL, WHO HAS BEEN A 1291 00:53:35,424 --> 00:53:38,060 GREAT FRIEND AND GREAT ADVISER 1292 00:53:38,060 --> 00:53:39,361 AND PROVIDES GOOD SERVICE NOT 1293 00:53:39,361 --> 00:53:41,230 ONLY TO THIS BOARD BUT BETWEEN 1294 00:53:41,230 --> 00:53:43,198 BOARD MEETINGS WHEN WE WANT TO 1295 00:53:43,198 --> 00:53:46,568 TALK ABOUT THE HOSPITAL I.T. 1296 00:53:46,568 --> 00:53:46,802 ISSUES. 1297 00:53:46,802 --> 00:53:47,903 JOHN POLLACK AND ANN BERGER WILL 1298 00:53:47,903 --> 00:53:50,305 BE HERE TO TALK ABOUT THE 1299 00:53:50,305 --> 00:53:51,707 CLINICAL CENTER WELLNESS 1300 00:53:51,707 --> 00:53:53,709 PROGRAM, FOCUSED ON THE CLINICAL 1301 00:53:53,709 --> 00:53:54,810 CENTER STAFF. 1302 00:53:54,810 --> 00:53:59,081 AND THEN WE'LL WIND UP WITH A 1303 00:53:59,081 --> 00:54:00,249 PRESENTATION BY ANDYY SINGLETON 1304 00:54:00,249 --> 00:54:01,683 ON CENTER FOR ALZHEIMER'S AND 1305 00:54:01,683 --> 00:54:02,317 RELATED DEMENTIAS. 1306 00:54:02,317 --> 00:54:06,822 IF I LOOK AT OUR STRATEGIC PLAN 1307 00:54:06,822 --> 00:54:10,325 PLAN FOR 2024, FOR 2019 1308 00:54:10,325 --> 00:54:12,561 THE ONE WE'RE REDOING AT THE 1309 00:54:12,561 --> 00:54:14,263 PRESENT TIME YOU'LL SEE THAT 1310 00:54:14,263 --> 00:54:14,930 ALZHEIMER'S AND RELATED 1311 00:54:14,930 --> 00:54:16,365 DEMENTIAS IS AN AREA WE THOUGHT 1312 00:54:16,365 --> 00:54:20,402 WE SHOULD BE DOING MORE IN A FEW 1313 00:54:20,402 --> 00:54:23,939 YEARS AGO. 1314 00:54:23,939 --> 00:54:25,240 AN OPPORTUNITY CAME UP TO 1315 00:54:25,240 --> 00:54:27,576 PROVIDE SPACE WITHIN THE 1316 00:54:27,576 --> 00:54:28,043 CLINICAL CENTER. 1317 00:54:28,043 --> 00:54:31,079 IT REQUIRED A LITTLE BIT OF 1318 00:54:31,079 --> 00:54:33,348 NEGOTIATION WITH SOME OTHER 1319 00:54:33,348 --> 00:54:34,082 PEOPLE, REWICKERRING, MOVING 1320 00:54:34,082 --> 00:54:36,652 SOME MONEY AROUND, BUT WE 1321 00:54:36,652 --> 00:54:39,254 FINALLY HAVE A SPACE FOR THE 1322 00:54:39,254 --> 00:54:42,057 CLINICAL PROGRAM FOR ALZHEIMER'S 1323 00:54:42,057 --> 00:54:45,460 AND RELATED DEMENTIA TO GO. 1324 00:54:45,460 --> 00:54:49,197 DR. SINGLETON IS THE PROGRAM -- 1325 00:54:49,197 --> 00:54:50,332 IS THE MANAGER FOR ALL THINGS 1326 00:54:50,332 --> 00:54:52,134 CARD AND HE WILL BE HERE TO TALK 1327 00:54:52,134 --> 00:54:55,737 ABOUT THE VISION FOR THAT 1328 00:54:55,737 --> 00:54:58,373 PROGRAM, INCLUDING THE CLINICAL 1329 00:54:58,373 --> 00:54:58,874 WORK. 1330 00:54:58,874 --> 00:54:59,608 NEXT SLIDE. 1331 00:54:59,608 --> 00:55:01,376 AND SORT OF LATE BREAKING NEWS 1332 00:55:01,376 --> 00:55:04,947 BUT DR. SINGLETON WHO WILL BE 1333 00:55:04,947 --> 00:55:06,715 OUR PRESENTER, IS AN NIH 1334 00:55:06,715 --> 00:55:07,916 DISTINGUISHED INVESTIGATOR AND 1335 00:55:07,916 --> 00:55:13,188 ONLY A SMALL PERCENTAGE OF NIH 1336 00:55:13,188 --> 00:55:14,723 INVESTIGATORS ACHIEVE THAT 1337 00:55:14,723 --> 00:55:16,325 STANDING. 1338 00:55:16,325 --> 00:55:18,894 AND HE IS THE -- HE IS RUNNING 1339 00:55:18,894 --> 00:55:20,529 THE CENTER FOR ALZHEIMER'S AND 1340 00:55:20,529 --> 00:55:22,197 RELATED DEMENTIAS, RECENTLY 1341 00:55:22,197 --> 00:55:23,365 RECEIVED A VERY PRESTIGIOUS 1342 00:55:23,365 --> 00:55:24,633 AWARD CALLED THE BREAKTHROUGH 1343 00:55:24,633 --> 00:55:27,436 PRIZE, AND I WON'T READ TO YOU 1344 00:55:27,436 --> 00:55:28,670 EVERYTHING ABOUT THE PRIZE. 1345 00:55:28,670 --> 00:55:31,607 I WOULD JUST DROP DOWN TO SAY 1346 00:55:31,607 --> 00:55:35,444 THAT DR. SINGLETON WAS NOT THE 1347 00:55:35,444 --> 00:55:41,783 ONLY NIH WINNER THIS TIME 1348 00:55:41,783 --> 00:55:43,719 AROUND, THAT ELLEN SIDRANSKY AT 1349 00:55:43,719 --> 00:55:45,253 THE NATIONAL HUMAN GENOME 1350 00:55:45,253 --> 00:55:47,489 RESEARCH INSTITUTE AT NIH WAS 1351 00:55:47,489 --> 00:55:51,293 ALSO RECOGNIZED THIS TIME. 1352 00:55:51,293 --> 00:55:55,130 DR. SINGLETON'S EFFORTS ARE WITH 1353 00:55:55,130 --> 00:55:58,900 RESPECT TO IDENTIFYING THE GENES 1354 00:55:58,900 --> 00:56:00,936 THAT SEEM TO PREDISPOSE FOR 1355 00:56:00,936 --> 00:56:05,707 PARKINSON'S DISEASE AND HOW THEY 1356 00:56:05,707 --> 00:56:07,109 DO THAT, HOW THE PATHOPHYSIOLOGY 1357 00:56:07,109 --> 00:56:08,510 OF THAT. 1358 00:56:08,510 --> 00:56:13,515 SO ANDY WILL BE HERE IN A LITTLE 1359 00:56:13,515 --> 00:56:13,915 BIT. 1360 00:56:13,915 --> 00:56:16,051 THEY APPROACHED ME, BOTH ANDY 1361 00:56:16,051 --> 00:56:18,654 ALONG WITH FOLKS FROM NINDS, AND 1362 00:56:18,654 --> 00:56:22,958 THE NATIONAL INSTITUTE FOR 1363 00:56:22,958 --> 00:56:24,993 AGING, AND THEY ARE LOOKING -- I 1364 00:56:24,993 --> 00:56:26,895 MEAN, PART OF THIS IS GOING TO 1365 00:56:26,895 --> 00:56:28,497 BE AN ADVERTISEMENT, THEY ARE 1366 00:56:28,497 --> 00:56:30,732 LOOKING FOR SOMEBODY TO LEAD THE 1367 00:56:30,732 --> 00:56:32,801 CLINICAL PROGRAM AT THE CENTER 1368 00:56:32,801 --> 00:56:33,435 FOR ALZHEIMER'S AND RELATED 1369 00:56:33,435 --> 00:56:38,006 DEMENTIAS, AND ONE OF THE 1370 00:56:38,006 --> 00:56:39,141 BARRIERS TO RECRUIT BE SOMEBODY 1371 00:56:39,141 --> 00:56:40,876 TO RUN THIS PROGRAM THEY DIDN'T 1372 00:56:40,876 --> 00:56:42,544 HAVE A SPACE, THEY DIDN'T HAVE A 1373 00:56:42,544 --> 00:56:43,612 BUILDING, DIDN'T HAVE A SPACE TO 1374 00:56:43,612 --> 00:56:44,613 SAY THIS IS WHERE YOU'RE GOING 1375 00:56:44,613 --> 00:56:48,183 TO BE ABLE TO GET YOUR WORK 1376 00:56:48,183 --> 00:56:48,450 DONE. 1377 00:56:48,450 --> 00:56:50,052 AND I THINK IT TOOK A FAIR 1378 00:56:50,052 --> 00:56:51,286 AMOUNT OF WORK AND A LITTLE BIT 1379 00:56:51,286 --> 00:56:52,888 OF NEGOTIATION BY A NUMBER OF 1380 00:56:52,888 --> 00:56:55,424 PEOPLE BUT I THINK WE'VE FINALLY 1381 00:56:55,424 --> 00:56:57,459 FIGURED THAT OUT NOW. 1382 00:56:57,459 --> 00:56:57,659 OKAY. 1383 00:56:57,659 --> 00:56:59,594 SO THAT'S KIND OF THE UPDATE. 1384 00:56:59,594 --> 00:57:01,763 AGAIN, THANK YOU FOR BEING HERE. 1385 00:57:01,763 --> 00:57:03,765 AND IF THERE ARE NO QUESTIONS I 1386 00:57:03,765 --> 00:57:14,309 WILL TURN IT OVER TO DR. SHERN. 1387 00:57:14,643 --> 00:57:14,743 1388 00:57:14,743 --> 00:57:18,613 >> NEXT SPEAKER IS DR. JACK 1389 00:57:18,613 --> 00:57:19,614 SHERN, PHYSICIAN-SCIENTIST WITH 1390 00:57:19,614 --> 00:57:21,116 PEDIATRIC ONCOLOGY BRANCH, 1391 00:57:21,116 --> 00:57:23,418 RESEARCH FOCUSED ON DEFINING AND 1392 00:57:23,418 --> 00:57:25,287 DEVELOPING PRECISION THERAPIES 1393 00:57:25,287 --> 00:57:27,022 TARGETING GENETIC MUTATIONS THAT 1394 00:57:27,022 --> 00:57:27,989 DRIVE TUMORIGENESIS, MOST 1395 00:57:27,989 --> 00:57:29,224 RECENTLY EFFORTS HAVE TURNED 1396 00:57:29,224 --> 00:57:31,193 TOWARD USING SINGLE CELL 1397 00:57:31,193 --> 00:57:32,661 SEQUENCING TO DISCOVER TUMOR 1398 00:57:32,661 --> 00:57:34,596 SUBCLONAL POPULATIONS THAT ARE 1399 00:57:34,596 --> 00:57:36,765 RESPONSIBLE FOR RELAPSE AND 1400 00:57:36,765 --> 00:57:38,066 REFRACTORY DISEASE. 1401 00:57:38,066 --> 00:57:39,534 JACK'S PRESENTATION TODAY 1402 00:57:39,534 --> 00:57:41,169 FOCUSES ON CAMP FANTASTIC, AN 1403 00:57:41,169 --> 00:57:43,238 AMAZING PROGRAM STRONGLY 1404 00:57:43,238 --> 00:57:46,641 SUPPORTED BY THE NIH, ESPECIALLY 1405 00:57:46,641 --> 00:57:47,809 NCI PEDIATRIC ONCOLOGY BRANCH. 1406 00:57:47,809 --> 00:57:49,010 CAMP SERVES MANY PARTNER MEDICAL 1407 00:57:49,010 --> 00:57:51,046 CENTERS IN THE REGION OFFERING 1408 00:57:51,046 --> 00:57:52,748 CAMPING EXPERIENCES FOR CHILDREN 1409 00:57:52,748 --> 00:57:54,015 WITH CANCER. 1410 00:57:54,015 --> 00:57:56,051 SO, JACK, I TURN IT OVER TO YOU. 1411 00:57:56,051 --> 00:57:58,687 >> WELL, THANK YOU FOR HAVING ME 1412 00:57:58,687 --> 00:57:59,387 HERE TODAY. 1413 00:57:59,387 --> 00:58:02,924 AS YOU HEARD I'M A PEDIATRIC 1414 00:58:02,924 --> 00:58:03,258 ONCOLOGIST. 1415 00:58:03,258 --> 00:58:05,627 AND FIRST I WANT TO APOLOGIZE TO 1416 00:58:05,627 --> 00:58:06,895 OTHER SPEAKERS BUT I'M PRETTY 1417 00:58:06,895 --> 00:58:08,530 SURE THIS WILL BE THE MOST 1418 00:58:08,530 --> 00:58:09,831 ENJOYABLE PRESENTATION OF THE 1419 00:58:09,831 --> 00:58:10,599 ENTIRE DAY. 1420 00:58:10,599 --> 00:58:12,801 SO, SIT BACK AND ENJOY THIS ONE. 1421 00:58:12,801 --> 00:58:15,604 THE REASON I SAY THAT IS BECAUSE 1422 00:58:15,604 --> 00:58:17,339 I'M HERE REPRESENTING AS THE 1423 00:58:17,339 --> 00:58:18,774 MEDICAL DIRECTOR OF THIS 1424 00:58:18,774 --> 00:58:20,475 WONDERFUL THING THAT HAS GONE ON 1425 00:58:20,475 --> 00:58:23,078 FOR DECADES NOW AT THE CLINICAL 1426 00:58:23,078 --> 00:58:27,349 CENTER CALLED CAMP FANTASTIC. 1427 00:58:27,349 --> 00:58:29,484 THE NEXT SLIDE PLEASE. 1428 00:58:29,484 --> 00:58:33,255 SO, THIS WAS STARTED IN 1983, 1429 00:58:33,255 --> 00:58:35,991 AND MY UNDERSTANDING IS THAT 1430 00:58:35,991 --> 00:58:37,325 THIS IS THE LONGEST-RUNNING 1431 00:58:37,325 --> 00:58:41,496 ACTIVE PROTOCOL AT THE CLINICAL 1432 00:58:41,496 --> 00:58:42,330 CENTER. 1433 00:58:42,330 --> 00:58:46,101 YOU SEE 83C 002 STARTED BY A 1434 00:58:46,101 --> 00:58:47,369 GROUP OF PEDIATRIC ONCOLOGISTS 1435 00:58:47,369 --> 00:58:49,704 AT THAT TIME, REALLY TREATING 1436 00:58:49,704 --> 00:58:52,040 WITH SOME INTENSIVE INPATIENT 1437 00:58:52,040 --> 00:58:52,941 TREATMENTS OUR PEDIATRIC 1438 00:58:52,941 --> 00:58:55,143 ONCOLOGY PATIENTS IN THE 1439 00:58:55,143 --> 00:58:55,577 CLINICAL CENTER. 1440 00:58:55,577 --> 00:58:58,647 AND SO THE IDEA CAME THAT MAYBE 1441 00:58:58,647 --> 00:59:00,282 SOMETHING FUN WOULD BE IMPORTANT 1442 00:59:00,282 --> 00:59:01,383 FOR THESE PATIENTS THAT WERE 1443 00:59:01,383 --> 00:59:03,819 COOPED UP IN THE HOSPITAL. 1444 00:59:03,819 --> 00:59:05,754 AND REALLY WHAT I'VE COME TO 1445 00:59:05,754 --> 00:59:09,224 SORT OF UNDERSTAND ABOUT THIS 1446 00:59:09,224 --> 00:59:11,459 CAMP AND PSYCHOLOGICAL BENEFITS 1447 00:59:11,459 --> 00:59:14,262 OF THIS CAMP ARE THREE THINGS. 1448 00:59:14,262 --> 00:59:16,731 THE FIRST IS THERE'S AN OBVIOUS 1449 00:59:16,731 --> 00:59:20,435 BENEFIT TO THE PATIENTS. 1450 00:59:20,435 --> 00:59:23,872 YOU KNOW, THE PATIENTS ARE UNDER 1451 00:59:23,872 --> 00:59:25,040 SUPREME STRESS AS THEY GO 1452 00:59:25,040 --> 00:59:26,107 THROUGH THEIR THERAPY. 1453 00:59:26,107 --> 00:59:28,243 WHEN WE GET THEM OUT INTO A 1454 00:59:28,243 --> 00:59:29,277 NORMAL CAMPING EXPERIENCE WHERE 1455 00:59:29,277 --> 00:59:31,346 THEY HAVE FUN, INTERACT WITH 1456 00:59:31,346 --> 00:59:32,480 PEERS, GAIN CONFIDENCE, THEY 1457 00:59:32,480 --> 00:59:34,115 LEARN TO TALK ABOUT THEIR 1458 00:59:34,115 --> 00:59:36,384 DISEASE, AND THEY GO HOME AND 1459 00:59:36,384 --> 00:59:37,652 THEY HAVE NEW INTERACTIONS WITH 1460 00:59:37,652 --> 00:59:39,120 THEIR PEERS AND WITH THEIR 1461 00:59:39,120 --> 00:59:39,521 PARENTS. 1462 00:59:39,521 --> 00:59:40,789 SO I THINK THIS IS FAIRLY 1463 00:59:40,789 --> 00:59:42,757 OBVIOUS THAT IF YOU DO SOMETHING 1464 00:59:42,757 --> 00:59:46,061 GOOD FOR THESE KIDS IN A NORMAL 1465 00:59:46,061 --> 00:59:46,761 EXPERIENCE OUTSIDE THE HOSPITAL 1466 00:59:46,761 --> 00:59:48,430 THAT THIS IS BENEFICIAL. 1467 00:59:48,430 --> 00:59:49,731 THERE'S A SECOND BENEFIT, AND 1468 00:59:49,731 --> 00:59:51,700 THAT'S TO THE HEALTH CARE TEAM. 1469 00:59:51,700 --> 00:59:55,303 TAKING CARE OF THESE PATIENTS IS 1470 00:59:55,303 --> 00:59:56,304 EMOTIONALLY CHALLENGING, AND 1471 00:59:56,304 --> 00:59:56,738 GRUELING AT TIMES. 1472 00:59:56,738 --> 00:59:59,274 AND IF YOU ARE A NURSE OR DOCTOR 1473 00:59:59,274 --> 01:00:01,142 OR SOCIAL WORKER OR TEAM MEMBER 1474 01:00:01,142 --> 01:00:02,577 IN THE HOSPITAL, SEEING THESE 1475 01:00:02,577 --> 01:00:05,480 PATIENTS DAY IN, DAY OUT, IN 1476 01:00:05,480 --> 01:00:06,147 THAT ENVIRONMENT, IT'S MUCH 1477 01:00:06,147 --> 01:00:09,818 DIFFERENT WHEN YOU GET THEM OUT 1478 01:00:09,818 --> 01:00:12,153 RIDING A HORSE IN FRONT ROYAL, 1479 01:00:12,153 --> 01:00:14,155 VIRGINIA, SEEING THEM HAVE FUN, 1480 01:00:14,155 --> 01:00:15,457 SEEING THEM LAUGH AND INTERACT 1481 01:00:15,457 --> 01:00:16,625 WITH THEIR PEERS. 1482 01:00:16,625 --> 01:00:19,494 IT'S A HUGE BENEFIT TO THE 1483 01:00:19,494 --> 01:00:22,364 MEDICAL TEAM'S MORALE AND 1484 01:00:22,364 --> 01:00:22,664 CONFIDENCE. 1485 01:00:22,664 --> 01:00:23,765 AND FINALLY, THE FAMILIES 1486 01:00:23,765 --> 01:00:25,200 ACTUALLY BENEFIT FROM THIS QUITE 1487 01:00:25,200 --> 01:00:27,569 A BIT AS WELL. 1488 01:00:27,569 --> 01:00:29,237 AND THOMAS SHEILA BAKER ARE HERE 1489 01:00:29,237 --> 01:00:30,105 REPRESENTING THE FAMILY. 1490 01:00:30,105 --> 01:00:32,440 THIS IS A COUPLE THAT STARTED 1491 01:00:32,440 --> 01:00:34,342 THIS CAMP IN 1983. 1492 01:00:34,342 --> 01:00:36,912 THEY LOST THEIR DAUGHTER JULIE 1493 01:00:36,912 --> 01:00:37,746 TO LYMPHOMA. 1494 01:00:37,746 --> 01:00:38,880 AND THEY DECIDED THIS WAS SORT 1495 01:00:38,880 --> 01:00:41,516 OF THEIR MISSION TO SORT OF 1496 01:00:41,516 --> 01:00:43,451 BUILD THIS OUT OVER TIME SO THEY 1497 01:00:43,451 --> 01:00:45,120 WERE THE FOUNDERS OF THE CAMP 1498 01:00:45,120 --> 01:00:46,321 AND REALLY PARTNERED WITH THE 1499 01:00:46,321 --> 01:00:48,790 CLINICAL CENTER TO MAKE THIS 1500 01:00:48,790 --> 01:00:49,557 HAPPEN. 1501 01:00:49,557 --> 01:00:50,592 SO, IT REALLY SERVES AS A 1502 01:00:50,592 --> 01:00:52,627 RESPITE FOR THE FAMILIES TAKING 1503 01:00:52,627 --> 01:00:55,030 CARE OF THESE MEDICALLY COMPLEX 1504 01:00:55,030 --> 01:00:55,597 CHILDREN, CONSTANTLY. 1505 01:00:55,597 --> 01:00:58,533 WE GET TEXTS FROM THE FAMILY 1506 01:00:58,533 --> 01:00:59,734 THAT THE PARENTS ARE OUT FOR 1507 01:00:59,734 --> 01:01:03,371 THEIR FIRST DATE NIGHT IN 1508 01:01:03,371 --> 01:01:05,040 FOREVER, BECAUSE THEIR MEDICALLY 1509 01:01:05,040 --> 01:01:06,408 COMPLEX CHILDREN ARE BEING TAKEN 1510 01:01:06,408 --> 01:01:07,642 CARE OF IN A SAFE ENVIRONMENT 1511 01:01:07,642 --> 01:01:08,843 AND HAVING FUN AND THEY DON'T 1512 01:01:08,843 --> 01:01:10,178 HAVE TO WORRY ABOUT THAT 1513 01:01:10,178 --> 01:01:10,679 ANYMORE. 1514 01:01:10,679 --> 01:01:14,916 SO REALLY THESE THREE GROUPS ARE 1515 01:01:14,916 --> 01:01:15,383 CRITICAL. 1516 01:01:15,383 --> 01:01:15,951 NEXT SLIDE. 1517 01:01:15,951 --> 01:01:19,321 WHERE DO WE DO THIS? 1518 01:01:19,321 --> 01:01:20,889 THE CAMP TAKES USUALLY ABOUT 100 1519 01:01:20,889 --> 01:01:22,524 PEDIATRIC ONCOLOGY PATIENTS OUT 1520 01:01:22,524 --> 01:01:23,491 TO FRONT ROYAL, VIRGINIA. 1521 01:01:23,491 --> 01:01:25,460 THIS IS AT THE 4-H CENTER. 1522 01:01:25,460 --> 01:01:28,396 IT'S BEEN SINCE ITS INCEPTION. 1523 01:01:28,396 --> 01:01:30,498 THIS IS A BEAUTIFUL FACILITY, 1524 01:01:30,498 --> 01:01:32,701 LARGE PROPERTY WITH LOTS OF 1525 01:01:32,701 --> 01:01:37,205 LAND, STABLES FOR THE HORSES, 1526 01:01:37,205 --> 01:01:39,741 KIDS STAY IN CABINS OR DORMS. 1527 01:01:39,741 --> 01:01:40,809 THERE'S A WONDERFUL POOL. 1528 01:01:40,809 --> 01:01:44,179 THERE'S A LAKE WHERE WE CAN DO 1529 01:01:44,179 --> 01:01:46,514 ALL SORTS OF FISHING AND 1530 01:01:46,514 --> 01:01:46,915 CANOEING. 1531 01:01:46,915 --> 01:01:49,117 AND THEN A SPOT FOR CAMPFIRES 1532 01:01:49,117 --> 01:01:51,453 EVERY NIGHT WHERE WE CAN SING 1533 01:01:51,453 --> 01:01:56,825 SONGS AND ENJOY THE OUTDOORS. 1534 01:01:56,825 --> 01:01:58,393 NEXT SLIDE. 1535 01:01:58,393 --> 01:01:59,995 SO, THE PATIENTS COME FROM 1536 01:01:59,995 --> 01:02:01,062 MULTIPLE CENTERS ACROSS THE 1537 01:02:01,062 --> 01:02:02,998 MID-ATLANTIC, AND WE SORT OF 1538 01:02:02,998 --> 01:02:05,800 RECRUIT TO TRY AND BRING 1539 01:02:05,800 --> 01:02:07,002 PATIENTS FROM A DIVERSE 1540 01:02:07,002 --> 01:02:09,938 BACKGROUND, INCLUDING LOTS OF 1541 01:02:09,938 --> 01:02:10,739 SMALLER INSTITUTIONS THAT MAY 1542 01:02:10,739 --> 01:02:13,908 NOT HAVE THE ABILITY TO RUN A 1543 01:02:13,908 --> 01:02:15,610 CAMP ON THEIR OWN. 1544 01:02:15,610 --> 01:02:17,779 YOU SEE BUSY CLINICAL CENTERS IN 1545 01:02:17,779 --> 01:02:19,314 THE AREA, HOPKINS, NOVA, 1546 01:02:19,314 --> 01:02:19,948 CHILDREN'S NATIONAL SEND 1547 01:02:19,948 --> 01:02:20,915 PATIENTS TO US. 1548 01:02:20,915 --> 01:02:22,684 SO IT'S REALLY A NICE MIX OF 1549 01:02:22,684 --> 01:02:23,852 PATIENTS FROM ACROSS THE 1550 01:02:23,852 --> 01:02:25,153 MID-ATLANTIC AND OF COURSE ANY 1551 01:02:25,153 --> 01:02:27,055 OF THE PATIENTS IN THE PEDIATRIC 1552 01:02:27,055 --> 01:02:28,957 ONCOLOGY BRANCH WHO ARE ELIGIBLE 1553 01:02:28,957 --> 01:02:31,826 WILL ALSO COME. 1554 01:02:31,826 --> 01:02:32,727 NEXT SLIDE. 1555 01:02:32,727 --> 01:02:34,195 SO, AS I SAID, THIS HAS BEEN 1556 01:02:34,195 --> 01:02:35,830 GOING ON A LONG TIME. 1557 01:02:35,830 --> 01:02:37,866 ANYBODY WHO GETS INVOLVED IN 1558 01:02:37,866 --> 01:02:39,334 THIS SEEMS TO GET LATCHED ON. 1559 01:02:39,334 --> 01:02:41,403 I'VE SEEN THIS OVER AND OVER. 1560 01:02:41,403 --> 01:02:43,471 THIS IS ONE OF THE EARLY CAMPS 1561 01:02:43,471 --> 01:02:43,905 HERE. 1562 01:02:43,905 --> 01:02:45,540 AND ONE OF THE THINGS I LEARNED 1563 01:02:45,540 --> 01:02:47,409 WHEN I WAS PUTTING THIS TOGETHER 1564 01:02:47,409 --> 01:02:49,177 IS DONNA GREGORY, WHO IS OUR 1565 01:02:49,177 --> 01:02:53,481 HEAD OF REHAB, IS ACTUALLY AN 1566 01:02:53,481 --> 01:02:54,682 18-YEAR-OLD COUNSELOR IN THIS 1567 01:02:54,682 --> 01:02:55,283 PICTURE HERE. 1568 01:02:55,283 --> 01:02:57,285 HE'S NOW SORT OF CONTINUED ON 1569 01:02:57,285 --> 01:02:59,821 AND BEEN PART OF THIS ALL THE 1570 01:02:59,821 --> 01:03:00,155 WAY THROUGH. 1571 01:03:00,155 --> 01:03:01,489 AMAZING THING WHERE YOU GET 1572 01:03:01,489 --> 01:03:03,358 INVOLVED AND THEN IT'S REALLY 1573 01:03:03,358 --> 01:03:05,093 HARD TO NOT GO EVERY AUGUST AND 1574 01:03:05,093 --> 01:03:07,362 DO THIS. 1575 01:03:07,362 --> 01:03:08,296 NEXT SLIDE. 1576 01:03:08,296 --> 01:03:08,897 SO, THIS IS 2019. 1577 01:03:08,897 --> 01:03:12,367 CAN YOU SEE IT WAS A BIG CAMP. 1578 01:03:12,367 --> 01:03:14,769 WE HAD I THINK 105 KIDS THAT 1579 01:03:14,769 --> 01:03:17,472 YEAR THAT JOINED US AT CAMP. 1580 01:03:17,472 --> 01:03:18,440 AND, YOU KNOW, REALLY WANT TO 1581 01:03:18,440 --> 01:03:20,008 SORT OF POINT OUT THE FACT THAT 1582 01:03:20,008 --> 01:03:23,778 COVID WAS A REAL CHALLENGE FOR 1583 01:03:23,778 --> 01:03:24,212 THIS. 1584 01:03:24,212 --> 01:03:26,881 YOU CAN'T BRING AN IMMUNE 1585 01:03:26,881 --> 01:03:28,283 COMPROMISED POPULATION TO FRONT 1586 01:03:28,283 --> 01:03:29,617 ROYAL, VIRGINIA, AND PUT THEM 1587 01:03:29,617 --> 01:03:32,087 TOGETHER WHEN COVID IS SORT OF 1588 01:03:32,087 --> 01:03:32,987 GOING THROUGH THE COMMUNITY. 1589 01:03:32,987 --> 01:03:34,589 SO, IT WAS A REAL CHALLENGE FOR 1590 01:03:34,589 --> 01:03:35,023 US. 1591 01:03:35,023 --> 01:03:39,994 WE HAD TO SHUT DOWN THE CAMP IN 1592 01:03:39,994 --> 01:03:42,831 2020, 2021, AND 2022. 1593 01:03:42,831 --> 01:03:44,232 AND SO THAT WAS, YOU KNOW, A 1594 01:03:44,232 --> 01:03:46,401 REAL CHALLENGE FOR US. 1595 01:03:46,401 --> 01:03:48,236 WE DID HAVE REMOTE CAMPS WHERE 1596 01:03:48,236 --> 01:03:51,372 WE WOULD SORT OF SEND A BOX OF 1597 01:03:51,372 --> 01:03:53,341 CRAFTS TO EACH PATIENT AND THEY 1598 01:03:53,341 --> 01:03:54,609 WOULD PERFORM THOSE ON ZOOM. 1599 01:03:54,609 --> 01:03:57,212 MANY OF THE KIDS REALLY ENJOYED 1600 01:03:57,212 --> 01:03:57,579 THAT. 1601 01:03:57,579 --> 01:03:58,580 WE ACTUALLY LEARNED THAT THIS 1602 01:03:58,580 --> 01:04:00,348 MIGHT BE A USEFUL MODEL FOR KIDS 1603 01:04:00,348 --> 01:04:02,283 THAT ARE IN THE HOSPITAL AND 1604 01:04:02,283 --> 01:04:03,051 CAN'T JOIN US EVERY YEAR. 1605 01:04:03,051 --> 01:04:04,085 PERHAPS IN THE FUTURE WE'LL 1606 01:04:04,085 --> 01:04:08,289 STILL BE ABLE TO HAVE THOSE KIDS 1607 01:04:08,289 --> 01:04:11,292 BE INCLUDED IN THIS FUN. 1608 01:04:11,292 --> 01:04:11,593 NEXT SLIDE. 1609 01:04:11,593 --> 01:04:13,695 SO, THIS IS THIS YEAR. 1610 01:04:13,695 --> 01:04:16,464 AGAIN FIRST YEAR BACK IN PERSON. 1611 01:04:16,464 --> 01:04:19,501 WE KEPT IT SMALL ON PURPOSE, 1612 01:04:19,501 --> 01:04:22,670 ABOUT 55 KIDS THIS YEAR JOINED 1613 01:04:22,670 --> 01:04:22,837 US. 1614 01:04:22,837 --> 01:04:26,374 WE WERE SELECTED ABOUT WHICH 1615 01:04:26,374 --> 01:04:27,675 PATIENTS TO BRING, STILL QUITE 1616 01:04:27,675 --> 01:04:34,916 WORRIED ABOUT COVID, WE WERE 1617 01:04:34,916 --> 01:04:35,550 SELECTIVE. 1618 01:04:35,550 --> 01:04:37,986 LIKE A CRUISE SHIP ON A MOUNTAIN 1619 01:04:37,986 --> 01:04:39,854 IN TERMS OF RISK, TOGETHER ALL 1620 01:04:39,854 --> 01:04:41,623 THE TIME, WE TOOK CONSERVATIVE 1621 01:04:41,623 --> 01:04:42,690 MEASURES, TESTING EACH PATIENT 1622 01:04:42,690 --> 01:04:45,093 TWICE BEFORE THEY SHOWED UP TO 1623 01:04:45,093 --> 01:04:47,529 CAMP, AND HAD PROTOCOLS IN PLACE 1624 01:04:47,529 --> 01:04:49,464 TO SORT OF MITIGATE ANY RISK 1625 01:04:49,464 --> 01:04:50,999 THAT WE HAVE. 1626 01:04:50,999 --> 01:04:52,367 DESPITE ALL OUR EFFORTS, WE HAD 1627 01:04:52,367 --> 01:04:55,303 A PATIENT CALL US ON MONDAY -- A 1628 01:04:55,303 --> 01:04:56,204 PATIENT'S MOTHER CALLED US ON 1629 01:04:56,204 --> 01:04:57,839 MONDAY SAYING SHE HAD JUST COME 1630 01:04:57,839 --> 01:04:58,940 DOWN WITH COVID. 1631 01:04:58,940 --> 01:05:00,675 AND DROPPED THE PATIENT OFF ON 1632 01:05:00,675 --> 01:05:00,909 SUNDAY. 1633 01:05:00,909 --> 01:05:04,646 AND SO WE HAD TO GO THROUGH OUR 1634 01:05:04,646 --> 01:05:06,147 PROTOCOLS TO AGAIN MAKE SURE 1635 01:05:06,147 --> 01:05:08,650 THAT WE WOULD NOT HAVE AN 1636 01:05:08,650 --> 01:05:09,517 OUTBREAK AT CAMP. 1637 01:05:09,517 --> 01:05:10,852 AND WE ACTUALLY WERE VERY 1638 01:05:10,852 --> 01:05:13,721 SUCCESSFUL IN DOING THAT THIS 1639 01:05:13,721 --> 01:05:14,355 YEAR. 1640 01:05:14,355 --> 01:05:15,190 NEXT SLIDE. 1641 01:05:15,190 --> 01:05:17,625 SO, WHO MAKES THIS HAPPEN? 1642 01:05:17,625 --> 01:05:20,628 SO, THIS IS SORT OF THE CORE 1643 01:05:20,628 --> 01:05:22,564 GROUP THAT REALLY IS SORT OF THE 1644 01:05:22,564 --> 01:05:23,798 DRIVING FORCE OF THIS. 1645 01:05:23,798 --> 01:05:28,736 I TOOK OVER A COUPLE YEARS BACK 1646 01:05:28,736 --> 01:05:31,172 FOR STEVE CHANOCK, OUR EMERITUS 1647 01:05:31,172 --> 01:05:33,041 MEDICAL DIRECTOR, KNOWN TO TELL 1648 01:05:33,041 --> 01:05:34,275 LOTS OF JOKES AT CAMP WITH A 1649 01:05:34,275 --> 01:05:36,244 GREAT SENSE OF HUMOR AND FUN 1650 01:05:36,244 --> 01:05:39,080 WITH THE KIDS. 1651 01:05:39,080 --> 01:05:39,981 NICOLE BINDER FROM THE PHARMACY 1652 01:05:39,981 --> 01:05:41,716 GROUPS COMES FOR THE WEEK AND 1653 01:05:41,716 --> 01:05:43,718 RUNS OUR PHARMACY. 1654 01:05:43,718 --> 01:05:47,388 YOU HEARD ABOUT DONNA GREGORY, 1655 01:05:47,388 --> 01:05:48,890 AN IMPORTANT PART OF RECREATION 1656 01:05:48,890 --> 01:05:52,560 THERAPY WE DELIVER OUT THERE. 1657 01:05:52,560 --> 01:05:54,128 AND THEN TAMMY JENKINS, MY RIGHT 1658 01:05:54,128 --> 01:05:56,798 HAND AS WE PUT TOGETHER ALL THE 1659 01:05:56,798 --> 01:05:58,132 DETAILS AND LOGISTICS OF 1660 01:05:58,132 --> 01:05:58,833 RECRUITING THE PATIENTS AND 1661 01:05:58,833 --> 01:06:00,702 GETTING TO KNOW THEM BEFORE WE 1662 01:06:00,702 --> 01:06:03,605 SHOW UP AT CAMP. 1663 01:06:03,605 --> 01:06:05,573 A FORMER PEDIATRIC ONCOLOGY 1664 01:06:05,573 --> 01:06:06,708 BRANCH ADMINISTRATIVE OFFICER 1665 01:06:06,708 --> 01:06:17,218 KATHY RUSSELL HELPS WITH ROW 1666 01:06:17,785 --> 01:06:23,558 LOGISTICS, AND WE PARTNER AND 1667 01:06:23,558 --> 01:06:25,426 DAVE STATE AND ANGELA ASHMAN 1668 01:06:25,426 --> 01:06:26,628 HELP US. 1669 01:06:26,628 --> 01:06:28,062 THE CLINICAL CENTER IS 1670 01:06:28,062 --> 01:06:29,130 INSTRUMENTAL. 1671 01:06:29,130 --> 01:06:31,132 YOU CAN SEE EVERY DEPARTMENT 1672 01:06:31,132 --> 01:06:33,501 THROWS IN SOME CONTRIBUTION TO 1673 01:06:33,501 --> 01:06:35,470 THIS FROM THE SHEETS WE NEED TO 1674 01:06:35,470 --> 01:06:37,772 BRING OUT THE CAMP, SHEETS AND 1675 01:06:37,772 --> 01:06:40,742 BLANKETS AND PILLOWS, TO THE 1676 01:06:40,742 --> 01:06:41,743 PHARMACY, TO THE LABORATORIES WE 1677 01:06:41,743 --> 01:06:44,345 NEED TO RUN UP HERE ON A SHUTTLE 1678 01:06:44,345 --> 01:06:47,348 EVERY DAY TO DO A CBC, 1679 01:06:47,348 --> 01:06:49,417 TRANSFUSION MEDICINE IF WE NEED 1680 01:06:49,417 --> 01:06:50,451 TO GIVE A PLATELET TRANSFUSION 1681 01:06:50,451 --> 01:06:52,920 AT CAMP WE CAN DO THAT. 1682 01:06:52,920 --> 01:06:53,788 IT'S A REMARKABLE TEAM EFFORT 1683 01:06:53,788 --> 01:06:55,423 FROM MANY DEPARTMENTS AT THE 1684 01:06:55,423 --> 01:06:57,892 CLINICAL CENTER. 1685 01:06:57,892 --> 01:06:59,727 NEXT SLIDE. 1686 01:06:59,727 --> 01:07:02,230 SO WHAT ARE WE REALLY DOING? 1687 01:07:02,230 --> 01:07:03,765 ABOUT A THIRD OF EFFORTS ARE 1688 01:07:03,765 --> 01:07:05,633 RECRUITMENT AND SCREENING OF NEW 1689 01:07:05,633 --> 01:07:07,535 PATIENTS, BRINGING THEM TO THE 1690 01:07:07,535 --> 01:07:09,771 CLINICAL CENTER AS A PATIENT. 1691 01:07:09,771 --> 01:07:12,140 THE PROTOCOL MANAGEMENT AND THEN 1692 01:07:12,140 --> 01:07:14,609 THE MED STAFF RECRUITING AND 1693 01:07:14,609 --> 01:07:15,410 CREDENTIALING. 1694 01:07:15,410 --> 01:07:17,378 WE REALLY GET A BROAD VARIETY OF 1695 01:07:17,378 --> 01:07:19,213 DIAGNOSES OUT THERE, COMMON 1696 01:07:19,213 --> 01:07:21,916 THINGS THAT HAPPEN IN 1697 01:07:21,916 --> 01:07:23,284 PEDIATRICS, LEUKEMIA, BRAIN 1698 01:07:23,284 --> 01:07:24,819 TUMORS, MANY SARCOMAS WE TAKE 1699 01:07:24,819 --> 01:07:26,954 FROM OUR PATIENT POPULATION HERE 1700 01:07:26,954 --> 01:07:29,657 AT THE NIH, AND SO ON AND SO 1701 01:07:29,657 --> 01:07:29,857 FORTH. 1702 01:07:29,857 --> 01:07:31,793 AND TO PULL THIS OFF IT REQUIRES 1703 01:07:31,793 --> 01:07:35,730 A LOT OF MEDICAL STAFF. 1704 01:07:35,730 --> 01:07:38,933 IT INCLUDES IN MOST CAMPS 45 1705 01:07:38,933 --> 01:07:41,936 MEDICAL STAFF PARTICIPATING. 1706 01:07:41,936 --> 01:07:42,437 NEXT SLIDE. 1707 01:07:42,437 --> 01:07:44,038 AND WHY IT TAKES SO MANY PEOPLE 1708 01:07:44,038 --> 01:07:46,541 IS BECAUSE WE LITERALLY BUILD 1709 01:07:46,541 --> 01:07:47,909 THE PEDIATRIC ONCOLOGY CLINIC AT 1710 01:07:47,909 --> 01:07:49,010 THE 4-H CENTER. 1711 01:07:49,010 --> 01:07:53,181 YOU CAN SEE SORT OF THE SETUP. 1712 01:07:53,181 --> 01:07:54,816 IT'S FULLY LOADED WITH ALL THE 1713 01:07:54,816 --> 01:08:00,188 EQUIPMENT WE MIGHT NEED FROM AN 1714 01:08:00,188 --> 01:08:03,891 EMERGENCY DEFIBRILLATOR TO FULLY 1715 01:08:03,891 --> 01:08:04,726 STOCKED PHARMACY FOR IV 1716 01:08:04,726 --> 01:08:06,027 ANTIBIOTICS OR ANYTHING WE MIGHT 1717 01:08:06,027 --> 01:08:07,995 NEED TO GIVE OUT AT CAMP. 1718 01:08:07,995 --> 01:08:09,731 AND YOU CAN SEE SORT OF THE 1719 01:08:09,731 --> 01:08:11,399 GROUP THAT PULLED THAT OFF THIS 1720 01:08:11,399 --> 01:08:14,335 YEAR DOWN IN THE BOTTOM CORNER, 1721 01:08:14,335 --> 01:08:19,006 A GROUP OF REALLY DEDICATED MED 1722 01:08:19,006 --> 01:08:20,108 STAFF. 1723 01:08:20,108 --> 01:08:21,542 NEXT SLIDE. 1724 01:08:21,542 --> 01:08:23,411 AGAIN, WE HAVE FULLY STOCKED 1725 01:08:23,411 --> 01:08:25,613 EVERYTHING, AND EVERY DAY WE ARE 1726 01:08:25,613 --> 01:08:27,448 CALLING THE CLINICAL CENTER AND 1727 01:08:27,448 --> 01:08:29,550 SAYING WE NEED MORE ACE 1728 01:08:29,550 --> 01:08:34,021 BANDAGES, WE NEED MORE MIRALAX, 1729 01:08:34,021 --> 01:08:35,757 MORE TYLENOL, AND THOSE THINGS 1730 01:08:35,757 --> 01:08:39,327 ARE SORT OF DELIVERED REMARKABLY 1731 01:08:39,327 --> 01:08:40,128 EFFICIENTLY BY THE CLINICAL 1732 01:08:40,128 --> 01:08:42,330 CENTER SO IT'S REALLY A GREAT 1733 01:08:42,330 --> 01:08:43,498 SUPPORTIVE OPERATION TO BE ABLE 1734 01:08:43,498 --> 01:08:46,100 TO ASK AND JUST TO KNOW WE HAVE 1735 01:08:46,100 --> 01:08:47,402 THE SUPPORT OF THE CLINICAL 1736 01:08:47,402 --> 01:08:51,172 CENTER BEHIND US OUT THERE. 1737 01:08:51,172 --> 01:08:52,640 NEXT SLIDE. 1738 01:08:52,640 --> 01:08:56,043 SO, THE MEDICAL TEAM, YOU KNOW, 1739 01:08:56,043 --> 01:08:56,978 WHAT ARE WE DOING? 1740 01:08:56,978 --> 01:08:58,913 REALLY IT'S IMPORTANT WE HAVE A 1741 01:08:58,913 --> 01:09:00,715 CORE GROUP THAT'S VERY DEDICATED 1742 01:09:00,715 --> 01:09:03,351 AND HAS A GREAT SENSE OF 1743 01:09:03,351 --> 01:09:03,684 COMMUNICATION. 1744 01:09:03,684 --> 01:09:06,654 ONE THING I'LL SAY ABOUT THIS IS 1745 01:09:06,654 --> 01:09:07,622 WE'RE HIGHLY RELIANT ON THE 1746 01:09:07,622 --> 01:09:09,957 STAFF THAT WE BRING OUT THERE. 1747 01:09:09,957 --> 01:09:14,796 AND WHAT I MEAN BY THAT IS WE 1748 01:09:14,796 --> 01:09:17,165 HAVE MULTIPLE PEDIATRIC 1749 01:09:17,165 --> 01:09:19,233 ONCOLOGISTS WHO COME FROM 1750 01:09:19,233 --> 01:09:21,602 PEDIATRIC ONCOLOGY BRANCH AND 1751 01:09:21,602 --> 01:09:24,038 SUPPORT THIS, PEDIATRIC NURSES 1752 01:09:24,038 --> 01:09:24,939 CAN GIVE CHEMOTHERAPY REGIMENS 1753 01:09:24,939 --> 01:09:28,409 AT CAMP AND BROADER NURSING, BUT 1754 01:09:28,409 --> 01:09:29,777 THE CAMP HAS HISTORICALLY RELIED 1755 01:09:29,777 --> 01:09:33,514 ON SOMETHING CALLED A SPECIAL 1756 01:09:33,514 --> 01:09:33,781 VOLUNTEER. 1757 01:09:33,781 --> 01:09:34,549 A SPECIAL VOLUNTEER WOULD FOR 1758 01:09:34,549 --> 01:09:37,051 INSTANCE BE A NURSE FROM AN 1759 01:09:37,051 --> 01:09:38,419 INSTITUTION THAT WAS SENDING 1760 01:09:38,419 --> 01:09:39,320 PATIENTS TO US. 1761 01:09:39,320 --> 01:09:41,088 A NURSE WHO TAKES CARE OF THOSE 1762 01:09:41,088 --> 01:09:44,325 PATIENTS DAY IN AND DAY OUT AT 1763 01:09:44,325 --> 01:09:45,693 NOVA OR RICHMOND AND THEY COULD 1764 01:09:45,693 --> 01:09:47,128 SEND SOME OF THEIR STAFF AS WELL 1765 01:09:47,128 --> 01:09:50,832 TO SORT OF HELP US KNOW THOSE 1766 01:09:50,832 --> 01:09:52,500 PATIENTS AND TO GIVE US 1767 01:09:52,500 --> 01:09:53,968 ADDITIONAL FEEDBACK AND HAVE THE 1768 01:09:53,968 --> 01:09:55,903 KIDS FEEL LIKE PART OF THEIR 1769 01:09:55,903 --> 01:09:57,772 TEAM IS ALSO AT CAMP. 1770 01:09:57,772 --> 01:09:59,707 AND SO WE'VE BEEN RELIANT ON 1771 01:09:59,707 --> 01:10:00,208 THOSE. 1772 01:10:00,208 --> 01:10:02,343 THIS YEAR WE SORT OF RAN INTO 1773 01:10:02,343 --> 01:10:03,544 SOME ISSUES WHERE THE NIH STAFF 1774 01:10:03,544 --> 01:10:06,047 HAD TO SORT OF CARRY A LITTLE 1775 01:10:06,047 --> 01:10:07,448 BIT HEAVIER LOAD, AND WE HAVE 1776 01:10:07,448 --> 01:10:08,382 WORKAROUNDS TO DO THAT. 1777 01:10:08,382 --> 01:10:10,084 WE DID PULL IT OFF BUT THE 1778 01:10:10,084 --> 01:10:12,854 SPECIAL VOLUNTEER I THINK IS AN 1779 01:10:12,854 --> 01:10:13,855 IMPORTANT FEATURE OF CAMP THAT 1780 01:10:13,855 --> 01:10:16,257 WE WOULD LIKE TO KEEP MOVING 1781 01:10:16,257 --> 01:10:16,824 FORWARD. 1782 01:10:16,824 --> 01:10:19,727 NEXT SLIDE. 1783 01:10:19,727 --> 01:10:22,697 THIS IS A TYPICAL DAY FOR THE 1784 01:10:22,697 --> 01:10:23,064 MED STAFF. 1785 01:10:23,064 --> 01:10:25,700 YOU KNOW, IT'S A LOT OF BUMPS 1786 01:10:25,700 --> 01:10:27,335 AND BRUISES, WHEN THESE KIDS ARE 1787 01:10:27,335 --> 01:10:28,836 OUT RUNNING AROUND DOING FUN 1788 01:10:28,836 --> 01:10:29,203 THINGS. 1789 01:10:29,203 --> 01:10:31,372 WE HAVE A FULL LABORATORY SET UP 1790 01:10:31,372 --> 01:10:34,208 SO WE, AGAIN, CAN DO THINGS LIKE 1791 01:10:34,208 --> 01:10:36,611 BLOOD WORK FOR OUR PATIENTS. 1792 01:10:36,611 --> 01:10:39,113 WE PUT A TON OF SUNSCREEN AND 1793 01:10:39,113 --> 01:10:40,114 BUG SPRAY ON OUR PATIENTS. 1794 01:10:40,114 --> 01:10:42,216 I THINK IT MIGHT BE A SPECIFIC 1795 01:10:42,216 --> 01:10:43,951 LINE ITEM IN THE CLINICAL CENTER 1796 01:10:43,951 --> 01:10:46,153 BUDGET, THE BUG SPRAY AND 1797 01:10:46,153 --> 01:10:47,889 SUNSCREEN WE PROVIDE OUT THERE. 1798 01:10:47,889 --> 01:10:49,423 IF WE HAVE A PATIENT THAT WE'RE 1799 01:10:49,423 --> 01:10:51,959 CONCERNED ABOUT WHO MIGHT BE 1800 01:10:51,959 --> 01:10:54,929 NEUTROPENIC OR AT HIGHER RISK, 1801 01:10:54,929 --> 01:10:56,430 WE'LL DO VITALS AND WE SEE THESE 1802 01:10:56,430 --> 01:10:58,466 PATIENTS AT LEAST THREE TIMES A 1803 01:10:58,466 --> 01:11:01,135 DAY WHAT WE CALL MEDLINE, THEY 1804 01:11:01,135 --> 01:11:03,170 GET MEDICINES AND CHECK IN WITH 1805 01:11:03,170 --> 01:11:05,773 NURSES AND CHECK IN WITH THE 1806 01:11:05,773 --> 01:11:08,476 DOCTOR WHO IS ON CALL. 1807 01:11:08,476 --> 01:11:09,243 YOU KNOW, THE REALITY IS A LOT 1808 01:11:09,243 --> 01:11:12,113 OF WHAT I DO AND WHAT SOME OTHER 1809 01:11:12,113 --> 01:11:15,650 STAFF DO ARE WE'RE SORT OF THE 1810 01:11:15,650 --> 01:11:18,319 PARENT AT CAMP. 1811 01:11:18,319 --> 01:11:20,621 AND SO HOMESICKNESS, STOMACH 1812 01:11:20,621 --> 01:11:21,722 ACHES, MY FRIENDS AREN'T PLAYING 1813 01:11:21,722 --> 01:11:23,591 WITH ME THE WAY I WANT TO PLAY 1814 01:11:23,591 --> 01:11:25,660 WITH THEM, I WANT TO DO THIS AND 1815 01:11:25,660 --> 01:11:26,894 I CAN'T DO THAT, MANY TIMES 1816 01:11:26,894 --> 01:11:28,262 WE'RE SORT OF SOLVING THOSE SORT 1817 01:11:28,262 --> 01:11:32,099 OF PROBLEMS RATHER THAN MAJOR 1818 01:11:32,099 --> 01:11:32,567 MEDICAL THINGS. 1819 01:11:32,567 --> 01:11:34,368 AND IF YOU CLICK THROUGH TO THE 1820 01:11:34,368 --> 01:11:36,938 NEXT SLIDE, A BIG PART OF WHAT 1821 01:11:36,938 --> 01:11:40,675 WE ALSO DO IS ENTERTAINMENT. 1822 01:11:40,675 --> 01:11:42,810 KIDS REALLY LOVE TO SEE THEIR 1823 01:11:42,810 --> 01:11:45,980 DOCTOR MAKE A FOOL OF HIMSELF BY 1824 01:11:45,980 --> 01:11:48,015 SMASHING RAW EGGS ON HIS HEAD. 1825 01:11:48,015 --> 01:11:48,883 THIS IS I THINK A LOT OF THE 1826 01:11:48,883 --> 01:11:51,385 PART OF WHAT WE DO IS SORT OF 1827 01:11:51,385 --> 01:11:53,387 TAKE OFF THE WHITE COAT AND HAVE 1828 01:11:53,387 --> 01:11:54,922 FUN AND BE SILLY AND THE KIDS 1829 01:11:54,922 --> 01:11:57,024 SEE THAT AND THEY SAY, WOW, THIS 1830 01:11:57,024 --> 01:11:58,359 IS NOT THE SAME PERSON THAT I 1831 01:11:58,359 --> 01:12:00,061 SEE IN THE CLINIC. 1832 01:12:00,061 --> 01:12:01,696 SO THIS IS AN IMPORTANT PART OF 1833 01:12:01,696 --> 01:12:06,534 WHAT WE DO. 1834 01:12:06,534 --> 01:12:07,268 NEXT SLIDE. 1835 01:12:07,268 --> 01:12:09,236 A BIG FEATURE EVERY YEAR IS THE 1836 01:12:09,236 --> 01:12:10,738 TALENT SHOW. 1837 01:12:10,738 --> 01:12:12,506 AND YOU SEE THAT THERE'S 1838 01:12:12,506 --> 01:12:13,774 FREQUENTLY SOME CELEBRITIES THAT 1839 01:12:13,774 --> 01:12:16,410 WILL COME OUT AND PERFORM FOR 1840 01:12:16,410 --> 01:12:16,677 US. 1841 01:12:16,677 --> 01:12:18,346 DR. COLLINS HAS ALWAYS BEEN A 1842 01:12:18,346 --> 01:12:21,048 GREAT SUPPORTER OF THIS. 1843 01:12:21,048 --> 01:12:25,152 AND HAS REALLY A REMARKABLE 1844 01:12:25,152 --> 01:12:26,954 CAPACITY TO GENERATE CAMP SONGS. 1845 01:12:26,954 --> 01:12:29,090 HE HAS A REAL TALENT FOR THIS. 1846 01:12:29,090 --> 01:12:30,925 THE ONE THING THAT I WANT TO 1847 01:12:30,925 --> 01:12:33,828 MENTION IS, YOU KNOW, THE TALENT 1848 01:12:33,828 --> 01:12:35,396 SHOW COULD GO ON FOR QUITE SOME 1849 01:12:35,396 --> 01:12:38,132 TIME AND BE KIND OF PAINFUL AT 1850 01:12:38,132 --> 01:12:39,000 TIMES TO WATCH. 