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WELCOME TO INNOVATIVE APPROACHES

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TO IMPROVE MATERNAL HEALTH 

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HYBRID WORKSHOP DAY 1.  THANKS 

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FOR JOINING VIRTUALLY AND IN 

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PERSON.  

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I'M WITH THE HEART, LUNG, AND 

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BLOOD INSTITUTE IN THE DIVISION 

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OF BLD DISEASES AND RESOURCES 

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AND WE ARE ALL GATHERED HERE 

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TODAY TO DISCUSS HOW TO IMPROVE 

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MAT TERNAL HEALTH FOR ALL 

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COMMUNITIES IN THE UNITED 

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STATES.  THIS WORKSHOP BRINGS 

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TOGETHER DIVERSE CULTURES AND 

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GEOGRAPHIC REGIONS AND MANY 

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EXPERTISE AND ARE EXCITED TO 

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HEAR DIFFERENT PERSPECTIVES IN 

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OUR DISCUSSION TODAY. 

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FIRST AND FOREMOST, I WOULD LIKE

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TO THANK THE ENTIRE WORKSHOP 

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PLANNING TEAM.  IT HAS BEEN 

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TRULY A TEAM EFFORT TO GET TO 

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THIS DAY AND HAS BEEN A TRANS 

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NIH EFFORT.  THIS IS WORKSHOP IS

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SPONSORED BY NIHLBI AND NIH'S 

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MATERNAL HEALTH AND PREGNANCY 

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OWE OUTCOMES VISION FOR EVERYONE

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OR IMPROVE INITIATIVE AND 

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SEVERAL NIH INSTITUTES AND 

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CENTERS THAT INCLUDE THE 

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NATIONAL INSTITUTE ON MINORITY 

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HEALTH AND HEALTH DISPARITIES 

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NIMHD AND NATIONAL INSTITUTE OF 

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NEUROLOGICAL DISORDERS AND 

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STROKE, NINDS AND NATIONAL 

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CENTER FOR COMPLEMENTARY AND 

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INTEGRATIVE HEALTH NICCH AND 

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INSTITUTE FOR TRIAL HEALTH 

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DEVELOPMENT, NICHD AND NATIONAL 

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INSTITUTE OF ENGINEERING AND 

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BIOMEDICAL ENGINEERING AND WE 

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HAVE SEVERAL INTERACTIVE PANELS 

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INCLUDING THE CLINICAL AND 

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TECHNOLOGY PANELS AND COMMUNITY 

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AND ENGAGEMENT PANEL AND 

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IMPLEMENTATION SCIENCE PANEL AND

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AT END OF THE DAY WE WILL HAVE 

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TWO CONCURRENT DISCUSSION 

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SESSIONS THAT ARE MODERATED 

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SESSIONS. 

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THEY ARE DESIGNED TO DISCUSS ON 

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FOCUS OF MATERNAL HEALTH E1 AND 

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E2 IDENTIFYING AND OVERCOMING 

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INNOVATION BARRIERS FOR MATERNAL

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LUNG HEART HEALTH AND BLOOD AND 

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SLEEP HEALTH AND DEVELOPMENT OF 

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INNOVATIVE TECHNOLOGIES TO 

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IMPROVE MATERNAL HEALTH 

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FACILITATING SUBSTANCE USE 

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DISORDER TREATMENT AND IF 

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INTERESTED IN ATTENDING SESSIONS

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IN PERSON, PLEASE SIGN UP ON 

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SHEETS AT THE REGISTRATION TABLE

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AND DUE TO SPACE LIMITATION OF 

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THE BREAKOUT ROOMS WE HAVE TO 

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LIMIT IN-PERSON ATTENDANCE AND 

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HAVE A SEPARATE ZOOM ROOM FOR 

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BREAKOUTS AND WILL ALLOW VIRTUAL

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ATTENDEES TO PARTICIPATE FULLY. 

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FINALLY, I WANT TO MAKE SURE 

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THAT I SHARE DISCLOSURE 

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STATEMENT.  NATIONAL INSTITUTES 

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OF HEALTH DOESN'T SPONSOR OR 

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ENDORSE INFORMATION SHARED OR 

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PRESENTED IN THE WORKSHOP SLU 

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INCLUDING PRODUCTS OR SERVICES 

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AND MATERIALS SHOULDN'T BE 

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REPRESENTED VIEWPOINT OF HEALTH 

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AND HUMAN SERVICES OR NATIONAL 

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INSTITUTES OF HEALTH.  

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WE ARE HONORED TO HAVE TWO 

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SENIOR LEADERS FROM NIH HERE TO 

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GIVE OPENING REMARKS DR. PANNA 

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PIN TO -- BEFORE JOINING NHLBI 

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IN 2021 SHE WAS A TENURED 

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PROFESSOR OF PEDIATRICS AND 

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HEMATOLOGY AND DIRECTOR OF 

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CENTER FOR CLINICAL 

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EFFECTIVENESS RESEARCH AT 

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MEDICAL COLLEGE OF WISCONSIN AND

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CHIRNS WISCONSIN AND CLINICIAN 

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RESEARCHER WITH BACKGROUND IN 

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PUBLIC HEALTH SHE FOCUSED HER 

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ACADEMIC CAREER UNDERSTANDING A-

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HEALTH OUTCOMES OF PATIENTS WITH

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CHRONIC DISEASES AND DR. THOMAS 

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IS -- WHICH OVERSEES THE IMPROVE

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INITIATIVE AND SPECIAL DIRECTOR 

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TO ORWH AND BEGAN RESEARCH 

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CAREER TO INTRAMURAL RESEARCH 

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PROGRAM AT NATIONAL INSTITUTE ON

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-- AND ON IMPACT OF OPIOIDS ON 

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PAIN AND JOINED NATIONAL 

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INSTITUTE ON DRUG ABUSE, NIDA 

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AND MANAGED NIDA'S PAIN AND 

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OPIOID RESEARCH. 

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HE IS A FOUNDING MEMBER OF NIH'S

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PAIN CONSORTIUM THAT DOES PAIN 

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RESEARCH ACROSS THE UNITED 

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STATES AND THANK YOU FOR BEING 

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HERE TODAY AND TURNING THE MIC 

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TO DR. PANE APIN TO. 

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>> GOOD MORNING. 
WELCOME.  IT 

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IS A PLEASURE TO SEE ALL OF YOU 

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HERE TODAY AND OPEN THE 

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INNOVATIVE APPROACHES TO IMPROVE

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MATERNAL HEALTH WORKSHOP AND 

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THANKS TO ORGANIZERS OF WORKSHOP

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ALONG WITH TRANS NIH WORKING 

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GROUP PUTTING IN SIGNIFICANT 

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AMOUNT OF WORK TO LAY OUT A VERY

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EXCITING AGENDA.  MANY OF YOU 

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KNOW IN THE UNITED STATES THAT 

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PREGNANCY-RELATED DEATHS AND 

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COMPLICATIONS ARE AMONG HIGHEST 

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IN DEVELOPED WORLD. 

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BLACKS AND AMERICAN INDIANS AND 

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ALASKA NATIVES THEY ARE 

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ESPECIALLY HIGH REGARDLESS OF 

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INCOME OR EDUCATION LEVELS AND 

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PANDEMIC ONLY MADE THE SITUATION

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WORSE.  COLLABORATION AMONG 

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RESEARCHERS SMALL BUSINESSES AND

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THE COMMUNITY COULD LEAD TO NEW 

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WAYS TO IMPROVE MATERNAL HEALTH 

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REDUCING US MATERNAL MORBIDITY 

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AND MORTALITY RATES.  

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CARDIOVASCULAR HEALTH AND SLEEP 

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DISORDERS AMONGST OTHERS 

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SIGNIFICANTLY CONTRIBUTE TO 

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MATERNAL MORBIDITY AND MORTALITY

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MAKING MATERNAL HEALTH PRIORITY 

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AREA FOR NHLBI AND ADDRESS THREE

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KEY QUESTIONS DURING THE 

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WORKSHOP.  NO. 1, WHAT ARE MAJOR

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SCIENTIFIC ADVANCES OF MATERNAL 

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HEALTH RESEARCH AND RELATED 

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DISEASES AND NO. 2 CHALLENGES 

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DEVELOPING AND TRANSLATING 

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SOLUTIONS TO REDUCE MATERNAL 

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MORBIDITY AND MORTALITY AND 3 

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HOW THEY COULD BE LEVERAGE THE 

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AND UNDERSERVED COMMUNITIES AND 

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THRILL TODAY SEE ALL WHO HAVE 

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JOINED US TODAY AND YOUR 

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INSIGHTS AND EXPERTISE ARE 

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ESSENTIAL TO HELP US ANSWER 

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QUESTIONS AND IMPROVE MATERNAL 

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HEALTH ACROSS THE COUNTRY. 

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THANKS FOR JOINING THE WORKSHOP.

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I WILL NOW TURN IT TO DR. TH

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THOMAS. 

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>> GOOD MORNING.  THANK
YOU DR.

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PANEPINTO FOR INTRODUCTION OF 

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ME.  THIS IS SURREAL AND MY 

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FIRST TIME SINCE THE PANDEMIC 

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AND NICE TO SEE FACES AND 

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VIRTUAL PEOPLE, I HAVEN'T 

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FORGOTTEN ABOUT YOU EITHER.  

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PLEASURE TO WELCOME YOU TO 

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INNOVATIVE APPROACHES TO IMPROVE

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MATERNAL HEALTH WORKSHOP.  

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MATERNAL HEALTH IS HUGE PRIORITY

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AT NIH AND EVIDENCE OF IMPROVED 

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PROGRAM AND OTHER FUNDING IN 

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THIS AREA AND THINK THAT A KEY 

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THING ABOUT IMPROVE IS THE 

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WORKSTREAMS ARE ALL 

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INTERCONNECTED THAT IS HOW WE 

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HAVE TO APPROACH MATERNAL HEALTH

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CRISIS ON EVERY FRONT AND ONLY 

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UNITE IN A UNITED WAY AND 

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IMPROVE INCLUDES VARIOUS 

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INITIATIVES AT THIS POINT AND 

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INCLUDES A CONNECT ATHON. 

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IT IS A -- IT IS ENGAGING 

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STAKEHOLDER COMMUNITIES TO 

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DEVELOP ELECTRONIC HEALTH RECORD

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STANDARDS AND ESTABLISH 

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LONGITUDINAL MATERNAL HEALTH 

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RECORDS AND ENABLE RECORDS TO 

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AUTOMATICALLY CONNECT THE CHILD 

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TO THE MOTHER AND LOOK AT 

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ELECTRONIC HEALTH RECORDS IN 

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TANDEM AND HAVE TWO CHALLENGES 

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AND THERE IS A MECHANISM WE HAVE

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THAT IS BEYOND GRANTS AND 

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CONTRACTS WHERE WE CAN MAKE 

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AWARDS TO PEOPLE THAT COME UP 

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WITH INNOVATIVE IDEAS AND ONE IS

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[INDISCERNIBLE], WHICH IS TO AIM

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TO ACCELERATE DEVELOPMENT OF 

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MATERNAL HEALTH DIAGNOSTICS AND 

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REMOTE SENSING DEVICES IT HAS 

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VERY ALIGN THE WITH WHAT WE WILL

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TALK ABOUT OVER THE NEXT TWO 

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DAYS AND THERE IS CONNECTING 

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COMMUNITIES AND MATERNAL HEALTH 

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CHALLENGE ALSO.  IT IS BUILDING 

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RESEARCH INFRASTRUCTURE AND 

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CAPACITY FOR NON-PROFIT 

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ORGANIZATIONS THAT ARE SEEKING 

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TO ADVANCE MATERNAL HEALTH 

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RESEARCH. 

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SO, BEYOND THAT, WE HAVE THE 

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MATERNAL HEALTH COMMUNITY 

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IMPLEMENTATION PROGRAM TO 

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DEVELOP AND TEST PROMISING 

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COMMUNITY-BASED INTERVENTIONS 

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AND STRATEGIES TO INCREASE 

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ADOPTION UPTAKE AND EXPANSION OF

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EVIDENCE-BASED INTERVENTIONS AND

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OF MATERNAL HEALTH AND 

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CORNERSTONE OF EFFORTS AND 

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MATERNAL HEALTH RESEARCH CENTERS

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OF EXCELLENCE TO DEVELOP AND 

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EVALUATE INNOVATIVE APPROACHES 

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FOR REDUCING PREGNANCY RELATED 

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COMPLICATIONS PROMOTING MATERNAL

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HEALTH EQUITY AND WE SEE THESE 

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THINGS REALLY COMING TOGETHER 

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JUST AT THE BEGINNING TO HOPE 

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THAT IMPROVE HAS A BIG IMPACT 

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AND WE HOPE IT GROWS AND BECOMES

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MORE AND MORE OF AN ENTITY AT 

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THE NIH WHERE WE WORK TOGETHER 

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TO FIGHT THE MATERNAL HEALTH 

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CRISIS. 

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WITH THAT, I WILL TURN IT BACK 

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TO MY ESTEEMED COLLEAGUE DR. 

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GOLDBERG WHO WILL INTRODUCE OUR 

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PLENARY SPEAKER. 

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>> THANK YOU SO MUCH DR. 

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PANEPINTO AND DR. THOMAS FOR 

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YOUR REMARKS.  BEFORE I 

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INTRODUCE OUR PLENARY SPEAKER, I

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WANT TO REMIND EVERYONE HERE 

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TODAY THAT AT NIH WE PROMOTE A 

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CULTURE OF ACCEPTANCE AND YOU 

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ARE ABOUT TO HEAR MATERNAL 

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ADVOCATE TELL HER PERSONAL STORY

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AND SOME THINGS YOU MAY HEAR 

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MIGHT NOT BE MEDICALLY ACCURATE 

254
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AND MIGHT NO THE BE PRACTICE AT 

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YOUR MEDICAL FACILITY.  WHAT YOU

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WILL HEAR IS ACCOUNTING OF 

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MEDICAL EVENTS AS UNDERSTOOD BY 

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A PATIENT DURING SOME OF HER 

259
00:10:43,920 --> 00:10:47,320
WORST LIFE EVENTS AND IS NOT TO 

260
00:10:47,320 --> 00:10:48,760
DISCREDIT HER ACCOUNT BUT TO 

261
00:10:48,760 --> 00:10:50,560
UNDERSTAND AND IDENTIFY 

262
00:10:50,560 --> 00:10:51,320
COMMUNICATION GAPS THAT CAN 

263
00:10:51,320 --> 00:10:53,520
OCCUR WHEN SPEAKING TO A PATIENT

264
00:10:53,520 --> 00:10:56,080
IN DEEP DISTRESS AND HEARING AND

265
00:10:56,080 --> 00:10:57,960
LISTENING TO HER STORY CAN HELP 

266
00:10:57,960 --> 00:10:59,520
US ALL TO UNDERSTAND WHAT IS 

267
00:10:59,520 --> 00:11:01,560
HAPPENING WHEN WE HAVE DIFFICULT

268
00:11:01,560 --> 00:11:02,960
CONVERSATIONS WITH PATIENTS AND 

269
00:11:02,960 --> 00:11:05,040
HOW HARD IT COULD BE TO 

270
00:11:05,040 --> 00:11:05,720
UNDERSTAND WHERE SOMEBODY ELSE 

271
00:11:05,720 --> 00:11:08,400
MIGHT BE LISTENING FROM.  ALL OF

272
00:11:08,400 --> 00:11:11,520
US IN THE ROOM HAVE A POWER TO 

273
00:11:11,520 --> 00:11:14,680
MAKE A DIFFERENCE IN THESE 

274
00:11:14,680 --> 00:11:15,960
PATIENT'S STORY.  

275
00:11:15,960 --> 00:11:18,480
NOW, I'M PROUD TO INTRODUCE 

276
00:11:18,480 --> 00:11:19,080
CANDICE. 

