>> WELL, HI, EVERYONE.
I'M HELENE LANG EVIN, DIRECTOR
OF THE NCCIH, AND RESEARCH
COORDINATOR FOR THE MEETING AND
IT'S MY PLEASURE TO OPEN THIS
MEETING AND I WANT TO FIRST OF
ALL THANK YOU ALL FOR JOINING US
VIRTUALLY AND I WANT TO AT
FIRST, GIVE YOU A SENSE OF
WHO'S--WHERE WE ARE IN OUR--IN
THE PROCESS OF APPOINTING NEW
MEMBERS, AS YOU KNOW, 1 OF THE
VERY VERY IMPORTANT ROLES OF
THIS COMMITTEE IS TO COORDINATE,
THE RESEARCH ACROSS FEDERAL
AGENCIES AND FOR THAT, WE WANT
TO MAKE SURE WE HAVE INPUT FROM
RESEARCHERS, FROM CLINICIANS,
FROM PAIN ADVOCACY GROUPS, ET
CETERA, SO WE SPENT A LOT OF
TIME REALLY MAKING SURE THAT WE
GET THE RIGHT EXPERTISE IN THIS
GROUP AND AT THE SAME TIME WE
HAVE TO DEAL WITH THE REALITIES
OF A MOVING--WHAT WE CALL OUR
SLATE OF APPOINTEES THROUGH THE
DIFFERENT STAGES OF APPROVEMENT
IN THE FEDERAL GOVERNMENT AND
THAT TAKES TIME.
AND SO THOSE WHO ARE ALREADY
FAMILIAR WITH THIS PROCESS KNOW
IT IS DEFINITELY A PROCESS THAT
CAN BE, YOU KNOW, LENGTHY AND
SO, BUT WE ARE HAPPY WITH THE
PROGRESS WE'VE MADE SO FOR.
SO WHEN I WANT TO JUST GIVE YOU
A QUICK SNAPSHOT OF THE STATUS
OF THE MEMBERS OF IPRCC WHO'S
COMING, WHO'S GOING, ET CETERA
AND WHERE WE ARE RIGHT NOW.
SO CURRENTLY, WHAT'S GOING ON IS
THAT WE HAVE--EVERY YEAR WE HAVE
TO SUBMIT A SLATE OF NOMINEES
FOR APPROVAL.
AND SO OUR SLATE OF NOMINEES FOR
FISCAL YEAR 2023 AND 2024 ARE
CURRENTLY BEING APPROVED BY THE
DEPARTMENT OF HEALTH AND HUMAN
SERVICES SIMULTANEOUSLY.
AND SO THEY SHOULD BE--HOPEFULLY
THEY WILL APPROVED TOGETHER BUT
WE HAVE NOT GOTTEN ANY RECENT
UPDATES ON THAT.
SO RIGHT NOW THEY'RE BOTH KIND
OF FOLLOWING A SIMILAR TRACK.
AND SO, WE WANT TO--AS A
CONSEQUENCE OF THIS, WE HAVE
ASKED MEMBERS WHOSE TERMS HAVE
BEEN EXTENDED DUE TO THIS DELAY
SO THESE ARE BETH WITH STANFORD
UNIVERSITY, DR. RODRIGUEZ
CHAIRMAN OF THE [INDISCERNIBLE]
ASSOCIATION, DR. YOUNG BRIGHAM
WOMEN'S RESEARCH GROUP AND
PROFESSOR OF ANESTHESIA AT
HARREGARD MEDICAL SCHOOL AND
MAGGIE BUCKLEY, BOARD OF
DIRECTORS OF THE PAIN COMMUNITY.
WE WANT TO SINCERELY THANK ALL
THESE INDIVIDUALS FOR AGREES TO
EXTEND THEIR TERMS.
NOW WE ALSO HAVE IN OUR CURRENT
FEDERAL MEMBERS, SO WE HAVE
DR. WALTER KOROSHETZ, WHO WILL
JOIN THE MEETING LATE.
HE HAD A COMMITMENT DOWN TOWN
TODAY.
ELIAISONS BETH KATO, AHRQ, AND
SO WE'RE VERY, VERY PLEASED TO
HAVE THOSE MEMBERS.
ALSO WE HAVE EXOFFICIO MEMBERS
FROM NIH, RENA DE'SOUZA,
DIRECTOR OF NATIONAL INSTITUTE
OF CRANIOFACIAL AND DENTAL
INSTITUTE, DIRECTOR OF THE
NATIONAL INSTITUTE OF NURSING
RESEARCH.
NOW GOING BACK TO 2022 THAT
SLATE OF NOMINEES HAS BEEN
APPROVED AND THE FOLLOWING
MEMBERS WILL BE OFFICIAL AS OF
JANUARY 2024.
IF THIS SOUNDS CONFUSING, YOU'RE
IN GOOD COMPANY.
SO--WE WOULD LIKE TO GIVE THESE
MEMBERS AN OPPORTUNITY TO
INTRODUCE THEMSELVES AND JUST
SAY A FEW WORDS ABOUT THEIR
AREAS OF INTEREST.
SO I'M JUST GOING TO LIST WHO
THEY ARE AND THEN I WILL GIVE
EACH AN OPPORTUNITY TO SAY A
WORD.
SO FIRST, THEY ARE MEMBERS OF
THE--REPRESENTING PAIN ADVOCACY
GROUPS, WE HAVE KATE NICHOLSON,
FOUNDER AND PRESIDENT OF THE
NATIONAL PAIB AND ADVOCACY
CENTER.
MONICA [INDISCERNIBLE] THE D. E.
O. OF THE SLEEP APNEA PARTNERS
REPRESENTING HEALTHY WOMEN.
PAUL ARMSTEIN RECOGNIZING THE
NURSES OF ACADEMY OF SLEEP AND
THEN PHYSICIANS OR RESEARCHERS
CAMERON BAKER, PROFESSOR
UNIVERSITY NORTH CAROLINA CHAPEL
HILL, SCOTT FISHMAN CHAIR AND
PAIN MS. YESTERDAY EVER
CALIFORNIA DAVIS.
AND THEN FUTURE THAT ARE--WHO'S
APPROVAL IS PENDING AND ARE NOW
EXOFFICIO, CHRISTOPHER
[INDISCERNIBLE] REPRESENTING THE
DEPARTMENT OF DEFENSE, AND
CHRISTINA [INDISCERNIBLE]
REPRESENTING THE CENTER FOR
DISEASE CONTROL AND PREVENTION.
SO THAT'S QUITE A LIST AS YOU
CAN SEE SO I WILL GO BACK NOW TO
THOSE--THOSE MEMBERS, NEW
MEMBERS, FROM THE 2022 SLATE AND
THEY WILL START WITH KATE
NICHOLSON.
DO YOU WANT TO SAY HELLO KATE?
INTRODUCE YOURSELF?
>> SURE.
HI, EVERYONE.
MY NAME IS KATE AS MENTIONED I
UPON REPRESENTING THE NATIONAL
PAN ADVOCACY CENTER WHICH
ADVOCATES FOR THE HEALTH AND
HUMAN RIGHTS OF PEOPLE LIVING
WITH BANE, WE'RE PARTICULARLY
INTERESTED IN INSURE AG
EQUITABLE AND EFFECTIVE PAIN
CARE.
I AM ALSO A PERSON WITH LIVED
EXPERIENCE OF PAIN AND ALTHOUGH
OUR GROUP IS A COALITION OF
SCIENTISTS AND CLINICIANS AND
PUBLIC HEALTH EXPERTS, WE ARE
RUN BY AND FOR PEOPLE WITH LIVED
EXPERIENCE OF PAIN.
VERY HAPPY TO BE HERE.
>> I HAVE TO KEEP MUTING AND
UNMUTING MYSELF.
THANK YOU SO MUCH AND YOU POINT
OUT THE ABSOLUTE VITAL ROLE OF
PEOPLE WHO HAVE LIVED EXPERIENCE
OF PAIN AND WE HAVE--THIS IS SO
IMPORTANT TO US.
SO THANK YOU VERY, VERY MUCH FOR
SERVING THAT ERROR IMPORTANT
ROLE.
MONICA MALLAMP A LLI.
>> GOOD MORNING, I AM A TRAINED
BIOMEDICAL SCIENTIST BUT HAVE
BEEN ADVOCATING FOR WOMEN'S
HEALTH FOR THE PAST 15 YEARS.
LOOKING AT EVERYTHING FROM THE
SEX AND GENDER ANGLE SO I'M HERE
REPRESENTING HEALTHY WOMEN
TODAY.
I BROUGHT ATTENTION TO THE TOPIC
OF WOMEN AND CHRONIC PAIN, ABOUT
5 YEARS AGO AND HAVE DONE SOME
PROGRAMMING THERE AT HEALTHY
WOMEN.
FRANKLY I AM THE EXECUTIVE-
CURRENTLY, I AM THE EXECUTIVE
DIRECTOR OF SLEEP PART MERS, AND
WE'RE VERY INTERESTED IN THE
CONNECTION BETWEEN SLEEP AND
PAIN.
>> EXCELLENT.
SUCH IMPORTANT TOPICS.
PAUL A RNSTEIN.
WE'RE NOT HEARING YOU PAUL?
LET'S SEE.
MICROPHONE ISSUES?
WE CAN COME BACK TO YOU, I DON'T
KNOW IF YOU WANT TO TRY
REBOOTING ZOOM OR SOMETHING LIKE
THAT BECAUSE WE'RE NOT HEARING
YOU AT ALL.
OKAY, I WILL COME BACK TO YOU.
THEN WE HAVE--SO TAMARA BAKER.
>> GOOD MORNING EVERYONE.
TAMARA BAKER, HERE AT UNC CHAPEL
HILL, DEPARTMENT OF MEDICINE,
DEPARTMENT OF PSYCHIATRY.
MY AREA OF RESEARCH--
>> YOUR SOWBD IS COMING IN AND
OUT TAMARA.
I HOPE WE DON'T HAVE A SYSTEMIC
ISSUE?
>> I'M AT A HOTEL SO I'M NOT
SURE.
>> WELL, CARRY ON THEN.
>> YOU WERE JUST CUTTING OUT.
IN OKAY, I WILL MAKE IT BRIEF.
I FOCUS PRIMARILY ON OLDER BLACK
ADULTS AND ISSUES AROUND
INIQUITIES AND PAIN MANAGEMENT
DID YOU HEAR THAT PART?
WOORKS WE CERTAINLY DID, THANK
YOU SO MUCH.
>> NEXT IS RENE MANWORREN,.
>> GOOD MORNING MY FOCUS AND
PAIN PEDIATRIC MANAGE AM, I AM A
ASSOCIATE PROFESSOR AT
NORTHWESTERN SCHOOL OF MEDICINE
AND AS YOU SAID THE DIRECTOR OF
NURSING RESEARCH AND MEDICAL
PRACTICE AT THE HOSPITAL WHERE I
HAVE A PRACTICE AS AN ADVANCED
PRACTICING NURSE AND I'M ALSO
THE Ph.D. DIRECTOR FOR NURSING
SCIENCE AT THE UNIVERSITY OF
TEXAS @ARLINGTON, SO THOSE WHO
ARE PLAYING CLOSE ATTENTION,
YES, I COMMUTE EVERY WEEK,
852-MILES.
OKAY, WELL, ROUND TRIP WOULD BE
MORE THAN THAT.
NTHAT'S A LOT OF MILES.
ESPECIALLY DEDICATION, THANK YOU
VERY MUCH AND THANK YOU FOR
BEING HERE.
>> SCOTT FISHMAN.
>> REQUESTED MORNING EVERYONE,
I'M SCOTT FISHMAN, I'VE BEEN THE
CHIEF OF MAIN MEDICINE HERE AT
UC DAVIS FOR OVER A COUPLE
DECADES AND I HAVE RUN AN
INTERPROFESSIONAL OFFICE THAT WE
CALL THE CENTER FOR ADVANCING
PAIN RELIEF HERE, JUST ON
JULY 1, I RETIRED AND AM NOW A
DISTINGUISHED PROFESSOR EMERITUS
BUT I'M COMING BACK TO CONTINUE
TO RUN THESE 2 PAIN OFFICES.
THE NEW 1 IS THE OFFICE OF
WELLNESS, EDUCATION, SO I'M THE
ENDOWED CHAIR OF WELLNESS FOR
THE UNIVERSITY AND THIS WILL BE
MORE OF A PART-TIME POSITION BUT
1 THAT I'M VERY PASSIONATE ABOUT
WHERE WE'VE BEEN HOLDING
SEMINARS ON PAIN AND WELLNESS
AND WE'RE HOLDING 1 IN AMSTERDAM
AT THE WORLD CONGRESS AND TRYING
TO RAISE AWARENESS ABOUT PAIN
PREVENTION WHICH HAS BEEN A NEW
PASSION OF MINE.
I'M GLAD TO BE HERE, THANK YOU.
>> THANK YOU.
THANK YOU VERY MUCH FOR YOUR
VERY IMPORTANT INPUT.
THANK YOU.
AND DR. --OKAY, SO NOW IS THE
DOCTOR HERE?
>> YES, I'M ONLINE, HAPPY TO BE
HERE TODAY, I'M CHRIS
[INDISCERNIBLE] I'M WITH THE
MILITARY PROGRAM HERE AT WALTER
REID, OUR AREAS OF INTEREST ARE
ACTIVE DUTY MEMBERS AND THE
BENEFICIARIES.
SO HAPPY TO PARTICIPATE.
>> EXCELLENT.
THANK YOU VERY MUCH.
AND CHRISTINA [INDISCERNIBLE]?
>> I DON'T SEE HER YET.
>> OKAY, LET'S SEE IF WE CAN GO
BACK TO PAUL, HOW'S IT GOING
NOW?
>> HI, CAN YOU HEAR ME NOW?
>> OH, GREAT.
WELL, THANK YOU VERY MUCH.
IT'S A PLEASURE BEING HERE.
I'VE BEEN AN ADVANCED PRACTICE
NURSE, TRAINED AS A NURSE
PRACTITIONER SPECIALIZING IN
DIFFERENT TYPES OF PAIN FROM
ACUTE PAIN TO CHRONIC PAIN TO
CANCER PAIN AND ACROSS MY CAREER
I WORKED IN REMOTE AREAS OF THE
SOUTHWEST IN UTAH ALL THE WAY TO
MASS GENERAL HOSPITAL FOR THE
LAST 16 YEARS OF MY CAREER.
I RECENTLY RETIRED FROM CLINICAL
PRACTICE AND I'M AN ADJUNCT
PROFESSOR AT MASS GENERAL
HOSPITAL OF INSTITUTE OF HEALTH
PROFESSIONS AND DOING
INDEPENDENT EDUCATION,
CONSULTING AND RESEARCH WORK.
SO THANK YOU VERY MUCH FOR
HAVING ME.
>> WE MAY WANT TO ACKNOWLEDGE
THE WORK OF DR. PORTER'S OFFICE
WHO PUT SO MUCH EFFORT INTO
REALLY MAKING SURE THAT OUR
SLATE OF REPRESENTATIVES ON THIS
COMMITTEE STAYS, VIBRANT AND YOU
KNOW GET ALL THIS INPUT THAT WE
SO NEED.
AND SO THANK YOU SO MUCH FOR
KEEPING THIS GOING.
SO I GUESS, NOW, IT'S TIME IF
YOU GO TO LINDA WHO IS COMING TO
US FROM WYOMING, I THINK?
NYEAH.
>> I MAY NEVER COME BACK.
>> TAKING TIME OFF FOR A
VACATION.
>> A LITTLE BIT OF WORK, A
LITTLE BIT OF PLAY.
THANK YOU.
SO WHAT WE HAVE TO DO AS A
COMMITTEE IS TO VOTE THE MINUTES
FROM THE PRIOR MEETINGS AND
THAT'S BECAUSE YOU'RE AN
OFFICIAL CONGRESSALLY MANDATED
COMMITTEE AND THOSE MINUTES ARE
PART OF OUR RECORDS IF YOU WILL,
SO LEA [INDISCERNIBLE] SENT THEM
OUT EARLIER, WE HOPE EVERYBODY
HAD A CHANCE TO READ THEM.
THEY WERE FROM LAST FALL, I
DON'T REMEMBER IF WE MET IN
OCTOBER OR NOVEMBER BUT IT WAS
IN THAT TIME FRAME AND FOR THOSE
WHO ARE NOW OFFICIAL MEMBERS,
YOU CAN VOTE.
THOSE OF YOU WHO ARE EXOFFICIO,
WE WOULD APPRECIATE ANY COMMENTS
YOU HAVE ON THE MINUTES IF YOU
LISTENED IN OR ANYTHING THAT YOU
READ IN THEM BUT WE CAN'T TAKE
YOUR OFFICIAL VOTE YET UNTIL YOU
ARE OFFICIALLY APPROVED AND AS
HELENE, THAT PROCESS IS RATHER
SLOW.
SOPHISTICATED I WOULD LIKE TO
TAKE A QUICK CHECK, DOES ANYBODY
NEED MORE TIME TO LOOK AT THEM,
LIKE A MINUTE OR 2 NOW OR CAN WE
GO AHEAD AND TAKE THE VOTE ON IT
IN?
I DON'T SEE ANY HANDS RAISED, SO
THE EASIEST WAY TO--TYPICALLY TO
DO THIS--IS TO SOMEONE IN THE
GROUP WHO'S OFFICIAL HAS TO MAKE
A MOTION TO APPROVE THE MINUTES
OR UPDATE THE MINUTES OR NOT
APPROVE THEM.
SO WHAT I WILL ASK IS DOES
ANYONE HAVE ANY REVISIONS THAT
NEED TO GO INTO THE MINUES?
IF SO IF YOU COULD LET US KNOW
NOW IN THE CHAT?
AND THEN IF ANYBODY IS WILLING,
I SEE SCOTT HAS MADE THE MOVE TO
APPROVE.
BETH HAS MADE I GUESS I WILL
CALL THAT A SECOND MOVE SO IF
YOU REST OF YOU WOULD PUT IN THE
CHAT WHETHER YOU APPROVE OR NOT,
WE WOULD NEED A QUORUM TO MOVE
THEM FORWARD.
IF YOU CAN'T GET AT THE CHAT,
THEN YOU COULD JUST RAISE YOUR
HAND RIGHT NOW AND LET ME KNOW.
IT LOOKS LIKE EVERYBODY IS GOING
IN.
ALL RIGHT, THANK YOU VERY MUCH
FOR THAT.
WE WILL GET THEM SIGNED, SEALED
AND PUT ON THE WEBSITE.
THANKS A LOT.
BACK TO YOU HELENE.
>> ALL RIGHT.
THANK YOU SO MUCH LINDA, SO THE
NEXT ITEM ON OUR AGENDA IS AN
UPDATE FROM THE FEDERAL PAIN
RESEARCH STRATEGY PORTFOLIO
ANALYSIS AND ANTHONY
DOMENICHIELLO WILL GIVE US THAT
UPDATE.
SO ANTHONY, TAKE IT AWAY.
>> ALL RIGHT EVERYONE, I WILL
JUST SHARE MY SCREEN.