1851 01:12:39,000 --> 01:12:42,169 BUT THIS YEAR WE HAD A REALLY 1852 01:12:42,169 --> 01:12:43,871 REMARKABLE SKIT, YOU'LL SEE THAT 1853 01:12:43,871 --> 01:12:45,139 IN THE BOTTOM LEFT-HAND CORNER 1854 01:12:45,139 --> 01:12:46,107 THERE. 1855 01:12:46,107 --> 01:12:47,408 FIRST TIME I'VE SEEN THIS GOING 1856 01:12:47,408 --> 01:12:49,577 THERE FOR 15 YEARS. 1857 01:12:49,577 --> 01:12:51,245 THESE LITTLE BOYS STUFFED THEIR 1858 01:12:51,245 --> 01:12:53,447 SHIRTS AS MUSCLE MEN, AND 1859 01:12:53,447 --> 01:12:55,549 PERFORMED THREE MINUTES OF 1860 01:12:55,549 --> 01:12:56,851 FLEXING TO SOME MUSIC. 1861 01:12:56,851 --> 01:13:00,187 THE CROWD JUST WENT WILD. 1862 01:13:00,187 --> 01:13:01,622 THIS WAS HIGHLY RATED, THE TOP 1863 01:13:01,622 --> 01:13:06,694 SKIT OF THE YEAR OF THE TALENT 1864 01:13:06,694 --> 01:13:06,894 SHOW. 1865 01:13:06,894 --> 01:13:10,197 NEXT SLIDE. 1866 01:13:10,197 --> 01:13:10,998 WE TAKE THEM SWIMMING. 1867 01:13:10,998 --> 01:13:13,067 THIS IS A PATIENT WHO IS 1868 01:13:13,067 --> 01:13:14,068 WHEELCHAIR BOUND, HAD NEVER BEEN 1869 01:13:14,068 --> 01:13:15,136 IN A POOL. 1870 01:13:15,136 --> 01:13:18,305 THE COUNSELORS FIGURED OUT A WAY 1871 01:13:18,305 --> 01:13:20,574 TO WRAP HIM IN FLOTATION DEVICE 1872 01:13:20,574 --> 01:13:23,878 AND GET HIM INTO THE POOL FOR 1873 01:13:23,878 --> 01:13:26,547 THE FIRST TIME AND SO WE DO 1874 01:13:26,547 --> 01:13:27,415 REALLY INCREDIBLE THINGS LIKE 1875 01:13:27,415 --> 01:13:29,483 THAT AND TO SEE THE SMILE ON 1876 01:13:29,483 --> 01:13:32,620 THESE KIDS' FACES WHEN THEY DO 1877 01:13:32,620 --> 01:13:34,455 SOMETHING LIKE DO KARATE OR PET 1878 01:13:34,455 --> 01:13:36,957 A BABY GOAT AT FARM DAY IS 1879 01:13:36,957 --> 01:13:42,096 REALLY A REMARKABLE THING. 1880 01:13:42,096 --> 01:13:43,030 NEXT SLIDE. 1881 01:13:43,030 --> 01:13:44,065 WE HAVE THAT BEAUTIFUL LAKE 1882 01:13:44,065 --> 01:13:46,634 THERE WHERE WE CAN DO THINGS 1883 01:13:46,634 --> 01:13:49,203 LIKE FISHING TOURNAMENT, WE HAVE 1884 01:13:49,203 --> 01:13:53,574 A CREEK WHERE THEY DO CREEPY 1885 01:13:53,574 --> 01:13:54,675 CREEK CRITTERS AND PULL WEIRD 1886 01:13:54,675 --> 01:13:55,876 THINGS FROM UNDER ROCKS. 1887 01:13:55,876 --> 01:13:57,745 TEENS CAN DO A THING CALLED THE 1888 01:13:57,745 --> 01:14:00,915 TEEN CHALLENGE, WHERE THIS IS A 1889 01:14:00,915 --> 01:14:05,486 ROPES COURSE WITH ZIP LINES AND 1890 01:14:05,486 --> 01:14:06,887 THINGS LIKE CLIMBING WALLS WHERE 1891 01:14:06,887 --> 01:14:08,723 THEY CAN CHALLENGE THEMSELVES TO 1892 01:14:08,723 --> 01:14:11,358 DO SOMETHING, BUILDING 1893 01:14:11,358 --> 01:14:12,526 CONFIDENCE, BUILDING TEAM WORK, 1894 01:14:12,526 --> 01:14:14,862 AND DOING REALLY INCREDIBLE 1895 01:14:14,862 --> 01:14:15,229 THINGS. 1896 01:14:15,229 --> 01:14:17,064 YOU'LL SEE ONE BOY DOING THE 1897 01:14:17,064 --> 01:14:18,933 LEAP OF FAITH, WHERE YOU CLIMB 1898 01:14:18,933 --> 01:14:21,335 TO THE TOP OF A 50-FOOT POLE, 1899 01:14:21,335 --> 01:14:23,537 PULL YOURSELF ONTO THE TOP OF 1900 01:14:23,537 --> 01:14:26,607 THAT AND THEN THROW YOURSELF OFF 1901 01:14:26,607 --> 01:14:27,007 TOWARDS THAT BALL. 1902 01:14:27,007 --> 01:14:28,743 THIS IS SOMETHING THAT I'VE 1903 01:14:28,743 --> 01:14:30,077 NEVER DONE BUT I LOVE TO WATCH 1904 01:14:30,077 --> 01:14:33,147 THEM DO IT BECAUSE IT REALLY IS 1905 01:14:33,147 --> 01:14:36,550 INCREDIBLE THING TO WATCH THESE 1906 01:14:36,550 --> 01:14:37,318 KIDS PUSH THEMSELVES TO DO 1907 01:14:37,318 --> 01:14:39,420 SOMETHING THAT THEY ARE NOT USED 1908 01:14:39,420 --> 01:14:43,124 TO DOING. 1909 01:14:43,124 --> 01:14:45,292 NEXT SLIDE. 1910 01:14:45,292 --> 01:14:53,267 DONNA HAS RUN A PROGRAM CALLED 1911 01:14:53,267 --> 01:14:54,268 MINAHOONEY SCIENCE CAMP TEACHING 1912 01:14:54,268 --> 01:14:56,270 ABOUT DNA AND THINGS WE MAKE UP 1913 01:14:56,270 --> 01:14:57,371 ABOUT SCIENCE, A FUN PROGRAM 1914 01:14:57,371 --> 01:15:01,609 THROUGH THE WEEK DOING THAT. 1915 01:15:01,609 --> 01:15:03,010 WE HAVE HORSES, HORSEBACK RIDING 1916 01:15:03,010 --> 01:15:04,311 CLASS, WOOD WORKING OR OTHER 1917 01:15:04,311 --> 01:15:05,780 CLASSES SET UP FOR THEM. 1918 01:15:05,780 --> 01:15:07,615 A BIG FEATURE OF THIS IS WE ALSO 1919 01:15:07,615 --> 01:15:11,619 GIVE THEM A LOT OF SUGAR THROUGH 1920 01:15:11,619 --> 01:15:13,454 THE WEEK. 1921 01:15:13,454 --> 01:15:14,388 NEXT SLIDE. 1922 01:15:14,388 --> 01:15:16,190 SO, LISTEN, I REALLY APPRECIATE 1923 01:15:16,190 --> 01:15:18,392 THE TIME TO COME OUT HERE AND 1924 01:15:18,392 --> 01:15:20,961 TELL YOU ABOUT THIS WONDERFUL 1925 01:15:20,961 --> 01:15:21,262 PROGRAM. 1926 01:15:21,262 --> 01:15:23,898 I HOPE THAT AS YOU SEE THIS, YOU 1927 01:15:23,898 --> 01:15:26,133 WILL WANT TO SUPPORT US AND GET 1928 01:15:26,133 --> 01:15:27,034 INVOLVED. 1929 01:15:27,034 --> 01:15:30,204 WE GO OUT EVERY AUGUST FOR ONE 1930 01:15:30,204 --> 01:15:30,638 WEEK. 1931 01:15:30,638 --> 01:15:31,872 AND YOU CERTAINLY WOULD BE 1932 01:15:31,872 --> 01:15:33,874 INVITED TO COME ON VISITOR NIGHT 1933 01:15:33,874 --> 01:15:36,076 TO SEE THIS LIVE AND IN PERSON. 1934 01:15:36,076 --> 01:15:37,411 SO, AGAIN, I APPRECIATE YOUR 1935 01:15:37,411 --> 01:15:39,113 TIME AND WOULD TAKE ANY 1936 01:15:39,113 --> 01:15:47,121 QUESTIONS THAT COME UP. 1937 01:15:47,121 --> 01:15:47,988 >> GREAT. 1938 01:15:47,988 --> 01:15:49,290 >> THE PROGRAM LOOKS 1939 01:15:49,290 --> 01:15:49,590 OUTSTANDING. 1940 01:15:49,590 --> 01:15:51,926 THANKS FOR THE GREAT OVERVIEW. 1941 01:15:51,926 --> 01:15:54,195 HAVE THERE BEEN ANY OTHER 1942 01:15:54,195 --> 01:15:55,763 CLINICAL CENTERS AROUND THE 1943 01:15:55,763 --> 01:15:58,399 COUNTRY THAT HAVE TRIED TO 1944 01:15:58,399 --> 01:15:59,266 REPLICATE THIS? 1945 01:15:59,266 --> 01:16:01,535 MODELED AFTER THE GREAT WORK 1946 01:16:01,535 --> 01:16:02,303 YOU'VE DONE? 1947 01:16:02,303 --> 01:16:04,972 >> YEAH, IT'S ACTUALLY 1948 01:16:04,972 --> 01:16:05,272 REMARKABLE. 1949 01:16:05,272 --> 01:16:11,111 THERE'S NOW AN ORGANIZATION 1950 01:16:11,111 --> 01:16:11,846 CALLED COCA, CAMPING 1951 01:16:11,846 --> 01:16:14,582 ORGANIZATION SPECIFICALLY 1952 01:16:14,582 --> 01:16:15,783 DEDICATED TO ORGANIZE MULTIPLE 1953 01:16:15,783 --> 01:16:17,051 CAMPS RUN ACROSS THE COUNTRY, 1954 01:16:17,051 --> 01:16:18,853 OURS WAS ONE OF THE FIRST BUT 1955 01:16:18,853 --> 01:16:21,088 IT'S NOW REPLICATED IN MANY 1956 01:16:21,088 --> 01:16:22,623 PLACES ACROSS THE COUNTRY. 1957 01:16:22,623 --> 01:16:25,326 MOST OF THE BIG PEDIATRIC 1958 01:16:25,326 --> 01:16:27,828 ONCOLOGY CENTERS WILL HAVE A 1959 01:16:27,828 --> 01:16:32,566 CAMP IN THEIR GEOGRAPHIC REGION, 1960 01:16:32,566 --> 01:16:33,734 AND WE ACTUALLY PERIODICALLY 1961 01:16:33,734 --> 01:16:35,269 WILL TRAVEL AROUND AND SEE HOW 1962 01:16:35,269 --> 01:16:37,137 OTHER CAMPS ARE DOING IT AND 1963 01:16:37,137 --> 01:16:39,807 HAVE OTHER CAMPS COME IN AND SEE 1964 01:16:39,807 --> 01:16:43,110 HOW WE DO IT AND SO WE SHARE 1965 01:16:43,110 --> 01:16:46,046 INFORMATION ACROSS THE CAMPS. 1966 01:16:46,046 --> 01:16:53,787 1967 01:16:53,787 --> 01:17:01,028 >> [ OFF MIC ] 1968 01:17:01,028 --> 01:17:11,238 (INAUDIBLE) 1969 01:17:22,549 --> 01:17:27,187 1970 01:17:27,187 --> 01:17:27,721 >> DR. DEVASKAR? 1971 01:17:27,721 --> 01:17:29,223 >> CAN YOU HEAR ME? 1972 01:17:29,223 --> 01:17:29,757 >> YES. 1973 01:17:29,757 --> 01:17:30,324 >> THANK YOU. 1974 01:17:30,324 --> 01:17:32,793 THANK YOU FOR THE WONDERFUL 1975 01:17:32,793 --> 01:17:33,227 PRESENTATION, HAVING 1976 01:17:33,227 --> 01:17:34,828 PARTICIPATED IN CAMPS MYSELF. 1977 01:17:34,828 --> 01:17:36,196 I WONDERED ABOUT THE FUNDING, IS 1978 01:17:36,196 --> 01:17:41,635 IT ALL FROM NIH OR DO YOU HAVE 1979 01:17:41,635 --> 01:17:42,503 SOME PRIVATE PARTNERSHIPS? 1980 01:17:42,503 --> 01:17:44,705 >> YEAH, THE MEDICAL SUPPORT 1981 01:17:44,705 --> 01:17:48,642 COMES FROM THE CLINICAL CENTER, 1982 01:17:48,642 --> 01:17:53,347 AND THEN THIS 501(c)3 A LONG 1983 01:17:53,347 --> 01:17:55,082 TERM PARTNERS CALLED SPECIAL 1984 01:17:55,082 --> 01:17:57,017 LOVE IS -- THEY ARE REALLY IN 1985 01:17:57,017 --> 01:17:58,852 CHARGE OF THE PROGRAMMING AND 1986 01:17:58,852 --> 01:18:01,322 SORT OF THE PATIENT COLLECTION, 1987 01:18:01,322 --> 01:18:03,424 AND HELPING US PULL OFF THE 1988 01:18:03,424 --> 01:18:05,693 CAMP. 1989 01:18:05,693 --> 01:18:08,228 SO THEY DO A LARGE -- THEY DO 1990 01:18:08,228 --> 01:18:09,930 HAVE A LARGE PARTNERSHIP WITH US 1991 01:18:09,930 --> 01:18:12,833 IN PULLING THIS OFF, SO THAT IS 1992 01:18:12,833 --> 01:18:13,600 OUR FUNDING STREAM. 1993 01:18:13,600 --> 01:18:16,437 >> THANK YOU. 1994 01:18:16,437 --> 01:18:19,106 1995 01:18:19,106 --> 01:18:20,074 >> GO AHEAD. 1996 01:18:20,074 --> 01:18:20,407 >> SORRY. 1997 01:18:20,407 --> 01:18:22,476 IF YOU EVER NEED -- I LIVE 20 1998 01:18:22,476 --> 01:18:24,778 MINUTES FROM HERE, IF YOU NEED 1999 01:18:24,778 --> 01:18:26,046 VOLUNTEERS TO DRIVE STUFF DOWN 2000 01:18:26,046 --> 01:18:27,982 TO FRONT ROYAL I'D BE HAPPY TO 2001 01:18:27,982 --> 01:18:28,749 DO IT. 2002 01:18:28,749 --> 01:18:33,620 >> I'M GROWING TO WRITE YOUR 2003 01:18:33,620 --> 01:18:35,356 NAME DOWN, YEAH. 2004 01:18:35,356 --> 01:18:36,857 >> SO RANDY SCHOOLS WAS 2005 01:18:36,857 --> 01:18:39,226 ADMINISTRATOR HERE INVOLVED I 2006 01:18:39,226 --> 01:18:41,428 BELIEVE WITH DR. PIZO SETTING UP 2007 01:18:41,428 --> 01:18:42,763 THE INITIAL CAMP. 2008 01:18:42,763 --> 01:18:44,932 FIRST, JACK, WE EXPECT GREAT 2009 01:18:44,932 --> 01:18:46,233 THINGS SINCE DR. PIZO WAS THE 2010 01:18:46,233 --> 01:18:48,268 DEAN OF THE SCHOOL OF MEDICINE 2011 01:18:48,268 --> 01:18:49,169 AT STANFORD WE'RE EXPECTING THE 2012 01:18:49,169 --> 01:18:53,340 SAME OUT OF YOU SOMEDAY. 2013 01:18:53,340 --> 01:18:53,674 >> SURE. 2014 01:18:53,674 --> 01:18:55,275 >> RANDY SCHOOLS WAS THE 2015 01:18:55,275 --> 01:18:56,076 ADMINISTRATOR. 2016 01:18:56,076 --> 01:18:57,311 ONE OF RANDY'S FAVORITE STORIES 2017 01:18:57,311 --> 01:18:58,746 IS TALKS ABOUT HIS SECRETARY 2018 01:18:58,746 --> 01:19:02,249 RUNNING INTO HIS OFFICE ONE DAY 2019 01:19:02,249 --> 01:19:03,517 AND SAID, MR. SCHOOLS, PAUL 2020 01:19:03,517 --> 01:19:04,885 NEWMAN IS ON THE PHONE, WOULD 2021 01:19:04,885 --> 01:19:06,720 LIKE TO TALK TO YOU. 2022 01:19:06,720 --> 01:19:09,590 I THINK YOU CAN SEE THAT. 2023 01:19:09,590 --> 01:19:11,925 THE WAY THE CAMP RUNS IS A 2024 01:19:11,925 --> 01:19:18,532 PARADIGM FOR THE WAY WE DO 2025 01:19:18,532 --> 01:19:18,799 RESEARCH. 2026 01:19:18,799 --> 01:19:20,868 YOU PLAN EVERYTHING. 2027 01:19:20,868 --> 01:19:23,570 YOU OVERRESOURCE. 2028 01:19:23,570 --> 01:19:24,938 AND YOU HAVE CONTINGENCY PLANS 2029 01:19:24,938 --> 01:19:27,541 FOR THINGS YOU DIDN'T PLAN. 2030 01:19:27,541 --> 01:19:31,945 IT IS ACTUALLY THE WAY YOU -- 2031 01:19:31,945 --> 01:19:36,617 IT'S A PERFECT PARADIGM FOR 2032 01:19:36,617 --> 01:19:39,620 CONDUCTING HIGH RISK, VERY 2033 01:19:39,620 --> 01:19:41,121 COMPLEX FIRST-IN-HUMAN KINDS OF 2034 01:19:41,121 --> 01:19:41,455 PROTOCOLS. 2035 01:19:41,455 --> 01:19:45,793 AND IT CAME TO ME IN MY FIRST 2036 01:19:45,793 --> 01:19:48,762 VISIT OUT THERE THAT THEY DO 2037 01:19:48,762 --> 01:19:50,431 EVERY YEAR WHAT WE DO EVERY TIME 2038 01:19:50,431 --> 01:19:57,538 WE SET UP A NEW PROTOCOL, WHAT 2039 01:19:57,538 --> 01:19:58,172 IT'S GOING TO INVOLVE. 2040 01:19:58,172 --> 01:20:00,574 JACK TALKED A LITTLE BIT ABOUT 2041 01:20:00,574 --> 01:20:03,444 THE CHALLENGES OF STAFFING. 2042 01:20:03,444 --> 01:20:05,079 AND I'LL TALK UNTIL NINA TELLS 2043 01:20:05,079 --> 01:20:09,683 ME OR TARA TELLS ME I HAVE TO 2044 01:20:09,683 --> 01:20:12,953 SHUT UP BUT WE -- DUE TO SOME 2045 01:20:12,953 --> 01:20:15,589 INTERPRETATIONS OF THE FEDERAL 2046 01:20:15,589 --> 01:20:19,393 TORT CLAIMS ACT, WE NO LONGER 2047 01:20:19,393 --> 01:20:20,394 CAN TELL VOLUNTEERS THAT THEY 2048 01:20:20,394 --> 01:20:22,996 ARE GOING TO BE COVERED. 2049 01:20:22,996 --> 01:20:26,333 NOW, WE HAVE THE SUPPORT OF THE 2050 01:20:26,333 --> 01:20:28,902 NIH LEADERSHIP AND DR. SCHOR IS 2051 01:20:28,902 --> 01:20:30,137 AMONG OUR BIGGEST SUPPORTERS TO 2052 01:20:30,137 --> 01:20:33,774 TRY TO GET SOMETHING DONE ABOUT 2053 01:20:33,774 --> 01:20:33,974 THAT. 2054 01:20:33,974 --> 01:20:37,878 AND IT'S NOT JUST AT CAMP 2055 01:20:37,878 --> 01:20:39,146 FANTASTIC. 2056 01:20:39,146 --> 01:20:41,415 THERE ARE OTHER ASPECTS OF THE 2057 01:20:41,415 --> 01:20:44,818 OPERATION AT THE NIH WHERE 2058 01:20:44,818 --> 01:20:46,353 RETIREES, PEOPLE WHO HAVE 2059 01:20:46,353 --> 01:20:47,988 COLLABORATED WITH THE NIH FOR 2060 01:20:47,988 --> 01:20:50,190 YEARS AND YEARS AND NOW ARE 2061 01:20:50,190 --> 01:20:52,693 RETIRED AND WANT TO CONTINUE TO 2062 01:20:52,693 --> 01:20:55,896 BE INVOLVED, WE HAVE A NUMBER OF 2063 01:20:55,896 --> 01:21:00,667 OTHER AREAS WHERE THE USE OF 2064 01:21:00,667 --> 01:21:01,502 VOLUNTEERS IS REALLY, REALLY 2065 01:21:01,502 --> 01:21:01,869 IMPORTANT. 2066 01:21:01,869 --> 01:21:07,174 WE HAVE TO BE ABLE TO ASSURE 2067 01:21:07,174 --> 01:21:07,441 THEM. 2068 01:21:07,441 --> 01:21:11,011 ANOTHER POINT TO MAKE IS THAT 2069 01:21:11,011 --> 01:21:13,046 OTHER FEDERAL AGENCIES HAVE BEEN 2070 01:21:13,046 --> 01:21:17,084 ABLE TO INCORPORATE THE COVERAGE 2071 01:21:17,084 --> 01:21:19,486 OF FTCA INTO LAW, AND WE WILL 2072 01:21:19,486 --> 01:21:21,588 ADVOCATE FOR THE SAME THING AND 2073 01:21:21,588 --> 01:21:23,590 KEEP PUSHING AS HARD AS WE CAN 2074 01:21:23,590 --> 01:21:24,658 UNTIL WE GET THE SAME 2075 01:21:24,658 --> 01:21:32,733 PROTECTION. 2076 01:21:32,733 --> 01:21:37,204 2077 01:21:37,204 --> 01:21:41,775 >> THIS IS THE THIRD TIME THIS 2078 01:21:41,775 --> 01:21:49,516 HAS HAPPENED, ABOUT 20 YEARS AGO 2079 01:21:49,516 --> 01:21:51,618 (INAUDIBLE) SO WE COULD BRING 2080 01:21:51,618 --> 01:21:52,786 VOLUNTEERS WHO ACTUALLY COULD DO 2081 01:21:52,786 --> 01:21:55,489 THINGS IN THE CLINICAL 2082 01:21:55,489 --> 01:21:55,856 DEPARTMENT. 2083 01:21:55,856 --> 01:21:57,758 FIFTEEN YEARS AGO THIS CAME UP 2084 01:21:57,758 --> 01:21:58,158 AGAIN. 2085 01:21:58,158 --> 01:21:59,826 AND, YOU KNOW, I HOPE THIS IS A 2086 01:21:59,826 --> 01:22:03,764 CYCLE THAT WE'RE AT THE BOTTOM 2087 01:22:03,764 --> 01:22:05,032 AND COME BACK VERY SOON. 2088 01:22:05,032 --> 01:22:07,768 >> IT'S WHY WE NEED TO GET IT 2089 01:22:07,768 --> 01:22:14,441 WRITTEN DOWN AND IN LAW. 2090 01:22:14,441 --> 01:22:17,611 >> THIS AFFECTS -- DOES THIS 2091 01:22:17,611 --> 01:22:18,278 PROBLEM AFFECT SPECIAL 2092 01:22:18,278 --> 01:22:22,249 VOLUNTEERS LIKE I AM TO NIH AS 2093 01:22:22,249 --> 01:22:23,250 WELL AS SGEs? 2094 01:22:23,250 --> 01:22:24,851 >> IT MOSTLY AFFECTS THOSE WHO 2095 01:22:24,851 --> 01:22:28,355 HAVE ANY KIND OF CLINICAL ROLE. 2096 01:22:28,355 --> 01:22:28,655 >> OH, OKAY. 2097 01:22:28,655 --> 01:22:34,194 >> DO YOU GET ANY SUPPORT FROM 2098 01:22:34,194 --> 01:22:37,497 FRIENDS OF THE CLINICAL CENTER 2099 01:22:37,497 --> 01:22:37,965 PATIENTS? 2100 01:22:37,965 --> 01:22:39,233 >> FOR SURE. 2101 01:22:39,233 --> 01:22:41,768 I MEAN, THE FRIENDS OF THE 2102 01:22:41,768 --> 01:22:43,237 CLINICAL CENTER PATIENTS, THE 2103 01:22:43,237 --> 01:22:45,772 FAMILIES ARE SUPER SUPPORTIVE OF 2104 01:22:45,772 --> 01:22:49,776 ALL OF THIS. 2105 01:22:49,776 --> 01:22:51,578 >> THE ORGANIZATION. 2106 01:22:51,578 --> 01:22:51,812 >> YEAH. 2107 01:22:51,812 --> 01:22:52,045 >> YEAH. 2108 01:22:52,045 --> 01:23:02,289 >> (INAUDIBLE) 2109 01:23:04,858 --> 01:23:07,728 >> DAVID, I'M NOT SURE THAT THE 2110 01:23:07,728 --> 01:23:09,296 FRIENDS OF PATIENTS IS INVOLVED 2111 01:23:09,296 --> 01:23:12,833 AT THE PRESENT TIME BUT WE CAN 2112 01:23:12,833 --> 01:23:17,804 TALK TO JERRY NEXT WEEK AT PAG 2113 01:23:17,804 --> 01:23:19,306 AND FIGURE IT OUT. 2114 01:23:19,306 --> 01:23:22,709 >> DR. SCHOR, DID YOU HAVE A 2115 01:23:22,709 --> 01:23:22,943 COMMENT? 2116 01:23:22,943 --> 01:23:26,046 >> YEAH, I MEAN, I THINK WE HAVE 2117 01:23:26,046 --> 01:23:27,614 BEEN ADVISED, AND I'VE BEEN A 2118 01:23:27,614 --> 01:23:31,385 VERY LARGE THORN IN THE SIDE OF 2119 01:23:31,385 --> 01:23:32,919 THE PEOPLE INVOLVED, BUT WE HAD 2120 01:23:32,919 --> 01:23:36,990 BEEN INVOLVED THAT IT WOULD TAKE 2121 01:23:36,990 --> 01:23:40,894 A LEGISLATIVE ACTION TO RESTORE 2122 01:23:40,894 --> 01:23:44,364 THE SPECIAL VOLUNTEERS TORT 2123 01:23:44,364 --> 01:23:46,199 CLAIM COVERAGE AND I GUESS I 2124 01:23:46,199 --> 01:23:49,336 DON'T HAVE TO SAY TO THIS GROUP 2125 01:23:49,336 --> 01:23:51,938 THAT THE LEGISLATURE AND FRANKLY 2126 01:23:51,938 --> 01:23:54,141 THE LEGISLATIVE GROUP AT NIH HAS 2127 01:23:54,141 --> 01:23:55,709 BEEN INVOLVED IN MANY, MANY 2128 01:23:55,709 --> 01:23:59,546 OTHER THINGS AT THIS POINT. 2129 01:23:59,546 --> 01:24:03,917 I THINK ONCE WE HAVE OUR 2130 01:24:03,917 --> 01:24:07,287 DIRECTOR AND ONCE THE HOUSE HAS 2131 01:24:07,287 --> 01:24:09,790 ITS SPEAKER THIS MAY GET A 2132 01:24:09,790 --> 01:24:13,760 LITTLE BIT EASIER TO ENACT. 2133 01:24:13,760 --> 01:24:16,430 2134 01:24:16,430 --> 01:24:18,031 >> YEAH, I'LL JUST GIVE A 2135 01:24:18,031 --> 01:24:19,199 CONCRETE EXAMPLE. 2136 01:24:19,199 --> 01:24:19,800 THERE'S AN ORTHOPEDIC SURGEON 2137 01:24:19,800 --> 01:24:22,636 WHO HAS BEEN PART OF THIS FOR 2138 01:24:22,636 --> 01:24:25,105 ABOUT 20 YEARS, THERE'S A 2139 01:24:25,105 --> 01:24:26,506 CRITICAL CARE DOCTOR WHO WAS 2140 01:24:26,506 --> 01:24:28,775 SORT OF PARTNERED WITH ME FOR 2141 01:24:28,775 --> 01:24:31,878 THE PAST 10 YEARS, AND THEY 2142 01:24:31,878 --> 01:24:34,948 REALLY COULDN'T PRACTICE THIS 2143 01:24:34,948 --> 01:24:35,749 YEAR OUT THERE. 2144 01:24:35,749 --> 01:24:38,352 AND SO ME AS A PEDIATRIC 2145 01:24:38,352 --> 01:24:41,855 ONCOLOGIST COULD NOT HAVE THAT 2146 01:24:41,855 --> 01:24:44,157 KIND OF SUPPORT BEHIND ME WAS A 2147 01:24:44,157 --> 01:24:45,926 LITTLE BIT MORE NERVE-RACKING 2148 01:24:45,926 --> 01:24:48,929 THIS YEAR SO I WOULD REITERATE 2149 01:24:48,929 --> 01:24:50,597 AND APPRECIATE ANY EFFORTS WE 2150 01:24:50,597 --> 01:24:53,233 CAN TO SORT OF FIGURE OUT HOW TO 2151 01:24:53,233 --> 01:25:01,308 MAKE THIS HAPPEN FOR US. 2152 01:25:01,308 --> 01:25:03,310 >> IF SOMEONE CAN VERY QUICKLY 2153 01:25:03,310 --> 01:25:06,413 WHEN YOU SAY VOLUNTEERS DO NOT 2154 01:25:06,413 --> 01:25:09,583 HAVE COVERAGE, DO YOU MEAN LIKE 2155 01:25:09,583 --> 01:25:11,752 INSURANCE OR JUST VERY QUICKLY 2156 01:25:11,752 --> 01:25:13,286 EXPLAIN WHAT THAT MEANS, TORT 2157 01:25:13,286 --> 01:25:13,720 COVERAGE. 2158 01:25:13,720 --> 01:25:16,423 >> MEANS THEY ARE NOT PROTECTED 2159 01:25:16,423 --> 01:25:18,458 FROM -- THEY WILL NOT BE COVERED 2160 01:25:18,458 --> 01:25:23,163 UNDER THE FEDERAL TORT CLAIMS 2161 01:25:23,163 --> 01:25:26,833 ACT SHOULD SOMEBODY FILE A SUIT 2162 01:25:26,833 --> 01:25:29,770 OR CLAIM AGAINST -- THAT 2163 01:25:29,770 --> 01:25:32,939 INVOLVED ANY ACTION THAT THEY 2164 01:25:32,939 --> 01:25:36,610 WERE INVOLVED WITH. 2165 01:25:36,610 --> 01:25:39,613 >> ANY OTHER QUESTIONS? 2166 01:25:39,613 --> 01:25:39,980 2167 01:25:39,980 --> 01:25:41,782 >> A FINAL QUESTION, WHAT SEEMS 2168 01:25:41,782 --> 01:25:44,384 TO BE THE FAVORITE ACTIVITY OF 2169 01:25:44,384 --> 01:25:45,352 THE KIDS OUT THERE? 2170 01:25:45,352 --> 01:25:48,088 >> OH, I WOULD SAY HORSEBACK 2171 01:25:48,088 --> 01:25:49,456 RIDING AND THERAPEUTIC HORSEBACK 2172 01:25:49,456 --> 01:25:50,690 RIDING IS PRETTY POPULAR BUT 2173 01:25:50,690 --> 01:25:55,061 ALSO VERY TOUGH TO GET THEM OUT 2174 01:25:55,061 --> 01:25:56,363 OF THE POOL. 2175 01:25:56,363 --> 01:26:00,100 AND SO IT'S HARD TO SAY. 2176 01:26:00,100 --> 01:26:01,468 BUT I THINK THOSE ARE PROBABLY 2177 01:26:01,468 --> 01:26:03,737 TWO THAT ARE VERY POPULAR. 2178 01:26:03,737 --> 01:26:04,738 >> GREAT. 2179 01:26:04,738 --> 01:26:06,239 THANK YOU VERY MUCH. 2180 01:26:06,239 --> 01:26:12,612 >> DONNA MAY HAVE AN 2181 01:26:12,612 --> 01:26:12,913 ALTERNATIVE. 2182 01:26:12,913 --> 01:26:23,156 >> (INAUDIBLE) 2183 01:26:28,161 --> 01:26:29,029 GIVING THEM THE OPPORTUNITY 2184 01:26:29,029 --> 01:26:30,130 INSTEAD OF BEING PATIENT IN THE 2185 01:26:30,130 --> 01:26:32,265 HOSPITAL TO BE KIND OF A KID, 2186 01:26:32,265 --> 01:26:38,338 ABLE TO HAVE A LITTLE BIT OF " 2187 01:26:38,338 --> 01:26:42,476 I'M IN CONTROL HERE" AND ALSO 2188 01:26:42,476 --> 01:26:42,809 PEER SUPPORT. 2189 01:26:42,809 --> 01:26:46,379 A LOT OF TIMES THAT CHANCE, 2190 01:26:46,379 --> 01:26:48,715 INTENTIONAL PROGRAM, GIVING THEM 2191 01:26:48,715 --> 01:26:51,151 AN OPPORTUNITY TO TAKE THEIR 2192 01:26:51,151 --> 01:26:53,253 PROSTHETIC LEG OR WIG OFF, A 2193 01:26:53,253 --> 01:26:54,387 SAFE ENVIRONMENT TO DO THAT AND 2194 01:26:54,387 --> 01:26:57,724 KNOW THEY ARE NOT ALONE. 2195 01:26:57,724 --> 01:27:00,727 >> YEAH, IT'S REMARKABLE. 2196 01:27:00,727 --> 01:27:02,729 THESE KIDS COME BACK, BACK 2197 01:27:02,729 --> 01:27:04,030 MULTIPLE YEARS, AND THEY SEE THE 2198 01:27:04,030 --> 01:27:05,365 SAME PEER GROUP. 2199 01:27:05,365 --> 01:27:08,268 AND THEY REALLY FORM VERY TIGHT 2200 01:27:08,268 --> 01:27:10,937 BONDS WITH EACH OTHER, WHICH IS 2201 01:27:10,937 --> 01:27:12,105 A VERY POWERFUL THING WHEN YOU 2202 01:27:12,105 --> 01:27:14,107 KNOW ANOTHER KID THAT'S GOING 2203 01:27:14,107 --> 01:27:17,410 THROUGH WHAT YOU'RE GOING 2204 01:27:17,410 --> 01:27:17,711 THROUGH. 2205 01:27:17,711 --> 01:27:19,346 SO, YEAH, THANK YOU SO MUCH. 2206 01:27:19,346 --> 01:27:22,048 >> THANK YOU VERY MUCH, 2207 01:27:22,048 --> 01:27:25,619 APPRECIATE IT. 2208 01:27:25,619 --> 01:27:27,554 NEXT PRESENTER IS DR. JORDAN, 2209 01:27:27,554 --> 01:27:28,889 CHIEF NURSE OFFICER, PROVIDING 2210 01:27:28,889 --> 01:27:30,757 THE LATEST UPDATE ON CLINICAL 2211 01:27:30,757 --> 01:27:31,925 CENTER MAGNET JOURNEY. 2212 01:27:31,925 --> 01:27:33,793 SHE'S A FAMILIAR FACE TO OUR 2213 01:27:33,793 --> 01:27:35,028 BOARD, ON BEHALF OF OUR MEMBERS 2214 01:27:35,028 --> 01:27:37,864 I OFFER YOU AGAIN A WARM 2215 01:27:37,864 --> 01:27:38,832 CONGRATULATIONS ON YOUR 2216 01:27:38,832 --> 01:27:41,601 APPOINTMENT IN JULY AS CHIEF 2217 01:27:41,601 --> 01:27:41,968 NURSING OFFICER. 2218 01:27:41,968 --> 01:27:44,204 FEW WOULD ARGUE THIS IS ONE OF 2219 01:27:44,204 --> 01:27:45,872 THE MOST CRITICAL LEADERSHIP 2220 01:27:45,872 --> 01:27:48,308 POSITIONS IN ANY HOSPITAL, AND 2221 01:27:48,308 --> 01:27:49,776 WE'RE CERTAINLY DELIGHTED YOU 2222 01:27:49,776 --> 01:27:51,678 ARE ASSUMING THIS ROLE 2223 01:27:51,678 --> 01:27:52,679 SEAMLESSLY, PERFECTLY POSITIONED 2224 01:27:52,679 --> 01:27:54,848 FOR THE DUTIES AND 2225 01:27:54,848 --> 01:27:55,715 RESPONSIBILITIES NOW AND FOR 2226 01:27:55,715 --> 01:27:59,286 WHAT LIES AHEAD. 2227 01:27:59,286 --> 01:28:00,787 >> THANK YOU SO MUCH. 2228 01:28:00,787 --> 01:28:04,524 THAT IS SO KIND. 2229 01:28:04,524 --> 01:28:07,260 I'M HONORED TO HAVE BEEN AWARDED 2230 01:28:07,260 --> 01:28:09,262 THIS POSITION, AND I JUST HAVE 2231 01:28:09,262 --> 01:28:11,498 TO SAY WORKING AT THE CLINICAL 2232 01:28:11,498 --> 01:28:12,566 CENTER, THIS IS THE LONGEST I'VE 2233 01:28:12,566 --> 01:28:13,733 WORKED ANYWHERE. 2234 01:28:13,733 --> 01:28:15,535 I'VE BEEN HERE FOR TEN YEARS. 2235 01:28:15,535 --> 01:28:17,704 IT REALLY IS A REMARKABLE PLACE 2236 01:28:17,704 --> 01:28:20,407 WITH SO MANY OPPORTUNITIES. 2237 01:28:20,407 --> 01:28:23,944 DR. SHERN HAD TO LEAVE BUT HE 2238 01:28:23,944 --> 01:28:25,378 WAS RIGHT, THAT WAS THE BEST 2239 01:28:25,378 --> 01:28:26,947 PRESENTATION ALL DAY, I HAVE TO 2240 01:28:26,947 --> 01:28:30,684 FOLLOW HIM BUT I'M EXCITED ABOUT 2241 01:28:30,684 --> 01:28:31,651 MY PRESENTATION TOO. 2242 01:28:31,651 --> 01:28:33,954 I WANT TO ADD CAMP FANTASTIC IF 2243 01:28:33,954 --> 01:28:36,222 YOU'VE NEVER HAD THE 2244 01:28:36,222 --> 01:28:37,591 OPPORTUNITY, NEXT YEAR PLEASE GO 2245 01:28:37,591 --> 01:28:39,426 OUT AND VISIT. 2246 01:28:39,426 --> 01:28:41,728 IT REALLY IS JUST A HEARTWARMING 2247 01:28:41,728 --> 01:28:41,928 PLACE. 2248 01:28:41,928 --> 01:28:45,565 WE'RE SO HONORED WE'RE ABLE TO 2249 01:28:45,565 --> 01:28:46,566 SUPPORT CAMP FANTASTIC. 2250 01:28:46,566 --> 01:28:50,170 WE SEND OUR NURSES THERE, OUR 2251 01:28:50,170 --> 01:28:51,438 PEDIATRIC AND OTHER NURSES, AND 2252 01:28:51,438 --> 01:28:53,406 THEY LOVE IT. 2253 01:28:53,406 --> 01:28:55,675 SO, THANK YOU ALL SO MUCH. 2254 01:28:55,675 --> 01:28:58,478 I'M HERE THIS MORNING TO PROVIDE 2255 01:28:58,478 --> 01:29:02,182 AN UPDATE ON OUR MAGNET JOURNEY. 2256 01:29:02,182 --> 01:29:04,384 NEXT SLIDE PLEASE. 2257 01:29:04,384 --> 01:29:05,418 SO, FOR OUR PROGRESS REPORT 2258 01:29:05,418 --> 01:29:07,954 WE'LL TALK ABOUT WHERE WE ARE 2259 01:29:07,954 --> 01:29:10,724 WITH OUR JOURNEY MILESTONES, 2260 01:29:10,724 --> 01:29:12,492 WITH OUR MAGNET DOCUMENT, I'LL 2261 01:29:12,492 --> 01:29:14,661 PROVIDE AN EXAMPLE FROM THE 2262 01:29:14,661 --> 01:29:17,297 DOCUMENT AND ALSO REVIEW SOME 2263 01:29:17,297 --> 01:29:19,699 PATIENT ENGAGEMENT METRICS. 2264 01:29:19,699 --> 01:29:20,600 NEXT SLIDE. 2265 01:29:20,600 --> 01:29:23,403 SO, ON OUR JOURNEY AS DR. GILMAN 2266 01:29:23,403 --> 01:29:28,575 POINTED OUT DURING HIS REMARKS 2267 01:29:28,575 --> 01:29:29,342 WE SENT OUR APPLICATION TO 2268 01:29:29,342 --> 01:29:33,913 DECLARE OUR INTENT TO BECOME A 2269 01:29:33,913 --> 01:29:34,714 MAGNET DESIGNATED ORGANIZATION 2270 01:29:34,714 --> 01:29:35,782 LAST JANUARY AND WE'RE NOW IN 2271 01:29:35,782 --> 01:29:38,318 THE THICK OF PREPARING THE 2272 01:29:38,318 --> 01:29:38,585 DOCUMENT. 2273 01:29:38,585 --> 01:29:43,223 IT REALLY IS A VERY LARGE 2274 01:29:43,223 --> 01:29:43,890 UNDERTAKING, THERE'S OVER 90 2275 01:29:43,890 --> 01:29:50,430 STANDARDS FOR WHICH WE HAVE TO 2276 01:29:50,430 --> 01:29:51,865 PROVIDE THE STORIES, EVIDENCE 2277 01:29:51,865 --> 01:29:53,466 AND METRICS REGARDING THAT. 2278 01:29:53,466 --> 01:29:56,536 AND HAVE IT IN A COHESIVE AND 2279 01:29:56,536 --> 01:29:59,305 READABLE FORMAT BECAUSE THE 2280 01:29:59,305 --> 01:30:01,775 APPRAISERS FROM AMERICAN NURSES 2281 01:30:01,775 --> 01:30:03,877 CREDENTIALING CENTER, THIS WILL 2282 01:30:03,877 --> 01:30:05,812 BE THEIR FIRST LEARNING OF THE 2283 01:30:05,812 --> 01:30:06,379 CLINICAL CENTER. 2284 01:30:06,379 --> 01:30:08,481 SO WE HAVE TO WRITE THE DOCUMENT 2285 01:30:08,481 --> 01:30:15,622 IN A WAY THAT TELLS THE STORY. 2286 01:30:15,622 --> 01:30:17,123 WE'RE PLANNING TO SUBMIT THE 2287 01:30:17,123 --> 01:30:19,592 DOCUMENT ON APRIL 1 OF NEXT YEAR 2288 01:30:19,592 --> 01:30:20,560 AND THEN FOLLOWING THAT THERE 2289 01:30:20,560 --> 01:30:22,195 WILL BE A PERIOD OF PUBLIC 2290 01:30:22,195 --> 01:30:24,297 COMMENT SO WE WILL MAKE THE 2291 01:30:24,297 --> 01:30:26,599 DOCUMENT AVAILABLE TO ALL. 2292 01:30:26,599 --> 01:30:28,968 AND THEN WE'RE VERY OPTIMISTIC 2293 01:30:28,968 --> 01:30:32,038 THAT THE APPRAISERS WILL SCORE 2294 01:30:32,038 --> 01:30:33,907 OUR DOCUMENT AS ACCEPTABLE AND 2295 01:30:33,907 --> 01:30:39,579 THEN PLAN THEIR SITE VISIT TO 2296 01:30:39,579 --> 01:30:39,779 US. 2297 01:30:39,779 --> 01:30:42,649 SO WHERE WE WITH THE DOCUMENT, 2298 01:30:42,649 --> 01:30:45,819 SO THE MAGNET MODEL IS DIVIDED 2299 01:30:45,819 --> 01:30:46,786 INTO FOUR COMPONENTS. 2300 01:30:46,786 --> 01:30:53,760 AND SO THERE ARE STANDARDS IN 2301 01:30:53,760 --> 01:30:54,227 EACH. 2302 01:30:54,227 --> 01:30:55,495 TRANSFORMATIONAL LEADERSHIP, 2303 01:30:55,495 --> 01:30:57,897 STRUCTURAL EMPOWERMENT, 2304 01:30:57,897 --> 01:30:58,832 EXEMPLARY PROFESSIONAL PRACTICE, 2305 01:30:58,832 --> 01:31:01,101 NEW KNOWLEDGE AND INNOVATIONS 2306 01:31:01,101 --> 01:31:01,801 AND IMPROVEMENTS. 2307 01:31:01,801 --> 01:31:03,636 THIS SLIDE IS A COUPLE WEEKS 2308 01:31:03,636 --> 01:31:03,803 OLD. 2309 01:31:03,803 --> 01:31:07,207 WE HAVE MORE IN DRAFT. 2310 01:31:07,207 --> 01:31:09,375 AND REDUCING THE NUMBER OF 2311 01:31:09,375 --> 01:31:11,444 EXAMPLES TO BE IDENTIFIED, AND 2312 01:31:11,444 --> 01:31:17,083 WE HAVE MORE IN THE COMPLETE 2313 01:31:17,083 --> 01:31:17,317 COLUMN. 2314 01:31:17,317 --> 01:31:17,917 NEXT SLIDE PLEASE. 2315 01:31:17,917 --> 01:31:21,488 I WANTED TO SHARE AN EXAMPLE OF 2316 01:31:21,488 --> 01:31:22,622 ONE OF THE STANDARDS AND 2317 01:31:22,622 --> 01:31:24,591 NARRATIVES WE'RE PROVIDING. 2318 01:31:24,591 --> 01:31:29,696 THE STANDARD THIS COMES FROM THE 2319 01:31:29,696 --> 01:31:30,497 EXEMPLARY PROFESSIONAL PRACTICE 2320 01:31:30,497 --> 01:31:31,798 CHAPTER, ONE EXAMPLE WITH 2321 01:31:31,798 --> 01:31:35,335 SUPPORTING EVIDENCE OF NURSES AS 2322 01:31:35,335 --> 01:31:37,237 PARTICIPANTS OF AN 2323 01:31:37,237 --> 01:31:38,338 INTERPROFESSIONAL TEAM APPLYING 2324 01:31:38,338 --> 01:31:40,874 AVAILABLE RESOURCES TO ADDRESS 2325 01:31:40,874 --> 01:31:43,810 ETHICAL ISSUES RELATED TO 2326 01:31:43,810 --> 01:31:44,778 CLINICAL PRACTICE. 2327 01:31:44,778 --> 01:31:48,748 THE EXAMPLE THAT WE'RE PROVIDING 2328 01:31:48,748 --> 01:31:51,484 COMES FROM THE ETHICAL 2329 01:31:51,484 --> 01:31:53,753 CONSIDERATION IN THE 2330 01:31:53,753 --> 01:31:54,754 INTERPROFESSIONAL CARE PLANNING 2331 01:31:54,754 --> 01:31:55,955 FOR PARAPLEGIC PATIENT 2332 01:31:55,955 --> 01:31:59,492 PARTICIPATING IN A CLINICAL 2333 01:31:59,492 --> 01:32:00,493 TRIAL. 2334 01:32:00,493 --> 01:32:01,861 SO, WHAT HAPPENED, 5 NORTHWEST, 2335 01:32:01,861 --> 01:32:04,297 ONE OF OUR MEDICAL SURGICAL 2336 01:32:04,297 --> 01:32:06,800 UNITS WE HAVE RADIATION SAFETY 2337 01:32:06,800 --> 01:32:07,000 ROOMS. 2338 01:32:07,000 --> 01:32:09,335 THESE ARE LEAD-LINED ROOMS. 2339 01:32:09,335 --> 01:32:12,372 SO PATIENTS WILL HAVE 2340 01:32:12,372 --> 01:32:13,273 RADIOLOGICAL IMPLANT INSERTED 2341 01:32:13,273 --> 01:32:15,675 AND STAY WITHIN THIS ROOM. 2342 01:32:15,675 --> 01:32:20,146 SO THERE'S A LOT OF TRAINING AND 2343 01:32:20,146 --> 01:32:22,348 A LOT OF PROTECTIONS IN PLACE SO 2344 01:32:22,348 --> 01:32:23,983 THAT ANYONE WHO IS INTERACTING 2345 01:32:23,983 --> 01:32:26,152 WITH THE PATIENT DOESN'T HAVE AN 2346 01:32:26,152 --> 01:32:26,886 EXPOSURE. 2347 01:32:26,886 --> 01:32:28,788 WE HAVE THE OPPORTUNITY TO 2348 01:32:28,788 --> 01:32:32,859 PROVIDE CARE FOR A PATIENT WHO 2349 01:32:32,859 --> 01:32:37,130 WAS PARAPLEGIC AND DID REQUIRE 2350 01:32:37,130 --> 01:32:38,798 MORE INTENSE SUPPORT THAN WHAT 2351 01:32:38,798 --> 01:32:40,433 OTHER PATIENTS HAVE REQUIRED. 2352 01:32:40,433 --> 01:32:44,804 A LOT MORE HANDS-ON CARE. 2353 01:32:44,804 --> 01:32:46,573 THERE WAS A LOT OF PLANNING 2354 01:32:46,573 --> 01:32:48,374 PERFORMED WITH THE MEDICAL TEAMW 2355 01:32:48,374 --> 01:32:49,475 ALL OF THE DIFFERENT DEPARTMENTS 2356 01:32:49,475 --> 01:32:52,979 IN THE CARE AND PLANNING FOR 2357 01:32:52,979 --> 01:32:56,182 THIS PATIENT, AND WE ALSO 2358 01:32:56,182 --> 01:32:57,450 INVOLVED OUR ETHICS TEAM JUST TO 2359 01:32:57,450 --> 01:33:00,053 MAKE SURE THAT WE WERE MEETING 2360 01:33:00,053 --> 01:33:02,422 THE NEEDS OF THE PATIENT WHILE 2361 01:33:02,422 --> 01:33:03,723 ALSO MEETING THE NEEDS OF THE 2362 01:33:03,723 --> 01:33:04,324 STAFF. 2363 01:33:04,324 --> 01:33:09,229 AND SO WE DID -- WERE ABLE TO 2364 01:33:09,229 --> 01:33:10,196 PROVIDE ADDITIONAL RESOURCES TO 2365 01:33:10,196 --> 01:33:12,932 5 NORTHWEST, INCREASE THE 2366 01:33:12,932 --> 01:33:15,101 STAFFING, SO WE COULD PROVIDE 2367 01:33:15,101 --> 01:33:18,504 SAFE AND EXCELLENT CARE TO THIS 2368 01:33:18,504 --> 01:33:18,738 PATIENT. 2369 01:33:18,738 --> 01:33:20,573 AND IT WAS SUCCESSFUL. 2370 01:33:20,573 --> 01:33:23,209 THE PATIENT WAS VERY GRATEFUL TO 2371 01:33:23,209 --> 01:33:26,045 HAVE BEEN ABLE TO PARTICIPATE IN 2372 01:33:26,045 --> 01:33:30,083 THIS STUDY, AND ALSO FOR THE 2373 01:33:30,083 --> 01:33:31,751 KIND AND CARING COMPASSIONATE 2374 01:33:31,751 --> 01:33:36,656 CARE SHE RECEIVED DURING HER 2375 01:33:36,656 --> 01:33:37,357 HOSPITALIZATION, THIS IS AN 2376 01:33:37,357 --> 01:33:39,292 EXEMPLAR OF THE WORK THAT 2377 01:33:39,292 --> 01:33:40,426 HAPPENS EVERY DAY IN THE 2378 01:33:40,426 --> 01:33:41,761 CLINICAL CENTER SO WE'RE SO 2379 01:33:41,761 --> 01:33:44,163 PLEASED TO BE ABLE TO SHARE THIS 2380 01:33:44,163 --> 01:33:48,935 IN OUR MAGNET DOCUMENT. 2381 01:33:48,935 --> 01:33:49,669 NEXT SLIDE PLEASE. 2382 01:33:49,669 --> 01:33:51,905 IN ADDITION TO ALL THE WRITING 2383 01:33:51,905 --> 01:33:54,540 AND COLLECTION OF EVIDENCE FOR 2384 01:33:54,540 --> 01:33:57,610 THE DOCUMENT, WE ALSO HAVE TO 2385 01:33:57,610 --> 01:34:00,346 MAKE SURE THAT EVERYBODY KNOWS 2386 01:34:00,346 --> 01:34:02,849 WHAT IS MAGNET. 2387 01:34:02,849 --> 01:34:05,685 I WAS WALKING WITH DR. CHEN TO 2388 01:34:05,685 --> 01:34:07,754 THE BUILDING THIS MORNING 2389 01:34:07,754 --> 01:34:08,955 REMARKING ON WHAT I'VE SEEN AS 2390 01:34:08,955 --> 01:34:11,925 PART OF THE MAGNET JOURNEY, IT 2391 01:34:11,925 --> 01:34:12,825 IS TRANSFORMATIVE. 2392 01:34:12,825 --> 01:34:14,694 WE'RE SEEING A CHANGE IN THE 2393 01:34:14,694 --> 01:34:18,798 CULTURE AS FAR AS HOW WE TALK 2394 01:34:18,798 --> 01:34:20,633 ABOUT EVIDENCE-BASED PRACTICE, 2395 01:34:20,633 --> 01:34:21,634 MAKING SURE WE'RE COLLECTING PRE 2396 01:34:21,634 --> 01:34:23,569 AND POST DATA, WE'RE REALLY GOOD 2397 01:34:23,569 --> 01:34:26,606 ON PROCESS BUT REALLY LOOKING AT 2398 01:34:26,606 --> 01:34:29,342 OUR OUTCOME MEASURES, THAT ALSO 2399 01:34:29,342 --> 01:34:31,844 PART OF THIS TOO IS INTERACTING 2400 01:34:31,844 --> 01:34:33,479 WITH THE STAFF OF THE CLINICAL 2401 01:34:33,479 --> 01:34:35,381 CENTER AND OUR INSTITUTE 2402 01:34:35,381 --> 01:34:37,116 PARTNERS SO THEY UNDERSTAND WHAT 2403 01:34:37,116 --> 01:34:39,185 IS MAGNET. 2404 01:34:39,185 --> 01:34:42,255 IT'S LIKE THIS NEBULOUS WORD. 2405 01:34:42,255 --> 01:34:45,725 SO WE'VE STARTED MAGNET ROUNDS 2406 01:34:45,725 --> 01:34:51,030 AND WE'RE HOSTING THOSE 24/7. 2407 01:34:51,030 --> 01:34:53,866 I CAME IN A COUPLE WEEKS AGO 2408 01:34:53,866 --> 01:34:55,301 INTERACTED ON THE WEEKEND 2409 01:34:55,301 --> 01:34:56,436 TALKING ABOUT MAGNET. 2410 01:34:56,436 --> 01:34:59,672 THE FOCUS ON PEER FEEDBACK, WE 2411 01:34:59,672 --> 01:35:01,374 IMPLEMENTED A PEER FEEDBACK IN 2412 01:35:01,374 --> 01:35:02,542 THE NURSING DEPARTMENT SEVERAL 2413 01:35:02,542 --> 01:35:03,843 YEARS AGO, REALLY TALKING ABOUT 2414 01:35:03,843 --> 01:35:06,512 IT AND WHAT DOES IT MEAN AND HOW 2415 01:35:06,512 --> 01:35:07,814 CAN IT BE MEANINGFUL. 2416 01:35:07,814 --> 01:35:12,418 THE GOAL IS TO REACH MAJORITY OF 2417 01:35:12,418 --> 01:35:13,886 THE STAFF. 2418 01:35:13,886 --> 01:35:15,421 SO, MAGNET NURSE LEADERS AS WELL 2419 01:35:15,421 --> 01:35:17,957 AS MEMBERS OF THE MAGNET 2420 01:35:17,957 --> 01:35:24,797 DOCUMENT TEAM AND MAGNET 2421 01:35:24,797 --> 01:35:25,431 AMBASSADORS DEPARTMENT LEVEL 2422 01:35:25,431 --> 01:35:28,101 CHAMPIONS PARTICIPATING IN THE 2423 01:35:28,101 --> 01:35:29,769 ROUND. 