277
00:11:19,080 --> 00:11:22,040
SHE IS AN AFRICAN AMERICAN 

278
00:11:22,040 --> 00:11:24,040
MATERNAL HEALTH ADVOCATE 

279
00:11:24,040 --> 00:11:25,520
DEDICATED CAREER TO IMPROVING 

280
00:11:25,520 --> 00:11:31,040
LIVES AND OUTCOMES OF BLACK 

281
00:11:31,040 --> 00:11:33,200
MOTHERS AND HIGHLY RESPECTED IN 

282
00:11:33,200 --> 00:11:35,160
FIELD OF MATERNAL HEALTH AND 

283
00:11:35,160 --> 00:11:37,520
POLICY AND INITIATIVES TO 

284
00:11:37,520 --> 00:11:39,760
PROMOTE MATERNAL HEALTH OUTCOMES

285
00:11:39,760 --> 00:11:42,320
FOR BLACK WOMEN AND RECOGNIZED 

286
00:11:42,320 --> 00:11:44,200
FROM SEVERAL ORGANIZATIONS FOR 

287
00:11:44,200 --> 00:11:45,920
RESULTS AND DEEP UNDERSTANDING 

288
00:11:45,920 --> 00:11:48,440
OF COMPLEX CHALLENGES FACING 

289
00:11:48,440 --> 00:11:49,760
BLACK MOTHERS AND FAMILIES AND 

290
00:11:49,760 --> 00:11:55,520
IN ADDITION TO ADVOCACY WORK 

291
00:11:55,520 --> 00:11:57,760
PASSIONATE ADVOCATOR AND MEN 

292
00:11:57,760 --> 00:11:59,520
TORE AND THANK YOU CANDICE FOR 

293
00:11:59,520 --> 00:12:01,320
BEING HERE WITH US TODAY AND FOR

294
00:12:01,320 --> 00:12:11,800
SHARING YOUR STORY WITH US. 

295
00:12:23,840 --> 00:12:31,760
>> MORNING.  HOW MANY
HAVE BEEN

296
00:12:31,760 --> 00:12:33,320
EFFECTED BY MATERNAL HEALTH IN 

297
00:12:33,320 --> 00:12:36,920
THE US?  LOTS OF HANDS RAISED.  

298
00:12:36,920 --> 00:12:40,160
I'M CANDICE AND HERE TO SHARE MY

299
00:12:40,160 --> 00:12:42,840
STORY WITH YOU.  MY STRUGGLE 

300
00:12:42,840 --> 00:12:45,560
HAPPENED LONG BEFORE PREG IN A 

301
00:12:45,560 --> 00:12:50,600
NCY AND HAVING A BABY.  -- WHEN 

302
00:12:50,600 --> 00:12:53,240
HAVING THAT SURGERY DONE, I 

303
00:12:53,240 --> 00:12:55,160
WASN'T AWARE THAT HAVING THAT 

304
00:12:55,160 --> 00:12:58,080
TYPE OF MANIPULATION DONE TO MY 

305
00:12:58,080 --> 00:13:00,680
UTERUS WOULD EFFECT ME DOWN THE 

306
00:13:00,680 --> 00:13:02,880
ROAD WHEN HAVING CHILDREN AND I 

307
00:13:02,880 --> 00:13:04,960
WAS TOLD TO WAIT A YEAR AND TRY 

308
00:13:04,960 --> 00:13:06,960
TO GET PREGNANT AND YOU EITHER 

309
00:13:06,960 --> 00:13:11,560
DO OR DON'T AND WE WILL HAVE A 

310
00:13:11,560 --> 00:13:12,240
DIFFERENT DISCUSSION. 

311
00:13:12,240 --> 00:13:15,640
ALMOST FIVE YEARS LATER I GOT 

312
00:13:15,640 --> 00:13:18,320
PREGNANT WITH MY SON AIDE AN AND

313
00:13:18,320 --> 00:13:21,320
JULY 2019 JULY 9TH MY SON WAS 

314
00:13:21,320 --> 00:13:23,520
FOUND TO NOT HAVE A HEARTBEAT 

315
00:13:23,520 --> 00:13:26,680
AND STARTED PREGNANCY OFF WITH 

316
00:13:26,680 --> 00:13:27,720
EXPECTATION I'M PREGNANT AND 

317
00:13:27,720 --> 00:13:29,640
NEED TO GET THROUGH INTOIN 

318
00:13:29,640 --> 00:13:31,400
MONTHS AND HAVE A BABY.  THAT 

319
00:13:31,400 --> 00:13:32,960
WASN'T THE CASE FOR ME.  

320
00:13:32,960 --> 00:13:35,920
PROBABLY AT 10 WEEKS I WAS AT A 

321
00:13:35,920 --> 00:13:37,400
REGULAR OB APPOINTMENT.  SHE 

322
00:13:37,400 --> 00:13:40,520
TOLD ME SHE COULD NO LONGER TAKE

323
00:13:40,520 --> 00:13:42,080
CARE OF ME MY CASE WAS TOO 

324
00:13:42,080 --> 00:13:46,160
COMPLEX AND TRANSFERRED TO FETAL

325
00:13:46,160 --> 00:13:48,160
MEDICAL DOCTOR WHO SAID WE WILL 

326
00:13:48,160 --> 00:13:50,560
DO EVERYTHING TO GET YOU THROUGH

327
00:13:50,560 --> 00:13:54,880
THIS PREGNANCY IN NEXT 6 MONTHS 

328
00:13:54,880 --> 00:13:58,080
I HAD GESTATIONAL DIABETES EARLY

329
00:13:58,080 --> 00:14:00,720
ON NOT KNOWING THAT IT COULD BE 

330
00:14:00,720 --> 00:14:02,760
VERY DEBT TREMENTAL TO ME AND MY

331
00:14:02,760 --> 00:14:06,760
BABY.  AT 23 WEEKS I WENT IN FOR

332
00:14:06,760 --> 00:14:09,120
A STANDARD APPOINTMENT. 

333
00:14:09,120 --> 00:14:10,200
STANDARD ULTRASOUND AND TWO 

334
00:14:10,200 --> 00:14:12,560
WEEKS PRIOR I HAD BEEN FOUND TO 

335
00:14:12,560 --> 00:14:16,120
HAVE A SHORT CERVIX AND KNEW 

336
00:14:16,120 --> 00:14:17,720
WHAT NONE OF THAT MEANT PRIOR TO

337
00:14:17,720 --> 00:14:21,440
GOING INTO PREGNANCY AND DIDN'T 

338
00:14:21,440 --> 00:14:26,040
KNOW WHAT SHORT CERVIX WAS -- 

339
00:14:26,040 --> 00:14:29,960
THEY WERE DOING THESE EXTRA 

340
00:14:29,960 --> 00:14:31,760
ULTRA SOUNDS TO MAKE SURE THAT I

341
00:14:31,760 --> 00:14:37,440
WAS KIND OF GAINING SOME C

342
00:14:37,440 --> 00:14:39,320
CERVICAL LENGTH BACK AND WAS BUT

343
00:14:39,320 --> 00:14:41,920
DIDN'T EXPECT TO GO IN AND HEAR 

344
00:14:41,920 --> 00:14:43,880
MY SON DIDN'T HAVE A HEARTBEAT. 

345
00:14:43,880 --> 00:14:45,840
THAT ALL QUICKLY KIND OF CHANGED

346
00:14:45,840 --> 00:14:48,000
IN THE MOMENTS WHEN I BEGAN -- 

347
00:14:48,000 --> 00:14:50,080
WHEN I HEARD MY SON DIDN'T HAVE 

348
00:14:50,080 --> 00:14:51,880
A HEARTBEAT IT WENT FROM YOU ARE

349
00:14:51,880 --> 00:14:57,360
PREGNANT TO NO LONGER BEING 

350
00:14:57,360 --> 00:14:59,480
PREGNANT TO LET'S FIGURE OUT HOW

351
00:14:59,480 --> 00:15:02,280
TO GET THE BABY OUT OF YOU AND 

352
00:15:02,280 --> 00:15:04,480
YOU OUT OF THIS HOSPITAL.  YOU 

353
00:15:04,480 --> 00:15:07,080
DON'T UNDERSTAND WHEN PERSON IS 

354
00:15:07,080 --> 00:15:09,360
HAVING WORST TIME OF THEIR LIFE 

355
00:15:09,360 --> 00:15:11,560
HOW MUCH EMPATHY PLAYS A BIG 

356
00:15:11,560 --> 00:15:12,880
ROLE IN.  

357
00:15:12,880 --> 00:15:15,480
I WAS TOLD BY A RESIDENT CAN 

358
00:15:15,480 --> 00:15:17,840
CAME INTO THE ROOM AND SAID WE 

359
00:15:17,840 --> 00:15:19,520
CAN NAME YOUR SON AND FIGURE OUT

360
00:15:19,520 --> 00:15:21,360
WHAT YOU WILL DO WITH HIS 

361
00:15:21,360 --> 00:15:22,960
REMAINS AT THAT POINT.  AT THAT 

362
00:15:22,960 --> 00:15:24,440
POINT I WASN'T IN SPACE TO HAVE 

363
00:15:24,440 --> 00:15:26,600
THAT CONVERSATION AND HAVING IT 

364
00:15:26,600 --> 00:15:28,560
WITH SOMEONE I HAD NEVER MET OR 

365
00:15:28,560 --> 00:15:30,960
HAD A CONVERSATION WITH AND WERE

366
00:15:30,960 --> 00:15:32,600
DECIDING WHAT WOULD HAPPEN TO MY

367
00:15:32,600 --> 00:15:36,440
SON.  I DECIDED TO HAVE A D
& E 

368
00:15:36,440 --> 00:15:40,120
DONE AND DURING MY D & E, I 

369
00:15:40,120 --> 00:15:41,840
HEMORRHAGED WHICH RESULTED IN ME

370
00:15:41,840 --> 00:15:48,560
HAVING A UAE, A UTERIN AT RATE 

371
00:15:48,560 --> 00:15:50,560
EMBOLISM.  IF YOU CAN GO TO NEXT

372
00:15:50,560 --> 00:15:53,960
SLIDE.  NEXT ONE AFTER THAT, 

373
00:15:53,960 --> 00:16:04,480
PLEASE THIS IS A LIST OF ALL 

374
00:16:07,800 --> 00:16:14,080
ISSUES I HAD.  I HAD UTERINE 

375
00:16:14,080 --> 00:16:20,920
ARTERY EM BBEMBOLIZATION I HAD Y

376
00:16:20,920 --> 00:16:22,600
DOCTOR KNEW I WANTED HAVE 

377
00:16:22,600 --> 00:16:25,160
CHILDREN AND I WAS CLOSE TO 

378
00:16:25,160 --> 00:16:27,080
HAVING A HYSTERECTOMY AND THEY 

379
00:16:27,080 --> 00:16:30,120
WORKED DILIGENTLY AND HARD TO 

380
00:16:30,120 --> 00:16:32,240
PRESERVE MY FERTILITY BUT DON'T 

381
00:16:32,240 --> 00:16:33,840
KNOW ALL WOMEN HAVE THAT 

382
00:16:33,840 --> 00:16:35,000
RELATIONSHIP WITH THEIR DOCTORS 

383
00:16:35,000 --> 00:16:36,160
AND DON'T KNOW IF I DIDN'T HAVE 

384
00:16:36,160 --> 00:16:38,920
THE RELATIONSHIP I HAD WITH THE 

385
00:16:38,920 --> 00:16:42,200
PROVIDER IF THAT WOULD HAVE BEEN

386
00:16:42,200 --> 00:16:50,400
THE CASE FOR ME UPON MY SON'S 

387
00:16:50,400 --> 00:16:51,640
PASSING AND VISIT YOU HAVE AFTER

388
00:16:51,640 --> 00:16:54,880
YOU HAVE A BABY YOU HAVE TO GO 

389
00:16:54,880 --> 00:16:57,040
TO [INDISCERNIBLE].  DOESN'T 

390
00:16:57,040 --> 00:16:58,840
STOP BECAUSE YOUR BABY DIDN'T 

391
00:16:58,840 --> 00:17:01,320
LIVE YOU HAVE POSTPARTUM VISITS 

392
00:17:01,320 --> 00:17:03,920
AND POSTPARTUM CARE AND I HAD A 

393
00:17:03,920 --> 00:17:07,520
VERY SHORT VISIT WITH MATERNAL 

394
00:17:07,520 --> 00:17:10,200
FETAL MEDICINE DOCTOR AND WENT 

395
00:17:10,200 --> 00:17:12,600
OVER SON'S AUTOPSY RESULT AND NO

396
00:17:12,600 --> 00:17:14,800
REASON ACTUALLY AFTER HIS DEATH 

397
00:17:14,800 --> 00:17:16,560
A COUPLE THINGS TRANSPIRED AND 

398
00:17:16,560 --> 00:17:19,480
THOUGHT MAY BE THE REASON.  BUT 

399
00:17:19,480 --> 00:17:21,840
I TOOK IT UPON MYSELF TO READ 

400
00:17:21,840 --> 00:17:24,480
THE AUTOPSY LINE BY LINE AND WAS

401
00:17:24,480 --> 00:17:27,080
ME AND GOOGLE AND THIS AUTOPSY 

402
00:17:27,080 --> 00:17:28,560
REPORT AND I'M GOING THERE YOU 

403
00:17:28,560 --> 00:17:31,400
IT LINE BY LINE AND IN THE 

404
00:17:31,400 --> 00:17:35,520
AUTOPSY REPORT IT WAS FOUND MY 

405
00:17:35,520 --> 00:17:40,240
SON HAD BETA SALISEMIA AND 

406
00:17:40,240 --> 00:17:41,640
DIDN'T KNOW WHAT IT MEANT UNTIL 

407
00:17:41,640 --> 00:17:43,440
I DID FURTHER RESEARCH AND IT 

408
00:17:43,440 --> 00:17:44,800
DIDN'T EFFECT ME DIRECTLY BUT MY

409
00:17:44,800 --> 00:17:48,160
SON DID HAVE IT.  IT WAS 

410
00:17:48,160 --> 00:17:50,080
SOMETHING THAT INFORMATION 

411
00:17:50,080 --> 00:18:00,160
WASN'T PROVIDED TO ME YOU CAN GO

412
00:18:00,160 --> 00:18:02,960
TOLE NEXT SLIDE, PLEASE. 

413
00:18:02,960 --> 00:18:05,000
LIST OF THINGS I HAVE AND THERE 

414
00:18:05,000 --> 00:18:07,160
ARE DEFINITIONS OF THEM AS WELL.

415
00:18:07,160 --> 00:18:10,560
I WENT ON TO HAVE ANOTHER BABY 

416
00:18:10,560 --> 00:18:14,680
AND MY SON GRAYSON WILL BE 2 IN 

417
00:18:14,680 --> 00:18:22,440
JUNE THANK YOU.  GRAYSON IS THE 

418
00:18:22,440 --> 00:18:25,840
LIGHT OF MY LIFE AND AIDE AN IS 

419
00:18:25,840 --> 00:18:28,240
IMPORTANT AS WELL.  I DO THIS 

420
00:18:28,240 --> 00:18:30,240
BECAUSE I DON'T WANT TO FORGET 

421
00:18:30,240 --> 00:18:35,520
AND DON'T WANT HIS DEATH TO BE 

422
00:18:35,520 --> 00:18:38,160
SOMETHING THAT HAPPENED IN VEIN 

423
00:18:38,160 --> 00:18:40,960
AND DECIDED AFTER THIS I NEEDED 

424
00:18:40,960 --> 00:18:42,920
A SPECIFIC TYPE OF PROVIDER THAT

425
00:18:42,920 --> 00:18:45,080
WOULD LISTEN TO ME AND HOLD MY 

426
00:18:45,080 --> 00:18:47,640
HAND AND WHEN THINGS GOT SCARY 

427
00:18:47,640 --> 00:18:55,040
FOR ME THEY WOULD LISTEN. 

428
00:18:55,040 --> 00:18:58,440
I WENT THROUGH THREE INTERVIEWS 

429
00:18:58,440 --> 00:19:01,720
AND FINALLY PICKED A PROVIDER 

430
00:19:01,720 --> 00:19:03,680
AND HAVE A WONDERFUL 

431
00:19:03,680 --> 00:19:05,720
RELATIONSHIP WITH HER.  I WISH 

432
00:19:05,720 --> 00:19:07,440
ALL BIRTHING MOMS COULD HAVE THE

433
00:19:07,440 --> 00:19:09,480
TYPE OF RELATIONSHIP I HAVE.  

434
00:19:09,480 --> 00:19:13,360
I'M REMOVED FROM MATERNAL 

435
00:19:13,360 --> 00:19:15,800
MEDICINE WORLD BECAUSE I HAVE A 

436
00:19:15,800 --> 00:19:18,760
BABY AND LEAN ON TO HER TO ASK 

437
00:19:18,760 --> 00:19:20,760
QUESTIONS AND QUESTIONS ABOUT MY

438
00:19:20,760 --> 00:19:23,440
CASE NO LONGER NOT ON FRONT KAIS

439
00:19:23,440 --> 00:19:25,880
LOAD SHE IS WILLING TO ANSWER 

440
00:19:25,880 --> 00:19:27,480
AND TALK ME THROUGH ANYTHING.  