ALL RIGHT, SO I TALKED TO THIS
GROUP PREVIOUSLY ABOUT THE
FEDERAL PAIN RESEARCH STRATEGY
ANALYSIS THAT WE'RE TRYING TO
UNDERTAKE OVER HERE AND I GUESS
BY THE TITLE OF THE SLIDE, YOU
MIGHT BE ABLE TO DEDUCE THAT
WE'VE MOVED ON TO A MACHINE
LEARNING APPROACH, SO TODAY I
WILL UPDATE EVERYONE ON WHERE
WE'RE AT WITH THAT AND GIVE A
LITTLE BIT OF BACKGROUNDOT
FEDERAL PAIN RESEARCH STRATEGY.
SO I HAVE THIS HERE MORE FOR
HOUSEKEEPING SO I WILL QUICKLY
GO THROUGH IT.
ESSENTIALLY THE FEDERAL PAIN
RESEARCH STRATEGY DATES BACK TO
THE AFFORDABLE CARE ACT WHERE
THE SECRETARY WAS DIRECTED TO
CONVENE THE IOM CONFERENCE AND
ESTABLISH THE IPRCC.
THE IPRCC OVERSAW THE CREATION
OF THE NATIONAL PAIN STRATEGY
AND THE IP--AND THE FEDERAL PAIN
RESEARCH STRATEGIES IS A
COMPANION TO THE NATIONAL PAIN
RESEARCH--NATIONAL PAIN STRATEGY
ESSENTIALLY, COMPLETE THE
RESEARCH ASPECT OF THE NATIONAL
PAIN STRATEGY.
WHAT THE FEDERAL PAIN RESEARCH
STRATEGY DOES IS IDENTIFY
CRITICAL GAPS AND BASIC CLINICAL
PAIN RESEARCH AND MAKES
RECOMMENDATIONS TO FEDERAL
AGENCIES TO AVOID DUPLICATION OF
EFFORT AND REAL QUICK HERE ARE
THE TOP PRIORITIES THAT WERE
RECOMMENDED IN THE FEDERAL PAIN
RESEARCH STRATEGY.
THESE WERE--THESE WERE VOTED BY
THE GROUP IN THE HIGHEST QUAR
TILE SO THEY WERE ASSIGNED AS
THE TOP PRIORITIES SO START
NOTHING 2022, LINDA PRESENTED TO
THE IPRCC A HIGH LEVEL ANALYSIS
THAT HE DID WHERE SHE MAPPED UP
HEAL PROGRAMS AND INDICATED
WHICH FEDERAL PAIN STRATEGY
PRIORITY THEY WERE ADDRESSING
AND THE IPRCC REALLY LIKED THE
ANALYSIS AND THOUGHT THAT WE
SHOULD EXPAND IT AND EXPAND TO
ULTIMATELIA OF NETWORK IH AND
ALL OF FEDERAL GOVERNMENT.
SO I STARTED TRYING TO FIGURE
OUT HOW WE'RE GOING DO THAT AND
I PRESENTED A COUPLE TIMES TO
THIS GROUP AND THERE WAS A LOT
OF ENTHUSIASM FOR REALLY DOING
GRANT LEVEL DATA AND FIGURE OUT
WHICH GRANTS ARE ADDRESSING
WHICH PARTS FELT PRIORITIES, ARE
WE GETTING THEM ALL, DO WE NEED
NEW PRIORITIES, THAT KIND OF
STUFF, BUT WHEN WE PILOTED DOING
THIS MANUAL LEAVE WITH ICs, IT
DIDN'T SEEM FEASIBLE, THERE WAS
TOO MUCH HAPPENING, THERE WAS
NOT ENOUGH TIME TO REALLY GET IT
DONE AND THERE WERE TOO MANY
GRANTS TO GO THROUGH, EVEN TO
IDENTIFY WHICH ARE PAIN VERSUS
WHICH ARE NOT AND THIS WAS
RECOMMENDED WE MOVE ON TO A
MACHINE LEARNING APPROACH AND
THAT'S HOW WE ENDED UP IN
COLLABORATION WITH
[INDISCERNIBLE] AT THE MISH
NICKER SCHOOL OF UNIVERSITY AND
THEY ARE WORKING ON MAKING A
MACHINE LEARNING APPROACH THAT
WILL IDENTIFY WHICH FEDERALLY
FUNDED PAIN GRANTS ARE PAIN
GRANTS AND THEN THEY WILL
CLASSIFY THOSE GRANTS BASED ON
WHICH FPRS PRIORITY THEY ARE
ADDRESS XG THAT WILL BE ALL
AUTOMATED AND WE'RE REALLY
EXCITED ABOUT WHERE WE'RE GOING
WITH THAT AND I WILL PRESENT TO
YOU TODAY, WHERE WHERE WE ARE
WITH THAT.
SO THEIR PROBLEM IS THEY NEED TO
IDENTIFY WHICH OF THE 13
PRIORITIES ARE FUNDED BY NIH
GRANTS AND THEY WANT TO DO THAT
SINCE THE RELEASE OF THE FEDERAL
PAIN RESEARCH STRATEGY WE GAVE
THEM GRANT DATA DATING BACK TO
2018.
ONCE THEY GET THIS WORKING FOR
NIH, THEY WANT TO EXTEND IT TO
OTHER FEDERAL AGENCIES.
SO THE BROAD KIND OF TECHNIQUE
THEY'RE USING IS CALLED TOPIC
MODELS, ESSENTIALLY TOPIC
MODELING IS USUALLY UNSUPER
VISED, ORIGINALLY UNSUPER VISED
AND IN THIS WAY, YOU CAN FEED
DATA TO YOUR MACHINE LEARNING
MODEL AND IT WAS ABLE TO ASSIGN
TOPICS TO GRANTS BASED ON WORDS
THAT ARE IN THE DIFFERENT GRANTS
AND THEN, IT'LL ASSIGN YOUR
GRANTS TO DIFFERENT TOPICS.
IT'S NICE WHEN YOU HAVE A SET OF
GRANTS THAT YOU KNOW WHICH
TOPICS THEY ARE AND THEY CAN BE
ASSIGNED TOO AND THEN THAT HELPS
YOU FOR EVALUATING THE MODEL AND
YOU CAN ALSO HELP TRAIN THE
MODEL.
I MIGHT USE THE WORD DOCK YOU
WANTS OR YOU MIGHT SEE IT IN THE
SLIDES, DOCUMENTS IN THIS CASE
ARE ALL IN MACHINE LEARNING OR
ALL OF THIS TEXT ANALYSIS WORK
REFERS TO THE ACTUAL LIKE TEXT
THAT YOU'RE ANALYZING SO IN THIS
CASE, IT'S GOING TO BE PUBLIC
ABSTRACTS AND IMRANTS FUNDED BY
NIH, THE GOAL IS EVENTUALLY TO
BE USING GRANTS FROM OTHER
AGENCIES OR EVEN MORE INFO
FROM--INTEGRATION THE GRANTS, SO
SPECIFIC AIMS, HOWEVER THERE ARE
CHALLENGES WE'VE BEEN NAVIGATING
THE CHALLENGES OF GETTING ACCESS
TO THAT OTHER INFORMATION SINCE
IT'S MORE RESTRICTED.
AND THEN IF I USE THE WORD
TOPICS OR SEE TOPICS IN THE
SLIDES THEY'RE JUST REFERRING TO
THE 13 FPRS TOP PRIORITIES.
SO THE MACHINE LEARNING
TECHNIQUE THAT THEY'RE USING IS
CALLED LATENT LDA, OR I'M NOT AN
EXPERT IN THIS PART, I CAN
ANSWER MORE QUESTIONS AFTER, SO
I GIVE YOU A HIGH LEVEL, MY
UNDERSTANDING OF THIS.
ESSENTIALLY WHAT LDA DOES IS IT
IDENTIFIES TOPICS AND TELLS YOU
THE PROBABILITY THAT THIS
CURRENT GRANT IS A MEMBER OF
THAT TOPIC, BASED ON THE WORDS
THAT ARE IN THAT GRANT.
NOW WHAT MICHIGAN IS DOING IS
CALLED SEEDED LDA, THAT'S WHEN
YOU TELL THE MACHINE THAT HERE
ARE THE TOPICS AND HERE ARE
WORDS THAT WE THINK ARE SPECIFIC
FOR THESE TOPICS AND WHAT THE
MACHINE'S GOING TO DO IS IT WILL
START, YOU FEED IT GRANTS AND
YOU TELL THEM WHICH 1S ARE
BELONGS TO WHICH TOPICS AND IT
WILL START MAKING MORE WORRIEDS
THAT ARE--THAT IT'S FINDING ARE
SPECIFIC TO THOSE TOPICS OR IT'S
GOING TO START DOING THAT SO
IT'S GOING TO DEFINE TOPICS FOR
YOU AND THEN IT'S GOING TO--THEN
YOU'RE--IT'S GOING TO TELL YOU
WHICH GRANTS FALL INTO WHICH
TOPICS AND THEN, YOU HAVE TO
GIVE IT A GOOD DATA SET, THEN
YOU WANT TO TEST IT AGAINST TRUE
POSITIVES AND MAKE SURE IT'S
ACTUALLY DOING WHAT YOU NEED IT
TO BE DOING.
SO WHERE WE'RE AT WITH THIS IS
WE GENERATED A LIST OF WHAT 7300
FEDERALLY FUNDED GRANTS, SO THIS
IS GRANTS FROM NIH, VA, SAMHSA,
CDC, AHRQ AND FDA AND THESE ARE
ITEMS RELATED TO PAIN SO I
IDENTIFIED THEM OFF A BROAD TEXT
SEARCH AND THEY WILL PROBABLY BE
A LOT OF FALSE-POSITIVES FROM IN
THERE.
FROM THIS WE ALREADY CODED 2000
OF THEM AS PAIN OR NOT PAIN.
NOW THE CAVEAT HERE IS THE 1S
WE'VE CODED ARE FROM FY23 OR
LATER AND K-AWARDS.
SO IT'S A BIT OF A NICHE DATA
SET.
APART FROM THIS WORKING WITH
MICHIGAN WE'VE BEEN ABLE TO
FIGURE OUT HOW GIVE THEM ACCESS
TO THE SENSITIVE DATA
SOPHISTICATED MICHIGAN HAS BEEN
IN PARALLEL WORKING ON THE THIS
PROJECT USING PUBLIC DATA.
SO WITH THAT IT'S ONLY NIH
GRANTS, ABSTRACTS, TITLES AND
ELEMENTS BUT NOW WE WILL ABLE TO
GIVE THEM SPECIFIC NAMES FOR THE
GRANT ANDS THEY WILL HELP BUILD
THE MODELS.
THEY ALREADY BUILT A MODEL TO
IDENTIFY WHICH NIH FUNDED GRANTS
ARE PAIN VERSUS NOT PAIN.
THEIR KIND OF ACCURACY SCORE IS
.6 WHICH ISN'T GREAT, IT ISN'T
GREAT BUT THEY SAY IT'S
ACCEPTABLE AND THAT'S GOING TO
IMPROVE A LOT, A LOT OF THE
ABSTRACTS DON'T MENTION PAIN AT
ALL BUT THEN YOU READ THE
SPECIFIC NAME ANDS IT'S VERY
CLEARLY A PAIN GRANT, SO THAT'S
REALLY GOING TO HELP THEM OUT
AND WHAT THEY'RE WORKING ON NOW
IS DEVELOPING A GUIDED LDA MODEL
TO ASSIGN GRANTS TO VARIOUS FPRS
PRIORITIES, SO HERE'S THEIR
ANALYSIS FRAMEWORK, SO THEY
START--THE DATA WE'VE GIIVE THEM
IS STUDY TITLED PUBLIC HEALTH
RELEVANCE AND ABSTRACTS AND WE
GAVE THEM A TRAINING DATA SET OF
PAIN VERSUS NOT PAIN GRANTS AND
THEN WHAT THEY DID IS LABEL
THOSE GRANTS BASED ON THEIR BEST
KNOWLEDGE AS TO WHICH BATCH
SHOULD BE IN WHICH PRIORITY AND
THEN THEY USE THAT TO BUILD
THEIR MODEL AND WHEN THEY
WERE--WHEN THEY BUILT THEIR
MODEL THEY GIVE IT SEED WORDS SO
FOR EACH TOPIC THEY TOLD WHICH
1S THEY THINK SHOULD MAKE UP
EACH TOPIC AND THEN THE MACHINE
MIGHT FIGURE OUT OTHER WORDS AND
NOW THEY HAVE A TEST SET SO
THAT'S ALL THE REST OF THE
GRANTS THAT THEY'RE USING TO
REFINE THEIR MODEL, NUMBER 2,
IT'S KIND OF--I DON'T KNOW IF
PEOPLE ARE INTERESTED IN THIS,
THEY MIGHT FIND IT FUNNY BUT
ESSENTIALLY WHAT THEY DO IS WHEN
YOU GIVE THEM A GRANT, THEY
REMOVE ALL THE FLUR,
PUNCTUATION, SYMBOLS, AND 1
THING THEY HAVE TO REMOVE IS
PAIN BECAUSE THAT'S A WORD TOO
COMMON ACROSS ALL THE GRANTS, I
THOUGHT THAT WAS KIND OF NEAT SO
I KEPT IT IN THERE, SO THEY MADE
SEED WORDS AND THEN THEY BUILT
THEIR MODEL USING SEEDED LDA AND
THE MODEL TOLD THEM FIRST OFF
WHAT WORDS ARE MAKING UP EACH
TOPICKIC AND WHICH GRANTS ARE
FALLING INTO EACH TOPIC AND NOW
WE NEED TO DO SOME EVALUATION.
SO WE'RE GOING TO LOOK AT THE
PROBABILITIES OF TOPIC
ASSIGNMENTS AND COMPARE THEM TO
THE TRUE TOPIC ASSIGNMENTS FOR
THE GRANTS.
SO, I THINK I DON'T KNOW HOW
MANY TIMES YOU HAVE TO DO THIS
BUT I THINK WE'RE PRETTY CLOSE
TO BEING DONE.
SO I'M HOPING IN THE NEXT 6
MONTHS OR SO I CAN PRESENT SOME
MORE RESULTS BUT AS OF NOW, HERE
ARE THE DIFFERENT TOPICS THAT
MICHIGAN HAS PUT TOGETHER, SO IN
BOLD IS THE FPRS PRIORITY TITLE
AND THEN EVERYTHING HIGHLIGHTED
IN RED IS A SEED WORD FOR THAT
TOPIC AND THEN THE OTHER WORDS
IN THE BUBBLE ARE THE WORDS THAT
THE MODEL HAS COME UP WITH AND
WHEN WE GIVE IT--WHEN WE GIVE
THIS MODEL SOME BETTER TRUE
POSITIVE DATA IT'S GOING TO BE
ABLE TO--IT WILL FINE TUNE SOME
OF THESE WORDS AND HOPEFULLY
[INDISCERNIBLE] AFTER THAT.
SO THAT'S THE NEXT STEPS JUST
FINE TUNING THE LDA AND HOW IT'S
DOING VERSUS TRUE POSITIVE ANDS
THIS IS THE PART WHERE NIH WILL
GET INVOLVED AND I WILL REACH
OUT TO SOME FOLKS HERE TO HELP
CODE SOME OF THESE GRANTS BASED
ON WHICH TOPIC AREA WE THINK
THEY'RE IN.
AND I'M HAPPY TO ANSWER ANY
QUESTIONS ON THIS, AND HERE'S MY
CONTACT INFO IF YOU HAVE
ANYTHING YOU WANT TO TALK ABOUT
OFFLINE.
>> THANK YOU SO MUCH ANTHONY FOR
THIS REALLY VERY COOL
PRESENTATION.
REALLY APPRECIATE THIS AND THE
WORK YOU'VE DONE ON THIS, A LOT
OF PROGRESS SINCE THE LAST TIME
YOU PRESENTED.
BETH HAS A QUESTION.
>> YEAH, THANKS SO MUCH ANTHONY.
LOOKS LIKE SOME--A LOT OF
AMAZING WORK HAS HAPPENED IN THE
LAST 6 MONTHS OR SO.
I WAS CURIOUS ABOUT THE KEY WORD
SEPARATION.
I NOTICED THE 2 MAIN KEY WORDS
ARE OPIOID AND PAIN AND 1 OF THE
ISSUES WE WERE TALKING ABOUT IN
THE LAST MEETING WAS THAT
THERE--WITH HEAL, THE HEAL
INITIATIVE, THEIR ACCURATE OR
INACCURATE BUT THERE'S A
PERCEPTION THAT THERE IS AN
EMPHASIS ON OPIOID AND ADDICTION
VERSUS PAIN AND I'M CURIOUS HOW
THIS IS GOING TO BE DELICATELY
PARSED OUT BECAUSE I COULD SEE A
LOT OF APPLICATIONS, YOU KNOW
THAT WE PUT IN, MIGHT MENTION
OPIOIDS ARE PAIN, BUT THEY'RE
NOT NECESSARILY FOCUSED ON THAT.
IT'S JUST A MENTION.
SO HOW CAN WE ASSURE THAT
THERE'S REAL CHARACTERIZATION
THAT'S ACCURATE AND MAYBE THIS
IS WHERE THAT MANUAL PIECE COMES
IN, BUT 1 OF THE MAIN GOALS, I
WAS--YOU KNOW SELFISHLY WAS
HOPING TO SEE COME OUT OF THIS
WAS REAL PRECISION DATA AND HOW
WE'RE DOING THE CAT
IMORRIZATIONS BECAUSE THERE
SEEMS TO BE A PERSISTENT
CONFLUENCE OF THESE TERMS AND
TOPICS.
THANK YOU.
>> YEAH.
AND THAT'S A CHALLENGE AND WHAT
I'M HOPING WILL HELP WITH THE
CHALLENGE IS THE TRAINING DATA
SET THAT WE HAVE GIVEN MICHIGAN
AS TO WHAT'S PAIN VERSUS WHAT'S
A NONPAIN GRANT.
LIKE THAT TOPIC THAT YOU JUST
DISCUSSED IS LIKE THE MAIN 1
THAT WE HAVE TO PARSE OUT AND A
LOT OF TIMES THESE GRANTS ARE
WHEN YOU READ THEM, THEY SAY
THEY'RE--HAY SAY THEY'RE PAIN
MANAGEMENT TECHNIQUES OR
TEACHING PAIN MANAGEMENT
TECHNIQUES BUT ESSENTIALLY WHAT
THEY'RE ACTUALLY DOING IS, LIKE
OPIOID USE DISORDER RESEARCH, SO
ON THE FRONT END WITH THOSE 2000
GRANTS WE'VE ALREADY CODED,
THOSE 1S WE HAVE ELIMINATED.
WE THINK WE ELIMINATED ALL OF
THOSE 1S THAT ARE MORE ON THE O.