2424 01:35:29,769 --> 01:35:33,940 WE'RE HOSTING A MAGNET FAIR 2425 01:35:33,940 --> 01:35:35,875 NEXT THURSDAY ON THE FAES 2426 01:35:35,875 --> 01:35:39,379 TERRACE IN CLINICAL CENTER RUN 2427 01:35:39,379 --> 01:35:40,947 BY MAGNET AMBASSADORS WITH 2428 01:35:40,947 --> 01:35:43,349 TABLES SET UP, GAMES, PRIZES, 2429 01:35:43,349 --> 01:35:46,919 FOCUSED ON EDUCATION AND 2430 01:35:46,919 --> 01:35:47,720 ENGAGEMENT AND WE'RE INVITING 2431 01:35:47,720 --> 01:35:49,722 ALL THE PEOPLE THAT WORK IN THE 2432 01:35:49,722 --> 01:35:51,891 CLINICAL CENTER TO COME AND 2433 01:35:51,891 --> 01:35:53,926 LEARN MORE ABOUT MAGNET. 2434 01:35:53,926 --> 01:35:57,096 I THINK THEY HAVE DONE A COOL 2435 01:35:57,096 --> 01:35:59,832 JOB, SET UP AS A JOURNEY WITH A 2436 01:35:59,832 --> 01:36:01,768 PASSPORT, THEY WILL GET STAMPS 2437 01:36:01,768 --> 01:36:04,237 AS THEY VISIT THE COUNTRIES OF 2438 01:36:04,237 --> 01:36:07,473 MAGNET SO IT WILL BE A REALLY 2439 01:36:07,473 --> 01:36:08,508 FUN TIME. 2440 01:36:08,508 --> 01:36:10,777 NEXT SLIDE PLEASE. 2441 01:36:10,777 --> 01:36:13,012 I DO REALIZE THAT FOR CLINICAL 2442 01:36:13,012 --> 01:36:20,019 CENTER AND NIH STAFF IT'S ALSO 2443 01:36:20,019 --> 01:36:20,620 THE COMBINED FEDERAL CAMPAIGN 2444 01:36:20,620 --> 01:36:22,455 KICKOFF AT THE SAME TIME BUT WE 2445 01:36:22,455 --> 01:36:23,322 LOOK FORWARD TO PEOPLE BEING 2446 01:36:23,322 --> 01:36:26,993 ABLE TO JOIN US AFTER THE 2447 01:36:26,993 --> 01:36:27,326 KICKOFF. 2448 01:36:27,326 --> 01:36:30,630 SO I MENTIONED THAT WE HAVE 2449 01:36:30,630 --> 01:36:32,465 VARIOUS STANDARDS AND METRICS WE 2450 01:36:32,465 --> 01:36:34,333 HAVE TO SUBMIT SO WHAT I WANTED 2451 01:36:34,333 --> 01:36:36,536 TO SHARE WITH YOU TODAY ARE THE 2452 01:36:36,536 --> 01:36:38,171 METRICS AND STANDARDS AROUND 2453 01:36:38,171 --> 01:36:41,374 PATIENT ENGAGEMENT. 2454 01:36:41,374 --> 01:36:42,041 SO DR. GILMAN MENTIONED PRESS 2455 01:36:42,041 --> 01:36:44,677 GANEY, THAT IS THE COMPANY THAT 2456 01:36:44,677 --> 01:36:48,514 WE USE TO MEASURE OUR PATIENT 2457 01:36:48,514 --> 01:36:50,650 SATISFACTION AND PATIENT 2458 01:36:50,650 --> 01:36:50,950 ENGAGEMENT. 2459 01:36:50,950 --> 01:36:52,885 WE HAVE TWO EXEMPLARY 2460 01:36:52,885 --> 01:36:54,087 PROFESSIONAL PRACTICE STANDARDS 2461 01:36:54,087 --> 01:36:56,789 IN WHICH WE HAVE TO SELECT FOUR 2462 01:36:56,789 --> 01:36:57,757 OF NINE CATEGORIES. 2463 01:36:57,757 --> 01:37:00,293 THEY GIVE US THE CATEGORIES. 2464 01:37:00,293 --> 01:37:05,364 WE SELECT FOUR OF THEM FOR BOTH 2465 01:37:05,364 --> 01:37:05,998 INPATIENT AND AMBULATORY 2466 01:37:05,998 --> 01:37:06,899 SETTINGS. 2467 01:37:06,899 --> 01:37:08,401 WE HAVE TO OUTPERFORM THE 2468 01:37:08,401 --> 01:37:11,270 BENCHMARK THAT'S PROVIDED BY THE 2469 01:37:11,270 --> 01:37:15,641 VENDORS NATIONAL DATABASE, AND 2470 01:37:15,641 --> 01:37:16,876 SO WE'VE CHOSEN THE MEAN, TO 2471 01:37:16,876 --> 01:37:18,377 EXCEED THE MEAN. 2472 01:37:18,377 --> 01:37:21,781 AND THE EXPECTATION IS THAT FOR 2473 01:37:21,781 --> 01:37:22,715 EACH CATEGORY THE MAJORITY OF 2474 01:37:22,715 --> 01:37:32,258 THE UNITS HAVE TO OUTPERFORM 2475 01:37:32,258 --> 01:37:35,528 THAT NATIONAL MEASURE OF CENTRAL 2476 01:37:35,528 --> 01:37:35,795 TENDENCY. 2477 01:37:35,795 --> 01:37:38,498 WE'VE CHOSEN THE CATEGORIES OF 2478 01:37:38,498 --> 01:37:41,067 COURTESY AND RESPECT, PATIENT 2479 01:37:41,067 --> 01:37:43,302 ENGAGEMENT OR PATIENT-CENTERED 2480 01:37:43,302 --> 01:37:45,371 CARE, RESPONSIVENESS AND SAFETY. 2481 01:37:45,371 --> 01:37:48,608 ON THE SURVEYS THE PATIENTS 2482 01:37:48,608 --> 01:37:51,310 RECEIVE AFTER DISCHARGE OR AFTER 2483 01:37:51,310 --> 01:37:53,479 THEIR VISIT, THERE ARE QUESTIONS 2484 01:37:53,479 --> 01:37:59,719 IN EACH OF THESE CATEGORIES. 2485 01:37:59,719 --> 01:38:03,256 NEXT SLIDE. 2486 01:38:03,256 --> 01:38:04,790 SO, THIS TABLE DEMONSTRATES 2487 01:38:04,790 --> 01:38:08,494 THREE QUESTIONS UNDER THE 2488 01:38:08,494 --> 01:38:10,463 COURTESY AND RESPECT CATEGORY. 2489 01:38:10,463 --> 01:38:11,797 NURSES ATTITUDE TOWARDS YOUR 2490 01:38:11,797 --> 01:38:16,936 REQUEST, COURTESY AND RESPECT OF 2491 01:38:16,936 --> 01:38:18,237 THE NURSES, CARE TEAMS CONCERN 2492 01:38:18,237 --> 01:38:21,340 FOR YOUR OR YOUR CHILD'S 2493 01:38:21,340 --> 01:38:23,643 PRIVACY, THAT'S ALSO IN OUR 2494 01:38:23,643 --> 01:38:24,443 PEDIATRIC AREAS. 2495 01:38:24,443 --> 01:38:28,381 SO, IN THE YELLOW IS WHERE THE N 2496 01:38:28,381 --> 01:38:29,749 WAS TOO SMALL, NUMBER OF 2497 01:38:29,749 --> 01:38:31,117 RESPONSES WAS TOO SMALL FOR 2498 01:38:31,117 --> 01:38:33,085 PRESS GANEY TO PROVIDE US DATA 2499 01:38:33,085 --> 01:38:34,320 FOR THAT. 2500 01:38:34,320 --> 01:38:37,423 SO THOSE ARE EXCLUDED. 2501 01:38:37,423 --> 01:38:39,125 GREEN BOXES SHOW WHERE WE'RE 2502 01:38:39,125 --> 01:38:41,994 ABOVE THE MEAN AND THE RED BELOW 2503 01:38:41,994 --> 01:38:42,895 THE MEAN. 2504 01:38:42,895 --> 01:38:45,498 AND SO WE ALWAYS HAVE 2505 01:38:45,498 --> 01:38:47,500 OPPORTUNITY FOR IMPROVEMENT. 2506 01:38:47,500 --> 01:38:50,303 WHAT'S DEMONSTRATED FOR OUR 2507 01:38:50,303 --> 01:38:54,340 INPATIENT AREAS, ALSO INCLUDES 2508 01:38:54,340 --> 01:38:55,841 ICU, THAT'S THE 3 SOUTHWEST 2509 01:38:55,841 --> 01:38:59,612 SOUTH, ICU HAS QUITE A BIT OF 2510 01:38:59,612 --> 01:39:01,581 YELLOW, IT'S AGAIN THE NUMBER OF 2511 01:39:01,581 --> 01:39:04,116 RESPONSES IS QUITE SMALL THERE. 2512 01:39:04,116 --> 01:39:07,186 1 SOUTHWEST IS OUR INPATIENT 2513 01:39:07,186 --> 01:39:08,254 CHILD PSYCHIATRIC UNIT, THAT TOO 2514 01:39:08,254 --> 01:39:10,156 WE'VE HAD A VERY SMALL NUMBER OF 2515 01:39:10,156 --> 01:39:13,359 PATIENTS SO WE JUST DON'T HAVE 2516 01:39:13,359 --> 01:39:15,228 THE DATA TO SHOW. 2517 01:39:15,228 --> 01:39:17,730 AGAIN, WE HAVE TO PROTECT THE 2518 01:39:17,730 --> 01:39:19,098 ANONYMITY OF THOSE WHO ARE 2519 01:39:19,098 --> 01:39:20,099 PROVIDING THE DATA. 2520 01:39:20,099 --> 01:39:22,935 BUT THE GREAT NEWS IS THAT OF 2521 01:39:22,935 --> 01:39:24,604 OUR EIGHT UNITS THAT ARE 2522 01:39:24,604 --> 01:39:27,106 ELIGIBLE, THOSE ARE THE ONES 2523 01:39:27,106 --> 01:39:29,742 THAT HAVE DATA, WE'RE AT 100%. 2524 01:39:29,742 --> 01:39:31,611 NOW, THIS IS A ROLLING 2525 01:39:31,611 --> 01:39:34,847 BENCHMARK, SO WE CANNOT REST ON 2526 01:39:34,847 --> 01:39:36,649 OUR LAURELS BECAUSE OUR -- THIS 2527 01:39:36,649 --> 01:39:41,020 TABLE IS FROM THE SECOND QUARTER 2528 01:39:41,020 --> 01:39:43,789 OF 2023 CALENDAR YEAR, SO BY THE 2529 01:39:43,789 --> 01:39:45,725 TIME WE SUBMIT OUR DOCUMENT IN 2530 01:39:45,725 --> 01:39:49,895 APRIL IT WILL BE AS OF FOURTH 2531 01:39:49,895 --> 01:39:50,863 QUARTER OF 2023. 2532 01:39:50,863 --> 01:39:53,199 SO WE ALWAYS HAVE TO BE LOOKING 2533 01:39:53,199 --> 01:39:55,534 AT OUR DATA AND MAKING SURE THAT 2534 01:39:55,534 --> 01:39:59,939 WE ARE DOING WHAT WE CAN TO MEET 2535 01:39:59,939 --> 01:40:03,075 THE NEEDS OF OUR PATIENTS. 2536 01:40:03,075 --> 01:40:05,211 NEXT SLIDE PLEASE. 2537 01:40:05,211 --> 01:40:07,513 AMBULATORY CARE, THIS INCLUDES 2538 01:40:07,513 --> 01:40:13,753 OUR PATIENT CLINICS, PROCEDURAL 2539 01:40:13,753 --> 01:40:18,958 AREAS, O.R., PACU, POST-ANSWER 2540 01:40:18,958 --> 01:40:21,327 A NESTHESIA CARE UNIT. 2541 01:40:21,327 --> 01:40:24,230 CARE COORDINATION, CAREFUL 2542 01:40:24,230 --> 01:40:26,365 LISTENING, SAFETY, SERVICE 2543 01:40:26,365 --> 01:40:26,699 RECOVERY. 2544 01:40:26,699 --> 01:40:29,101 NEXT SLIDE PLEASE. 2545 01:40:29,101 --> 01:40:32,705 SO EXAMPLE I CHOSE TO SHOW 2546 01:40:32,705 --> 01:40:34,340 SAFETY CATEGORY, FOR THE 2547 01:40:34,340 --> 01:40:35,441 QUESTIONS UNDER SAFETY CATEGORY 2548 01:40:35,441 --> 01:40:38,110 HOW WELL THE STAFF PROTECTED 2549 01:40:38,110 --> 01:40:43,349 YOUR SAFETY BY WASHING HANDS, ET 2550 01:40:43,349 --> 01:40:44,950 CETERA, EXTENT TO WHICH STAFF 2551 01:40:44,950 --> 01:40:46,419 WASHED THEIR HANDS, DEGREE OF 2552 01:40:46,419 --> 01:40:49,755 SAFETY AND SECURITY YOU FELT IN 2553 01:40:49,755 --> 01:40:51,157 OUR FACILITY, AND YOUR TRUST IN 2554 01:40:51,157 --> 01:40:53,059 SKILL OF STAFF WHO PROVIDED YOUR 2555 01:40:53,059 --> 01:40:55,428 TEST OR TREATMENT. 2556 01:40:55,428 --> 01:40:57,663 YOU CAN SEE THIS IS NOT FOCUSED 2557 01:40:57,663 --> 01:40:58,597 SOLELY ON NURSING BUT ON THE 2558 01:40:58,597 --> 01:41:00,533 PEOPLE WHO WORK IN THE CLINICAL 2559 01:41:00,533 --> 01:41:00,866 CENTER. 2560 01:41:00,866 --> 01:41:04,070 AGAIN, WE HAVE A COUPLE OF AREAS 2561 01:41:04,070 --> 01:41:06,472 THAT THE VOLUME IS TOO SMALL OR 2562 01:41:06,472 --> 01:41:08,874 NUMBER OF RESPONSES TOO LOW TO 2563 01:41:08,874 --> 01:41:11,911 INCLUDE IT. 2564 01:41:11,911 --> 01:41:16,549 BUT OVERALL, OUT OF OUR 16 2565 01:41:16,549 --> 01:41:18,517 ELIGIBLE UNITS, THEY ARE ALL 2566 01:41:18,517 --> 01:41:19,652 EXCEEDING THE BENCHMARK. 2567 01:41:19,652 --> 01:41:22,455 THERE'S A CERTAIN NUMBER OF 2568 01:41:22,455 --> 01:41:23,222 QUARTERS FOR WHICH THERE 2569 01:41:23,222 --> 01:41:23,589 EXCEEDS. 2570 01:41:23,589 --> 01:41:24,457 AGAIN SOME RED. 2571 01:41:24,457 --> 01:41:25,958 WE ALWAYS HAVE OPPORTUNITY FOR 2572 01:41:25,958 --> 01:41:26,525 IMPROVEMENT. 2573 01:41:26,525 --> 01:41:29,328 BUT THE GOOD NEWS IS WITH THE 2574 01:41:29,328 --> 01:41:30,863 PATIENT SATISFACTION SURVEYS 2575 01:41:30,863 --> 01:41:33,265 THAT WE HAVE AS OF THE SECOND 2576 01:41:33,265 --> 01:41:35,134 QUARTER OF THIS YEAR, SO THAT'S 2577 01:41:35,134 --> 01:41:38,304 THROUGH JUNE 30 OF THIS YEAR, 2578 01:41:38,304 --> 01:41:40,473 WE'RE IN GOOD SHAPE BUT WE HAVE 2579 01:41:40,473 --> 01:41:43,642 TO CONTINUE TO STRIVE OF THE 2580 01:41:43,642 --> 01:41:45,211 WE'LL BE SUBMITTING THE DATA IN 2581 01:41:45,211 --> 01:41:51,917 THIS TYPE OF FORMAT AS PART RT 2582 01:41:51,917 --> 01:41:56,389 OF OUR MAGNET DOCUMENTATION. 2583 01:41:56,389 --> 01:41:57,723 HELEN MAYBERRY IS OUR PROGRAM 2584 01:41:57,723 --> 01:41:59,992 DIRECTOR FOR NURSING QUALITY AND 2585 01:41:59,992 --> 01:42:00,226 SAFETY. 2586 01:42:00,226 --> 01:42:04,463 SHE AND HER TEAM, WE HAVE A 2587 01:42:04,463 --> 01:42:05,765 WONDERFUL MANAGEMENT ANALYST, 2588 01:42:05,765 --> 01:42:07,133 CELINE, WHO PUTS THIS DATA 2589 01:42:07,133 --> 01:42:09,268 TOGETHER FOR US. 2590 01:42:09,268 --> 01:42:14,640 RACHEL IS OUR MAGNET PROGRAM 2591 01:42:14,640 --> 01:42:15,608 MANAGER COORDINATING OUR EFFORTS 2592 01:42:15,608 --> 01:42:18,477 AND DOING A WONDERFUL JOB. 2593 01:42:18,477 --> 01:42:19,145 NEXT SLIDE. 2594 01:42:19,145 --> 01:42:21,313 THAT'S THE END OF MY 2595 01:42:21,313 --> 01:42:21,647 PRESENTATION. 2596 01:42:21,647 --> 01:42:27,119 THANK YOU. 2597 01:42:27,119 --> 01:42:28,087 2598 01:42:28,087 --> 01:42:32,458 >> THANKS. 2599 01:42:32,458 --> 01:42:39,465 ARE THERE ANY QUESTIONS? 2600 01:42:39,465 --> 01:42:39,598 2601 01:42:39,598 --> 01:42:39,799 DAVID? 2602 01:42:39,799 --> 01:42:40,232 >> TO BEGIN GREATER 2603 01:42:40,232 --> 01:42:40,833 ENCOURAGEMENT OF PARTICIPATION 2604 01:42:40,833 --> 01:42:41,901 ARE THESE THINGS OUT AND VISIBLE 2605 01:42:41,901 --> 01:42:45,638 TO THE STAFF THROUGH THE 2606 01:42:45,638 --> 01:42:47,373 INTERNET, BY ROTATING IN THE 2607 01:42:47,373 --> 01:42:53,078 SCREEN SAVERS ON THE DESKTOP OR 2608 01:42:53,078 --> 01:43:01,754 ELECTRONIC NEWS INFORMATION 2609 01:43:01,754 --> 01:43:04,423 BOARDS? 2610 01:43:04,423 --> 01:43:04,557 2611 01:43:04,557 --> 01:43:05,191 >> SO, THE TABLES, THEY ARE NOT. 2612 01:43:05,191 --> 01:43:05,758 THAT IS A GREAT SUGGESTION. 2613 01:43:05,758 --> 01:43:06,392 BUT WE DO HAVE DATA THOUGH THAT 2614 01:43:06,392 --> 01:43:07,026 DOES GO ON THE INTRANET AND THAT 2615 01:43:07,026 --> 01:43:10,229 IS THROUGH I BELIEVE DR. GILMAN 2616 01:43:10,229 --> 01:43:11,831 SPOKE TO DR. LANG'S INFORMATION 2617 01:43:11,831 --> 01:43:14,200 SO WE DO PUT THE PATIENT 2618 01:43:14,200 --> 01:43:15,768 EXPERIENCE DATA. 2619 01:43:15,768 --> 01:43:18,137 WE'VE BEEN WORKING VERY CLOSELY 2620 01:43:18,137 --> 01:43:19,972 WITH PRESS GANEY THROUGH THE 2621 01:43:19,972 --> 01:43:24,076 NURSING DEPARTMENT AND CLINICAL 2622 01:43:24,076 --> 01:43:25,744 CENTER AT LARGE, TEACHING NURSE 2623 01:43:25,744 --> 01:43:29,114 MANAGERS HOW TO LOOK AT THE 2624 01:43:29,114 --> 01:43:33,419 PATIENT, EXPERIENCE METRICS, AND 2625 01:43:33,419 --> 01:43:35,521 SO WE'VE BEEN WITH PRESS GANEY 2626 01:43:35,521 --> 01:43:36,722 TWO YEARS, WORKING CLOSELY 2627 01:43:36,722 --> 01:43:39,124 LOOKING AT THE DATA, USING IT, 2628 01:43:39,124 --> 01:43:40,893 DISSEMINATING IT SO PEOPLE ARE 2629 01:43:40,893 --> 01:43:41,760 FAMILIAR WITH IT. 2630 01:43:41,760 --> 01:43:43,996 SO IT'S STILL A WORK IN 2631 01:43:43,996 --> 01:43:44,263 PROGRESS. 2632 01:43:44,263 --> 01:43:45,130 >> THAT'S THE STATS. 2633 01:43:45,130 --> 01:43:45,364 >> YES. 2634 01:43:45,364 --> 01:43:47,566 >> THE ACTUAL GOALS, THE THINGS 2635 01:43:47,566 --> 01:43:51,170 YOU'RE TRYING TO ENCOURAGE, DO 2636 01:43:51,170 --> 01:43:54,173 THEY FLIP THROUGH ON THE WAY 2637 01:43:54,173 --> 01:43:56,876 OTHER INFORMATIONAL GOALS LIKE 2638 01:43:56,876 --> 01:44:02,915 HAND WASHING DID ON THE SCREEN 2639 01:44:02,915 --> 01:44:03,115 SAVER? 2640 01:44:03,115 --> 01:44:03,415 >> NOT YET. 2641 01:44:03,415 --> 01:44:13,893 THAT'S A GREAT SUGGESTION. 2642 01:44:14,426 --> 01:44:15,294 >> TWO-PART QUESTION BUT THE 2643 01:44:15,294 --> 01:44:15,794 ANSWER MAY BE THE SAME. 2644 01:44:15,794 --> 01:44:16,428 WHICH OF THE STANDARDS ARE MOST 2645 01:44:16,428 --> 01:44:17,263 DISTINCT FOR THE NIH TO ACHIEVE 2646 01:44:17,263 --> 01:44:18,063 VERSUS OTHER MAGNET 2647 01:44:18,063 --> 01:44:19,331 INSTITUTIONS? 2648 01:44:19,331 --> 01:44:21,267 AND WHICH ARE MOST DIFFICULT OR 2649 01:44:21,267 --> 01:44:30,142 CHALLENGING FROM YOUR POINT OF 2650 01:44:30,142 --> 01:44:34,713 VIEW? 2651 01:44:34,713 --> 01:44:35,347 >> THAT'S AN EXCELLENT QUESTION. 2652 01:44:35,347 --> 01:44:35,981 SO, IN THE CHAPTER, I'M CALLING 2653 01:44:35,981 --> 01:44:36,582 THEM CHAPTERS, NEW KNOWLEDGE, 2654 01:44:36,582 --> 01:44:38,417 INNOVATION, IMPROVEMENT, IS 2655 01:44:38,417 --> 01:44:39,685 WHERE NURSING, EVIDENCE-BASED 2656 01:44:39,685 --> 01:44:41,253 PROJECTS, THAT CHAPTER WE'RE 2657 01:44:41,253 --> 01:44:43,489 JUST ABOUT DONE WITH ALL OF IT. 2658 01:44:43,489 --> 01:44:45,658 SO THAT WE'RE GOOD. 2659 01:44:45,658 --> 01:44:51,230 THANKS IN LARGE PART TO DR. GWEN 2660 01:44:51,230 --> 01:44:55,134 WALLEN AND HER TRANSLATIONAL AND 2661 01:44:55,134 --> 01:44:55,734 BIOBEHAVIORAL HEALTH AND 2662 01:44:55,734 --> 01:44:56,802 DISPARITIES RESEARCH BRANCH, 2663 01:44:56,802 --> 01:44:59,405 WE'RE USING A NUMBER OF THE 2664 01:44:59,405 --> 01:45:00,139 RESEARCH -- NURSING RESEARCH 2665 01:45:00,139 --> 01:45:01,807 STUDIES FROM THAT. 2666 01:45:01,807 --> 01:45:05,644 SOME OF THE CHALLENGES ARE WHERE 2667 01:45:05,644 --> 01:45:08,414 DATA, OUTCOMES DATA, IS 2668 01:45:08,414 --> 01:45:08,981 REQUIRED. 2669 01:45:08,981 --> 01:45:10,716 WE JUST HAVEN'T BEEN THINKING 2670 01:45:10,716 --> 01:45:12,284 THAT WAY, AS WE DO A PROJECT, 2671 01:45:12,284 --> 01:45:13,052 RIGHT? 2672 01:45:13,052 --> 01:45:15,654 BUT THAT'S PART OF THE 2673 01:45:15,654 --> 01:45:17,289 TRANSFORMATION THAT I'VE SEEN IS 2674 01:45:17,289 --> 01:45:22,094 WE NOW HAVE PEOPLE COLLECTING 2675 01:45:22,094 --> 01:45:24,330 PRE-DATA SO THEN WE HAVE THEN 2676 01:45:24,330 --> 01:45:25,731 POST FOR OUTCOMES. 2677 01:45:25,731 --> 01:45:27,666 WE'RE GOOD WITH PROCESS MEASURES 2678 01:45:27,666 --> 01:45:30,202 AND MAKING PROCESS IMPROVEMENT, 2679 01:45:30,202 --> 01:45:31,971 BUT IT'S STARTING TO THINK WHAT 2680 01:45:31,971 --> 01:45:34,173 ARE OUTCOMES, THAT'S ALSO BEEN A 2681 01:45:34,173 --> 01:45:35,708 BIG EDUCATION. 2682 01:45:35,708 --> 01:45:38,210 IT'S PATIENT OUTCOMES, IT'S 2683 01:45:38,210 --> 01:45:39,511 STAFF OUTCOMES, IT'S IN LARGE 2684 01:45:39,511 --> 01:45:45,017 PART. 2685 01:45:45,017 --> 01:45:48,621 THANK YOU. 2686 01:45:48,621 --> 01:45:51,824 >> THANK YOU. 2687 01:45:51,824 --> 01:45:52,424 THANKS FOR YOUR PRESENTATION. 2688 01:45:52,424 --> 01:45:53,025 AND LEADERSHIP AND ENERGY AND 2689 01:45:53,025 --> 01:45:53,258 PASSION. 2690 01:45:53,258 --> 01:45:53,892 I HEARD EARLIER ABOUT THE -- WE 2691 01:45:53,892 --> 01:45:54,860 HEARD EARLIER ABOUT THE SAFETY 2692 01:45:54,860 --> 01:45:57,229 CULTURE SURVEY THAT WE HOPE TO 2693 01:45:57,229 --> 01:45:57,463 CONDUCT. 2694 01:45:57,463 --> 01:45:59,231 HAVE YOU YET THOUGHT ABOUT OR 2695 01:45:59,231 --> 01:46:02,935 BEEN ABLE TO CONSIDER HOW TO TIE 2696 01:46:02,935 --> 01:46:04,603 THE TWO SURVEY RESULTS TOGETHER? 2697 01:46:04,603 --> 01:46:07,272 I MEAN, HOW WE TIE TOGETHER 2698 01:46:07,272 --> 01:46:08,540 ENGAGEMENT WITH SAFETY, IF WE 2699 01:46:08,540 --> 01:46:10,376 SEE A NURSING UNIT WHERE 2700 01:46:10,376 --> 01:46:13,078 EVERYONE IS HIGHLY ENGAGED AND 2701 01:46:13,078 --> 01:46:14,446 HIGHLY ENERGIZE AND MOTIVATED IS 2702 01:46:14,446 --> 01:46:16,081 THAT ALSO A SAFER UNIT FROM THE 2703 01:46:16,081 --> 01:46:17,416 STANDPOINT OF A CULTURE OF 2704 01:46:17,416 --> 01:46:20,019 SAFETY OR IS THAT PREMATURE ASK 2705 01:46:20,019 --> 01:46:26,892 AT THIS POINT? 2706 01:46:26,892 --> 01:46:27,493 >> I THINK THAT WOULD BE VERY 2707 01:46:27,493 --> 01:46:27,993 INTERESTING TO LOOK AT. 2708 01:46:27,993 --> 01:46:28,494 WE DON'T HAVE THOSE TWO 2709 01:46:28,494 --> 01:46:28,961 CORRELATED RIGHT NOW. 2710 01:46:28,961 --> 01:46:32,831 IT DEPENDS ON HOW WE GET THE 2711 01:46:32,831 --> 01:46:33,198 DATA. 2712 01:46:33,198 --> 01:46:35,234 IT DEPENDS HOW WE GET RESULTS 2713 01:46:35,234 --> 01:46:35,668 BACK. 2714 01:46:35,668 --> 01:46:38,971 THEY ARE AT THE UNIT LEVEL, AND 2715 01:46:38,971 --> 01:46:40,806 WE HAVE FEDERAL EMPLOYEE 2716 01:46:40,806 --> 01:46:42,474 VIEWPOINT SURVEY RESULTS AT UNIT 2717 01:46:42,474 --> 01:46:42,675 LEVEL. 2718 01:46:42,675 --> 01:46:46,812 THERE'S PERHAPS YOU CAN LOOK TO 2719 01:46:46,812 --> 01:46:47,946 SEE IF THERE'S ANYTHING TO LEARN 2720 01:46:47,946 --> 01:46:49,281 FROM IT. 2721 01:46:49,281 --> 01:46:51,517 I DON'T WANT TO SAY CORRELATIONS 2722 01:46:51,517 --> 01:46:53,819 BECAUSE, AGAIN, WE'LL ALSO HAVE 2723 01:46:53,819 --> 01:46:55,154 DIFFERENT PEOPLE ARE COMPLETING 2724 01:46:55,154 --> 01:46:56,388 THE SURVEYS TOO. 2725 01:46:56,388 --> 01:46:58,190 CULTURE OF SAFETY SURVEY IS OPEN 2726 01:46:58,190 --> 01:47:00,192 TO EVERYBODY WHO WORKS AT THE 2727 01:47:00,192 --> 01:47:01,960 CLINICAL CENTER WHEREAS THE 2728 01:47:01,960 --> 01:47:03,062 FEDERAL EMPLOYEE VIEWPOINT 2729 01:47:03,062 --> 01:47:06,765 SURVEY IS GEARED TOWARDS 2730 01:47:06,765 --> 01:47:07,232 EMPLOYEES. 2731 01:47:07,232 --> 01:47:08,300 BUT STILL IT'S AN INTERESTING 2732 01:47:08,300 --> 01:47:17,376 THING TO LOOK AT. 2733 01:47:17,376 --> 01:47:18,043 >> A QUESTION FROM ZOOM FROM 2734 01:47:18,043 --> 01:47:21,747 DAVID. 2735 01:47:21,747 --> 01:47:22,281 >> TERRIFIC PRESENTATION. 2736 01:47:22,281 --> 01:47:22,848 IT'S WONDERFUL THAT THE NIH 2737 01:47:22,848 --> 01:47:23,415 CLINICAL CENTER IS GOING FOR 2738 01:47:23,415 --> 01:47:26,819 MAGNET STATUS. 2739 01:47:26,819 --> 01:47:28,253 I'M CURIOUS THAT NATIONALLY 2740 01:47:28,253 --> 01:47:29,154 CLINICIAN BURNOUT PARTICULARLY 2741 01:47:29,154 --> 01:47:30,255 AND NURSING AND STAFFING IS A 2742 01:47:30,255 --> 01:47:31,757 MAJOR ISSUE. 2743 01:47:31,757 --> 01:47:33,892 HOW DOES THAT AFFECT THIS 2744 01:47:33,892 --> 01:47:37,629 ACCREDITATION PROCESS FOR THE 2745 01:47:37,629 --> 01:47:44,703 NIH CLINICAL CENTER? 2746 01:47:44,703 --> 01:47:45,170 >> WELL, WE FACED SAME 2747 01:47:45,170 --> 01:47:45,471 CHALLENGES. 2748 01:47:45,471 --> 01:47:45,938 WE HAVE VACANCIES AND 2749 01:47:45,938 --> 01:47:46,472 RECRUITMENT CHALLENGES, AS 2750 01:47:46,472 --> 01:47:46,805 EVERYONE ELSE. 2751 01:47:46,805 --> 01:47:49,541 BUT I THINK THE MAGNET JOURNEY 2752 01:47:49,541 --> 01:47:51,577 HAS BEEN KIND OF A RALLY TO 2753 01:47:51,577 --> 01:47:55,647 REALLY SHOW HOW WELL WE DO. 2754 01:47:55,647 --> 01:47:58,117 IT'S REALLY REFLECTING, IT'S THE 2755 01:47:58,117 --> 01:47:59,218 NURSES, THE CAREGIVERS, ALL OF 2756 01:47:59,218 --> 01:48:00,819 THE STAFF OF THE CLINICAL 2757 01:48:00,819 --> 01:48:02,321 CENTER, IT'S A REFLECTION OF 2758 01:48:02,321 --> 01:48:03,956 THEIR WORK. 2759 01:48:03,956 --> 01:48:05,290 WE'RE CATALOGING THEIR WORK. 2760 01:48:05,290 --> 01:48:07,626 WE WERE AT A CONFERENCE 2761 01:48:07,626 --> 01:48:10,195 RECENTLY, THERE WAS SOME OF OUR 2762 01:48:10,195 --> 01:48:12,164 STAFF MEMBERS, WE NEED TO BE 2763 01:48:12,164 --> 01:48:14,800 PRESENTING HERE BECAUSE WE CAN 2764 01:48:14,800 --> 01:48:15,901 HELP PEOPLE. 2765 01:48:15,901 --> 01:48:19,071 SO I THINK WHILE THE JOURNEY AND 2766 01:48:19,071 --> 01:48:21,273 THE -- IT'S REALLY THE DOCUMENT 2767 01:48:21,273 --> 01:48:23,375 WRITING THAT'S REALLY THE 2768 01:48:23,375 --> 01:48:23,776 BIGGEST CHALLENGE. 2769 01:48:23,776 --> 01:48:27,246 I THINK BEING ABLE TO REFLECT 2770 01:48:27,246 --> 01:48:29,148 AND SHOWCASE ALL THE WORK THAT'S 2771 01:48:29,148 --> 01:48:35,387 BEING DONE CAN BE A MORALE 2772 01:48:35,387 --> 01:48:36,155 BOOSTER. 2773 01:48:36,155 --> 01:48:37,489 ALSO THERE ARE THINGS WE LEARN 2774 01:48:37,489 --> 01:48:39,658 PERHAPS WHERE WE NEED TO 2775 01:48:39,658 --> 01:48:40,993 RESOURCE DIFFERENTLY TOO TO HELP 2776 01:48:40,993 --> 01:48:44,830 SUPPORT THOSE AREAS. 2777 01:48:44,830 --> 01:48:48,634 WE ALSO RECENTLY PUBLISHED THE 2778 01:48:48,634 --> 01:48:49,668 2021-2022 NURSING DEPARTMENT 2779 01:48:49,668 --> 01:48:52,037 ANNUAL REPORT, IT WAS DONE 2780 01:48:52,037 --> 01:48:53,038 DIFFERENTLY. 2781 01:48:53,038 --> 01:48:54,740 AND HAPPY TO SHARE THE LINK TO 2782 01:48:54,740 --> 01:48:56,842 THAT TO THE BOARD MEMBERS. 2783 01:48:56,842 --> 01:48:59,945 BUT THE FEEDBACK WE'VE SEEN WAS 2784 01:48:59,945 --> 01:49:00,445 SO POSITIVE, ESPECIALLY 2785 01:49:00,445 --> 01:49:01,747 EVERYONE'S PICTURES IN IT AS 2786 01:49:01,747 --> 01:49:03,015 WELL BUT A REFLECTION OF ALL OF 2787 01:49:03,015 --> 01:49:05,250 THE WORK THAT'S DONE NOT ONLY IN 2788 01:49:05,250 --> 01:49:06,151 THE NURSING DEPARTMENT BUT 2789 01:49:06,151 --> 01:49:07,786 THROUGHOUT THE CLINICAL CENTER. 2790 01:49:07,786 --> 01:49:13,292 I HOPE I ANSWERED YOUR QUESTION. 2791 01:49:13,292 --> 01:49:13,725 THANKS VERY MUCH. 2792 01:49:13,725 --> 01:49:17,262 THANK YOU. 2793 01:49:17,262 --> 01:49:17,496 OKAY. 2794 01:49:17,496 --> 01:49:17,996 IF THERE ARE KNOW OTHER 2795 01:49:17,996 --> 01:49:18,597 QUESTIONS, BARBARA, THANK YOU, 2796 01:49:18,597 --> 01:49:18,864 WELL DONE. 2797 01:49:18,864 --> 01:49:21,567 IT IS INDEED A JOURNEY. 2798 01:49:21,567 --> 01:49:23,669 YES. 2799 01:49:23,669 --> 01:49:26,004 WE LOOK FORWARD TO UPDATES IN 2800 01:49:26,004 --> 01:49:27,139 THE FUTURE. 2801 01:49:27,139 --> 01:49:27,606 THANK YOU SO MUCH. 2802 01:49:27,606 --> 01:49:28,106 THANK YOU VERY MUCH. 2803 01:49:28,106 --> 01:49:28,740 WE'RE JUST A LITTLE BIT BEHIND 2804 01:49:28,740 --> 01:49:29,308 BUT WE STILL NEED TO TAKE A 2805 01:49:29,308 --> 01:49:29,708 10-MINUTE BREAK. 2806 01:49:29,708 --> 01:49:32,132 SO WE'LL BREAK FOR TEN MINUTES. 2807 01:49:35,085 --> 01:49:35,619 WE'RE EXCITED TO HEAR FROM 2808 01:49:35,619 --> 01:49:36,153 DR. McKEEBY WHO SOLICITED 2809 01:49:36,153 --> 01:49:36,820 INPUT FOR CLINICAL CENTER 2810 01:49:36,820 --> 01:49:37,988 ELECTRONIC HEALTH RECORD 2811 01:49:37,988 --> 01:49:41,425 BUSINESS CASE, AND NOW MORE THAN 2812 01:49:41,425 --> 01:49:42,860 FOUR YEARS LATER RETURNS TO 2813 01:49:42,860 --> 01:49:44,995 SHARE THE CURRENT STATUS OF THE 2814 01:49:44,995 --> 01:49:46,130 EHR AND LOOK AHEAD. 2815 01:49:46,130 --> 01:49:47,464 I'LL TURN IT OVER TO YOU. 2816 01:49:47,464 --> 01:49:48,599 >> THANK YOU VERY MUCH. 2817 01:49:48,599 --> 01:49:51,568 I'LL TRY TO MAKE THIS THE MOST 2818 01:49:51,568 --> 01:49:52,937 EXCITING PRESENTATION OF THE 2819 01:49:52,937 --> 01:49:54,972 DAY. 2820 01:49:54,972 --> 01:49:57,074 THAT'S MY GOAL. 2821 01:49:57,074 --> 01:49:58,375 WE MIGHT HAVE TO SING A SONG. 2822 01:49:58,375 --> 01:49:59,643 WE'LL FIGURE THAT OUT. 2823 01:49:59,643 --> 01:50:02,112 DR. GILMAN THAT IS A SPECIAL 2824 01:50:02,112 --> 01:50:05,249 SONG HE LIKES TO SING, WE'LL SEE 2825 01:50:05,249 --> 01:50:09,019 IF WE WILL HAVE THAT AS PART OF 2826 01:50:09,019 --> 01:50:09,353 THIS. 2827 01:50:09,353 --> 01:50:11,722 SO, DR. GILMAN SAYS I'M UNIQUE, 2828 01:50:11,722 --> 01:50:16,060 SO YOU'LL SEE THAT DURING THIS 2829 01:50:16,060 --> 01:50:17,594 PRESENTATION HOPEFULLY. 2830 01:50:17,594 --> 01:50:20,030 DR. SANO HELPED WITH THE SLIDES. 2831 01:50:20,030 --> 01:50:22,766 HE'S ARE BASED ON SLIDES DR. 2832 01:50:22,766 --> 01:50:23,767 GILMAN CREATED. 2833 01:50:23,767 --> 01:50:28,205 WE ADDED A FEW THINGS BUT NOT 2834 01:50:28,205 --> 01:50:28,639 MUCH. 2835 01:50:28,639 --> 01:50:32,543 I STOLE A LOT OF THE MATERIAL HE 2836 01:50:32,543 --> 01:50:35,479 STARTED WITH. 2837 01:50:35,479 --> 01:50:37,948 DR. SONO IS LEAVING THE NIH. 2838 01:50:37,948 --> 01:50:41,919 I CRIED A FEW TIMES, GOING TO 2839 01:50:41,919 --> 01:50:43,787 THE V.A., BUT HE'S HELPED 2840 01:50:43,787 --> 01:50:45,356 PRODUCE MANY OF THE DOCUMENTS 2841 01:50:45,356 --> 01:50:49,360 THAT ARE NEEDED AS PART OF THE 2842 01:50:49,360 --> 01:50:54,431 EHR MODERNIZATION. 2843 01:50:54,431 --> 01:50:55,232 NEXT SLIDE. 2844 01:50:55,232 --> 01:50:59,970 THIS IS A HIGH VALUED ASSET, 2845 01:50:59,970 --> 01:51:02,272 HOMELAND SECURITY WENT THROUGH 2846 01:51:02,272 --> 01:51:05,676 ALL THE GOVERNMENT'S SYSTEMS AND 2847 01:51:05,676 --> 01:51:09,480 IDENTIFIED HIGH VALUE ASSETS. 2848 01:51:09,480 --> 01:51:11,281 THEY IDENTIFIED TOP 10% HIGH 2849 01:51:11,281 --> 01:51:15,552 VALUE ASSETS AND HANDED THAT 2850 01:51:15,552 --> 01:51:17,221 OVER TO HHS, HEALTH AND HUMAN 2851 01:51:17,221 --> 01:51:18,455 SERVICES DECIDED CRIS WAS NUMBER 2852 01:51:18,455 --> 01:51:19,256 ONE. 2853 01:51:19,256 --> 01:51:21,825 I DIDN'T WANT TO BE NUMBER ONE. 2854 01:51:21,825 --> 01:51:23,994 I WANTED TO BE IN THE TOP, AND 2855 01:51:23,994 --> 01:51:25,462 THAT WAS GREAT, BUT I DIDN'T 2856 01:51:25,462 --> 01:51:35,639 WANT TO NECESSARILY BE NUMBER 2857 01:51:35,639 --> 01:51:37,341 ONE. 2858 01:51:37,341 --> 01:51:38,642 INDIAN HEALTH SERVICES AND CMS 2859 01:51:38,642 --> 01:51:40,544 ONE AND TWO, CRIS BECAME NUMBER 2860 01:51:40,544 --> 01:51:43,714 THREE. 2861 01:51:43,714 --> 01:51:47,217 SO WHAT THAT MEANS IS EVERY 2862 01:51:47,217 --> 01:51:48,852 THREE YEARS THERE'S AN 2863 01:51:48,852 --> 01:51:50,120 ASSESSMENT, THEY ASK QUESTIONS, 2864 01:51:50,120 --> 01:51:51,455 REVIEW A LOT OF TIMES. 2865 01:51:51,455 --> 01:51:52,923 WE'VE GONE THROUGH TWO 2866 01:51:52,923 --> 01:51:54,525 ASSESSMENTS, THE FIRST ONE THEY 2867 01:51:54,525 --> 01:51:57,494 SAID WE DID A GREAT JOB AND 2868 01:51:57,494 --> 01:52:00,998 SHOWED A HEAT MAP WITH ALL RED. 2869 01:52:00,998 --> 01:52:04,068 I ASKED IF RED MEANT GOOD. 2870 01:52:04,068 --> 01:52:05,936 THEY TOLD ME NO. 2871 01:52:05,936 --> 01:52:08,472 BUT WE HAVE THE ANSWERS TO ALL 2872 01:52:08,472 --> 01:52:10,908 THE QUESTIONS BUT PART OF THE 2873 01:52:10,908 --> 01:52:13,777 ITEM WAS TO MAKE SURE OUR 2874 01:52:13,777 --> 01:52:17,081 DOCUMENTATION IDENTIFIED EVERY 2875 01:52:17,081 --> 01:52:18,315 SINGLE COMPONENT, EVERY SECURITY 2876 01:52:18,315 --> 01:52:20,117 CONTROL THAT THEY WERE 2877 01:52:20,117 --> 01:52:20,651 ASSESSING. 2878 01:52:20,651 --> 01:52:24,288 THE SECOND TIME WE GOT MORE 2879 01:52:24,288 --> 01:52:26,223 GREEN, MORE OPPORTUNITIES. 2880 01:52:26,223 --> 01:52:28,392 WE HAD A FEW ITEMS WE HAD TO 2881 01:52:28,392 --> 01:52:31,728 ADDRESS PARTIALLY OR THE BIGGEST 2882 01:52:31,728 --> 01:52:34,364 ONE WAS ENSURING CRIS AND ITS 2883 01:52:34,364 --> 01:52:35,265 SECURITY BOUNDARY WAS SEPARATE 2884 01:52:35,265 --> 01:52:38,102 FROM ALL THE OTHER SYSTEMS. 2885 01:52:38,102 --> 01:52:42,005 THAT IS SOMETHING WE ARE WORKING 2886 01:52:42,005 --> 01:52:42,739 ON. 2887 01:52:42,739 --> 01:52:44,641 FIRST ASSESSMENT WE NEEDED TO 2888 01:52:44,641 --> 01:52:47,177 ENSURE EVERYTHING WAS ENCRYPTED 2889 01:52:47,177 --> 01:52:48,512 IN TRANSIT. 2890 01:52:48,512 --> 01:52:50,280 SECOND THEY SAID, OH, NOT ALWAYS 2891 01:52:50,280 --> 01:52:51,415 ENCRYPTED BECAUSE YOU NEED TO 2892 01:52:51,415 --> 01:52:56,153 SEE WHAT TRAFFIC IS GOING 2893 01:52:56,153 --> 01:52:56,587 ACROSS. 2894 01:52:56,587 --> 01:52:58,856 WE'VE HAD TO MODIFY OUR 2895 01:52:58,856 --> 01:53:03,360 ARCHITECTURE TO ACCOUNT FOR THAT 2896 01:53:03,360 --> 01:53:03,794 ASSESSMENT. 2897 01:53:03,794 --> 01:53:05,462 THIS IDENTIFIES A DESCRIPTION OF 2898 01:53:05,462 --> 01:53:07,698 WHAT CRIS IS FROM A SECURITY 2899 01:53:07,698 --> 01:53:09,766 STANDPOINT THAT WE PROVIDE ON 2900 01:53:09,766 --> 01:53:12,069 ALL OUR SECURITY DOCUMENTS, 2901 01:53:12,069 --> 01:53:14,972 ESPECIALLY FOR THE HIGH VALUED 2902 01:53:14,972 --> 01:53:16,473 ASSET. 2903 01:53:16,473 --> 01:53:17,774 NEXT SLIDE. 2904 01:53:17,774 --> 01:53:24,281 SO, SUMMARIZE CLINICAL -- 2905 01:53:24,281 --> 01:53:26,817 SUNRISE COMMERCIAL MANAGER IS 2906 01:53:26,817 --> 01:53:27,951 THE COMMERCIAL PLATFORM, 2907 01:53:27,951 --> 01:53:28,619 CLINICAL RESEARCH INFORMATION 2908 01:53:28,619 --> 01:53:29,319 SYSTEM, CRIS. 2909 01:53:29,319 --> 01:53:32,489 MY WIFE SAYS CRIS IS MY MOST 2910 01:53:32,489 --> 01:53:33,624 IMPORTANT CHILD. 2911 01:53:33,624 --> 01:53:36,593 I HAVE ACTUALLY THREE CHILDREN 2912 01:53:36,593 --> 01:53:38,662 BUT CRIS IS A VERY IMPORTANT 2913 01:53:38,662 --> 01:53:43,767 PART OF MY BEING AND MY LIFE, AT 2914 01:53:43,767 --> 01:53:45,802 LEAST IT HAS BEEN. 2915 01:53:45,802 --> 01:53:47,437 I WORKED FOR CLINICAL CENTER FOR 2916 01:53:47,437 --> 01:53:51,808 32 YEARS, 17 YEARS AS THE CIO, 2917 01:53:51,808 --> 01:53:57,314 ALL OF IT ALWAYS OVER THE 2918 01:53:57,314 --> 01:53:58,582 MEDICAL INFORMATION SYSTEM. 2919 01:53:58,582 --> 01:54:01,185 WE INSTALLED IN 2004, THE BEST 2920 01:54:01,185 --> 01:54:03,520 AVAILABLE EHR SOLUTION AT THE 2921 01:54:03,520 --> 01:54:05,489 TIME, ESPECIALLY FOR CLINICAL 2922 01:54:05,489 --> 01:54:07,424 RESEARCH. 2923 01:54:07,424 --> 01:54:11,428 ALLOWS US THE ABILITY TO DO MANY 2924 01:54:11,428 --> 01:54:12,362 THINGS, CUSTOMIZE, THE BLESSING 2925 01:54:12,362 --> 01:54:14,531 AND CURSE IS WE CAN BUILD 2926 01:54:14,531 --> 01:54:16,200 ANYTHING WE WANT AND BUT WE HAVE 2927 01:54:16,200 --> 01:54:18,202 TO SUPPORT IT, RIGHT? 2928 01:54:18,202 --> 01:54:23,240 SO WE HAVE THAT AS PART OF IT. 2929 01:54:23,240 --> 01:54:26,710 STEPHANIE HAS BEEN PART OF A FEW 2930 01:54:26,710 --> 01:54:27,377 OPERATIONAL REVIEWS, REVIEWING 2931 01:54:27,377 --> 01:54:30,314 DCRI AS WELL AS CRIS, AND WHEN 2932 01:54:30,314 --> 01:54:33,817 SHE CAME ONCE I TOLD HER HOW 2933 01:54:33,817 --> 01:54:34,518 MANY PROTOCOL ORDER SETS WE 2934 01:54:34,518 --> 01:54:36,587 DEVELOP IN A YEAR AND SHE WENT 2935 01:54:36,587 --> 01:54:38,222 BACK TO HER PROTOCOL ORDER SET 2936 01:54:38,222 --> 01:54:42,726 PEOPLE AND SHE CAME BACK AND 2937 01:54:42,726 --> 01:54:44,328 SAID THAT'S NOT POSSIBLE. 2938 01:54:44,328 --> 01:54:48,131 THAT IS OUR AMOUNT. 2939 01:54:48,131 --> 01:54:52,636 EVEN THOUGH WE HAVE PATIENT 2940 01:54:52,636 --> 01:54:57,140 CENSUS IN THE HUNDREDS, CRIS HAS 2941 01:54:57,140 --> 01:54:58,775 TO SUPPORT EVERY DIFFERENT 2942 01:54:58,775 --> 01:55:00,477 INSTITUTE WORKFLOW, AND SO WE'RE 2943 01:55:00,477 --> 01:55:01,211 A LITTLE BIT OF EVERYTHING, 2944 01:55:01,211 --> 01:55:01,411 RIGHT? 2945 01:55:01,411 --> 01:55:04,248 WE'RE A LITTLE BIT OF CANCER, A 2946 01:55:04,248 --> 01:55:07,384 LITTLE BIT OF NEUROLOGY, A 2947 01:55:07,384 --> 01:55:10,520 LITTLE BIT OF EVERY COMPONENT OF 2948 01:55:10,520 --> 01:55:11,521 EVERY INSTITUTE'S INTRAMURAL 2949 01:55:11,521 --> 01:55:11,922 RESEARCH PROGRAM. 2950 01:55:11,922 --> 01:55:13,757 AND SO WE HAVE TO BE ABLE TO 2951 01:55:13,757 --> 01:55:21,064 CUSTOMIZE AND MEET ALL THOSE 2952 01:55:21,064 --> 01:55:21,398 REQUIREMENTS. 2953 01:55:21,398 --> 01:55:22,699 SUNRISE HAS GONE THROUGH 2954 01:55:22,699 --> 01:55:28,839 DIFFERENT VENDORS, WHEN WE 2955 01:55:28,839 --> 01:55:30,941 PURCHASED PROCUREMENT WAS ECLIP 2956 01:55:30,941 --> 01:55:33,644 SYS AND THEN ALLSCRIPTS TO 2957 01:55:33,644 --> 01:55:35,379 INTEGRATE OUR INPATIENT AND 2958 01:55:35,379 --> 01:55:35,679 OUTPATIENT. 2959 01:55:35,679 --> 01:55:37,180 WE USE OUR PRODUCT FOR BOTH 2960 01:55:37,180 --> 01:55:38,382 INPATIENT AND OUTPATIENT. 2961 01:55:38,382 --> 01:55:40,651 WE DON'T HAVE THE AMBULATORY 2962 01:55:40,651 --> 01:55:41,518 CARE MODULE. 2963 01:55:41,518 --> 01:55:43,820 AND SO WE WERE HOPING ALLSCRIPTS 2964 01:55:43,820 --> 01:55:45,722 WOULD FILL THAT HOLE BUT 2965 01:55:45,722 --> 01:55:50,160 UNFORTUNATELY THEY DIDN'T. 2966 01:55:50,160 --> 01:55:53,096 AND THEY WERE NOW ALTERRA 2967 01:55:53,096 --> 01:55:54,097 DIGITAL HEALTH, AND THAT'S 2968 01:55:54,097 --> 01:55:55,365 ENTERTAINING AS WELL BECAUSE 2969 01:55:55,365 --> 01:55:56,300 WE'RE WORKING THROUGH THE SAME 2970 01:55:56,300 --> 01:55:59,603 PROBLEMS THAT WE'VE HAD FOR THE 2971 01:55:59,603 --> 01:56:03,307 LAST 15 YEARS, REPEATING A LOT 2972 01:56:03,307 --> 01:56:05,475 OF CONVERSATIONS THAT WE'VE HAD 2973 01:56:05,475 --> 01:56:07,010 TO UNDERSTAND OUR DIFFERENCES. 2974 01:56:07,010 --> 01:56:08,979 AND SINCE WE ARE FOCUSED ON 2975 01:56:08,979 --> 01:56:09,880 CLINICAL RESEARCH, NOT 2976 01:56:09,880 --> 01:56:11,748 EVERYTHING THAT WORKS IN THE 2977 01:56:11,748 --> 01:56:15,519 COMMERCIAL WORLD WILL WORK FOR 2978 01:56:15,519 --> 01:56:16,019 US. 2979 01:56:16,019 --> 01:56:19,189 AND SOMETIMES WHEN DEVELOPERS 2980 01:56:19,189 --> 01:56:20,991 THINK THE COMMERCIAL MARKET, 2981 01:56:20,991 --> 01:56:23,593 THEY IMPLEMENT DIFFERENT 2982 01:56:23,593 --> 01:56:24,861 COMPONENTS THAT DON'T 2983 01:56:24,861 --> 01:56:26,296 NECESSARILY MEET THE CLINICAL 2984 01:56:26,296 --> 01:56:28,632 RESEARCH COMPONENT OR HAVE THAT 2985 01:56:28,632 --> 01:56:34,037 FLEXIBILITY THAT WE NEED. 2986 01:56:34,037 --> 01:56:34,638 NEXT SLIDE. 2987 01:56:34,638 --> 01:56:37,174 WE ARE HANDS ANALYTICS STAGE 7, 2988 01:56:37,174 --> 01:56:39,509 THE HIGHEST FOR -- THAT'S THE 2989 01:56:39,509 --> 01:56:40,277 HIGHEST STAGE. 2990 01:56:40,277 --> 01:56:43,447 IT MEANS WE HAVE ADOPTED AND 2991 01:56:43,447 --> 01:56:44,481 UTILIZED EMR WELL, WE DON'T 2992 01:56:44,481 --> 01:56:46,783 BELIEVE IN PAPER, TRY NOT TO 2993 01:56:46,783 --> 01:56:48,952 RELY ON PAPER. 2994 01:56:48,952 --> 01:56:52,389 THERE IS PAPER BUT VERY SMALL 2995 01:56:52,389 --> 01:56:54,157 AMOUNT OF PAPER AT THE CLINICAL 2996 01:56:54,157 --> 01:56:54,491 CENTER. 