441
00:19:27,480 --> 00:19:28,880
WHEN PREPARING FOR THIS I SAID I

442
00:19:28,880 --> 00:19:30,000
HAVE QUESTIONS ABOUT WHAT KIND 

443
00:19:30,000 --> 00:19:32,040
OF HAPPENED TO ME IN THE OR.  

444
00:19:32,040 --> 00:19:34,040
SHE WAS LIKE ABSOLUTELY LET'S 

445
00:19:34,040 --> 00:19:41,520
SIT DOWN AND TALK ABOUT IT CH.  

446
00:19:41,520 --> 00:19:44,040
LOT OF TIMES PROVIDERS ARE 

447
00:19:44,040 --> 00:19:45,520
FOCUSED ON GETTING THE MOM 

448
00:19:45,520 --> 00:19:47,920
THROUGH WHATEVER IS GOING ON 

449
00:19:47,920 --> 00:19:50,360
WITH HER AND MY SECOND PREGNANCY

450
00:19:50,360 --> 00:19:54,360
I HAVE PRECLAMPS YA AND 

451
00:19:54,360 --> 00:19:57,840
GESTATIONAL DIABETES FROM THE 

452
00:19:57,840 --> 00:20:00,600
VERY, VERY BEGINNING. 

453
00:20:00,600 --> 00:20:03,760
WHAT I LOVED ABOUT MY PROVIDER, 

454
00:20:03,760 --> 00:20:05,360
SHE WAS VERY TRANSPARENT WITH ME

455
00:20:05,360 --> 00:20:07,520
FROM THE VERY BEGINNING DO I 

456
00:20:07,520 --> 00:20:10,840
THINK WE CAN GET YOU THROUGH THE

457
00:20:10,840 --> 00:20:12,840
PREGNANCY ABSOLUTELY TO TERM?  

458
00:20:12,840 --> 00:20:13,280
PROBABLY NOT. 

459
00:20:13,280 --> 00:20:15,080
I WAS ABLE TO FOCUS IN ON THAT 

460
00:20:15,080 --> 00:20:18,480
AND BE PREPARED FOR IT.  I 

461
00:20:18,480 --> 00:20:20,280
CARRIED A BAG IN MY CAR FOR 

462
00:20:20,280 --> 00:20:21,880
WEEKS PRIOR TO BEING ADMITTED TO

463
00:20:21,880 --> 00:20:23,720
THE HOSPITAL I KNEW I PROBABLY 

464
00:20:23,720 --> 00:20:25,760
WOULDN'T MAKE IT TO 37 WEEKS AND

465
00:20:25,760 --> 00:20:27,080
WOULDN'T GET TO THAT POINT BUT I

466
00:20:27,080 --> 00:20:28,920
WAS PREPARED FOR IT AND THERE 

467
00:20:28,920 --> 00:20:30,440
WAS NO REAL SURPRISES AT THAT 

468
00:20:30,440 --> 00:20:32,600
POINT.  WHEN I WENT IN TO HAVE 

469
00:20:32,600 --> 00:20:39,200
MY STANDARD APPOINTMENT WITH HER

470
00:20:39,200 --> 00:20:41,600
AND SHE LOOKED AT ME I THINK YOU

471
00:20:41,600 --> 00:20:44,400
ARE STAYING I'M READY FOR THIS 

472
00:20:44,400 --> 00:20:46,600
BAG IN CAR CALL MY FAMILY I'M 

473
00:20:46,600 --> 00:20:48,000
PREPARED.  I WANT TO ALSO NOTE 

474
00:20:48,000 --> 00:20:50,080
THAT WHEN I WAS PREGNANT WITH MY

475
00:20:50,080 --> 00:20:52,920
SECOND SON I WENT INTO LABOR AND

476
00:20:52,920 --> 00:20:54,720
DELIVERY 12 DIFFERENT TIMES AND 

477
00:20:54,720 --> 00:20:56,080
THAT IS NOT COMMON BECAUSE YOU 

478
00:20:56,080 --> 00:20:57,760
ONLY KNOW WHAT YOU KNOW WHEN YOU

479
00:20:57,760 --> 00:21:00,320
ARE PREGNANT.  I WENT IN BECAUSE

480
00:21:00,320 --> 00:21:02,760
I HAD THIS HORRIBLE OUTCOME 

481
00:21:02,760 --> 00:21:04,920
FIRST TIME I HAD MY FIRST SON 

482
00:21:04,920 --> 00:21:06,120
AND EVERY TIME SOMETHING WASN'T 

483
00:21:06,120 --> 00:21:08,200
RIGHT I WAS CALLING AND JUST 

484
00:21:08,200 --> 00:21:09,240
LIKE HEY SOMETHING DOESN'T FEEL 

485
00:21:09,240 --> 00:21:19,000
RIGHT I NEED TO COME IN.  

486
00:21:19,000 --> 00:21:21,160
ONE THING I'M SO THANKFUL TO MY 

487
00:21:21,160 --> 00:21:23,000
PROVIDER UNDERSTANDING IS 24 

488
00:21:23,000 --> 00:21:25,000
WEEKS SHORTLY AFTER WHERE I LOST

489
00:21:25,000 --> 00:21:26,920
MY FIRST SON MY DEPRESSION SET 

490
00:21:26,920 --> 00:21:28,840
IN AND SET IN, IN A WAY I WASN'T

491
00:21:28,840 --> 00:21:30,760
ABLE TO GET UP IN THE MORNING 

492
00:21:30,760 --> 00:21:33,240
AND WASN'T ABLE TO FUNCTION OR 

493
00:21:33,240 --> 00:21:35,080
WORK AND REMEMBER GOING IN FOR A

494
00:21:35,080 --> 00:21:36,320
VISIT WITH HER AND SAYING TO 

495
00:21:36,320 --> 00:21:38,560
HER, I CAN'T DO THIS.  SHE SAID,

496
00:21:38,560 --> 00:21:41,320
YOU DON'T HAVE TO.  YOU KNOW, IF

497
00:21:41,320 --> 00:21:43,040
YOU CAN'T GET UP AND CAN'T 

498
00:21:43,040 --> 00:21:44,680
FUNCTION WE WILL DO THIS WEEK BY

499
00:21:44,680 --> 00:21:50,280
WEEK AND SEE WHERE YOU LAND IN 

500
00:21:50,280 --> 00:21:50,640
TH

501
00:21:50,640 --> 00:21:50,960
TH

502
00:21:50,960 --> 00:21:51,160
THIS. 

503
00:21:51,160 --> 00:21:52,360
I NEVER ENDED UP GOING BACK TO 

504
00:21:52,360 --> 00:21:54,240
WORK AND SHE GAVE ME A SMALL 

505
00:21:54,240 --> 00:21:55,760
LIST OF THINGS TO DO DAILY GET 

506
00:21:55,760 --> 00:21:58,280
UP IN MORNING WALK FOR 10 

507
00:21:58,280 --> 00:22:00,240
MINUTES EAT BREAKFAST AND I HAD 

508
00:22:00,240 --> 00:22:01,400
TO JOURNAL WERE THREE THINGS 

509
00:22:01,400 --> 00:22:02,880
THAT WERE MOST IMPORTANT TO HER.

510
00:22:02,880 --> 00:22:05,480
SHE WAS LIKE IF YOU CAN DO THOE

511
00:22:05,480 --> 00:22:08,640
THREE THINGS YOU HAVE DONE THREE

512
00:22:08,640 --> 00:22:10,800
THINGS I'M ASKING YOU TO DO IN 

513
00:22:10,800 --> 00:22:13,160
THIS PREGNANCY AND CHANGED 

514
00:22:13,160 --> 00:22:17,120
TRAJECTORY OF ME GETTING THROUGH

515
00:22:17,120 --> 00:22:23,360
PREGNANCY AFTER ALL I DO WANT TO

516
00:22:23,360 --> 00:22:25,080
FOCUS IN ON WHAT IT WAS LIKE 

517
00:22:25,080 --> 00:22:26,880
AFTER LOSING MY FIRST ONE.  THEY

518
00:22:26,880 --> 00:22:29,160
SEND YOU HOME.  YOU ARE SUPPOSED

519
00:22:29,160 --> 00:22:30,160
TO JUST FIGURE EVERYTHING OUT.  

520
00:22:30,160 --> 00:22:32,360
YOU ARE NOT REALLY A PATIENT TO 

521
00:22:32,360 --> 00:22:34,000
THEM ANYMORE.  YOU NO LONGER 

522
00:22:34,000 --> 00:22:35,920
HAVE A BABY.  THAT SHOULDN'T BE 

523
00:22:35,920 --> 00:22:38,000
THE CASE FOR ANYONE THAT HAS 

524
00:22:38,000 --> 00:22:40,000
LOST THE CHILD YOU STILL HAVE TO

525
00:22:40,000 --> 00:22:41,400
GO THROUGH POSTPARTUM PERIOD AND

526
00:22:41,400 --> 00:22:43,720
DEAL WITH ALL OF THE THINGS A 

527
00:22:43,720 --> 00:22:48,160
PERSON BRINGING A BABY HOME HAD 

528
00:22:48,160 --> 00:22:50,440
TO DEAL WITH AND I WASN'T 

529
00:22:50,440 --> 00:22:52,320
PREPARED FOR THAT AND BREAST 

530
00:22:52,320 --> 00:22:54,760
MILK COMING IN AND PHYSICAL 

531
00:22:54,760 --> 00:22:56,360
CHANGES HAPPENING SO QUICKLY 

532
00:22:56,360 --> 00:22:58,480
BECAUSE MY SON WAS NO LONGER 

533
00:22:58,480 --> 00:23:00,880
THERE AND WAS GIVEN A LIST OF 

534
00:23:00,880 --> 00:23:02,640
PROVIDERS AND TOLD TO CALL THEM 

535
00:23:02,640 --> 00:23:05,320
AND GET MYSELF A MENTAL HEALTH 

536
00:23:05,320 --> 00:23:08,040
PROVIDER.  I HAD A CONVERSATION 

537
00:23:08,040 --> 00:23:10,120
AND LEFT A VOICEMAIL FOR A WOMAN

538
00:23:10,120 --> 00:23:11,960
BY NAME OF ANDY. 

539
00:23:11,960 --> 00:23:14,080
WHEN SHE CALLED ME BACK SHE SAID

540
00:23:14,080 --> 00:23:16,240
TO ME AND SAID YOU CAN'T MAKE 

541
00:23:16,240 --> 00:23:20,000
THESE PHONE CALLS ON YOUR OWN 

542
00:23:20,000 --> 00:23:21,360
PROVIDER'S OFFICE SHOULD.  I 

543
00:23:21,360 --> 00:23:22,000
COULDN'T UNDERSTAND WHAT YOU 

544
00:23:22,000 --> 00:23:23,760
WERE SAYING LET ALONE I CAN'T 

545
00:23:23,760 --> 00:23:25,440
HELP YOU IN THIS WAY.  SHE IS 

546
00:23:25,440 --> 00:23:27,560
LIKE YOUR PROVIDERS NEED TO CALL

547
00:23:27,560 --> 00:23:30,080
AND TELL US EXACTLY WHAT 

548
00:23:30,080 --> 00:23:31,040
HAPPENED.  

549
00:23:31,040 --> 00:23:32,960
SO, I'M FOREVER INDEBTED TO ANDY

550
00:23:32,960 --> 00:23:35,440
WHO CALLED TO MY PROVIDER'S 

551
00:23:35,440 --> 00:23:37,480
OFFICE AND GOT ME A PROVIDER TO 

552
00:23:37,480 --> 00:23:39,400
ASSIST WITH MY POSTPARTUM 

553
00:23:39,400 --> 00:23:40,960
DEPRESSION.  I HAD NO CLUE WHAT 

554
00:23:40,960 --> 00:23:44,520
THAT WAS.  NO ONE PREPARES YOU 

555
00:23:44,520 --> 00:23:49,920
FOR THAT.  YOU KNOW, I HAVE BEEN

556
00:23:49,920 --> 00:23:51,480
IN THERAPY EVER SINCE.  SON 

557
00:23:51,480 --> 00:23:54,160
WOULD HAVE BEEN 4 IN JULY.  I GO

558
00:23:54,160 --> 00:23:57,880
TO THERAPY EVERY WEEK LIKE CLOCK

559
00:23:57,880 --> 00:24:01,440
WORK.  

560
00:24:01,440 --> 00:24:04,520
I ALSO WANT TO TOUCH ON MENTAL 

561
00:24:04,520 --> 00:24:05,800
HEALTH ASPECTS FOR FATHERS AS 

562
00:24:05,800 --> 00:24:09,280
WELL.  I'M IN THE MIDDLE OF A 

563
00:24:09,280 --> 00:24:11,320
SEPARATION.  I DO THINK THAT 

564
00:24:11,320 --> 00:24:14,520
THERE IS A BIG STATISTIC THAT 

565
00:24:14,520 --> 00:24:16,520
80% OF COUPLES THAT LOSE 

566
00:24:16,520 --> 00:24:18,120
CHILDREN DON'T MAKE IT THROUGH 

567
00:24:18,120 --> 00:24:20,080
THEIR MARRIAGE.  I'M STANDING 

568
00:24:20,080 --> 00:24:21,960
HERE TO TELL YOU THAT IS TRUE 

569
00:24:21,960 --> 00:24:25,280
AND THINK THAT PLAYED A LARGE 

570
00:24:25,280 --> 00:24:29,000
PART IN OUR SEPARATION AND ALSO 

571
00:24:29,000 --> 00:24:31,320
DO THINK IF THERE WAS FOCUS ON 

572
00:24:31,320 --> 00:24:34,120
ME AND ON DAD THINGS MIGHT HAVE 

573
00:24:34,120 --> 00:24:35,360
BEEN DIFFERENT.  MY HUSBAND 

574
00:24:35,360 --> 00:24:36,920
DIDN'T HAVE A REAL UNDERSTANDING

575
00:24:36,920 --> 00:24:39,160
WHAT I WAS GOING THROUGH EXACTLY

576
00:24:39,160 --> 00:24:40,440
AND I DIDN'T HAVE AN 

577
00:24:40,440 --> 00:24:42,160
UNDERSTANDING WHAT I WAS GOING 

578
00:24:42,160 --> 00:24:43,560
THROUGH AND NO WAY FOR HIM TO 

579
00:24:43,560 --> 00:24:46,440
HAVE AN UNDERSTANDING AS WELL. 

580
00:24:46,440 --> 00:24:50,400
AND HE WASN'T REALLY WELL VERSED

581
00:24:50,400 --> 00:24:53,880
ON WHAT COMPLICATIONS FOR MY 

582
00:24:53,880 --> 00:24:54,640
PREGNANCY JUST THAT WE WERE 

583
00:24:54,640 --> 00:24:58,080
PREGNANT AND GOING TO THE 

584
00:24:58,080 --> 00:25:06,400
DOCTORS EVERY WEEK. 

585
00:25:06,400 --> 00:25:09,120
I WISH THERE WAS MORE FOR MOMS 

586
00:25:09,120 --> 00:25:11,320
IN POSTPARTUM PERIOD AND LESS 

587
00:25:11,320 --> 00:25:12,960
BABY BLUES AND IT IS OKAY TO NOT

588
00:25:12,960 --> 00:25:15,640
BE OKAY.  WHEN I HAD SECOND SON 

589
00:25:15,640 --> 00:25:18,920
PROBABLY WHEN HE WAS 6 WEEKS OLD

590
00:25:18,920 --> 00:25:20,080
CALLED DOCTOR SOMETHING IS NOT 

591
00:25:20,080 --> 00:25:21,200
RIGHT I'M NOT CONNECTING WITH 

592
00:25:21,200 --> 00:25:23,200
HIM.  THIS IS SUPPOSED TO BE 

593
00:25:23,200 --> 00:25:24,320
VERY DIFFERENT AND SUPPOSED TO 

594
00:25:24,320 --> 00:25:25,640
FEEL VERY DIFFERENTLY ABOUT HIM.

595
00:25:25,640 --> 00:25:28,360
I LOVE HIM BUT DON'T LIKE HIM 

596
00:25:28,360 --> 00:25:31,400
VERY MUCH RIGHT NOW. 