U. D. SIDE AND WE HAVE A REALLY
STRICT DEFINITION OF PAIN, SO
YOU ACTUALLY HAVE TO BE EITHER
TREATING PAIN OR LOOKING AT THE
EFFECTS OF PAIN OR THE GRANT HAS
TO BE REALLY, REALLY INTO PAIN
AND WE'RE SENSITIVE TO NOT HAVE
IT TOO MUCH--NOT HAVE THESE
GRANTS BE O. U. D. GRANTS AND BE
TRUE PAIN GRANTS.
>> I WILL GET TO YOU IN JUST
1-SECOND, BUT 1 IMPORTANT--FIELD
FUNCTIONS UNDERSTAND CORRECTLY
WE'RE NOT--THIS IS NOT
EXCLUSIVELY PAIN GRANTS THAT
HAVE A COMPONENT OF OPIOID USE
DISORDER TREATMENT BECAUSE YOU
KNOW PEOPLE WHO HAVE O. U. D.,
THEY CAN HAVE PAIN AND THEN WE
HAVE TO FIGURE OUT HOW TO MANAGE
THAT.
SO, WHAT YOU'RE DOING IN
EXCLUDING THE OPIOID USE
DISORDER GRANT AS LONG AS
THERE'S A PAIN CONCOMPONENT, IN
IT, CORRECT?
NYES, SO A LOT OF GRAPTS WILL
SAY THEY'RE TREATING PAIN AND
THEIR METRIC IS INTRODUCTION
INTO OPIOIDS, THAT GRANT
WOULDN'T BE INCLUDED IN THIS
DATA SET AS A PAIN GRANT.
IF THEY SAY THEY'RE TREATING
PAIN AND THEY WILL RELOOK AT
REDUCTION OF OPIOIDS AND THEY
WILL ALSO LOOK AT WHAT PEOPLE'S
PAIN LEVELS ARE, THEN YOU GET IN
EMPLOY THAT'S LIKE A VERY, VERY
EASY CASE BUT ESSENTIALLY, YOU
HAVE TO BE TREATING PAIN OR
LOOKING AT HOW THE--WHAT IS THE
COMPONENT OF THE PAIN THAT'S
AFFECTING OTHER THINGS.
>> YEAH, YEAH, THANK YOU.
RENE?
>> SO ANTHONY I WANT TO
COMPLEMENT YOU BECAUSE I KNOW
IT'S REALLY HARD TO PRESENT THIS
WHEN YOU ARE NOT A MACHINE
LEARNING SCIENTIST AND I AM NOT
A MACHINE LEARNING SCIENTIST
ALTHOUGH I KNOW THERE'S A PRESS
RELEASE THAT SUGGIESTED I WAS.
MY EXPERTISE IS IN PAIN AND I
GET TO WORK WITH 2 DIFFERENT
ENGINEERING GROUPS AND I LEARNED
FROM THEM THEY ALL HAVE
THERE--JUST LIKE I HAVE MY
FAVORITE WAY OF MANAGING PAIN,
THEY HAVE THEIR FAVORITE MODELS.
DID MICHIGAN TEST OTHER MODELS?
OR IS THIS REALLY WHAT THEY'RE
EXPERT ON AND IF THEY'VE ONLY
LOOKED AT THIS MODEL, IS THERE
THE OPPORTUNITY FOR A
COMPETITIVE GRANT FOR OTHER
MACHINE LEARNING GROUPS TO SEE
IF THEY CAN PERFORM BETTER.
NYEAH, SO ACTUALLY 1 OF THE COOL
THINGS THAT MICHIGAN DID WAS
THEY STARTED THIS PROJECT SO THE
PI TEACHES A CLASS ON HOW TO DO
THIS.
THEIR BREAD AND BUTTER IS TEXT
MINING AND FINDING GAPS IF
FIELDS BASED OFF OF TEXT MINING,
SO YEAH, HE HAS A COURSE.
SO 1 OF THE PROJECTS WAS FOR HIS
STUDENTS WAS THERE, SO SEVERAL
TEAMS WERE WORKING ON FIGURING
OUT HOW TO DO THIS WITH THE
PUBLIC DATA AND THEY TESTED--I
DON'T KNOW HOW MANY DIFFERENT
MODELS THEY TESTED BUT THEY
TESTED SEVERAL AND THE 1 WE'RE
MOVING FORWARD WITH IS THE 1
THAT HAS PERFORMED BEST.
>> AND THAT MUST BE THE MODEL
FOR HOW THEY DO IT BECAUSE
THAT'S HOW I GOT INVOLVED WITH
BOTH ENGINEERING GROUPS BECAUSE
I SUBMITTED HEY, CAN YOU HAVE
YOUR STUDENTS WORK ON THIS WHICH
GETS THINGS DONE VERY RAPIDLY
BECAUSE YOU HAVE SO BRIGHT MINE
MINDS WHO ARE EAGER TO MAKE A
DIFFERENCE AND WHAT I FOUND IS
WHEN I SAY IT'S ABOUT PEOPLE AND
PAIN, THEY REALLY WANT TO HELP.
SO THANK YOU FOR YOUR WORK.
NYEAH, GREAT.
IT'S A FULL MODEL.
I NEVER HEARD OF THAT.
I THOUGHT IT WAS UNIQUE, BUT I
MEAN I GUESS THAT'S THE STANDARD
PRACTICE IN THAT PEELED WHICH IS
SUPER COOL NPUT ALL THOSE YOUNG
BRAINS TO WORK.
THIS IS THE FUTURE AND YOU KNOW
WE TALK ABOUT WOULD ABOUTING THE
WORKFORCE, RIGHT?
BY INVOLVING STUDENTS, AND I
THINK THIS IS GREAT WAY TO GET
PEOPLE ABOUTED IN PAIN RESEARCH
THROUGH SOME OF THESE
INITIATIVES.
SO IT'S REALLY--
>> THE DEDICATED TO LINE IS THE
NEXT SEMESTER BECAUSE YOU GET A
RAPID RESPONSE BECAUSE THEY HAVE
TO GET ON TO THE NEXT CLASS.
>> EXACTLY.
EXACTLY.
ANY OTHER COMMENTS ON THIS WORK
SOME.
>> THERE'S 1 IN THE CHAT.
YES IT DOES INCLUDE R13 GRANTS.
AND THEN BETH SAYS I DON'T KNOW
IF IT'S USEFUL BUT IT COULD BE
USEFUL TO CATEGORIZE PAIN IN
OTHER CATEGORIES.
>> THAT COULD BE HELPFUL AND
THAT COULD BE PICKED UP WITH THE
TOPICS BUT THAT'S SOMETHING MORE
THAN WE DO LIKE AN INTERNAL
PORTFOLIO ANALYSIS, I DON'T KNOW
IF WE CAN GET THAT 1 DONE AND
THIS 1.
>> YEAH, ANY OTHER COMMENTS?
I THINK WE'RE JUST ABOUT ON TIME
TO MOVE ON BUT FIRST I WANT TO
THANK ANTHONY FOR THIS
PRESENTATION AND REALLY MOVING
THIS ALONG WHICH IS SUCH AN
IMPORTANT PIECE.
GOING BACK TO THE PRIORITY
TOPICS OF THE FEDERAL PAIN
RESEARCH STRATEGY, I REMEMBER WE
HAD DISCUSSIONS AT PRIOR
IPRCC MEETINGS AND HOW
CHALLENGING IT WOULD BE TO
REALLY MAKE SURE THAT ALL THE
RESEARCH THAT WE'RE DOING WITHIN
THE HEAL INITIATIVE, DOESN'T
SORT OF TAKE OFF IN ITS OWN
DIRECTION AND THAT'S 1 OF THE
THINGS THAT--WITHOUT SORT OF
INCORPORATING AND INTEGRATING
WITH THE OTHER PAIN RESEARCH
THAT'S HAPPENING OUTSIDE OF
HEAL, AND AS EXCITED AS WE ARE
ABOUT HEAL, WE ALSO RECOGNIZE A
LOT OF OTHER RESEARCH ON PAIN
HAPPENING.
THIS IS WHAT THIS EXACT ANALYSIS
IS GOING TO SHOW US.
SO VERY, VERY IMPORTANT WORK.
SO THANK YOU.
>> THANKS.
THANK YOU EVERYONE.
>> ALL RIGHT SO WE WILL NOW MOVE
ON TO THE NEXT SECTION HERE OF
DISCUSSION OF TALKING ABOUT,
SPEAKING ABOUT HEAL OF THE HEAL
STRATEGIC PLAN AND AGAIN
PORTFOLIO ANALYSIS.
LINDA?
>> OKAY.
THANK YOU VERY MUCH.
I'M GOING TO SHARE MY SCREEN, I
HOPE QUICKLY AND IF YOU WILL LET
ME KNOW IF YOU SEE THE FIRST
SLIDE.
NO?
NOT YET?
I SEE IT.
>> DOES ANYBODY ELSE SEE IT
BECAUSE I DON'T.
NO.
>> THEN I WILL STOP HERE BECAUSE
I WILL GO TO SHARE MODE.
LET ME TRY 1 MORE TIME.
>> YEAH, PERFECT.
>> GREAT.
SO AS HELENE SAID, WE HAVE THE
HEAL INITIATIVE WHICH IS HELPING
TO END ADDICTION LONG-TERM FOR I
THINK PROBABLY EVERYONE ON THIS
COMMITTEE IS MORE THAN FAMILIAR
WITH HEAL BUT WHAT I'M GOING TO
DO THIS MORNING IS GO BACK A
LITTLE BIT TO THE EARLY DAYS OF
HOW THE FIRST 5 YEARS OF HEAL
SORT OF THE HIGH LEVEL OF AREAS
OF WHERE HEAL WAS FOCUSED HOW
THEY WERE DEVELOPED AND HOW WE
PLAN TO MOVE FORWARD INTO THE
NEXT 5 YEARS OR SO OF HEAL WITH
A MORE FORM AT STRATEGIC
PLANNING PROCESS AT THIS POINT.
IT'S A NICE TRANSITION POINT.
A LOT OF THE WORK THAT ANTHONY
HAS DONE WITH THE FPRS IS GOING
TO BE SUPER HELPFUL IN DRIVING
WHAT THE FINAL RECOMMENDATIONS
FROM THE STRATEGIC PLANNING
PROCESS MIGHT BE AND HE IS ALSO
WORKING REALLY HARD ON DIFFERENT
TYPES OF PORTFOLIO ANALYSIS,
FOCUSED ON THE HEAL PORTFOLIO,
IN ORDER TO HELP MOVE THE
PLANNING PROCESS ALONG AS WELL.
SO MY THANK YOUS LET ME ADD TO
HELENE'S, LET ME THANK ANTHONY
HE'S WORKED REALLY HARD ON THIS
ANALYSIS.
DAVE WILLIAMS WHO USED TO BE ON
THE COMMITTEE AND RETIRE FRIDAY
THIS COMMITTEE ABOUT A YEAR AGO
HAS BEEN REALLY HELPFUL IN
CONNECTING US WITH UNIVERSITY OF
MICHIGAN AND THEY'RE REALLY
VALUABLE TEAM AS WELL.
SO LET ME START WITH A LITTLE
BIT OF BACKGROUND.
SO THE HEAL INITIATIVE WAS
LAUNCHED IN 2018 AND BEFORE THAT
WE HAD A LITTLE BIT OF TIME TO
THINK ABOUT WHERE, YOU KNOW, IF
WE--THIS WAS WISHFUL THINKING AT
THE TIME, HAD MONEY TO FULFILL
THE RECOMMENDATIONS OF THE
FEDERAL PAIN RESEARCH STRATEGY,
HOW WE WOULD BEST GO AHEAD TO
INVEST THOSE DOLLARS IN ORDER TO
ADDRESS THE OPIOID CRISIS WAS
OUR MANDATE AT THAT TIME FROM
THE FEDERAL GOVERNMENT.
AND SO THE TIMING OF THE FEDERAL
PAIN RESEARCH STRATEGY
COMPLETELY RUN THROUGH THE
IPRCC, AND WITH THE HELP OF I
THINK ABOUT 80 EXTERNAL ADVISORS
ENCLOUDING MEMBERS--INCLUDING
MEMBERS FROM THE FEDERAL
GOVERNMENT AGENCIES THAT SUPPORT
PAIN RESEARCH, DEVELOP THE PAIN
RESEARCH STRATEGY.
IT WAS PUBLICLY RELEASED IN
2017.
SO IT ENDED UP BEING AN
IMPORTANT DOCUMENT IN HELPING TO
ESTABLISH SOME OF THE PRIORITIES
EARLY ON IN HEAL AND IN ADDITION
TO THE FIRST FPRS, THE NIH
SPONSORED 3 MEETINGS, IT PULLED
IN, I'M GOING TO SAY 40 PEOPLE
EXPERTS FROM OUTSIDE TO ATTEND
EACH 1 OF THOSE MEETINGS AND
HELP US ADDRESS 3 DIFFERENT
TOPIC AREAS WE HAD IDENTIFIED IN
ADVANCE TO INFORM HOW WE WOULD
SPEND HEAL DOLLARS.
AT THAT POINT THIS WAS A LITTLE
BIT--WE WERE EXPECTING DOLLARS
FROM THEM, AND WE HAD AN IDEA OF
WHAT OUR BUDGET WOULD BE.
SO THOSE MEETINGS WERE TO
DEVELOP 1 MEETING WAS TO DEVELOP
SAFE AND EFFECTIVE PAIN
TREATMENTS AND WE BROUGHT IN
EXPERTS TO TELL US WHAT AREAS
WERE OF NEED, WHAT WERE THE
CHALLENGES, WE MIGHT FACE AND
NOT SPECIFIC RECOMMENDATIONS ON
RESEARCH INITIATIVES BUT WHERE
WE REALLY NEEDED TO MAKE A BIG
IRB INVESTMENT IN GAP AREAS FOR
PAIN AND O. U. D.
THE SECOND 1 WAS TO UNDERSTAND
PAIN MECHANISMS SO THIS GOES
BACK TO A BIT MORE MAYBE BASIC
RESEARCH BUT TO UNDERSTAND HOW
IT DRIVES PAIN AND HOW WE COULD
BETTER TREAT IT AND THEN THERE
WAS A THIRD MEETING ON O. U. D.
PREVENTION, WHICH PREVENTION AND
TREATMENT, BUT THE PREVENTION
PART OBVIOUSLY INCLUDES
IMPROVING PAIN MANAGEMENT.
SO THE FPRS, THE TIMING WAS
REALLY HELPFUL AND ON TOP OF THE
RECOMMENDATIONS FROM FPRS, WE
HAD THE INPUT FROM ECPETTERS ON
THESE CUTTING EDGE MEETINGS TO
HELP DRIVE--WE'LL CALL IT PHASE
1 HEAL, BUT IT'S REALLY A
TRANSITION INTO THE NEXT STAGES
FOR HEAL.
SO CURRENTLY, MANY OF YOU
PROBABLY KNOW THAT THE HEAL
INITIATIVE WAS INITIALLY SETTLED
IN THE OFFICE OF DIRECTOR NIH,
AND WAS MANAGED FROM THAT
OFFICE.
SO CENTRALLY MANAGED FOR A LARGE
PROGRAM IS A LITTLE BIT ATYPICAL
FOR NIH BECAUSE MOST OF THE
PROGRAM STAFF ARE IN THE
INSTITUTES BUT REBECCA BAKER LED
THE EFFORT FOR MANAGEMENT AND
OVERSIGHT OF HEAL INITIATIVE
WHILE IT WAS IN THE OFFICE OF
THE DIRECTOR AND REALLY DID A
WONDERFUL JOB?
ESTABLISHING THE PROGRAMS,
ESTABLISHING THE ORGANIZATIONAL
STRUCTURE.
AFTER 5 YEARS, THE DECISION WAS
MADE TO MOVE THE LEADERSHIP TO
THE INSTITUTES OF NIDA AND
NINDS, AND TO HAVE IT MORE OR
LESS RUN THROUGH
ORGANIZATIONALLY RUN THROUGH THE
INSTITUTES WHERE A LOT OF THE
RESEARCHERS WERE FOR PROGRAM
SUPPORT, FOR COMMUNICATIONS, ET
CETERA.
SO A VERY SENSIBLE TRANSITION IF
YOU WILL AND IT TOOK A WHILE TO
GET THE [INDISCERNIBLE] SETTLED
AND THE ORGANIZATIONAL
STRUCTURING DONE.
WALTER KOROSHETZ, WAS REALLY
INTENSE AND WORKED REALLY HARD
TO INVOLVE OTHER INSTITUTES,
CENTERS, AND OFFICES ACROSS NIH
IN THE ORGANIZATIONAL AND
OPERATIONAL TRANSITION.
SO HE HAS 2 CO-CHAIRS AS
LEADERSHIP TO WORK WITH HIM,
HELENE IS 1, AND LINDE CRISWELL
FROM NIAMS IS ANOTHER.
AND THEN REPRESENTATIVES FROM
THE INSTITUTE AND CENTER
DIRECTORS, WEIGH IN ON HEAL
PROGRAMS, FUNDING OPPORTUNITIES,
ET CETERA, ET CETERA.
SO WHERE WE ARE NOW, WITH THAT
TRANSITION IS SETTLED, IS
LOOKING FORWARD TO THE NEXT 5
YEARS OF HEAL AND HOW WE CAN
BEST PERHAPS REDIRECT SOME OF
OUR FUNDS, EXPAND ON SUCCESSFUL
PROGRAMS, FILL GAP AREAS AND SO
THERE IS NOW A FORMAL PROCESS
THAT HAS STARTED FOR A STRATEGIC
PLAN TO SET US UP MOST
EFFECTIVELY FOR OUR NEXT 5 YEARS
IN HEAL.
AND SO A COMMITTEE, I WILL GIVE
YOU A LITTLE BIT OF WHERE WE ARE
IN THAT STRATEGIC PLANNING
PROCESS.
IT'S REALLY LAUNCHING NICELY NOW
UNDER THE LEADERSHIP OF JACKIE
WARD WHO IS A SENIOR SUPERVISOR
IN THE OFFICE OF PAIN POLICY AND
WITH INPUT FROM THE LEADERSHIP.
THE STRATEGIC PLANNING PROCESS
IS BEING DONE AS KIND OF AIAN
2-STEP PHASE IF YOU WILL.
SO FOR THE PAIN RESEARCH, WE
HAVE A STRUCTURE AND A PLAN TO
MOVE VERY DETAILED ANALYSIS OF
WHAT HAS ALREADY BEEN DONE IN
HEAL AND EVALUATING THE PROGRAMS
AND NOW MOVING INTO IDENTIFYING
GAPS AND OPPORTUNITIES TO MOVE
FORWARD.
WE'RE WORKING WITH NIDA BECAUSE
NIDA IS ALSO DOING A MORE GLOBAL
STRATEGIC PLANNING PROCESS FOR
SUBSTANCE USE DISORDER,
PREVENTION, TREATMENT, AND
OVERDOSE TREATMENT AND THAT IS
MORE FOCUSED, THAT RESEARCH IS
MORE FOCUSED ON A SINGLE
INSTITUTE AND SO THE PROCESSES
OF DOING THE STRATEGIC PLANNING
ARE A BIT DIFFERENT BUT WE'RE
DEFINITELY WORKING TOGETHER.