2997 01:56:54,491 --> 01:56:57,828 WE'LL SHOW A PICTURE OF WHERE WE 2998 01:56:57,828 --> 01:56:59,529 ARE. 2999 01:56:59,529 --> 01:57:02,966 BASICALLY WHEN WE WERE ANALYZED 3000 01:57:02,966 --> 01:57:04,534 FOR HANDS ANALYTICS THEY NEEDED 3001 01:57:04,534 --> 01:57:06,903 AN HOUR-AND-A-HALF TO REVIEW OUR 3002 01:57:06,903 --> 01:57:07,804 MEDICAL RECORD ROOM. 3003 01:57:07,804 --> 01:57:10,741 NO, WE SAID YOU ONLY NEED FIVE 3004 01:57:10,741 --> 01:57:10,974 MINUTES. 3005 01:57:10,974 --> 01:57:13,543 NO, THEY WERE ADAMANT THEY 3006 01:57:13,543 --> 01:57:14,945 NEEDED AN HOUR-AND-A-HALF. 3007 01:57:14,945 --> 01:57:18,415 I'M LIKE, BUT THERE IS NO ROOM. 3008 01:57:18,415 --> 01:57:23,320 SO, FINALLY WHEN THEY WENT OVER 3009 01:57:23,320 --> 01:57:29,926 TO OUR HEALTH INFORMATION THEY 3010 01:57:29,926 --> 01:57:36,466 REALIZED WE DON'T HAVE SHELVES, 3011 01:57:36,466 --> 01:57:39,503 A SMALL SHELF FOR PAPER TO GET 3012 01:57:39,503 --> 01:57:40,370 STAND, AT THAT TIME 10 OR 12 3013 01:57:40,370 --> 01:57:41,872 RECORDS OR PIECES OF PAPER ON 3014 01:57:41,872 --> 01:57:44,241 THE SHELF BECAUSE WE SCAN ON THE 3015 01:57:44,241 --> 01:57:44,474 FLOORS. 3016 01:57:44,474 --> 01:57:47,244 AND SO WE DON'T HAVE THE PAPER 3017 01:57:47,244 --> 01:57:50,914 THAT THEY WERE LOOKING FOR. 3018 01:57:50,914 --> 01:57:53,016 SO, THEY WERE SURPRISED BUT THEY 3019 01:57:53,016 --> 01:57:54,151 WERE GREATLY APPRECIATIVE OF 3020 01:57:54,151 --> 01:58:00,457 WHAT WE WERE TRYING TO SAY. 3021 01:58:00,457 --> 01:58:03,193 WE WERE FOR ALLSCRIPTS NUMBER 3022 01:58:03,193 --> 01:58:11,034 ONE OR NUMBER TWO OF THE HIMSS 3023 01:58:11,034 --> 01:58:11,301 ANALYTICS. 3024 01:58:11,301 --> 01:58:17,507 IT WAS GOOD FOR US TO GO THROUGH 3025 01:58:17,507 --> 01:58:18,708 TO RECOGNIZE WHERE WE ARE AND 3026 01:58:18,708 --> 01:58:22,446 THAT'S WHY WE WENT THROUGH THAT 3027 01:58:22,446 --> 01:58:23,580 CERTIFICATION. 3028 01:58:23,580 --> 01:58:25,615 NEXT SLIDE. 3029 01:58:25,615 --> 01:58:28,251 AND SO THE BOTTOM LINE, DR. 3030 01:58:28,251 --> 01:58:29,586 GILMAN'S SLIDE THAT I'M STEALING 3031 01:58:29,586 --> 01:58:36,660 AND USING WHENEVER I GO. 3032 01:58:36,660 --> 01:58:38,762 THE CURRENT EHR IS 19 YEARS OLD, 3033 01:58:38,762 --> 01:58:39,963 THE DAY MY WIFE MOVED TO 3034 01:58:39,963 --> 01:58:41,631 MICHIGAN, I'M NOT SURE THE 3035 01:58:41,631 --> 01:58:43,033 RELATIONSHIP, IT WAS DEFINITELY 3036 01:58:43,033 --> 01:58:47,370 A STRESSFUL DAY BUT IT'S BEEN 19 3037 01:58:47,370 --> 01:58:48,171 YEARS THIS AUGUST. 3038 01:58:48,171 --> 01:58:50,507 AND IT IS REACHING ITS END OF 3039 01:58:50,507 --> 01:58:51,975 USEFUL LIFE. 3040 01:58:51,975 --> 01:58:55,545 WE ARE ON THE CURRENT VERSION, 3041 01:58:55,545 --> 01:58:57,180 WE'LL BE MIGRATED TO VERSION 22 3042 01:58:57,180 --> 01:59:00,617 IN FEBRUARY, SO WE'LL BE ON THE 3043 01:59:00,617 --> 01:59:01,084 CURRENT VERSION. 3044 01:59:01,084 --> 01:59:04,454 BUT THERE IS SUCH A LEVEL OF 3045 01:59:04,454 --> 01:59:06,890 COMPLEXITY AND YOU'LL SEE THAT 3046 01:59:06,890 --> 01:59:08,825 IN THE NEXT DIAGRAMS. 3047 01:59:08,825 --> 01:59:12,162 IT IS FRAGILE. 3048 01:59:12,162 --> 01:59:16,333 ANY LITTLE THING CAN CAUSE 3049 01:59:16,333 --> 01:59:16,733 ISSUES. 3050 01:59:16,733 --> 01:59:18,235 ANY LITTLE SECURITY REQUIREMENT 3051 01:59:18,235 --> 01:59:23,540 REQUIRES US TO MAKE SURE THAT WE 3052 01:59:23,540 --> 01:59:24,975 SOLVE DIFFERENT ISSUES AT THE 3053 01:59:24,975 --> 01:59:26,076 SAME TIME. 3054 01:59:26,076 --> 01:59:31,982 THERE'S UNINTENDED CONSEQUENCES 3055 01:59:31,982 --> 01:59:38,221 TO MANY DIFFERENT THINGS. 3056 01:59:38,221 --> 01:59:39,489 USER ACCEPTANCE AND USER 3057 01:59:39,489 --> 01:59:40,724 SATISFACTION, NOBODY LIKES THEY 3058 01:59:40,724 --> 01:59:43,527 ARE EHR BUT I DON'T WANT PEOPLE 3059 01:59:43,527 --> 01:59:47,931 TO HATE THE ORGANIZATION OR 3060 01:59:47,931 --> 01:59:49,366 AFFECT THEIR MORALE AND 3061 01:59:49,366 --> 01:59:53,336 SOMETIMES WHAT IS IN CRIS HAS 3062 01:59:53,336 --> 01:59:54,671 AFFECTED PEOPLE'S MORALE. 3063 01:59:54,671 --> 01:59:56,606 NOW, SOME PIECES OF SATISFACTION 3064 01:59:56,606 --> 01:59:59,276 ARE DIFFICULT BECAUSE WE MADE 3065 01:59:59,276 --> 02:00:00,310 ORGANIZATIONAL DECISIONS, AND 3066 02:00:00,310 --> 02:00:02,946 THEY AFFECT THE SATISFACTION. 3067 02:00:02,946 --> 02:00:04,247 WE DON'T DO ENCOUNTERS, 20 YEARS 3068 02:00:04,247 --> 02:00:05,815 AGO WE DIDN'T EVEN KNOW WHEN 3069 02:00:05,815 --> 02:00:07,317 PATIENTS WERE GOING TO BE HERE 3070 02:00:07,317 --> 02:00:08,985 AND DIDN'T KNOW UNTIL THEY LEFT. 3071 02:00:08,985 --> 02:00:10,854 WE DIDN'T HAVE IT 3072 02:00:10,854 --> 02:00:11,254 ELECTRONICALLY. 3073 02:00:11,254 --> 02:00:13,790 NOW IT WAS PAPER, SO WE KNEW TO 3074 02:00:13,790 --> 02:00:15,759 PREPARE FOR THEM FROM THAT 3075 02:00:15,759 --> 02:00:17,861 STANDPOINT, BUT IT WASN'T 3076 02:00:17,861 --> 02:00:20,297 ELECTRONIC SO WE COULDN'T 3077 02:00:20,297 --> 02:00:23,466 NECESSARILY BE ENCOUNTER BASED. 3078 02:00:23,466 --> 02:00:24,267 WE'RE HIPAA EXEMPT, AND SO BASED 3079 02:00:24,267 --> 02:00:28,638 ON THAT WE CAN'T DO CERTAIN 3080 02:00:28,638 --> 02:00:29,539 THINGS LIKE e-PRESCRIBE, WE 3081 02:00:29,539 --> 02:00:32,475 HAVE TO MAKE SURE WE DON'T TURN 3082 02:00:32,475 --> 02:00:34,711 THE HIPAA SWITCH. 3083 02:00:34,711 --> 02:00:36,880 NINE YEARS AGO, FOR ABOUT A 3084 02:00:36,880 --> 02:00:38,248 BRIEF PERIOD OF TIME, WE WERE 3085 02:00:38,248 --> 02:00:40,984 GOING TO DO THIRD PARTY BILLING. 3086 02:00:40,984 --> 02:00:44,588 AND WE HAD TO GO THROUGH THE 3087 02:00:44,588 --> 02:00:46,489 HIPAA PROCESS BUT THEN DR. 3088 02:00:46,489 --> 02:00:48,925 COLLINS WENT TO CONGRESS AND 3089 02:00:48,925 --> 02:00:50,527 TURNED THAT OFF, ABOUT TWO WEEKS 3090 02:00:50,527 --> 02:00:52,729 BEFORE WE WERE SUPPOSED TO GO 3091 02:00:52,729 --> 02:00:56,433 LIVE FOR BILLING OF THIRD PARTY 3092 02:00:56,433 --> 02:00:56,766 FOR RADIOLOGY. 3093 02:00:56,766 --> 02:01:01,605 AND SO WE ARE NOT HIPAA, SO WE 3094 02:01:01,605 --> 02:01:05,542 HAVE TO WATCH HOW WE DO 3095 02:01:05,542 --> 02:01:06,643 INTEROPERABILITY TYPE THINGS TO 3096 02:01:06,643 --> 02:01:08,979 MAKE SURE WE STAY THAT WAY. 3097 02:01:08,979 --> 02:01:11,481 WE DON'T WANT ANY UNINTENDED 3098 02:01:11,481 --> 02:01:13,283 CONSEQUENCES THERE. 3099 02:01:13,283 --> 02:01:13,984 NEXT SLIDE. 3100 02:01:13,984 --> 02:01:18,288 SO THIS IS THE PROPOSED SYSTEM 3101 02:01:18,288 --> 02:01:20,757 IN 2003. 3102 02:01:20,757 --> 02:01:22,892 DR. ROSENFELD WAS CIO AT THE 3103 02:01:22,892 --> 02:01:24,094 TIME. 3104 02:01:24,094 --> 02:01:25,962 ELAINE WAS HIS BIGGEST SUPPORT 3105 02:01:25,962 --> 02:01:30,767 ON MANY DIFFERENT LEVELS TO MAKE 3106 02:01:30,767 --> 02:01:35,005 SURE CRIS HAPPENED. 3107 02:01:35,005 --> 02:01:36,406 DR. GILMAN ASKS IF FLOWER 3108 02:01:36,406 --> 02:01:37,807 DIAGRAM IS STANDARD. 3109 02:01:37,807 --> 02:01:39,242 IT'S STANDARD IN MY MIND, IT'S 3110 02:01:39,242 --> 02:01:42,312 THE ONLY THING I KNOW. 3111 02:01:42,312 --> 02:01:44,447 I REFER TO THE FLOWER DIAGRAM. 3112 02:01:44,447 --> 02:01:47,817 IT'S SUPPOSED TO LOOK LIKE 3113 02:01:47,817 --> 02:01:49,953 PETALS AROUND THE EHR, AND THEN 3114 02:01:49,953 --> 02:01:52,155 A STEM FEEDING INTO A 3115 02:01:52,155 --> 02:01:52,722 REPOSITORY. 3116 02:01:52,722 --> 02:01:55,291 WE USED TO CALL IT AN AIRPORT 3117 02:01:55,291 --> 02:01:58,094 DIAGRAM AS WELL BUT I THINK IT 3118 02:01:58,094 --> 02:02:00,196 REALLY LOOKS LIKE A FLOWER. 3119 02:02:00,196 --> 02:02:08,104 THIS QUOTE IS FROM THE NIH 3120 02:02:08,104 --> 02:02:10,106 RECORD, TALKS ABOUT 26 YEARS 3121 02:02:10,106 --> 02:02:11,241 OLD, DIDN'T EVOLVE CORRECTLY. 3122 02:02:11,241 --> 02:02:13,843 WE'VE DONE OUR BEST WITH CRIS TO 3123 02:02:13,843 --> 02:02:15,712 EVOLVE AND MEET THE NEEDS BUT IT 3124 02:02:15,712 --> 02:02:24,220 HAS BEEN 19 YEARS WITH THE SAME 3125 02:02:24,220 --> 02:02:24,788 SYSTEM, AND SAME VENDOR 3126 02:02:24,788 --> 02:02:27,824 PHILOSOPHY, AND SO IT'S TIME TO 3127 02:02:27,824 --> 02:02:28,458 REVIEW WHAT'S OUT THERE, THAT 3128 02:02:28,458 --> 02:02:30,093 WAS PART OF THE BUSINESS CASE 3129 02:02:30,093 --> 02:02:33,029 WAS TO REVIEW WHAT'S OUT THERE 3130 02:02:33,029 --> 02:02:35,432 AND THAT RECOMMENDATION FROM THE 3131 02:02:35,432 --> 02:02:41,171 BUSINESS CASE WAS TO WORK ON THE 3132 02:02:41,171 --> 02:02:41,938 PROCUREMENT COMPONENT, SO THAT'S 3133 02:02:41,938 --> 02:02:44,441 WHERE WEIR HERE. 3134 02:02:44,441 --> 02:02:46,476 I TAKE THE FLOWER DIAGRAM AND 3135 02:02:46,476 --> 02:02:52,348 CREATE WHAT WAS - WHAT LOOKED 3136 02:02:52,348 --> 02:02:53,083 LIKE 2004. 3137 02:02:53,083 --> 02:02:55,351 WHEN WE DO AN ITERATION WE 3138 02:02:55,351 --> 02:02:58,621 UPDATE THIS DIAGRAM. 3139 02:02:58,621 --> 02:03:03,760 THIS WAS BASED ON ECLIPYSYS, 3140 02:03:03,760 --> 02:03:04,928 3.3, STEPHANIE MIGHT KNOW THE 3141 02:03:04,928 --> 02:03:09,299 NUMBER, IT DID HAVE EIMAR AND 3142 02:03:09,299 --> 02:03:10,934 VITALS, IMPLEMENTED NURSING 3143 02:03:10,934 --> 02:03:11,468 DOCUMENTATION, PHYSICIAN 3144 02:03:11,468 --> 02:03:11,801 DOCUMENTATION. 3145 02:03:11,801 --> 02:03:13,937 AT THE TIME WE WERE THE ONLY 3146 02:03:13,937 --> 02:03:16,673 ONES THAT CAN CHEMOTHERAPY 3147 02:03:16,673 --> 02:03:17,907 INSIDE THE EHR, ANOTHER HOSPITAL 3148 02:03:17,907 --> 02:03:19,976 EVERY TIME I WENT TO A MEETING 3149 02:03:19,976 --> 02:03:22,779 WAS UPSET THAT THEY WOULD SAY 3150 02:03:22,779 --> 02:03:24,714 NIH WAS FIRST, SO OF COURSE WEEP 3151 02:03:24,714 --> 02:03:27,617 HAVE TO BE FIRST FOR 3152 02:03:27,617 --> 02:03:28,051 CHEMOTHERAPY. 3153 02:03:28,051 --> 02:03:30,787 I MEAN, THAT MAKES SENSE. 3154 02:03:30,787 --> 02:03:32,455 BUT IT WAS ANOTHER CANCER 3155 02:03:32,455 --> 02:03:35,525 INSTITUTE THAT THEY WANTED TO BE 3156 02:03:35,525 --> 02:03:37,127 KNOWN AS NUMBER ONE. 3157 02:03:37,127 --> 02:03:39,529 SO, IN THE BLUE EVERYTHING IN 3158 02:03:39,529 --> 02:03:42,899 THE BLUE IS CRIS BOUNDARY, 3159 02:03:42,899 --> 02:03:45,001 CLOVER LEAF IS INTERFACE, 3160 02:03:45,001 --> 02:03:47,137 ANYTHING BELOW OR INSIDE THAT 3161 02:03:47,137 --> 02:03:48,838 CIRCLE IS THE VENDOR PRODUCT AND 3162 02:03:48,838 --> 02:03:52,208 WHAT'S IN THE VENDOR PRODUCT. 3163 02:03:52,208 --> 02:03:55,979 YELLOW ARE THE CLINICAL 3164 02:03:55,979 --> 02:03:57,547 INFORMATION SYSTEMS. 3165 02:03:57,547 --> 02:04:01,618 THEY ARE SEPARATE SO IT WAS AT 3166 02:04:01,618 --> 02:04:02,285 BEST A BRAID APPROACH. 3167 02:04:02,285 --> 02:04:05,755 AT THE TIME WE ONLY HAD ONE I.C. 3168 02:04:05,755 --> 02:04:09,793 THAT WE INTERFACED, THEY OWN THE 3169 02:04:09,793 --> 02:04:10,927 SOFT PATH MODULE OF SOFT 3170 02:04:10,927 --> 02:04:11,561 COMPUTER CORE. 3171 02:04:11,561 --> 02:04:12,929 IT'S IN OUR DATA CENTER. 3172 02:04:12,929 --> 02:04:15,198 WE SUPPORT IT BUT THEY OWN THAT 3173 02:04:15,198 --> 02:04:18,234 MODULE, SO THAT WAS THE ONLY 3174 02:04:18,234 --> 02:04:20,069 INSTITUTE INTERFACE, IF YOU 3175 02:04:20,069 --> 02:04:20,737 WILL. 3176 02:04:20,737 --> 02:04:23,439 ON THE RIGHT IS THE MEDICAL 3177 02:04:23,439 --> 02:04:25,942 RECORD ROOM, FLOOR TO CEILING, 3178 02:04:25,942 --> 02:04:27,944 FIRE MARSHAL HATED TO GO THROUGH 3179 02:04:27,944 --> 02:04:30,780 BECAUSE THEY WERE UP TO THE 3180 02:04:30,780 --> 02:04:31,080 SPRINKLERS. 3181 02:04:31,080 --> 02:04:32,882 AND SO WE DON'T HAVE THAT ROOM 3182 02:04:32,882 --> 02:04:34,717 ANYMORE SO WE DON'T HAVE TO 3183 02:04:34,717 --> 02:04:34,918 WORRY. 3184 02:04:34,918 --> 02:04:37,387 AT THE TIME WE DIDN'T HAVE 3185 02:04:37,387 --> 02:04:40,390 BTRIS, IT WAS A CLINICAL DATA 3186 02:04:40,390 --> 02:04:42,659 WAREHOUSE WE CREATED AS PART OF 3187 02:04:42,659 --> 02:04:43,593 THE MEDICAL INFORMATION SYSTEM 3188 02:04:43,593 --> 02:04:50,099 THAT WAS PART OF TECHNICON, 3189 02:04:50,099 --> 02:04:54,370 ORIGINAL EHR AT NIH. 3190 02:04:54,370 --> 02:04:59,042 AND CDW FED OTHER INSTITUTE 3191 02:04:59,042 --> 02:04:59,442 SYSTEMS. 3192 02:04:59,442 --> 02:05:00,343 NEXT SLIDE. 3193 02:05:00,343 --> 02:05:04,113 SO THIS IS ABOUT TEN YEARS 3194 02:05:04,113 --> 02:05:04,981 AFTER. 3195 02:05:04,981 --> 02:05:06,082 EXCUSE ME. 3196 02:05:06,082 --> 02:05:07,784 ALLSCRIPTS WAS THE VENDOR AT THE 3197 02:05:07,784 --> 02:05:08,284 TIME. 3198 02:05:08,284 --> 02:05:12,088 WE HAD A FEW MORE COMPONENTS. 3199 02:05:12,088 --> 02:05:16,292 WE HAD THE EEMR, PATIENT PORTAL, 3200 02:05:16,292 --> 02:05:18,995 WE HAD SCHEDULING THAT WAS PART 3201 02:05:18,995 --> 02:05:23,099 OF THE PRODUCT, PART OF SEM. 3202 02:05:23,099 --> 02:05:27,136 WHEN WE WENT LIVE WITH CRIS WE 3203 02:05:27,136 --> 02:05:27,971 HAD A SEPARATE INTEGRATED 3204 02:05:27,971 --> 02:05:30,073 SCHEDULING SYSTEM. 3205 02:05:30,073 --> 02:05:32,742 WE DID HAVE BTRIS AT THAT POINT 3206 02:05:32,742 --> 02:05:35,345 SO EVERYTHING FROM CRIS AS WELL 3207 02:05:35,345 --> 02:05:36,746 AS THE CLINICAL INFORMATION 3208 02:05:36,746 --> 02:05:40,483 SYSTEMS FEED INTO BTRIS AND THEN 3209 02:05:40,483 --> 02:05:42,652 BTRIS FEEDS INSTITUTE SYSTEMS. 3210 02:05:42,652 --> 02:05:46,356 WE'VE HAD MORE SYSTEMS FROM THE 3211 02:05:46,356 --> 02:05:49,525 INSTITUTES, AND THEN WE HAD A 3212 02:05:49,525 --> 02:05:50,927 FEW MORE CLINICAL INFORMATION 3213 02:05:50,927 --> 02:05:52,328 SYSTEMS. 3214 02:05:52,328 --> 02:05:54,697 WE HAD A PORTAL FROM SUNRISE BUT 3215 02:05:54,697 --> 02:05:58,801 IT WAS SEPARATE IN A WAY. 3216 02:05:58,801 --> 02:06:02,038 AND WE HAVE OUR ADMISSION 3217 02:06:02,038 --> 02:06:02,906 SYSTEM, PRE-ADMISSION SYSTEM, 3218 02:06:02,906 --> 02:06:04,841 YOU MIGHT HAVE HEARD OF ATB. 3219 02:06:04,841 --> 02:06:10,246 THIS IS WHAT IT LOOKED LIKE IN 3220 02:06:10,246 --> 02:06:10,647 2014. 3221 02:06:10,647 --> 02:06:10,847 NEXT. 3222 02:06:10,847 --> 02:06:12,715 AND SO WHERE ARE WE NOW? 3223 02:06:12,715 --> 02:06:20,390 I UPDATED IT ON THE SECOND 3224 02:06:20,390 --> 02:06:22,892 BECAUSE WE ADDED FROM INTERFACE, 3225 02:06:22,892 --> 02:06:25,862 ORDERS AND RESULTS BACK TO CRIS. 3226 02:06:25,862 --> 02:06:29,165 WE DO HAVE A THIRD PARTY 3227 02:06:29,165 --> 02:06:32,168 COMPONENT THAT IS SANCTIONED BY 3228 02:06:32,168 --> 02:06:33,903 ALTERRA, WORKING DIAGNOSIS, THAT 3229 02:06:33,903 --> 02:06:40,209 HELPS WITH OUR HUDDLE AND CARE 3230 02:06:40,209 --> 02:06:41,978 PLAN AND DIFFERENT I-PASS TYPE 3231 02:06:41,978 --> 02:06:44,347 TRANSITIONS FOR CARE FOR NURSING 3232 02:06:44,347 --> 02:06:46,716 AND PHYSICIANS. 3233 02:06:46,716 --> 02:06:48,518 AGAIN, MORE YELLOWS, MORE 3234 02:06:48,518 --> 02:06:51,754 INFORMATION SYSTEMS, CLINICAL 3235 02:06:51,754 --> 02:06:53,690 INFORMATION SYSTEMS, ELECTRONIC 3236 02:06:53,690 --> 02:07:03,499 CONSENTS, IMET CONSENT IS A BIG 3237 02:07:03,499 --> 02:07:04,334 DEAL. 3238 02:07:04,334 --> 02:07:04,901 DOCUMENTATION FROM EXTERNAL 3239 02:07:04,901 --> 02:07:06,035 ORGANIZATIONS THEY CAN LOAD TO 3240 02:07:06,035 --> 02:07:06,269 CRIS. 3241 02:07:06,269 --> 02:07:08,604 WE DON'T HAVE A CDA CONTINUITY 3242 02:07:08,604 --> 02:07:12,241 CARE DOCUMENT. 3243 02:07:12,241 --> 02:07:20,917 WE DON'T HAVE THAT 3244 02:07:20,917 --> 02:07:21,317 INTEROPERABILITY. 3245 02:07:21,317 --> 02:07:23,553 SOMETHING WE NEED. 3246 02:07:23,553 --> 02:07:27,657 DURING COVID ALTERRA WAS A 3247 02:07:27,657 --> 02:07:29,959 BLESSING, ABLE TO STAND UP A 3248 02:07:29,959 --> 02:07:32,328 TESTING ENVIRONMENT FOR NIH 3249 02:07:32,328 --> 02:07:34,230 EMPLOYEES, DR. GILMAN GAVE ME 3250 02:07:34,230 --> 02:07:36,599 FOUR WEEKS, WE DID IT IN THREE, 3251 02:07:36,599 --> 02:07:39,869 WOULDN'T HAVE BEEN ABLE TO DO IT 3252 02:07:39,869 --> 02:07:41,938 WITH ANOTHER EHR. 3253 02:07:41,938 --> 02:07:42,772 SAME REQUIREMENT FOR VACCINES 3254 02:07:42,772 --> 02:07:43,306 FOR EMPLOYEES. 3255 02:07:43,306 --> 02:07:45,274 I MIGHT HAVE GAVE ME FIVE WEEKS, 3256 02:07:45,274 --> 02:07:47,043 WE DID IT IN FOUR. 3257 02:07:47,043 --> 02:07:50,580 SO WE WERE ABLE TO MEET IT 3258 02:07:50,580 --> 02:07:52,582 BECAUSE WE'RE ALLOWED TO DO SO 3259 02:07:52,582 --> 02:07:54,050 MUCH CUSTOMIZATION AND BUILD 3260 02:07:54,050 --> 02:07:55,051 THINGS THROUGH INTERFACE AND 3261 02:07:55,051 --> 02:07:57,754 PLUS I HAVE A REALLY GOOD TEAM 3262 02:07:57,754 --> 02:07:59,288 THAT CAN DESIGN AND BUILD AND 3263 02:07:59,288 --> 02:08:00,089 THINK THROUGH. 3264 02:08:00,089 --> 02:08:01,791 IF YOU CAN BRING UP A PROBLEM, 3265 02:08:01,791 --> 02:08:03,493 THEY CAN FIGURE OUT A SOLUTION. 3266 02:08:03,493 --> 02:08:07,130 BUT IT'S HARD TO SUSTAIN THAT. 3267 02:08:07,130 --> 02:08:08,364 AND THAT'S PART OF WHY WE'RE 3268 02:08:08,364 --> 02:08:11,034 WHERE WE ARE RIGHT NOW. 3269 02:08:11,034 --> 02:08:16,339 ONE THING FOR OTHER 3270 02:08:16,339 --> 02:08:16,906 ORGANIZATIONS, STEPHANIE CAN 3271 02:08:16,906 --> 02:08:18,107 CORRECT ME IF I'M WRONG, BUT 3272 02:08:18,107 --> 02:08:20,843 JOHNS HOPKINS AS WELL AS MAYO 3273 02:08:20,843 --> 02:08:22,745 CLINIC, AS WELL AS VANDERBILT, 3274 02:08:22,745 --> 02:08:24,747 THEY HAD A LOT OF SEPARATE 3275 02:08:24,747 --> 02:08:24,981 SYSTEMS. 3276 02:08:24,981 --> 02:08:27,417 SO WHEN THEY MOVED TO A NEW EHR, 3277 02:08:27,417 --> 02:08:31,320 THEY WERE ABLE TO GET RID OF 3278 02:08:31,320 --> 02:08:33,423 MANY OF THOSE SYSTEMS. 3279 02:08:33,423 --> 02:08:34,590 I HAD EVERYTHING BUILT AS PART 3280 02:08:34,590 --> 02:08:35,324 OF CRIS. 3281 02:08:35,324 --> 02:08:37,593 SO WHEN WE GO LIVE WITH A NEW 3282 02:08:37,593 --> 02:08:39,862 EHR WE HAVE TO MAKE SURE ALL 3283 02:08:39,862 --> 02:08:42,165 THOSE THINGS WE BUILT AS PART OF 3284 02:08:42,165 --> 02:08:43,900 CRIS ARE BUILT LIVE. 3285 02:08:43,900 --> 02:08:46,402 OUR GO LIVE WILL BE MORE 3286 02:08:46,402 --> 02:08:47,236 COMPLICATED THAN OTHERS BECAUSE 3287 02:08:47,236 --> 02:08:51,140 THEY WERE ABLE TO EVOLVE OVER 3288 02:08:51,140 --> 02:08:53,176 TIME INTO WHERE THEY ARE AT BUT 3289 02:08:53,176 --> 02:08:55,244 I'M AT THE END GAME. 3290 02:08:55,244 --> 02:08:59,082 I HAD EVERYTHING BUILT IN CRIS 3291 02:08:59,082 --> 02:09:01,184 ON PURPOSE BECAUSE I DIDN'T WANT 3292 02:09:01,184 --> 02:09:02,819 EXTRA SYSTEMS FOR SUPPORT. 3293 02:09:02,819 --> 02:09:06,055 BUT THE YELLOWS ARE EXTRA 3294 02:09:06,055 --> 02:09:08,357 SYSTEMS, AND THAT LEADS TO THE 3295 02:09:08,357 --> 02:09:12,128 COMPLEXITY AND FRAGILITY. 3296 02:09:12,128 --> 02:09:12,628 NEXT SLIDE. 3297 02:09:12,628 --> 02:09:15,932 >> JOHN, IS FOLLOW MY HEALTH A 3298 02:09:15,932 --> 02:09:16,499 PATIENT PORTAL? 3299 02:09:16,499 --> 02:09:16,799 >> YES. 3300 02:09:16,799 --> 02:09:18,634 THEIR PERSONAL HEALTH RECORD. 3301 02:09:18,634 --> 02:09:21,003 DAVID CAN TELL YOU EVERYTHING 3302 02:09:21,003 --> 02:09:24,307 THAT'S RIGHT OR WRONG WITH THAT. 3303 02:09:24,307 --> 02:09:27,176 WE USE DAVID A LOT TO HELP US 3304 02:09:27,176 --> 02:09:32,882 WITH OUR VENDOR TO IDENTIFY WHAT 3305 02:09:32,882 --> 02:09:43,326 SYSTEMS SHOULD LOOK LIKE. 3306 02:09:46,429 --> 02:09:52,168 >> LIKE THE OTHER 3307 02:09:52,168 --> 02:09:54,370 (INDISCERNIBLE). 3308 02:09:54,370 --> 02:09:54,871 >> YEAH, IT'S A BOLT-ON. 3309 02:09:54,871 --> 02:09:55,238 >> (INAUDIBLE). 3310 02:09:55,238 --> 02:09:55,872 >> NOW FOLLOW MY HEALTH IS WITH 3311 02:09:55,872 --> 02:09:56,472 VARIDIGM AND ALLSCRIPTS, THEY 3312 02:09:56,472 --> 02:09:57,006 DIDN'T SELL TO ALTERRA. 3313 02:09:57,006 --> 02:10:02,612 THE STORY, ONE OF THE ARCHITECTS 3314 02:10:02,612 --> 02:10:06,182 AT ECLYPSYS LEFT TO TAKE CARE OF 3315 02:10:06,182 --> 02:10:07,650 FEMME, REALIZE THE PORTALS 3316 02:10:07,650 --> 02:10:09,685 WEREN'T FOCUSED ON, BUILT IT, 3317 02:10:09,685 --> 02:10:11,754 SOLD IT BACK TO ALLSCRIPTS. 3318 02:10:11,754 --> 02:10:16,025 SO IT IS A BOLT ON. 3319 02:10:16,025 --> 02:10:19,529 SO, THE COMPLEX -- ANY OTHER 3320 02:10:19,529 --> 02:10:20,830 QUESTIONS? 3321 02:10:20,830 --> 02:10:21,297 SORRY. 3322 02:10:21,297 --> 02:10:23,833 ALTERRA IS THE CURRENT VENDOR. 3323 02:10:23,833 --> 02:10:26,402 THERE ARE PORTIONS LIKE FOLLOW 3324 02:10:26,402 --> 02:10:27,270 MY HEALTH, PATIENT REGISTRATION 3325 02:10:27,270 --> 02:10:29,972 THAT WE'RE HOPING TO GO LIVE IN 3326 02:10:29,972 --> 02:10:31,541 MARCH, MOBILE PATIENT 3327 02:10:31,541 --> 02:10:32,041 EXPERIENCE. 3328 02:10:32,041 --> 02:10:42,552 THAT IS STILL PART OF VERIDIGM 3329 02:10:43,819 --> 02:10:49,659 AND ALLSCRIPTS. 3330 02:10:49,659 --> 02:10:50,860 PATIENTS, YOU KNOW, DATA IS 3331 02:10:50,860 --> 02:10:52,528 BETTER THAN GOING THROUGH 3332 02:10:52,528 --> 02:10:54,096 SOMEBODY ELSE FOR REGISTRATION 3333 02:10:54,096 --> 02:10:54,463 PROCESS. 3334 02:10:54,463 --> 02:10:56,999 WE HAVE MANY CLINICAL 3335 02:10:56,999 --> 02:10:58,968 INFORMATION SYSTEMS, AT LEAST 3336 02:10:58,968 --> 02:11:02,772 15, THAT'S NOT COUNTING THE I.C. 3337 02:11:02,772 --> 02:11:03,005 SYSTEMS. 3338 02:11:03,005 --> 02:11:05,041 THERE'S OVER 280+ INTERFACES 3339 02:11:05,041 --> 02:11:07,176 WHEN THIS SLIDE WAS IDENTIFIED. 3340 02:11:07,176 --> 02:11:14,016 I WAS TOLD LAST WEEK THERE'S 3341 02:11:14,016 --> 02:11:17,520 320. 3342 02:11:17,520 --> 02:11:19,589 THERE MIGHT BE FIVE INTERFACES 3343 02:11:19,589 --> 02:11:21,123 FOR ONE SYSTEM. 3344 02:11:21,123 --> 02:11:22,825 DEMOGRAPHICS WOULD BE ITS OWN. 3345 02:11:22,825 --> 02:11:24,026 PATIENT REGISTRATION INFORMATION 3346 02:11:24,026 --> 02:11:26,696 WOULD BE ITS OWN INTERFACE. 3347 02:11:26,696 --> 02:11:29,298 YOU HAVE ORDERS AND RESULTS. 3348 02:11:29,298 --> 02:11:33,869 THEY WOULD BE SEPARATE, 3349 02:11:33,869 --> 02:11:35,004 DOCUMENTS MIGHT BE SEPARATE, A 3350 02:11:35,004 --> 02:11:38,107 SYSTEM MIGHT HAVE THREE TO FIVE 3351 02:11:38,107 --> 02:11:39,108 INTERFACES. 3352 02:11:39,108 --> 02:11:44,180 THREE DATA CENTERS, PART OF THE 3353 02:11:44,180 --> 02:11:47,383 ASSESSMENT AND PART OF OUR OIG 3354 02:11:47,383 --> 02:11:49,518 AUDIT, IS THAT RIGHT, DAVID? 3355 02:11:49,518 --> 02:11:52,822 OIG AUDIT SAID WE NEEDED A DATA 3356 02:11:52,822 --> 02:11:56,492 CENTER SO MANY MILES AWAY. 3357 02:11:56,492 --> 02:11:58,461 AND THEY CITED US ON IT. 3358 02:11:58,461 --> 02:12:02,865 AND BUT WE WERE MOVING TO 3359 02:12:02,865 --> 02:12:09,972 CULPEPER, AND IT'S OVER THE 3360 02:12:09,972 --> 02:12:11,073 MILEAGE THAT HIMSS, BUT THE 3361 02:12:11,073 --> 02:12:14,043 STATEMENT SIT NEEDS TO BE A 3362 02:12:14,043 --> 02:12:16,312 STAFFED DATA CENTER BECAUSE IF 3363 02:12:16,312 --> 02:12:17,480 SOMETHING HAPPENED HERE, IN 3364 02:12:17,480 --> 02:12:19,815 ORDER TO TURN THAT ONE ON, 3365 02:12:19,815 --> 02:12:23,152 PEOPLE WOULD HAVE TO DRIVE 3366 02:12:23,152 --> 02:12:23,653 THERE. 3367 02:12:23,653 --> 02:12:24,687 AND THEIR BIGGER CONCERN WAS 3368 02:12:24,687 --> 02:12:27,723 PEOPLE HERE IF THERE WAS A 3369 02:12:27,723 --> 02:12:34,497 DISASTER IN BETHESDA, WOULD BE 3370 02:12:34,497 --> 02:12:36,332 FOCUSED ON THEIR OTHER FAMILY 3371 02:12:36,332 --> 02:12:37,466 AND WOULDN'T BE ABLE TO ACCOUNT 3372 02:12:37,466 --> 02:12:38,968 FOR THE DATA CENTER. 3373 02:12:38,968 --> 02:12:42,838 WE DID A RISK ANALYSIS, SIS 3374 02:12:42,838 --> 02:12:44,473 DIDN'T HAVE CONCERNS WITH 3375 02:12:44,473 --> 02:12:52,315 LOCATIONS PLUS WE CAN TURN IT ON 3376 02:12:52,315 --> 02:12:53,115 FROM ANYWHERE. 3377 02:12:53,115 --> 02:12:57,820 WE HAVE HUNDREDS OF 3378 02:12:57,820 --> 02:13:08,297 VIRTUALIZATION SERVERS, HUNDREDS 3379 02:13:08,297 --> 02:13:10,166 OF-- 80+ CITRIX SERVERS, CAN RUN 3380 02:13:10,166 --> 02:13:16,105 FROM BUILDING 10, 12, OR 3381 02:13:16,105 --> 02:13:16,605 CULPEPER. 3382 02:13:16,605 --> 02:13:19,408 NOT ALL SYSTEMS BUT CRIS WE 3383 02:13:19,408 --> 02:13:21,410 DEFINITELY CAN. 3384 02:13:21,410 --> 02:13:23,546 COMPLEXITY, SO SECURITY 3385 02:13:23,546 --> 02:13:24,080 REQUIREMENTS FROM FEDERAL 3386 02:13:24,080 --> 02:13:24,980 GOVERNMENT, YOU HAVE TO CHANGE 3387 02:13:24,980 --> 02:13:29,985 YOUR PASSWORD ON A FREQUENT 3388 02:13:29,985 --> 02:13:30,186 BASIS. 3389 02:13:30,186 --> 02:13:35,524 WE CAN'T CHANGE WITHOUT TURNING 3390 02:13:35,524 --> 02:13:36,459 DATABASES DOWN. 3391 02:13:36,459 --> 02:13:37,727 FIVE NODES. 3392 02:13:37,727 --> 02:13:40,529 SAFEST WAY IS TURN THINGS DOWN. 3393 02:13:40,529 --> 02:13:42,331 THAT TAKES FOUR HOURS EVERY -- 3394 02:13:42,331 --> 02:13:43,466 TWICE A YEAR. 3395 02:13:43,466 --> 02:13:46,235 MICROSOFT UPDATES ARE EVERY 3396 02:13:46,235 --> 02:13:46,602 MONTH. 3397 02:13:46,602 --> 02:13:49,538 WE DON'T CALL IT DOWN BUT THERE 3398 02:13:49,538 --> 02:13:51,340 IS AN INTERRUPTION FOR PRINTING 3399 02:13:51,340 --> 02:13:52,975 AND INTERFACES SO WE COUNT THAT 3400 02:13:52,975 --> 02:13:53,743 AS A DOWN. 3401 02:13:53,743 --> 02:13:57,713 IF YOU ADD UP ALL THE THINGS YOU 3402 02:13:57,713 --> 02:14:01,517 HAVE TO DO, FROM THE VENDOR AND 3403 02:14:01,517 --> 02:14:03,619 FROM SECURITY, IT ADDS UP TO 3404 02:14:03,619 --> 02:14:06,555 OVER 2,000 MINUTES. 3405 02:14:06,555 --> 02:14:11,460 AND SO OUR UP TIME JUST BASED ON 3406 02:14:11,460 --> 02:14:12,695 THAT IS 99.58. 3407 02:14:12,695 --> 02:14:14,997 WE DO KEEP TRACK OF ALL OUR 3408 02:14:14,997 --> 02:14:15,698 DOWNS. 3409 02:14:15,698 --> 02:14:18,134 WE'RE ON THE NIH NETWORK, WE'VE 3410 02:14:18,134 --> 02:14:20,436 ALSO GOT OUR OWN NETWORK 3411 02:14:20,436 --> 02:14:23,706 COMPONENTS, ALL THE INTERFACES. 3412 02:14:23,706 --> 02:14:26,709 USUALLY UP TIME IS IDENTIFIED OR 3413 02:14:26,709 --> 02:14:29,412 SYSTEM AVAILABILITY BASED ON 3414 02:14:29,412 --> 02:14:29,845 UNSCHEDULED DOWNS. 3415 02:14:29,845 --> 02:14:32,448 BUT TO A USER AND TO THE 3416 02:14:32,448 --> 02:14:34,250 PATIENTS, IF IT'S DOWN, IT'S 3417 02:14:34,250 --> 02:14:34,984 DOWN. 3418 02:14:34,984 --> 02:14:38,387 SO I DON'T CARE ABOUT WHAT THE 3419 02:14:38,387 --> 02:14:40,122 WORLD SAYS ABOUT SYSTEM 3420 02:14:40,122 --> 02:14:40,656 AVAILABILITY. 3421 02:14:40,656 --> 02:14:43,426 I KEEP TRACK OF SCHEDULED AND 3422 02:14:43,426 --> 02:14:43,759 UNSCHEDULED. 3423 02:14:43,759 --> 02:14:48,364 AND AS OF SEPTEMBER 30, IT WAS 3424 02:14:48,364 --> 02:14:48,764 98.52. 3425 02:14:48,764 --> 02:14:50,566 THAT IS NOT A GOOD NUMBER. 3426 02:14:50,566 --> 02:14:53,803 I'M PROUD OF EVERY SINGLE PERSON 3427 02:14:53,803 --> 02:14:55,371 THAT WORKS IN THE CLINICAL 3428 02:14:55,371 --> 02:15:00,276 CENTER AND WORKS TO MAINTAIN 3429 02:15:00,276 --> 02:15:01,744 CRIS, AND THEY DO A TERRIFIC 3430 02:15:01,744 --> 02:15:03,512 JOB. 3431 02:15:03,512 --> 02:15:06,115 I CAN'T BE PROUDER OF ANYTHING. 3432 02:15:06,115 --> 02:15:10,319 BUT THIS IS NOT A NUMBER TO BE 3433 02:15:10,319 --> 02:15:12,988 PROUD OF. 3434 02:15:12,988 --> 02:15:14,523 NEXT SLIDE. 3435 02:15:14,523 --> 02:15:19,528 TOP SIX ISSUES, LACK OF SEAMLESS 3436 02:15:19,528 --> 02:15:21,831 INTEGRATION, LACK OF ENCOUNTER 3437 02:15:21,831 --> 02:15:23,566 BASED PATIENT MODULES, NOT 3438 02:15:23,566 --> 02:15:24,266 INTUITIVE. 3439 02:15:24,266 --> 02:15:27,736 DOCUMENTATION AND FLOW SHEETS 3440 02:15:27,736 --> 02:15:29,505 NOT BUILT USING STANDARD 3441 02:15:29,505 --> 02:15:30,005 TERMINOLOGY. 3442 02:15:30,005 --> 02:15:32,041 TWENTY YEARS AGO THERE WASN'T. 3443 02:15:32,041 --> 02:15:35,511 TO REDO THAT WILL TAKE A LARGE 3444 02:15:35,511 --> 02:15:36,579 TASK. 3445 02:15:36,579 --> 02:15:37,913 WORKFLOW IS NOT BUILT 3446 02:15:37,913 --> 02:15:38,981 NECESSARILY INTO CRIS. 3447 02:15:38,981 --> 02:15:44,386 WE CAN'T BUILD EVERY WORKFLOW TO 3448 02:15:44,386 --> 02:15:47,523 MATCH EVERY BRANCH AT NIH. 3449 02:15:47,523 --> 02:15:49,658 AND WE NEED IMPROVED AUTOMATION 3450 02:15:49,658 --> 02:15:51,827 FOR MANAGING PHYSICIAN AND 3451 02:15:51,827 --> 02:15:53,796 NURSING TASKS AND WORKFLOW 3452 02:15:53,796 --> 02:15:54,129 CAPABILITIES. 3453 02:15:54,129 --> 02:15:56,432 THEY SAY THEY HAVE IT, THE ISSUE 3454 02:15:56,432 --> 02:16:00,369 IS THEY HAVE IT ABOUT 75% DONE, 3455 02:16:00,369 --> 02:16:01,937 I CAN'T GO LIVE WITH SOME OF THE 3456 02:16:01,937 --> 02:16:05,641 THINGS THAT ARE IN THE CURRENT 3457 02:16:05,641 --> 02:16:06,709 SYSTEM AT 85%. 3458 02:16:06,709 --> 02:16:09,245 THEY HEAR THAT LINE FROM ME 3459 02:16:09,245 --> 02:16:11,947 EVERY DAY, SAYING IT HERE IS NOT 3460 02:16:11,947 --> 02:16:13,215 SOMETHING NEW. 3461 02:16:13,215 --> 02:16:15,618 AND THEN INABILITY TO SUSTAIN 3462 02:16:15,618 --> 02:16:17,319 CUSTOM DEVELOPMENT BASED ON 3463 02:16:17,319 --> 02:16:20,723 LIMITATIONS OF CURRENT SYSTEM, 3464 02:16:20,723 --> 02:16:23,526 AND BASED ON STAFFING. 3465 02:16:23,526 --> 02:16:27,129 30 OUT OF MY 100 STAFF ARE 3466 02:16:27,129 --> 02:16:27,796 RETIREMENT ELIGIBLE SO THEY HAVE 3467 02:16:27,796 --> 02:16:29,598 A LOT OF THIS KNOWLEDGE THAT 3468 02:16:29,598 --> 02:16:33,869 WE'RE TRYING TO ENSURE WE HAVE 3469 02:16:33,869 --> 02:16:34,703 DOCUMENTED AND KNOWLEDGE 3470 02:16:34,703 --> 02:16:36,805 TRANSFER BUT THAT IS A LOT OF 3471 02:16:36,805 --> 02:16:45,648 PEOPLE TO ACCOUNT FOR. 3472 02:16:45,648 --> 02:16:45,848 NEXT. 3473 02:16:45,848 --> 02:16:47,283 THE ANNUAL CRIS SURVEY MANY 3474 02:16:47,283 --> 02:16:48,717 PEOPLE SAY NOBODY LIKES THEIR 3475 02:16:48,717 --> 02:16:49,151 EHR. 3476 02:16:49,151 --> 02:16:52,321 I DON'T KNOW IF THAT'S REALLY 3477 02:16:52,321 --> 02:16:52,788 TRUE. 3478 02:16:52,788 --> 02:16:54,990 WHEN PEOPLE COME IN THEY TELL US 3479 02:16:54,990 --> 02:16:56,225 WE NEED THIS MODULE. 3480 02:16:56,225 --> 02:16:57,793 THEY CAN DO IT IN X. 3481 02:16:57,793 --> 02:16:59,929 AND WHEN I'M LIKE, YEAH, BUT 3482 02:16:59,929 --> 02:17:05,768 THIS IS WHAT I HAVE,, SOME 3483 02:17:05,768 --> 02:17:07,836 THINGS THEY ASK FOR ARE IN THE 3484 02:17:07,836 --> 02:17:09,071 SYSTEM AND THEY DON'T REALIZE 3485 02:17:09,071 --> 02:17:14,143 IT, IT'S NOT IN FRONT OF THEM, 3486 02:17:14,143 --> 02:17:15,844 PLUS WE DON'T DO RETRAINING ON A 3487 02:17:15,844 --> 02:17:16,445 REGULAR BASIS, SOMETHING WE'RE 3488 02:17:16,445 --> 02:17:18,514 WORKING ON. 3489 02:17:18,514 --> 02:17:22,651 THE BIGGEST POINT IT HASN'T 3490 02:17:22,651 --> 02:17:23,953 INCREASED IN SATISFACTION, AS 3491 02:17:23,953 --> 02:17:27,022 PART OF BEING AN ENTERPRISE 3492 02:17:27,022 --> 02:17:28,824 SYSTEM AND HIGH VALUED ASSET WE 3493 02:17:28,824 --> 02:17:31,660 HAVE TO DO A SURVEY EVERY YEAR, 3494 02:17:31,660 --> 02:17:36,966 AND THE NUMBERS DON'T INCREASE 3495 02:17:36,966 --> 02:17:38,767 FOR SATISFACTION. 3496 02:17:38,767 --> 02:17:39,168 NEXT. 3497 02:17:39,168 --> 02:17:41,670 I THINK PAT FIXED THAT SLIDE 3498 02:17:41,670 --> 02:17:42,538 BECAUSE SATISFACTION IS GOOD SO 3499 02:17:42,538 --> 02:17:49,578 THANK YOU VERY MUCH FOR DOING 3500 02:17:49,578 --> 02:17:50,479 THAT. 3501 02:17:50,479 --> 02:17:53,549 PROPOSED EHR WE WANT SOMETHING 3502 02:17:53,549 --> 02:17:55,384 INTEGRATED, MONOLITHTIC, TO BE 3503 02:17:55,384 --> 02:17:57,753 PART OF THE EHR SOLUTION, WE 3504 02:17:57,753 --> 02:18:02,925 DON'T WANT TO BOLT ON OR HAVE 3505 02:18:02,925 --> 02:18:03,892 SEPARATE SYSTEMS, IF THEY ARE 3506 02:18:03,892 --> 02:18:08,430 AVAILABLE AS PART OF THE 3507 02:18:08,430 --> 02:18:09,398 INTEGRATED SYSTEM. 3508 02:18:09,398 --> 02:18:13,335 AM -- I LEFT INSTITUTE SYSTEMS 3509 02:18:13,335 --> 02:18:14,637 AS THEY ARE. 3510 02:18:14,637 --> 02:18:17,406 I'M ASSUMING SOME OF THOSE WOULD 3511 02:18:17,406 --> 02:18:20,442 BE ABLE TO BE IN AN 3512 02:18:20,442 --> 02:18:21,977 INTEGRATED -- I KNOW SOME WOULD 3513 02:18:21,977 --> 02:18:25,047 BE IN AN INTEGRATED SOLUTION. 3514 02:18:25,047 --> 02:18:27,016 BUT I WANT TO MAKE SURE WE TAKE 3515 02:18:27,016 --> 02:18:29,284 CARE OF CRIS FIRST AND THOSE 3516 02:18:29,284 --> 02:18:32,888 MODULES HAVE THOSE DISCUSSIONS 3517 02:18:32,888 --> 02:18:37,793 WITH THE INSTITUTES. 3518 02:18:37,793 --> 02:18:41,363 LESS SYSTEMS, BTRIS IS STILL 3519 02:18:41,363 --> 02:18:43,565 LISTED, THERE'S A CRIS B PROJECT 3520 02:18:43,565 --> 02:18:47,770 GOING ON, DR. SCHOR, UNDER HER 3521 02:18:47,770 --> 02:18:50,673 LEADERSHIP BUT I NEEDED TO LEAVE 3522 02:18:50,673 --> 02:18:51,407 SOMETHING BECAUSE I DON'T KNOW 3523 02:18:51,407 --> 02:18:52,641 WHAT IT WILL BE WHEN WE GET TO 3524 02:18:52,641 --> 02:18:54,109 THAT STAIN IN THE GAME. 3525 02:18:54,109 --> 02:18:56,445 DR. SCHOR AND I TALKED FOR TWO 3526 02:18:56,445 --> 02:18:58,514 MINUTES AND MOST OF THE VENDORS 3527 02:18:58,514 --> 02:19:00,649 DO HAVE A RESEARCH SOLUTION BUT 3528 02:19:00,649 --> 02:19:01,917 IT'S NOT A RESEARCH SOLUTION I 3529 02:19:01,917 --> 02:19:06,088 DON'T THINK THAT CAN WORK HERE. 3530 02:19:06,088 --> 02:19:09,258 SO, WE'RE DEFINITELY 3531 02:19:09,258 --> 02:19:09,591 CUSTOMIZABLE. 3532 02:19:09,591 --> 02:19:11,160 NEXT SLIDE. 3533 02:19:11,160 --> 02:19:13,162 AND SO THE EHR MODERNIZATION 3534 02:19:13,162 --> 02:19:16,298 PROJECT, THIS IS A COMPLEX 3535 02:19:16,298 --> 02:19:17,166 ORGANIZATIONAL PROJECT, WITH 3536 02:19:17,166 --> 02:19:17,900 I.T. COMPONENTS. 3537 02:19:17,900 --> 02:19:19,334 I KNOW I'M THE I.T. GUY. 3538 02:19:19,334 --> 02:19:21,437 I HEAR THAT A LOT. 3539 02:19:21,437 --> 02:19:22,271 I'M OKAY WITH IT. 3540 02:19:22,271 --> 02:19:24,073 I LOVE TO BE KNOWN AS THE I.T. 3541 02:19:24,073 --> 02:19:24,573 GUY. 3542 02:19:24,573 --> 02:19:26,475 THIS CAN'T BE AN I.T. PROJECT, 3543 02:19:26,475 --> 02:19:26,975 RIGHT? 3544 02:19:26,975 --> 02:19:29,978 IT WILL FAIL. 3545 02:19:29,978 --> 02:19:30,646 MISERABLY. 3546 02:19:30,646 --> 02:19:32,514 I KNOW MORE ABOUT CLINICAL 3547 02:19:32,514 --> 02:19:34,883 WORKFLOW THAN THE AVERAGE I.T. 3548 02:19:34,883 --> 02:19:36,752 GUY, BUT I'M NOT A CLINICIAN, 3549 02:19:36,752 --> 02:19:37,986 RIGHT? 3550 02:19:37,986 --> 02:19:41,557 SO, THIS IS AN ORGANIZATIONAL 3551 02:19:41,557 --> 02:19:41,790 PROJECT. 3552 02:19:41,790 --> 02:19:45,260 THIS WILL REQUIRE EVERYBODY'S 3553 02:19:45,260 --> 02:19:45,761 PARTICIPATION. 3554 02:19:45,761 --> 02:19:46,295 EVERYBODY HERE, PATIENTS, 3555 02:19:46,295 --> 02:19:47,796 EVERYBODY IN THE CLINICAL 3556 02:19:47,796 --> 02:19:49,898 CENTER, EVERYBODY IN THE 3557 02:19:49,898 --> 02:19:51,133 INSTITUTES, AND WE'RE GOING TO 3558 02:19:51,133 --> 02:19:58,774 WORK IN THE NEW YEAR TO GET THAT 3559 02:19:58,774 --> 02:19:59,708 INTEGRATED GROUP OF MORE PEOPLE 3560 02:19:59,708 --> 02:20:02,111 THAN THE I.T. GUY. 3561 02:20:02,111 --> 02:20:04,313 THIS WILL MIGRATE EXTERNAL 3562 02:20:04,313 --> 02:20:06,014 CLINICAL INFORMATION SYSTEMS 3563 02:20:06,014 --> 02:20:08,450 INTO AN INTEGRATED EHR, SO ALL 3564 02:20:08,450 --> 02:20:09,852 THE DEPARTMENTS HAVE A VERY 3565 02:20:09,852 --> 02:20:12,354 VESTED INTEREST TO BE PART OF 3566 02:20:12,354 --> 02:20:13,555 THIS PROJECT, BECAUSE WE'RE 3567 02:20:13,555 --> 02:20:21,130 GOING TO REPLACE SOME OF THOSE 3568 02:20:21,130 --> 02:20:25,000 SYSTEMS. 3569 02:20:25,000 --> 02:20:26,735 AS MANY AS POSSIBLE. 