597
00:25:31,400 --> 00:25:33,960
I HAD CONVERSATIONS WITH HER 

598
00:25:33,960 --> 00:25:35,840
OVER AND OVER AND SHE WAS 

599
00:25:35,840 --> 00:25:37,320
FINALLY LIKE WE WILL GET YOU 

600
00:25:37,320 --> 00:25:39,600
INTO A DAY PROGRAM AND SEE IF IT

601
00:25:39,600 --> 00:25:41,560
HELPS A LITTLE BIT.  IT CHANGED 

602
00:25:41,560 --> 00:25:43,280
THINGS COMPLETELY.  I WAS ABLE 

603
00:25:43,280 --> 00:25:44,680
TO SEE OTHER WOMEN GOING THROUGH

604
00:25:44,680 --> 00:25:46,800
SAME THINGS I WAS GOING THROUGH 

605
00:25:46,800 --> 00:25:48,840
AND DIDN'T FEEL AS CRAZY AS I 

606
00:25:48,840 --> 00:25:51,280
WAS FEELING AND IN THIS MOMENT 

607
00:25:51,280 --> 00:25:53,440
OF BEING LIKE OH, MY GOODNESS.  

608
00:25:53,440 --> 00:25:55,280
I'M ONLY PERSON GOING THROUGH 

609
00:25:55,280 --> 00:25:57,000
THIS.  PEOPLE DON'T TALK ABOUT 

610
00:25:57,000 --> 00:25:58,560
WHAT POSTPARTUM DEPRESSION 

611
00:25:58,560 --> 00:26:04,000
REALLY LOOKS LIKE.  IT IS HARD. 

612
00:26:04,000 --> 00:26:05,800
I WANT TO ALSO TOUCH ON 

613
00:26:05,800 --> 00:26:08,440
IMPORTANCE OF GIVING PATIENTS 

614
00:26:08,440 --> 00:26:10,000
CLEAR DIAGNOSIS AND EXPLAINING 

615
00:26:10,000 --> 00:26:10,720
TO THEM. 

616
00:26:10,720 --> 00:26:14,640
SO, I KNEW I HAD A SHORT CERVIX 

617
00:26:14,640 --> 00:26:16,440
IN FIRST PREGNANCY AND DIDN'T 

618
00:26:16,440 --> 00:26:18,440
KNOW WHAT IT MEANT EXACTLY.  

619
00:26:18,440 --> 00:26:19,520
WHATEVER DOCTOR NOELD I NEED 

620
00:26:19,520 --> 00:26:22,080
TODAY DO I WAS GOING TO.  DO I 

621
00:26:22,080 --> 00:26:25,200
NEED TODAY GET THROUGH MY 

622
00:26:25,200 --> 00:26:25,520
PREGNANCY. 

623
00:26:25,520 --> 00:26:27,720
SECOND PREGNANCY, I WAS VERY 

624
00:26:27,720 --> 00:26:28,640
INTENTIONAL ABOUT THE 

625
00:26:28,640 --> 00:26:30,520
CONVERSATION I WAS HAVING WITH 

626
00:26:30,520 --> 00:26:33,920
MY PROVIDER AND WANTED TO SAY I 

627
00:26:33,920 --> 00:26:35,360
WANT [INDISCERNIBLE] RIGHT AT 13

628
00:26:35,360 --> 00:26:37,040
WEEKS WHEN IT IS SAFE TO HAVE A 

629
00:26:37,040 --> 00:26:38,800
PLACE AND I WANT TO YOU KNOW 

630
00:26:38,800 --> 00:26:40,840
HAVE THAT AS ONE LESS THING ON 

631
00:26:40,840 --> 00:26:44,600
LIST OF THINGS TO HAVE TO WORRY 

632
00:26:44,600 --> 00:26:46,000
ABOUT.  IF YOU BELIEVE IN YOUR 

633
00:26:46,000 --> 00:26:47,240
[INDISCERNIBLE] IT WILL HOLD AND

634
00:26:47,240 --> 00:26:49,040
YOU WILL GET THROUGH A 

635
00:26:49,040 --> 00:26:52,120
PREGNANCY.  YOU CAN GO THROUGH 

636
00:26:52,120 --> 00:26:54,480
THE NEXT SLIDE.  

637
00:26:54,480 --> 00:26:58,960
NEXT SLIDE AS WELL. 

638
00:26:58,960 --> 00:27:01,920
ONE THING THAT I LIKE TO TOUCH 

639
00:27:01,920 --> 00:27:05,320
ON IS LACK OF EMPATHY OF 

640
00:27:05,320 --> 00:27:07,560
PROVIDERS IN THE MATERNAL HEALTH

641
00:27:07,560 --> 00:27:10,280
WORLD.  THERE IS A LOT OF TIMES 

642
00:27:10,280 --> 00:27:11,160
PROVIDERS WILL HAVE 

643
00:27:11,160 --> 00:27:12,920
CONVERSATIONS WITH YOU IN THE 

644
00:27:12,920 --> 00:27:14,760
ROOMS AND IN THESE SPACES AND 

645
00:27:14,760 --> 00:27:16,720
WANT YOU TO JUST ACCEPT WHATEVER

646
00:27:16,720 --> 00:27:20,480
THEY ARE SAYING AND 

647
00:27:20,480 --> 00:27:22,280
UNFORTUNATELY IF YOU ARE LIKE 

648
00:27:22,280 --> 00:27:25,080
HOW I WAS IN FIRST PREGNANCY 

649
00:27:25,080 --> 00:27:26,320
WHATEVER DOCTOR TOLD ME TO DO I 

650
00:27:26,320 --> 00:27:29,000
WAS GOING TO DO AND THAT WAS 

651
00:27:29,000 --> 00:27:30,400
WITHOUT RESEARCH AND WITHOUT -- 

652
00:27:30,400 --> 00:27:32,080
YOU ARE THE PROVIDER AND 

653
00:27:32,080 --> 00:27:33,520
ASSUMING THIS IS YOUR JOB AND 

654
00:27:33,520 --> 00:27:34,840
YOU WILL DO WHATEVER IS GOING TO

655
00:27:34,840 --> 00:27:36,120
BE BEST FOR ME. 

656
00:27:36,120 --> 00:27:38,080
IT IS SUPER IMPORTANT TO DISCUSS

657
00:27:38,080 --> 00:27:39,880
WHAT ALL THOSE THINGS ARE GOING 

658
00:27:39,880 --> 00:27:42,440
TO LOOK LIKE. 

659
00:27:42,440 --> 00:27:48,200
I HAD PREECLAMPSIA WITH MY 

660
00:27:48,200 --> 00:27:50,000
SECOND SON AND DOCTOR CAME IN.  

661
00:27:50,000 --> 00:27:52,840
SHE WAS GOING ON VACATION AND WE

662
00:27:52,840 --> 00:27:54,920
PLANNED OUT THIS WHOLE BIG 

663
00:27:54,920 --> 00:27:56,960
DELIVERY AND WHEN THINGS CHANGED

664
00:27:56,960 --> 00:27:59,440
THEY CHANGED DRAMATICALLY.  

665
00:27:59,440 --> 00:28:01,160
DROPPING KIDS OFF AT CAMP I NEED

666
00:28:01,160 --> 00:28:03,440
YOU TO SIT HERE.  SIT HERE AND 

667
00:28:03,440 --> 00:28:04,920
JUST WAIT.  WAIT AND SHE WAS 

668
00:28:04,920 --> 00:28:06,840
LIKE WE WILL WAIT AND SEE WHAT 

669
00:28:06,840 --> 00:28:09,720
KIND OF HAPPENS.  WHILE SHE WAS 

670
00:28:09,720 --> 00:28:11,920
AWAY DROPPING HER KIDS OFF, SHE 

671
00:28:11,920 --> 00:28:14,080
-- MY BLOOD PRESSURE KEPT 

672
00:28:14,080 --> 00:28:19,760
GETTING HIGHER AND HIGH. ER.  

673
00:28:19,760 --> 00:28:21,120
THEY WEREN'T ABLE TO CONTROL 

674
00:28:21,120 --> 00:28:22,400
THEM AND SATURDAY BEFORE MY SON 

675
00:28:22,400 --> 00:28:25,360
WAS BORN TOOK ME TO LABOR AND 

676
00:28:25,360 --> 00:28:26,840
DELIVERY AND STARTED MAGNESIUM 

677
00:28:26,840 --> 00:28:29,200
FOR ME.  I REMEMBER CALLING HER 

678
00:28:29,200 --> 00:28:30,520
BEING LIKE I'M NOT PREPARED FOR 

679
00:28:30,520 --> 00:28:32,080
THIS OR READY FOR THIS.  WE 

680
00:28:32,080 --> 00:28:33,720
PLANNED ON ME HAVING THIS BABY 

681
00:28:33,720 --> 00:28:35,280
WITH YOU I DON'T KNOW ANY OF 

682
00:28:35,280 --> 00:28:38,920
THESE OTHER PROVIDERS.  I'M VERY

683
00:28:38,920 --> 00:28:39,920
UNCOMFORTABLE WITH THIS AND 

684
00:28:39,920 --> 00:28:41,520
REMEMBER HER SAYING YOU ARE IN 

685
00:28:41,520 --> 00:28:42,840
THE BEST PLACE YOU NEED TO BE 

686
00:28:42,840 --> 00:28:46,280
AND YOU WILL GET THE BEST CARE. 

687
00:28:46,280 --> 00:28:48,400
UNFORTUNATELY BEING AN AFRICAN 

688
00:28:48,400 --> 00:28:51,040
AMERICAN WOMAN, THOSE WORDS 

689
00:28:51,040 --> 00:28:52,800
DON'T MEAN MUCH TO ME.  WHEN YOU

690
00:28:52,800 --> 00:28:54,800
HAVE A PROVIDER YOU TRUST AND 

691
00:28:54,800 --> 00:28:56,360
SOMEONE THAT YOU ARELE TO PUT 

692
00:28:56,360 --> 00:28:57,800
YOUR LIFE IN THEIR HANDS THAT IS

693
00:28:57,800 --> 00:28:59,400
KIND OF THE ONLY PERSON YOU WANT

694
00:28:59,400 --> 00:29:02,440
TO BE ABLE TO DO EVERYTHING FOR 

695
00:29:02,440 --> 00:29:02,840
YOU. 

696
00:29:02,840 --> 00:29:04,680
I DON'T KNOW WHO SHE CALLED OR 

697
00:29:04,680 --> 00:29:06,960
WHAT CONVERSATION SHE HAD THEY 

698
00:29:06,960 --> 00:29:09,360
KEPT ME ON LABOR AND DELIVERY 

699
00:29:09,360 --> 00:29:13,000
FOR 48 HOURS INLE SHE WAS BACK 

700
00:29:13,000 --> 00:29:14,360
THAT MONDAY AND SHE DELIVERED MY

701
00:29:14,360 --> 00:29:17,120
SON AND I HEM RANLED AGAIN IN 

702
00:29:17,120 --> 00:29:19,960
THE OR.  I HAD A VERY LARGE C 

703
00:29:19,960 --> 00:29:22,840
SECTION AND WHEN I WAS DIAGNOSED

704
00:29:22,840 --> 00:29:25,240
WITH SOME OF MY OTHER ISSUES 

705
00:29:25,240 --> 00:29:26,800
ENDO MITES THEY FOUND AND HAD TO

706
00:29:26,800 --> 00:29:29,160
HAVE DNC AND HAD TO RECEIVE 

707
00:29:29,160 --> 00:29:32,080
BLOOD PRODUCTS WHEN IN THE OR 

708
00:29:32,080 --> 00:29:34,520
AND HAD TO RECEIVE BLOOD 

709
00:29:34,520 --> 00:29:36,400
PRODUCTS AFTER MY SON WAS BORN. 

710
00:29:36,400 --> 00:29:38,880
YOU ARE NOT EXPECTING THAT WHEN 

711
00:29:38,880 --> 00:29:40,440
YOU ARE HAVING A BABY. 

712
00:29:40,440 --> 00:29:43,360
I WAS ON A HIGH FOR THE FIRST 24

713
00:29:43,360 --> 00:29:45,440
HOURS AND HIGH STARTED TO COME 

714
00:29:45,440 --> 00:29:49,080
DOWN ONCE THINGS WEREN'T ALL 

715
00:29:49,080 --> 00:29:50,200
RAINBOW AND ROSES AS I THOUGHT 

716
00:29:50,200 --> 00:29:55,080
THEY WERE GOING TO BE I HAD SUCH

717
00:29:55,080 --> 00:29:56,080
A DIFFERENT OUTCOME SECOND TIME 

718
00:29:56,080 --> 00:29:58,160
I HAD A BABY.  I FELT THAT 

719
00:29:58,160 --> 00:30:00,720
PEOPLE LISTENED TO ME AND 

720
00:30:00,720 --> 00:30:02,760
PROVIDER -- SHE SPENT EXTRA TIME

721
00:30:02,760 --> 00:30:04,480
AND FIVE MINUTES SUFFERING OR 

722
00:30:04,480 --> 00:30:05,800
GOING OVER THINGS WITH ME AGAIN 

723
00:30:05,800 --> 00:30:07,600
AND REASSURING ME WE WOULD GET 

724
00:30:07,600 --> 00:30:10,120
TO THE OTHER SIDE.  THERE WERE 

725
00:30:10,120 --> 00:30:11,120
PLENTY TIMES I DIDN'T BELIEVE 

726
00:30:11,120 --> 00:30:13,000
THAT WOULD HAPPEN AND THERE WERE

727
00:30:13,000 --> 00:30:17,440
PLENTY OF TIMES WHERE I HAD 

728
00:30:17,440 --> 00:30:19,560
ANTIER YOOR PLACENTA AS WELL AND

729
00:30:19,560 --> 00:30:21,000
COULDN'T FEEL MY SON MOVE AND 

730
00:30:21,000 --> 00:30:22,800
WAS A REASON I ALWAYS WAS GOING 

731
00:30:22,800 --> 00:30:24,680
INTO LABOR AND DELIVERY.  I 

732
00:30:24,680 --> 00:30:25,640
COULDN'T FEEL THINGS. 

733
00:30:25,640 --> 00:30:27,800
I REMEMBER WHEN I FIRST MET HER 

734
00:30:27,800 --> 00:30:29,840
I SAID TO HER, OH, I HAVE A 

735
00:30:29,840 --> 00:30:31,040
[INDISCERNIBLE] AT HOME.  SHE 

736
00:30:31,040 --> 00:30:32,640
WAS LIKE YOU WILL GET RID OF 

737
00:30:32,640 --> 00:30:33,920
THAT.  THAT IS NOT SOMETHING YOU

738
00:30:33,920 --> 00:30:35,600
WILL USE.  IF YOU FEEL LIKE 

739
00:30:35,600 --> 00:30:37,600
SOMETHING IS NOT RIGHT YOU WILL 

740
00:30:37,600 --> 00:30:38,920
COME INTO THE HOSPITAL.  I DON'T

741
00:30:38,920 --> 00:30:42,640
WANT YOU MONTH NTORRING YOURSELF

742
00:30:42,640 --> 00:30:44,400
AT HOME. 

743
00:30:44,400 --> 00:30:45,920
THAT CHANGED EVERYTHING FOR ME 

744
00:30:45,920 --> 00:30:52,880
AND MADE IT SO I WAS ABLE TO BE 

745
00:30:52,880 --> 00:30:56,120
LESS WORRIED ABOUT WHAT MY 

746
00:30:56,120 --> 00:30:57,600
PROVIDER WOULD THINK AND MORE 

747
00:30:57,600 --> 00:31:00,680
CONCERNED ABOUT MY ACTUAL HEALTH

748
00:31:00,680 --> 00:31:01,280
AND WELLBEING. 

749
00:31:01,280 --> 00:31:03,280
AND I WANT TO TOUCH ON THAT 

750
00:31:03,280 --> 00:31:05,280
MEDICAL CARE SHOULD BE A 

751
00:31:05,280 --> 00:31:06,800
PARTNERSHIP NOT DICTATORSHIP.  

752
00:31:06,800 --> 00:31:08,440
YOU SHOULDN'T HAVE TO FEEL YOU 

753
00:31:08,440 --> 00:31:11,200
CAN'T TALK TO YOUR PROVIDER 

754
00:31:11,200 --> 00:31:13,680
WHOMEVER THE PROVIDER IS WHETHER

755
00:31:13,680 --> 00:31:15,120
A NURSE OR DOCTOR.  YOU SHOULD 

756
00:31:15,120 --> 00:31:16,720
BE ABLE TO HAVE WHATEVER 

757
00:31:16,720 --> 00:31:19,120
CONVERSATION YOU ARE HAVING AND 

758
00:31:19,120 --> 00:31:21,640
DOESN'T MEAN I'M ASKING 

759
00:31:21,640 --> 00:31:22,560
QUESTIONS THAT DON'T TRUST YOU 

760
00:31:22,560 --> 00:31:27,480
JUST THAT I NEED MORE 

761
00:31:27,480 --> 00:31:27,840
INFORMATION. 