THERE WILL BE A LOT OF CROSS
CUTTING RESEARCH IN HEAL THAT
FALLS WITHIN THE STRATEGIC
PLANNING, CONCERNS AND
OPPORTUNITIES FOR BOTH THE PAIN
AND THE O. U. D. COMPONENTS OF
HEAL.
SO THE EXTERNAL COMMITTEE IS SET
UP ALREADY.
IT IS CONSIDERED A WORKING GROUP
OF THE NINDS' ADVISORY COUNCIL,
SO THIS AN AFICIAL FEDERALLY
APPROVED WORKING GROUP IF YOU
WILL AND IT'S--IT'S MANDATE IS
TO ADVANCE THE PAIN RESEARCH
MISSION THROUGH THE HEAL
INITIATIVE.
AND WE HAVE CURRENT MEMBERS WHO
HAVE BEEN ASKED, WE DID A LITTLE
BIT OF ARM TWISTING BUT WE HAVE
A WONDERFUL EXTERNAL COMMITTEE
TO GET US STARTED.
KATHLEEN SLUKA AND ROB GERRO,
ARE CO CHAIRS FOR THIS COMMITTEE
AND THEN WE HAVE TENTATIVE TOPIC
AREAS WHERE WE ARE PLANNING TO
SET UP WORKING GROUPS AND BRING
IN EXPERTS TO THOSE WORKING
GROUPS TO LOOK AT FOR EXAMPLE,
THE ANALYSIS OF WHAT WE'RE
CURRENTLY DOING IN HEAL THAT
ANTHONY IS LEADING TO LOOK AT
EVALUATION OF SOME OF THE LARGE
PROGRAMS.
WE HAVE SEVERAL PAIN NETWORKS IN
THE--WITHIN--EMBEDDED WITHIN THE
PAIN SIDE OF HEAL.
SO VERY GOOD PROGRAMMING, WE
HAVE ANNAL GEEZIC PROGRAM AND WE
WE ARE A LOT OF MONEY BE BEING
INVESTED AND WE WANT TO MAKE
SURE IT'S INVESTED SUCCESSFULLY,
AND MAKING IMPROVEMENTS AND HOW
WE WANT TO MOVE FORWARD.
SO HERE'S A LIST OF WHAT I THINK
WE CAN DESCRIBE AS THOSE
SUBGROUP LEADS.
EACH SUBGROUP HAS 2 EXPERT LEADS
IN IT, AND THERE'S ALSO A PERSON
WITH LIVED EXPERIENCE ON THIS
PANEL WHO WILL BE HELPING OUT
ACROSS THE DIFFERENT SUBGROUPS.
THE SUBGROUPS HAVE NOT BEEN
POPULATED YET.
WE'RE ASKING THIS EXTERNAL
COMMITTEE TO HELP US IDENTIFY
PEOPLE.
WE'RE REALLY FOCUSING ON PEOPLE
WHO KNOW THE FIELD WHO WILL
REALLY CONTRIBUTE SOME TIME AND
COOPERATIVELY TOGETHER.
WE ALSO WANT TO MAKE SURE
THERE'S COMMUNICATION ACROSS
THESE GROUPS, SOMETIMES YOU SLIP
INTO BUCKETS AND YOU KIND OF
FOCUS ON YOUR AREA, SO THERE'S A
LOT OF BACKGROUND WORK GOING ON
TO MAKE SURE THAT WE'VE GOT
LIAISONS ACROSS THE GROUP.
A LOT OF NIH STAFF, WE'RE
HELPING TO MANAGE THEM AND WE
HOPE TO REALLY, BY THE END OF
SPRING IN 2025 TO HAVE SOME
OUTPUT FROM THIS GROUP.
SO JACKIE WARD KINDLY PUT
TOGETHER THE TIME FRAME FOR WHEN
AND HOW AND SO WE HAVE AN EARLY
APRIL/MAY 2024 I SHOWED YOU OUR
LEADERSHIP IN PLACE FOR IT.
THERE IS CURRENTLY A REQUEST FOR
INFORMATION OUT AND BOTH HELENE
AND I ARE GOING TO REALLY PROD
YOU ALL TO LOOK AT IT TO SEND IN
YOUR INPUT, ON SPECIFIC
QUESTIONS THAT ARE BEING ASKED
FOR O. U. D. AND PAIN RESEARCH
AS WE MOVE FORWARD.
IT WILL BE HELPFUL TO GET
FEEDBACK ON THAT.
WE WILL LOOK CAREFULLY AT THE
FEEDBACK AND TRY TO INCORPORATE
THE KEY POINTS FROM THE FEEDBACK
INTO THE STRATEGIC PLANNING
PROCESS.
SO JULY WE'RE LOOKING TO CONVENE
THE INDIVIDUAL GROUPS AND WE'RE
CLOSE.
YOU KNOW WE'RE STILL LOOKING TO
FILL OUT THE MEMBERSHIP AND THEN
WE WILL GET TO WORK ON HAVING
THOSE GROUPS MEET, COMMUNICATE
WITH 1 ANOTHER, AND DEVELOP
ANOTHER PROCESS TO LIST THE PAIN
RESEARCH PRIORITIES RECOMMENDED
ACROSS THE GROUPS VERY SIMILAR
TO WHAT WE DID IN THE DELPH I
ITERATIONS OF COMING TO A SMALL
SET OF REALLY HIGH LEVEL
RESEARCH PRIORITIES DURING THIS
PROCESS.
AND THEN RELEASE EARLY IN THE
SPRING NEXT YEAR, MIDWAY THROUGH
THE SPRING A PUBLIC FACING
DOCUMENT.
AND SO, SO WHAT I'M GOING TOIVE
GO YOU NOW IS A SUPER HIGH LEVEL
IDEA OF WHAT ANTHONY IS
LAUNCHING FOR A PORTFOLIO
RESEARCH, A RESEARCH PORTFOLIO
RATHER TO SUPPORT THE EFFORT OF
THESE GROUPS.
BECAUSE IF THEY DON'T KNOW WHAT
WE'RE DOING, IT'S HARD FOR THEM
TO RECOMMEND TO US WHAT WE NEED
TO DO IN FUTURE.
SO ANTHONY HAS DONE A LOT MORE
DETAILED WORK HERE BUT WHAT WE
HAVE FOR YOU NOW IS A VERY HIGH
LEVEL LOOK AT THE HEAL RELATED
TO NONHEAL FUNDED RESEARCH AT
NIH CURRENTLY AND HE OBVIOUSLY
WILL BE PULLING UP A LOT MORE
INFORMATION TO SUPPORT THE WORK
GROUPS FOR THE STRATEGIC PLAN.
I THINK 1 THING THAT THIS
HIGHLIGHTS HERE IS 2 SLIDES WILL
LOOK ALMOST EXACTLY THE SAME TO
YOU, BUT IN OUR REPORTING, OUR
PUBLIC REPORTING SYSTEM, WE HAVE
A COLLECTION OF AWARDS THAT ARE
CONSIDERED PAIN RESEARCH, WE
HAVE ANOTHER SOMEWHAT MORE
RESTRICTED SET OF AWARDS CALLED
CHRONIC PAIN RESEARCH AND SO THE
PAIN RESEARCH 1, IS A LARGER
PORTFOLIO, IT INCLUDES A LOT OF
MECHANISTIC GRANTS THAT ARE NOT
IN THE CHRONIC PAIN RESEARCH
PORTFOLIO, AND THIS IS NIH WIDE.
THIS IS NOT JUST HEAL, BUT IT'S
CODED IN ORDER TO REALLY HELP
THE OUTSIDE WORLD AND TO HELP US
UNDERSTAND GLOBALLY WHAT WE'RE
FUNDING FOR PAIN RESEARCH.
THE INTERESTING PIECE HERE IS
THAT ACROSS THE BOARD, WE
STARTED FUNDING HEAL IN 2018,
AND SO 2018 AND 2019 LOOK A
LITTLE BIT UNUSUAL BECAUSE WE
GOT OUR FUNDING IN 2018, YOU
CAN'T GET YOUR FUND NOTHING 1
YEAR AND REALLY PUT IT OUT IN AN
EFFECTIVE AND MEANINGFUL WAY FOR
FUNDING OPPORTUNITIES FOR THAT
YEAR.
IT'S GOING TO TAKE 2 YEARS, SO
2019 AND REALLY 2 YEARS WORTH OF
HEAL DOLLARS, WE WERE
$8,500,000,000 IN ALLOCATIONS,
2018, 2019, AND THEN IT'S
INCREASED A LITTLE BIT OVER THE
YEARS UP UNTIL 2023 AND HELENE,
YOU CAN CORRECT ME IF I'M A BIT
OFF BUT I THINK WE'RE BETWEEN
NIDA, OUD AND PAIN DOLLARS ABOUT
$585 MILLION PER YEAR.
SO IT'S GONE UP A LITTLE BIT.
AS YOU CAN SEE, OVERALL, HEAL
ACCOUNTS FOR 21% OF THE TOTAL
PAIN RESEARCH FUNDING AT THE NIH
SO WE KEEP--YOU KNOW HEAL IS
BIG.
IT'S A WONDERFUL CONTRIBUTION,
BUT PLEASE KEEP IN MIND THERE'S
A LOT OF OTHER RESEARCH GOING ON
AT NIH IN THE PAIN ARENA AND
THIS IS WHERE THE FPRS WILL HELP
US BECAUSE OF NIH AND THE OTHER
AGENCIES THAT WILL BE INCLUDED
IN THAT ANALYSIS.
SO THIS IS THE PAIN RESEARCH 1,
SLIGHTLY LARGER AMOUNT OF MONEY
THAN THE CHRONIC PAIN 1,
AND--BUT THE CHARTS LOOK FAIRLY
SIMILAR AND SO FORNOW, TELL BE
MORE INFORMATION ON THIS,
ESPECIALLY AS THE STRATEGIC
PLANNING PROCESS MOVES ALONG, I
DO WANT TO HIGHLIGHT THAT WE
WOULD LIKE YOUR INPUT ON THE
REQUEST FOR INFORMATION AS TO
IMPORTANT THINGS THAT SHOULD BE
INCLUDED IN THE STRATEGIC
PLANNING PROCESS.
AGAIN, THIS IS FOR SUBSTANCE USE
DISORDER AND FOR PAIN HERE IS
THE LINK TO GET TO IT AND WE
WILL ASKLIA TO RESEND IT TO THE
COMMITTEE FOR THEIR INPUT.
AND FROM HERE I WILL GO BACK TO
HELENE, WE HAVE THIS WONDERFUL
HIGH LEVEL OF EXPERTISE IN THIS
COMMITTEE AND WE HAVE AN
OPPORTUNITY THROUGH THE
COMMITTEE TO MAKE
RECOMMENDATIONS, AGENCY WIDE AND
DEPARTMENT WIDE BECAUSE WE ARE
TRANSAGENCY REPRESENTED BUT WE
WOULD LIKE TO GET YOUR INPUT ON
HOW SOME OF YOU WHO ARE
INTERESTED CAN HELP US WITH THE
STRATEGIC PLANNING PROCESS.
WE WANT TO THANK KATE NICHOLSON
AND TAMARA BAKER FOR THEIR
PARTICIPATION AND THEN HELENE, I
WILL TURN TO YOU FOR THE OPEN
DISCUSSION WITH THE GROUP UNLESS
ANYBODY HAS SPECIFIC QUESTIONS
ON THE SLIDE SET.
>> THANK YOU SO MUCH LINDA AND
IT'S SO GREAT TO SEE THIS
PROCESS MARCHING ALONG AND AS
YOU CAN SEE THE TIMELINE IS
PROGRESSING NICELY.
I MEAN THERE'S NOT A LOT OF TIME
AND WE FEEL LIKE IT'S GOING TO
BE VITAL TO GET ALL THE
INFORMATION THAT WE CAN
INCLUDING FROM THIS GROUP.
SO I THINK--LET'S FIRST SEE IF
THERE'S ANY IMMEDIATE QUESTIONS
OR COMMENTS ON LINDA'S
PRESENTATION AND THEN WE CAN
SORT OF BROADEN THE DISCUSSION.
>> IT WAS CRYSTAL CLEAR LINDA, I
REALLY FELT--I THINK THE LAST 2
GRAPHS YOU PRESENTED WERE SO
REVEALING TO A LOT OF--A LOT OF
PEOPLE AT NIH INCLUDING MYSELF,
WERE KIND OF SURPRISED TO SEE
THIS RIGHT?
THERE'S SO MUCH PAIN RESEARCH
HAPPENING AT NIH THAT IT'S GREAT
TO HAVE HEAL AND IT HAS REALLY
TURBOCHARGE INDEED A WAY WAWE'RE
ALREADY DOING, WHICH IS REALLY
FANTASTIC.
BETH SAYS I COMMENTED ONLINE
ALREADY.
FANTASTIC.
OKAY.
WONDERFUL SO I HOPE MANY, MANY
OF YOU WILL TAKE ADVANTAGE OF
THAT.
SO I THINK THAT WHAT WE WOULD
LIKE YOU TO THINK ABOUT AS A
COMMITTEE IS WHAT IN WHAT WAYS
OTHER THAN OBVIOUSLY IN EACH OF
YOUR INDIVIDUAL INPUTS IS
CRITICAL AND THAT'S WHAT THIS
RFI IS GOING TO DO AND OFFER
THAT OPPORTUNITY TO DO THIS.
AND I SEE MORE COMMENTS IN THE
CHAT, YES, THIS IS EXACTLY WHAT
WE HOPE YOU WILL ALL DO IS TAKE
THIS RFI BACK TO YOUR RESPECTIVE
ORGANIZATIONS, GET INPUT,
COMMENT.
SO ANYBODY CAN DO THAT BUT WE
ESPECIALLY WANT INPUT THAT
REFLECTS THE FEEDBACK FROM
INDIVIDUALS AS WELL AS
ORGANIZATIONS.
SO ANOTHER POSSIBILITY IS THAT
THE IPRCC COULD PLAY A ROLE IN
THE STRATEGIC PLANNING PROCESS
ITSELF.
THERE'S A LOT OF DIFFERENT WAYS
IN WHICH THIS COULD HAPPEN.
ONE POSSIBILITY IS THAT THERE
MIGHT BE OPPORTUNITIES FOR
EXAMPLE TO PARTICIPATE IN
WORKSHOPS, OR SUBCOMMITTEES, AND
WE WILL BE--AS THESE
OPPORTUNITIES ARISE, WE WILL BE
COMMUNICATING WITH THIS GROUP
AND SEE WHETHER PEOPLE ARE
INTERESTED IN THIS.
AND SO, ANOTHER POSSIBILITY IS
THAT IERK PRCC FEDERAL MEMBERS
COULD PARTICIPATE EXOFFICIO IN
SOME OF THESE COMMITTEES AND
SUBCOMMITTEES AND ALREADY, SO
TAMARA IS ALREADY SERVING WHICH
IS GREAT AND WE WANT TO JUST LET
YOU ALL KNOW THAT THERE WOULD BE
OTHER OPPORTUNITIES FOR THAT AND
I THINK THAT WE WANT TO
BASICALLY FIND OUT FROM ALL OF
YOU IF THIS IS OF INTEREST TO
AND IN WHAT CAPACITY NOW.
I SEE HEADS CHAIKING.
KATE, YOU'RE INTERESTED IN THIS,
ANY OTHER INPUT REGARDING THIS?
YES, VERY INTERESTED, BETH IS,
CURIOUS HAS TO WHO AND WHICH
INSTITUTION ARE APPLYING FOR
THIS TYPE OF--THIS IS IN
RESPONSE TO--DO YOU WANT TO
EXPLAIN YOUR COMMENT OR
QUESTION?
THEN WE'LL GO TO PAUL?
TCAN YOU HEAR ME OKAY?
IT SAYS MY INTERNET IS UNSTABLE
SO--
>> YEAH, THIS WAS BASICALLY IN
RESPONSE TO LINDA'S PRESENTATION
AND JUST IN GENERAL AS WE TALK
ABOUT THE STRATEGIC PLAN AND WE
WERE TALKING ABOUT NIH FUNDING
AND I WAS JUST CURIOUS IF THIS
INFORMATION IS AVAILABLE AS TO
WHO IS APPLYING FOR
[INDISCERNIBLE] FOR TYPE OF
FUNDING AND INSTITUTIONS AND
AGAIN WE'RE TALKING ABOUT PAIN,
ET CETERA, ET CETERA.
BUT I'M WONDERING IF IT'S
REACHING GROUPS LIKE PWIs, SO
I'M WONDERING AND CURIOUS WHAT
IS THE PUSH FOR EXAMPLE FOR
MINORITY SERVING INSTITUTIONS,
FACULTY FOR THESE INSTITUTIONS
TO,A PLIE FOR THIS TYPE OF
FUNDING AND WHAT IS THE SUPPORT
THAT THEY COULD RECEIVE BECAUSE
AGAIN WHEN WE TALK ABOUT
DISPARITIES, I THINK THERE'S A
HUGE GAP AS TO WHO IS RECEIVING
THIS TYPE OF FUNDING.
SO THAT'S WHY MY QUESTION IS
FOCUSING ON IT AND IT MAY BE
TAKING A HARD RIGHT AS TO WHAT
WE'RE TALKING ABOUT NOW, IT MAY
BE SOMETHING TO THINK ABOUT IN
THE FUTURE.
>> SO TAMARA MAKE 1 QUICK NOTE,
WE'LL ANSWER YOUR QUESTION IF I
UNDERSTAND IT CORRECTLY, THE
FUNDING OPPORTUNITIES THAT COME
OUT OF HEAL ARE OPEN TO ALL
INVESTIGATORS IN THE SAME WAY
THAT THEY ARE NEAR NONHEAL
FUNDING OPPORTUNITY
ANNOUNCEMENTS.
SO THEY'RE WIDE OPEN, VERY
HIGHLY DISSEMINATED SO WE HAVE
SEVERAL PROCESSES OF HOW WE GET
THE WORDS OUT.
AND THEY'RE OPEN TO ANY ELIGIBLE
INSTITUTIONS OR BUSINESSES SO WE
ALSO HAVE A SMALL BUSINESS
PROGRAM EMBEDDED IN HEAL THAT
ARE ELIGIBLE FOR NIH AWARDS.
SO I THINK I'M GETTING AT YOUR
QUESTION CORRECTLY BUT IF NOT WE
CAN TALK OFFLINE BUT THERE ARE
PROGRAMS ON HEALTH EQUITIES THAT
WERE RELEASED THROUGH HEAL,
SPECIFICALLY FOR HEALTH EQUITIES
AND SO, I GUESS THE SHORT ANSWER
IS IT'S WIDE OPEN.
>> BUT WE'RE ALSO VERY
INTERESTED AS LINDA SAID IN
UNDERSTANDING WHAT ARE THE
OBSTACLES TO PAIN RESEARCH AS
WELL AS PAIN CARE IN UNDERSERVED
COMMUNITIES, IF ORDER TO REALLY
UNDERSTAND THAT, HAVE YOU ON DO
THE RESEARCH WHERE THE CARE IS
BEING DELIVERED AND SO, REALLY
ENCOURAGING THE KIND OF RESEARCH
THAT IS PERFORMED IN EXTERIOR
EXAMPLE PRAGMATIC AND
IMPLEMENTATION TRIALS, OR
RESEARCH THAT LOOKS AT HOW CARE
IS DELIVERED IN THE COMMUNITIES
THAT ARE IN THE GREATEST NEED.