3570 02:20:26,735 --> 02:20:27,669 STREAMLINE, ENSURE THE PATIENT 3571 02:20:27,669 --> 02:20:31,507 STORY IS TOLD AND EASY TO SEE. 3572 02:20:31,507 --> 02:20:34,409 ONE PHYSICIAN SAYS THIS IS HOW I 3573 02:20:34,409 --> 02:20:35,244 DETERMINE THE PATIENT'S STORY. 3574 02:20:35,244 --> 02:20:38,013 I GO TO THE BED AND HIT HIS FOOT 3575 02:20:38,013 --> 02:20:40,616 AND SAY, OKAY, HOW DO YOU FEEL 3576 02:20:40,616 --> 02:20:40,816 TODAY? 3577 02:20:40,816 --> 02:20:41,784 I DON'T WANT THAT. 3578 02:20:41,784 --> 02:20:45,687 IT NEEDS TO BE PART OF THE 3579 02:20:45,687 --> 02:20:47,122 SYSTEM TO TELL THAT STORY, SO 3580 02:20:47,122 --> 02:20:48,824 BEFORE THEY GET TO THE PATIENT'S 3581 02:20:48,824 --> 02:20:51,527 ROOM THEY KNOW EVERYTHING THEY 3582 02:20:51,527 --> 02:20:52,528 NEED TO KNOW. 3583 02:20:52,528 --> 02:20:54,363 IMPROVE PATIENT SAFETY AND 3584 02:20:54,363 --> 02:20:55,731 CLINICAL CARE DELIVERY QUALITY. 3585 02:20:55,731 --> 02:20:58,634 IMPROVE PATIENT EXPERIENCE AND 3586 02:20:58,634 --> 02:20:59,101 ENGAGEMENT. 3587 02:20:59,101 --> 02:21:01,503 IMPROVE DECISION MAKING ACROSS 3588 02:21:01,503 --> 02:21:02,971 CLINICAL CARE ROLES. 3589 02:21:02,971 --> 02:21:04,006 REDUCE COMPLEXITY TO SUPPORT 3590 02:21:04,006 --> 02:21:04,606 SYSTEM. 3591 02:21:04,606 --> 02:21:05,707 EVERY ONE OF THOSE YELLOW 3592 02:21:05,707 --> 02:21:07,743 SYSTEMS WE HAVE TO PATCH ON A 3593 02:21:07,743 --> 02:21:11,613 MONTHLY BASIS AND MEET SECURITY 3594 02:21:11,613 --> 02:21:11,947 REQUIREMENTS. 3595 02:21:11,947 --> 02:21:14,917 IF THERE IS A CRITICAL 3596 02:21:14,917 --> 02:21:17,486 VULNERABILITY, NIH WILL SAY THAT 3597 02:21:17,486 --> 02:21:20,489 YOU HAVE TWO WEEKS TO SOLVE A 3598 02:21:20,489 --> 02:21:21,890 CERTAIN ITEM. 3599 02:21:21,890 --> 02:21:24,726 I NEED SIX WEEKS, WHENEVER 3600 02:21:24,726 --> 02:21:25,460 THERE'S A CRITICAL 3601 02:21:25,460 --> 02:21:26,595 VULNERABILITY, BECAUSE THERE'S A 3602 02:21:26,595 --> 02:21:29,331 LEVEL OF TESTING THAT WE DO ON 3603 02:21:29,331 --> 02:21:31,500 CRIS, AND ALL THE CLINICAL 3604 02:21:31,500 --> 02:21:31,800 SYSTEMS. 3605 02:21:31,800 --> 02:21:33,602 BECAUSE I NEED TO MAKE SURE WE 3606 02:21:33,602 --> 02:21:39,141 DON'T HAVE ANY INTEGRITY ISSUES 3607 02:21:39,141 --> 02:21:40,142 AT ALL. 3608 02:21:40,142 --> 02:21:41,810 IMPROVE SYSTEM AVAILABILITY. 3609 02:21:41,810 --> 02:21:43,212 NEXT SLIDE. 3610 02:21:43,212 --> 02:21:48,483 SO, IF WE CAN'T FIND FUNDS, IF 3611 02:21:48,483 --> 02:21:51,286 WE KICK THE BALL CONTINUOUSLY, 3612 02:21:51,286 --> 02:21:55,157 THERE'S THINGS THAT HAVE TO BE 3613 02:21:55,157 --> 02:21:55,424 UPGRADED. 3614 02:21:55,424 --> 02:21:57,526 SO WE WENT THROUGH MAJOR 3615 02:21:57,526 --> 02:21:59,094 SYSTEMS, THESE ADDRESS OUTCOMES 3616 02:21:59,094 --> 02:22:01,430 AS WELL AS ISSUES IDENTIFIED BY 3617 02:22:01,430 --> 02:22:02,831 THE BUSINESS CASE. 3618 02:22:02,831 --> 02:22:05,801 PUT SOME NUMBERS TO IT SO WE CAN 3619 02:22:05,801 --> 02:22:07,836 ENSURE OUR BUSINESS CASE WAS 3620 02:22:07,836 --> 02:22:09,071 FULL AND COMPLETE. 3621 02:22:09,071 --> 02:22:11,506 SO, I'M NOT GOING THROUGH THEM 3622 02:22:11,506 --> 02:22:14,843 FROM A MONEY AND YEARS AND STAFF 3623 02:22:14,843 --> 02:22:19,681 BUT ENCOUNTER BASED USABILITY, 3624 02:22:19,681 --> 02:22:20,315 DOCUMENTATION, e-PRESCRIBE, 3625 02:22:20,315 --> 02:22:24,586 HAVE TO MAKE SURE DIFFERENT 3626 02:22:24,586 --> 02:22:25,020 COMPONENTS OF THAT, 3627 02:22:25,020 --> 02:22:27,956 INTEROPERABILITY GETTING DATA 3628 02:22:27,956 --> 02:22:33,729 FROM THE OUTSIDE INTERFACING TO 3629 02:22:33,729 --> 02:22:34,963 DIFFERENT HIEs, PRECISION 3630 02:22:34,963 --> 02:22:37,966 MEDICINE AS WELL AS CLINICAL 3631 02:22:37,966 --> 02:22:38,467 DECISION SUPPORT. 3632 02:22:38,467 --> 02:22:41,003 SO, THESE ARE IMPROVEMENTS TO 3633 02:22:41,003 --> 02:22:45,774 MAINTAIN A SYSTEM. 3634 02:22:45,774 --> 02:22:46,308 NEXT. 3635 02:22:46,308 --> 02:22:49,611 SO, WE DID THE BUSINESS CASE. 3636 02:22:49,611 --> 02:22:51,613 THAT WAS WITH DELOITTE, AS PART 3637 02:22:51,613 --> 02:22:54,016 OF THAT WE WENT TO MITRE, THIS 3638 02:22:54,016 --> 02:22:59,421 IS ONE OF THE THINGS THEY 3639 02:22:59,421 --> 02:23:00,622 PROVIDE. 3640 02:23:00,622 --> 02:23:02,057 THEY HELPED MILITARY HELP, 3641 02:23:02,057 --> 02:23:04,393 HELPED DoD, OR SAME THING. 3642 02:23:04,393 --> 02:23:07,095 THEY HELPED THE V.A. 3643 02:23:07,095 --> 02:23:10,332 THEY ARE HELPING IHS, IN THE 3644 02:23:10,332 --> 02:23:11,800 PROCESS DOING DIFFERENT 3645 02:23:11,800 --> 02:23:13,769 COMPONENTS FROM THE PERFORMANCE 3646 02:23:13,769 --> 02:23:16,271 WORK STATEMENT AS WELL AS 3647 02:23:16,271 --> 02:23:18,240 CLINICAL WORKFLOWS. 3648 02:23:18,240 --> 02:23:19,942 SO, WE'RE INCLUDING THEM. 3649 02:23:19,942 --> 02:23:22,077 WHEN WE GET TO THE PROCUREMENT 3650 02:23:22,077 --> 02:23:26,048 STAGE IT WILL BE OPEN BID TO ALL 3651 02:23:26,048 --> 02:23:27,082 VENDORS. 3652 02:23:27,082 --> 02:23:28,517 THEY WILL HAVE REQUIREMENTS, 3653 02:23:28,517 --> 02:23:30,452 THAT'S WHAT THE PERFORMANCE WORK 3654 02:23:30,452 --> 02:23:32,454 STATEMENT IS. 3655 02:23:32,454 --> 02:23:35,490 AND WE WANT AN EHR WILL THAT 3656 02:23:35,490 --> 02:23:36,658 SUPPORT SAFE QUALITY CLINICAL 3657 02:23:36,658 --> 02:23:39,528 CARE, ALIGNS WITH CURRENT AND 3658 02:23:39,528 --> 02:23:40,829 FUTURE GOOD CLINICAL PRACTICE 3659 02:23:40,829 --> 02:23:41,663 STANDARDS, REVIEW COMPONENTS 3660 02:23:41,663 --> 02:23:45,500 THAT ARE NEEDED THAT ARE IN THE 3661 02:23:45,500 --> 02:23:46,601 SOW, PWS, REVIEW COMPONENTS AND 3662 02:23:46,601 --> 02:23:49,071 HOW THEY ARE GOING TO BE 3663 02:23:49,071 --> 02:23:50,539 IMPLEMENTED, REVIEWS HOW SYSTEM 3664 02:23:50,539 --> 02:23:53,008 WILL PROVISION DATA TO BE USEFUL 3665 02:23:53,008 --> 02:23:58,847 FOR CLINICAL RESEARCH. 3666 02:23:58,847 --> 02:23:59,147 NEXT. 3667 02:23:59,147 --> 02:24:00,382 WE HAD MITRE. 3668 02:24:00,382 --> 02:24:01,883 WE HAD ADDITIONAL CONTRACT. 3669 02:24:01,883 --> 02:24:05,787 WE WERE ABOUT 75% DONE WITH THE 3670 02:24:05,787 --> 02:24:07,622 PWS AND SOW, AND THEN CONTRACT 3671 02:24:07,622 --> 02:24:11,693 ENDED AND TOOK US A LONG TIME 3672 02:24:11,693 --> 02:24:15,764 BECAUSE THE PROCESS WITH CMS TO 3673 02:24:15,764 --> 02:24:17,799 UTILIZE MITRE CHANGED, WAS UNDER 3674 02:24:17,799 --> 02:24:19,735 A DIFFERENT LEVEL OF SCRUTINY 3675 02:24:19,735 --> 02:24:22,571 AND TOOK US SIX MONTHS TO GET IT 3676 02:24:22,571 --> 02:24:23,905 RESTARTED. 3677 02:24:23,905 --> 02:24:25,007 IT'S NOW RESTARTED. 3678 02:24:25,007 --> 02:24:28,310 THEY ARE FINALIZING THE PWS AND 3679 02:24:28,310 --> 02:24:31,246 SOW, AND THEY ARE GOING TO START 3680 02:24:31,246 --> 02:24:38,420 THE CLINICAL WORKFLOW MODELING 3681 02:24:38,420 --> 02:24:39,354 COMPONENT IN FEBRUARY. 3682 02:24:39,354 --> 02:24:40,088 WE'VE HAD FOCUS GROUPS. 3683 02:24:40,088 --> 02:24:42,657 MANY WERE PART OF THE BUSINESS 3684 02:24:42,657 --> 02:24:47,062 CASE AS WELL AS PART OF THE PWS 3685 02:24:47,062 --> 02:24:47,729 CREATION. 3686 02:24:47,729 --> 02:24:50,298 AND SO MITRE HAD I THINK OVER 3687 02:24:50,298 --> 02:24:52,901 30+ FOCUS GROUPS. 3688 02:24:52,901 --> 02:24:55,871 WE'VE HAD JOB SHADOWING, JOB 3689 02:24:55,871 --> 02:24:57,906 SHADOWING WITH NURSING WAS VERY 3690 02:24:57,906 --> 02:24:58,874 CRITICAL, PHYSICIANS AS WELL. 3691 02:24:58,874 --> 02:25:03,512 SO THESE ARE ALL THE DIFFERENT 3692 02:25:03,512 --> 02:25:06,381 FOCUS GROUPS THAT OCCURRED. 3693 02:25:06,381 --> 02:25:07,015 THOSE THAT WERE INTERVIEWED AS 3694 02:25:07,015 --> 02:25:12,020 PART OF THE PROCESS AS WELL. 3695 02:25:12,020 --> 02:25:13,121 NEXT. 3696 02:25:13,121 --> 02:25:15,690 WE HAVE OVER A THOUSAND 3697 02:25:15,690 --> 02:25:16,858 INDIVIDUAL REQUIREMENTS. 3698 02:25:16,858 --> 02:25:18,760 PWS IS BROKEN OUT FOR DIFFERENT 3699 02:25:18,760 --> 02:25:22,097 FUNCTION AREAS, IDENTIFYING THE 3700 02:25:22,097 --> 02:25:24,299 TOP FIVE, AND THEN WE HAVE 3701 02:25:24,299 --> 02:25:28,637 APPENDIX OR SPREADSHEET WITH 3702 02:25:28,637 --> 02:25:29,137 INDIVIDUAL REQUIREMENTS, 3703 02:25:29,137 --> 02:25:32,074 VALIDATING THEM NOW. 3704 02:25:32,074 --> 02:25:32,507 NEXT. 3705 02:25:32,507 --> 02:25:34,943 AND THEN THE CLINICAL WORKFLOW 3706 02:25:34,943 --> 02:25:37,446 MODELING CREATED INVENTORY OF 3707 02:25:37,446 --> 02:25:39,147 ALL THE CLINICAL WORKFLOWS, THEY 3708 02:25:39,147 --> 02:25:41,883 HAVE DONE THIS WITH IHS AND 3709 02:25:41,883 --> 02:25:43,518 OTHER PEOPLE, AND THEY THEY HAVE 3710 02:25:43,518 --> 02:25:47,456 A FRAMEWORK TO DO THAT. 3711 02:25:47,456 --> 02:25:51,159 OUR CONTRACT WAS TO DO 50 3712 02:25:51,159 --> 02:25:52,994 CLINICAL WORKFLOWS FROM ORDERING 3713 02:25:52,994 --> 02:25:54,296 TO RESULTS. 3714 02:25:54,296 --> 02:25:57,599 AND THEN AFTER THE 50 WE NEED TO 3715 02:25:57,599 --> 02:26:04,539 DETERMINE WHAT'S LEFT AND THEN 3716 02:26:04,539 --> 02:26:05,707 HOW THE INTERDISCIPLINARY TEAM 3717 02:26:05,707 --> 02:26:07,109 CAN DO THOSE. 3718 02:26:07,109 --> 02:26:10,812 AND THEN THE BIGGEST IS SECURE 3719 02:26:10,812 --> 02:26:11,680 FUNDING. 3720 02:26:11,680 --> 02:26:16,651 SO WE -- THERE IS THIS MECHANISM 3721 02:26:16,651 --> 02:26:18,286 CALLED NON-EXPIRING FUNDS, IT'S 3722 02:26:18,286 --> 02:26:20,122 FUNDS BASED ON PROJECTS THAT 3723 02:26:20,122 --> 02:26:21,857 DON'T CONTINUE, THE MONEY GOES 3724 02:26:21,857 --> 02:26:26,628 INTO A POT, AND IT'S TO SUPPORT 3725 02:26:26,628 --> 02:26:29,197 LARGE I.T. PROJECTS, AND 3726 02:26:29,197 --> 02:26:30,665 CONSTRUCTION PROJECTS. 3727 02:26:30,665 --> 02:26:34,436 AND WE DONE THE INITIAL REQUEST, 3728 02:26:34,436 --> 02:26:39,641 AND WE'RE STILL WORKING THROUGH 3729 02:26:39,641 --> 02:26:41,076 THAT PROCESS. 3730 02:26:41,076 --> 02:26:43,712 IT WON'T BE AVAILABLE FOR 2024 3731 02:26:43,712 --> 02:26:48,216 OR 2025, BUT WE'RE MAKING SURE 3732 02:26:48,216 --> 02:26:51,520 WE HAVE EVERYTHING READY IF ANY 3733 02:26:51,520 --> 02:26:52,654 FUNDS COME AVAILABLE. 3734 02:26:52,654 --> 02:26:56,158 IF ANYBODY WANTS TO DONATE $150 3735 02:26:56,158 --> 02:26:57,592 MILLION, I'M PRETTY SURE WE CAN 3736 02:26:57,592 --> 02:27:00,662 FIGURE OUT HOW TO DO THAT. 3737 02:27:00,662 --> 02:27:03,131 AND WE FOUND OUT WHEN WE 3738 02:27:03,131 --> 02:27:07,302 SUBMITTED THE NEF REQUEST THE 3739 02:27:07,302 --> 02:27:14,075 FIRST THING FROM HHS CIO WHAT'S 3740 02:27:14,075 --> 02:27:16,344 YOUR FEDERAL ITF REFORM ACT 3741 02:27:16,344 --> 02:27:17,946 NUMBER, I DIDN'T HAVE ONE, IT 3742 02:27:17,946 --> 02:27:19,714 WAS ON MY LIST OF THINGS TO DO 3743 02:27:19,714 --> 02:27:22,284 BUT THE OPPORTUNITY FOR THE NEF 3744 02:27:22,284 --> 02:27:24,953 FUNDING CAME BEFORE WE DID THAT, 3745 02:27:24,953 --> 02:27:29,691 AND SO WE'VE COMPLETED THE FTARA 3746 02:27:29,691 --> 02:27:32,194 AND HAVE A NUMBER, HHS IS 3747 02:27:32,194 --> 02:27:34,396 REVIEWING IT, WE HAVE IT 3748 02:27:34,396 --> 02:27:41,603 APPROVED BY NIH. 3749 02:27:41,603 --> 02:27:43,271 NEXT SLIDE. 3750 02:27:43,271 --> 02:27:45,440 NEXT STEPS, MITRE CONTINUE TO 3751 02:27:45,440 --> 02:27:50,679 WORK, SECURE FUNDING, HAVE OUR 3752 02:27:50,679 --> 02:27:58,286 PWS/SOW SIGNED, SEALED, SHOVEL 3753 02:27:58,286 --> 02:27:58,620 READY. 3754 02:27:58,620 --> 02:27:59,854 WE'RE TRYING TO MAKE SURE 3755 02:27:59,854 --> 02:28:01,122 EVERYTHING IS DONE SO WHEN THE 3756 02:28:01,122 --> 02:28:02,290 TIME HAPPENS, WE'RE READY. 3757 02:28:02,290 --> 02:28:03,058 NEXT SLIDE. 3758 02:28:03,058 --> 02:28:06,795 I THINK THAT'S IT. 3759 02:28:06,795 --> 02:28:09,731 DID I DO ALL RIGHT, DR. GILMAN? 3760 02:28:09,731 --> 02:28:10,498 OKAY. 3761 02:28:10,498 --> 02:28:11,499 HE LOOKED FRUSTRATED SO I WANTED 3762 02:28:11,499 --> 02:28:14,402 TO MAKE SURE. 3763 02:28:14,402 --> 02:28:24,446 3764 02:28:26,915 --> 02:28:31,219 >> DON'T TRY TO READ JIM'S FACE. 3765 02:28:31,219 --> 02:28:32,988 >> YEAH, I KNOW, I KNOW. 3766 02:28:32,988 --> 02:28:35,523 >> ARE THERE ANY QUESTIONS? 3767 02:28:35,523 --> 02:28:35,724 DAVID? 3768 02:28:35,724 --> 02:28:36,324 >> OBSERVATION, THE COMPLEXITY 3769 02:28:36,324 --> 02:28:36,858 DEFINING REQUIREMENTS AND 3770 02:28:36,858 --> 02:28:37,292 INTERRELATIONS AMONG 3771 02:28:37,292 --> 02:28:38,593 REQUIREMENTS, IT'S LIKE BUILDING 3772 02:28:38,593 --> 02:28:40,595 A SATELLITE SYSTEM WITH 3773 02:28:40,595 --> 02:28:42,597 COMMUNICATIONS PAYLOAD, WHICH 3774 02:28:42,597 --> 02:28:45,967 REQUIRES A FAIRLY COMPREHENSIVE 3775 02:28:45,967 --> 02:28:47,669 AND ROBUST REQUIREMENTS TRACKING 3776 02:28:47,669 --> 02:28:50,372 SYSTEM, WHICH THEN BECOMES PART 3777 02:28:50,372 --> 02:28:53,408 OF YOUR TESTING PACKAGE FOR 3778 02:28:53,408 --> 02:28:55,510 REGRESSION TESTING AND THEN IS 3779 02:28:55,510 --> 02:28:57,312 USED FOR MAINTENANCE OF THE LINE 3780 02:28:57,312 --> 02:28:58,380 AFTER THE FACT. 3781 02:28:58,380 --> 02:29:01,616 DO WE HAVE ANY CONTROL OVER HOW 3782 02:29:01,616 --> 02:29:02,384 MITRE IS DOING THAT? 3783 02:29:02,384 --> 02:29:05,487 >> NO. 3784 02:29:05,487 --> 02:29:06,888 WE HAD THAT CONVERSATION BASED 3785 02:29:06,888 --> 02:29:10,358 ON YOUR COMMENT, OR I THINK YOU 3786 02:29:10,358 --> 02:29:12,694 AND I DISCUSSED THAT. 3787 02:29:12,694 --> 02:29:15,330 AND I AM FAILING TO REMEMBER 3788 02:29:15,330 --> 02:29:20,302 WHAT THE SOLUTION IS. 3789 02:29:20,302 --> 02:29:21,102 >> THEY DO HAVE IT IN THEIR 3790 02:29:21,102 --> 02:29:21,703 SYSTEM BUT I NEED IT SO I CAN 3791 02:29:21,703 --> 02:29:32,113 MANAGE IT AFTER, RIGHT. 3792 02:29:35,583 --> 02:29:35,750 >> YEAH. 3793 02:29:35,750 --> 02:29:37,986 >> SO I NEED TO DETERMINE THAT. 3794 02:29:37,986 --> 02:29:44,326 DAVID ON ZOOM. 3795 02:29:44,326 --> 02:29:47,529 JON, TERRIFIC PRESENTATION. 3796 02:29:47,529 --> 02:29:48,463 YOU'VE MADE A CONVINCING CASE 3797 02:29:48,463 --> 02:29:50,999 HOW COMPLICATED THIS SYSTEM IS. 3798 02:29:50,999 --> 02:29:53,001 AND NEEDS TO BE REPLACED. 3799 02:29:53,001 --> 02:29:53,535 AND I HAVE TWO QUESTIONS. 3800 02:29:53,535 --> 02:29:54,833 ONE IS A QUESTION. 3801 02:29:54,833 --> 02:29:55,467 YOU MENTIONED EARLY ON, AND THIS 3802 02:29:55,467 --> 02:29:56,101 MAY BE A POINT OF IGNORANCE ON 3803 02:29:56,101 --> 02:29:57,102 MY PART, THAT THE SYSTEM IS 3804 02:29:57,102 --> 02:29:58,003 HIPAA EXEMPT. 3805 02:29:58,003 --> 02:30:02,307 AND WHAT DOES THAT MEAN FROM A 3806 02:30:02,307 --> 02:30:03,809 PROVIDER, PATIENT, AND 3807 02:30:03,809 --> 02:30:05,110 INSTITUTIONAL PERSPECTIVE? 3808 02:30:05,110 --> 02:30:08,013 THE SECOND QUESTION STEMS FROM 3809 02:30:08,013 --> 02:30:13,986 COMPLEXITY OF SYSTEM THAT YOU SO 3810 02:30:13,986 --> 02:30:15,888 HAPPILY OR COGENTLY DESCRIBED, 3811 02:30:15,888 --> 02:30:18,857 $150 MILLION SEEMS CHEAP FOR A 3812 02:30:18,857 --> 02:30:23,896 SYSTEM AS COMPLEX AS THIS. 3813 02:30:23,896 --> 02:30:26,265 YOU'RE AWARE OF ACADEMIC MEDICAL 3814 02:30:26,265 --> 02:30:28,600 CENTERS THAT SPENT MORE ON I.T. 3815 02:30:28,600 --> 02:30:30,135 STRUCTURE THAN THAT. 3816 02:30:30,135 --> 02:30:31,937 >> I'LL ANSWER THE SECOND FIRST 3817 02:30:31,937 --> 02:30:33,305 BECAUSE I MIGHT NEED HELP WITH 3818 02:30:33,305 --> 02:30:36,275 THE FIRST ONE. 3819 02:30:36,275 --> 02:30:38,277 THE SECOND FIRST, THAT WAS 3820 02:30:38,277 --> 02:30:40,412 OWNERSHIP VALUE THAT WAS 3821 02:30:40,412 --> 02:30:42,080 IDENTIFIED BY MITRE BUT I THINK 3822 02:30:42,080 --> 02:30:44,183 WE STILL NEED TO DO SOME 3823 02:30:44,183 --> 02:30:47,019 VALIDATION ON THAT NUMBER. 3824 02:30:47,019 --> 02:30:49,354 BUT THE IDEA WAS $30 MILLION A 3825 02:30:49,354 --> 02:30:51,523 YEAR, AND THAT $30 MILLION WOULD 3826 02:30:51,523 --> 02:30:51,890 CONTINUE. 3827 02:30:51,890 --> 02:30:54,726 SO, THE FIRST FIVE YEARS IS THE 3828 02:30:54,726 --> 02:30:55,594 $150 MILLION. 3829 02:30:55,594 --> 02:30:59,431 BUT WE DO NEED TO VALIDATE THAT 3830 02:30:59,431 --> 02:31:00,799 NUMBER. 3831 02:31:00,799 --> 02:31:02,868 I DON'T TRUST ANYTHING FROM 3832 02:31:02,868 --> 02:31:03,101 ANYBODY. 3833 02:31:03,101 --> 02:31:04,970 IT'S THAT VERIFY AND TRUST RULE. 3834 02:31:04,970 --> 02:31:06,572 PART OF GETTING MORE 3835 02:31:06,572 --> 02:31:09,374 REQUIREMENTS AND GETTING THIS 3836 02:31:09,374 --> 02:31:12,311 OUT TO INDUSTRY TO TELL US THE 3837 02:31:12,311 --> 02:31:14,546 COST, WE'RE GOING TO DO, BUT 3838 02:31:14,546 --> 02:31:18,917 THAT NUMBER WAS BASED ON MITRE 3839 02:31:18,917 --> 02:31:20,886 DOING RESEARCH WITH OTHER LIKE 3840 02:31:20,886 --> 02:31:23,121 HOSPITALS, RIGHT? 3841 02:31:23,121 --> 02:31:25,023 WE'RE A SINGLE INSTANCE, AND SO 3842 02:31:25,023 --> 02:31:26,592 THAT'S PART OF THE VALUE. 3843 02:31:26,592 --> 02:31:30,262 BUT WE DO HAVE TO VALIDATE THAT 3844 02:31:30,262 --> 02:31:30,495 NUMBER. 3845 02:31:30,495 --> 02:31:33,665 I AGREE WITH WHAT YOU SAID. 3846 02:31:33,665 --> 02:31:35,200 FOR THE HIPAA EXEMPT WE DON'T 3847 02:31:35,200 --> 02:31:38,136 BILL, RIGHT? 3848 02:31:38,136 --> 02:31:42,808 SO WE DON'T HAVE THAT BUSINESS 3849 02:31:42,808 --> 02:31:44,276 ASSOCIATE COMPONENT. 3850 02:31:44,276 --> 02:31:47,946 WE DON'T HAVE THAT SENDING OF 3851 02:31:47,946 --> 02:31:50,382 DATA TO PAYERS OR TO ANYBODY. 3852 02:31:50,382 --> 02:31:54,486 AND WE DON'T SEND ANYTHING OUT 3853 02:31:54,486 --> 02:31:55,721 FROM CRIS. 3854 02:31:55,721 --> 02:31:58,390 IF THINGS GO OUT FOR DIFFERENT 3855 02:31:58,390 --> 02:31:59,791 PURPOSES, THEY ARE EXTERNAL TO 3856 02:31:59,791 --> 02:32:00,092 CRIS. 3857 02:32:00,092 --> 02:32:02,928 BUT WE DON'T BILL SO THE BIGGEST 3858 02:32:02,928 --> 02:32:05,764 ISSUE FROM A HIPAA STANDPOINT IS 3859 02:32:05,764 --> 02:32:05,998 BILLING. 3860 02:32:05,998 --> 02:32:11,303 IF WE BILLED ANY COMPONENT, OR 3861 02:32:11,303 --> 02:32:14,373 WE START INTERFACING OUR DATA TO 3862 02:32:14,373 --> 02:32:17,109 EXTERNAL SOURCES DIRECTLY FROM 3863 02:32:17,109 --> 02:32:18,577 OUR EHR FOR SOMETHING LIKE 3864 02:32:18,577 --> 02:32:24,416 e-PRESCRIBE WE MIGHT CHANGE THE 3865 02:32:24,416 --> 02:32:25,417 HIPAA EXEMPT CONDITION. 3866 02:32:25,417 --> 02:32:35,627 SO I NEED TO BE CAREFUL OF THAT. 3867 02:32:35,627 --> 02:32:37,429 BUT THAT'S PART OF -- THAT'S THE 3868 02:32:37,429 --> 02:32:40,032 WAY SINCE I'VE BEEN HERE SO I'M 3869 02:32:40,032 --> 02:32:40,866 NOT SURE WHAT INITIATED THE 3870 02:32:40,866 --> 02:32:41,700 HIPAA EXEMPT. 3871 02:32:41,700 --> 02:32:52,244 BUT IT'S MAINLY BECAUSE WE DON'T 3872 02:32:58,550 --> 02:32:58,684 BILL. 3873 02:32:58,684 --> 02:33:03,055 >> BUT WE ARE BOUND BY THE 3874 02:33:03,055 --> 02:33:04,957 PRIVACY ACT. 3875 02:33:04,957 --> 02:33:05,190 >> YES. 3876 02:33:05,190 --> 02:33:06,191 >> WITH REGARD TO PROTECTION OF 3877 02:33:06,191 --> 02:33:06,825 INFORMATION, WE'RE IN VIRTUALLY 3878 02:33:06,825 --> 02:33:08,126 EVERY WAY HIPAA OBSERVANTS OWN 3879 02:33:08,126 --> 02:33:14,733 THOUGH WE'RE NOT FULLY HIPAA 3880 02:33:14,733 --> 02:33:19,271 COMPLIANT. 3881 02:33:19,271 --> 02:33:19,905 >> WELL, AREN'T WE HIPAA EXEMPT 3882 02:33:19,905 --> 02:33:20,405 AS A RESEARCH HOSPITAL? 3883 02:33:20,405 --> 02:33:21,039 >> THAT'S WHY IT'S MAINTAINED, 3884 02:33:21,039 --> 02:33:24,977 YES. 3885 02:33:24,977 --> 02:33:25,243 >> GREAT. 3886 02:33:25,243 --> 02:33:26,078 >> BUT IF WE WERE A RESEARCH 3887 02:33:26,078 --> 02:33:26,712 HOSPITAL AND BILLED WE WOULDN'T 3888 02:33:26,712 --> 02:33:31,883 BE EXEMPT ANYMORE, RIGHT? 3889 02:33:31,883 --> 02:33:32,517 >> SO I APPLAUD YOU FOR A COUPLE 3890 02:33:32,517 --> 02:33:32,751 THINGS. 3891 02:33:32,751 --> 02:33:33,318 ONE, THAT YOU'VE REMAINED SO 3892 02:33:33,318 --> 02:33:36,021 CALM JUST BY THE VERY CLEAR 3893 02:33:36,021 --> 02:33:37,222 COMPLEXITY OF THE PROJECT. 3894 02:33:37,222 --> 02:33:38,523 >> DR. GILMAN COMES TO MY OFFICE 3895 02:33:38,523 --> 02:33:41,126 ONCE A MONTH TO MAKE SURE I 3896 02:33:41,126 --> 02:33:44,796 HAVEN'T FIGURED OUT A WAY TO 3897 02:33:44,796 --> 02:33:45,297 OPEN WINDOWS. 3898 02:33:45,297 --> 02:33:46,498 >> I APPLAUD YOU FOR RECOGNIZING 3899 02:33:46,498 --> 02:33:48,667 THIS IS NOT AN I.T. ENDEAVOR AND 3900 02:33:48,667 --> 02:33:49,868 IT'S A CLINICAL ENDEAVOR AND 3901 02:33:49,868 --> 02:33:52,237 THERE NEEDS TO BE A WIDE ARRAY 3902 02:33:52,237 --> 02:33:54,072 OF PEOPLE THAT TOUCH WHAT YOU'RE 3903 02:33:54,072 --> 02:33:54,806 DOING. 3904 02:33:54,806 --> 02:33:56,375 I HAVE A TWO-PART QUESTION. 3905 02:33:56,375 --> 02:34:00,412 ONE IS GIVEN THE DEGREE OF 3906 02:34:00,412 --> 02:34:01,013 COMPLEXITY, ARE YOU CONFIDENT 3907 02:34:01,013 --> 02:34:03,515 THAT THERE IS AN EHR SYSTEM THAT 3908 02:34:03,515 --> 02:34:06,351 CAN ACTUALLY DO ALL OF THIS? 3909 02:34:06,351 --> 02:34:08,453 THAT'S THE FIRST QUESTION. 3910 02:34:08,453 --> 02:34:11,523 THE SECOND QUESTION IS, IT STEMS 3911 02:34:11,523 --> 02:34:16,194 FROM YOUR COMMENT ABOUT THANK 3912 02:34:16,194 --> 02:34:18,330 GOODsNESS FOR ALTERRA DURING 3913 02:34:18,330 --> 02:34:19,498 COVID, CUSTOMIZABLE TO DO WHAT 3914 02:34:19,498 --> 02:34:20,432 YOU NEEDED. 3915 02:34:20,432 --> 02:34:26,171 IN MANY RESPECTS ARE YOU LOOKING 3916 02:34:26,171 --> 02:34:27,706 FOR A CANDIDATE THAT DOESN'T 3917 02:34:27,706 --> 02:34:28,540 JUST HAVE CAPABILITIES YOU NEED 3918 02:34:28,540 --> 02:34:29,808 TODAY BUT WILL HAVE THE 3919 02:34:29,808 --> 02:34:30,842 CAPABILITIES YOU NEED FOR THE 3920 02:34:30,842 --> 02:34:34,046 NEXT TWO OR THREE DECADES AS YOU 3921 02:34:34,046 --> 02:34:40,419 CONTINUE TO CUSTOMIZE THE 3922 02:34:40,419 --> 02:34:40,685 SOLUTION? 3923 02:34:40,685 --> 02:34:41,286 >> I CAN ANSWER THE SECOND ONE 3924 02:34:41,286 --> 02:34:42,754 FIRST AND IF YOU CAN REASK THE 3925 02:34:42,754 --> 02:34:43,922 FIRST BECAUSE I ALREADY FORGOT. 3926 02:34:43,922 --> 02:34:45,690 SORRY ABOUT THAT. 3927 02:34:45,690 --> 02:34:47,359 SECOND QUESTION IS WE NEED TO 3928 02:34:47,359 --> 02:34:50,796 HAVE REQUIREMENTS IN THERE TO -- 3929 02:34:50,796 --> 02:34:52,431 I HATE THE METHODOLOGY AGILE. 3930 02:34:52,431 --> 02:34:54,800 I USED TO HATE THE METHODOLOGY 3931 02:34:54,800 --> 02:34:58,036 AGILE BUT WE HAVE TO BE AGILE, 3932 02:34:58,036 --> 02:34:58,703 RIGHT? 3933 02:34:58,703 --> 02:35:00,138 I TEACH SOFTWARE ENGINEERING SO 3934 02:35:00,138 --> 02:35:03,275 I'VE STARTED TO LIKE THE TERM, 3935 02:35:03,275 --> 02:35:06,278 AGILE, AND WE HAVE TO HAVE 3936 02:35:06,278 --> 02:35:08,980 REQUIREMENTS FROM OUR PWS THAT 3937 02:35:08,980 --> 02:35:09,781 IDENTIFIES THAT ENVIRONMENT THAT 3938 02:35:09,781 --> 02:35:12,584 WE WERE ABLE TO OPERATE DURING 3939 02:35:12,584 --> 02:35:12,951 COVID. 3940 02:35:12,951 --> 02:35:15,120 AND SO I NEED TO HAVE THOSE 3941 02:35:15,120 --> 02:35:16,688 REQUIREMENTS IN THERE BUT THERE 3942 02:35:16,688 --> 02:35:19,191 HAS TO BE SOME FLEXIBILITY. 3943 02:35:19,191 --> 02:35:28,467 AND WHAT WE BUILT WAS A SEPARATE 3944 02:35:28,467 --> 02:35:29,501 SCHEDULING SYSTEM THAT COULD 3945 02:35:29,501 --> 02:35:34,940 INTERFACE TO CRIS AND CRIS COULD 3946 02:35:34,940 --> 02:35:35,907 FEED THE LAB SYSTEM AND 3947 02:35:35,907 --> 02:35:36,441 EVERYTHING WORKED. 3948 02:35:36,441 --> 02:35:39,044 WE NEED TO IDENTIFY THOSE 3949 02:35:39,044 --> 02:35:39,711 REQUIREMENTS, THAT AGILE 3950 02:35:39,711 --> 02:35:41,279 DEVELOPMENT AND THAT TYPE OF 3951 02:35:41,279 --> 02:35:42,848 ENVIRONMENT WE CREATED HAVE TO 3952 02:35:42,848 --> 02:35:51,990 BE PART OF THE REQUIREMENTS. 3953 02:35:51,990 --> 02:35:52,357 >> GOOD TO HEAR. 3954 02:35:52,357 --> 02:35:52,958 FIRST QUESTION WAS IS THERE AN 3955 02:35:52,958 --> 02:35:53,558 ORGANIZATION THAT CAN DO THIS? 3956 02:35:53,558 --> 02:35:54,059 I COULD IMAGINE LEADING 3957 02:35:54,059 --> 02:35:55,694 CONTENTERS WOULD BE EPIC OR 3958 02:35:55,694 --> 02:35:59,197 ORACLE OR MEDI TECH, BUT ARE YOU 3959 02:35:59,197 --> 02:36:01,266 COMFORTABLE THE LONG LIST OF 3960 02:36:01,266 --> 02:36:03,101 CAPABILITIES THAT THE LEADING 3961 02:36:03,101 --> 02:36:06,438 EHR COMPANIES AT THE PRICE THAT 3962 02:36:06,438 --> 02:36:11,710 YOU'VE DESIGNATED CAN DO -- 3963 02:36:11,710 --> 02:36:13,345 >> WELL, THAT'S A KICKER. 3964 02:36:13,345 --> 02:36:15,947 YEAH, OTHER ORGANIZATIONS THAT 3965 02:36:15,947 --> 02:36:18,116 ARE ACADEMIC MEDICAL CENTERS AND 3966 02:36:18,116 --> 02:36:21,453 PRIDE THEMSELVES ON RESEARCH 3967 02:36:21,453 --> 02:36:28,360 LIKE JOHNS HOPKINS AND 3968 02:36:28,360 --> 02:36:29,861 VANDERBILT AND MAYO, HAVE SHOWN 3969 02:36:29,861 --> 02:36:31,062 USING COMMERCIAL EHR IS POSSIBLE 3970 02:36:31,062 --> 02:36:33,698 SO I DO BELIEVE IT'S POSSIBLE 3971 02:36:33,698 --> 02:36:35,867 BUT I'M NOT GOING TO IDENTIFY 3972 02:36:35,867 --> 02:36:37,035 VENDORS BECAUSE I CAN'T, RIGHT? 3973 02:36:37,035 --> 02:36:39,404 I DON'T LOOK GOOD IN ORANGE. 3974 02:36:39,404 --> 02:36:41,006 I DON'T -- ANY SHIRT WITH MORE 3975 02:36:41,006 --> 02:36:45,043 THAN TWO DIGITS, NO LINES UP AND 3976 02:36:45,043 --> 02:36:46,845 DOWN, I HAVE TO BE CAREFUL OF 3977 02:36:46,845 --> 02:36:48,847 PROCUREMENT SIDE OF THAT. 3978 02:36:48,847 --> 02:36:51,116 BUT I BELIEVE THERE'S COMMERCIAL 3979 02:36:51,116 --> 02:36:53,919 PRODUCT, AND IT'S UP TO US TO 3980 02:36:53,919 --> 02:36:56,855 MAKE SURE THE REQUIREMENTS ARE 3981 02:36:56,855 --> 02:37:00,292 RIGHT, AND SOLID, FOR OUR 3982 02:37:00,292 --> 02:37:08,233 CLINICAL RESEARCH ENVIRONMENT. 3983 02:37:08,233 --> 02:37:10,001 >> FINAL QUESTION, WILL ALTERRA 3984 02:37:10,001 --> 02:37:10,435 ALSO RECEIVE THE -- 3985 02:37:10,435 --> 02:37:12,404 >> YES. 3986 02:37:12,404 --> 02:37:12,771 ANYBODY CAN BID. 3987 02:37:12,771 --> 02:37:15,740 IT'S OPEN. 3988 02:37:15,740 --> 02:37:16,641 >> I JUST WANTED TO ALSO THANK 3989 02:37:16,641 --> 02:37:17,242 YOU, JON, ON JUST ABOUT EVERY 3990 02:37:17,242 --> 02:37:20,779 ORGANIZATION I'VE BEEN PART OF, 3991 02:37:20,779 --> 02:37:22,847 MOST NOT HEALTH CARE, THE I.T. 3992 02:37:22,847 --> 02:37:24,849 IS THE MOST THANKLESS SO I 3993 02:37:24,849 --> 02:37:25,784 APPRECIATE THE COMPLEXITY. 3994 02:37:25,784 --> 02:37:27,886 THIS IS NOT MY AREA OF EXPERTISE 3995 02:37:27,886 --> 02:37:30,655 BUT I DID NOTICE I TOOK SPECIAL 3996 02:37:30,655 --> 02:37:32,023 NOTE OF THAT PERFORMANCE SCORE, 3997 02:37:32,023 --> 02:37:35,927 WHICH AT THE END OF THE DAY 3998 02:37:35,927 --> 02:37:37,429 WE'RE ALL ABOUT SERVING PEOPLE, 3999 02:37:37,429 --> 02:37:44,536 NOTED AS YOU SAY TRENDING THE 4000 02:37:44,536 --> 02:37:47,138 WRONG WAY, I'D BE CURIOUS HOW 4001 02:37:47,138 --> 02:37:48,873 THAT BENCHMARKS AGAINST OTHER 4002 02:37:48,873 --> 02:37:50,742 MAJOR HOSPITAL SYSTEMS, WHAT'S 4003 02:37:50,742 --> 02:37:53,345 JOHNS HOPKINS, WHAT'S MAYO, THEY 4004 02:37:53,345 --> 02:37:54,212 MUST SHARE THEIR SATISFACTION 4005 02:37:54,212 --> 02:38:04,589 RATING OR DO THEY NOT? 4006 02:38:04,823 --> 02:38:07,025 >> I'M GOING TO LET DR. REEL 4007 02:38:07,025 --> 02:38:07,425 ANSWER BECAUSE -- 4008 02:38:07,425 --> 02:38:08,026 >> SO, I DON'T AT THIS MOMENT 4009 02:38:08,026 --> 02:38:16,668 HAVE AT MY FINGERTIPS A GOOD 4010 02:38:16,668 --> 02:38:17,969 COMPARATOR, BUT THE VENDOR 4011 02:38:17,969 --> 02:38:19,271 COMMUNITY CAN COUNT THINGS 4012 02:38:19,271 --> 02:38:20,438 DIFFERENTLY THAN I THINK -- JON 4013 02:38:20,438 --> 02:38:24,009 IS ONE OF THE MOST MODEST, 4014 02:38:24,009 --> 02:38:24,776 HUMBLE, DEDICATED, PASSIONATE 4015 02:38:24,776 --> 02:38:28,146 PEOPLE I KNOW IN THIS INDUSTRY 4016 02:38:28,146 --> 02:38:30,382 SO HIS ATTENTION TO THE WAY DATA 4017 02:38:30,382 --> 02:38:32,417 ARE CAPTURED AND REPORTED IS 4018 02:38:32,417 --> 02:38:34,319 UNIQUELY JON BECAUSE HE CARES SO 4019 02:38:34,319 --> 02:38:38,490 MUCH ABOUT OUR PATIENTS AND 4020 02:38:38,490 --> 02:38:39,858 PEOPLE WHO TAKE CARE OF OUR 4021 02:38:39,858 --> 02:38:41,693 PATIENTS THE I THINK WHAT THE 4022 02:38:41,693 --> 02:38:43,528 VENDOR COMMUNITY DOES TO KEEP 4023 02:38:43,528 --> 02:38:45,664 METRICS HIGH IS TO HAVE A SHADOW 4024 02:38:45,664 --> 02:38:48,233 SYSTEM, IF YOU WILL, SOMETHING 4025 02:38:48,233 --> 02:38:52,337 THAT IS AVAILABLE TO THE 4026 02:38:52,337 --> 02:38:53,805 PROVIDER 24/7 REGARDLESS WHETHER 4027 02:38:53,805 --> 02:39:03,114 THE SYSTEM IS DOWN, MAY NOT BE 4028 02:39:03,114 --> 02:39:03,748 TOTALLY INTEROPEARABLE. 4029 02:39:03,748 --> 02:39:05,784 IT'S A BIT OF COOKING THE BOOKS. 4030 02:39:05,784 --> 02:39:07,419 FROM THE USER COMMUNITY AS JON 4031 02:39:07,419 --> 02:39:09,220 SAID IF A USER SAYS IT'S DOWN, 4032 02:39:09,220 --> 02:39:10,188 IT'S DOWN. 4033 02:39:10,188 --> 02:39:12,424 THE USER DOESN'T SEE THE DOWN 4034 02:39:12,424 --> 02:39:14,125 TIME BECAUSE THERE'S A REPLICA 4035 02:39:14,125 --> 02:39:16,428 THAT'S MADE AVAILABLE TO THE 4036 02:39:16,428 --> 02:39:19,164 USER, ALMOST ALWAYS. 4037 02:39:19,164 --> 02:39:20,398 SO THAT'S -- 4038 02:39:20,398 --> 02:39:25,570 >> WE CALL IT SUNDOWN. 4039 02:39:25,570 --> 02:39:25,970 SUNRISE, SUNDOWN. 4040 02:39:25,970 --> 02:39:30,075 SO WE DO HAVE A SYSTEM AND YOU 4041 02:39:30,075 --> 02:39:31,876 CAN PRINT LABELS BUT YOU CAN'T 4042 02:39:31,876 --> 02:39:33,712 ENTER DATA IN IT, RIGHT? 4043 02:39:33,712 --> 02:39:37,782 SO THAT'S HOW WE MEET THE HIMSS 4044 02:39:37,782 --> 02:39:39,117 ANALYTICS IN OUR REQUIREMENTS. 4045 02:39:39,117 --> 02:39:41,119 I THINK WHERE YOU ARE REFERRING 4046 02:39:41,119 --> 02:39:44,556 TO THE SATISFACTION COMPONENT 4047 02:39:44,556 --> 02:39:45,256 TOO? 4048 02:39:45,256 --> 02:39:47,125 THE SATISFACTION COMPONENT, I 4049 02:39:47,125 --> 02:39:50,562 HAVEN'T BEEN ABLE -- WE'VE TRIED 4050 02:39:50,562 --> 02:39:52,230 TO GET BENCHMARKS ACROSS AND 4051 02:39:52,230 --> 02:39:54,332 WE'VE NEVER HAD LUCK. 4052 02:39:54,332 --> 02:39:59,938 SO IT'S REALLY PERSONAL TO YOUR 4053 02:39:59,938 --> 02:40:03,608 ENVIRONMENT, YEAH. 4054 02:40:03,608 --> 02:40:05,243 SO-- THERE IS INDUSTRY CLASS 4055 02:40:05,243 --> 02:40:07,078 REVIEWS, EACH OF THEM, 4056 02:40:07,078 --> 02:40:10,749 IDENTIFIES THE PLUSES AND MINUS 4057 02:40:10,749 --> 02:40:11,750 AND SOME LEVEL OF SATISFACTION 4058 02:40:11,750 --> 02:40:14,686 FOR EACH OF THE VENDORS BUT MY 4059 02:40:14,686 --> 02:40:22,460 SCORES ARE BASED ON SURVEY 4060 02:40:22,460 --> 02:40:23,461 RESULTS. 4061 02:40:23,461 --> 02:40:25,897 THERE WAS 200 RESPONDENTS, A LOW 4062 02:40:25,897 --> 02:40:27,599 NUMBER GIVEN WE HAVE 4,000 USERS 4063 02:40:27,599 --> 02:40:38,109 BUT IT'S STILL NOT A POSITIVE 4064 02:40:39,177 --> 02:40:39,477 NUMBER. 4065 02:40:39,477 --> 02:40:40,111 >> EMPLOYEE ENGAGEMENT SCORING, 4066 02:40:40,111 --> 02:40:40,712 THERE'S THINGS LIKE I HAVE ALL 4067 02:40:40,712 --> 02:40:41,346 THE TOOLS AVAILABLE TO DO THE 4068 02:40:41,346 --> 02:40:42,447 JOB AS WELL AS POSSIBLE OR 4069 02:40:42,447 --> 02:40:45,049 SOMETHING LIKE THAT. 4070 02:40:45,049 --> 02:40:46,451 AND TYPICALLY AT HOPKINS WE DID 4071 02:40:46,451 --> 02:40:48,353 VERY WELL. 4072 02:40:48,353 --> 02:40:51,089 BUT IT'S BECAUSE THE TOOL SET IS 4073 02:40:51,089 --> 02:41:01,633 SO MUCH BIGGER THAN JUST AN EHR. 4074 02:41:07,238 --> 02:41:07,739 >> I KNOW THAT WASN'T A GOOD 4075 02:41:07,739 --> 02:41:07,972 ANSWER. 4076 02:41:07,972 --> 02:41:08,540 >> IF NO OTHER QUESTIONS -- 4077 02:41:08,540 --> 02:41:13,978 TONY, GO AHEAD. 4078 02:41:13,978 --> 02:41:14,579 >> IT'S NOT A QUESTION, IT'S A 4079 02:41:14,579 --> 02:41:14,879 COMPLEMENT. 4080 02:41:14,879 --> 02:41:15,480 THANKS FOR ALL YOU DO AND FOR 4081 02:41:15,480 --> 02:41:19,017 BREAKING DOWN WHAT YOU MENTIONED 4082 02:41:19,017 --> 02:41:23,521 REGARDING THE -- THAT NIH IN 4083 02:41:23,521 --> 02:41:25,790 REFERENCE TO IT NOT BEING -- 4084 02:41:25,790 --> 02:41:26,891 IT'S HIPAA EXEMPT, I'M GLAD YOU 4085 02:41:26,891 --> 02:41:29,494 BROKE THAT DOWN BECAUSE I WAS 4086 02:41:29,494 --> 02:41:31,029 GETTING A HEADACHE SINCE I HEARD 4087 02:41:31,029 --> 02:41:32,030 THAT. 4088 02:41:32,030 --> 02:41:37,635 BY THE WAY, YOU DO LOOK GREAT IN 4089 02:41:37,635 --> 02:41:38,102 ORANGE. 4090 02:41:38,102 --> 02:41:41,239 [LAUGHTER] 4091 02:41:41,239 --> 02:41:41,840 >> WELL, YEAH, THIS IS KIND OF 4092 02:41:41,840 --> 02:41:42,073 ORANGE. 4093 02:41:42,073 --> 02:41:42,640 I WEAR THIS TO MAKE SURE I'M 4094 02:41:42,640 --> 02:41:43,875 ALWAYS SMILING, BUT IT'S MY 4095 02:41:43,875 --> 02:41:44,209 STAFF. 4096 02:41:44,209 --> 02:41:46,578 DAVID INTERACTS WITH THEM. 4097 02:41:46,578 --> 02:41:48,713 WE HAVE TRISHA KOFFEY HERE, WE 4098 02:41:48,713 --> 02:41:50,148 MERGED WITH THEM. 4099 02:41:50,148 --> 02:41:52,484 WE HAVE A TREMENDOUS STAFF. 4100 02:41:52,484 --> 02:41:56,287 THEY ARE IN IT TO WIN IT EVERY 4101 02:41:56,287 --> 02:41:56,521 DAY. 4102 02:41:56,521 --> 02:41:58,256 WORKING 80-HOUR WEEKS, SOME OF 4103 02:41:58,256 --> 02:41:58,790 THEM. 4104 02:41:58,790 --> 02:42:00,792 SOME OF THEM THAT I TRIED TO GET 4105 02:42:00,792 --> 02:42:06,164 THEM TO ACTUALLY GO HOME. 4106 02:42:06,164 --> 02:42:07,098 WHEN WE'RE DOWN THEY HAVE TO BE 4107 02:42:07,098 --> 02:42:07,298 THERE. 4108 02:42:07,298 --> 02:42:10,435 THEY ARE ON THE PHONE. 4109 02:42:10,435 --> 02:42:14,973 IT'S EVERY SINGLE PHONE IN DCRI 4110 02:42:14,973 --> 02:42:18,443 INCLUDING EVERY SECTION, HIM, 4111 02:42:18,443 --> 02:42:20,545 THE TECHNICAL, CRIS BUILD, 4112 02:42:20,545 --> 02:42:23,081 SECURITY, I'M GOING TO -- 4113 02:42:23,081 --> 02:42:23,781 TESTERS. 4114 02:42:23,781 --> 02:42:25,250 WE'RE VERY FORTUNATE OF THE 4115 02:42:25,250 --> 02:42:29,854 SKILL LEVEL OF THE STAFF THAT 4116 02:42:29,854 --> 02:42:30,221 WORK FOR US. 4117 02:42:30,221 --> 02:42:33,925 THANKED -- AND EVERYBODY THAT 4118 02:42:33,925 --> 02:42:36,394 USES THE SYSTEM. 4119 02:42:36,394 --> 02:42:39,697 I'M FINE HEARING CRITIQUES, 4120 02:42:39,697 --> 02:42:41,466 SOMETIMES I GO HOME EARLY BALLS 4121 02:42:41,466 --> 02:42:43,067 IT'S TOO MANY BUT I CAN'T GET 4122 02:42:43,067 --> 02:42:44,569 BETTER IF I DON'T HEAR THEM. 4123 02:42:44,569 --> 02:42:50,842 WE'RE FORTUNATE TO BE IN AN 4124 02:42:50,842 --> 02:42:52,410 ENVIRONMENT THAT MY STAFF, THE 4125 02:42:52,410 --> 02:42:53,711 STAFF, THEY ARE ALL VERY PROUD 4126 02:42:53,711 --> 02:42:56,414 AND NEED TO BE PROUD OF WHAT 4127 02:42:56,414 --> 02:42:57,181 THEY DO. 4128 02:42:57,181 --> 02:42:59,817 AND WE -- TRISH AND I TRY TO 4129 02:42:59,817 --> 02:43:01,586 SELL THAT EVERY DAY, BECAUSE 4130 02:43:01,586 --> 02:43:04,422 THEY ARE AMAZING. 4131 02:43:04,422 --> 02:43:09,928 4132 02:43:09,928 --> 02:43:11,162 >> ONE COMMENT, IF I MAY THEN. 4133 02:43:11,162 --> 02:43:11,763 AS A PATIENT ADVOCATE SITTING 4134 02:43:11,763 --> 02:43:13,231 HERE I CAN TELL YOU THERE WERE 4135 02:43:13,231 --> 02:43:14,766 PATIENT FOCUS GROUPS, THEY 4136 02:43:14,766 --> 02:43:16,768 DIDN'T FOR SOME REASON MAKE THE 4137 02:43:16,768 --> 02:43:17,068 LIST. 4138 02:43:17,068 --> 02:43:17,769 >> THAT'S MY FAULT. 