762
00:31:27,840 --> 00:31:29,400
ONE OTHER THING -- ONE THING I 

763
00:31:29,400 --> 00:31:31,320
WANT TO SUMMARIZE ON MAIN POINTS

764
00:31:31,320 --> 00:31:35,160
I WANT YOU GUYS TO REMEMBER IS 

765
00:31:35,160 --> 00:31:36,880
GIVING YOUR PATIENTS MENTAL 

766
00:31:36,880 --> 00:31:38,880
HEALTH THAT THEY NEED DURING AND

767
00:31:38,880 --> 00:31:42,680
AFTER THEIR PREGNANCIES. 

768
00:31:42,680 --> 00:31:45,720
ALSO, GIVING THEM QUALITY CARE, 

769
00:31:45,720 --> 00:31:47,640
WHATEVER IT LOOKS LIKE TO YOU. 

770
00:31:47,640 --> 00:31:49,240
REALLY SPEAKING TO WOMEN YOU ARE

771
00:31:49,240 --> 00:31:51,160
SEEING AND SPEAKING TO DADS YOU 

772
00:31:51,160 --> 00:31:52,640
ARE SEEING IN CLINICS AS WELL 

773
00:31:52,640 --> 00:31:54,480
AND ASKING THEM WHAT WOULD MAKE 

774
00:31:54,480 --> 00:31:58,160
THIS EASIER FOR YOU AMD MAKE 

775
00:31:58,160 --> 00:32:00,720
THIS SOMETHING THAT YOU WOULD 

776
00:32:00,720 --> 00:32:05,000
FEEL COMFORTABLE WITH?  

777
00:32:05,000 --> 00:32:07,320
I ENCOURAGE YOU TO GET INVOLVED 

778
00:32:07,320 --> 00:32:10,560
IN MATERNAL HEALTH ADVOCACY AND 

779
00:32:10,560 --> 00:32:13,560
SUPPORT POLICIES INITIATIVE THAT

780
00:32:13,560 --> 00:32:15,800
PROMOTES MATERNAL HEALTH 

781
00:32:15,800 --> 00:32:17,880
OUTCOMES IN WHATEVER WAY IT LOOK

782
00:32:17,880 --> 00:32:20,080
LIKES SO MANY NON-PROFIT 

783
00:32:20,080 --> 00:32:21,720
PROGRAMS OUT THERE OFFER 

784
00:32:21,720 --> 00:32:24,000
TRAININGS AND ALL SORTS OF 

785
00:32:24,000 --> 00:32:26,280
THINGS FOR PATIENT AND PROVIDERS

786
00:32:26,280 --> 00:32:28,680
AND IMPLORE ALL OF YOU TO AT 

787
00:32:28,680 --> 00:32:30,480
LEAST ATTEMPT TO TRY SOME OF 

788
00:32:30,480 --> 00:32:32,520
THEM AND TALKING TO PATIENTS IS 

789
00:32:32,520 --> 00:32:35,280
MOST IMPORTANT THING AS WELL. 

790
00:32:35,280 --> 00:32:37,480
YOU CAN GO TO THE NEXT SLIDE.  

791
00:32:37,480 --> 00:32:41,360
THERE IS A PICTURE OF MY SON.  

792
00:32:41,360 --> 00:32:51,640
THAT IS GRAYSON.  

793
00:32:55,040 --> 00:32:59,680
>> IF THERE ARE ANY
QUESTIONS, 

794
00:32:59,680 --> 00:33:02,080
CANDICE IS WILLING TO TAKE 

795
00:33:02,080 --> 00:33:03,600
QUESTIONS.  WE HAVE MICS.  YOU 

796
00:33:03,600 --> 00:33:10,440
CAN GO UP TO THE MICS. 

797
00:33:10,440 --> 00:33:12,760
>> HI.  THANK YOU SO MUCH
FOR 

798
00:33:12,760 --> 00:33:14,880
SHARING YOUR STORY.  MY QUESTION

799
00:33:14,880 --> 00:33:19,400
WAS WHEN YOU WENT FOR THE OPEN 

800
00:33:19,400 --> 00:33:21,200
MYOECTOMY, WAS IT FOR FERTILITY 

801
00:33:21,200 --> 00:33:23,280
ISSUES OR SYMPTOMS YOU WERE 

802
00:33:23,280 --> 00:33:24,000
GETTING TREATED?  

803
00:33:24,000 --> 00:33:25,880
>> IT WAS FOR SYMPTOMS. 

804
00:33:25,880 --> 00:33:28,160
ACTUALLY, PRIOR TO HAVING -- 

805
00:33:28,160 --> 00:33:30,160
PRIOR TO LIKE EVEN MEETING MY 

806
00:33:30,160 --> 00:33:31,600
HUSBAND, I DIDN'T WANT CHILDREN.

807
00:33:31,600 --> 00:33:33,720
SO, IT WAS FOR SYMPTOMS I WAS 

808
00:33:33,720 --> 00:33:34,000
HAVING. 

809
00:33:34,000 --> 00:33:35,960
THEN WHEN I WENT IN AND MET WITH

810
00:33:35,960 --> 00:33:38,480
MY SURGEON, SHE WAS LIKE THIS 

811
00:33:38,480 --> 00:33:41,040
WILL CLEAR UP ANY FERTILITY 

812
00:33:41,040 --> 00:33:44,000
ISSUES YOU MIGHT HAVE.  DIDN'T 

813
00:33:44,000 --> 00:33:45,800
NECESSARILY CLEAR IT UP FOR ME 

814
00:33:45,800 --> 00:33:49,160
BUT I HAD A VERY LARGE OPEN 

815
00:33:49,160 --> 00:33:51,120
MYOECTOMY AND I ALSO HEMORRHAGED

816
00:33:51,120 --> 00:33:53,160
THEN.  I'M JUST A BLEEDER, 

817
00:33:53,160 --> 00:33:54,920
APPARENTLY.  YEAH.  IT WAS FOR 

818
00:33:54,920 --> 00:33:56,200
SYMPTOMS I WAS HAVING. 

819
00:33:56,200 --> 00:33:57,240
>> THANK YOU. 

820
00:33:57,240 --> 00:33:57,560
>> UH-HUH. 

821
00:33:57,560 --> 00:34:00,040
>> THANK YOU SO MUCH FOR
SHARE 

822
00:34:00,040 --> 00:34:00,360
YURG STORY. 

823
00:34:00,360 --> 00:34:02,040
>> ABSOLUTELY. 

824
00:34:02,040 --> 00:34:05,040
>> I'M A MATERNAL FETAL 

825
00:34:05,040 --> 00:34:07,120
MEDICINE DOC AND EVERY TIME I 

826
00:34:07,120 --> 00:34:09,280
HEAR A PATIENT'S NARRATIVE, IT 

827
00:34:09,280 --> 00:34:11,160
CHANGES ME AGAIN.  I SAY THAT 

828
00:34:11,160 --> 00:34:12,920
NOW AFTER 10 YEARS DOING THIS.  

829
00:34:12,920 --> 00:34:14,600
MY QUESTION FOR YOU IS WHAT 

830
00:34:14,600 --> 00:34:17,840
ADVICE WOULD YOU OFFER A BRAND 

831
00:34:17,840 --> 00:34:19,360
NEW PERSON?  I THINK ABOUT THIS 

832
00:34:19,360 --> 00:34:22,680
A LOT WITH MEDICAL EDUCATION AND

833
00:34:22,680 --> 00:34:23,920
BRINGING IN INTERNS WHO HAVEN'T 

834
00:34:23,920 --> 00:34:26,680
HAD A BABY AND NEVER GAVE BIRTH 

835
00:34:26,680 --> 00:34:28,200
AND CHOSE A FIELD TO SUPPORT AND

836
00:34:28,200 --> 00:34:30,800
THEY GO THROUGH THE STEPS AND 

837
00:34:30,800 --> 00:34:32,000
SOMETHING IS LOST AND SPARK GOES

838
00:34:32,000 --> 00:34:33,560
OUT FOR THE WOMAN OR PERSON WHO 

839
00:34:33,560 --> 00:34:35,080
IS BIRTHING AND WONDER IF YOU 

840
00:34:35,080 --> 00:34:38,480
HAVE THOUGHTS OR IDEAS HOW TO 

841
00:34:38,480 --> 00:34:40,680
FRAME TRAINING GOOD HIGH-QUALITY

842
00:34:40,680 --> 00:34:42,120
MEDICINE FOR THE PERSON THAT 

843
00:34:42,120 --> 00:34:44,560
MIGHT BE BRAND NEW TO THE TRUE 

844
00:34:44,560 --> 00:34:46,280
HUMAN INTERACTION OF IT. 

845
00:34:46,280 --> 00:34:47,920
>> ABSOLUTELY.  

846
00:34:47,920 --> 00:34:50,080
I THOUGHT ABOUT THAT QUESTION A 

847
00:34:50,080 --> 00:34:52,000
LOT AND EMPATHY. 

848
00:34:52,000 --> 00:34:54,800
IF EMPATHY IS TRAJECTORY FOR 

849
00:34:54,800 --> 00:34:56,800
EVERYTHING, YOU WILL GO A LONG 

850
00:34:56,800 --> 00:34:57,120
WAY. 

851
00:34:57,120 --> 00:35:01,600
AND I LIKE TO TELL PEOPLE TO 

852
00:35:01,600 --> 00:35:03,520
THINK ABOUT YOUR MOTHER AND 

853
00:35:03,520 --> 00:35:05,320
SISTER AND FRIEND AND WIFE AND 

854
00:35:05,320 --> 00:35:06,320
PARTNER THAT WILL GO THROUGH 

855
00:35:06,320 --> 00:35:07,680
THESE THINGS. 

856
00:35:07,680 --> 00:35:09,960
I THINK THAT UNFORTUNATELY 

857
00:35:09,960 --> 00:35:11,280
PEOPLE BECOME SENSITIZED WHEN 

858
00:35:11,280 --> 00:35:13,400
THEY HAVE BEEN DOING THINGS FOR 

859
00:35:13,400 --> 00:35:15,920
A WHILE.  BABIES DIE; RIGHT?  

860
00:35:15,920 --> 00:35:17,440
I'M NOT THE FIRST PERSON AND 

861
00:35:17,440 --> 00:35:19,520
WON'T BE THE LAST PERSON. 

862
00:35:19,520 --> 00:35:22,640
BUT, THAT WAS MY BABY THAT DIED.

863
00:35:22,640 --> 00:35:23,040
>> UH-HUH. 

864
00:35:23,040 --> 00:35:25,280
>> IT IS NOT JUST A BABY
THAT 

865
00:35:25,280 --> 00:35:26,960
DIED. 

866
00:35:26,960 --> 00:35:29,320
IF YOU ARE ABLE TO GIVE THAT 

867
00:35:29,320 --> 00:35:31,840
EXTRA FIVE MINUTES AND GIVE THAT

868
00:35:31,840 --> 00:35:35,360
PERSON THE ATTENTION THAT THEY 

869
00:35:35,360 --> 00:35:37,680
NEED, A HUG, EXTRA TISSUE, 

870
00:35:37,680 --> 00:35:39,640
WATER, ANYTHING, IT GOES A LONG 

871
00:35:39,640 --> 00:35:42,360
WAY.  EMPATHY IS THE BIGGEST 

872
00:35:42,360 --> 00:35:42,600
THING. 

873
00:35:42,600 --> 00:35:44,000
>> THANK YOU. 

874
00:35:44,000 --> 00:35:45,160
>> YOU'RE WELCOME. 

875
00:35:45,160 --> 00:35:46,440
>> CANDICE?  

876
00:35:46,440 --> 00:35:47,680
>> BEFORE WE TAKE THE
NEXT 

877
00:35:47,680 --> 00:35:49,320
FLOOR MIC QUESTION, I HAVE TO 

878
00:35:49,320 --> 00:35:53,400
ASK IF WE HAVE ANY VIRTUAL 

879
00:35:53,400 --> 00:35:54,280
QUESTIONS. 

880
00:35:54,280 --> 00:35:56,960
>>. 

881
00:35:56,960 --> 00:36:00,680
>> JUST A LOT OF PEOPLE
ARE 

882
00:36:00,680 --> 00:36:02,720
EMPATHIZING WITH THE STORY YOU 

883
00:36:02,720 --> 00:36:05,800
ARE SHARING AND VERY THANKFUL 

884
00:36:05,800 --> 00:36:09,360
YOU ARE SHARING AND ASKING IF 

885
00:36:09,360 --> 00:36:12,200
YOU HAVE ANY IDEA WHERE YOU CAN 

886
00:36:12,200 --> 00:36:12,680
IMPROVE IT. 

887
00:36:12,680 --> 00:36:14,960
>> BIGGEST THING FOR
PEOPLE TO 

888
00:36:14,960 --> 00:36:17,560
IMPROVE MATERNAL HEALTH OUTCOME 

889
00:36:17,560 --> 00:36:19,840
DON'T CARE IF STANDARD OR 

890
00:36:19,840 --> 00:36:22,240
COMPLEX PREGNANCY.  LISTENING TO

891
00:36:22,240 --> 00:36:24,000
YOUR PATIENT WHO IS LIVING IN 

892
00:36:24,000 --> 00:36:25,200
THEIR BODY. 

893
00:36:25,200 --> 00:36:27,000
THEY KNOW WHAT IS GOING ON AND 

894
00:36:27,000 --> 00:36:30,080
WHAT IS OR IS NOT NORMAL AND 

895
00:36:30,080 --> 00:36:31,720
UNFORTUNATELY WHEN PEOPLE HAVE 

896
00:36:31,720 --> 00:36:34,240
THEIR FIRST PREGNANCY WITH MY 

897
00:36:34,240 --> 00:36:36,440
SON, I THOUGHT THESE THINGS WERE

898
00:36:36,440 --> 00:36:38,880
NORMAL AND REMEMBER CALLING AND 

899
00:36:38,880 --> 00:36:41,680
IN LABOR AND DELIVERY ONE NIGHT 

900
00:36:41,680 --> 00:36:43,160
SOMEONE SAYING TO ME THOSE ARE 

901
00:36:43,160 --> 00:36:45,680
NORMAL PAINS OF BEING PREGNANT 

902
00:36:45,680 --> 00:36:47,520
AND DON'T KNOW HOW DIFFICULT IT 

903
00:36:47,520 --> 00:36:48,880
IS TO BRING SOMEONE IN THE HO PT

904
00:36:48,880 --> 00:36:52,640
TO GIVE REASSURANCE AND 

905
00:36:52,640 --> 00:36:53,960
INSURANCE PLAYS A PART IN THAT 

906
00:36:53,960 --> 00:36:55,880
AND IF YOU TALK TO SOMEONE FOR 

907
00:36:55,880 --> 00:36:58,480
NEXT TO FIVE MINUTES NOT 

908
00:36:58,480 --> 00:36:59,720
DISMISSING YOU SEE LOTS OF 

909
00:36:59,720 --> 00:37:02,080
PEOPLE AND IT MIGHT BE STANDARD 

910
00:37:02,080 --> 00:37:05,080
FOR YOU AND IS IMPORTANT TO 

911
00:37:05,080 --> 00:37:06,800
LISTEN TO THAT PERSON CALLING OR

912
00:37:06,800 --> 00:37:10,920
HAVING THAT CONVERSATION AND IS 

913
00:37:10,920 --> 00:37:13,120
VERY SCARY AND NOT -- IT IS NOT 

914
00:37:13,120 --> 00:37:15,400
A WALK IN THE PARK.  YOU SEE 

915
00:37:15,400 --> 00:37:16,440
PREGNANT PEOPLE ALL THE TIME.  

916
00:37:16,440 --> 00:37:19,080
LOTS OF TIMES THESE ARE PEOPLE 

917
00:37:19,080 --> 00:37:22,960
FIRST AND SOMETIMES ONLY 

918
00:37:22,960 --> 00:37:23,240
PREGNANCY. 

919
00:37:23,240 --> 00:37:27,200
SO, AGAIN, I TOUCH ON BEING 

920
00:37:27,200 --> 00:37:29,600
EMPATHETIC AND TRYING TO PUT 

921
00:37:29,600 --> 00:37:35,960
YOURSELF IN THEIR SHOES. 

922
00:37:35,960 --> 00:37:38,080
>> CANDICE I WILL SPEAK
AGAIN 

923
00:37:38,080 --> 00:37:39,640
TO MEMBERS IN THE AUDIENCE AND 

924
00:37:39,640 --> 00:37:42,160
WANT TO THANK YOU FOR GIVING US 

925
00:37:42,160 --> 00:37:43,960
THAT TALK.  ALSO, YOUR BRAVERY 

926
00:37:43,960 --> 00:37:45,600
IN BEING ABLE TO DO THAT.  I 

927
00:37:45,600 --> 00:37:49,400
KNOW IT IS NOT EASY. 