THIS IS--THIS IS A CHALLENGING
AREA, BUT IT'S AN AREA THAT NIH
IN GENERAL IS REALLY INTERESTED
IN AND THE HEAL INITIATIVE AS
WELL.
I THINK THIS WILL ADDRESS A LOT
OF THAT SORT OF INEQUITY IN
SENSE, IT'S NOT JUST INEQUITY
AND CARE, IT'S INEQUITY IN THE
RESEARCH AS ITS BEING CONDUCTED
BECAUSE IT'S CHALLENGING TO DO
THIS KIND OF RESEARCH.
THERE ARE ADDITIONAL CHALLENGES
TO DOING IT AND WE ARE REALLY
WORKING HARD TO ADDRESS THAT IN
OUR PRAGMATIC AND IMPLEMENTATION
RESEARCH.
FOR EXAMPLE, CONDUCTING RESEARCH
IN RURAL HEALTH SITTING.
THIS IS HARD TO DO AND THERE ARE
ADDITIONAL CHALLENGES IN DOING
THAT AND WE ARE REALLY LOOKING
AT THAT VERY CAREFULLY.
>> AND HEALTH EQUITY.
>> AND I APPRECIATE BOTH YOUR
COMMENTS, SO MAYBE THIS IS A
SEPARATE CONVERSATION BUT
DEFINITELY SOMETHING THAT I WANT
TO CONTINUE TO EXPLORE.
>> SURE.
>> [INDISCERNIBLE]
>> AND IT'S IN REPORTER, IT
TAKES A LITTLE BIT OF DIGGING
ABOUT YOU WE CAN HELP FIND IT
BUT IT'S ALL PUBLICLY AVAILABLE,
BUT, YEAH, WE CAN HELP WITH IT.
>> WE'RE TALKING ABOUT THE
DEMOGRAPHICS.
>> RIGHT.
>> OF THE GRANTEES.
NYES, YES OF COURSE.
THAT'S ALL AVAILABLE.
YEAH, YEAH.
SO PAUL, YOU HAVE A QUESTION?
>> YES, THANK YOU.
IF LINDA'S FIRST SLIDE IN 1 OF
THE BOXES ON THE TOP IT TALKED
ABOUT THE TRANSITION FROM ACUTE
TO CHRONIC PAIN AS BEING AN AREA
OF FOCUS BUT I WONDER IF THERE
IS AN AREA OF FOCUS IN THE
TRANSITION FROM CHRONIC PAIN TO
HIGH IMPACT CHRONIC PAIN, IT
WILL REQUIRE INVESTIGATORS TO
LOOK AT VITAL PSYCHOSOCIAL
FUNCTIONING AS A MEASURE BECAUSE
AS WAS MENTIONED IN THE
INTRODUCTIONS, IT'S REALLY
IMPORTANT ABOUT HOW THAT
TRANSITION OCCURS OR HOW DO WE
PREVENT THE TRANSITION FROM
CHRONIC PAIN TO HIGH IMPACT
CHRONIC PAIN.
>> SO PAUL, THAT NOTE IN THE
SLIDES WAS FOR THE TOPIC AREAS
THAT WERE COVERED IN FEDERAL
PAIN RESEARCH STRATEGY, I AM
SURE THEY WILL CARRY OVER NOT IN
THE SAME KIND OF DESIGNATIONS OR
SLOTS IF YOU WILL, BUCKETS, BUT
YES, THAT WAS A TOPIC THEN AND
I'M SURE IT WILL BE A TOPIC NOW.
IT WAS THEN I THINK DESCRIBED AS
TERTIARY PREVENTION MOVING FROM
ACUTE TO HIGH IMPACT CHRONIC
PAIN.
THE DEFINITIONS NOW FOR HIGH
IMPACT CHRONIC PAIN ARE SO MUCH
CLEARER THAN THEY WERE WHEN THE
NATIONAL STRATEGY AND THE FPRS
WERE DONE, AS YOU KNOW.
SO YES, IT'S DEFINITELY WILL BE
AN AREA OF INTEREST.
>> GREAT.
THANK YOU.
NGREAT, NOW THE CHAT IS BEING
QUITE BUSY.
LET'S GO TO ELIZABETH, HAVE YOU
A QUESTION ABOUT OUTCOMES?
BEST PRACTICES AND CHANGES IN
PATIENT EXPERIENCE OUTCOME, YOU
WANT TO EXPAND ON THAT?
>> SURE, IT'S NOT SO MUCH A
QUESTION BUT I WANT TO LOOK AT
THE RFI AND TAKE IT BACK TO MY
AGENCY BUT I THINK THOSE ARE THE
ANGLES THAT AHRQ WOULD BE
ESPECIALLY INTERESTED IN.
>> YES, THAT'S EXACTLY THE KIND
OF FEEDBACK, THAT'S RIGHT, THAT
THE RFI CAN CAPTURE.
WONDERFUL OKAY.
NOW WE HAVE--HOPEFULLY WE
ANSWERED THE QUESTION ABOUT THE
DEMOGRAPHICS.
WELL THE'S SEE, NOW I HAVE TO
SAY, ACCORDING TO OUR AGENDA WE
MIGHT WANT TO MOVE ON TO OUR
NEXT TOPIC BUT THERE WILL BE AN
OPPORTUNITY AFTER WE HEAR SCOTT
FISHMAN'S PRESENTATION ON
PROVIDER EDUCATION AND POTENTIAL
FOR WORKING GROUP ACTIVITIES, OF
THIS--OF THE IPRCC YOU MAY WANT
TO COME BACK TO THIS TOPIC HOW
TO GET INPUT TO THE HEAL
STRATEGIC PLAN AFTER WE'VE HEARD
SCOTT'S PRESENTATION, HOW DOES
THAT SOUND?
SO WHY DON'T WE NOW MOVE ON TO
SCOTT FISHMAN WHO WILL GIVE US
HIS THOUGHTS ON THE VERY
IMPORTANT TOPIC OF PROVIDER
EDUCATION.
>> WELL, THANKS, I WILL SHARE MY
SCREEN HERE.
THIS IS A REQUEST FOR A LITTLE
BIT MORE FORMAL PRESENTATION ON
WHAT I SPOKE ON LAST MEETING
JUST VERY SPONTANEOUSLY AROUND
INYAISHATIVES AROUND PAIN,
EDUCATION AND OPPORTUNITIES AND
I'VE ALSO INCLUDED A LITTLE BIT
ABOUT WELLNESS AND RESILIENCE,
PAIN PREVENTION HERE AS WELL
WHICH MAY BE ANOTHER POSSIBLE
TOPIC TO LOOK AT.
SO I'M GOING TO SHARE MY SCREEN.
CAN YOU SEE THAT SLIDE?
>> YOU'RE NOT IN PRESENTATION
MODE YET?
MAYBE SWAP YOUR DISPLAY?
UPPER LEFT IT SAYS SWAP
DISPLAYS.
>> YES.
>> THAT OKAY?
>> GREAT.
GREAT.
PERFECT.
NEVER KNEW ABOUT THAT.
SO THE TOPIC IS THE EDUCATION
GAP IN PAIN, I WILL GO VERY
QUICKLY BECAUSE OF THE TIME AND
I SUSPECT THAT MOST OF YOU KNOW
A LOT OF THIS INFORMATION.
YOU KNOW IT GOES BACK WELL
BEFORE THE IOM OR THE INSTITUTE
OF THE LANDMARK REPORT ON PAIN
IN AMERICA IN 2011 THAT
RECOGNIZED THAT THE DIFFUSION
ANALOGY ABOUT PAIN IS INADEQUATE
THAT IT AFFECTED ALL HEALTH
PROFESSIONALS BOTH PREAND POST
LICENSURE IN TERMS OF PHASES ET
CETERA AND THAT EVERYBODY SHARES
THE BURDEN IN TERMS OF CLINICAL
PRACTICE AND HEALTHCARE, NOT
JUST PHYSICIANS OR NURSES.
IT'S PRETTY WIDE.
AND THE DEFICIT OCCURS ACROSS
THE BOARD.
THE NATIONAL PAIN STRATEGY SPOKE
TO THIS QUOTE ALTHOUGH PAIN IS 1
OF THE MOST COMMON REASONS FOR
HEALTHCARE VISITS, MOST
HEALTHCARE POSITIONS, EDUCATION
PROGRAMS HAVE YET TO GIVE
ADEQUATE ATTENTION.
ONE OF THE SILVER LININGS OF
OPIOID CRISIS WAS THAT IT
DEFINITELY GOT ATTENTION.
I THINK CRITICISM OF WHAT'S
HAPPENED IS THAT THERE'S BEEN
KIND OF THE ACCESS PUT ON MAYBE
THE WRONG SYLLABLE KIND OF
PROBLEM WHERE A LOT OF THE
EDUCATION WAS ABOUT NOT USING
OPIOIDS, BUT THE UNDERLYING
PROBLEM OF WHAT TO DO TO TREAT
PAIN REALLY WAS THE CORE
FUNDAMENTAL PROBLEM THAT WASN'T
FULLY ADDRESSED IN ALL THE
CURRICULAR INTERVENTIONS.
I MENTIONED THIS BEFORE THAT
BACK IN 2013 WE PUBLISHED A SET
OF CORE COMPETENCIES, THEY'RE
SIMPLY THE GOALS OF TREATMENT
AND WHILE THIS WAS A REALLY
DISTINGUISHED GROUP OF PAIN
EDUCATORS AND SPECIALISTS, ET
CETERA, THAT CAME UP WITH THESE
CORE COMPETENCIES, WHAT REALLY
HELD UP FOR THE 4 DOMAINS THAT
WE CAME UP WITH AROUND, WHAT IS
IT THAT ANY HEALTH PROFESSIONAL
SHOULD KNOW AS THE FLOOR, AS THE
BASICS AND IT CAME DOWN TO
EVERYONE WHO TREATS PATIENTS
SHOULD KNOW WHAT PAIN IS, HOW TO
RECOGNIZE AND ASSESS PAIN, HOW
TO RELIEVE PAIN SAFELY AND
EFFECTIVELY AND HOW CONTEXT
EFFECTS PAIN, YOU KNOW THE
DIFFERENCE BETWEEN A CHILD AND A
AN ADULT, THE DIFFERENCE BETWEEN
ACUTE AND CHRONIC, ET CETERA.
THESE NUANCES SHOULD BE
UNDERSTOOD WITHIN THE CONTEXT OF
THE COPE OF PRACTICE FOR ALL OF
THE PROFESSIONS THAT COME TO THE
TABLE.
AGAIN I'M NOT DIVING IN DEEP,
HAPPY TO ANSWER QUESTIONS BUT
THE BOTTOM LINE IS THAT THESE
HAVE BEEN WIDELY EMBRACED AND
WIDELY USED AND THAT STRUCTURES
CONTINUED.
AT THE UNIVERSITY OF CALIFORNIA
WHERE I PRACTICE, WE'VE ACTUALLY
CREATED A UC-WIDE SET OF CORE
COMTENCYS THAT ALL THE DEANS
AGREED ON, WE INCLUDED SUBSTANCE
USE DISORDER AND PAIN, AND WE'RE
QUITE MINDFUL THAT THEY'RE NOT
INTERCHANGEABLE, THEY'RE
DIFFERENT, AND HOW DO YOU
RECOGNIZE IT, HOW DO YOU SAFELY
AND EFFECTIVELY APPROACH IT IN
HOW DOES CONTEXT APPROACH IT?
REALLY HELD UP FOR THIS MODEL
AND THERE HAVE BEEN MANY STATES
SRO DONE THIS, THE ISSUE IS IN
TERMS OF HOW IT'S GOTTEN
TRANSLATED AND I WILL SPEAK TO
THIS AT THE END, BUT, I STILL
REMAIN QUITE CONCERNED ABOUT THE
NEED FOR SCHOOLS TO REALLY
INCORPORATE WHAT I THINK CAME UP
IN SOME OF THE CHAT WHICH IS
REALLY SEPARATING THE PAIN FROM
THE SUBSTANCE USE DISORDER AND
ANXIOUS WE HAVE RIGHTFULLY SO
THAT OPIOID USE DISORDER AND
ADDICTION, USE DISORDERS ARE SO
PROFOUND THAT WE'VE GOT TO TEACH
OUR STUDENTS TO ADDRESS IT, BUT
THEN THAT'S ALL WE GET AND THE
UNDERLYING NEED TO ACTUALLY KNOW
HOW TO TREAT PAIN, DOESN'T GET
TO THE TABLE AND CLASSICALLY, AS
I'M SURE ALL OF YOU KNOW, PAIN
IS PART OF EVERY CLINICAL
DISCIPLINE AND WHEN THE KRIM
LUMGROUP COMES TO THE TABLE AT
MOST SCHOOLS IT BECOMES
[INDISCERNIBLE] AT THAT TABLE
BECAUSE THERE'S NO 1 GROUP THAT
PRIORITIZES IT.
SO THIS IS WHAT WE'RE CONCERNED
ABOUT.
ONE OUTCOME OF THE COMPETENCIES
WAS WE WERE INVITED BY THE
NATIONAL BOARD OF MEDICAL
EXAMINERS TO REVIEW THE USME,
THE U.S. LICENSING EXAM, MOST OF
YOU, PROBABLY THE MOST IMPORTANT
TEST A PHYSICIAN HAS TO TAKE TO
PRACTICE MEDICINE, YOU REALLY
CAN'T PRACTICE MEDICINE WITHOUT
PASSING THIS AND GET A STATE
MEDICAL LICENSE, SO WHAT I FOUND
AND I WON'T GO INTO A LET OF
DETAIL THAT AFTER LOOKING AT THE
ACTUAL EXAMS, WE WENT IN, WE
BROUGHT A BLUE RIBBON PANEL TO
PHILADELPHIA WHERE THE NATIONAL
BOARD OF EXAMINERS LIVINGS.
THEY BROUGHT US INTO A SECURE
ENVIRONMENT AND THEY BROUGHT US
THE ACTUAL TESTS, AND WE
ACTUALLY REVIEWS OVER 2 DAYS,
QUESTION AFTER QUESTION AND THIS
IS ESSENTIALLY THE PUNCH LINE OF
WHAT WE FOUND AND I CAN TELL YOU
MORE ABOUT IT BUT ULTIMATELY
THAT WE FOUND THAT ALMOST 90% OF
THE QUESTIONS,--ACTUALLY I
SHOULD SAY, WE WENT IN BELIEVING
THAT PAIN WOULDN'T BE PART OF
THE EXAM VERY MUCH BUT PAIN WAS
ALL OVER THIS EXAM, MOSTLY AS A
DESCRIPTOR BUT WE FOUND WAS THAT
15% OF THE EXAM TESTED ON PAIN.
AND WHEN YOU LOOKED AT THOSE
QUESTIONS THAT TESTED ON PAIN,
ALMOST 90% OF THOSE QUESTIONS
WERE SIMPLY ABOUT HOW TO
RECOGNIZE PAIN, HOW TO,A
ASSESSES PAIN.
AND WE TRIED TO UNDERSTAND THIS
IN THE CONTEXT OF WHAT WAS
HAPPENING ON THE THE TIME WHICH
WAS AN OPIOID CRISIS AND WHAT
WE'RE ABLE TO CORRELATE IS THAT
IF YOU--YOU KNOW THESE ARE
THINGS THAT I KNOW YOU ALL KNOW,
THAT WHEN YOU LOOK AT THAT
INFLECTION POINT WHEN THE
OVERDOSE, THE INTERNAL AUDIT
TENDED OVERDOSE DEATHS WITH
OPIOIDS STARTED TO RISE, IT
OVERLAPPED ALMOST PRECISELY WITH
WHEN THE JACO OR JOINT
COMMISSION PAIN [INDISCERNIBLE]
VITAL EMERGED AND 1 WOULD
HYPOTHESIZE THAT ONCE THAT
HAPPENED THERE WAS A PUSH IN
SCHOOLS TO CHANGE CURRICULUM AND
WHEN THEY CHANGE THE CURRICULUM
WHAT THEY DID WAS WHEN JOINT
COMMISSION MADE PAIN WITH THE
VITAL SIGN, THEY ASSUME THAT IF
CLINICIANS SIMPLY RECOGNIZE PAIN
OF COURSE THEY WOULD WANT TO
TREAT IT APPROPRIATELY AND YET
THEY WERE NEVER REALLY TRAINED.
SO IF YOU BELIEVE THAT THE TEST
REFLECTS THE CONTENT, HERE IT'S
REFLECTING THAT WE EMPHASIZE
ASSESSMENT BUT WE REALLY DON'T
EMPHASIZE THE OTHER CORE
COMPETENCIES OF UNDERSTANDING
PAIN, HOW TO SAFELY, EFFECTIVELY
TREAT IT IN CONTEXT, WE'RE
REALLY NOT REPRESENTED IN THE
U.S. MLE WHICH WAS SHOCKING TO
FIND.
AND WE DID A PROCESS LOOKING AT
PRELICENSURE TRAINING AND AN
EMPHASIS THAT THIS HAS TO
CHANGE, ET CETERA AND I THINK
THERE'S BEEN A GREAT DEAL OF
INVESTMENT IN THIS AND YET, THE
UPTAKE OF IT IS DIFFICULT
BECAUSE AS I THINK MOST OF YOU
PROBABLY KNOW, IF YOU'VE SEEN 1
CURRICULUM, YOU'VE SEEN 1
CURRICULUM, IT'S AN ART FORM.
EVERYBODY DOES IT DIFFERENTLY
BUT FOR 1 THING WE COULD FIND
AGREEMENT ON IS WHAT'S THE
OBJECTIVE OF THE CURRICULUM
WHICH IS TO HAVE A COMPETENT
HEALTH PROFESSIONAL WHO CAN
MANAGE PAIN AND THERE'S
AGREEMENT ON THAT AND IF WE'RE
GOING TO GET THAT COMPETENCY TO
REALLY GET EMBEDDED, I THINK WE
WILL NEED TO GET THE CREDITORS
INVOLVED THAT WOULD
INSTANTANEOUSLY CHANGE THE
CALCULUS HERE FOR SCHOOLS AND I
THINK IT'S POSSIBLE TO DO THAT.
I WILL SPEAK TO THAT AT THE END.
THE OTHER IS WHAT DO WE DO ABOUT
THE REST OF THE WORKFORCE WHO
WILL NEVER GET THE BENEFIT OF
CHANGING MEDICAL EDUCATION.
THIS IS SOMETHING WE'VE
ADDRESSED THROUGH MANY DIFFERENT
CHANNELS.
AGAIN I WILL GO THROUGH QUICKLY
HERE.
I'M SURE YOU ALL HEARD OF
PROJECT ECHO, WE--WE LOOKEDDA
THE PROJECT ECHO FOR PAIN.