4139 02:43:17,769 --> 02:43:19,837 >> THE PATIENT ADVISORY GROUP 4140 02:43:19,837 --> 02:43:21,439 WAS INVITED TO PARTICIPATE IN 4141 02:43:21,439 --> 02:43:24,976 FOCUS GROUPS AND I AND A NUMBER 4142 02:43:24,976 --> 02:43:27,145 OF OTHER PATIENTS HAD 4143 02:43:27,145 --> 02:43:29,113 CONVERSATION WAS DR. SANO, WHO 4144 02:43:29,113 --> 02:43:30,615 HAS BEEN THE INTERNAL COLLECTOR, 4145 02:43:30,615 --> 02:43:35,486 AND THE ONE THAT SETS UP THE 4146 02:43:35,486 --> 02:43:37,855 FOCUS GROUPS. 4147 02:43:37,855 --> 02:43:38,122 >> THANKS. 4148 02:43:38,122 --> 02:43:38,723 WE LOOK FORWARD TO HEARING AN 4149 02:43:38,723 --> 02:43:40,291 UPDATE ONCE THE VENDOR HAS BEEN 4150 02:43:40,291 --> 02:43:41,726 IDENTIFIED AND THE BUILD STARTS. 4151 02:43:41,726 --> 02:43:45,797 THANK YOU VERY MUCH FOR THAT. 4152 02:43:45,797 --> 02:43:47,599 NEXT TWO PRESENTERS, DR. ANN 4153 02:43:47,599 --> 02:43:49,901 BERGER AND DR. JOHN POLLACK, 4154 02:43:49,901 --> 02:43:51,436 PRESENTED TO THE BOARD TWO YEARS 4155 02:43:51,436 --> 02:43:54,238 AGO TO SHARE THE EFFORTS 4156 02:43:54,238 --> 02:43:56,641 PROVIDED BY THEIR TEAMS FOR 4157 02:43:56,641 --> 02:43:58,910 CLINICAL CENTER HOSPICE CARE FOR 4158 02:43:58,910 --> 02:43:59,177 PATIENTS. 4159 02:43:59,177 --> 02:44:00,812 SO TODAY THEY RETURN TO DESCRIBE 4160 02:44:00,812 --> 02:44:03,314 THEIR JOINT EFFORTS WITH A 4161 02:44:03,314 --> 02:44:04,415 WELLNESS INITIATIVE RECENTLY 4162 02:44:04,415 --> 02:44:05,950 LAUNCHED WHICH ALIGNS WITH THE 4163 02:44:05,950 --> 02:44:07,685 SURGEON GENERAL'S FRAMEWORK FOR 4164 02:44:07,685 --> 02:44:09,287 MENTAL HEALTH AND WELL-BEING 4165 02:44:09,287 --> 02:44:12,390 ESTABLISHED IN ASSOCIATION WITH 4166 02:44:12,390 --> 02:44:12,957 THE PANDEMIC. 4167 02:44:12,957 --> 02:44:21,399 THANK YOU. 4168 02:44:21,399 --> 02:44:21,966 >> THANK YOU FOR HAVING US. 4169 02:44:21,966 --> 02:44:22,734 JOHN AND I WILL TALK ABOUT THE 4170 02:44:22,734 --> 02:44:24,202 WELLNESS INITIATIVE AT THE 4171 02:44:24,202 --> 02:44:26,004 CLINICAL CENTER. 4172 02:44:26,004 --> 02:44:26,904 THAT WE STARTED PROBABLY ABOUT A 4173 02:44:26,904 --> 02:44:30,975 YEAR AND A HALF, TWO YEARS AGO 4174 02:44:30,975 --> 02:44:33,177 WITH THE UNDERSTANDING THAT 4175 02:44:33,177 --> 02:44:35,480 WELLNESS IS -- MENTAL HEALTH AND 4176 02:44:35,480 --> 02:44:37,882 WELLNESS IS ACTUALLY A LARGE 4177 02:44:37,882 --> 02:44:39,250 ISSUE, BURNOUT IS A LARGE ISSUE, 4178 02:44:39,250 --> 02:44:40,652 STRESS IS A LARGE ISSUE IN 4179 02:44:40,652 --> 02:44:46,557 HEALTH CARE AND IN THE 4180 02:44:46,557 --> 02:44:46,858 WORKPLACE. 4181 02:44:46,858 --> 02:44:49,060 I'M GOING TO SET UP WHY THIS IS 4182 02:44:49,060 --> 02:44:53,865 IMPORTANT, AND THEN JOHN IS 4183 02:44:53,865 --> 02:44:56,134 GOING TO GIVE US -- THE RESEARCH 4184 02:44:56,134 --> 02:44:58,369 AND JOHN WILL GIVE US DETAILS OF 4185 02:44:58,369 --> 02:44:59,504 WHAT'S GOING WITH THE PROGRAM 4186 02:44:59,504 --> 02:45:01,839 HERE. 4187 02:45:01,839 --> 02:45:04,175 AS HAS BEEN INDICATED, DURING 4188 02:45:04,175 --> 02:45:06,277 QUESTIONS LIKE DURING NURSING 4189 02:45:06,277 --> 02:45:10,348 MAGNET DISCUSSION, IT'S WELL 4190 02:45:10,348 --> 02:45:11,716 UNDERSTOOD THAT BURNOUT, STRESS, 4191 02:45:11,716 --> 02:45:14,986 ANXIETY IN THE WORKPLACE IS A 4192 02:45:14,986 --> 02:45:18,122 BIG PROBLEM. 4193 02:45:18,122 --> 02:45:22,293 U.S. SURGEON GENERAL PUT TALE A 4194 02:45:22,293 --> 02:45:23,828 -- TOGETHER A FRAMEWORK, AN 4195 02:45:23,828 --> 02:45:25,329 EXCELLENT READ IF YOU LOOK IT 4196 02:45:25,329 --> 02:45:25,897 UP. 4197 02:45:25,897 --> 02:45:27,465 IT STARTS WITH THIS FRAMEWORK OF 4198 02:45:27,465 --> 02:45:29,133 DEDICATED TO ALL WORKERS WHO 4199 02:45:29,133 --> 02:45:30,868 LOST THEIR LIFE DURING THE 4200 02:45:30,868 --> 02:45:32,403 PANDEMIC AND TO THEIR FAMILIES. 4201 02:45:32,403 --> 02:45:34,305 MAY THIS SERVE AS A CALL TO 4202 02:45:34,305 --> 02:45:37,075 ACTION TO LIFT UP THE VOICE OF 4203 02:45:37,075 --> 02:45:38,476 WORKERS PARTICULARLY THOSE MOST 4204 02:45:38,476 --> 02:45:41,879 VULNERABLE AND TO PROTECT THEIR 4205 02:45:41,879 --> 02:45:44,082 HEALTH AND WELL-BEING. 4206 02:45:44,082 --> 02:45:46,250 CERTAINLY IN HEALTH CARE, AS I 4207 02:45:46,250 --> 02:45:47,885 SAID OUTSIDE OF HEALTH CARE, BUT 4208 02:45:47,885 --> 02:45:49,587 CERTAINLY IN HEALTH CARE THE 4209 02:45:49,587 --> 02:45:53,424 BURNOUT HAS BEEN SO HIGH, STRESS 4210 02:45:53,424 --> 02:45:55,526 SO HIGH, THAT SUICIDE RATES ARE 4211 02:45:55,526 --> 02:45:58,663 UP AND THERE ARE ALL KINDS OF 4212 02:45:58,663 --> 02:46:00,631 ACTION BILLS LIKE THE LAUREN 4213 02:46:00,631 --> 02:46:04,168 GREEN, A BILL THAT CAME OUT, A 4214 02:46:04,168 --> 02:46:07,305 PHYSICIAN, E.R. PHYSICIAN WHO 4215 02:46:07,305 --> 02:46:08,706 COMMITTED SUICIDE DURING COVID 4216 02:46:08,706 --> 02:46:10,241 TIMES IN NEW YORK. 4217 02:46:10,241 --> 02:46:12,009 AND THEN HER FAMILY WORKED TO 4218 02:46:12,009 --> 02:46:13,611 PUT TOGETHER THIS BILL. 4219 02:46:13,611 --> 02:46:15,346 SO THERE'S A LOT OF 4220 02:46:15,346 --> 02:46:18,983 UNDERSTANDING, A LOT OF WORK IN 4221 02:46:18,983 --> 02:46:20,618 THE BIGGER FEDERAL AND 4222 02:46:20,618 --> 02:46:22,453 NON-FEDERAL ENVIRONMENT. 4223 02:46:22,453 --> 02:46:23,921 NEXT SLIDE PLEASE. 4224 02:46:23,921 --> 02:46:26,624 SAMHSA IS ALSO VERY COMMITTED TO 4225 02:46:26,624 --> 02:46:29,393 THE AREA OF BURNOUT AND MENTAL 4226 02:46:29,393 --> 02:46:31,596 HEALTH, AND SO THEY PUT TOGETHER 4227 02:46:31,596 --> 02:46:33,698 FIVE ESSENTIALS FOR WORKPLACE 4228 02:46:33,698 --> 02:46:34,665 MENTAL HEALTH AND WELL-BEING. 4229 02:46:34,665 --> 02:46:38,636 AND THERE ARE COMPONENTS 4230 02:46:38,636 --> 02:46:39,971 DISCUSSED, PROTECTION FROM HARM, 4231 02:46:39,971 --> 02:46:44,408 WHICH INVOLVES PHYSICAL AND 4232 02:46:44,408 --> 02:46:46,410 PSYCHOLOGICAL SAFETY, ENABLES 4233 02:46:46,410 --> 02:46:49,147 REST, NORMALIZES AND SUPPORTS 4234 02:46:49,147 --> 02:46:51,916 MENTAL HEALTH, AND 4235 02:46:51,916 --> 02:46:52,950 OPERATIONALIZES DEIA NORMS, 4236 02:46:52,950 --> 02:46:54,986 POLICY, AND PROGRAMS, INCLUDES 4237 02:46:54,986 --> 02:46:58,523 CONNECTION AND COMMUNITY, WITH 4238 02:46:58,523 --> 02:47:00,858 CULTURAL AWARENESS OF BELONGING, 4239 02:47:00,858 --> 02:47:01,926 CULTIVATE TRUSTED RELATIONSHIPS, 4240 02:47:01,926 --> 02:47:03,294 AND FOSTER COLLABORATION AND 4241 02:47:03,294 --> 02:47:04,162 TEAM WORK. 4242 02:47:04,162 --> 02:47:06,631 IT INVOLVES WORK LIFE HARM ANY, 4243 02:47:06,631 --> 02:47:09,467 PROVIDING AUTONOMY OVER HOW WORK 4244 02:47:09,467 --> 02:47:16,073 IS DONE, MAKING SCHEDULES MORE 4245 02:47:16,073 --> 02:47:17,475 FLEXIBLE, SOMETHING DONE VERY 4246 02:47:17,475 --> 02:47:21,212 MUCH DURING THE PANDEMIC AS WELL 4247 02:47:21,212 --> 02:47:22,747 AS POST-PANDEMIC TIME. 4248 02:47:22,747 --> 02:47:25,316 INCREASE ACCESS TO PAID LEAVE, 4249 02:47:25,316 --> 02:47:28,152 AND RESPECT BOUNDARIES BETWEEN 4250 02:47:28,152 --> 02:47:30,087 WORK AND NON-WORK TIME. 4251 02:47:30,087 --> 02:47:32,824 MATTERING AT WORK, PROVIDING A 4252 02:47:32,824 --> 02:47:34,759 LIVING WAGE, ENGAGING WORKERS IN 4253 02:47:34,759 --> 02:47:37,395 DECISIONS, BUILDING A CULTURE OF 4254 02:47:37,395 --> 02:47:39,630 GRATITUDE AND RECOGNITION IS 4255 02:47:39,630 --> 02:47:40,698 SOMETHING THAT HAS VERY MUCH 4256 02:47:40,698 --> 02:47:42,867 BEEN BUILT IN THE CLINICAL 4257 02:47:42,867 --> 02:47:45,670 CENTER AND IS CONTINUOUSLY BEING 4258 02:47:45,670 --> 02:47:47,872 RELOOKED AT AT GROWING MORE AND 4259 02:47:47,872 --> 02:47:48,339 MORE. 4260 02:47:48,339 --> 02:47:50,374 CONNECTING INDIVIDUAL WORK WITH 4261 02:47:50,374 --> 02:47:50,908 ORGANIZED MISSION. 4262 02:47:50,908 --> 02:47:52,777 AND THEN THE OPPORTUNITY FOR 4263 02:47:52,777 --> 02:47:55,613 GROWTH IS SOMETHING THAT 4264 02:47:55,613 --> 02:47:56,380 PARTICULARLY IN HEALTH CARE A 4265 02:47:56,380 --> 02:48:00,184 LOT OF PEOPLE ASK FOR AND IS 4266 02:48:00,184 --> 02:48:03,154 VERY BIG COMPONENT OF ESSENTIALS 4267 02:48:03,154 --> 02:48:04,488 FOR MENTAL WELL-BEING AND MENTAL 4268 02:48:04,488 --> 02:48:09,994 HEALTH IN THE WORKPLACE. 4269 02:48:09,994 --> 02:48:12,230 NEXT SLIDE. 4270 02:48:12,230 --> 02:48:14,098 SAMHSA'S THING HERE, DIAGRAM 4271 02:48:14,098 --> 02:48:17,001 SHOWS IT INVOLVES SOCIAL, 4272 02:48:17,001 --> 02:48:17,935 EMOTIONAL, INTELLECTUAL, 4273 02:48:17,935 --> 02:48:19,637 PHYSICAL, ENVIRONMENTAL, 4274 02:48:19,637 --> 02:48:23,074 FINANCIAL OCCUPATIONAL AND 4275 02:48:23,074 --> 02:48:23,608 SPIRITUAL. 4276 02:48:23,608 --> 02:48:26,677 AND AGAIN IT INVOLVES THE WHOLE 4277 02:48:26,677 --> 02:48:28,546 WORKPLACE AND THE WHOLE BEING, A 4278 02:48:28,546 --> 02:48:31,916 LOT OF THIS HAS TO DO WITH 4279 02:48:31,916 --> 02:48:32,683 BUILDING RESILIENCE. 4280 02:48:32,683 --> 02:48:37,455 AND THERE ARE ALL KINDS OF 4281 02:48:37,455 --> 02:48:39,190 NATIONAL PROGRAMS, TEAMS I'M ON 4282 02:48:39,190 --> 02:48:41,792 THAT ARE ACROSS THE FEDERAL 4283 02:48:41,792 --> 02:48:42,860 GOVERNMENT, AGAIN LOOKING AT 4284 02:48:42,860 --> 02:48:43,995 FEDERAL RESILIENCE AND HOW WE 4285 02:48:43,995 --> 02:48:46,163 BUILD THIS INTO OUR WORKPLACES 4286 02:48:46,163 --> 02:48:49,500 AND OUR COMMUNITIES AND OUR 4287 02:48:49,500 --> 02:48:50,001 STATES. 4288 02:48:50,001 --> 02:48:56,307 AND EVERYWHERE. 4289 02:48:56,307 --> 02:48:56,874 NEXT SLIDE. 4290 02:48:56,874 --> 02:48:57,708 NATIONAL ACADEMY OF MEDICINE HAS 4291 02:48:57,708 --> 02:49:02,213 ALSO IN THE PAST FEW YEARS TAKEN 4292 02:49:02,213 --> 02:49:04,348 THIS UPON THEMSELF TO HAVE 4293 02:49:04,348 --> 02:49:10,922 WORKSHOPS AND COLLABORATIVE 4294 02:49:10,922 --> 02:49:11,289 GROUPS ON THIS. 4295 02:49:11,289 --> 02:49:13,624 THERE ARE SUBSTANTIAL SYMPTOMS 4296 02:49:13,624 --> 02:49:15,226 IN HEALTH CARE PROVIDERS, 35 TO 4297 02:49:15,226 --> 02:49:22,600 54% MUCH NURSES AND PHYSICIANS 4298 02:49:22,600 --> 02:49:25,102 AND 45% TO 60% OF MEDICAL 4299 02:49:25,102 --> 02:49:26,103 STUDENTS AND LEARNERS. 4300 02:49:26,103 --> 02:49:28,906 CREATING A CULTURE OF WELLNESS, 4301 02:49:28,906 --> 02:49:38,349 THESE ARE SOME DRIVERS THAT LEAD 4302 02:49:38,349 --> 02:49:39,116 TO BURNOUT. 4303 02:49:39,116 --> 02:49:41,085 UNLESS ONE TRIES TO FIX THESE, 4304 02:49:41,085 --> 02:49:46,190 YOU WON'T HAVE ENGAGEMENT IN THE 4305 02:49:46,190 --> 02:49:46,557 WORK. 4306 02:49:46,557 --> 02:49:49,660 MUCH WORK WAS DONE AT MAYO. 4307 02:49:49,660 --> 02:49:51,662 MAYO HAS ROBUST NOT ONLY 4308 02:49:51,662 --> 02:49:53,230 WELLNESS PROGRAM BUT WELLNESS 4309 02:49:53,230 --> 02:49:57,435 RESEARCH, AND THEY HAVE ALSO 4310 02:49:57,435 --> 02:50:00,071 DEVELOPED A SURVEY FOR BOTH 4311 02:50:00,071 --> 02:50:01,806 HEALTHCARE PROVIDERS BUT GENERAL 4312 02:50:01,806 --> 02:50:02,873 WORKERS IN THE WORKPLACE FOR 4313 02:50:02,873 --> 02:50:06,110 WELL-BEING AND THIS IS A SURVEY 4314 02:50:06,110 --> 02:50:09,780 THAT WE WILL BE DOING HERE IN 4315 02:50:09,780 --> 02:50:11,582 THE FALL AND/OR WINTER. 4316 02:50:11,582 --> 02:50:12,850 WE'LL BE STARTING HERE. 4317 02:50:12,850 --> 02:50:16,420 IT'S BEEN A LITTLE PROCESS TO 4318 02:50:16,420 --> 02:50:19,623 GET APPROVED THROUGH ALL THE 4319 02:50:19,623 --> 02:50:26,297 DIFFERENT AREAS YOU NEED HAVE 4320 02:50:26,297 --> 02:50:26,864 APPROVED. 4321 02:50:26,864 --> 02:50:31,802 CULTURE WELLNESS IN THE CLINICAL 4322 02:50:31,802 --> 02:50:34,005 CENTER, WE SPOKE WITH DR. 4323 02:50:34,005 --> 02:50:35,906 GILMAN TWO YEARS AGO, YEAR AND A 4324 02:50:35,906 --> 02:50:37,775 HALF AGO, HE HAS BEEN AN AMAZING 4325 02:50:37,775 --> 02:50:39,543 SUPPORTER OF THIS. 4326 02:50:39,543 --> 02:50:43,214 ESSENTIALLY IS THE CHIEF 4327 02:50:43,214 --> 02:50:44,615 WELLNESS OFFICER AND WE WORK 4328 02:50:44,615 --> 02:50:47,952 WITH HIM TO DEVELOP THIS CULTURE 4329 02:50:47,952 --> 02:50:50,287 BECAUSE HE SUPPORTS THAT THIS IS 4330 02:50:50,287 --> 02:50:50,788 EXTREMELY IMPORTANT. 4331 02:50:50,788 --> 02:50:52,923 SO, WHAT ARE THE BENEFITS? 4332 02:50:52,923 --> 02:50:56,327 WELL, WHEN STRESS AND BURNOUT 4333 02:50:56,327 --> 02:51:00,431 ARE DECREASED THERE'S LESS STAFF 4334 02:51:00,431 --> 02:51:02,299 TURNOVER, REDUCED COSTS TO 4335 02:51:02,299 --> 02:51:04,235 RECRUIT AND RETAIN STAFF, 4336 02:51:04,235 --> 02:51:05,302 INCREASED PATIENT SATISFACTION, 4337 02:51:05,302 --> 02:51:07,271 DECREASED MEDICAL ERRORS, LESS 4338 02:51:07,271 --> 02:51:09,673 NEED FOR DISCIPLINARY ACTION, 4339 02:51:09,673 --> 02:51:13,110 IMPROVED WORK ENVIRONMENT. 4340 02:51:13,110 --> 02:51:14,812 WE WANTED A WELLNESS PROGRAM 4341 02:51:14,812 --> 02:51:17,415 THAT INVOLVED ALL STAFF FROM 4342 02:51:17,415 --> 02:51:22,353 LOADING DOCK BEDSIDE TO THE 4343 02:51:22,353 --> 02:51:24,488 C-SUITE BECAUSE CLEARLY IF THE 4344 02:51:24,488 --> 02:51:26,957 CULTURE OF WELLNESS IS NOT 4345 02:51:26,957 --> 02:51:28,159 THROUGHOUT THE HOSPITAL, NOT 4346 02:51:28,159 --> 02:51:29,560 JUST BEDSIDE CARE PEOPLE, WE 4347 02:51:29,560 --> 02:51:34,065 DON'T HAVE A WELL COMMUNITY. 4348 02:51:34,065 --> 02:51:37,835 SO, WE WANT EVERYBODY TO FEEL 4349 02:51:37,835 --> 02:51:38,135 SUPPORTED. 4350 02:51:38,135 --> 02:51:40,104 AND INCREASED FOCUS ON THE NIH 4351 02:51:40,104 --> 02:51:41,472 MISSION AND CLINICAL CENTER AS A 4352 02:51:41,472 --> 02:51:43,107 HOUSE OF HOPE TO DRIVE A SENSE 4353 02:51:43,107 --> 02:51:45,342 OF MEANING AND PURPOSE 4354 02:51:45,342 --> 02:51:46,377 THROUGHOUT THE ORGANIZATION. 4355 02:51:46,377 --> 02:51:48,712 BECAUSE AS I SHOWED WITH SAMHSA, 4356 02:51:48,712 --> 02:51:51,916 THE SPIRITUAL PIECE, MEANING AND 4357 02:51:51,916 --> 02:51:57,254 PURPOSE OF WHAT WE DO IS A VERY 4358 02:51:57,254 --> 02:51:58,389 IMPORTANT COMPONENT OF 4359 02:51:58,389 --> 02:52:00,157 DECREASING STRESS AND BURNOUT. 4360 02:52:00,157 --> 02:52:01,125 IF YOU REALLY FEEL IT'S 4361 02:52:01,125 --> 02:52:03,127 IMPORTANT TO COME TO WORK AND 4362 02:52:03,127 --> 02:52:05,996 WHY IT'S IMPORTANT AND 4363 02:52:05,996 --> 02:52:07,498 UNDERSTAND THAT, YOU'RE GOING TO 4364 02:52:07,498 --> 02:52:09,066 LOVE BEING HERE EVERY SINGLE 4365 02:52:09,066 --> 02:52:09,533 DAY. 4366 02:52:09,533 --> 02:52:12,002 AND SO I'VE ALWAYS SAID, MY WORK 4367 02:52:12,002 --> 02:52:13,838 HAS ALWAYS BEEN A SPIRITUAL 4368 02:52:13,838 --> 02:52:15,940 CALLING TO ME, AND THERE ISN'T A 4369 02:52:15,940 --> 02:52:19,110 DAY THAT I DON'T LOVE WHAT I'M 4370 02:52:19,110 --> 02:52:20,678 DOING. 4371 02:52:20,678 --> 02:52:21,846 AND EVERYBODY IN THE INSTITUTION 4372 02:52:21,846 --> 02:52:25,149 WE WANT TO FEEL THAT WAY. 4373 02:52:25,149 --> 02:52:27,518 AND THAT WILL THEN ALSO COME 4374 02:52:27,518 --> 02:52:31,122 ACROSS TO PATIENTS, SO IT'S 4375 02:52:31,122 --> 02:52:31,388 CRITICAL. 4376 02:52:31,388 --> 02:52:34,125 NEXT SLIDE. 4377 02:52:34,125 --> 02:52:36,026 SO, STATEMENT OF PURPOSE, 4378 02:52:36,026 --> 02:52:36,594 PROMOTE CULTURE OF WELLNESS, 4379 02:52:36,594 --> 02:52:38,729 WANT TO PROVIDE OVERSIGHT OF 4380 02:52:38,729 --> 02:52:39,463 EXISTING PROGRAMS, ALREADY 4381 02:52:39,463 --> 02:52:43,100 PROGRAMS HAVE BEEN GOING ON FOR 4382 02:52:43,100 --> 02:52:43,934 MANY YEARS. 4383 02:52:43,934 --> 02:52:45,369 DEVELOP NEW STRATEGIES AND 4384 02:52:45,369 --> 02:52:48,005 ENSURE INCLUSION OF ENTIRE 4385 02:52:48,005 --> 02:52:48,372 WORKFORCE. 4386 02:52:48,372 --> 02:52:50,608 OUR PROGRAMS IN THE PAST WERE 4387 02:52:50,608 --> 02:52:51,509 MORE DEDICATED TO HEALTHCARE 4388 02:52:51,509 --> 02:52:53,677 PROVIDERS ALONE. 4389 02:52:53,677 --> 02:52:54,879 NEXT SLIDE. 4390 02:52:54,879 --> 02:52:57,815 SO AS I SAID, MANY INITIATIVES 4391 02:52:57,815 --> 02:53:01,285 WERE ALREADY IN PROGRESS. 4392 02:53:01,285 --> 02:53:05,823 THESE INCLUDED ACG WELLNESS 4393 02:53:05,823 --> 02:53:08,425 COMMITTEE, NURSING WELLNESS, 4394 02:53:08,425 --> 02:53:08,926 PEER-TO-PEER DEBRIEFING, 4395 02:53:08,926 --> 02:53:10,961 MINDFULNESS, YOGA, ALL KINDS OF 4396 02:53:10,961 --> 02:53:12,163 THINGS. 4397 02:53:12,163 --> 02:53:14,865 JOHN WILL BE GOING OVER THESE AT 4398 02:53:14,865 --> 02:53:15,599 LENGTH. 4399 02:53:15,599 --> 02:53:19,136 THERE ARE NIH-WIDE PROGRAMS, 4400 02:53:19,136 --> 02:53:21,805 EAP, OIPE, R AND W, AND DoD. 4401 02:53:21,805 --> 02:53:24,008 SO THERE ARE A LOT OF WELLNESS 4402 02:53:24,008 --> 02:53:27,111 PROVIDES HERE AT THE NIH. 4403 02:53:27,111 --> 02:53:29,113 NEXT SLIDE. 4404 02:53:29,113 --> 02:53:33,984 PROGRESS TO DATE, WE ESTABLISHED 4405 02:53:33,984 --> 02:53:34,685 A LEADERSHIP, INVENTORIED 4406 02:53:34,685 --> 02:53:35,419 EXISTING PROGRAMS, A STEERING 4407 02:53:35,419 --> 02:53:37,855 COMMITTEE HAS BEEN FORMED. 4408 02:53:37,855 --> 02:53:40,257 THERE WAS AN INITIAL PROGRAM TO 4409 02:53:40,257 --> 02:53:42,026 REALLY GET THIS STARTED CALLED 4410 02:53:42,026 --> 02:53:47,531 CARE FOR THE CAREGIVER TRAINING. 4411 02:53:47,531 --> 02:53:50,267 THIS WAS OUT OF THE MARYLAND 4412 02:53:50,267 --> 02:53:51,569 SAFETY -- STATE OF MARYLAND 4413 02:53:51,569 --> 02:53:56,440 SAFETY OFFICE, OFFICE OF PATIENT 4414 02:53:56,440 --> 02:53:56,807 SAFETY. 4415 02:53:56,807 --> 02:53:58,008 IN CONJUNCTION WITH HOPKINS. 4416 02:53:58,008 --> 02:54:00,177 AND SO THEY DID A TRAINING AND 4417 02:54:00,177 --> 02:54:01,579 IT WAS A TWO-DAY THING. 4418 02:54:01,579 --> 02:54:03,214 ONE WAS WHY WELLNESS IS 4419 02:54:03,214 --> 02:54:04,448 IMPORTANT TYPE THING. 4420 02:54:04,448 --> 02:54:06,884 WE HAD ALL THE LEADERS, ALL THE 4421 02:54:06,884 --> 02:54:09,153 DEPARTMENT HEADS AT THIS. 4422 02:54:09,153 --> 02:54:10,921 THERE WERE OVER 100 PEOPLE 4423 02:54:10,921 --> 02:54:11,121 THERE. 4424 02:54:11,121 --> 02:54:14,825 AND THEN THE SECOND DAY WAS TO 4425 02:54:14,825 --> 02:54:16,827 LEARN THE ACTUAL HOW TO DO 4426 02:54:16,827 --> 02:54:18,762 PEER-TO-PEER TRAINING. 4427 02:54:18,762 --> 02:54:20,030 AND DO DEBRIEFINGS, SOME OF 4428 02:54:20,030 --> 02:54:23,067 WHICH WE WERE ALREADY DOING HERE 4429 02:54:23,067 --> 02:54:26,136 BUT A MORE HOW-TO. 4430 02:54:26,136 --> 02:54:27,004 AGAIN, WE HAD PROBABLY A FEW 4431 02:54:27,004 --> 02:54:31,175 HUNDRED PEOPLE DOM -- COME TO 4432 02:54:31,175 --> 02:54:31,575 THAT. 4433 02:54:31,575 --> 02:54:34,945 THERE WAS DESIRE TO GET THIS 4434 02:54:34,945 --> 02:54:36,947 PROGRAM GOING. 4435 02:54:36,947 --> 02:54:41,552 WE HAVE NOW 24/7, 365 DAY 4436 02:54:41,552 --> 02:54:42,353 ON-CALL AVAILABILITY, A 4437 02:54:42,353 --> 02:54:43,520 COMMUNICATION PLAN, THE PEOPLE 4438 02:54:43,520 --> 02:54:45,289 WORK CLOSELY WITH US. 4439 02:54:45,289 --> 02:54:47,591 WE HAVE A FUNCTIONING REALLY 4440 02:54:47,591 --> 02:54:50,995 GOOD WEBSITE THAT IS 4441 02:54:50,995 --> 02:54:53,163 CONTINUOUSLY BEING UPDATED. 4442 02:54:53,163 --> 02:54:54,198 WE HAVE QUALITATIVE METRICS JOHN 4443 02:54:54,198 --> 02:54:57,034 WILL REVIEW. 4444 02:54:57,034 --> 02:54:58,502 NEXT SLIDE. 4445 02:54:58,502 --> 02:55:01,338 WE DID A TRIAL ON ENHANCING 4446 02:55:01,338 --> 02:55:03,240 WELL-BEING AND A BRIEF 4447 02:55:03,240 --> 02:55:04,341 MINDFULNESS COURSE FOR 4448 02:55:04,341 --> 02:55:05,843 HEALTHCARE PROVIDERS IN THE 4449 02:55:05,843 --> 02:55:06,744 CLINICAL CENTER. 4450 02:55:06,744 --> 02:55:14,752 AND THIS IS ACTUALLY PUBLISHED 4451 02:55:14,752 --> 02:55:18,122 IN 2020 IN JAMA. 4452 02:55:18,122 --> 02:55:20,758 65 WOMEN, 13 MEN, MEDIAN AGE 32, 4453 02:55:20,758 --> 02:55:23,894 SETTING WAS CLINTON CAR CENTER, 4454 02:55:23,894 --> 02:55:28,065 AND THERE WAS A FIVE WEEKLY 1.5 4455 02:55:28,065 --> 02:55:29,600 HOUR IN-CLASS PRACTICE SESSION, 4456 02:55:29,600 --> 02:55:34,138 COMPARED TO A CONTROL GROUP. 4457 02:55:34,138 --> 02:55:43,113 PRIMARY OUTCOME WAS STRESS. 4458 02:55:43,113 --> 02:55:44,481 NEXT SLIDE. 4459 02:55:44,481 --> 02:55:46,717 MINDFULNESS GROUP SHOWED REDUCED 4460 02:55:46,717 --> 02:55:50,387 ANXIETY, IMPROVED AFFECT, 4461 02:55:50,387 --> 02:55:51,221 IMPROVED MINDFULNESS, ATTENDANCE 4462 02:55:51,221 --> 02:55:52,456 RATE POST-COURSE EVALUATION 4463 02:55:52,456 --> 02:55:55,159 RESPONSE RATE PROVIDED SUPPORT 4464 02:55:55,159 --> 02:55:56,827 FOR PROGRAM FEASIBILITY. 4465 02:55:56,827 --> 02:55:58,962 SINCE THAT TIME WE HAVE ACTUALLY 4466 02:55:58,962 --> 02:56:00,164 DONE SOME OTHER TRIALS OUTSIDE 4467 02:56:00,164 --> 02:56:02,132 OF THE CLINICAL CENTER, ONE AT 4468 02:56:02,132 --> 02:56:03,934 WALTER REED USING NATURE, THAT 4469 02:56:03,934 --> 02:56:05,536 IS PUBLISHED, AND TWO MORE THAT 4470 02:56:05,536 --> 02:56:09,473 WILL BE PUBLISHED IN THE SPRING, 4471 02:56:09,473 --> 02:56:11,175 ONE FOR HEALTH CARE PROVIDERS, 4472 02:56:11,175 --> 02:56:13,310 TAKING CARE OF COVID PATIENTS, 4473 02:56:13,310 --> 02:56:19,149 USING NATURE, PLUS OR MINUS 4474 02:56:19,149 --> 02:56:21,318 MINDFULNESS AND ONE FOR A 4475 02:56:21,318 --> 02:56:28,392 PROGRAM FOR TEACHERS WHO ARE IN 4476 02:56:28,392 --> 02:56:28,659 COLORADO. 4477 02:56:28,659 --> 02:56:29,760 WE SUPPORT WELL-BEING AND 4478 02:56:29,760 --> 02:56:31,128 RESEARCH ON THIS A LOT. 4479 02:56:31,128 --> 02:56:32,963 I'LL HAVE JOHN TALK ABOUT WHAT 4480 02:56:32,963 --> 02:56:43,507 EXACTLY THE NUTS AND BOLTS ARE 4481 02:56:44,441 --> 02:56:46,877 AND SOME METRICS. 4482 02:56:46,877 --> 02:56:49,413 >> THIS IS OUR OVERALL GUIDING 4483 02:56:49,413 --> 02:56:51,515 PICTURE I SUPPOSE WHERE THE 4484 02:56:51,515 --> 02:56:55,119 COMPONENTS OF WHAT SHOULD BE IN 4485 02:56:55,119 --> 02:56:58,956 A WELLNESS PROGRAM ARE. 4486 02:56:58,956 --> 02:56:59,790 SO PREVENTION, CERTAINLY. 4487 02:56:59,790 --> 02:57:02,960 SOMEONE AND SOME WAY OF 4488 02:57:02,960 --> 02:57:03,894 MONITORING ENVIRONMENTAL STRESS, 4489 02:57:03,894 --> 02:57:05,262 WHAT TO DO IN TERMS OF CRISIS, 4490 02:57:05,262 --> 02:57:07,931 WHAT WE CAN DO IMMEDIATELY, AND 4491 02:57:07,931 --> 02:57:10,000 WHERE WE NEED REFER. 4492 02:57:10,000 --> 02:57:12,436 WE'VE ALWAYS DONE I THINK A VERY 4493 02:57:12,436 --> 02:57:14,004 GOOD JOB ON CRISIS EVENTS. 4494 02:57:14,004 --> 02:57:16,440 AND PART OF THE PROGRAM NOW IS 4495 02:57:16,440 --> 02:57:18,175 REALLY TO FOCUS MORE OF OUR 4496 02:57:18,175 --> 02:57:19,376 ATTENTION ON WHAT DOES 4497 02:57:19,376 --> 02:57:22,146 PREVENTION LOOK LIKE AND HOW DO 4498 02:57:22,146 --> 02:57:24,014 WE FIND THINGS IN THE MOMENT 4499 02:57:24,014 --> 02:57:26,450 THAT DESERVE OUR FURTHER 4500 02:57:26,450 --> 02:57:26,884 ATTENTION. 4501 02:57:26,884 --> 02:57:30,020 COULD I HAVE THE NEXT SLIDE 4502 02:57:30,020 --> 02:57:31,789 PLEASE. 4503 02:57:31,789 --> 02:57:33,991 THE LARGEST PART OF THE PROGRAM 4504 02:57:33,991 --> 02:57:36,427 AT THE MOMENT AS FAR AS NUMBER 4505 02:57:36,427 --> 02:57:40,431 OF PEOPLE SERVING IN IT IS THE 4506 02:57:40,431 --> 02:57:40,898 PEER-TO-PEER SUPPORT. 4507 02:57:40,898 --> 02:57:42,900 THIS IS -- HAS ROOTS GOING BACK 4508 02:57:42,900 --> 02:57:46,737 PROBABLY 15 OR SO YEARS AGO AS 4509 02:57:46,737 --> 02:57:50,174 WELL, WHERE WE STARTED OFF AS A 4510 02:57:50,174 --> 02:57:52,009 PROGRAM WORKING WITH BEREAVEMENT 4511 02:57:52,009 --> 02:57:53,177 FOR WHEN PATIENTS DIED. 4512 02:57:53,177 --> 02:57:54,711 EVENTUALLY OVER THE COURSE OF 4513 02:57:54,711 --> 02:57:57,581 TIME THAT MODEL OF PEER SUPPORT 4514 02:57:57,581 --> 02:58:00,250 BECAME RECOGNIZED AS SOMETHING 4515 02:58:00,250 --> 02:58:04,721 THAT WAS USEFUL FOR MULTIPLE 4516 02:58:04,721 --> 02:58:07,157 KINDS OF EVENTS THAT BROUGHT ON 4517 02:58:07,157 --> 02:58:11,295 STAFF CRISIS THROUGHOUT THE 4518 02:58:11,295 --> 02:58:11,628 ORGANIZATION. 4519 02:58:11,628 --> 02:58:12,196 THE LARGEST THING I'M PROUD 4520 02:58:12,196 --> 02:58:14,164 ABOUT AS FAR AS THE PEER 4521 02:58:14,164 --> 02:58:20,704 CONFIDENCE, THESE ARE PEOPLE WHO 4522 02:58:20,704 --> 02:58:22,172 ARE TRAINED TO PROVIDE CARE, 4523 02:58:22,172 --> 02:58:24,441 MADE UP OF SOCIAL WORKERS, 4524 02:58:24,441 --> 02:58:25,476 CHAPLAINS, MENTAL HEALTH 4525 02:58:25,476 --> 02:58:27,277 PROFESSIONALS, AND NOW BRINGING 4526 02:58:27,277 --> 02:58:29,780 IN MORE TRAINED WHAT MIGHT BE 4527 02:58:29,780 --> 02:58:31,849 CALLED LAYPERSONS TO ASSIST IN 4528 02:58:31,849 --> 02:58:33,817 THAT PROJECT AS WELL. 4529 02:58:33,817 --> 02:58:36,253 BUT WE CAN DEPLOY THESE FOLKS 4530 02:58:36,253 --> 02:58:36,587 VERY QUICKLY. 4531 02:58:36,587 --> 02:58:40,424 A FEW MONTHS AGO THERE WAS A 4532 02:58:40,424 --> 02:58:43,894 VERY TRAGIC INCIDENT INVOLVING A 4533 02:58:43,894 --> 02:58:46,897 STAFF MEMBER AT HER -- WHILE 4534 02:58:46,897 --> 02:58:50,033 OUTSIDE OF WORK, THE MANAGER GOT 4535 02:58:50,033 --> 02:58:52,436 THE PHONE CALL, PHONE CALL CAME 4536 02:58:52,436 --> 02:58:54,404 TO US ABOUT TEN MINUTES LATER, 4537 02:58:54,404 --> 02:58:57,708 AND HALF AN HOUR LATER WE HAD 4538 02:58:57,708 --> 02:58:59,810 DEPLOYED A TEAM OF ABOUT FIVE 4539 02:58:59,810 --> 02:59:01,612 PEOPLE INTO THAT UNIT TO DEAL 4540 02:59:01,612 --> 02:59:03,180 WITH THE IMMEDIATE GRIEF AND 4541 02:59:03,180 --> 02:59:05,382 LOSS AND SHOCK OF THE SITUATION. 4542 02:59:05,382 --> 02:59:09,486 IT WAS A UNIT WHICH ALSO WAS 4543 02:59:09,486 --> 02:59:10,287 CLOSED AND LOCKED WITH PEOPLE 4544 02:59:10,287 --> 02:59:12,122 THAT COULD NOT STEP AWAY FROM 4545 02:59:12,122 --> 02:59:15,726 THEIR DUTIES, AND WE WERE ALSO 4546 02:59:15,726 --> 02:59:17,194 ABLE TO PROVIDE THREE OR FOUR 4547 02:59:17,194 --> 02:59:19,162 PEOPLE TO SIT AT A CONFERENCE 4548 02:59:19,162 --> 02:59:20,464 ROOM THROUGHOUT THE COURSE OF 4549 02:59:20,464 --> 02:59:23,567 THE DAY SO AS CLINICAL DUTIES 4550 02:59:23,567 --> 02:59:25,435 SLOWED DOWN THEY COULD STEP AWAY 4551 02:59:25,435 --> 02:59:27,604 AND TAKE ADVANTAGE OF THAT AS 4552 02:59:27,604 --> 02:59:28,972 WELL. 4553 02:59:28,972 --> 02:59:31,942 WE ALSO WERE ABLE TO IN OUR 4554 02:59:31,942 --> 02:59:33,577 HOSPICE UNIT FOR EXAMPLE A 4555 02:59:33,577 --> 02:59:35,379 NUMBER OF DEATHS, LONG-TERM 4556 02:59:35,379 --> 02:59:39,216 PATIENTS, AND THE TEAM WAS JUST 4557 02:59:39,216 --> 02:59:39,616 FEELING DEPLETED. 4558 02:59:39,616 --> 02:59:41,018 AND SO, AGAIN, IN THIS CASE IT 4559 02:59:41,018 --> 02:59:42,886 WAS A LONGER POINT OF VIEW, 4560 02:59:42,886 --> 02:59:45,422 WHERE WE WERE ABLE TO DEPLOY 4561 02:59:45,422 --> 02:59:47,624 PEOPLE TO MEET WITH ALL OF THE 4562 02:59:47,624 --> 02:59:49,593 STAFF WHO WERE INTERESTED OVER 4563 02:59:49,593 --> 02:59:52,963 THE COURSE OF ALL SHIFTS IN A 4564 02:59:52,963 --> 02:59:54,932 WEEK'S PERIOD. 4565 02:59:54,932 --> 02:59:58,001 SO AGAIN THAT'S PROBABLY THE -- 4566 02:59:58,001 --> 03:00:00,437 I THINK THE FLAGSHIP OF THE 4567 03:00:00,437 --> 03:00:04,341 PROGRAM IS AVAILABLE 24/7 4568 03:00:04,341 --> 03:00:06,577 RESPONSE, AND RENEW PART IS THE 4569 03:00:06,577 --> 03:00:10,514 PEER CHAMPIONS, AGAIN FILLING IN 4570 03:00:10,514 --> 03:00:11,682 THAT SECTION OF ENVIRONMENTAL 4571 03:00:11,682 --> 03:00:14,618 STRESS, SO THEY WILL BE EMBEDDED 4572 03:00:14,618 --> 03:00:15,752 IN UNITS TO GET A SENSE OF 4573 03:00:15,752 --> 03:00:20,424 WHAT'S GOING ON IN A PARTICULAR 4574 03:00:20,424 --> 03:00:22,859 PLACE. 4575 03:00:22,859 --> 03:00:24,494 SOME EARLY WARNING BUT ALSO 4576 03:00:24,494 --> 03:00:26,096 KNOWLEDGEABLE ABOUT WELLNESS 4577 03:00:26,096 --> 03:00:27,130 RESOURCES AVAILABLE AT NIH AND 4578 03:00:27,130 --> 03:00:29,733 CLINICAL CENTER WHICH WHEN ONE 4579 03:00:29,733 --> 03:00:31,201 STARTS LOOKING AT INVENTORY, 4580 03:00:31,201 --> 03:00:33,170 IT'S A VERY, VERY LONG LIST. 4581 03:00:33,170 --> 03:00:34,838 THIS IS ALSO A NUMBER I'D LIKE 4582 03:00:34,838 --> 03:00:35,572 TO SEE AS ZERO. 4583 03:00:35,572 --> 03:00:37,307 SO MOST OF THE OTHER NUMBERS I 4584 03:00:37,307 --> 03:00:38,976 LIKE TO SEE GO UP. 4585 03:00:38,976 --> 03:00:41,912 BUT THIS ONE IS CERTAINLY ONE 4586 03:00:41,912 --> 03:00:45,749 WHERE ZERO IS A GOOD THING. 4587 03:00:45,749 --> 03:00:47,751 NEXT SLIDE PLEASE. 4588 03:00:47,751 --> 03:00:49,820 WE ALSO, IF THIS EFFORT IS ABOUT 4589 03:00:49,820 --> 03:00:51,455 COLLABORATION, THERE HAVE BEEN 4590 03:00:51,455 --> 03:00:52,789 MANY GOOD THINGS GOING IN THE 4591 03:00:52,789 --> 03:00:54,691 CLINICAL CENTER WITHIN 4592 03:00:54,691 --> 03:00:56,360 INDIVIDUAL DEPARTMENTS, THIS IS 4593 03:00:56,360 --> 03:00:57,561 AN EXAMPLE OF SOMETHING THAT IS 4594 03:00:57,561 --> 03:01:00,764 GOING ON IN THE NURSING 4595 03:01:00,764 --> 03:01:02,866 DEPARTMENT. 4596 03:01:02,866 --> 03:01:05,135 A NURSING RESPITE ROOM. 4597 03:01:05,135 --> 03:01:06,937 A WORD CLOUD OF WHY VARIOUS 4598 03:01:06,937 --> 03:01:10,340 NURSES HAD CHOSEN TO GO INTO THE 4599 03:01:10,340 --> 03:01:12,409 ROOM AND BE ABLE TO TAKE SOME 4600 03:01:12,409 --> 03:01:14,878 TIME AWAY AND RELAXATION CHAIR. 4601 03:01:14,878 --> 03:01:15,746 THESE ARE ACTUAL NURSES. 4602 03:01:15,746 --> 03:01:17,614 THEY WOULD ONLY AGREE TO BE IN 4603 03:01:17,614 --> 03:01:19,950 THE PICTURE IF THEY COULD REMAIN 4604 03:01:19,950 --> 03:01:21,785 MASKED, BUT THEY CLEARLY ARE 4605 03:01:21,785 --> 03:01:27,457 ENJOYING THEIR TIME THERE AS 4606 03:01:27,457 --> 03:01:28,425 WELL. 4607 03:01:28,425 --> 03:01:28,725 NEXT SLIDE. 4608 03:01:28,725 --> 03:01:30,193 AGAIN, MORALE. 4609 03:01:30,193 --> 03:01:33,163 THAT'S A COMPONENT OF ANY 4610 03:01:33,163 --> 03:01:37,000 WELLNESS PROGRAM AND OUR 4611 03:01:37,000 --> 03:01:38,168 MATERIALS MANAGEMENT DEPARTMENT 4612 03:01:38,168 --> 03:01:41,805 IS A LEADER THROUGHOUT THE 4613 03:01:41,805 --> 03:01:42,773 ORGANIZATION OF CELEBRATING THE 4614 03:01:42,773 --> 03:01:45,609 WORK, AND THIS IS ALSO A GROUP 4615 03:01:45,609 --> 03:01:47,310 OF WORKERS WHO, AGAIN, DON'T 4616 03:01:47,310 --> 03:01:50,647 HAVE A GREAT OPPORTUNITY TO SIT 4617 03:01:50,647 --> 03:01:53,517 DOWN AND GO TO PARTICIPATE IN A 4618 03:01:53,517 --> 03:01:56,787 TALK ON WELLNESS OR AN EXERCISE 4619 03:01:56,787 --> 03:01:58,755 IN MINDFULNESS MEDITATION. 4620 03:01:58,755 --> 03:02:00,023 WORK JUST DOESN'T PERMIT IT. 4621 03:02:00,023 --> 03:02:02,526 BUT THERE ARE TIMES, WINDOWS 4622 03:02:02,526 --> 03:02:04,428 WHERE STEPPING ASIDE, 4623 03:02:04,428 --> 03:02:05,562 CELEBRATING THE WORK, ARE 4624 03:02:05,562 --> 03:02:06,063 POSSIBLE. 4625 03:02:06,063 --> 03:02:10,834 AGAIN, I THINK THE SMILES ON 4626 03:02:10,834 --> 03:02:12,235 THESE FACES ARE FAIRLY GREAT 4627 03:02:12,235 --> 03:02:13,437 METRIC TO SEE THE SUCCESS OF 4628 03:02:13,437 --> 03:02:19,209 THAT PROGRAM. 4629 03:02:19,209 --> 03:02:21,411 NEXT SLIDE PLEASE. 4630 03:02:21,411 --> 03:02:24,948 DCRI HAS BEEN A LEADER I THINK 4631 03:02:24,948 --> 03:02:26,483 IN THE ORGANIZATION. 4632 03:02:26,483 --> 03:02:30,520 IN WELLNESS WITHIN A PARTICULAR 4633 03:02:30,520 --> 03:02:31,555 DEPARTMENT. 4634 03:02:31,555 --> 03:02:35,192 I THINK SOME OF THE NEEDS IN THE 4635 03:02:35,192 --> 03:02:37,928 BEGINNING OF COVID, THE I.T. 4636 03:02:37,928 --> 03:02:40,297 DEPARTMENT WAS AT THE FOREFRONT, 4637 03:02:40,297 --> 03:02:42,132 AND STRESS AND MAKING SURE THAT 4638 03:02:42,132 --> 03:02:43,166 EVERYBODY HAD THE TOOLS THEY 4639 03:02:43,166 --> 03:02:47,838 NEEDED TO DO THEIR WORK WAS 4640 03:02:47,838 --> 03:02:48,305 PARAMOUNT IMPORTANCE. 4641 03:02:48,305 --> 03:02:55,045 SO THESE INITIATIVES AS FAR AS 4642 03:02:55,045 --> 03:02:57,781 RELAXATION SESSIONS, CHAIR YOGA, 4643 03:02:57,781 --> 03:02:59,549 RELAXATION WITH MUSIC, BEGAN TO 4644 03:02:59,549 --> 03:03:00,584 TAKE ROOT IN DCRI. 4645 03:03:00,584 --> 03:03:04,254 ONE OF THE THINGS AS WE WERE 4646 03:03:04,254 --> 03:03:05,589 INVENTORYING WHAT PROGRAMS WERE 4647 03:03:05,589 --> 03:03:07,624 AVAILABLE IN THE CLINICAL CENTER 4648 03:03:07,624 --> 03:03:08,959 IN ORDER NOT TO DUPLICATE WHICH 4649 03:03:08,959 --> 03:03:10,527 PROGRAMS COULD WE LOOK AT AND 4650 03:03:10,527 --> 03:03:12,562 SAY, CAN WE EXPAND THE 4651 03:03:12,562 --> 03:03:13,997 FOOTPRINT, AND THIS IS AN 4652 03:03:13,997 --> 03:03:17,567 EXAMPLE OF ONE OF THOSE CASES 4653 03:03:17,567 --> 03:03:21,404 WHERE THE FIX WAS VERY EASY. 4654 03:03:21,404 --> 03:03:22,405 EXISTING PROGRAM, BROADER NOTICE 4655 03:03:22,405 --> 03:03:26,676 OF WHAT THE PROGRAM WAS, AND HOW 4656 03:03:26,676 --> 03:03:28,445 IT WAS AVAILABLE AND NOW PEOPLE 4657 03:03:28,445 --> 03:03:29,279 THROUGHOUT THE CLINICAL CENTER 4658 03:03:29,279 --> 03:03:32,716 ARE ABLE TO DROP INTO THESE AS 4659 03:03:32,716 --> 03:03:35,452 THEIR TIME AND INCLINATION 4660 03:03:35,452 --> 03:03:36,052 PERMIT. 4661 03:03:36,052 --> 03:03:37,387 JOHN, I THINK THEY ARE 15 4662 03:03:37,387 --> 03:03:41,825 MINUTES OR SO EACH AS I RECALL. 4663 03:03:41,825 --> 03:03:41,992 YES. 4664 03:03:41,992 --> 03:03:43,760 NEXT SLIDE PLEASE. 4665 03:03:43,760 --> 03:03:46,696 GOOD GRIEF AND CHOCOLATE, IT'S A 4666 03:03:46,696 --> 03:03:48,498 PROGRAM THAT'S BEEN WITH US FOR 4667 03:03:48,498 --> 03:03:51,902 QUITE SOME TIME BUT IT REALLY IS 4668 03:03:51,902 --> 03:03:52,903 AROUND CHILD DEATH. 4669 03:03:52,903 --> 03:03:54,571 AS YOU KNOW FROM YOUR OWN 4670 03:03:54,571 --> 03:03:56,439 EXPERIENCES IN YOUR OWN 4671 03:03:56,439 --> 03:03:58,408 HOSPITALS, PEDIATRICS IS A HARD 4672 03:03:58,408 --> 03:04:02,012 PLACE TO WORK. 4673 03:04:02,012 --> 03:04:04,347 AND THE RELATIONSHIPS GO QUITE 4674 03:04:04,347 --> 03:04:06,349 DEEP AND LOSSES ARE EQUALLY AS 4675 03:04:06,349 --> 03:04:06,750 DEEP. 4676 03:04:06,750 --> 03:04:09,586 AND SO GOOD GRIEF AND CHOCOLATE 4677 03:04:09,586 --> 03:04:13,023 IS A PROGRAM THAT MEETS 4678 03:04:13,023 --> 03:04:13,857 QUARTERLY, TIME IS TAKEN PERHAPS 4679 03:04:13,857 --> 03:04:16,426 FOR A SPEAKER WHO MIGHT BE ABLE 4680 03:04:16,426 --> 03:04:18,228 TO SHARE SOME INSIGHTS IN ITEMS 4681 03:04:18,228 --> 03:04:21,198 OF GRIEF AND LOSS MANAGEMENT BUT 4682 03:04:21,198 --> 03:04:24,134 ALSO AN OPPORTUNITY FOR PEOPLE 4683 03:04:24,134 --> 03:04:26,036 WHO WORK IN PEDIATRICS TO GET 4684 03:04:26,036 --> 03:04:28,305 TOGETHER TO EXPRESS THOUGHTS AND 4685 03:04:28,305 --> 03:04:31,141 FEELS AND EMOTIONS THAT THEY ARE 4686 03:04:31,141 --> 03:04:36,546 NOT REALLY OTHERWISE ABLE TO DO 4687 03:04:36,546 --> 03:04:39,616 IN -- WITHOUT A DEDICATED TIME. 4688 03:04:39,616 --> 03:04:41,885 AGAIN, ONE OF THE THINGS KEY TO 4689 03:04:41,885 --> 03:04:44,421 OUR SUCCESS IS REALLY ABOUT 4690 03:04:44,421 --> 03:04:44,754 COLLABORATION. 4691 03:04:44,754 --> 03:04:47,390 SO ON MOST SIDES YOU'LL SEE 4692 03:04:47,390 --> 03:04:48,225 COLLABORATORS. 4693 03:04:48,225 --> 03:04:50,327 SO THE NURSING DEPARTMENT ON THE 4694 03:04:50,327 --> 03:04:54,598 1 NORTHWEST AND PEDIATRIC 4695 03:04:54,598 --> 03:04:59,936 CLINIC, NUTRITION DEPARTMENT, 4696 03:04:59,936 --> 03:05:00,737 DCRI, RECREATION THERAPY, THE 4697 03:05:00,737 --> 03:05:01,705 NCI AND CHILDREN'S INN. 4698 03:05:01,705 --> 03:05:04,241 SO ALL OF THESE FOLKS COMING 4699 03:05:04,241 --> 03:05:05,542 TOGETHER AND TAKING LEADERSHIP 4700 03:05:05,542 --> 03:05:10,080 ROLE IN MAKING THIS WORK. 4701 03:05:10,080 --> 03:05:11,248 NEXT SLIDE PLEASE. 