928
00:37:49,400 --> 00:37:52,040
ONE THING WHEN I WAS LISTENING 

929
00:37:52,040 --> 00:37:54,760
TO YOU TALK ABOUT HOW CORROSIVE 

930
00:37:54,760 --> 00:37:58,240
A LOSS OF A CHILD OR TWO OR FIVE

931
00:37:58,240 --> 00:37:58,520
SOMETIMES. 

932
00:37:58,520 --> 00:38:01,160
HOW IT CAN BE TO A RELATIONSHIP,

933
00:38:01,160 --> 00:38:04,000
I TEND TO FIND IN THESE SETTINGS

934
00:38:04,000 --> 00:38:08,080
THAT THEY ARE PROBABLY THE MOST 

935
00:38:08,080 --> 00:38:10,520
CORROSIVE SORT OF EMOTION THAT 

936
00:38:10,520 --> 00:38:11,120
IS GUILT. 

937
00:38:11,120 --> 00:38:13,560
AND I TRIED TO TAKE IT HEAD ON 

938
00:38:13,560 --> 00:38:15,840
WITH THE PATIENTS SAYING, YOU 

939
00:38:15,840 --> 00:38:19,080
KNOW, THIS WASN'T YOUR FAULT.  

940
00:38:19,080 --> 00:38:22,320
YOU DIDN'T -- BUT IT IS LIKE A 

941
00:38:22,320 --> 00:38:24,400
POISONED ARROW THAT IS INSIDE. 

942
00:38:24,400 --> 00:38:26,560
AND I WAS WONDERING IF YOU COULD

943
00:38:26,560 --> 00:38:28,720
TALK A LITTLE ABOUT THAT AND HOW

944
00:38:28,720 --> 00:38:31,640
THOSE OF US WHO TAKE CARE OF 

945
00:38:31,640 --> 00:38:33,200
PATIENTS CAN DEAL WITH THAT. 

946
00:38:33,200 --> 00:38:34,520
>> ABSOLUTELY.  

947
00:38:34,520 --> 00:38:39,960
SO, ONE OF THE THINGS THAT I 

948
00:38:39,960 --> 00:38:42,120
TOUCH ON A LOT IS THAT IT IS 

949
00:38:42,120 --> 00:38:44,560
EASY TO SAY THAT IT IS NOT YOUR 

950
00:38:44,560 --> 00:38:48,040
FAULT.  MY BABY DIED IN MY BODY,

951
00:38:48,040 --> 00:38:50,760
A PLACE THEY WERE SUPPOSED TO BE

952
00:38:50,760 --> 00:38:51,080
SAFE. 

953
00:38:51,080 --> 00:38:54,680
AND AS DIFFICULT AS THAT IS TO 

954
00:38:54,680 --> 00:38:56,920
ACCEPT AND AS DIFFICULT AS IT 

955
00:38:56,920 --> 00:38:58,840
HAS BEEN TO -- I SPEND A LOT OF 

956
00:38:58,840 --> 00:39:01,880
TIME -- I HAVE A LOT OF FRIENDS 

957
00:39:01,880 --> 00:39:03,640
WHO ARE IN THE LOSS WORLD WITH 

958
00:39:03,640 --> 00:39:04,800
ME AND HAVE VERY GOOD 

959
00:39:04,800 --> 00:39:06,080
CONNECTIONS WITH WOMEN WHO HAVE 

960
00:39:06,080 --> 00:39:07,640
GONE THROUGH THE SAME THING I 

961
00:39:07,640 --> 00:39:08,560
HAVE GONE THROUGH. 

962
00:39:08,560 --> 00:39:12,480
AND WHILE THAT IS TRUE THAT YOU 

963
00:39:12,480 --> 00:39:14,600
-- IT IS NOT YOUR FAULT THAT IT 

964
00:39:14,600 --> 00:39:16,520
HAPPENED, IT IS HARD TO REFRAME 

965
00:39:16,520 --> 00:39:18,840
YOUR BRAIN IN THAT. 

966
00:39:18,840 --> 00:39:21,160
SO, I DO IMPLORE DOCTORS TO PUSH

967
00:39:21,160 --> 00:39:25,520
FOR THEIR PATIENTS TO GO GET 

968
00:39:25,520 --> 00:39:29,000
MENTAL HEALTH THEY NEED PRACH I 

969
00:39:29,000 --> 00:39:30,960
IMPLORE DOCTORS TO DO WORK THEY 

970
00:39:30,960 --> 00:39:32,920
NEEDED.  I WAS IN A PLACE I 

971
00:39:32,920 --> 00:39:35,000
WASN'T GETTING OUT OF BED OR UP 

972
00:39:35,000 --> 00:39:36,840
TO SHOWER AND GET OUT EVERY DAY 

973
00:39:36,840 --> 00:39:39,440
GOT UP AND SHOWERED AND DAD MADE

974
00:39:39,440 --> 00:39:41,160
SURE I WAS EATING. 

975
00:39:41,160 --> 00:39:43,520
AND YOU -- THERE IS NOT A SPACE 

976
00:39:43,520 --> 00:39:45,080
FOR PEOPLE WHEN THEY LOSE KIDS. 

977
00:39:45,080 --> 00:39:46,960
THEY WANT YOU TO GO BACK TO WORK

978
00:39:46,960 --> 00:39:49,520
AND LIVE A NORMAL LIFE AND ACT 

979
00:39:49,520 --> 00:39:51,440
AS IF YOU DIDN'T IF YOU HAVE A 

980
00:39:51,440 --> 00:39:52,840
BABY AND YOU GO THROUGH ALL 

981
00:39:52,840 --> 00:39:54,800
THINGS YOU GO THROUGH HAVING A 

982
00:39:54,800 --> 00:39:56,880
BABY AND GO THROUGH POSTPARTUM 

983
00:39:56,880 --> 00:39:58,840
PERIOD AND YOU JUST DON'T HAVE 

984
00:39:58,840 --> 00:39:59,400
THE CHILD. 

985
00:39:59,400 --> 00:40:04,000
AND WHAT I WOULD LOVE TO SEE IS 

986
00:40:04,000 --> 00:40:07,480
THERE BE ADVOCATES THAT ARE ABLE

987
00:40:07,480 --> 00:40:08,880
TO COME INTO HOSPITALS AND SPEAK

988
00:40:08,880 --> 00:40:11,440
TO MOMS AND IS EASIER TO HAVE A 

989
00:40:11,440 --> 00:40:12,640
CONVERSATION WITH SOMEONE THAT 

990
00:40:12,640 --> 00:40:13,760
HAS GONE THROUGH IT AND KNOWS 

991
00:40:13,760 --> 00:40:15,960
WHAT YOU WILL GO THROUGH FOR THE

992
00:40:15,960 --> 00:40:18,000
NEXT SIX MONTHS OR A YEAR OR TWO

993
00:40:18,000 --> 00:40:19,160
YEARS. 

994
00:40:19,160 --> 00:40:20,680
BECAUSE THERE WAS A TIME I 

995
00:40:20,680 --> 00:40:22,200
DIDN'T THINK I WOULD EVER DO 

996
00:40:22,200 --> 00:40:24,320
THIS AND TIME I DIDN'T THINK I 

997
00:40:24,320 --> 00:40:25,680
WOULD EVER SMILE AGAIN OR LAUGH 

998
00:40:25,680 --> 00:40:27,000
AGAIN AND DIDN'T THINK I WOULD 

999
00:40:27,000 --> 00:40:28,000
HAVE THIS.  

1000
00:40:28,000 --> 00:40:31,360
HERE I AM FOUR YEARS LATER AND 

1001
00:40:31,360 --> 00:40:34,200
I'M ABLE TO SHARE MY STORY AND 

1002
00:40:34,200 --> 00:40:35,440
ABLE TO HOPEFULLY CHANGE THINGS 

1003
00:40:35,440 --> 00:40:36,400
FOR PEOPLE.  

1004
00:40:36,400 --> 00:40:39,640
I WOULD LOVE TO SEE DOCTORS AND 

1005
00:40:39,640 --> 00:40:41,040
NURSES AND PEOPLE IN THESE 

1006
00:40:41,040 --> 00:40:43,720
SPACES TO TAKE MENTAL HEALTH 

1007
00:40:43,720 --> 00:40:45,440
PORTION MORE SERIOUSLY. 

1008
00:40:45,440 --> 00:40:48,320
IT IS SO DETRIMENTAL THAT IF YOU

1009
00:40:48,320 --> 00:40:51,480
DON'T GET HELP THAT YOU CAN TURN

1010
00:40:51,480 --> 00:40:53,080
INWARDS AND BLAME YOURSELF AND 

1011
00:40:53,080 --> 00:40:54,920
BE THIS PERSON THAT IS SUPER 

1012
00:40:54,920 --> 00:40:56,600
ANGRY AT THE WORLD.  I WAS THERE

1013
00:40:56,600 --> 00:40:59,320
AND SUPER ANGRY AND HATED 

1014
00:40:59,320 --> 00:41:00,920
EVERYONE FOR SIX MONTHS AND I 

1015
00:41:00,920 --> 00:41:03,480
WAS OUT OF WORK FOR FOUR MONTHS 

1016
00:41:03,480 --> 00:41:05,040
AND SPENT DAY WHERE'S I COULDN'T

1017
00:41:05,040 --> 00:41:07,080
GET BEHIND A WHEEL OF A CAR AND 

1018
00:41:07,080 --> 00:41:10,680
FELT I HAD A SCARLET LETTER ON 

1019
00:41:10,680 --> 00:41:12,280
ME.  I DIDN'T START TO REFRAME 

1020
00:41:12,280 --> 00:41:14,640
THAT UNTIL I WAS IN THERAPY. 

1021
00:41:14,640 --> 00:41:17,160
SO, I REALLY PUSHED MAKING SURE 

1022
00:41:17,160 --> 00:41:20,200
THAT YOUR PATIENTS GOING THROUGH

1023
00:41:20,200 --> 00:41:21,960
LOSS GET THERAPY HELP THEY NEED 

1024
00:41:21,960 --> 00:41:25,280
EVEN IF THEY DON'T WANT IT. 

1025
00:41:25,280 --> 00:41:28,320
>> DO WE STILL HAVE TIME
FOR A 

1026
00:41:28,320 --> 00:41:29,920
FEW MORE QUESTIONS. 

1027
00:41:29,920 --> 00:41:31,920
>> LET'S TAKE ONE MORE
QUESTION

1028
00:41:31,920 --> 00:41:33,560
FROM VIRTUAL AUDIENCE. 

1029
00:41:33,560 --> 00:41:37,120
>> SO, S AGAIN, EVERYONE
IN THE

1030
00:41:37,120 --> 00:41:39,360
VIRTUAL AUDIENCE IS THANKING YOU

1031
00:41:39,360 --> 00:41:41,800
FOR SHARING YOUR STORY VERY MUCH

1032
00:41:41,800 --> 00:41:44,000
IT THEY APPRECIATE IT.  THEY ARE

1033
00:41:44,000 --> 00:41:46,160
ASKING WHAT YOUR BEST ADVICE 

1034
00:41:46,160 --> 00:41:49,120
WOULD BE FOR -- THERE ARE 

1035
00:41:49,120 --> 00:41:52,360
SEVERAL QUESTIONS BUT FOR 

1036
00:41:52,360 --> 00:41:53,760
EXPECTANT MOTHERS AND IF IN HIGH

1037
00:41:53,760 --> 00:41:57,240
RISK COMMUNITY LIKE THE BLACK 

1038
00:41:57,240 --> 00:41:59,040
COMMUNITY, WHAT WOULD BE YOUR 

1039
00:41:59,040 --> 00:42:00,840
BEST WAY TO ADVISE THEM TO GET 

1040
00:42:00,840 --> 00:42:02,000
THROUGH THE SYSTEM?  

1041
00:42:02,000 --> 00:42:04,360
>> LEARNING TO ADVOCATE
FOR 

1042
00:42:04,360 --> 00:42:06,800
YOURSELF AND IT TOOK A LONG TIME

1043
00:42:06,800 --> 00:42:11,240
FOR ME TO DECIPHER THAT LIKE I 

1044
00:42:11,240 --> 00:42:13,800
SAID EARLIER, THIS IS NOT A 

1045
00:42:13,800 --> 00:42:16,400
DICTATORSHIP.  THIS IS A 

1046
00:42:16,400 --> 00:42:19,680
PARTNERSHIP.  WE ARE IN THIS 

1047
00:42:19,680 --> 00:42:22,560
TOGETHER.  YOU ARE BIRTHING BABY

1048
00:42:22,560 --> 00:42:24,480
AND I'M CARRYING BABY AND 

1049
00:42:24,480 --> 00:42:26,000
HOLDING HANDS TO GET THROUGH 

1050
00:42:26,000 --> 00:42:29,560
THIS AND LOOKING FOR A DOULA AND

1051
00:42:29,560 --> 00:42:31,560
PUSHING TO HAVE DOULAS WHEN 

1052
00:42:31,560 --> 00:42:33,280
CAN'T TALK TO MEDICAL 

1053
00:42:33,280 --> 00:42:34,200
PROFESSIONAL THEY HAVE SOMEONE 

1054
00:42:34,200 --> 00:42:37,120
ELSE TO GO TO AND MAKING SURE 

1055
00:42:37,120 --> 00:42:38,200
THEY ARE IN SPACE WHERE OPEN 

1056
00:42:38,200 --> 00:42:40,000
DOOR POLICY THEY WILL ASK 

1057
00:42:40,000 --> 00:42:41,600
QUESTIONS AND ANSWER QUESTIONS 

1058
00:42:41,600 --> 00:42:44,080
AND WON'T MAKE THEM FEEL STUPID 

1059
00:42:44,080 --> 00:42:46,880
FOR ASKING SAID QUESTIONS AND, 

1060
00:42:46,880 --> 00:42:49,400
AGAIN, BEING EMPATHETIC TO THE 

1061
00:42:49,400 --> 00:42:51,320
PERSON.  YOU HAVE NO CLUE WHAT 

1062
00:42:51,320 --> 00:42:53,240
IT HAS TAKEN FOR SOMEONE TO GET 

1063
00:42:53,240 --> 00:42:54,920
THERE AND YOU HAVE NO CLUE WHAT 

1064
00:42:54,920 --> 00:42:57,040
IT HAS TAKEN TO HAVE SOMEONE 

1065
00:42:57,040 --> 00:42:58,840
TRUST YOU. 

1066
00:42:58,840 --> 00:42:59,880
UNFORTUNATELY, IN THE BLACK 

1067
00:42:59,880 --> 00:43:01,760
COMMUNITY, THERE IS A LOT OF 

1068
00:43:01,760 --> 00:43:03,920
DISTRUST WITH PROVIDERS. 

1069
00:43:03,920 --> 00:43:07,400
THAT CULTURE HAS BEEN P MADE. 

1070
00:43:07,400 --> 00:43:09,920
SO, YOU KNOW, BEING AS TRUTHFUL 

1071
00:43:09,920 --> 00:43:11,520
AS YOU POSSIBLY CAN AND WHATEVER

1072
00:43:11,520 --> 00:43:12,480
THE OUTCOME WILL BE. 

1073
00:43:12,480 --> 00:43:15,240
I MEAN, YOU KNOW, LIKE I SAID 

1074
00:43:15,240 --> 00:43:17,920
EARLIER, BABIES DO DIE.  I WAS 

1075
00:43:17,920 --> 00:43:21,600
NEVER PREPARED FOR THAT OR TO 

1076
00:43:21,600 --> 00:43:24,160
HAVE THE CONVERSATION NOW YOU 

1077
00:43:24,160 --> 00:43:27,560
HAVE TO FIGURE OUT WHAT TO DO 

1078
00:43:27,560 --> 00:43:29,640
FOR YOUR CHILD.  I WASN'T 

1079
00:43:29,640 --> 00:43:31,240
PREPARED FOR.  THAT AS SCARY AS 

1080
00:43:31,240 --> 00:43:32,680
IT MIGHT BE SOME PEOPLE WANT ALL

1081
00:43:32,680 --> 00:43:35,080
OF THE FACTS I WOULD HAVE WANTED

1082
00:43:35,080 --> 00:43:44,080
ALL OF THE FACTS UP FRONT. 

1083
00:43:44,080 --> 00:43:48,440
>> THANK YOU SO MUCH,
CANDICE. 

1084
00:43:48,440 --> 00:43:58,560
>>. 