I WILL FLIP THROUGH HERE, I JUST
PULLED UP ALL THE DIFFERENT
ARTICLES I FOUND OVER REALLY THE
LAST 10 YEARS ON ECHO AND PAIN.
OUR APPROACH WAS A LITTLE BIT
DIFFERENT THAN MOST IN THAT
RATHER THAN DOING A ONE-ON-ONE
WITH A RURAL PROVIDER OR
UNDERSERVED PROVIDER AND
TEACHING THEM HOW TO TREAT THEIR
PATIENT, WE TRIED TO RETRAIN
PRIMARY CARE ORGANIZATIONS AND
WE SPEND 6 MONTHS TO A YEAR WITH
ORGANIZATIONS.
TEACHING THEM TO REALLY BE A
PRIMARY CARE, THE CENTER OF
EXCELLENCE FOR PAIN MANAGE AM.
IT WAS ACTUALLY QUITE FULFILLING
AND QUITE EFFECTIVE AND THE
MEASURE OF THAT EFFECTIVENESS
WAS THAT WE HAD INSURANCE
COMPANIES COMING TO US WANTING
TO PAY US TO DO FOR THEIR
PROGRAMS FOR FQHCs, FOR PUBLIC
HEALTH PROGRAMS, ET CETERA AND
YOU KNOW WHAT IT TURNED OUT IS
THERE REALLY WASN'T JUST ENOUGH
OF US AND IT WAS A GOOD PROGRAM
AND QUITE EFFECTIVE AND SOME OF
THESE PROGRAMS EVEN DID OUTCOMES
RESEARCH TO SHOW THAT THERE WAS
GREATER PATIENT AND PROVIDER
SATISFACTION, RESOURCE
UTILIZATION WENT DOWN.
OPIOID PROBLEMS WENT DOWN,
REFERRALS TO SPECIALISTS EACH
WEPT DOWN AND THERE WERE BETTER
OUTCOMES AS MEASURED IN PRIMARY
CARE AND EMERGENCY ROOMS, ET
CETERA.
BUT IT WAS THE PROBLEM HERE IS
THAT, WE DIDN'T HAVE ENOUGH OF
US TO DO IT SO WE HAD TO FIGURE
OUT HOW TO MAG FIELD
FUNCTIONSIFY THE FORCE OF THIS
AND WE CAME UP WITH THIS TRAIN
THE TRAINER MODEL WHICH WE'VE
NOW DONE FOR 5 YEARS.
IT'S A VERY SIMPLE MODEL IN THE
SENSE WHERE WE TRAIN SOMEONE
FROM A PRACTICE TO WORK WITH US
FOR A YEAR AT A DISTANCE.
WE ALSO HAVE MOST OF OUR GROUPS
BEFORE COVID WOULD COME IN FOR A
PREAND A POST CONFERENCING
PERSON TO DO HANDS ON TRAINING
AND WE'VE EVEN TRAINED THESE
FOLKS TO DO ULTRASOUND BUT
MOSTLY WE TRAIN THEM TO DO
ADEQUATE EXAMS SO THAT THEY CAN
MAKE A DECISION THAT'S MORE
SOUND AND GET IT RIGHT BEFORE
THEY HAVE TO SAY REACH FOR AN
OPIOID INSTEAD OF REACHING FOR
AN OPIOID CHOOSING THE RIGHT
TREATMENT WHICH WE FOUND IS
RARELY AN OPIOID.
WE'RE NOT DEMONIZING OPIOIDS BUT
THEY DON'T NEED TO BE A FIRST
LINE CHOICE WHEN YOU REALLY
UNDERSTAND PAIN AND THAT'S WHAT
WE FOUND IN THIS PROCESS.
THIS IS GONE ON FOR ABOUT 5
YEARS, WE'VE TRAINED MANY
FELLOWS IN CALIFORNIA AND
NATIONALLY.
WE BELIEVE THAT THIS IS
EFFECTIVE BUT WE'VE NOT HAD THE
BUDGET TO DO THAT RESEARCH STUDY
THAT FEEDS TO BE DONE.
WE DID APPLY FOR A HEAL GRANT TO
DO THE STUDY BUT IT DOESN'T--IT
DIDN'T GET VERY FAR BECAUSE I
DON'T THINK IT WAS VIEWED AS
SOMETHING THAT HEAL IS SUPPOSED
TO FUND IN TERMS OF THE
INTERVENTION.
YOU KNOW OUR GOAL WAS TO LOOK
AT, DO A PERSPECTIVE CONTROLLED
TRIAL LOOKING AT AN INTERVENTION
VERSUS NONINTERVENTION AND
REALLY DIGGING INTO HEALTH
SYSTEMS OUTCOME DATA, MY POINT
HERE IS THAT, I THINK THAT
THAT'S WHAT WE NEED TO DO.
WE HAVE DONE OUTCOMES DATA AND
WE FIND THAT THE GRADUATES
INCREASE THEIR KNOWLEDGE,
INCREASE THEIR CONFIDENCE, THEY
FIND THAT THEY'RE EFFECTIVE IN
TEACHING THEIR COLLEAGUES, ET
CETERA.
BUT THIS IS QUALITATIVE
RESEARCH.
WE REALLY NEED TO DO THE
QUANTITATIVE RESEARCH AND WE
BELIEVE THIS COULD BE A NATIONAL
MODEL, ET CETERA.
WE ARE WORKING WITH CDC RIGHT
NOW LOOKING AT IT.
I'M NOT SURE IF THAT'S GOING TO
GET FUNDED OR NOT, I HOPE IT
WILL TO EXPAND THIS REGIONALLY
AND NATIONALLY, BUT AGAIN DATA
IS IMPORTANT.
THERE ARE MANY OTHER MODELS.
I MEAN THIS IS JUST 1 OF THEM
THAT WE'VE APPROACHED, THERE ARE
MANY OTHER WAYS TO LOOK AT.
I WANT TO DO A SHOUT OUT TO
[INDISCERNIBLE] AT NCCIM,
DR. LANG EVIN, I'M SURE YOU'RE
FAMILIAR WITH THIS, HE'S LOOKING
AT PROGRAMS TO EDUCATE
PROFESSIONALS WHO REALLY HAVE AN
UNDERSTANDING OF THE BASIC
SCIENCE AND KNOWLEDGE OF WHAT
PAIN IS.
THE QUESTION IS WHO THE AUDIENCE
SHOULD BE TO GET, YOU KNOW,
REALLY THE IMPACT WE WANT.
IF WE REALLY WANT TO CHANGE THE
WORKFORCE, WE'RE GOING TO NEED
TO LOOK AT A WORKFORCE
INTERVENTION BUT WE ALSO NEED,
WE'VE GOT THESE GENERATIONS OF
CLINICIANS COMING FORWARD.
THERE ARE MODELS TO CHANGE THE
WAY THAT WE LOOK AT TRAINING OUR
FUTURE HEALTHCARE PROFESSIONALS.
MY PLEA IS THAT WE FUND RESEARCH
THAT SHOWS THE VALUE OF
INTERVENTIONS IN PAIN.
THE IMPACT, YOU KNOW OF
INADEQUATE KNOWLEDGE ON THE
OPIOID CRISIS, THE POTENTIAL
THAT THAT INADEQUATE KNOWLEDGE
EVEN THOUGH WE NOW FOCUSED ON IT
NOT BEING AN OPIOID PROBLEM THAT
THE BALLOON IS JUST SQUEEZED
SOMEWHERE ELSE BECAUSE OF THE
EDUCATION INADEQUACY AND THAT WE
OVERUSE SOMETHING ELSE BECAUSE
DOCTORS DON'T KNOW WHAT TO DO.
AND THE IMPACT OF THE
INTERVENTIONS TO BENEFIT US
BECAUSE I THINK IF YOU LOOK AT
THE COST OF THESE INTERVENTIONS,
THE RETURN ON INVESTMENT IS
GREATER THAN THE POTENTIAL
RETURN ON FINDING THAT NEW
MOLECULE OR THE OTHER PATHWAYS
THAT, YOU KNOW MAY HAVE BEEN
FUNDED PREVIOUSLY.
YOU KNOW, I SAID IT BEFORE THAT
IF WE JUST CHANGE CURRICULUM,
YOU'VE SEEN 1, YOU'VE SEEN THEM
ALL, BUT IF WE GET OUR CREDITORS
TO LOOK AT, YOU KNOW, SHOW
ASKING THE SCHOOL SAY A CREDIT
TO DEMONSTRATE BASIC PAIN
COMPETENCIES AS A PRIORITY FOR
ACCREDITATION, THE PROBLEM WOULD
CHANGE TOMORROW.
I CAN TELL YOU THIS IS SOMETHING
WE'VE TRIED TO BRING FORWARD
FROM GROUPS AND OTHERS, WE'RE
NOT FAR FROM HAVING A
WHITE HOUSE CONFERENCE ON PAIN,
LOOK AT THIS AND BRING THE
ACCREDITORS IN THE ROOM AND I
THINK IT'S MOM AND APPLE BY THEA
THE END -
-APPLE PIE AT THE END OF
THE DAY.
AND LOOKING AT WORKFORCE
RETRAINING IS--WE'VE GOT A
WORKFORCE OUT THERE THAT WON'T
BENEFIT FROM THE EDUCATIONAL
CURRICULUM REFORM THAT I THINK
IS COMING AND WE'VE GOT TO FIND
WAYS TO MAGNIFY THE FORCE AND
GET PRACTICES CHANGED.
WE'VE TALKED WITH HHS A LITTLE
BIT ABOUT THE IDEA OF CMS GIVING
A FINANCIAL INCENTIVE TO PRIMARY
CARE GROUPS THAT MIGHT IN FACT
PRIORITIZE RETRAINING THEIR
MEMBERS AND I KNOW THAT WITHLET
DATA WE HAVE MORE INSURANCE
COMPANIES VERY EGGER TO DO THIS
AS WELL.
I KNOW THIS HAS BEEN A VERY FAST
TOUR, I DON'T KNOW IF DR. LANG
EVIN IF YOU WOULD LIKE ME TO
STOP HERE BUT I WAS ALSO GOING
TO TALK ABOUT THE PAIN AND
RESILIENCE.
>> YOU HAVE MORE TIME.
>> IF YOU WANT TO TALK ABOUT
THAT AS WELL, IT'S FINE.
>> I BANG IT OUT QUICKLY AND
THEN I WILL ANSWER ANY
QUESTIONS.
SO THE OTHER AREA I'M INTERESTED
IN IS THIS IDEA OF PREVENTION.
YOU KNOW, 35-40 YEARS OF LOOKING
AT PATIENTS IN PAIN, IT'S SO
OBVIOUS THAT PAIN IS THE DOWN
STREAM CHRONIC ILLNESS, OF WHICH
MUCH IS PREVENTIBLE.
YOU KNOW WE HAVE GREAT
HEALTHCARE AND YET WE DIE
YOUNGER THAN PEOPLE IN MANY
OTHER COUNTRIES AND THIS I THINK
IS REALLY IMPORTANT.
THIS IS SECRETARY BECERAs
STATEMENT THAT WE MUST SHIFT TO
AN ILL CARE SYSTEM TO A WELLNESS
CARE SYSTEM.
HE SAID THE WORDS, THIS IS NOT
JUST A HEALTH ISSUE BUT IT'S A
ISSUE OF NATIONAL SECURITY.
IF YOU LOOK AT THE ECONOMICS IT
MAKES SENSE.
YOU KNOW CHRONIC PAIN IS VERY,
VERY COMMON.
IT'S A LEADING CAUSE OF
DISABILITY, BILLIONS OF DOLLARS
PER YEAR, HIGHER INCIDENCE THAN
MANY OF THE OTHER CHRONIC
ILLNESSES WE GIVE MUCH MORE
FOCUS TO LIKE DIABETES,
DEPRESSION, HYPERTENSION, ALL OF
WHICH WE KNOW HOW LIFESTYLE
PREVENTIVE ELEMENTS THAT HAVE
BEEN IDENTIFIED, STUDIED AND ARE
VERY PARALLEL TO THE PROBLEM OF
CHRONIC PAIN BUT WE DON'T STUDY
THAT DIRECTLY.
THERE IS ADJACENT RESEARCH THAT
TALKS ABOUT IT AND THIS IS AN
ARTICLE THAT JUST GOT PUBLISHED
FROM THE USA S P JOURNAL,
JOURNAL OF PAIN, PATIENTS WITH
CHRONIC PAIN HAVE TWICE THE
MORTALITY RISK AS PATIENTS
WITHOUT PAIN AND IF YOU HAVE
HIGH IMPACT PAIN, IT'S 2.5% AND
IF YOU LOOK AT THE ASSOCIATED
VARIABLES, THEY'RE ALL
VARIABLES.
I HIGHLIGHTED THEM THAT WE KNOW
ARE REVERSIBLE WHEN LAST DIALED
INTERVENTION.
ISP MADE 2020 THE GLOBAL YEAR OF
PREVENTION.
A LOT CAME OUT OF IT BUT THERE
WASN'T A LOT OF DISSEMINATION,
IT WAS DURING COVID.
WE'RE TRYING TO KIND OF BRING
THAT BACK A LITTLE BIT, NOW, ISP
HAS PUBLISHED MODIFIABLE FACTORS
ASSOCIATED WITH PAIN.
WE KNOW THAT THERE ARE
MODIFIABLE LIFESTYLE
INTERVENTIONS THAT IMPACT THE
POTENTIAL FOR PAIN.
MY POSITION IS THAT PAIN IS
A--IT'S NOT ABOUT GETTING RID OF
PAIN, IT'S ABOUT HAVING A PAIN
ALARM THAT WORKS PROPERLY.
IT'S A VULNERABLE ALARM.
SOME OF US ARE MORE RESILIENT
THAT OTHERS, THAT'S WHY I VERY
MUCH LIKE THE TERM RESILIENCE
RATHER THAN WELLNESS.
WELLNESS THAT IS BEEN
CAPITALIZED, MONETIZE EXPLOITED,
ET CETERA AND RESILIENCE PEEKS
TO WHATY WOO WANT FOR PEOPLE SO
THAT THEIR ALARMS WORK.
WE KNOW THERE ARE MODIFIABLE
FACTORS IN ALMOST ALL CHRONIC
ILLNESSES THAT REDUCE MORBIDITY
AND MORTALITY, CHRONIC PAIN IS
PROBABLY NO DIFFERENT.
WE KNOW THE MIND IS INVOLVED.
THIS IS JUST 1 THIS IS
[INDISCERNIBLE] THIS IS JUST WOB
AREA OF INTERVENTION WITH THE
TERMS OF MINDFULNESS, MANY, MANY
OTHERS, WE KNOW THAT MOVEMENT IS
INVOLVED AND INACTIVITY IS THE
ENEMY AND MOVEMENT--INACTIVITY
BECAUSE OF PAIN IS A DOUBLE
WHAMMY.
WE KNOW THAT PHYSICAL EXERCISE,
PHYSICAL ACTIVITY TREATS
EMOTIONAL AND PHYSICAL OUTCOMES
OF CHRONIC ILLNESS, WE KNOW THAT
FOOD IS IMPORTANT BUT WE'RE
HONESTLY, IF YOU ASK ME WHAT YOU
SHOULD EAT, I WILL TALK A LITTLE
BIT ABOUT IT.
THERE'S A LOT OF CONTROVERSY
ABOUT WHAT NOT TO EAT AND REALLY
THE SIMPLE THINGS OF EAT WHOLE
FOOD RATHER THAN ULTRA PROCESSED
FOOD IS PROBABLY THE FORMULA,
EVEN NONMODIFIABLE THINGS LIKE
GENETICS ARE NOW BEING
RECONSIDERED AS POTENTIALLY
MODIFIABLE.
YOU KNOW, THE WORK FROM LIZ
BLACK BURN AND MELISSA ON
TELOMERE SYSTEM GETTING A LOT OF
PRESS.
YOU KNOW I THINK IT'S FAR FROM
PROVEN BUT IT ACTUALLY GIVES
HOPE TO THE IDEA THAT WE CAN--WE
CAN CHANGE THROUGH LIFESTYLE AT
A VERY, VERY DEEP LEVEL IF WE
CHOOSE TO LOOK AT IT BUT IT'S
UNLIKELY THAT WE WILL, YOU KNOW
GET MAJOR UPTAKE UNTIL WE REALLY
DO THE RESEARCH, FUND THE
RESEARCH THAT'S NEEDED TO PROVE
THAT THESE WORK, THAT THESE ARE
THE RETURN ON INVESTMENT FOR
THESE CHANGES IS IN OUR
INTEREST.
SO YOU KNOW WELLNESS AS I SAID
MEANINGS TO PEOPLE AND
EVERYONE'S FOR IT AND FEW AGREE
THAT THE AREA OF MISINFORMATION
IN THIS AREA IS VAST.
THE SURGEON GENERAL TALKED ABOUT
THIS IN TERMS OF ILLNESS BASED
INFORMATION.
IT APPLIES EVEN MORE TO
WELLNESS.
YOU KNOW AND PEOPLE ARE CONFUSED
ABOUT WHAT TO DO.
YOU KNOW THE BOTTOM LINE THAT
HEALTHY EATING, EXACTLY WHAT
HEALTHY EATING IS NOT AS RIGID
AS MOST PEOPLE THINK, IT'S
PRETTY SIMPLE STUFF.
THERE'S A LOT OUT THERE ON PAIN
AND DIET.
I DON'T KNOW THAT A LOT OF IT'S
PROVEN BUT THE MORE BASIC IDEAS
ABOUT EATING ARE PRETTY WELL
PROVEN TO REDUCE MORBIDITY AND
MORTALITY ASSOCIATED WITH
CHRONIC ILLNESS.
ULTRA PROCESSED FOOD WAS VERY,
VERY GOOD DATA THAT THIS IS
REALLY HARMFUL AND DRIVES A LOT
OF THE PREVENTIBLE ILLNESS THAT
WE SEE.
YOU KNOW SHOULD WE MOVE MORE?
WE SHOULD MOVE MORE.
CULTURES WHERE THEY HAVE LIVES
IN MOTION.
YOU KNOW IN MY FAMILY, IT WAS A
BADGE OF SHAME IF YOU GOT A
PARKING SPACE THAT WASN'T AS
CLOSE AS POSSIBLE AS IF WALKING
A FEW STEPS WAS A TERRIBLE
THING.
I FIND THAT--YOU KNOW I'M
LOOKING AT KIND OF THE WAY WE
LIVE OUR LIVES AND THESE
UNCONSCIOUS DRIVES WE HAVE.
CULTURES WHERE THEY MOVE
NATURALLY AND THEY--THESE ARE
KIND OF THE THINGS, THE BLUE
ZONES TELL US NOT A LOT OF DATA
IN THE BLUE ZONES BUT THE
OBSERVATION IS ALL OF THESE
AREAS ARE PLACES WHERE PEOPLE
MOVE.
SEDENTARY BEHAVIOR, AGAIN, THE
DATA ON THE POSITIVE IS NOT AS
STRONG AS THE DATA ON THE
NEGATIVE, VERY, VERY CLEAR ABOUT
SEDENTARY BEHAVIOR AND MORBIDITY
AND MORTALITY.