4702 03:05:11,248 --> 03:05:15,518 WE'VE ALSO LAUNCHED A NEW 4703 03:05:15,518 --> 03:05:16,720 WEBSITE, CLEARINGHOUSE FOR ALL 4704 03:05:16,720 --> 03:05:19,222 OF THE PROGRAMS THAT WE'VE GOT 4705 03:05:19,222 --> 03:05:23,393 GOING IN WELLNESS, IN THE 4706 03:05:23,393 --> 03:05:25,495 CLINICAL CENTER, WITH CLICKS FOR 4707 03:05:25,495 --> 03:05:30,433 RESOURCES WITH CLICKS FOR 4708 03:05:30,433 --> 03:05:33,503 ARTICLES TO REVIEW AND ITEMS OF 4709 03:05:33,503 --> 03:05:34,871 WELLNESS AND ALSO OPPORTUNITIES 4710 03:05:34,871 --> 03:05:38,975 FOR REVIEWING SOME OF THESE 4711 03:05:38,975 --> 03:05:40,176 PROGRAMS THAT WE'VE DONE, SO 4712 03:05:40,176 --> 03:05:42,145 WHEN BEAM HAVEN'T BEEN ABLE TO 4713 03:05:42,145 --> 03:05:43,413 JOIN THEM IN -- PEOPLE HAVEN'T 4714 03:05:43,413 --> 03:05:46,650 BEEN ABLE TO JOIN THEM IN REAL 4715 03:05:46,650 --> 03:05:47,517 TIME, TWO QUARTER NUMBER AT 590 4716 03:05:47,517 --> 03:05:53,390 HITS, ONE OF THE THINGS TOO OF 4717 03:05:53,390 --> 03:05:56,559 THE WE'VE DONE SOME PUBLICIZING 4718 03:05:56,559 --> 03:05:57,394 OF THINGS, COMMUNICATION PLAN IS 4719 03:05:57,394 --> 03:06:02,132 ONE OF THE THINGS THAT WILL BE 4720 03:06:02,132 --> 03:06:03,900 COMING ALONG, MORE ROBUST, BUT 4721 03:06:03,900 --> 03:06:06,202 SO FAR THE INTEREST IN ALL OF 4722 03:06:06,202 --> 03:06:09,739 THESE PROGRAMS HAS REMAINED 4723 03:06:09,739 --> 03:06:10,907 HIGH. 4724 03:06:10,907 --> 03:06:13,009 NEXT SLIDE PLEASE. 4725 03:06:13,009 --> 03:06:15,211 LIEUTENANT COMMANDER ABIGAIL 4726 03:06:15,211 --> 03:06:17,247 APPOINTED BY THE SURGEON 4727 03:06:17,247 --> 03:06:18,882 GENERAL, AND SHE'S THE HONORARY 4728 03:06:18,882 --> 03:06:21,685 MASCOT OF OUR WELLNESS 4729 03:06:21,685 --> 03:06:22,118 INITIATIVE. 4730 03:06:22,118 --> 03:06:25,221 SHE IS NAMED AFTER FIRST LADY 4731 03:06:25,221 --> 03:06:29,125 ABIGAIL ADAMS, JOHN ADAMS SIGNED 4732 03:06:29,125 --> 03:06:31,261 THE INITIAL LEGISLATION WHICH 4733 03:06:31,261 --> 03:06:32,362 THE ORGANIZATION WHICH 4734 03:06:32,362 --> 03:06:35,165 ULTIMATELY EVOLVED INTO THE 4735 03:06:35,165 --> 03:06:37,300 PUBLIC HEALTH SERVICE. 4736 03:06:37,300 --> 03:06:41,638 TRAINED WARRIOR K9 CONNECTION, 4737 03:06:41,638 --> 03:06:43,707 SHE'S A COMMISSIONED OFFICER, 4738 03:06:43,707 --> 03:06:46,009 AFFORDED CUSTOMS AND COURTESIES 4739 03:06:46,009 --> 03:06:46,810 OF ANY ACTIVE DUTY OFFICER 4740 03:06:46,810 --> 03:06:50,013 EXCEPT WITHOUT PAY AND PENSION, 4741 03:06:50,013 --> 03:06:51,781 87 ENCOUNTERS WITH STAFF OVER 4742 03:06:51,781 --> 03:06:53,683 THE COURSE OF THE LAST TWO 4743 03:06:53,683 --> 03:06:55,418 QUARTERS, AND WE'RE LOOKING 4744 03:06:55,418 --> 03:06:57,053 FORWARD TO GETTING HER MORE AND 4745 03:06:57,053 --> 03:06:58,421 MORE OUT INTO THE FIELD. 4746 03:06:58,421 --> 03:07:00,290 WE ALSO AT THE MOMENT HAVE A 4747 03:07:00,290 --> 03:07:01,224 WAITING LIST FOR DEPARTMENTS 4748 03:07:01,224 --> 03:07:02,926 THAT WOULD LIKE HER TO COME BY 4749 03:07:02,926 --> 03:07:03,927 AND VISIT. 4750 03:07:03,927 --> 03:07:05,628 I PARTICULARLY LIKE HAVING HER 4751 03:07:05,628 --> 03:07:07,764 HERE BECAUSE IF YOU DON'T LIKE 4752 03:07:07,764 --> 03:07:09,232 PRESENTERS, YOU DON'T LIKE THE 4753 03:07:09,232 --> 03:07:12,535 PRESENTATION, YOU CAN'T GO AWAY 4754 03:07:12,535 --> 03:07:14,971 UNHAPPY WITH THAT FACE AS PART 4755 03:07:14,971 --> 03:07:19,109 OF THE PROGRAM. 4756 03:07:19,109 --> 03:07:20,510 NEXT SLIDE PLEASE. 4757 03:07:20,510 --> 03:07:23,747 AND SO APRIL 23 THROUGH END OF 4758 03:07:23,747 --> 03:07:24,714 SEPTEMBER, THESE ARE THE 4759 03:07:24,714 --> 03:07:25,315 ENCOUNTERS. 4760 03:07:25,315 --> 03:07:27,117 I MUST ADMIT I WAS SURPRISED TO 4761 03:07:27,117 --> 03:07:28,952 SEE THE HIGH NUMBERS AS WE BEGAN 4762 03:07:28,952 --> 03:07:31,554 TO PULL DATA TOGETHER OF THE 4763 03:07:31,554 --> 03:07:32,789 MANY GOOD THINGS THAT HAVE BEEN 4764 03:07:32,789 --> 03:07:35,525 GOING ON FOR SOME TIME WHICH WE 4765 03:07:35,525 --> 03:07:38,595 HAVE ENCOUNTERED AND FOR SOME OF 4766 03:07:38,595 --> 03:07:42,532 THE NEW THINGS THAT HAVE COME 4767 03:07:42,532 --> 03:07:42,766 ONLINE. 4768 03:07:42,766 --> 03:07:43,833 APRIL WAS THE FIRST MONTH IN 4769 03:07:43,833 --> 03:07:50,440 WHICH WE STARTED TO COLLECT THE 4770 03:07:50,440 --> 03:07:51,708 DATA. 4771 03:07:51,708 --> 03:07:52,042 NEXT SLIDE. 4772 03:07:52,042 --> 03:07:53,209 AND SO WELLNESS CHAMPIONS, WE 4773 03:07:53,209 --> 03:07:54,944 HAVE A NUMBER OF TRAINED PEOPLE 4774 03:07:54,944 --> 03:07:59,049 TO BE EMBEDDED IN THE UNITS, 4775 03:07:59,049 --> 03:08:00,150 NEXT EMPHASIS NOW THAT'S RISEN 4776 03:08:00,150 --> 03:08:04,187 TO THE TOP IS TO PLACE MORE 4777 03:08:04,187 --> 03:08:05,055 PEOPLE IN DIFFERENT DEPARTMENTS, 4778 03:08:05,055 --> 03:08:07,924 AND SO WE WILL OVER THE NEXT FEW 4779 03:08:07,924 --> 03:08:12,395 MONTHS BE ENGAGING WITH 4780 03:08:12,395 --> 03:08:13,263 DEPARTMENT MANAGERS TO SAY WHO 4781 03:08:13,263 --> 03:08:15,598 COULD YOU IDENTIFY THAT WOULD 4782 03:08:15,598 --> 03:08:17,000 MAKE A GOOD WELLNESS CHAMPION IN 4783 03:08:17,000 --> 03:08:18,368 YOUR AREA. 4784 03:08:18,368 --> 03:08:20,370 WHO IS THE -- MAYBE THERE'S A 4785 03:08:20,370 --> 03:08:22,038 GO-TO PERSON. 4786 03:08:22,038 --> 03:08:24,240 WHO IS SOMEONE WHO HAS AN EASY 4787 03:08:24,240 --> 03:08:26,109 GENTLE PRESENCE, WHO WOULD BE A 4788 03:08:26,109 --> 03:08:26,976 GOOD PRESENTER WHEN THERE ARE 4789 03:08:26,976 --> 03:08:28,478 THINGS IN A STAFF MEETING TO 4790 03:08:28,478 --> 03:08:30,513 TALK ABOUT AS FAR AS WHAT 4791 03:08:30,513 --> 03:08:31,448 WELLNESS OPPORTUNITIES THERE ARE 4792 03:08:31,448 --> 03:08:37,220 GOING ON IN THE CLINICAL CENTER. 4793 03:08:37,220 --> 03:08:39,355 AND SO AGAIN PUSHING OUR 4794 03:08:39,355 --> 03:08:41,324 FOOTPRINT OUT FROM THE CLINICAL 4795 03:08:41,324 --> 03:08:43,626 UNITS, IS A TOP PRIORITY, WE'LL 4796 03:08:43,626 --> 03:08:45,795 BE DOING WELLNESS SURVEYS, DR. 4797 03:08:45,795 --> 03:08:47,130 BERGER MENTIONED. 4798 03:08:47,130 --> 03:08:48,298 WHAT ARE SYSTEMS THAT NEED TO BE 4799 03:08:48,298 --> 03:08:53,403 IN PLACE WHEN ISSUES OCCUR? 4800 03:08:53,403 --> 03:08:56,639 SOME OF THE THINGS ARE BIG RED 4801 03:08:56,639 --> 03:08:59,976 FLAG AND THINGS, MANY OF OUR 4802 03:08:59,976 --> 03:09:01,578 PEOPLE HAVE RECENTLY BEEN 4803 03:09:01,578 --> 03:09:08,184 AFFECTED BY WAR IN VARIOUS 4804 03:09:08,184 --> 03:09:10,120 PLACES, FAMILIES, COUNTRIES OF 4805 03:09:10,120 --> 03:09:10,687 ORIGIN. 4806 03:09:10,687 --> 03:09:13,223 THOSE ARE THINGS WE KNOW ABOUT 4807 03:09:13,223 --> 03:09:14,724 BUT WHAT OTHER THINGS ARE 4808 03:09:14,724 --> 03:09:15,325 COOKING ABOUT? 4809 03:09:15,325 --> 03:09:16,392 SO WHAT ARE OPPORTUNITIES WE 4810 03:09:16,392 --> 03:09:18,795 NEED TO DEVELOP FOR SPIRITUAL 4811 03:09:18,795 --> 03:09:19,662 GROWTH MEANING PURPOSE. 4812 03:09:19,662 --> 03:09:23,833 ONE OF THE THINGS THAT I FIND 4813 03:09:23,833 --> 03:09:24,667 WITH MOST WELLNESS PROGRAMS, 4814 03:09:24,667 --> 03:09:27,804 WORDS I CHOOSE TO USE ARE -- 4815 03:09:27,804 --> 03:09:29,973 THEY OFTEN LEAVE ONE IN A PLACE 4816 03:09:29,973 --> 03:09:31,407 YOU'RE ALL DRESSED UP WITH 4817 03:09:31,407 --> 03:09:34,077 NOWHERE TO GO. 4818 03:09:34,077 --> 03:09:38,548 AT SOME POINT WHEN THERE'S A 4819 03:09:38,548 --> 03:09:42,819 STATE OF GENERAL WELL-BEING, 4820 03:09:42,819 --> 03:09:44,120 WELL, SO WHAT? 4821 03:09:44,120 --> 03:09:44,454 WHAT'S NEXT? 4822 03:09:44,454 --> 03:09:46,523 WHAT ARE OPPORTUNITIES WE MIGHT 4823 03:09:46,523 --> 03:09:48,424 BE ABLE TO OFFER AND CERTAINLY 4824 03:09:48,424 --> 03:09:51,461 MAY NOTE BE A BROAD BASEED THING 4825 03:09:51,461 --> 03:09:53,429 WHICH EVERYONE PAYS ATTENTION TO 4826 03:09:53,429 --> 03:09:54,497 BUT WILL THERE BE OPPORTUNITIES 4827 03:09:54,497 --> 03:09:57,467 FOR STAFF PEOPLE TO THINK ABOUT 4828 03:09:57,467 --> 03:10:00,136 ABOUT PURPOSE, OPPORTUNITIES FOR 4829 03:10:00,136 --> 03:10:00,603 GROWTH. 4830 03:10:00,603 --> 03:10:02,906 WHAT WOULD ENHANCE THEIR OWN 4831 03:10:02,906 --> 03:10:04,874 WELL-BEING IN ORDER TO BRING 4832 03:10:04,874 --> 03:10:05,875 MORE OF THEMSELVES INTO THE 4833 03:10:05,875 --> 03:10:09,045 CLINICAL CARE OF OUR PATIENTS? 4834 03:10:09,045 --> 03:10:12,415 AND, AGAIN, ALL FLOWING INTO 4835 03:10:12,415 --> 03:10:13,550 ORGANIZATIONAL MORALE. 4836 03:10:13,550 --> 03:10:15,185 NEXT SLIDE. 4837 03:10:15,185 --> 03:10:17,220 ALL RIGHT. 4838 03:10:17,220 --> 03:10:18,021 IT'S YOUR TURN. 4839 03:10:18,021 --> 03:10:19,289 >> THANK YOU. 4840 03:10:19,289 --> 03:10:20,256 GREAT PRESENTATION. 4841 03:10:20,256 --> 03:10:21,791 ANY QUESTIONS? 4842 03:10:21,791 --> 03:10:28,331 IT'S GOOD TO SEE THESE PROGRAMS, 4843 03:10:28,331 --> 03:10:34,137 YOU'VE IDENTIFIED SOME AT-RISK 4844 03:10:34,137 --> 03:10:34,938 FOLKS. 4845 03:10:34,938 --> 03:10:36,639 THE EVENING AND WEEKEND STAFF 4846 03:10:36,639 --> 03:10:39,342 GENERALLY DON'T GET A LOT OF 4847 03:10:39,342 --> 03:10:39,943 ATTENTION BECAUSE MOST THINGS 4848 03:10:39,943 --> 03:10:41,344 ARE DURING THE WORK WEEK, DURING 4849 03:10:41,344 --> 03:10:41,778 THE DAY. 4850 03:10:41,778 --> 03:10:45,515 DO YOU HAVE A CARE CART THAT 4851 03:10:45,515 --> 03:10:46,482 TAKES SNACKS AND THINGS? 4852 03:10:46,482 --> 03:10:49,485 >> WELL, ONE OF THE THINGS WE -- 4853 03:10:49,485 --> 03:10:51,788 A CORNERSTONE OF THIS IS 4854 03:10:51,788 --> 03:10:52,121 COLLABORATION. 4855 03:10:52,121 --> 03:10:53,389 SO WHERE THERE ARE OTHER 4856 03:10:53,389 --> 03:10:54,824 DEPARTMENTS WORKING ON IT, WE 4857 03:10:54,824 --> 03:10:58,428 WORK ALONG WITH THEM. 4858 03:10:58,428 --> 03:11:00,697 SO THE NURSING DEPARTMENT IS 4859 03:11:00,697 --> 03:11:02,065 WORKING ON A CARE CART. 4860 03:11:02,065 --> 03:11:06,002 BARBARA MIGHT WANT TO SAY A WORD 4861 03:11:06,002 --> 03:11:07,937 ON THAT. 4862 03:11:07,937 --> 03:11:12,408 >> YES, WE HAVE A GROUP WORKING 4863 03:11:12,408 --> 03:11:18,348 ON CODE LAVENDER, WHERE SOMEONE 4864 03:11:18,348 --> 03:11:19,549 IS IDENTIFIED, THE PERSON 4865 03:11:19,549 --> 03:11:21,050 SELF-IDENTIFIES OR MAY OBSERVE 4866 03:11:21,050 --> 03:11:22,719 SOMEONE IN DISTRESS SO WE HAVE A 4867 03:11:22,719 --> 03:11:27,624 CART THAT WILL HAVE ALL 4868 03:11:27,624 --> 03:11:29,359 DIFFERENT TYPES OF EITHER TREATS 4869 03:11:29,359 --> 03:11:34,097 OR TEAS, IT WILL STAY ON THE 4870 03:11:34,097 --> 03:11:34,764 OPPORTUNITY. -- UNIT. 4871 03:11:34,764 --> 03:11:36,432 IT'S NOT JUST THE INDIVIDUAL BUT 4872 03:11:36,432 --> 03:11:37,900 CAN BE THE UNIT, SOMETHING WE'RE 4873 03:11:37,900 --> 03:11:40,169 LOOKING TO LAUNCH VERY SOON. 4874 03:11:40,169 --> 03:11:42,305 >> ONCE IT IS WORKING IN A 4875 03:11:42,305 --> 03:11:44,874 PARTICULAR AREA, HOW CAN WE 4876 03:11:44,874 --> 03:11:46,509 ENLARGE THE FOOTPRINT AND TAKE 4877 03:11:46,509 --> 03:11:53,449 IT TO OTHER PLACES. 4878 03:11:53,449 --> 03:11:53,683 >> TONI? 4879 03:11:53,683 --> 03:12:00,490 >> AGAIN, THANKS FOR YOUR GREAT 4880 03:12:00,490 --> 03:12:00,823 PRESENTATION. 4881 03:12:00,823 --> 03:12:06,796 AS A PATIENT HERE AT NIH, I 4882 03:12:06,796 --> 03:12:08,998 REALLY BENEFITED FROM THE 4883 03:12:08,998 --> 03:12:13,503 SERVICES OF JOHN POLLACK AND DR. 4884 03:12:13,503 --> 03:12:15,471 BERGER BECAUSE WITHOUT THEIR 4885 03:12:15,471 --> 03:12:16,906 ASSISTANCE, BEING IN MY SPACE, I 4886 03:12:16,906 --> 03:12:18,341 DON'T THINK I WOULD HAVE BEEN 4887 03:12:18,341 --> 03:12:19,709 ABLE TO MAKE IT. 4888 03:12:19,709 --> 03:12:23,980 I'M GLAD THAT YOU ALL HAVE 4889 03:12:23,980 --> 03:12:25,381 EXPANDED THE SERVICES THAT YOU 4890 03:12:25,381 --> 03:12:30,520 PROVIDED ME, AS A PATIENT, THE 4891 03:12:30,520 --> 03:12:34,290 RELAXATION CHAIR, AS WELL AS THE 4892 03:12:34,290 --> 03:12:36,392 SERVICE ANIMAL BECAUSE WHEN I 4893 03:12:36,392 --> 03:12:37,860 WAS AN INPATIENT JUST HAVING THE 4894 03:12:37,860 --> 03:12:44,567 ANIMAL COME AND LAY NEXT TO YOU 4895 03:12:44,567 --> 03:12:46,903 IN THE BED, IT REALLY, REALLY -- 4896 03:12:46,903 --> 03:12:49,038 IT WAS VERY HEALING FOR ME 4897 03:12:49,038 --> 03:12:51,674 BECAUSE I WAS HERE A LONG TIME, 4898 03:12:51,674 --> 03:12:54,977 FROM TIME TO TIME. 4899 03:12:54,977 --> 03:12:57,680 AND I'M SO HAPPY TO HEAR THAT 4900 03:12:57,680 --> 03:13:02,618 THESE SERVICES HAVE BEEN 4901 03:13:02,618 --> 03:13:04,253 EXPANDED TO THE STAFF BECAUSE I 4902 03:13:04,253 --> 03:13:05,922 IMAGINE WHAT THEY ARE GOING 4903 03:13:05,922 --> 03:13:09,258 THROUGH AFTER COVID OR DURING 4904 03:13:09,258 --> 03:13:10,626 COVID, AS WELL AS LIKE YOU SAID 4905 03:13:10,626 --> 03:13:17,400 WITH ALL THE PATIENTS THAT HAVE 4906 03:13:17,400 --> 03:13:19,469 BEEN PASSING AND SUCH. 4907 03:13:19,469 --> 03:13:20,436 THANK YOU. 4908 03:13:20,436 --> 03:13:21,371 >> AGAIN, COLLABORATION. 4909 03:13:21,371 --> 03:13:22,872 COLLEAGUES IN THERAPY AND ANIMAL 4910 03:13:22,872 --> 03:13:26,909 PROGRAM AS FAR AS GETTING 4911 03:13:26,909 --> 03:13:29,212 ANIMALS TO THE BEDSIDE, 4912 03:13:29,212 --> 03:13:29,846 LIEUTENANT COMMANDER ABIGAIL 4913 03:13:29,846 --> 03:13:31,981 ALSO PARTICIPATES IN THAT 4914 03:13:31,981 --> 03:13:32,448 PROGRAM. 4915 03:13:32,448 --> 03:13:33,916 SO AGAIN THERE'S A LOT OF 4916 03:13:33,916 --> 03:13:36,419 CROSSOVERS, AND REALLY HOPING TO 4917 03:13:36,419 --> 03:13:38,955 BUILD ON THOSE THINGS THAT ARE 4918 03:13:38,955 --> 03:13:39,589 ALREADY PRESENT AND FOCUS THEM. 4919 03:13:39,589 --> 03:13:40,390 >> THANK YOU VERY MUCH. 4920 03:13:40,390 --> 03:13:41,591 THIS IS REALLY GREAT. 4921 03:13:41,591 --> 03:13:43,359 OUR WORK IS NOT GETTING LESS 4922 03:13:43,359 --> 03:13:44,627 STRESSFUL, THAT'S FOR SURE. 4923 03:13:44,627 --> 03:13:47,697 THANK YOU VERY MUCH. 4924 03:13:47,697 --> 03:13:48,197 >> THANK YOU. 4925 03:13:48,197 --> 03:13:53,102 >> THANK YOU. 4926 03:13:53,102 --> 03:13:57,774 >> WE HAVE ONE LAST 4927 03:13:57,774 --> 03:13:58,708 PRESENTATION. 4928 03:13:58,708 --> 03:14:01,210 DR. ANDREW SINGLETON, DIRECTOR 4929 03:14:01,210 --> 03:14:03,446 OF INTRAMURAL EFFORT, CENTER FOR 4930 03:14:03,446 --> 03:14:04,280 ALZHEIMER'S AND RELATED 4931 03:14:04,280 --> 03:14:13,222 DEMENTIAS, OR CARD 4932 03:14:13,222 --> 03:14:16,225 FOR THIS HIGH PRIORITY RESEARCH 4933 03:14:16,225 --> 03:14:16,592 PROGRAM. 4934 03:14:16,592 --> 03:14:19,262 >> THANKS SO MUCH FOR THE 4935 03:14:19,262 --> 03:14:23,566 OPPORTUNITY TO TALK TODAY. 4936 03:14:23,566 --> 03:14:27,203 I REALLY WANT AN ABIGAIL NOW. 4937 03:14:27,203 --> 03:14:28,337 AWESOME NOT JUST FOR 4938 03:14:28,337 --> 03:14:29,839 PRESENTATIONS BUT KEEPING THE 4939 03:14:29,839 --> 03:14:31,407 STRESS DOWN, A WONDERFUL 4940 03:14:31,407 --> 03:14:31,874 PRESENTATION. 4941 03:14:31,874 --> 03:14:33,643 I'M GOING TO TALK ABOUT THE 4942 03:14:33,643 --> 03:14:35,211 CENTER FOR ALZHEIMER'S AND 4943 03:14:35,211 --> 03:14:35,611 RELATED DEMENTIAS. 4944 03:14:35,611 --> 03:14:39,048 IF THERE'S ONE THING YOU CAN 4945 03:14:39,048 --> 03:14:42,618 TAKE AWAY FROM THIS 4946 03:14:42,618 --> 03:14:48,257 PRESENTATION, THIS IS REALLY A 4947 03:14:48,257 --> 03:14:49,325 VERY COLLABORATIVE INITIATIVE, 4948 03:14:49,325 --> 03:14:51,093 JOINT BETWEEN NATIONAL INSTITUTE 4949 03:14:51,093 --> 03:14:55,264 OF AGING AND NEUROLOGICAL 4950 03:14:55,264 --> 03:15:02,939 DISORDERS AND STROKE BUT MUCH 4951 03:15:02,939 --> 03:15:04,040 BROADER THAN THAT. 4952 03:15:04,040 --> 03:15:14,584 WE'RE WORKING WITH FOUR OR FIVE 4953 03:15:19,155 --> 03:15:23,759 INSTITUTES, THE STRUCTURE IS 4954 03:15:23,759 --> 03:15:26,429 UNIQUE AND THE SUPPORT IS 4955 03:15:26,429 --> 03:15:26,929 UNIQUE. 4956 03:15:26,929 --> 03:15:32,001 THE IDEA FOR THE CENTER CAME 4957 03:15:32,001 --> 03:15:33,736 ABOUT OVER CHRISTMAS 2018. 4958 03:15:33,736 --> 03:15:35,671 YOU ALWAYS GET AN E-MAIL FROM 4959 03:15:35,671 --> 03:15:38,074 YOUR BOSS IN THE BEGINNING OF 4960 03:15:38,074 --> 03:15:39,141 DECEMBER, HEY, I'VE GOT A GREAT 4961 03:15:39,141 --> 03:15:42,178 IDEA, CAN YOU WORK ON THIS OVER 4962 03:15:42,178 --> 03:15:42,578 CHRISTMAS? 4963 03:15:42,578 --> 03:15:45,047 SO THIS IS WHAT I WORKED ON OVER 4964 03:15:45,047 --> 03:15:46,015 CHRISTMAS. 4965 03:15:46,015 --> 03:15:49,151 THE NOTION WAS A REALLY BIG 4966 03:15:49,151 --> 03:15:50,419 INVESTMENT IN ALZHEIMER'S 4967 03:15:50,419 --> 03:15:56,425 DISEASE AND RELATED DEMENTIAS. 4968 03:15:56,425 --> 03:16:01,664 DEMENTIA WITH LEWY BODIES, 4969 03:16:01,664 --> 03:16:05,668 FRONTOTEMPORAL, VASCULAR 4970 03:16:05,668 --> 03:16:07,103 DEMENTIA, A LARGE INCREASE IN 4971 03:16:07,103 --> 03:16:08,604 FUNDING, LOTS OF GRANTS AND 4972 03:16:08,604 --> 03:16:10,706 INITIATIVES. 4973 03:16:10,706 --> 03:16:12,375 WE STARTED TO THINK ABOUT THE 4974 03:16:12,375 --> 03:16:14,977 INTRAMURAL PROGRAM. 4975 03:16:14,977 --> 03:16:17,680 WHAT COULD WE CONTRIBUTE? 4976 03:16:17,680 --> 03:16:19,282 CLEARLY A PRESSING PROBLEM, OUR 4977 03:16:19,282 --> 03:16:20,683 POPULATION IS AGING, THESE 4978 03:16:20,683 --> 03:16:23,252 DISEASES ARE BECOMING MORE OF A 4979 03:16:23,252 --> 03:16:24,020 BURDEN. 4980 03:16:24,020 --> 03:16:27,490 WHAT CAN WE DO INTERNALLY? 4981 03:16:27,490 --> 03:16:31,227 WE TALK ABOUT WHAT'S SPECIAL 4982 03:16:31,227 --> 03:16:33,696 WITHIN THE INTRAMURAL PROGRAM. 4983 03:16:33,696 --> 03:16:34,330 WITHIN THE INTRAMURAL RESEARCH 4984 03:16:34,330 --> 03:16:36,365 PROGRAM AT THE NIH. 4985 03:16:36,365 --> 03:16:37,767 IF WE COULD GO TO THE NEXT 4986 03:16:37,767 --> 03:16:39,969 SLIDE, I'LL TALK ABOUT THE 4987 03:16:39,969 --> 03:16:41,671 RATIONALE FOR HOW WE DEFINE 4988 03:16:41,671 --> 03:16:43,472 THIS. 4989 03:16:43,472 --> 03:16:46,709 WE HAVE A STRUCTURAL 4990 03:16:46,709 --> 03:16:49,345 OPPORTUNITY, STABLE GENEROUS 4991 03:16:49,345 --> 03:16:49,912 RESOURCES. 4992 03:16:49,912 --> 03:16:52,415 WE'RE SECURE, WE KNOW WE CAN 4993 03:16:52,415 --> 03:16:54,250 STICK AROUND FOR A LONG TIME. 4994 03:16:54,250 --> 03:16:54,850 THIS IS IMPORTANT. 4995 03:16:54,850 --> 03:16:59,255 OUR REVIEW IS NOT PERSPECTIVE. 4996 03:16:59,255 --> 03:17:00,389 WE CAN MOVE QUICKLY. 4997 03:17:00,389 --> 03:17:02,825 WE DON'T HAVE TO GO THROUGH THE 4998 03:17:02,825 --> 03:17:04,193 USUAL GRANT CYCLES OF COMING UP 4999 03:17:04,193 --> 03:17:07,129 WITH AN IDEA, WRITING A 5000 03:17:07,129 --> 03:17:08,397 PROPOSAL, GETTING TURNED DOWN, 5001 03:17:08,397 --> 03:17:09,398 TRYING AGAIN, REPEAT. 5002 03:17:09,398 --> 03:17:12,568 WE CAN JUST GO WITH IDEAS AS 5003 03:17:12,568 --> 03:17:15,838 THEY COME ALONG AND COURSE 5004 03:17:15,838 --> 03:17:16,405 ADJUST. 5005 03:17:16,405 --> 03:17:18,507 THERE'S POTENTIAL TO FIND OUR 5006 03:17:18,507 --> 03:17:20,209 OWN METRICS OF SUCCESS. 5007 03:17:20,209 --> 03:17:22,612 OUR SUCCESS DOESN'T HAVE TO BE 5008 03:17:22,612 --> 03:17:23,446 DRIVEN BY A PUBLICATION 5009 03:17:23,446 --> 03:17:25,014 NECESSARILY, WHICH OFTEN IS IN 5010 03:17:25,014 --> 03:17:27,583 THE OUTSIDE WORLD BUT RATHER 5011 03:17:27,583 --> 03:17:28,918 TANGIBLE PROGRESS TOWARDS A 5012 03:17:28,918 --> 03:17:29,785 FINAL GOAL. 5013 03:17:29,785 --> 03:17:33,289 WE COULD GO TO THE NEXT SLIDE 5014 03:17:33,289 --> 03:17:34,557 PLEASE. 5015 03:17:34,557 --> 03:17:35,791 I THINK WITH THAT OPPORTUNITY 5016 03:17:35,791 --> 03:17:37,426 WITH THAT STRUCTURAL OPPORTUNITY 5017 03:17:37,426 --> 03:17:38,894 THERE'S A LOT OF RESPONSIBILITY. 5018 03:17:38,894 --> 03:17:42,264 WE'RE IN WHAT I THINK OF AS A 5019 03:17:42,264 --> 03:17:43,099 DIFFERENT AND SOMEWHAT 5020 03:17:43,099 --> 03:17:45,101 PRIVILEGED POSITION SO WE HAVE A 5021 03:17:45,101 --> 03:17:45,635 RESPONSIBILITY. 5022 03:17:45,635 --> 03:17:47,703 I THINK WE SHOULD BE TAKING ON 5023 03:17:47,703 --> 03:17:49,271 PROJECTS THAT JUST AREN'T EASY 5024 03:17:49,271 --> 03:17:51,907 TO ADDRESS IN THE OUTSIDE WORLD. 5025 03:17:51,907 --> 03:17:53,709 EITHER BECAUSE THEY ARE TOO LONG 5026 03:17:53,709 --> 03:17:56,012 TERM OR TOO HIGH RISK, WE 5027 03:17:56,012 --> 03:17:57,013 SHOULDN'T BE TRYING TO COMPETE 5028 03:17:57,013 --> 03:17:58,114 WITH OTHER INITIATIVES. 5029 03:17:58,114 --> 03:18:00,082 WE SHOULD BE COMPLEMENTING 5030 03:18:00,082 --> 03:18:03,552 CURRENT RESEARCH ACTIVITIES. 5031 03:18:03,552 --> 03:18:05,054 ADDRESSING CRITICAL RESOURCE 5032 03:18:05,054 --> 03:18:05,788 AREAS, REQUIRED RESEARCH GAPS, 5033 03:18:05,788 --> 03:18:08,791 I'LL TALK MORE ABOUT HOW WE'RE 5034 03:18:08,791 --> 03:18:10,259 DOING THIS ALREADY. 5035 03:18:10,259 --> 03:18:13,329 GOING BACK TO METRICS OF 5036 03:18:13,329 --> 03:18:15,598 SUCCESS, FOCUS EXCLUSIVELY ON 5037 03:18:15,598 --> 03:18:18,000 RESEARCH PROGRESS, ONLY ON 5038 03:18:18,000 --> 03:18:18,267 PROGRESS. 5039 03:18:18,267 --> 03:18:20,236 NEXT SLIDE PLEASE. 5040 03:18:20,236 --> 03:18:21,737 SO WE CREATED THIS CENTER WHICH 5041 03:18:21,737 --> 03:18:29,812 HAS A CLEAR MISSION TO INITIATE 5042 03:18:29,812 --> 03:18:32,682 STIMULATE ACCELERATE SUPPORT IN 5043 03:18:32,682 --> 03:18:35,718 ADRD LEADING TO TREATMENT AND 5044 03:18:35,718 --> 03:18:41,090 CURE, WHETHER DIRECTLY OR 5045 03:18:41,090 --> 03:18:42,224 ACCELERATING ROLE, SUPPORT ROLE, 5046 03:18:42,224 --> 03:18:43,626 I DON'T MIND AS LONG AS WE'VE 5047 03:18:43,626 --> 03:18:44,827 MADE A DIFFERENCE. 5048 03:18:44,827 --> 03:18:46,328 NEXT SLIDE PLEASE. 5049 03:18:46,328 --> 03:18:48,264 SO WE HAVE SOME PROGRAMMATIC 5050 03:18:48,264 --> 03:18:49,999 PRIORITIES, I'VE HINTED AT THESE 5051 03:18:49,999 --> 03:18:53,135 ALREADY A LITTLE BIT. 5052 03:18:53,135 --> 03:18:55,171 AND THEY ARE QUITE DIFFERENT. 5053 03:18:55,171 --> 03:18:57,173 WE HAVE PRIORITIZED PROJECTS 5054 03:18:57,173 --> 03:18:58,641 THAT REQUIRE HIGH TOLERANCE FOR 5055 03:18:58,641 --> 03:19:00,276 FAILURE AND WE'LL SEE IF THE 5056 03:19:00,276 --> 03:19:04,380 REVIEWERS AGREE WITH ME WHEN WE 5057 03:19:04,380 --> 03:19:06,615 GET TO REVIEW, THAT IF A DECENT 5058 03:19:06,615 --> 03:19:07,850 PROPORTION OF PROJECTS ARE NOT 5059 03:19:07,850 --> 03:19:09,452 FAILING THEN WE'RE NOT TRYING 5060 03:19:09,452 --> 03:19:11,087 THINGS THAT ARE DIFFICULT 5061 03:19:11,087 --> 03:19:11,721 ENOUGH. 5062 03:19:11,721 --> 03:19:14,824 WE ALSO ARE TAKING ON RAPIDLY 5063 03:19:14,824 --> 03:19:16,158 EMERGING OPPORTUNITIES. 5064 03:19:16,158 --> 03:19:19,095 THIS IDEA WE HAVE STABLE MONEY 5065 03:19:19,095 --> 03:19:20,329 AT NIH, THE INTRAMURAL PROGRAM, 5066 03:19:20,329 --> 03:19:22,198 MEANS WE CAN BE REALLY QUICK AND 5067 03:19:22,198 --> 03:19:25,367 NIMBLE AS NEW THINGS COME ALONG, 5068 03:19:25,367 --> 03:19:26,168 NEW TECHNOLOGIES, OPPORTUNITIES 5069 03:19:26,168 --> 03:19:28,037 EVOLVE WE CAN JUMP ON THEM 5070 03:19:28,037 --> 03:19:29,038 QUICKLY, THERE'S NOT THAT LAG 5071 03:19:29,038 --> 03:19:33,109 YOU HAVE IN THE OUTSIDE WORLD. 5072 03:19:33,109 --> 03:19:35,511 AN ADVANTAGE IN THE OTHER SPACE, 5073 03:19:35,511 --> 03:19:39,248 WE CAN TAKE ON REALLY LONG-TERM 5074 03:19:39,248 --> 03:19:40,249 PROJECTS, SOMETHING THAT'S 5075 03:19:40,249 --> 03:19:41,550 PERSONALLY BEEN VERY BENEFICIAL 5076 03:19:41,550 --> 03:19:42,752 TO ME. 5077 03:19:42,752 --> 03:19:46,756 I'VE BEEN AT NIH FOR 22 YEARS 5078 03:19:46,756 --> 03:19:46,922 NOW. 5079 03:19:46,922 --> 03:19:50,192 AND SOME OF THE PROJECTS I WORK 5080 03:19:50,192 --> 03:19:52,194 ON, WE STARTED 15 YEARS AGO AND 5081 03:19:52,194 --> 03:19:54,663 WE'RE STILL WORKING WITH THE 5082 03:19:54,663 --> 03:19:58,300 SAME INVESTIGATORS AND CAN 5083 03:19:58,300 --> 03:19:59,368 PROVIDE THAT STABILITY. 5084 03:19:59,368 --> 03:20:02,404 WE'RE FOCUSING ON CHALLENGES ON 5085 03:20:02,404 --> 03:20:03,672 PRODUCING PLATFORMS OR 5086 03:20:03,672 --> 03:20:05,541 INFRASTRUCTURE OR RESOURCES THAT 5087 03:20:05,541 --> 03:20:06,942 ARE GENERALLY AND BROADLY USEFUL 5088 03:20:06,942 --> 03:20:08,711 TO THE OUTSIDE WORLD. 5089 03:20:08,711 --> 03:20:11,814 SO IS THERE SOMETHING THAT'S 5090 03:20:11,814 --> 03:20:14,049 NEEDED JUST A PLATFORM OR PIECE 5091 03:20:14,049 --> 03:20:18,654 OF DATA OR A RESOURCE THAT'S 5092 03:20:18,654 --> 03:20:19,088 NEEDED? 5093 03:20:19,088 --> 03:20:20,589 WE'RE EXTREMELY FOCUSED ON 5094 03:20:20,589 --> 03:20:22,925 COLLABORATION AND COORDINATION. 5095 03:20:22,925 --> 03:20:25,694 I HINTED AT THAT INTERNALLY. 5096 03:20:25,694 --> 03:20:26,462 BUT ALSO EXTERNALLY. 5097 03:20:26,462 --> 03:20:28,798 AND THE OTHER PART THAT I THINK 5098 03:20:28,798 --> 03:20:31,000 WE CAN DO REALLY WELL HERE, WHEN 5099 03:20:31,000 --> 03:20:33,302 PEOPLE COME TO NIH AND THEY ARE 5100 03:20:33,302 --> 03:20:36,138 INTERVIEWING FOR A JOB THEY ASK 5101 03:20:36,138 --> 03:20:38,240 ME WHAT'S SPECIAL ABOUT NIH, THE 5102 03:20:38,240 --> 03:20:40,709 INTRAMURAL PROGRAM. 5103 03:20:40,709 --> 03:20:41,977 ONE SPECIAL THING IS THAT THERE 5104 03:20:41,977 --> 03:20:44,413 ARE I DON'T KNOW 20,000, 25,000 5105 03:20:44,413 --> 03:20:45,681 PEOPLE WORKING HERE, IF YOU 5106 03:20:45,681 --> 03:20:47,883 DON'T KNOW HOW TO DO SOMETHING, 5107 03:20:47,883 --> 03:20:49,618 SOMEONE HERE KNOWS HOW TO DO IT. 5108 03:20:49,618 --> 03:20:51,687 AND THEY WILL PROBABLY DO IT FOR 5109 03:20:51,687 --> 03:20:53,122 YOU. 5110 03:20:53,122 --> 03:20:53,823 BECAUSE IT'S AN EXTREMELY 5111 03:20:53,823 --> 03:20:54,523 COLLABORATIVE SPACE. 5112 03:20:54,523 --> 03:20:55,825 WE'RE NOT COMPETING WITH EACH 5113 03:20:55,825 --> 03:20:56,592 OTHER FOR MONEY. 5114 03:20:56,592 --> 03:21:01,197 AND I THINK THE PEOPLE HERE ARE 5115 03:21:01,197 --> 03:21:04,834 GIVEN BY IDEAS AND EXCITEMENT SO 5116 03:21:04,834 --> 03:21:09,638 COLLABORATION IS EASY AND WE CAN 5117 03:21:09,638 --> 03:21:13,175 SPAN DISEASE AND METHODOLOGIC 5118 03:21:13,175 --> 03:21:13,809 BOUNDARIES. 5119 03:21:13,809 --> 03:21:15,377 THESE ARE THE TEAMS. 5120 03:21:15,377 --> 03:21:18,113 I EXPECT THESE TO CHANGE. 5121 03:21:18,113 --> 03:21:20,082 IF ALL THINGS I'VE TALKED ABOUT 5122 03:21:20,082 --> 03:21:22,585 ARE TRUE, WE CAN BE NIMBLE AND 5123 03:21:22,585 --> 03:21:23,819 QUICK AND CHANGE COURSE, THESE 5124 03:21:23,819 --> 03:21:24,920 WILL PROBABLY CHANGE. 5125 03:21:24,920 --> 03:21:27,122 THIS IS WHERE WE'RE STARTING 5126 03:21:27,122 --> 03:21:27,590 WITH. 5127 03:21:27,590 --> 03:21:31,594 SO, UNDERSTANDING THE BIOLOGY OF 5128 03:21:31,594 --> 03:21:32,795 DISEASE ANCHORED IN GENETICS, 5129 03:21:32,795 --> 03:21:34,563 UNDERSTANDING WHAT THE DISEASE 5130 03:21:34,563 --> 03:21:39,568 IS FROM A BIOLOGICAL 5131 03:21:39,568 --> 03:21:39,869 PERSPECTIVE. 5132 03:21:39,869 --> 03:21:41,337 UNDERSTANDING WHAT THESE 5133 03:21:41,337 --> 03:21:43,105 DISEASES ARE MECHANISTICALLY, SO 5134 03:21:43,105 --> 03:21:44,707 SUBTYPING EACH OF THESE 5135 03:21:44,707 --> 03:21:48,410 ALZHEIMER'S DISEASE AND RELATED 5136 03:21:48,410 --> 03:21:50,112 DEMENTIA DISORDERS INTO 5137 03:21:50,112 --> 03:21:53,482 DIFFERENT MECHANISTIC CLINICAL 5138 03:21:53,482 --> 03:21:54,717 PATHOLOGICAL SUBTYPES. 5139 03:21:54,717 --> 03:21:56,552 REDUCING RISK FOR COMPANIES TO 5140 03:21:56,552 --> 03:21:58,854 TAKE ON THERAPEUTIC STRATEGIES, 5141 03:21:58,854 --> 03:22:00,956 EITHER BY DEVELOPING NEW 5142 03:22:00,956 --> 03:22:03,993 THERAPEUTIC APPROACHES OR 5143 03:22:03,993 --> 03:22:04,426 DE-RISKING TARGETS. 5144 03:22:04,426 --> 03:22:06,962 THERE IS AN ABUNDANCE OF TARGETS 5145 03:22:06,962 --> 03:22:08,264 BUT TARGETS WITH LITTLE 5146 03:22:08,264 --> 03:22:10,566 ADDITIONAL DATA OUT THERE THAT 5147 03:22:10,566 --> 03:22:12,101 JUST MAKE THEM TOO RISKY FOR 5148 03:22:12,101 --> 03:22:13,535 STARTUPS TO TAKE ON. 5149 03:22:13,535 --> 03:22:18,073 SO WE'RE WORKING IN THAT SPACE. 5150 03:22:18,073 --> 03:22:21,877 AND LASTLY THE PIECE THAT'S TIED 5151 03:22:21,877 --> 03:22:27,082 THIS TOGETHER IS DEVELOPMENT AND 5152 03:22:27,082 --> 03:22:28,317 APPLICATION OF PRECISION OF 5153 03:22:28,317 --> 03:22:28,884 THERAPEUTICS, UNDERSTANDING 5154 03:22:28,884 --> 03:22:30,319 BIOLOGY, WHICH PATIENTS HAVE 5155 03:22:30,319 --> 03:22:34,323 WHICH BIOLOGY, DEVELOP TARGETS 5156 03:22:34,323 --> 03:22:36,992 AND THERAPEUTIC APPROACHES, 5157 03:22:36,992 --> 03:22:37,960 APPLY THOSE APPROACHES TARGETING 5158 03:22:37,960 --> 03:22:40,095 THE RIGHT PATIENT AT THE RIGHT 5159 03:22:40,095 --> 03:22:43,999 TIME WITH THE RIGHT MECHANISM. 5160 03:22:43,999 --> 03:22:48,137 AS IMPORTANT TO ME AS THE 5161 03:22:48,137 --> 03:22:52,207 SCIENTIFIC THEMES, THESE 5162 03:22:52,207 --> 03:22:52,741 ORGANIZATIONAL PRIORITIES, 5163 03:22:52,741 --> 03:22:53,709 DIVERSIFYING RESEARCH ENDEAVOR 5164 03:22:53,709 --> 03:22:54,843 AT EVERY LEVEL, BOTH IN THE 5165 03:22:54,843 --> 03:22:55,978 FOLKS THAT ARE DOING THE WORK 5166 03:22:55,978 --> 03:22:59,782 BUT ALSO IN THE SUBJECTS OF OUR 5167 03:22:59,782 --> 03:23:00,516 WORK. 5168 03:23:00,516 --> 03:23:03,185 DEMOCRATIZATION OF DATA SO THIS 5169 03:23:03,185 --> 03:23:04,853 ISN'T DATA SHARING, THIS IS DATA 5170 03:23:04,853 --> 03:23:06,288 SHARING AND ENABLING THE 5171 03:23:06,288 --> 03:23:08,090 COMMUNITY TO BE ABLE TO DO 5172 03:23:08,090 --> 03:23:11,193 USEFUL THINGS WITH THAT DATA. 5173 03:23:11,193 --> 03:23:11,927 COLLABORATION AND COOPERATION, 5174 03:23:11,927 --> 03:23:15,164 I'VE SAID THAT SEVEN OR EIGHT 5175 03:23:15,164 --> 03:23:16,165 TIMES TODAY ALREADY. 5176 03:23:16,165 --> 03:23:17,299 BEING TRANSPARENT. 5177 03:23:17,299 --> 03:23:18,334 WE TALK ABOUT REPRODUCIBILITY 5178 03:23:18,334 --> 03:23:21,337 AND I THINK TRANSPARENCY IS KEY 5179 03:23:21,337 --> 03:23:22,671 TO THAT. 5180 03:23:22,671 --> 03:23:24,440 AND THEN UNDERLYING ALL OF THIS 5181 03:23:24,440 --> 03:23:26,442 IS OUR WORK BEING FOUNDATIONAL, 5182 03:23:26,442 --> 03:23:27,810 IS IT BEING ACTIONABLE? 5183 03:23:27,810 --> 03:23:29,411 YOU CAN PUT OUT AN INTERESTING 5184 03:23:29,411 --> 03:23:30,479 DISCOVERY BUT UNLESS SOMEONE CAN 5185 03:23:30,479 --> 03:23:32,281 DO SOMETHING USEFUL WITH IT, 5186 03:23:32,281 --> 03:23:34,750 IT'S KIND OF A WASTE OF TIME. 5187 03:23:34,750 --> 03:23:40,422 SO EVERYTHING WE DO HAS TO BE 5188 03:23:40,422 --> 03:23:42,825 ACTIONABLE. 5189 03:23:42,825 --> 03:23:43,993 NEXT SLIDE PLEASE. 5190 03:23:43,993 --> 03:23:46,095 SO, I HINTED EARLIER, ONE OF THE 5191 03:23:46,095 --> 03:23:47,162 GREAT THINGS ABOUT THE 5192 03:23:47,162 --> 03:23:49,131 INTRAMURAL PROGRAM IS HUMAN 5193 03:23:49,131 --> 03:23:52,401 TALENT WE HAVE IN THE INTRAMURAL 5194 03:23:52,401 --> 03:23:52,801 PROGRAM. 5195 03:23:52,801 --> 03:23:55,270 A LOT OF SMART PEOPLE HERE AT 5196 03:23:55,270 --> 03:23:56,305 NIH, ACTUALLY IN THE INTRAMURAL 5197 03:23:56,305 --> 03:23:59,141 PROGRAM AND IN THE EXTRAMURAL 5198 03:23:59,141 --> 03:23:59,375 PROGRAM. 5199 03:23:59,375 --> 03:24:02,945 SO WE'VE TRIED TO LEVERAGE THAT 5200 03:24:02,945 --> 03:24:06,682 BY CREATING AN IDEA FACTORY FOR 5201 03:24:06,682 --> 03:24:08,684 ALZHEIMER'S DISEASE AND RELATED 5202 03:24:08,684 --> 03:24:12,688 DEMENTIA RESEARCH, THAT'S WHAT 5203 03:24:12,688 --> 03:24:14,023 THE CIRCLE IS. 5204 03:24:14,023 --> 03:24:16,492 STARTING IN THE IRP GOING OUT 5205 03:24:16,492 --> 03:24:18,660 AND HAVING DISCUSSIONS WITH 5206 03:24:18,660 --> 03:24:21,530 INDUSTRY, WITH FOUNDATIONS, 5207 03:24:21,530 --> 03:24:23,499 BRINGING IN EXTERNAL SPEAKERS, 5208 03:24:23,499 --> 03:24:25,167 EXTERNAL GROUPS TO GIVE US IDEAS 5209 03:24:25,167 --> 03:24:28,103 ABOUT BARRIERS TO PROGRESS AND 5210 03:24:28,103 --> 03:24:29,338 CRITICAL RESEARCH QUESTIONS. 5211 03:24:29,338 --> 03:24:32,408 WE GO THROUGH THE SERIES OF DUE 5212 03:24:32,408 --> 03:24:36,011 DILIGENCE, THIS IS A NEED IN 5213 03:24:36,011 --> 03:24:37,379 ADRD SPACE, DOES IT FIT OUR 5214 03:24:37,379 --> 03:24:37,780 MISSION? 5215 03:24:37,780 --> 03:24:40,416 YOU'VE SEEN THE MISSION. 5216 03:24:40,416 --> 03:24:43,352 SECONDLY, DOES IT FIT 5217 03:24:43,352 --> 03:24:43,752 PROGRAMMATICALLY? 5218 03:24:43,752 --> 03:24:45,521 EVERYTHING WE'RE DOING IN CARD 5219 03:24:45,521 --> 03:24:46,722 IS INTERRELATED. 5220 03:24:46,722 --> 03:24:49,124 I CAN THINK OF ONLY ONE OF 20, 5221 03:24:49,124 --> 03:24:51,026 25 PROJECTS THAT SITS BY ITSELF, 5222 03:24:51,026 --> 03:24:54,229 ALL OF THE OTHERS ARE 5223 03:24:54,229 --> 03:24:54,563 INTERRELATED. 5224 03:24:54,563 --> 03:24:56,065 AND THE IDEA IS OF COURSE THE 5225 03:24:56,065 --> 03:24:57,099 WHOLE BECOMES MUCH GREATER THAN 5226 03:24:57,099 --> 03:24:59,301 THE SUM OF THE INDIVIDUAL PARTS. 5227 03:24:59,301 --> 03:25:02,304 WE GO THROUGH THE CIRCULAR 5228 03:25:02,304 --> 03:25:06,341 PROCESS AND DEFINE CRITICAL 5229 03:25:06,341 --> 03:25:07,743 PROBLEMS, FIGURE OUT DOES THE 5230 03:25:07,743 --> 03:25:09,878 PROGRAM FIT, DOES THE MISSION 5231 03:25:09,878 --> 03:25:11,046 FIT, ARE WE THE RIGHT PEOPLE TO 5232 03:25:11,046 --> 03:25:15,851 DO THEM? -- TO DO THIS. 5233 03:25:15,851 --> 03:25:18,287 IF WE ARE, HOW DO WE DO IT? 5234 03:25:18,287 --> 03:25:19,788 THE TEMPTATION IS TO DO THINGS 5235 03:25:19,788 --> 03:25:20,322 INTERNALLY. 5236 03:25:20,322 --> 03:25:20,889 THAT'S NOT NECESSARILY WHAT 5237 03:25:20,889 --> 03:25:23,025 WE'RE DOING IN CARD. 5238 03:25:23,025 --> 03:25:28,197 WE OUTSOURCE A LOT OF WORK TO 5239 03:25:28,197 --> 03:25:30,132 CROs, ACADEMIC COLLABORATORS, 5240 03:25:30,132 --> 03:25:33,235 INDUSTRY, AND WE'VE CREATED 5241 03:25:33,235 --> 03:25:35,270 INTERNAL EXPERTISE BOTH VISITING 5242 03:25:35,270 --> 03:25:36,171 SCIENTISTS, SO I MENTIONED 5243 03:25:36,171 --> 03:25:39,141 EARLIER THAT WE WORK WITH OTHER 5244 03:25:39,141 --> 03:25:40,409 INSTITUTES. 5245 03:25:40,409 --> 03:25:41,643 WE HAVE CURRENT INVESTIGATORS 5246 03:25:41,643 --> 03:25:44,179 WHO ARE AT NIH, WHO HAVE A 5247 03:25:44,179 --> 03:25:47,583 POSITION IN CARD AND WORK ON 5248 03:25:47,583 --> 03:25:49,885 CARD PROJECTS SO THEY COME AND 5249 03:25:49,885 --> 03:25:52,421 RUN PROJECTS IN CARD, KEEP THEIR 5250 03:25:52,421 --> 03:25:56,225 OWN LAB, WORKING WITH 5251 03:25:56,225 --> 03:25:58,827 INVESTIGATORS FROM NHGRI, NIDDK, 5252 03:25:58,827 --> 03:26:01,997 NINDS, NIA, NOW STARTING TO WORK 5253 03:26:01,997 --> 03:26:04,967 WITH NCATS, SO AGAIN THE IDEA IS 5254 03:26:04,967 --> 03:26:06,502 THAT ANYONE CAN COME AND 5255 03:26:06,502 --> 03:26:08,103 CONTRIBUTE TO CARD. 5256 03:26:08,103 --> 03:26:09,271 NEXT SLIDE PLEASE. 5257 03:26:09,271 --> 03:26:10,906 AND THEN THE REALLY CRITICAL 5258 03:26:10,906 --> 03:26:12,841 PART ABOUT ALL OF THIS IS 5259 03:26:12,841 --> 03:26:16,044 BECAUSE OF THE NATURE OF OUR 5260 03:26:16,044 --> 03:26:20,082 FUNDING, OUR FUNDING IS FOCUSED 5261 03:26:20,082 --> 03:26:22,351 ON AD/ADRD, WE CAN'T DRIFT OUT 5262 03:26:22,351 --> 03:26:24,786 OF THAT SPACE. 