1085
00:44:09,400 --> 00:44:14,840
>> WE WILL START WITH THE
NEXT 

1086
00:44:14,840 --> 00:44:19,920
CLINICAL OUTCOMES PANEL.  

1087
00:44:19,920 --> 00:44:30,000
>>. 

1088
00:45:06,800 --> 00:45:09,960
>> GOOD MORNING,
EVERYONE.  

1089
00:45:09,960 --> 00:45:12,320
I'M WITH THE NATIONAL HEART, 

1090
00:45:12,320 --> 00:45:15,440
LUNG AND BLOOD INSTITUTE AND ON 

1091
00:45:15,440 --> 00:45:16,960
BEHALF OF ORGANIZING COMMUNITY I

1092
00:45:16,960 --> 00:45:19,040
WOULD LIKE TO WELCOME YOU TO THE

1093
00:45:19,040 --> 00:45:23,520
CLINICAL OUTCOME PANELS AND SO 

1094
00:45:23,520 --> 00:45:26,760
MAJOR OBJECTIVE OF THE SESSION 

1095
00:45:26,760 --> 00:45:28,920
IS TO FIRST SUMMARIZE CURRENT 

1096
00:45:28,920 --> 00:45:32,160
STATE OF RESEARCH AND IN CASE OF

1097
00:45:32,160 --> 00:45:34,000
DISCOVERIES OF PREVENTION AND 

1098
00:45:34,000 --> 00:45:36,280
DIAGNOSIS AND TREATMENT AND 

1099
00:45:36,280 --> 00:45:38,440
MANAGEMENT CONDITIONS WHICH ARE 

1100
00:45:38,440 --> 00:45:40,840
CONTRIBUTING TO RISING RATES OF 

1101
00:45:40,840 --> 00:45:44,120
MORTALITY AND MORBIDITY AND 

1102
00:45:44,120 --> 00:45:47,400
SECONDLY TO IDENTIFY AREAS READY

1103
00:45:47,400 --> 00:45:48,960
FOR TRANSLATION TO GET WHAT 

1104
00:45:48,960 --> 00:45:51,520
MIGHT BE POTENTIALLY ADDRESSED 

1105
00:45:51,520 --> 00:45:56,800
THROUGH TECHNOLOGY INNOVATION. 

1106
00:45:56,800 --> 00:45:59,320
IT IS MY GREAT PLEASURE TO 

1107
00:45:59,320 --> 00:46:04,240
INTRODUCE TWO MODERATORS DR. 

1108
00:46:04,240 --> 00:46:08,120
AARON PAWLYK WHO IS IN THE 

1109
00:46:08,120 --> 00:46:09,680
NATIONAL INSTITUTE OF CHILD 

1110
00:46:09,680 --> 00:46:13,160
HEALTH AND HUMAN DEVELOPMENT AND

1111
00:46:13,160 --> 00:46:23,640
DR. GEORGE SAADE WHO IS IN 

1112
00:46:24,720 --> 00:46:26,920
WOMEN'S HEALTH AT EASTERN 

1113
00:46:26,920 --> 00:46:29,560
VIRGINIA MEDICAL SCHOOL AND 

1114
00:46:29,560 --> 00:46:33,480
WELCOME AGAIN AND HOPE YOU ENJOY

1115
00:46:33,480 --> 00:46:38,360
THE DISCUSSION AND PRESENTATION.

1116
00:46:38,360 --> 00:46:48,680
TURNING IT TO YOU. 

1117
00:46:54,760 --> 00:46:57,120
>> ALL RIGHT.  HOW DO WE 

1118
00:46:57,120 --> 00:46:59,920
ADVANCE THIS SLIDE?  NICE TO SEE

1119
00:46:59,920 --> 00:47:01,640
EVERYBODY BACK AROUND EVERYONE 

1120
00:47:01,640 --> 00:47:03,520
SHOWING UP IN PERSON AND GREAT 

1121
00:47:03,520 --> 00:47:07,040
VIRTUAL ATTENDANCE AND BEFORE I 

1122
00:47:07,040 --> 00:47:10,080
DIVE IN, THANK YOU CANDICE FOR 

1123
00:47:10,080 --> 00:47:12,160
TALKING TODAY TO HIGHLIGHT WHAT 

1124
00:47:12,160 --> 00:47:15,480
IS IMPORTANT AND DOING A BETTER 

1125
00:47:15,480 --> 00:47:20,600
JOB OF FIGURING OUT MATERNAL 

1126
00:47:20,600 --> 00:47:23,880
HEALTH. 

1127
00:47:23,880 --> 00:47:26,840
IT IS IMPORTANT THAT AS WE TALK 

1128
00:47:26,840 --> 00:47:27,840
THROUGH SCIENCE WE FOCUS TODAY 

1129
00:47:27,840 --> 00:47:33,840
ON WHAT TO GET OUT THERE IN THE 

1130
00:47:33,840 --> 00:47:34,520
CLINIC. 

1131
00:47:34,520 --> 00:47:39,000
NEXT SLIDE.  

1132
00:47:39,000 --> 00:47:40,800
NO REVEL LENT INTERESTS. 

1133
00:47:40,800 --> 00:47:41,640
NEXT SLIDE. 

1134
00:47:41,640 --> 00:47:43,720
GOING THROUGH A SERIES OF 

1135
00:47:43,720 --> 00:47:46,240
SLIDES.  EACH COULD BE AN 

1136
00:47:46,240 --> 00:47:48,200
HOUR-LONG TALK AND WANT TO 

1137
00:47:48,200 --> 00:47:50,280
INTRODUCE REGULATORY CONCEPTS 

1138
00:47:50,280 --> 00:47:52,200
THAT MIGHT COME UP TODAY AND 

1139
00:47:52,200 --> 00:47:54,080
SLIDES WILL BE AVAILABLE AND 

1140
00:47:54,080 --> 00:47:54,880
REFERENCES THERE AND FIRST WHAT 

1141
00:47:54,880 --> 00:47:57,840
IS A BIOMARKER THAT IS A TERM 

1142
00:47:57,840 --> 00:47:59,520
THAT WE TOSS AROUND AND 

1143
00:47:59,520 --> 00:48:02,400
TECHNICAL AND REGULATORY 

1144
00:48:02,400 --> 00:48:02,920
DEFINITIONS. 

1145
00:48:02,920 --> 00:48:04,520
HANDBOOK THAT IS BEST RESOURCE 

1146
00:48:04,520 --> 00:48:08,360
PUT TOGETHER BY FDA AND 

1147
00:48:08,360 --> 00:48:10,320
BIOMARKER WORKING GROUP AND FDA 

1148
00:48:10,320 --> 00:48:11,560
USED AND HIGHLY RECOMMEND THIS 

1149
00:48:11,560 --> 00:48:14,320
IS A RESOURCE AND ESSENCE OF 

1150
00:48:14,320 --> 00:48:16,800
BIOMARKER DEFINED 

1151
00:48:16,800 --> 00:48:17,640
CHARACTERISTICS MEASURING 

1152
00:48:17,640 --> 00:48:20,440
INDICATOR OF NORMAL PATHOLOGICAL

1153
00:48:20,440 --> 00:48:21,760
BIOLOGICAL PROCESS AND IMPORTANT

1154
00:48:21,760 --> 00:48:23,400
AS WE GO THROUGH TODAY TO THINK 

1155
00:48:23,400 --> 00:48:26,720
ABOUT WHAT BIOMARKERS ARE NOT 

1156
00:48:26,720 --> 00:48:27,880
ASSESSMENTS HOW AN INDIVIDUAL 

1157
00:48:27,880 --> 00:48:29,920
FEELS, FUNCTIONS OR SURVIVES AND

1158
00:48:29,920 --> 00:48:34,560
IS NOT A CLINICAL ENDPOINT. 

1159
00:48:34,560 --> 00:48:36,160
NEXT SLIDE. 

1160
00:48:36,160 --> 00:48:37,880
BRIEFLY, WHAT IS A CLINICAL 

1161
00:48:37,880 --> 00:48:38,400
OUTCOME?  

1162
00:48:38,400 --> 00:48:42,040
AGAIN, GOING HERE TO THE FDA AND

1163
00:48:42,040 --> 00:48:43,320
REGULATORY DEFINITION AND 

1164
00:48:43,320 --> 00:48:46,040
CLINICAL OUTCOME AASSESSMENT IS 

1165
00:48:46,040 --> 00:48:47,720
DESCRIBING HOW PATIENT FEELS AND

1166
00:48:47,720 --> 00:48:49,600
FUNCTIONS AND SURVIVES AND 

1167
00:48:49,600 --> 00:48:51,080
VARIETY OF DIFFERENT TYPES THAT 

1168
00:48:51,080 --> 00:48:53,680
IS NOT EXCLUSIVE AND HITS ON 

1169
00:48:53,680 --> 00:48:54,680
MAJOR ONES.

1170
00:48:54,680 --> 00:48:55,760
NEXT SLIDE. 

1171
00:48:55,760 --> 00:48:58,240
SO, NEXT TWO SLIDESLY TALK ABOUT

1172
00:48:58,240 --> 00:49:00,280
ARE DEFINITIONS THAT ARE 

1173
00:49:00,280 --> 00:49:01,480
PARTICULARLY RELEVANT TO 

1174
00:49:01,480 --> 00:49:02,640
AUDIENCES AND TODAY WE TALK 

1175
00:49:02,640 --> 00:49:04,440
ABOUT INNOVATIONS AND 

1176
00:49:04,440 --> 00:49:06,040
TECHNOLOGIES AND FIRST WHAT IS A

1177
00:49:06,040 --> 00:49:07,720
DIGITAL BIOMARKER?  

1178
00:49:07,720 --> 00:49:12,080
THIS IS NOT AN FDA FWIEDANCE 

1179
00:49:12,080 --> 00:49:15,320
FROM A PUBLICATION PUBLISHED 

1180
00:49:15,320 --> 00:49:21,720
FROM FDA PUBLIC AUTHORS A SET OF

1181
00:49:21,720 --> 00:49:24,680
CHARACTERISTICS COLLECTED FROM 

1182
00:49:24,680 --> 00:49:27,240
DIGITAL HEALTH TECHNOLOGIES 

1183
00:49:27,240 --> 00:49:29,280
BIOMARKER IT IS THAT, THAT IS 

1184
00:49:29,280 --> 00:49:31,760
KEY HERE FOR DIGITAL BIOMARKER. 

1185
00:49:31,760 --> 00:49:32,600
NEXT SLIDE. 

1186
00:49:32,600 --> 00:49:35,440
WHAT ARE MULTICOMPONENT 

1187
00:49:35,440 --> 00:49:35,840
BIOMARKERS?  

1188
00:49:35,840 --> 00:49:37,720
THEY INCLUDE FEATURES BASED ON 

1189
00:49:37,720 --> 00:49:39,800
TWO ORE MORE MEASUREMENTS 

1190
00:49:39,800 --> 00:49:42,680
CLINICAL CHARACTERISTICS AND 

1191
00:49:42,680 --> 00:49:43,480
DEMOGRAPHICS, ET CETERA, THAT 

1192
00:49:43,480 --> 00:49:46,440
COULD BE USED INDEPENDENTLY OR 

1193
00:49:46,440 --> 00:49:48,240
COMBINED BY SOME TYPE OF 

1194
00:49:48,240 --> 00:49:49,680
ALGORITHM AND IS A GREAT 

1195
00:49:49,680 --> 00:49:52,320
WORKSHOP ON THIS TO SEE WHAT THE

1196
00:49:52,320 --> 00:49:53,160
FDA HAD. 

1197
00:49:53,160 --> 00:49:55,560
THIS IS IMPORTANT AND THINKING 

1198
00:49:55,560 --> 00:49:57,360
ABOUT ALGORITHM OF DIGITAL 

1199
00:49:57,360 --> 00:50:00,200
BIOMARKER IS A MULTICOMPONENT 

1200
00:50:00,200 --> 00:50:01,680
AND THESE LEAD TOGETHER AND 

1201
00:50:01,680 --> 00:50:03,200
BLEND AND DEFINITIONS BECOME 

1202
00:50:03,200 --> 00:50:04,720
VERY IMPORTANT THINKING ABOUT 

1203
00:50:04,720 --> 00:50:06,920
ADVANCING SOMETHING DOWN A 

1204
00:50:06,920 --> 00:50:09,560
REGULATORY PATHWAY. 

1205
00:50:09,560 --> 00:50:10,240
NEXT SLIDE. 

1206
00:50:10,240 --> 00:50:14,080
I WANT TO TOUCH BRIEFLY ON 

1207
00:50:14,080 --> 00:50:16,680
BIOMARKER PROCESS THAT FDA 

1208
00:50:16,680 --> 00:50:18,480
UNDERGOES.  LETTER INTENT GOING 

1209
00:50:18,480 --> 00:50:21,880
TO FDA IS REALLY IMPORTANT AND 

1210
00:50:21,880 --> 00:50:23,320
INITIATES QUALIFICATION PROCESS 

1211
00:50:23,320 --> 00:50:24,560
AND WANT TO STATE QUALIFICATION 

1212
00:50:24,560 --> 00:50:27,160
OF BIOMARKER IS REGULATORY TERM 

1213
00:50:27,160 --> 00:50:31,560
OF ART AND APPROVED BIOMARKER IS

1214
00:50:31,560 --> 00:50:33,760
QUALIFIED BY FDA NOT APPROVED 

1215
00:50:33,760 --> 00:50:35,440
BUT QUALIFIED AND PROPOSED 

1216
00:50:35,440 --> 00:50:36,720
CONTEXT OF USE TALKING ABOUT 

1217
00:50:36,720 --> 00:50:44,160
THIS MORE AND CONTEXT OF USE OF 

1218
00:50:44,160 --> 00:50:46,880
BIOMARKER.  YOU HAVE ONE AND 

1219
00:50:46,880 --> 00:50:48,680
WHAT YOU ARE PLAN GS TO USE IT 

1220
00:50:48,680 --> 00:50:52,080
FOR AND HAMMERING OUT LETTER OF 

1221
00:50:52,080 --> 00:50:54,600
INTENT AND SUBMITTING TO FDA 

1222
00:50:54,600 --> 00:50:56,360
WHAT WILL YOU GET IN TERMS OF 

1223
00:50:56,360 --> 00:51:00,160
DATA TO SUPTHOORT AND FULL 

1224
00:51:00,160 --> 00:51:03,640
QUALIFICATION PACKAGE INCLUDING 

1225
00:51:03,640 --> 00:51:05,000
DATA AND DETERMINATION TO 

1226
00:51:05,000 --> 00:51:08,360
QUALIFY BIOMARKER OR NOT. 

1227
00:51:08,360 --> 00:51:09,200
NEXT SLIDE. 

1228
00:51:09,200 --> 00:51:11,520
LEFT HERE IS BIOMARKER 

1229
00:51:11,520 --> 00:51:12,320
CATEGORIES FROM THE BEST 

1230
00:51:12,320 --> 00:51:14,040
HANDBOOK AND VARIETY OF 

1231
00:51:14,040 --> 00:51:15,240
DIFFERENT TYPES WON'T READ THEM 

1232
00:51:15,240 --> 00:51:17,040
IN THE INTEREST OF TIME AND THEY

1233
00:51:17,040 --> 00:51:18,840
ARE BROKEN OUT AND DEFINITIONS 

1234
00:51:18,840 --> 00:51:20,400
CAN BE TRICKY TO GET THROUGH AND

1235
00:51:20,400 --> 00:51:23,520
WHY HAVING THAT LETTER OF INTENT

1236
00:51:23,520 --> 00:51:26,040
WORKING ON IT WITH FDA EARLY ON 

1237
00:51:26,040 --> 00:51:28,160
OR REGULATORY EXPERTS IS VERY 

1238
00:51:28,160 --> 00:51:29,160
IMPORTANT AND RIGHT HERE IS 

1239
00:51:29,160 --> 00:51:32,880
CONTEXT OF USES AND WE WILL LOOK

1240
00:51:32,880 --> 00:51:36,760
HERE AT A SECOND FOR PROGNOSTIC 

1241
00:51:36,760 --> 00:51:39,280
BIOMARKERS AND TWO CONTENTS OF 

1242
00:51:39,280 --> 00:51:42,040
LISTED AND STRATIFICATION OF 

1243
00:51:42,040 --> 00:51:45,880
PATIENTS OR CLINICAL TRIAL OR 

1244
00:51:45,880 --> 00:51:46,680
ENRICHMENT INCLUSION AND 

1245
00:51:46,680 --> 00:51:47,760
EXCLUSION DATA TWO DIFFERENT 

1246
00:51:47,760 --> 00:51:51,560
USES AND BIOMARKERS TWO LETTER 

1247
00:51:51,560 --> 00:51:57,360
OF INTENTS AND CUTOFF MIGHT BE 

1248
00:51:57,360 --> 00:52:02,760
DIFFERENT USING SAME BIOMARKER. 