THE SAME WITH LONELINESS AND
ISOLATION.
YOU SEE HEALTHY GROUPS,
THEY--YOU KNOW HEALTHY
COMMUNITIES ARE CONNECTED,
THEY--YOU KNOW EVEN THIS IDEA
THAT THERE'S NO HEALTHY DOSE OF
ALCOHOL AND I BELIEVE THAT TO BE
TRUE BUT THESE GROUPS, MOST OF
THEM DRINK ALCOHOL BUT THEY
DRINK MODEST AMOUNT OF ALCOHOL
TO ASSOCIATE, RATHER THAN TO
DISASSOCIATE.
I THINK THESE ARE REALLY KEY
THINGS THAT WE FIND.
THERE ARE STUDIES THAT ARE LONG
STANDING STUDIES, I WON'T GO BO
INTO DETAIL BUT I FIND THAT
HAPPIER, MORE SATISFYING
HEALTHIER LIVES ARE PREDICTED BY
HAVING SOCIAL RELATIONSHIPS AND
COMMUNITIES AND PRURPS ON,
THINGS THAT YOU WOULD I THINK
RECOGNIZE.
THE BLUE ZONES YOU MAY ALL KNOW
ABOUT AREAS WHERE PEOPLE LIVE
LONGER, HAPPIER AND HEALTHIER
LIVES, THERE'S VERY LITTLE CLEAR
DATA AND THE BLUE ZONES ARE
RAPIDLY MONETIZED BUT THE
OBSERVATION OF THESE AREAS IS
REALLY INTERESTING IN THAT IF
THERE'S 1 THING THAT'S TRUE OF
THEM ALL, IT'S THAT THEIR
COMMUNITIES THAT ARE ENGAGED AND
THEY HAVE LIVES IN MOTION.
THERE IS GUIDELINES ON HOW--YOU
KNOW THE THINGS THAT YOU CAN DO
BUT IT'S ABOUT TAKING THE WAY
THOSE THINGS THAT ARE HARMFUL, I
LIKE THE IDEA OF RESILIENCE
RATHER THAN WELLNESS BUT IT
REALLY IS ABOUT HAVING A WELL
LIFE RATHER THAN HAVING AN ILL
LIFE.
SO THERE'S WORK FOR US HERE THAT
I THINK WE IGNORED AS A FIELD.
BASICALLY WE KNOW THAT THE PAIN
ALARM IS A VULNERABLE ALARM.
WE'VE LEARNED THAT.
THESE ARE SOME OF THE MORE
VULNERABLE NERVES IN THE BODY
AND THAT SOME PEOPLE ARE MORE
RESILIENT THAN OTHERS.
SO, YOU KNOW LIFESTYLE CHOICES
DO EXIST BUT IT'S NOT THE ROLE
OF SPECIALLY CLINICIANS BECAUSE
IT'S TOO LATE AT THAT POINT BUT
AS A PROFESSION WE SHOULD LOOK
AT THE RESEARCH AND THE
EDUCATION THAT'S NEEDED FOR THE
FIELD OF HEALTHCARE.
AND I WOULD SAY THAT YOU KNOW
MOST MOST OF US COME FROM HEALTH
SYSTEMS THAT WE CLAIM ARE HEALTH
SYSTEMS BUT WERE REALLY DEC
RESPONSE SYSTEMS.
AND WE LOOK THEA HOW WE EDUCATE
PEOPLE, WE REALLY EDUCATE OUR
CLINICIANS TO BE DISEASE
RESPONDERS AND WE'RE TRULY
TRYING TO CHANGE THAT SCOPE OF
PRACTICE.
OUR MEDICAL STUDENTS AND NURSING
STUDENTS THEY DON'T SEE
PREVENTION AS PART OF THEIR
SCOPE OF PRACTICE AND THAT'S A
CHANGE TAKEN--THEY WE CAN EASILY
MAKE.
SO WHAT WE'VE BEEN DOING IS
HOLDING MEETINGS TO DISCUSS THIS
AND HOPEFULLY BRING FORWARD A
DECLARATION OF WHAT I JUST SAID
THAT THIS IS IMPORTANT FOR OUR
RESEARCH FUNDERS FOR OUR
EDUCATORS, ET CETERA.
AND, YOU KNOW AGAIN, I'M SORRY
FOR THE SPEED BUT I'VE TRIED TO
BE MINDFUL OF THE TIME.
I THANK YOU FOR LETTING ME
PRESENT THIS.
I WOULD BE DELIGHTED TO ANSWER
ANY QUESTIONS THAT YOU HAVE.
THANK YOU.
>> WELL, THANK YOU SO MUCH
SCOTT, YOU REALLY HAVE MADE A
VERY FORCEFUL CASE FOR 2 THINGS,
1 IS VITAL IMPORTANCE OF THE
EDUCATION OF OUR HEALTHCARE
PROFESSIONALS IN THE AREA OF
PAIN AND THEN THIS TOPIC THAT
YOU'RE RAISING IN TERPS OF THE
IMPORTANCE OF UNDERSTANDING
POSITIVE NOTE PROCESSES IN
ADDITION TO THE NEGATIVE 1S.
SO IMPORTANT.
VERY MUCH DEAR TO MY HEART, I
CAN TELL YOU IN TERMS OF VERY
MUCH OF AN INTEREST AT NCCIH BUT
INCREASINGLY AT NIH IN GENERAL.
SO I WILL GIVE A CHANCE FOR
CHRISTINE TO COMMENT?
>> THANK YOU SO MUCH AND THANKS
SCOTT.
FABULOUS TALK.
AND I WILL START TO PARK FARTHER
AWAY FROM THE GROCERY STORE FROM
NOW ON.
REGARDING EDUCATION, YES, 1
IMPORTANT APPROACH TO ADDRESS
INCREDIBLY IMPORTANT APPROACH TO
ADDRESS GAPS IN THE PAIN
RESEARCH WORKFORCE.
AT THE MEDICAL SCHOOL LEVEL AND
AT THE MEDICAL TRAINING LEVEL 1
OF MANY POSSIBLE APPROACHES MAY
INCLUDE PARTNERING WITH CLINICAL
PHARMACOLOGY.
I SAY THIS BECAUSE I TEACH THE
PAIN SEMINAR IN A FOURTH YEAR
CLINICAL FROM COLLEGIATE COURSE
AT TUFTs AND THIS IS SUCH A
PERFECT TIME TO PLANT THE
RESEARCH BUG AND SO I JUST WANT
TO PUT THAT IN THERE, SOME FOOD
FOR THOUGHT.
>> YOU KNOW IF I CAN JUST SAY
THAT M ISHA IS LOOKING AT THIS
AND TRAINING AND I THINK WHAT
YOU DESCRIBED CHRISTINE IS
SOMETHING REALLY IMPORTANT AND
MAYBE SOMETHING TO TALK TO MISHA
ABOUT.
I KNOW YOU KNOW THEM.
>> I'VE SEEN QUESTIONS IN THE
CHAT.
I ALSO WANT TO KIND OF SHAPE
ALET BIT THIS DISCUSSION IN NCH
COURAGING YOU TO THINK ABOUT,
ARE THERE POSSIBLE WORKING
GROUPS OF THE IPRCC THAT YOU
ALL, SOME OF YOU MIGHT BE
INTERESTED IN FORMING AND TO
FOCUS ON THIS SPECIFIC TOPIC AND
I THINK THE 2 TOPICS THAT WERE
JUST PRESENTED BY BE EXAMPLES OF
THAT, AND AT THE SAME TIME THESE
WORKING GROUPS COULD PLAY A ROLL
PERHAPS IN INTERACTING WITH THE
HEAL STRATEGIC PLANNING PROCESS
THAT LINDA PRESENTED.
SO RENEE?
>> YEAH, I PUT THIS IN THE CHAT,
THE NIH MADE A SIGNIFICANT
INVESTMENT IN THE CENTERS FOR
EXCELLENCE FOR PAIN EDUCATION
AND I DON'T KNOW HOW WELL THAT
HAS BEEN EVALUATED.
I WILL PERSONALLY TELL YOU THAT
I HAVE NOT USED ABOUT ANY OF THE
CASE SCENARIOS BECAUSE IT
DOESN'T FIT WITH THE TYPE OF
EDUCATION THAT HAS REALLY
EMERGED SINCE 2020 WHICH IS
EVERYTHING HAS TO BE A 3 MINUTE
YouTUBE VIDEO OR TIKTOK OR
SOME VERY FAST WAY, WHEREAS
THOSE ARE HOUR-LONG CME TYPE
LECTURES AND WE DON'T--OUR
PRELICENSURE STUDENTS DON'T
RESPOND TO THAT TYPE OF
EDUCATION.
BUT MY INTEREST WOULD BE HAVE WE
EVEN LOOKED AT IS ANYBODY
DOWNLOADING THEM?
ARE THEY USING THEM?
THEY WERE VERY DEFINED IN HOW
THEY HAD TO BE DEVELOPED AND
WHAT YOU'VE DESCRIBED SCOTT IS
VERY DIFFERENT THAN THAT MODEL
IS HOW DO WE MAKE FUNDING
AVAILABLE FOR DIFFERENT MODELS.
>> RENEE, I CAN HELP A LITTLE
BIT WITH THE EVAL EVACUATION OF
THE FOCUS MODELS, THEY WERE
DEVELOPED BY A NUMBER OF
DIFFERENT INSTITUTIONS, ACADEMIC
INSTITUTIONS DEVELOPED SETS AND
OUR SENSE WAS WHEN WE DID HOW
OFTEN ARE THEY BEING USED KIND
OF EVALUATION, THEY WERE BEING
USED IN THE INSTITUTIONS THAT
DEVELOPED THEM AND PART OF
REASON THEY DIDN'T GET MORE USE
OUTSIDE OF THE DEVELOPING
INSTITUTIONS IS THAT THEY WERE
NOT CME ACCREDITED.
WE SHOULD HAVE DONE THAT.
THAT'S SOMETHING WE LOOK BACK ON
AND REALIZE, THAT WAS PROBABLY A
MISTAKE AND WE SHOULD HAVE MADE
THE INVESTMENT.
THEY WERE HARD AT THE TIME
BECAUSE OF THE TECHNOLOGY TO
CONVERT THEM TO EASY USE ACROSS
DIFFERENT PLATFORMS AND PROFILES
AND LET'S SEE THERE WERE A
COUPLE OTHER ISSUES.
LENGTH AND DURATION, THEY WERE
HARD TO PUT TOGETHER SO EACH
INSTITUTION DID A SMALL NUMBER.
THEY WERE NOT AN EXHAUSTIVE
CURRICULUM.
THEY WERE SAMPLES.
THE PEOPLE WHO USED THEM, FOUND
THEM VERY HELPFUL, THEY ACTUALLY
DID SOME TESTS IN WHETHER THEY
CHANGED, FORGET WHAT THE EXAM
WAS THAT THEY USE, BUT FOR THOSE
STUDENTS WHO WERE REQUIRED TO
WATCH THEM, THEY DID BETTER ON
THEIR END OF THE YEAR EXAMS OR
LICENSING EXAMS, I HONESTLY
DON'T REMEMBER AND IT DID HELP
BUT THE USE WAS LIMITED AND SO
NIH MADE A DECISION TO NOT
CONTINUE THE DEVELOPMENT OF THEM
FOR ALL OF THE ABOVE AND HASN'T
REALLY PICKED UP THE BALL AGAIN
TO LOOK AT POTENTIAL OTHER
OPPORTUNITIES TO DEVELOP.
I THINK IT'S A LITTLE BIT AND
WAS A LITTLE BIT OUT OF OUR
SCOPE AT THE TIME ASK REMAINS A
BIT OUT OF OUR SCOPE BUT
INCREDIBLY IMPORTANT.
>> I WOULD THINK HAVING TO
DEVELOP 1, ARE WHAT WE DID AT
THE UNIVERSITY OF CONNECTICUT
WHEN I WAS THERE WAS IT WAS A
GAME AND THEN WHEN IT WENT TO
THE NIH, THEY UNDID THE GAME TO
FIT THAT PATTERN BECAUSE OF THE
TECHNOLOGY AND THE ABILITY TO
USE THAT TECHNOLOGY AND MAKE IT
DOWNLOADABLE ACROSS MANY
PLATFORMS WAS VERY DIFFICULT.
>> OKAY.
>> LORA, HAVE YOU A COMMENT?
>> YEAH, JUST WANT TO QUICKLY
PROVIDE AN UPDATE THAT THERE
HAVE BEEN A COUPLE OF
SUPPLEMENTS THAT HAVE RECENTLY
BEEN AWARDED TO INSTITUTES LIKE
THE UNIVERSITY OF MICHIGAN FOR
EXAMPLE, TO CREATE PAIN
EDUCATION COURSE THAT WILL BE
MADE AVAILABLE TO THE FULL
COMMUNITY THROUGH THE PURPOSE
NETWORK AND THROUGH OTHER MEANS,
SO THEY WILL BE A LITTLE BIT
BRIEFER THAN WHAT COPE'S HAD.
THEY WON'T BE THE SCENARIOS THAT
WERE DESCRIBED BUT IT WILL BE ON
CERTAIN PAIN TOPICS THAT WILL
HELP GEAR, IT WILL BE GEARED
MORE TOWARDS THE COLLEGE
GRADUATE STUDENT LEVEL SO THOSE
ARE GOING TO BE MADE AVAILABLE
WITHIN THE NEXT 6 MONTHS OR SO.
>> --IN ORDER TO ACCESS THEM,
RIGHT LAURA?
>> THEY WOULD HAVE TO JOIN
PURPOSE IN ORDER TO ACCESS THEM
BUT WE'VE ALSO BEEN TALKING TO
THE MICHIGAN PIs ABOUT MAKING
THEM ACCESSIBLE THROUGH OTHER
PLATFORMS.
SO IN CASE UNIVERSITIES WANT TO
BE ABLE TO ACCESS AND DOWNLOAD
THAT MATERIAL, SO THERE WILL BE
ANOTHER OPTION TO BE ABLE TO
DOWNLOAD IT AS WELL.
>> THANK YOU.
>> I THINK THERE ARE OTHER
PROGRAMS SIMILAR TO THAT THAT
ARE CREATING SOME CONTENT.
>> YOU KNOW I JUST WANT TO SAY I
THINK IT'S REALLY CRITICALLY
IMPORTANT.
I THOUGHT THE COKE CASES WERE
FANTASTIC TO USE.
THE PROBLEM IS THAT IN 30 YEARS
OF TRYING TO CREATE THE YELL
CURRICULUM, WE FIND THAT YOU'VE
SEEN 1 CURRICULUM, YOU'VE SEEN 1
CLICK LUM, EVERYONE MAKINGS
EDUCATION DIFFERENT.
SO THE IDEA OF GIVING PEOPLE
CASES AND RESOURCES, I THINK WAS
A GREAT IDEA, BUT I DO THINK
THAT WE'VE GOT TO EMPHASIZE AND
HOLD ACCOUNTABLE THE OUTCOME AND
THAT OUTCOME IS THE PART WHERE
EVERYONE'S IN AGREEMENT, BUT
IT'S THE IDEA THAT IF YOU DON'T
KNOW WHERE YOU'RE GOING, IT'S
HARD TO GET THERE AND IF YOU
START BY WHERE YOU'RE GOING AND
REVERSE ENGINEER IT THAT WILL
GET ALL THESE CURRICULAR
RESOURCES EMBEDDED AND USED
OTHERWISE THEY JUST FALL.
THEY START OUT MANDATORY, THEY
BOTTOM VOLUNTARY AND THEY
DISAPPEAR OFTEN.
THAT'S ALL I WANTED.
>> PAUL?
>> YES, THANK YOU.
I THINK THE VALUABLE
CONTRIBUTION OF THE COPES WAS
THE INTERNATIONAL DIALOGUE AND
AS SCOTT LAID OUT THERE ARE CORE
COMPETENCIES THAT CROSS CUT
DISCIPLINES AND TO GET PEOPLE OF
DIFFERENT DISCIPLINES IN THE
SAME ROOM WITH THE SAME BASIC
CORE COMPETENCY ANDS WALKING
ABOUT WHAT DO I KNOW AS A NURSE
AND WHAT DO YOU KNOW AS A
DOCTOR, WHAT DO YOU KNOW AS A
TENTIST, PHYSICAL THERAPISTS, AS
A PSYCHOLOGY, THAT WAS THE REAL
VALUE ADDED KRIEWK, BUT THAT WAS
ALSO THE GREATEST CHALLENGE OF
MAKING THE COPE'S WORK WAS
GETTING PEOPLE IN THE ROOM
TOGETHER.
SOME INSTITUTIONS SUCCEEDED IN
THAT BUT MOST STRUGGLED WITH IT
THAT WAY.
>> I THINK THAT--DR. KOROSHEZ---
>> WELCOME.
>> I KNOW WALTER WAS DOWN TOWN
AT CONGRESSIONAL HEARING AND NOW
HE'S JOINING US FROM HIS CAR.
>> AND HE WALKED VERY FAR TO GET
TO HIS CAR.
[LAUGHTER]
>> WE WERE JUST TALKING ABOUT
WALKING WALTER.
>> SO I HEAR IN TERMS OF--I'M
HEARING ENTHUSIASM AROUND THIS
EDUCATION, PROVIDER EDUCATION
THEME.
IT SEEMS TO BE QUITE A FEW
PEOPLE INTERESTED IN IT.
>> I CAN COMMENT ON 1 OF THE
OTHER THINGS THAT BOTH PAUL AND
SCOTT SAID, THE NEW COMPETENCIES
ON EDUCATION WERE JUST RELEASED,
PAIN IS NOT 1 OF THEM BUT
CARDIOVASCULAR HEALTH IS NOT 1
OF THEM.
THEY'VE COMPLETELY GONE AWAY
FROM SYSTEMS LIKE THAT WHICH
MEANS THAT THERE'S FLEXIBILITY
IN TERMS OF WHAT'S BEING TAUGHT,
BUT WHAT PAUL REMINDED ME OF AND
THAT IMPLEMENTATION IS A CORE CO
MUCH TENCY IN NURSING EDUCATION
EMPLOY SO A WAY TO SHOW THAT
LEVERAGING THAT PAIN, WE WILL
ALL AGREE THAT'S VERY IMPORTANT
THAT WE HAVE THAT COMMUNICATION
ACROSS DISCIPLINES.
>> EXACTLY AND LET'S NOT FORGET
THAT WHAT WE'RE ALL HERE TO
DISCUSS IS RESEARCH, RIGHT IN
AND THAT'S WHAT LINDA WAS
ALLUDING TO IN TERMS OF THE
SCOPE, CERTAINLY AT NIH, WE
SPEND A LOT OF TIME THINKING
ABOUT WHERE ARE THE BOUNDARIES
OF WHAT OUR MISSION IS, AND 1 OF
THE AREAS THAT WE LOOKED VERY
HARD ABOUT IS THE INTERACTION,
THEY WERE INTERSECTION OF
RESEARCH AND PATIENT CARE RIGHT
NOW, AND WHAT I MENTIONED
EARLIER, OF VENTURING INTO IMP
REMENTATION SCIENCE AND
RESEARCH, IS A WAY TO REALLY USE
RESEARCH IN ORDER TO EXAMINE HOW
HEALTHCARE IS DELIVERED.