5263 03:26:24,786 --> 03:26:25,821 WE HAVE A CONTINUAL ASSESSMENT 5264 03:26:25,821 --> 03:26:26,922 PROCESS WHERE EVERY PROJECT IS 5265 03:26:26,922 --> 03:26:29,358 RUN BY A PROJECT MANAGEMENT 5266 03:26:29,358 --> 03:26:30,926 GROUP, CHECK IN EVERY SIX 5267 03:26:30,926 --> 03:26:32,661 MONTHS, ARE WE ON COURSE, DO WE 5268 03:26:32,661 --> 03:26:34,329 NEED TO MAKE COURSE CORRECTIONS, 5269 03:26:34,329 --> 03:26:37,366 HAVE WE COME TO A PLACE TO MAKE 5270 03:26:37,366 --> 03:26:41,203 A GO/NO-GO DECISION AND MOVE 5271 03:26:41,203 --> 03:26:41,436 FORWARD? 5272 03:26:41,436 --> 03:26:42,871 I'M TRYING TO DESCRIBE A 5273 03:26:42,871 --> 03:26:45,174 FLEXIBLE STRUCTURE THAT COMES UP 5274 03:26:45,174 --> 03:26:46,808 WITH NEW IDEAS, DECIDES WHETHER 5275 03:26:46,808 --> 03:26:48,644 THEY SHOULD BE JUST DONE, 5276 03:26:48,644 --> 03:26:49,778 WHETHER WE'RE THE RIGHT PEOPLE 5277 03:26:49,778 --> 03:26:52,481 TO DO THEM AND CREATES A 5278 03:26:52,481 --> 03:26:55,484 SOLUTION TO EXECUTE THE PROJECT, 5279 03:26:55,484 --> 03:26:56,418 THAT FITS THE PROJECT RATHER 5280 03:26:56,418 --> 03:26:58,253 THAN FITS OUR GROUP. 5281 03:26:58,253 --> 03:27:00,122 NEXT SLIDE PLEASE. 5282 03:27:00,122 --> 03:27:03,158 SO YOU CAN GO NOW TO THE NIH 5283 03:27:03,158 --> 03:27:04,193 WEBSITE AND PROPOSE A RESEARCH 5284 03:27:04,193 --> 03:27:05,594 PROJECT FOR US TO WORK ON. 5285 03:27:05,594 --> 03:27:08,430 WE HAVE 20 OF THESE NOW. 5286 03:27:08,430 --> 03:27:09,998 INVESTIGATORS COME UP WITH AN 5287 03:27:09,998 --> 03:27:13,535 IDEA, WE'VE MET OVER A SERIES OF 5288 03:27:13,535 --> 03:27:16,638 MEETINGS, FLESHED OUT THE IDEA, 5289 03:27:16,638 --> 03:27:20,409 USUALLY CHANGES AND WE'VE GONE 5290 03:27:20,409 --> 03:27:21,577 ON TO EXECUTING PROJECTS. 5291 03:27:21,577 --> 03:27:23,545 THIS IS SOMETHING WE'VE BEEN 5292 03:27:23,545 --> 03:27:26,148 DOING ON THE BASIC SIDE BUT I 5293 03:27:26,148 --> 03:27:27,783 FULLY EXPECT THIS TO WORK ON THE 5294 03:27:27,783 --> 03:27:30,852 CLINICAL RESEARCH SIDE TOO. 5295 03:27:30,852 --> 03:27:32,754 AGAIN, COLLABORATION, LEVERAGING 5296 03:27:32,754 --> 03:27:34,022 THE HUMAN TALENT THAT'S BOTH IN 5297 03:27:34,022 --> 03:27:37,025 NIH AND OUTSIDE OF NIH. 5298 03:27:37,025 --> 03:27:38,527 NEXT SLIDE PLEASE. 5299 03:27:38,527 --> 03:27:43,332 SO, CURRENTLY WE HAVE A PHYSICAL 5300 03:27:43,332 --> 03:27:43,599 PRESENCE. 5301 03:27:43,599 --> 03:27:45,067 OUR BUILDING, WE STARTED TO 5302 03:27:45,067 --> 03:27:47,603 OCCUPY A BUILDING IN MARCH OF 5303 03:27:47,603 --> 03:27:49,504 LAST YEAR, IT WASN'T FUNCTIONAL 5304 03:27:49,504 --> 03:27:52,040 UNTIL AROUND JULY OR AUGUST. 5305 03:27:52,040 --> 03:27:53,175 WE'VE BEEN THERE ABOUT A YEAR 5306 03:27:53,175 --> 03:27:57,112 AND TWO OR THREE MONTHS, 5307 03:27:57,112 --> 03:27:59,448 SOMETHING LIKE THAT. 5308 03:27:59,448 --> 03:28:05,854 IT'S A T4 4, CENTER FOR 5309 03:28:05,854 --> 03:28:07,589 ALZHEIMER'S AND DEMENTIA 5310 03:28:07,589 --> 03:28:09,291 RESEARCH. 5311 03:28:09,291 --> 03:28:10,759 24,000 SQUARE FEET, HALF IS LAB 5312 03:28:10,759 --> 03:28:11,293 SPACE. 5313 03:28:11,293 --> 03:28:16,031 THIS IDEA WE TAKE ON PROJECTS, 5314 03:28:16,031 --> 03:28:17,599 THINGS CHANGE, ALL THESE BENCHES 5315 03:28:17,599 --> 03:28:19,935 AND STRUCTURE IS MODULAR AND CAN 5316 03:28:19,935 --> 03:28:20,202 BE MOVED. 5317 03:28:20,202 --> 03:28:21,670 ELECTRICITY COMES FROM THE ROOF. 5318 03:28:21,670 --> 03:28:23,705 WE CAN MOVE THINGS AROUND 5319 03:28:23,705 --> 03:28:24,573 QUICKLY, EVERYTHING IS SUPPOSED 5320 03:28:24,573 --> 03:28:27,342 TO BE OPEN AND FLEXIBLE. 5321 03:28:27,342 --> 03:28:29,945 SO ABOUT HALF OF THE SPACE IS 5322 03:28:29,945 --> 03:28:30,178 LAB. 5323 03:28:30,178 --> 03:28:31,480 NEXT SLIDE PLEASE. 5324 03:28:31,480 --> 03:28:33,415 AND THEN ABOUT HALF OF THE SPACE 5325 03:28:33,415 --> 03:28:35,751 IS DESK AND OPEN OFFICE. 5326 03:28:35,751 --> 03:28:39,154 WE HAVE ROOM FOR 130 PEOPLE. 5327 03:28:39,154 --> 03:28:40,722 HALF OF THE OFFICES ARE 5328 03:28:40,722 --> 03:28:41,256 BOOKABLE. 5329 03:28:41,256 --> 03:28:44,192 THE REST ARE PERMANENT OFFICES. 5330 03:28:44,192 --> 03:28:47,929 AND WE HAVE A VERY LARGE 5331 03:28:47,929 --> 03:28:49,498 COMPUTATIONAL DATA SCIENCE 5332 03:28:49,498 --> 03:28:50,098 PRESENCE THERE. 5333 03:28:50,098 --> 03:28:51,466 THE IDEA HERE IS OF COURSE THAT 5334 03:28:51,466 --> 03:28:52,401 PEOPLE CAN COME ALONG IF THEY 5335 03:28:52,401 --> 03:28:54,469 ARE WORKING ON A PROJECT FOR SIX 5336 03:28:54,469 --> 03:28:55,504 MONTHS, WE GIVE THEM SOME SPACE, 5337 03:28:55,504 --> 03:28:59,708 THEY CAN COME AND GO PRETTY 5338 03:28:59,708 --> 03:29:00,042 FREELY. 5339 03:29:00,042 --> 03:29:02,377 NEXT SLIDE PLEASE. 5340 03:29:02,377 --> 03:29:04,346 THIS IS THE STRUCTURE OF CARD. 5341 03:29:04,346 --> 03:29:05,714 THINGS I'VE TALKED ABOUT SO FAR 5342 03:29:05,714 --> 03:29:09,384 ON THE BASIC AND EARLY 5343 03:29:09,384 --> 03:29:12,321 TRANSLATIONAL RESEARCH PROGRAM 5344 03:29:12,321 --> 03:29:12,521 SIDE. 5345 03:29:12,521 --> 03:29:13,689 NEXT SLIDE PLEASE. 5346 03:29:13,689 --> 03:29:18,460 THERE ARE A BUNCH OF 5347 03:29:18,460 --> 03:29:18,760 INITIATIVES. 5348 03:29:18,760 --> 03:29:19,895 I TALK ABOUT THESE BECAUSE THEY 5349 03:29:19,895 --> 03:29:22,664 WILL BE RELEVANT AS WE EXPAND 5350 03:29:22,664 --> 03:29:24,433 OUR CLINICAL AND TRANSLATIONAL 5351 03:29:24,433 --> 03:29:29,971 RESEARCH PROGRAM. 5352 03:29:29,971 --> 03:29:33,975 SO WE HAVE ARDIS AND ARDRF FOR 5353 03:29:33,975 --> 03:29:35,344 EARLY INVESTIGATORS, FOLKS THAT 5354 03:29:35,344 --> 03:29:39,314 ARE LESS THAN FOUR YEARS FROM 5355 03:29:39,314 --> 03:29:41,149 THEIR DOCTORAL DEGREE, WE GIVE 5356 03:29:41,149 --> 03:29:43,985 THEM INDEPENDENT RESOURCES, GIVE 5357 03:29:43,985 --> 03:29:45,887 THEM STAFF, THEY ARE A P.I. AND 5358 03:29:45,887 --> 03:29:47,189 RUN THEIR OWN PROJECT. 5359 03:29:47,189 --> 03:29:50,025 THIS IS TO FIND REALLY TALENTED 5360 03:29:50,025 --> 03:29:51,660 EARLY CAREER INVESTIGATORS, GIVE 5361 03:29:51,660 --> 03:29:56,431 THEM RESOURCES FOR A FEW YEARS, 5362 03:29:56,431 --> 03:29:58,333 AND ALLOW THEM TO SUCCEED. 5363 03:29:58,333 --> 03:29:59,468 WE ESTABLISHED A GRANT MECHANISM 5364 03:29:59,468 --> 03:30:02,504 TO ALLOW THEM TO GET MONEY TO GO 5365 03:30:02,504 --> 03:30:03,472 ELSEWHERE. 5366 03:30:03,472 --> 03:30:04,072 WE HAVE TENURE-TRACK 5367 03:30:04,072 --> 03:30:05,307 INVESTIGATORS, NOT MANY. 5368 03:30:05,307 --> 03:30:07,776 WE HAVE ONE STARTING ON MONDAY 5369 03:30:07,776 --> 03:30:08,744 ACTUALLY, ADVERTISING FOR A 5370 03:30:08,744 --> 03:30:09,878 SECOND NOW. 5371 03:30:09,878 --> 03:30:13,782 BUT THE MAJORITY OF PROJECTS ARE 5372 03:30:13,782 --> 03:30:15,951 RUN BY VISITING INVESTIGATORS 5373 03:30:15,951 --> 03:30:16,952 FROM OUTSIDE, PEOPLE WHO COME TO 5374 03:30:16,952 --> 03:30:20,155 CARD TO RUN PROJECTS. 5375 03:30:20,155 --> 03:30:22,324 SUPPORTING THOSE ARE EXPERT 5376 03:30:22,324 --> 03:30:28,563 GROUPS IN DATA SCIENCE, ADVANCED 5377 03:30:28,563 --> 03:30:31,199 ANALYTICS, SINGLE CELL 5378 03:30:31,199 --> 03:30:35,137 SEQUENTIALING, PROTEOMICS, 5379 03:30:35,137 --> 03:30:36,271 GENETICS, LONG READ GENETICS. 5380 03:30:36,271 --> 03:30:38,740 I THINK THEY ARE ALL 5381 03:30:38,740 --> 03:30:39,508 INTERRELATED. 5382 03:30:39,508 --> 03:30:43,545 I'LL SKIP THROUGH THE NEXT 5383 03:30:43,545 --> 03:30:44,179 SLIDES QUICKLY. 5384 03:30:44,179 --> 03:30:45,580 THE DETAILS OF THE PROJECTS 5385 03:30:45,580 --> 03:30:47,582 DON'T MATTER TOO MUCH BUT WHAT 5386 03:30:47,582 --> 03:30:49,184 WE'RE TRYING TO ACHIEVE I THINK 5387 03:30:49,184 --> 03:30:51,420 MATTERS BECAUSE, AGAIN, I THINK 5388 03:30:51,420 --> 03:30:53,388 IT WILL INFORM HOW WE APPROACH 5389 03:30:53,388 --> 03:30:55,724 OUR CLINICAL PROGRAM. 5390 03:30:55,724 --> 03:30:57,592 NEXT SLIDE PLEASE. 5391 03:30:57,592 --> 03:31:02,798 SO, THIS IS A PROGRAM TO CREATE 5392 03:31:02,798 --> 03:31:04,433 AN UNDERSTANDING OF WHAT'S GOING 5393 03:31:04,433 --> 03:31:14,976 ON AT THE SINGLE CELL LEVEL IN 5394 03:31:15,477 --> 03:31:17,746 ANCESTRALLY DIVERSE BRAINS FROM 5395 03:31:17,746 --> 03:31:19,448 NABEC AND HBCC. 5396 03:31:19,448 --> 03:31:21,550 LOTS OF DATA IS PRODUCED AND 5397 03:31:21,550 --> 03:31:22,884 AVAILABLE BUT USUALLY ONLY 5398 03:31:22,884 --> 03:31:25,620 PRODUCED IN PEOPLE WITH NORTHERN 5399 03:31:25,620 --> 03:31:26,254 EUROPEAN ANCESTRY. 5400 03:31:26,254 --> 03:31:29,558 THIS IS AN EFFORT TO PRODUCE 5401 03:31:29,558 --> 03:31:31,660 REFERENCE DATA IN A MORE 5402 03:31:31,660 --> 03:31:32,961 ANCESTRALLY DIVERSE GROUP. 5403 03:31:32,961 --> 03:31:36,264 NEXT SLIDE PLEASE. 5404 03:31:36,264 --> 03:31:36,965 MODELING CELLULAR SENESCENCE 5405 03:31:36,965 --> 03:31:38,200 WE'RE TRYING TO UNDERSTAND WHAT 5406 03:31:38,200 --> 03:31:42,571 HAPPENS TO CELLS OVER TIME AND 5407 03:31:42,571 --> 03:31:45,006 CREATE A MODEL THAT 5408 03:31:45,006 --> 03:31:47,175 RECAPITULATES KEY ASPECTS OF 5409 03:31:47,175 --> 03:31:47,509 AGING. 5410 03:31:47,509 --> 03:31:49,010 NEXT SLIDE. 5411 03:31:49,010 --> 03:31:51,046 DRIVING AGING AGAIN IN CELLULAR 5412 03:31:51,046 --> 03:31:52,581 SYSTEMS WE DON'T -- WE WORK IN 5413 03:31:52,581 --> 03:31:56,418 CELLS SO MUCH BUT DON'T WORK IN 5414 03:31:56,418 --> 03:31:57,986 AGING CELLS, AGING IS A LARGE 5415 03:31:57,986 --> 03:31:59,354 PART OF THE DISEASE, THIS IS 5416 03:31:59,354 --> 03:32:00,021 CRITICAL. 5417 03:32:00,021 --> 03:32:03,892 NEXT SLIDE PLEASE. 5418 03:32:03,892 --> 03:32:05,760 CREATING A RESOURCE, AGAIN HERE 5419 03:32:05,760 --> 03:32:10,332 YOU'VE ALL HEARD OF INDUCED 5420 03:32:10,332 --> 03:32:11,666 PLURIPOTENT STEM CELLS THAT YOU 5421 03:32:11,666 --> 03:32:13,668 CAN TURN INTO ANY KIND OF CELL 5422 03:32:13,668 --> 03:32:15,403 YOU WANT, AN AMAZING DISCOVERY. 5423 03:32:15,403 --> 03:32:16,838 BUT THE SOURCES OF THOSE CELLS 5424 03:32:16,838 --> 03:32:18,707 TEND NOT TO BE PARTICULARLY 5425 03:32:18,707 --> 03:32:20,141 DIVERSE SO WE'VE BEEN WORKING 5426 03:32:20,141 --> 03:32:22,210 WITH THE ALZHEIMER'S DISEASE 5427 03:32:22,210 --> 03:32:24,646 NEUROIMAGING INITIATIVE TO 5428 03:32:24,646 --> 03:32:25,914 CREATE MORE DIVERSE ANCESTRALLY 5429 03:32:25,914 --> 03:32:26,915 DIVERSE GROUP OF iPS LINES 5430 03:32:26,915 --> 03:32:29,284 THAT CAN BE USED BY THE 5431 03:32:29,284 --> 03:32:29,551 COMMUNITY. 5432 03:32:29,551 --> 03:32:32,020 THE FIRST THING WE'RE DOING IS 5433 03:32:32,020 --> 03:32:32,721 MAKING THESE AVAILABLE TO 5434 03:32:32,721 --> 03:32:35,857 BROADER RESEARCH COMMUNITY. 5435 03:32:35,857 --> 03:32:37,492 NEXT SLIDE PLEASE. 5436 03:32:37,492 --> 03:32:39,828 THIS IS A REALLY IMPORTANT 5437 03:32:39,828 --> 03:32:40,028 TOPIC. 5438 03:32:40,028 --> 03:32:41,863 ONE OF THE THINGS THAT IS A 5439 03:32:41,863 --> 03:32:44,065 PARTICULAR CHALLENGE AS WE 5440 03:32:44,065 --> 03:32:49,271 GENERATE MORE GENETICS DATA IS 5441 03:32:49,271 --> 03:32:54,242 THAT CLINICIANS AND PATIENTS AND 5442 03:32:54,242 --> 03:32:55,143 VARIANTS MUCH UNKNOWN 5443 03:32:55,143 --> 03:32:56,211 SIGNIFICANCE, A CHANGE BUT YOU 5444 03:32:56,211 --> 03:32:58,380 DON'T KNOW WHETHER IT'S INVOLVED 5445 03:32:58,380 --> 03:32:58,847 IN DISEASE. 5446 03:32:58,847 --> 03:33:01,583 WE'RE TRYING TO CREATE A PATHWAY 5447 03:33:01,583 --> 03:33:03,885 WHICH WILL ALLOWS US TO 5448 03:33:03,885 --> 03:33:05,086 DETERMINE WHETHER GENE CHANGES 5449 03:33:05,086 --> 03:33:08,857 ARE LINKED TO DISEASE OR NOT. 5450 03:33:08,857 --> 03:33:09,858 INCREDIBLY IMPACTFUL FOR 5451 03:33:09,858 --> 03:33:11,059 PATIENTS, ALSO IMPACTFUL FOR 5452 03:33:11,059 --> 03:33:13,161 TRIALS AS WE MOVE TOWARDS 5453 03:33:13,161 --> 03:33:16,031 PRECISION THERAPEUTICS. 5454 03:33:16,031 --> 03:33:17,566 NEXT SLIDE PLEASE. 5455 03:33:17,566 --> 03:33:19,234 THIS IS ANOTHER RESOURCE 5456 03:33:19,234 --> 03:33:21,603 PROJECT, PEOPLE ALL OVER THE 5457 03:33:21,603 --> 03:33:24,706 WORLD ARE GENERATING iPS LINES 5458 03:33:24,706 --> 03:33:26,775 TO STUDY THEIR OWN PARTICULAR 5459 03:33:26,775 --> 03:33:28,176 GENETIC FLAVOR OF DISEASE. 5460 03:33:28,176 --> 03:33:31,580 THEY ARE ALL BEING GENERATED IN 5461 03:33:31,580 --> 03:33:32,414 SLIGHTLY DIFFERENT WAYS, 5462 03:33:32,414 --> 03:33:33,048 DIFFERENT QUALITY CONTROLS, WE 5463 03:33:33,048 --> 03:33:36,418 DECIDED TO DO IT FOR EVERYBODY. 5464 03:33:36,418 --> 03:33:39,754 HERE WE'VE CREATED 800 LINES 5465 03:33:39,754 --> 03:33:42,424 DISTRIBUTED ALL OVER THE WORLD 5466 03:33:42,424 --> 03:33:42,624 NOW. 5467 03:33:42,624 --> 03:33:45,160 NEXT SLIDE PLEASE. 5468 03:33:45,160 --> 03:33:49,864 THIS IS AN EFFORT TO EXPAND OUR 5469 03:33:49,864 --> 03:33:53,368 UNDERSTANDING OF DEMENTIA IN AN 5470 03:33:53,368 --> 03:33:54,169 UNDERREPRESENTED POPULATION, SO 5471 03:33:54,169 --> 03:33:55,270 WITHIN LATIN AMERICA WHERE 5472 03:33:55,270 --> 03:33:58,807 THERE'S A HUGE AMOUNT OF 5473 03:33:58,807 --> 03:34:00,842 ANCESTRAL DIVERSITY. 5474 03:34:00,842 --> 03:34:02,611 NEXT SLIDE PLEASE. 5475 03:34:02,611 --> 03:34:04,846 AGAIN, SIMILAR FOR STROKE AND 5476 03:34:04,846 --> 03:34:08,149 VASCULAR DEMENTIA, LOOKING AT 5477 03:34:08,149 --> 03:34:10,685 MOSTLY AFRICAN AMERICAN AND 5478 03:34:10,685 --> 03:34:13,521 BLACK AMERICAN POPULATION AND 5479 03:34:13,521 --> 03:34:15,790 NORTHERN EUROPEAN POPULATION. 5480 03:34:15,790 --> 03:34:17,626 NEXT SLIDE PLEASE. 5481 03:34:17,626 --> 03:34:22,864 A NEW DISCOVERY WE JUST MADE 5482 03:34:22,864 --> 03:34:25,467 SHOWED VIRAL EXPOSURE AND SEVERE 5483 03:34:25,467 --> 03:34:27,602 INFECTION INCREASES RISK FOR 5484 03:34:27,602 --> 03:34:28,770 NEURODEGENERATION SO WE'VE 5485 03:34:28,770 --> 03:34:32,407 STARTED A NEW PROGRAM WITH THE 5486 03:34:32,407 --> 03:34:33,708 INSTITUTE FOR ENVIRONMENTAL 5487 03:34:33,708 --> 03:34:36,544 HEALTH SCIENCES TO TRY AND MODEL 5488 03:34:36,544 --> 03:34:38,480 THIS IN CELLULAR SYSTEMS. 5489 03:34:38,480 --> 03:34:41,416 NEXT SLIDE PLEASE. 5490 03:34:41,416 --> 03:34:43,618 CREATING ANOTHER RESOURCE AROUND 5491 03:34:43,618 --> 03:34:45,787 GENETICS, AND DIVERSE 5492 03:34:45,787 --> 03:34:46,087 POPULATIONS. 5493 03:34:46,087 --> 03:34:47,656 NEXT SLIDE PLEASE. 5494 03:34:47,656 --> 03:34:50,158 THIS EFFORT RUN BY MICHAEL WARD 5495 03:34:50,158 --> 03:34:52,427 WITHIN NINDS WHICH I THINK IS 5496 03:34:52,427 --> 03:34:55,730 COMING UP WITH A CRITICAL 5497 03:34:55,730 --> 03:34:59,134 BIOMARKER FOR THE DIAGNOSIS AND 5498 03:34:59,134 --> 03:34:59,834 TRAJECTORY OF FRONTOTEMPORAL 5499 03:34:59,834 --> 03:35:00,268 DEMENTIA. 5500 03:35:00,268 --> 03:35:02,203 AGAIN, GETS TO THE IDEA OF BEING 5501 03:35:02,203 --> 03:35:05,106 ABLE TO SUBTYPE PATIENTS. 5502 03:35:05,106 --> 03:35:07,142 NEXT SLIDE PLEASE. 5503 03:35:07,142 --> 03:35:10,211 AND THEN A PROJECT BEING RUN BY 5504 03:35:10,211 --> 03:35:13,214 RICHARD EWELL OF NINDS TO CREATE 5505 03:35:13,214 --> 03:35:16,518 A BRAND-NEW THERAPEUTIC APPROACH 5506 03:35:16,518 --> 03:35:19,854 TO REMOVE A CRITICAL PROTEIN IN 5507 03:35:19,854 --> 03:35:25,627 ALZHEIMER'S DISEASE CALLED TAU, 5508 03:35:25,627 --> 03:35:27,962 A PROJECT CALLED AUTOTAC, HIGH 5509 03:35:27,962 --> 03:35:29,097 RISK, BUT AMAZINGLY HIGH REWARD 5510 03:35:29,097 --> 03:35:30,999 IF IT HAPPENS TO WORK. 5511 03:35:30,999 --> 03:35:32,701 THESE WERE MEANT TO GIVE AN IDEA 5512 03:35:32,701 --> 03:35:34,536 WHAT WE'VE BEEN DOING ON BASIC 5513 03:35:34,536 --> 03:35:36,404 AND EARLY TRANSLATIONAL PROGRAM, 5514 03:35:36,404 --> 03:35:38,606 TAKING ON THINGS HIGH RISK, 5515 03:35:38,606 --> 03:35:39,574 CREATING RESOURCES, DOING 5516 03:35:39,574 --> 03:35:42,944 LONG-TERM PROJECTS, MAKING SURE 5517 03:35:42,944 --> 03:35:45,046 THAT THE RESEARCH ENDEAVOR IS 5518 03:35:45,046 --> 03:35:47,215 DIVERSIFIED, BRINGING IN NEW 5519 03:35:47,215 --> 03:35:49,651 TALENT, COLLABORATING WITH LOTS 5520 03:35:49,651 --> 03:35:55,423 OF PEOPLE, SHARING DATA. 5521 03:35:55,423 --> 03:35:56,725 WE'VE COME A LONG WAY, ONLY BEEN 5522 03:35:56,725 --> 03:35:58,026 OPEN A YEAR OR SO. 5523 03:35:58,026 --> 03:36:01,663 WE'RE NOW AT THE STAGE WE'RE 5524 03:36:01,663 --> 03:36:06,401 MAKING TRACTION ON CLINICAL AND 5525 03:36:06,401 --> 03:36:07,168 TRANSLATIONAL RESEARCH PROGRAM. 5526 03:36:07,168 --> 03:36:09,304 MANY OF THE FACETS AND 5527 03:36:09,304 --> 03:36:11,940 PHILOSOPHY OF THE BASIC PROGRAM 5528 03:36:11,940 --> 03:36:14,042 WILL CARRY OVER TO CLINICAL AND 5529 03:36:14,042 --> 03:36:15,944 TRANSLATION RESEARCH PROGRAM. 5530 03:36:15,944 --> 03:36:18,079 I HOPE THESE WILL NOT BE AS 5531 03:36:18,079 --> 03:36:21,015 SEPARATE AS THEY APPEAR ON THIS 5532 03:36:21,015 --> 03:36:23,118 DIAGRAM. 5533 03:36:23,118 --> 03:36:24,085 NEXT SLIDE PLEASE. 5534 03:36:24,085 --> 03:36:25,620 SO, OUR BROAD VISION AND THE 5535 03:36:25,620 --> 03:36:27,055 VISION WILL CHANGE AS WE 5536 03:36:27,055 --> 03:36:30,225 IDENTIFY SOMEONE TO COME ON AND 5537 03:36:30,225 --> 03:36:32,660 LEAD THIS PROGRAM IS AROUND 5538 03:36:32,660 --> 03:36:35,196 THESE FOUR ANCHORS OF RESEARCH 5539 03:36:35,196 --> 03:36:37,031 WITHIN CARD. 5540 03:36:37,031 --> 03:36:38,600 THEY ALL LEAD US TOWARDS THE 5541 03:36:38,600 --> 03:36:39,667 RIGHT PATIENT, THE RIGHT 5542 03:36:39,667 --> 03:36:41,302 THERAPY, TO GET THE RIGHT TIME. 5543 03:36:41,302 --> 03:36:43,705 THIS IDEA OF PRECISION. 5544 03:36:43,705 --> 03:36:46,374 EVERYTHING WE'RE GOING REALLY 5545 03:36:46,374 --> 03:36:47,675 CULMINATES IN THE CLINICAL 5546 03:36:47,675 --> 03:36:49,277 RESEARCH ENDEAVOR WE'RE TRYING 5547 03:36:49,277 --> 03:36:51,946 TO CREATE. 5548 03:36:51,946 --> 03:36:55,416 NEXT SLIDE PLEASE. 5549 03:36:55,416 --> 03:36:58,953 SO, OUR INTENTION IS TO REALLY 5550 03:36:58,953 --> 03:37:03,858 INVEST HEAVILY IN PRECISION 5551 03:37:03,858 --> 03:37:04,726 THERAPEUTICS. 5552 03:37:04,726 --> 03:37:05,560 THERE ARE GREAT TARGETS OUT 5553 03:37:05,560 --> 03:37:06,461 THERE. 5554 03:37:06,461 --> 03:37:11,833 NIH HAS A STORIED HISTORY IN 5555 03:37:11,833 --> 03:37:14,335 GENETICS-BASED THERAPEUTICS. 5556 03:37:14,335 --> 03:37:16,271 THERE'S NEAT TECHNOLOGIES, 5557 03:37:16,271 --> 03:37:18,973 ASOs, CRISPR, ENJOYING EARLY 5558 03:37:18,973 --> 03:37:20,074 SUCCESS IN NEURODEGENERATIVE 5559 03:37:20,074 --> 03:37:20,608 DISEASES. 5560 03:37:20,608 --> 03:37:23,111 AND AGAIN COMING BACK TO THIS 5561 03:37:23,111 --> 03:37:26,114 IDEA OF ADVANTAGES OF INTRAMURAL 5562 03:37:26,114 --> 03:37:29,117 RESEARCH PROGRAM, NUMBER ONE 5563 03:37:29,117 --> 03:37:32,554 ADVANTAGE, THE CLINICAL CENTER 5564 03:37:32,554 --> 03:37:34,989 WHERE PEOPLE COME FROM ALL OVER 5565 03:37:34,989 --> 03:37:36,558 THE WORLD TO WORK WITH EXPERTS 5566 03:37:36,558 --> 03:37:37,559 IN THIS SPACE. 5567 03:37:37,559 --> 03:37:41,062 WE HAVE A SPACE WHERE WE CAN 5568 03:37:41,062 --> 03:37:43,398 BRING PATIENTS IN, WE HAVE GREAT 5569 03:37:43,398 --> 03:37:44,632 CLINICAL AND HOSPITAL 5570 03:37:44,632 --> 03:37:47,001 INFRASTRUCTURE, THERE'S ALREADY 5571 03:37:47,001 --> 03:37:47,669 EXISTING INFRASTRUCTURE WITH 5572 03:37:47,669 --> 03:37:48,036 NINDS. 5573 03:37:48,036 --> 03:37:50,672 WE HAVE A LOT OF HISTORY AND 5574 03:37:50,672 --> 03:37:52,941 EXPERIENCE IN GENOMIC MEDICINE. 5575 03:37:52,941 --> 03:37:55,009 AND WE HAVE RESOURCES AVAILABLE 5576 03:37:55,009 --> 03:37:56,611 TO REALLY MOVE QUICKLY HERE SO 5577 03:37:56,611 --> 03:37:59,013 WE CAN BE QUICK AND WE CAN BE 5578 03:37:59,013 --> 03:37:59,981 EQUITABLE. 5579 03:37:59,981 --> 03:38:01,382 AS I SHOWED ON THE PREVIOUS 5580 03:38:01,382 --> 03:38:03,084 SLIDE, ALL OF THIS LINKS, THIS 5581 03:38:03,084 --> 03:38:04,619 IS REALLY THE CULMINATION OF ALL 5582 03:38:04,619 --> 03:38:07,622 OF THE OTHER PARTS OF OUR 5583 03:38:07,622 --> 03:38:09,524 PROCESS WITHIN CARD. 5584 03:38:09,524 --> 03:38:10,425 NEXT SLIDE PLEASE. 5585 03:38:10,425 --> 03:38:12,360 SO THESE ARE THE THREE MAIN ARMS 5586 03:38:12,360 --> 03:38:14,028 OF WHAT WE'RE DOING, WHAT WE'RE 5587 03:38:14,028 --> 03:38:16,297 PLANNING ON DOING. 5588 03:38:16,297 --> 03:38:16,764 NATURAL HISTORY WORK, 5589 03:38:16,764 --> 03:38:18,299 TRANSLATIONAL WORK, TRIAL WORK. 5590 03:38:18,299 --> 03:38:20,168 I'LL GO INTO THESE IN A LITTLE 5591 03:38:20,168 --> 03:38:22,704 BIT MORE DETAIL ON THE NEXT 5592 03:38:22,704 --> 03:38:23,137 SLIDE. 5593 03:38:23,137 --> 03:38:24,973 NATURAL HISTORY WORK IS AROUND 5594 03:38:24,973 --> 03:38:27,475 DEEP PHENOTYPING OF ALZHEIMER'S 5595 03:38:27,475 --> 03:38:30,712 DISEASE AND ADRD-RELATED 5596 03:38:30,712 --> 03:38:30,979 PATIENTS. 5597 03:38:30,979 --> 03:38:34,449 BRINGING NEW PATIENTS, STUDYING 5598 03:38:34,449 --> 03:38:37,185 LONGITUDINALLY, THOSE WITH 5599 03:38:37,185 --> 03:38:39,420 SINGLE GENETIC DRIVER BUT MORE 5600 03:38:39,420 --> 03:38:41,256 TYPICAL DISEASE PATIENTS WHO 5601 03:38:41,256 --> 03:38:43,024 CARRY -- ARE MORE COMPLEX IN 5602 03:38:43,024 --> 03:38:44,158 NATURE. 5603 03:38:44,158 --> 03:38:45,560 WE'LL WORK WITH EXISTING EFFORTS 5604 03:38:45,560 --> 03:38:49,130 WITHIN THE INTRAMURAL PROGRAM 5605 03:38:49,130 --> 03:38:52,400 BUT ALSO OUTSIDE, AND 5606 03:38:52,400 --> 03:38:54,168 CHARACTERIZATION YOU WOULD 5607 03:38:54,168 --> 03:38:56,771 EXPECT, HISTORIES AND PHYSICALS, 5608 03:38:56,771 --> 03:38:57,405 NEUROPSYCH IMAGING, GENETICS, 5609 03:38:57,405 --> 03:38:59,974 BIOMARKER WORK. 5610 03:38:59,974 --> 03:39:01,643 NEXT SLIDE PLEASE. 5611 03:39:01,643 --> 03:39:03,511 TRANSLATIONAL OF COURSE I TALKED 5612 03:39:03,511 --> 03:39:05,880 ABOUT THIS ALREADY, DEVELOPING 5613 03:39:05,880 --> 03:39:07,615 AND DE-RISKING THERAPEUTICS. 5614 03:39:07,615 --> 03:39:11,252 SO LOOKING AT TARGET CAUSALITY, 5615 03:39:11,252 --> 03:39:16,257 TARGET ENGAGEMENT, DE-RISKING 5616 03:39:16,257 --> 03:39:20,128 THERAPIES BY USING iPSCs, 5617 03:39:20,128 --> 03:39:20,995 TRANSPLANTATION EFFORTS, 5618 03:39:20,995 --> 03:39:22,764 TOXICOLOGY, WE ALREADY HAVE A 5619 03:39:22,764 --> 03:39:25,700 GREAT BIOMARKER PROGRAM IN CARD 5620 03:39:25,700 --> 03:39:27,402 SO TIEING THAT WITH CLINICAL 5621 03:39:27,402 --> 03:39:29,103 PROGRAM WILL BE ABSOLUTELY KEY. 5622 03:39:29,103 --> 03:39:31,306 AGAIN, MUCH OF THIS WE MIGHT 5623 03:39:31,306 --> 03:39:32,407 OUTSOURCE. 5624 03:39:32,407 --> 03:39:35,643 AND LASTLY THE ULTIMATE ON THE 5625 03:39:35,643 --> 03:39:39,814 NEXT SLIDE IS OF COURSE EXECUTE 5626 03:39:39,814 --> 03:39:40,682 PRECISION THERAPEUTIC TRIALS 5627 03:39:40,682 --> 03:39:43,251 WITHIN THE CLINICAL CENTER. 5628 03:39:43,251 --> 03:39:46,020 SO TAKE THESE PATIENTS WE 5629 03:39:46,020 --> 03:39:47,655 RECRUITED, REGIONALLY, 5630 03:39:47,655 --> 03:39:48,356 NATIONALLY, SOMETIMES 5631 03:39:48,356 --> 03:39:50,491 INTERNATIONALLY FOR THE 5632 03:39:50,491 --> 03:39:52,860 PARTICULARLY RARE GENETIC FORMS, 5633 03:39:52,860 --> 03:39:54,462 START WITH WELL-DEFINED GENES 5634 03:39:54,462 --> 03:39:56,998 AND MECHANISMS AND THEN MOVE TO 5635 03:39:56,998 --> 03:39:57,565 MUCH, MUCH MORE COMPLEX 5636 03:39:57,565 --> 03:39:59,367 MECHANISMS AS WE BEGIN TO 5637 03:39:59,367 --> 03:40:01,169 UNDERSTAND THEM FROM THE BASIC 5638 03:40:01,169 --> 03:40:01,369 SIDE. 5639 03:40:01,369 --> 03:40:02,804 THERE ARE SOME TARGETS NOW READY 5640 03:40:02,804 --> 03:40:05,173 TO ROLL TO BE HONEST, SO I THINK 5641 03:40:05,173 --> 03:40:07,742 WE CAN REALLY GET A GREAT HEAD 5642 03:40:07,742 --> 03:40:10,044 START ON THIS. 5643 03:40:10,044 --> 03:40:11,145 NEXT SLIDE PLEASE. 5644 03:40:11,145 --> 03:40:13,481 WE'LL ALSO HAVE CHALLENGE 5645 03:40:13,481 --> 03:40:14,282 PROJECTS, THREE IDEAS THAT HAVE 5646 03:40:14,282 --> 03:40:15,316 COME IN. 5647 03:40:15,316 --> 03:40:17,051 I'VE TALKED ABOUT ONE, 5648 03:40:17,051 --> 03:40:18,219 UNDERSTANDING VARIANTS OF 5649 03:40:18,219 --> 03:40:20,989 UNKNOWN SIGNIFICANCE IN THE 5650 03:40:20,989 --> 03:40:21,823 MIDDLE. 5651 03:40:21,823 --> 03:40:23,858 THE OTHER IS DEVELOPING 5652 03:40:23,858 --> 03:40:25,126 CRISPR-BASED THERAPEUTICS AND 5653 03:40:25,126 --> 03:40:27,295 THEN WORKING WITH GROUPS IN THE 5654 03:40:27,295 --> 03:40:28,963 SPACE OF WEARABLES AND DIGITAL 5655 03:40:28,963 --> 03:40:29,364 HEALTH. 5656 03:40:29,364 --> 03:40:31,632 SO PASSIVE DATA COLLECTION. 5657 03:40:31,632 --> 03:40:33,201 WHAT CAN YOU GET FROM 5658 03:40:33,201 --> 03:40:37,805 INDIVIDUALS 24 HOURS A DAY, 7 5659 03:40:37,805 --> 03:40:40,408 DAYS A WEEK, USING WEARABLES OR 5660 03:40:40,408 --> 03:40:42,276 SENSING TECHNOLOGIES. 5661 03:40:42,276 --> 03:40:43,845 NEXT SLIDE PLEASE. 5662 03:40:43,845 --> 03:40:46,581 SO THIS FITS IN AGAIN THE IDEA 5663 03:40:46,581 --> 03:40:49,784 THAT THE BASIC AND CLINICALS ARE 5664 03:40:49,784 --> 03:40:50,585 ESSENTIALLY SEAMLESS, FITTING 5665 03:40:50,585 --> 03:40:55,656 REALLY WELL WITH EFFORTS WE'VE 5666 03:40:55,656 --> 03:40:58,326 GOT ONGOING, THIS iPSC 5667 03:40:58,326 --> 03:40:59,694 PROGRAM, FUNCTIONAL GENOMICS 5668 03:40:59,694 --> 03:41:01,429 EFFORTS TO UNDER MOLECULAR 5669 03:41:01,429 --> 03:41:07,068 BASIS, EFFORTS TO DEVELOP 5670 03:41:07,068 --> 03:41:07,735 BIOMARKERS, TDP43 PROGRAM, DATA 5671 03:41:07,735 --> 03:41:10,038 SCIENCE, THE GLUE THAT TIES US 5672 03:41:10,038 --> 03:41:10,705 TOGETHER. 5673 03:41:10,705 --> 03:41:12,640 WE ALL PRODUCE TONS OF DATA. 5674 03:41:12,640 --> 03:41:15,977 I EXACT THE SAME TO BE TRUE ON 5675 03:41:15,977 --> 03:41:18,146 CLINICAL SIDE, INCREDIBLE DATA 5676 03:41:18,146 --> 03:41:20,448 SCIENTISTS WHO TIE EVERY PROJECT 5677 03:41:20,448 --> 03:41:24,419 TOGETHER AND THEN UNDERLYING 5678 03:41:24,419 --> 03:41:27,255 CULTURE OF BEING COLLABORATIVE, 5679 03:41:27,255 --> 03:41:28,489 RIGOROUS, BEING TRANSPARENT. 5680 03:41:28,489 --> 03:41:30,291 REALLY THE ULTIMATE AIM HERE IS 5681 03:41:30,291 --> 03:41:33,394 FOR US TO MAKE -- BUILD A CLINIC 5682 03:41:33,394 --> 03:41:34,462 THAT'S THE DESTINATION MEDICAL 5683 03:41:34,462 --> 03:41:37,432 CENTER FOR PRECISION TRIALS AND 5684 03:41:37,432 --> 03:41:38,733 ALZHEIMER'S DISEASE AND ADRDs. 5685 03:41:38,733 --> 03:41:39,934 NEXT SLIDE PLEASE. 5686 03:41:39,934 --> 03:41:41,702 WE'VE BEEN WORKING WITH THE 5687 03:41:41,702 --> 03:41:43,438 CLINICAL CENTER FOR QUITE A TIME 5688 03:41:43,438 --> 03:41:49,043 NOW TO TRY TO IDENTIFY SPACE, 5689 03:41:49,043 --> 03:41:51,279 INCREDIBLY HELPFUL, I THINK WE 5690 03:41:51,279 --> 03:41:55,149 HAVE NOW ABOUT 9,000 SQUARE FEET 5691 03:41:55,149 --> 03:41:58,686 OF SPACE THAT WE CAN USE FOR THE 5692 03:41:58,686 --> 03:42:01,923 CARD CLINIC, WE ALREADY HAVE A 5693 03:42:01,923 --> 03:42:04,425 SPACE SUBDIVIDED OUT IN 5694 03:42:04,425 --> 03:42:07,662 COLLABORATION WITH NEI WHICH 5695 03:42:07,662 --> 03:42:08,796 SHOWS THIS IDEA OF COLLABORATIVE 5696 03:42:08,796 --> 03:42:11,833 SPIRIT, IT WILL BE FAIRLY BASIC, 5697 03:42:11,833 --> 03:42:13,301 GENERIC SPACE, SO AGAIN WE HAVE 5698 03:42:13,301 --> 03:42:14,702 THAT FLEXIBILITY I TALKED ABOUT 5699 03:42:14,702 --> 03:42:16,804 HOW WE CAN CHANGE THE LAB ON A 5700 03:42:16,804 --> 03:42:17,138 WHIM. 5701 03:42:17,138 --> 03:42:18,973 WE SHOULD BE ALSO ABLE TO ALTER 5702 03:42:18,973 --> 03:42:22,910 WHAT WE DO HERE FAIRLY EASILY SO 5703 03:42:22,910 --> 03:42:24,345 FAIRLY BASIC EXAM ROOMS, 5704 03:42:24,345 --> 03:42:26,214 PROCEDURE ROOMS FOR LPs, 5705 03:42:26,214 --> 03:42:27,515 THINGS LIKE THAT, CONFERENCE 5706 03:42:27,515 --> 03:42:28,649 ROOMS, OFFICES. 5707 03:42:28,649 --> 03:42:30,585 SO SPACE IS ONE THING THAT I 5708 03:42:30,585 --> 03:42:34,122 THINK WE HAVE GOOD TRACTION ON. 5709 03:42:34,122 --> 03:42:37,892 THE NEXT PIECE ON THE NEXT SLIDE 5710 03:42:37,892 --> 03:42:40,761 IS IDENTIFYING A LEADER. 5711 03:42:40,761 --> 03:42:44,899 SO, THE SEARCH IS ABOUT TO 5712 03:42:44,899 --> 03:42:46,501 RESTART FOR A LEADER, DIRECTOR 5713 03:42:46,501 --> 03:42:47,768 OF CLINICAL/TRANSLATIONAL 5714 03:42:47,768 --> 03:42:48,002 PROGRAM. 5715 03:42:48,002 --> 03:42:50,972 WE HAD AN EARLIER SEARCH BUT 5716 03:42:50,972 --> 03:42:52,773 DECIDED UNTIL WE SQUARED AWAY 5717 03:42:52,773 --> 03:42:54,275 SPACE AND RESOURCES IT WASN'T 5718 03:42:54,275 --> 03:42:55,176 FEASIBLE TO CONTINUE. 5719 03:42:55,176 --> 03:42:57,078 WE'VE DONE THAT AND FEEL 5720 03:42:57,078 --> 03:42:57,712 COMFORTABLE MOVING FORWARD 5721 03:42:57,712 --> 03:42:58,513 LOOKING FOR A DIRECTOR. 5722 03:42:58,513 --> 03:43:01,449 THIS HAS TO BE SOMEONE WITH A 5723 03:43:01,449 --> 03:43:07,188 TRACK RECORD IN AD/ADRD SPACE. 5724 03:43:07,188 --> 03:43:08,489 I THINK REALLY AS IMPORTANT AS 5725 03:43:08,489 --> 03:43:10,591 THAT IS SOMEONE THAT REALLY 5726 03:43:10,591 --> 03:43:12,793 UNDERSTANDS THE POTENTIAL OF HOW 5727 03:43:12,793 --> 03:43:16,330 SPECIAL THE IRP IS, AND JUST 5728 03:43:16,330 --> 03:43:18,065 WHAT THE POTENTIAL IS TO DO 5729 03:43:18,065 --> 03:43:19,667 THINGS HERE THAT'S DIFFERENT TO 5730 03:43:19,667 --> 03:43:21,369 THE OUTSIDE WORLD NOT TO COMPETE 5731 03:43:21,369 --> 03:43:25,506 WITH THEM BUT TO COMPLEMENT THAT 5732 03:43:25,506 --> 03:43:25,873 WORK. 5733 03:43:25,873 --> 03:43:27,074 LASTLY SOMEONE WHO CAN REALLY 5734 03:43:27,074 --> 03:43:29,410 COME UP WITH A VISION AND HAS 5735 03:43:29,410 --> 03:43:30,978 THE SKILLS NECESSARY TO 5736 03:43:30,978 --> 03:43:36,817 IMPLEMENT AND EXECUTE THAT 5737 03:43:36,817 --> 03:43:37,318 VISION. 5738 03:43:37,318 --> 03:43:40,621 WE'VE BUILT THIS BASIC PROGRAM. 5739 03:43:40,621 --> 03:43:43,257 WE'RE CONTINUING TO RECRUIT, 19 5740 03:43:43,257 --> 03:43:45,193 WORKING, ANOTHER 40 OR 50 TO 5741 03:43:45,193 --> 03:43:47,528 RECRUIT, A COUPLE YEARS BEHIND 5742 03:43:47,528 --> 03:43:48,629 THE CLINICAL PROGRAM BUT I'M 5743 03:43:48,629 --> 03:43:50,131 GRATEFUL FOR THE SUPPORT WE'VE 5744 03:43:50,131 --> 03:43:52,667 GOTTEN FROM THE CLINICAL CENTER 5745 03:43:52,667 --> 03:43:55,636 SO FAR AND EXCITED ABOUT THIS 5746 03:43:55,636 --> 03:43:57,171 PATH. 5747 03:43:57,171 --> 03:44:01,275 I WILL END THERE AND BE HAPPY TO 5748 03:44:01,275 --> 03:44:01,642 TAKE QUESTIONS. 5749 03:44:01,642 --> 03:44:04,612 >> THANK YOU. 5750 03:44:04,612 --> 03:44:06,681 ABSOLUTELY FASCINATING. 5751 03:44:06,681 --> 03:44:09,417 YOUR STRUCTURAL METHODOLOGY IS 5752 03:44:09,417 --> 03:44:13,454 VERY MUCH ARPA-H-ISH, IT SOUNDS, 5753 03:44:13,454 --> 03:44:14,255 CREATING NETWORKS. 5754 03:44:14,255 --> 03:44:19,627 WHILE OUTCOMES AND DELIVERABLES 5755 03:44:19,627 --> 03:44:25,132 IS PRE-VISION IS -- PRECISION 5756 03:44:25,132 --> 03:44:27,702 AND SPEED, HOW DO YOU SHARE THE 5757 03:44:27,702 --> 03:44:28,769 SAME LEVEL OF URGENCY AND SPEED 5758 03:44:28,769 --> 03:44:34,542 TO GET TO THESE OUTCOMES? 5759 03:44:34,542 --> 03:44:38,279 >> YEAH, THERE'S CERTAINLY A 5760 03:44:38,279 --> 03:44:38,679 SENSE OF URGENCY. 5761 03:44:38,679 --> 03:44:40,448 I THINK ONE OF THE PIECES OF 5762 03:44:40,448 --> 03:44:43,150 ADVICE WE WERE GIVEN REALLY 5763 03:44:43,150 --> 03:44:46,187 EARLY ON WAS GET SOME QUICK 5764 03:44:46,187 --> 03:44:48,022 WINS, AND I REALLY RESISTED THAT 5765 03:44:48,022 --> 03:44:48,889 PIECE OF ADVICE. 5766 03:44:48,889 --> 03:44:50,358 I STILL TRY AND RESIST THAT 5767 03:44:50,358 --> 03:44:53,227 PIECE OF ADVICE, TO BE HONEST, 5768 03:44:53,227 --> 03:44:54,829 BECAUSE I WOULD RATHER BUILD 5769 03:44:54,829 --> 03:44:57,898 SOMETHING SUBSTANNIVE AND 5770 03:44:57,898 --> 03:44:59,834 SUCCESSFUL RATHER THAN GRAB A 5771 03:44:59,834 --> 03:45:01,002 QUICK VICTORY ANYBODY ELSE COULD 5772 03:45:01,002 --> 03:45:03,571 HAVE DONE. 5773 03:45:03,571 --> 03:45:10,945 WE HAVE SPEED AND URGENCY BUT 5774 03:45:10,945 --> 03:45:12,413 FOCUS ON PATH AND MISSION TO 5775 03:45:12,413 --> 03:45:14,482 ACHIEVE THAT. 5776 03:45:14,482 --> 03:45:16,984 EVERY PRESENTATION IN CARD 5777 03:45:16,984 --> 03:45:18,619 STARTS WITH HOW DOES THIS FIT 5778 03:45:18,619 --> 03:45:20,154 OUR MISSION, HOW DOES THIS FIT 5779 03:45:20,154 --> 03:45:22,957 THE GENERAL MISSION OF NIA AND 5780 03:45:22,957 --> 03:45:23,958 ADRD MILESTONES, WHY SHOULD WE 5781 03:45:23,958 --> 03:45:25,293 BE DOING IT HERE, CAN ANYONE 5782 03:45:25,293 --> 03:45:28,896 ELSE DO IT BETTER THAN US? 5783 03:45:28,896 --> 03:45:31,966 I THINK THAT HELPS KEEP US 5784 03:45:31,966 --> 03:45:32,199 FOCUSED. 5785 03:45:32,199 --> 03:45:33,768 >> THANK YOU. 5786 03:45:33,768 --> 03:45:36,470 ANY QUESTIONS? 5787 03:45:36,470 --> 03:45:38,639 CAN WE SEE THE -- IF ANYONE IN 5788 03:45:38,639 --> 03:45:43,678 ZOOMLAND HAS QUESTIONS? 5789 03:45:43,678 --> 03:45:43,944 5790 03:45:43,944 --> 03:45:45,146 ALL RIGHT. 5791 03:45:45,146 --> 03:45:48,482 >> AT THE RISK OF ECHOING WHAT 5792 03:45:48,482 --> 03:45:52,219 YOU SAID, I WOULD SAY HASHTAG 5793 03:45:52,219 --> 03:45:52,486 #HURRY UP. 5794 03:45:52,486 --> 03:45:54,622 >> YEAH, YEAH. 5795 03:45:54,622 --> 03:45:55,523 WE'RE NOT -- YEAH, WE'RE 5796 03:45:55,523 --> 03:45:59,593 DEFINITELY TRYING. 5797 03:45:59,593 --> 03:46:00,094 WE'RE DEFINITELY TRYING. 5798 03:46:00,094 --> 03:46:02,563 >> THANK YOU VERY MUCH. 5799 03:46:02,563 --> 03:46:05,232 FABULOUS, WISH YOU THE BEST OF 5800 03:46:05,232 --> 03:46:05,433 LUCK. 5801 03:46:05,433 --> 03:46:06,801 >> THANK YOU SO MUCH. 5802 03:46:06,801 --> 03:46:11,072 >> AND LOOK FORWARD TO UPDATES 5803 03:46:11,072 --> 03:46:12,239 IN A FUTURE MEETING. 5804 03:46:12,239 --> 03:46:13,140 OKAY. 5805 03:46:13,140 --> 03:46:17,845 WE HAVE A FEW MINUTES. 5806 03:46:17,845 --> 03:46:19,146 ANY QUESTIONS OR DISCUSSION, 5807 03:46:19,146 --> 03:46:19,413 ANYTHING? 5808 03:46:19,413 --> 03:46:20,815 NEW BUSINESS ANYONE WANTS TO 5809 03:46:20,815 --> 03:46:23,718 BRING UP BEFORE THE BOARD? 5810 03:46:23,718 --> 03:46:27,088 IF NOT, LET ME GIVE YOU CLOSING 5811 03:46:27,088 --> 03:46:27,788 REMARKS. 5812 03:46:27,788 --> 03:46:29,590 THIS IS A GREAT MEETING, LOTS OF 5813 03:46:29,590 --> 03:46:31,425 EXCITING STUFF THAT'S GOING ON, 5814 03:46:31,425 --> 03:46:32,426 LOTS OF GREAT UPDATES. 5815 03:46:32,426 --> 03:46:33,828 THANK YOU VERY MUCH AND THANKS 5816 03:46:33,828 --> 03:46:34,762 TO ALL THE PRESENTERS AND 5817 03:46:34,762 --> 03:46:35,730 EVERYBODY WHO HAS BEEN HERE 5818 03:46:35,730 --> 03:46:37,665 TODAY FOR THIS. 5819 03:46:37,665 --> 03:46:40,000 WE APPRECIATE IT. 5820 03:46:40,000 --> 03:46:41,001 OUR 2024 MEETING DATES, YOU 5821 03:46:41,001 --> 03:46:43,871 SHOULD HAVE THEM ON YOUR 5822 03:46:43,871 --> 03:46:47,508 CALENDARS ALREADY, FEBRUARY 16, 5823 03:46:47,508 --> 03:46:49,043 JUNE 21, OCTOBER 18. 5824 03:46:49,043 --> 03:46:50,144 SO, IT IS FALL. 5825 03:46:50,144 --> 03:46:52,780 WINTER IS ON THE WAY. 5826 03:46:52,780 --> 03:46:54,749 CHRISTMAS HOLIDAYS AND NEW 5827 03:46:54,749 --> 03:46:56,484 YEAR'S WILL BE HERE BEFORE WE 5828 03:46:56,484 --> 03:46:59,887 MET AGAIN. 5829 03:46:59,887 --> 03:47:01,188 WE LOOK FORWARD TO SEEING 5830 03:47:01,188 --> 03:47:02,590 EVERYONE IN FEBRUARY. THERE IS 5831 03:47:02,590 --> 03:47:04,392 NO OTHER DISCUSSION, THEN THIS 5832 03:47:04,392 --> 03:47:05,092 MEETING STANDS ADJOURNED. 5833 03:47:05,092 --> 03:47:08,028 THANK YOU ALL VERY MUCH AND GOD 5834 03:47:08,028 --> 03:47:08,396 BLESS EVERYONE. 5835 03:47:08,396 --> 03:47:18,396 [END OF PROGRAM]