THIS IS A NEW FIELD.
THIS IS A NEW AREA.
I THINK A SIMILAR THEME COULD
PERHAPS BE CONTEMPLATED IN THE
FIELD OF EDUCATION.
YOU KNOW HOW DO YOU USE--COULD
YOU APPLY THE PRINCIPLES AND
WHAT WE ALREADY KNOW ABOUT HOW
TO CONDUCT IMPLEMENTATION
SCIENCE, IMPLEMENTATION RESEARCH
IN THE FIELD OF PAIN EDUCATION?
WOULD THAT BE A TOPIC THAT WOULD
BE OF INTEREST?
I SEE HEADS NODDING.
NDEFINITELY A BIG GAP AREA FOR
SURE.
>> BIG GAP.
THAT'S IT TO IDENTIFY REALLY
WHAT ARE THE GAPS AND HOW CAN
RESEARCH HELP US TO GET THE
INFORMATION, THE DATA THAT WE
NEED IN ORDER TO ADVANCE
ESSENTIALLY IN THE END WHAT WE
WANT IS REDUCE PAIN AND
SUFFERING FOR PEOPLE.
IF PROVIDERS AND MEDICAL
STUDENTS FOR EXAMPLE, BUT NOT
JUST MEDICAL STUDENTS, I REALLY
LIKE THE COMMENT ABOUT THE
INTERPROFESSIONAL, IT'S THE
GAMUT, IT'S INTB WHO INTERACTS
WITH A PATIENT AND HOW THERE
NEEDS TO BE KNOWLEDGE ABOUT
PAYING THAT ACROSSS, ACROSS
THESE DISCIPLINES SO FOR EXAMPLE
THAT PHYSICAL THERAPISTS AND
NURSES AND HEALTH COACHES AND
PHYSICIANS REALLY SORT OF
EXCHANGE KNOWLEDGE AND HAVE A
COMMON LANGUAGE THAT THEY CAN
USE.
SO THIS IS SO IMPORTANT.
YEAH.
AND I WANT TO COME BACK TO THE
THEME OF HEALTH AND WELL BEING
THAT SCOTT RAISED BECAUSE I
THINK THIS IS AN AREA THAT CAN
HELP WITH THE FULL CROSS CUTTING
WAY TO ADDRESS THE--THAT PAIN IS
NOT TREATED AS AN ISOLATED
SYMPTOM.
THAT IT'S CONNECTED TO SO MANY
THINGS IN PEOPLE'S LIVES.
I THINK THIS IS WHAT WE'RE
STARTING TO UNDERSTAND IS THAT
WHEN WE--IN ORDER TO DEVELOP
EFFECTIVE INTERVENTIONS WE HAVE
TO CONSIDER THAT WE'RE NOT JUST
GIVING TEMPORARY PAIN RELIEF, WE
HAVE TO THINK ABOUT WHAT IS IT
THAT WE CAN HELP WITH SO THAT
PEOPLE--EVOLVING IN A POSITIVE
DIRECTION OVER THE COURSE OF
THEIR LIFE.
SO, I THINK TO INCORPORATE SOME
OF THIS, INTO OUR PAIN
MANAGEMENT STRATEGIES AND
RESEARCH THAT SUPPORTS THEM,
COULD BE VERY, VERY IMPORTANT.
SO REALLY WANT TO THANK SCOTT
FOR BRINGING THAT TOPIC FORWARD.
ALL RIGHT, DO I HEAR ANY--OKAY.
THERE'S A COMMENT.
MIGHT BE A GOOD TIME MENTION THE
OUTCOMES AND IMPACTS OF THE
CENTER ON THE GRAPH THAT CORE
COMPETENCIES THAT SCOTT OFFERED
THAT PEOPLE--[MUMBLING ] YES,
ABSOLUTELY.
THIS IS WHAT PEOPLE TELL US LOUD
AND CLEAR THEY WANT US TO DO
RESEARCH THAT IS RELEVANT TO
THEIR LIVES NOT JUST A SMALL
NARROW, YOU KNOW PORTION OF WHAT
THEY'RE EXPERIENCING.
>> BUT EVEN IF WE'RE TALKING
ABOUT RESEARCHING AND INCLUDING
CLINICAL PRACTICE AND
IMPLEMENTATION AND OUTCOMES, I
THINK WE ALSO NEED TO TALK ABOUT
INCLUDING PEOPLE WITH LIVED
EXPERIENCE IN THAT CONVERSATION
AT EACH LEVEL.
IT'S JUST SORT OF A STANDARD.
>> YEAH, YEAH, AND THE MORE WE
UNDERSTAND THE REALITY OF
PEOPLE'S LIVES, WHO LIVE WITH
PAIN AND THE COMPLEXITY OF IT,
THE BETTER OFF WE'LL BE IN ORDER
TO DESIGN RESEARCH QUESTIONS,
CORRECT?
YEAH.
>> COULD I JUST--THE CENTER OF
THE GRAPH OF THE COMPETENCY
DOMAINS IS THE PERSON IN PAIN.
SO YEAH, I COULDN'T AGREE WITH
YOU MORE KATE, THANKS.
>> YEAH, YES.
EXCELLENT.
SO, SO WOULD THERE ARE PEOPLE
INTERESTED ON A WORKING GROUP ON
EDUCATION OR ANY OF THE OTHER
TOPICS.
LET'S TALK ABOUT EDUCATION
FIRST.
PROVIDER EDUCATION, HOW TO
FIGURE OUT AND GET--AND REALLY
THINK HARD ABOUT WHAT KIND OF
RESEARCH WOULD BEST HELP MOVE
THIS OUT OF THIS REALLY
UNSATISFACTORY SITUATION THAT
WE'RE IN RIGHT NOW.
BETH IS INTERESTED.
SCOTT IS INTERESTED.
GROUP OF IPRCC.
THIS WOULD BE IPRCC.
>> YEAH, BECAUSE WE TALKED ABOUT
THE--
>> WELL, ONCE THE SUBGROUP IS
FORMED THEN WE CAN SEE HOW THE
SUBGROUP CAN INTERACT, RIGHT?
>> OKAY.
>> A NUMBER OF PEOPLE
INTERESTED, RIGHT?
GREAT.
SO IT LOOKS LIKE SCOTT, YOU HAVE
INSPIRED PEOPLE.
>> YEAH THIS, IS AN AREA THAT'S
A BIG GAP AND I THINK THIS GROUP
WOULD BE WELL SUITED TO ADDRESS
ANY OTHER KIND?
>> WALTER?
>> YEAH, SO, I GUESS THE ISSUE
USUALLY--IT'S SUCH A BROAD AREA
TO WHERE THE FOCUS SHOULD BE TO
HAVE THE BIGGEST IMPACT AND YOU
KNOW SOMETIMES THAT'S RELATED TO
HOW THE STARS ARE ALIGNING AND I
JUST WANT TO THROW OUT AND
HELENE KNOWS THIS, THAT 1 OF
DR. BERTAGNOLLI'S GOALS AS I SEE
DREKORS DEVELOP RESEARCH IN
PRIMARY CARE, THAT I WOULD OFFER
THAT YOU KNOW IF THERE'S AN
IMPACT THAT CAN BE MADE, IT'S
REALLY NOT--I MEAN IT'S ALWAYS
GREAT TO BE ABLE TO TALK TO THE
PEOPLE WHO ARE, YOU KNOW PAIN
SPECIALISTS, BUT I THINK THAT
THE REAL IMPACT COULD BE AT THE
PRIMARY CARE LEVEL.
SO I JUST THROW THAT OUT AS A
COMMENT.
NABSOLUTELY WALTER, I
ACCOUNTEDN'T AGREE MORE.
THERE COULD BE--AND PRIMARY CARE
OF COURSE INCREASINGLY RIGHT AND
DELIVERED IN TEAMS, RIGHT?
SO PRIMARY CARE IS OBVIOUSLY NOT
ONLY MDs, YOU KNOW IT'S THE
WHOLE TEAM BASED APPROACH, I
THINK HAS BEEN--IS IDEAL, THAT
REALLY INCLUDES DIFFERENT TYPES
OF PROFESSIONS THAT COULD IERK
DEALLY INTERACT TOGETHER BUT IN
THE CONTEXT OF PRIMARY CARE TO
HELP MANAGE PAIN BETTER SO I
THINK, YEAH, I THINK I WOULD
SUGGEST PERHAPS A FOCUS ON BOTH
PRIMARY CARE AND TEAM BASED PAIN
MANAGEMENT AT THAT LEVEL.
>> THAT'S GREAT.
YES, I AGREE.
>> SO LET'S SEE.
LINDA SHOULD WE GO AHEAD AND
PERHAPS CHARGE A GROUP OR
PERHAPS WITH SCOTT, SINCE YOU
GAVE US THIS WONDERFUL
PRESENTATION WOULD YOU
INTERESTED IN LEADING A GROUP
LIKE THIS?
NSO I WOULD BE HAPPY TO HELP SET
IT UP HELENE AND I CAN TALK TO
SCOTT AND SEE WHAT HIS
AVAILABILITY FOR TIME IS, BUT
DEFINITELY CAN WORK TO SORT OF
GET THE FIRST CONVERSATIONS
GOING AND WHAT KIND OF THINGS WE
MIGHT WANT TO CONSIDER IN MORE
DETAIL.
SO YEAH, I'M HAPPY TO GET THAT
STARTED.
I WOULD LIKE TO ASK WHOEVER IS
RUNNING THE RECORDING OF THIS
THAT WE GET THE CHAT SAVED.
NYES.
>> BECAUSE THERE'S A LOT OF
REALLY VALUABLE INFORMATION IN
THERE AND WE WILL REVIEW IT AND
SEE IF THERE ARE ANY QUESTIONS
LEFT THAT WE NEED TO ADDRESS.
>> RIGHT.
THE CHAT IS JUST EXPLODING SO
THIS IS GREAT.
SOUNDS LIKE WE TOUCHED ON AN
AREA THAT REALLY RESONATES WITH
PEOPLE THAT TAKES US IN A VERY
NEEDED DIRECTION.
GREAT.
>> BETH?
>> AND THEN LAURA HAS A
QUESTION.
>> GREAT.
THANKS.
I WAS NOTING CHRISTINE'S COMMENT
AND THEN WANTED TO KEY OFF WHAT
YOU SAID EARLIER HELENE, AND I
THINK IS IT ACCURATE THAT THE
IDEA WITH THE PAIN EDUCATION
WORK GROUP OR SUBCOMMITTEE
HOWEVER THAT'S DESCRIBED, THAT
IS SORT OF NESTED UNDERTHE PAIN
RESEARCH WORK GROUP?
IS IT ACCURATE THAT EVERYTHING
AROUND EICATION WOULD ACTUALLY
BE GEARED TOWARDS RESEARCH ABOUT
PAIN EDUCATION VERSUS CLINICAL
EDUCATION FOR THE SAKE OF
CLINICAL EDUCATION WHICH IS
REALLY IMPORTANT.
IT JUST DOESN'T FALL UNDER THE
PERVIEW OF THE IPRCC, IF I'M
UNDERSTANDING IT CORRECTLY.
>> RIGHT, THIS NEEDS TO BE ABOUT
RESOURCE BECAUSE THAT'S WHAT
THIS COMMITTEE IS ABOUT.
>> AND PLEASE KEEP IN MIND, TOO,
THAT WE ARE NOT ONLY NIH, WE
HAVE OTHER FEDERAL MEMBERS ON
HERE THAT ARE DOING A LOT OF
WORK IN THIS AREA, AND I THINK
ELIZABETH CAN HELP OUT WITH
THAT, CDC, YOU KNOW THEY'RE
DEFINITELY BEYOND NIH.
YEAH.
>> RIGHT.
IT'S REALLY AT THE EDGE BUT IT
REALLY NEEDS TO BE DONE THROUGH
RESEARCH.
>> SOMEONE PUT A QUESTION IN
HERE ABOUT OPPORTUNITIES FOR
AREAS OF INTEREST FOR OTHER
SUBGROUPS.
ONE WAS ABOUT--OKAY, THE LIST
JUST MOVED SO I WAS GOING TO
READ IT OUT OR MAYBE YOU COULD
JUST JUMP IN AND GIVE A BIT MORE
OF WHAT YOU WERE THINKING?
>> YEAH, SURE.
THANKS, LINDA, I MEAN 1 OF THE
TOPICS FOR THIS IPRCC IS
BRINGING TOGETHER OUR FEDERAL
PARTNERS, AND SO, 1 THING THAT
WE MIGHT BE ABLE TO DO AS PART
OF IPRCC IS COAALATE SOME OF THE
GUIDE LINES AND THE PAIN GUIDE
LINES AT DIFFERENT AGENCIES SO
SINCE WE HAVE FDA, CDC, D.O.D.
AND VA, AND COMPILE THAT
INFORMATION IN 1 PLACE, SO I'M
WONDERING IF THAT MIGHT BE OF
INTEREST FOR THIS GROUP AND
HAVING A WORK GROUP TO GET A
SENSE OF WHAT ARE THE MOST
RECENT GUIDELINES THAT PEOPLE
ARE WORKING ON, HOW DO WE GET
SOME OF THAT INFORMATION, KIND
OF STANDARDIZED AND DISSEMINATED
OUT TO THE PUBLIC AS WELL.
>> I WILL INTERESTED IN
IMPLEMENTATION, WE DON'T DO
GUIDE LINES BUT VERY INTERESTED
IN IMPLEMENTATION.
>> IMPLEMENTATION AND
DISSEMINATION.
GREAT.
OKAY.
WE SEE A COUPLE PEOPLE IN THE
CHA THAT ARE INTERESTED IN THIS
IDEA.
WONDERFUL LAURA.
YEAH BECAUSE THIS IS WHERE THE
RUBBER MEETS THE ROAD IN A LOT
OF WAYS RIGHT IS THIS CLINICAL
GUIDELINES THAT ARE SUPPOSED TO
BE OUR GUIDE POSTS AND WE'RE
FINDING THAT THEY'RE NOT USED AS
MUCH AS THEY SHOULD BE BY A LONG
SHOT.
>> SOMETIMES IT'S JUST HARD FOR
PEOPLE TO FIND THEM.
SO IF WE COULD CENTRALIZE THOSE
RESOURCES, WE COULD DO GOOD
DISSEMINATION EFFORT, ALL OF US
TOGETHER THAT WAY WE COULD MAKE
IT EASIER FOR THE PUBLIC.
NYEAH, YEAH, YEAH.
>> EXCELLENT IDEA.
>> BETH ASKED ABOUT THE PC ORI,
AND I WILL BACK UP A BIT ON OUR
FPRS ANALYSIS, WE HAD A LOT OF
CONVERSATIONS WITH THEM ABOUT
WHAT THEY WERE DOING, WHAT THEY
WERE PLANNING BECAUSE THEY DO
HAVE A STRATEGIC PLANNING
PROCESS.
DON'T REMEMBER IF IT'S FINISHED
OR CLOSE TO FINISHED BUT THEY
WERE IN THE WORKS AND THEY DO
HAVE A HUGE PAIN PORTFOLIO.
AS FAR AS AND BETH, I'M
INTERPRETINGIOURE QUESTION IN 2
DIFFERENT WAYS, 1 IS HAVE WE
LOOKED AT THE PORTFOLIO AND
THEY'RE HELPING SHARE THAT WITH
US.
IT'S NOT IN OUR DATABASE BECAUSE
THEY'RE NOT FEDERAL.
INCLUDING THEM IN THE IPRCC AS A
NONMEMBER IS AN OPTION, WE HAVE
A COUPLE OTHER AGENCIES THAT WE
WOULD, I THINK WOULD BE HELPFUL
TO BE REPRESENTED HERE, WE HAVE
A MANDATE OF HOW MANY
REPRESENTATIVES FROM HOW MANY
FEDERAL AGENCIES, FROM OUTSIDE
PUBLIC MEMBERS, FROM SCIENTIFIC
MEMBERS, SO WE HAVE CAPS, BUT
THAT'S NOT TO SAY THAT WE CAN'T
INVITE PEOPLE TO COME OR JOIN
THE CONVERSATIONS AND
INFORMATION BUT WE HAVE BEEN
WORKING WITH PC ORI ON THERE ON
THEIR PORTFOLIO FOR PAIN.
>> SO WE'RE ABOUT OUT OF TIME
BUT THERE'S A FEW OTHER
QUESTIONS IN THE CHAT THAT WE
COULD BRING UP AT OUR NEXT
MEETING, SCOTT IS WONDERING WHAT
PEOPLE THINK ABOUT A RESILIENCE
AND PREVENTION OF CHRONIC PAIN
IF THERE ARE PEOPLE INTERESTED
IN THAT PERHAPS WE COULD PUT
THAT ON THE AGENDA THE ON OUR
NEXT MEETING.
THERE WAS ANOTHER 1 ON
IMPLEMENTATION--INTERESTED IN
IMPLEMENTATION SCIENCES GROUP IN
THE RESILIENCE, PAUL IS
INTERESTED IN THAT.
OKAY, SO THEREY A FAIR AMOUNT.
SO CAPTURE EVERYTHING THAT'S IN
THE CHAT, WE REALLY WANT TO
THANK YOU FOR YOUR ENGAGEMENT
AND YOUR ENTHUSIASM.
WE THINK THAT FORMING THESE
WORKING GROUPS IS GOING TO BE A
GREAT WAY TO GALVANIZE ALL THE
WONDERFUL TALENT THAT IS IN THIS
ROOM AND IN THIS VIRTUAL ROOM,
AND LINDA DID WE WANT TO SAY
ANYTHING ABOUT THE FALL MEETING?
>> WE HAVE A DATE FOR THE FALL
MEETING, I WILL ASK LEA TO PUT
THAT OUT THERE SO I GET IT A
HUNDRED% RIGHT, I KNOW IT'S NOT
A NUMBER, SHE WILL GIVE YOU THE
DATE AND THE TIME, WE ARE
PLANNING TO HOLD IT IN PERSON IN
WASHINGTON SO THAT WOULD BE
SOMEWHERE ON THE CAMPUS, IT'S
YIEWCIALLY A FULL DAY MEETING IN
THE FALL SO IT GENERATES A
REALLY LIVELY CONVERSATION BY
HAVING IT HERE.
SO WE'LL GIVE YOU MORE
INFORMATION ON THAT, BUT LEA CAN
YOU CONFIRM TIMES AND DATES FOR
ME SO THAT I DON'T DO SOMETHING
WRONG?
NOVEMBER 5th.
NINE-5.
>> ALL RIGHT.
WELL, THANK YOU FOR A GREAT
MEETING AND WE LOOK FORWARD TO
SEEING YOU ON NOVEMBER 5th.
>> THANK YOU.
>> ALL RIGHT EVERYBODY THIS IS
GREAT NTAKE CARE.
>> BYE-BYE.
>> THANK YOU.