1249
00:52:02,760 --> 00:52:05,120
MAY NEED DIFFERENT LETTERS OF 

1250
00:52:05,120 --> 00:52:06,400
INTENT AND ALL SHOULD BE THOUGHT

1251
00:52:06,400 --> 00:52:08,560
THROUGH THINKING OF BIOMARKERS 

1252
00:52:08,560 --> 00:52:12,160
AND ASSESSMENT AND VALIDATION 

1253
00:52:12,160 --> 00:52:13,960
AND NEXT SLIDE.  

1254
00:52:13,960 --> 00:52:16,480
I WANT TO TALK ABOUT A PROJECT 

1255
00:52:16,480 --> 00:52:18,040
THAT HAS BEEN IN DEVELOPMENT FOR

1256
00:52:18,040 --> 00:52:20,200
OVER TWO YEARS THROUGH THE 

1257
00:52:20,200 --> 00:52:22,240
FOUNDATION FOR NIH THAT FOR 

1258
00:52:22,240 --> 00:52:24,240
THOSE THAT DON'T KNOW NON-PROFIT

1259
00:52:24,240 --> 00:52:26,440
CREATED BY CONGRESS TO SUPPORT 

1260
00:52:26,440 --> 00:52:28,720
PUBLIC AND PRIVATE PARTNERSHIPS 

1261
00:52:28,720 --> 00:52:30,720
INVOLVING NATIONAL INSTITUTES OF

1262
00:52:30,720 --> 00:52:32,480
HEALTH AND CERTAIN LIMITATIONS 

1263
00:52:32,480 --> 00:52:34,880
FEDERAL AGENCY AND BIOMARKER 

1264
00:52:34,880 --> 00:52:38,080
PROJECT RISK STRATIFICATION AND 

1265
00:52:38,080 --> 00:52:41,240
EARLY ONSET OF PREECOLLAPSIA AND

1266
00:52:41,240 --> 00:52:43,920
DOING IT SOON AS POSSIBLE TO 

1267
00:52:43,920 --> 00:52:45,280
AVOID THINGS THAT CANDICE WENT 

1268
00:52:45,280 --> 00:52:46,800
THROUGH.  I WON'T HAVE 

1269
00:52:46,800 --> 00:52:48,120
ACKNOWLEDGEMENTS FOR THIS AND 

1270
00:52:48,120 --> 00:52:49,800
WANT TO RECOGNIZE A TREMENDOUS 

1271
00:52:49,800 --> 00:52:52,600
AMOUNT OF WORK GOING INTO 

1272
00:52:52,600 --> 00:52:54,040
PROJECTS ONCE IT IS LAUNCH THE 

1273
00:52:54,040 --> 00:52:56,440
IT WILL BE CLEAR AND WE ARE NOT 

1274
00:52:56,440 --> 00:52:59,120
IDENTIFYING THAT AND HEARING 

1275
00:52:59,120 --> 00:53:01,120
MORE ABOUT SIGNIFICANCE OF 

1276
00:53:01,120 --> 00:53:03,160
PRECOLLAPSIA AND PERSONAL STORY 

1277
00:53:03,160 --> 00:53:04,680
OF MATERNAL HEALTH ISSUE EARLIER

1278
00:53:04,680 --> 00:53:06,560
TODAY AND I WANT TO HIGHLIGHT 

1279
00:53:06,560 --> 00:53:09,880
FROM THE SLIDE REEMPHASIZING ONE

1280
00:53:09,880 --> 00:53:13,320
THIS IS A TWO PATIENT ISSUE FOR 

1281
00:53:13,320 --> 00:53:15,120
MOTHER AND CHILD AND BOTH SHORT 

1282
00:53:15,120 --> 00:53:19,440
AND ACUTE EFFECTS AND LONG-TERM 

1283
00:53:19,440 --> 00:53:21,920
CARDIOVASCULAR RISK ASSOCIATED 

1284
00:53:21,920 --> 00:53:24,800
WITH PRECOLLAPSIA FOR MOTHER AND

1285
00:53:24,800 --> 00:53:27,200
CHILD NOT JUST IMMEDIATE BUT 

1286
00:53:27,200 --> 00:53:29,920
LONG-TERM EFFECTS TO ADDRESS 

1287
00:53:29,920 --> 00:53:33,040
EARLIER AND THIS IS FROM AMNESTY

1288
00:53:33,040 --> 00:53:34,200
USA AND UNITED STATES IS 50 YENL

1289
00:53:34,200 --> 00:53:35,960
IN THE WORLD AND THIS IS A 

1290
00:53:35,960 --> 00:53:41,680
COUPLE YEARS LATE AND WE ARE NOT

1291
00:53:41,680 --> 00:53:46,440
MUCH BETTER AND DOG A GOOD JOB 

1292
00:53:46,440 --> 00:53:49,240
HER TALKING ABOUT TODAY THIS 

1293
00:53:49,240 --> 00:53:52,480
PANEL THAT IS DRIVEN BY 

1294
00:53:52,480 --> 00:53:57,320
DISPARITY AND DRIVEN ON A LOT OF

1295
00:53:57,320 --> 00:53:59,040
LEVELS FOR THAT AND THIS IS 

1296
00:53:59,040 --> 00:54:02,280
COMING UP BIOMARKER CONSORTIUM 

1297
00:54:02,280 --> 00:54:05,360
HUGE EXPERTISE FDA AND PUBLIC 

1298
00:54:05,360 --> 00:54:09,440
AND PRIVATE PARTNERSHIPS AND 

1299
00:54:09,440 --> 00:54:12,640
BIOMARKERS FOR PREECOLLAPSIA FOR

1300
00:54:12,640 --> 00:54:13,680
DIAGNOSIS AND RISK PREDICTION 

1301
00:54:13,680 --> 00:54:17,720
AND WE ARE PROPOSING TO DO IN 

1302
00:54:17,720 --> 00:54:20,000
RACIALLY DIVERSE COHORT OF NORTH

1303
00:54:20,000 --> 00:54:20,920
AMERICAN INDIVIDUALS USING 

1304
00:54:20,920 --> 00:54:23,360
EXISTING BIOSAMPLES ASSOCIATED 

1305
00:54:23,360 --> 00:54:26,760
AND NEED TO GET DATA IN NORTH 

1306
00:54:26,760 --> 00:54:27,560
AMERICAN COHORT THAT IS 

1307
00:54:27,560 --> 00:54:29,200
DIFFERENT FROM MANY COHORTS FOR 

1308
00:54:29,200 --> 00:54:32,040
WHICH GENETIC BIOMARKERS ARE 

1309
00:54:32,040 --> 00:54:32,800
[INDISCERNIBLE] AND SECOND 

1310
00:54:32,800 --> 00:54:34,840
SPECIFIC AIM IS DEVELOPING IN 

1311
00:54:34,840 --> 00:54:37,120
ALGORITHM AND WHERE WE GET TO 

1312
00:54:37,120 --> 00:54:39,960
MULTICOMPONENT BIOMARKERS THAT 

1313
00:54:39,960 --> 00:54:42,240
WILL INCORPORATE PATIENT 

1314
00:54:42,240 --> 00:54:43,160
DEMOGRAPHICS AND WILL TALK ABOUT

1315
00:54:43,160 --> 00:54:44,400
THIS MORE IN A SECOND. 

1316
00:54:44,400 --> 00:54:46,840
SOME FOLKS ARE GOING WE KNOW 

1317
00:54:46,840 --> 00:54:48,800
ABOUT BIOMARKERS AND WHY AREN'T 

1318
00:54:48,800 --> 00:54:51,160
WE FOCUSING ON THEM?  

1319
00:54:51,160 --> 00:54:53,840
WE HAVE EXPLORATORY AIM TO DELVE

1320
00:54:53,840 --> 00:54:56,640
INTO NEW THINGS.

1321
00:54:56,640 --> 00:55:00,400
NEXT SLIDE. 

1322
00:55:00,400 --> 00:55:08,840
I WANT TO HIGHLIGHT GROUPS AND 

1323
00:55:08,840 --> 00:55:12,440
WE WILL USE COMMERCIALLY 

1324
00:55:12,440 --> 00:55:14,720
AVAILABLE KITS AND THEY ARE USED

1325
00:55:14,720 --> 00:55:17,480
IN THE UNITED STATES IN LOTS OF 

1326
00:55:17,480 --> 00:55:17,720
PLACES. 

1327
00:55:17,720 --> 00:55:19,920
WE NEED TO GET WHAT IS AVAILABLE

1328
00:55:19,920 --> 00:55:23,600
IN THE UNITED STATES TO IMPROVE 

1329
00:55:23,600 --> 00:55:26,120
INSURANCE AND LABS ACROSS 

1330
00:55:26,120 --> 00:55:29,880
COUNTRY CAN DO THIS AND GETTING 

1331
00:55:29,880 --> 00:55:34,000
CARE ACROSS COUNTRY LAND INVOLVE

1332
00:55:34,000 --> 00:55:34,960
ACADEMIC COLLABORATORS TO DO 

1333
00:55:34,960 --> 00:55:37,400
ANALYSIS AND GENERATE DATA FOR 

1334
00:55:37,400 --> 00:55:41,320
REGULATORY FILINGS AND BE USED 

1335
00:55:41,320 --> 00:55:45,480
TO SUPPORT DRUG DEVELOPMENTS AND

1336
00:55:45,480 --> 00:55:47,920
TREATMENTS FOR PREECOLLAPSIA AND

1337
00:55:47,920 --> 00:55:50,080
HIGH RISK PATIENTS NOT GETTING 

1338
00:55:50,080 --> 00:55:53,360
CARE TO PEOPLE ESPECIALLY 

1339
00:55:53,360 --> 00:55:55,200
AFRICAN AMERICANS. 

1340
00:55:55,200 --> 00:55:56,200
NEXT SLIDE. 

1341
00:55:56,200 --> 00:55:57,600
DRIVING THIS HOME AGAIN THIS IS 

1342
00:55:57,600 --> 00:56:03,400
A CALCULATOR AVAILABLE FROM 

1343
00:56:03,400 --> 00:56:07,120
FETAL MEDICINE FOUNDATION AND 

1344
00:56:07,120 --> 00:56:08,880
THIS IS OUTSIDE OF THE UNITED 

1345
00:56:08,880 --> 00:56:11,840
STATES AND DON'T KNOW CUTOFF FOR

1346
00:56:11,840 --> 00:56:14,440
AMERICAN COHORT AND ETHNIC 

1347
00:56:14,440 --> 00:56:18,040
VARIABILITY IN IT AND ANGIOGENIC

1348
00:56:18,040 --> 00:56:20,240
BIOMARKERS ARE NOT AVAILABLE AND

1349
00:56:20,240 --> 00:56:22,000
MEDICAL CENTERS COULD GET LABS 

1350
00:56:22,000 --> 00:56:23,920
DONE AND AFRICAN AMERICAN WOMAN 

1351
00:56:23,920 --> 00:56:25,760
ENROLLED IN MISSISSIPPI, YOU 

1352
00:56:25,760 --> 00:56:27,320
CAN'T GET LABS DONE AND WE WANT 

1353
00:56:27,320 --> 00:56:31,880
TO GET IT UPDATED TO BE USED. 

1354
00:56:31,880 --> 00:56:33,800
NEXT SLIDE.  A FEW QUESTIONS 

1355
00:56:33,800 --> 00:56:35,720
HERE AND CONSIDERATIONS AND 

1356
00:56:35,720 --> 00:56:38,160
BIOMARKERS RELY ON DEVICES AND 

1357
00:56:38,160 --> 00:56:39,520
TECHNOLOGIES HEAVILY AND 

1358
00:56:39,520 --> 00:56:41,480
CLINICAL OUTCOME MEASURES AND 

1359
00:56:41,480 --> 00:56:43,400
ARE THERE ADDITIONAL 

1360
00:56:43,400 --> 00:56:45,360
TECHNOLOGIES TO USE AT HOME 

1361
00:56:45,360 --> 00:56:47,320
MEASURES MORE FREQUENT 

1362
00:56:47,320 --> 00:56:49,760
MEASUREMENTS FOR THESE TYPES OF 

1363
00:56:49,760 --> 00:56:50,040
BIOMARKERS. 

1364
00:56:50,040 --> 00:56:52,840
MACHINE LEARNING ENABLE MORE 

1365
00:56:52,840 --> 00:56:54,880
DYNAMIC AND FLEXI COMPONENT 

1366
00:56:54,880 --> 00:56:56,520
BIOMARKERS TO ADAPT AS WE LEARN 

1367
00:56:56,520 --> 00:56:58,680
AND WHAT TECHNOLOGIES COULD 

1368
00:56:58,680 --> 00:56:59,880
ENHANCE IMPLEMENTATION GETTING 

1369
00:56:59,880 --> 00:57:02,600
THIS OUT TO COMMUNITY IN VARIOUS

1370
00:57:02,600 --> 00:57:05,240
LEVELS AND WHAT COULD COM

1371
00:57:05,240 --> 00:57:06,600
COMINOVATION AND CREATIVITY IS 

1372
00:57:06,600 --> 00:57:08,320
IN THE AUDIENCE THAN I HAVE.  

1373
00:57:08,320 --> 00:57:10,200
I'M REALLY LOOKING FORWARD TO 

1374
00:57:10,200 --> 00:57:11,320
DISCUSSIONS TODAY. 

1375
00:57:11,320 --> 00:57:14,280
WE WILL TAKE QUESTIONS AT THE 

1376
00:57:14,280 --> 00:57:15,800
QUESTION PERIOD AND WE WILL GET 

1377
00:57:15,800 --> 00:57:18,640
THROUGH ALL SPEAKERS WAND THAT I

1378
00:57:18,640 --> 00:57:23,520
WOULD LIKE TO TURN IT TO LORI 

1379
00:57:23,520 --> 00:57:28,560
HARPER AT UNIVERSITY OF TEXAS, 

1380
00:57:28,560 --> 00:57:28,800
AUSTIN. 

1381
00:57:28,800 --> 00:57:33,000
>> >> THANK YOU. 
I'M SPEAKING

1382
00:57:33,000 --> 00:57:35,800
ABOUT HYPERTENSIVE DISORDERS AND

1383
00:57:35,800 --> 00:57:38,280
PREGNANCY ON BEHALF OF 

1384
00:57:38,280 --> 00:57:38,960
CONSORTIUM AND [INDISCERNIBLE] 

1385
00:57:38,960 --> 00:57:41,760
WHO WAS NOT ABLE TO MAKE IT 

1386
00:57:41,760 --> 00:57:44,040
TODAY.  NEXT SLIDE, PLEASE. 

1387
00:57:44,040 --> 00:57:45,600
HYPERTENSIVE DISORDERS AND 

1388
00:57:45,600 --> 00:57:49,040
PREGNANCY ARE LEADING CAUSE OF 

1389
00:57:49,040 --> 00:57:52,160
MATERNAL MORTALITY WORLDWIDE IN 

1390
00:57:52,160 --> 00:57:58,920
THE U SCS HYPERTENSIVE DISORDER 

1391
00:57:58,920 --> 00:58:04,600
COULD BE DIVIDED INTO CHRONIC 

1392
00:58:04,600 --> 00:58:07,360
HYPERTENSION AND -- HIGH BLOOD 

1393
00:58:07,360 --> 00:58:11,040
PRESSURE 20 WEEKS WITHOUT 

1394
00:58:11,040 --> 00:58:18,720
PREGNANCY AND -- PREECOLLAPSIA 

1395
00:58:18,720 --> 00:58:21,120
COULD LEAD TO ECOLLAPSIA AND 

1396
00:58:21,120 --> 00:58:24,000
THROW IN DISORDER ELEVATED LIVER

1397
00:58:24,000 --> 00:58:26,400
ENZYMES AND LOW PLATEMENTS IN 

1398
00:58:26,400 --> 00:58:29,640
THIS SPECTRUM DOESN'T REQUIRE TO

1399
00:58:29,640 --> 00:58:31,840
HAVE HIGH BLOOD PRESSURES AND 

1400
00:58:31,840 --> 00:58:34,680
NEXT SLIDE.  FOCUSING IN ON 

1401
00:58:34,680 --> 00:58:36,160
CHRONIC HYPERTENSION AND THE 

1402
00:58:36,160 --> 00:58:37,320
STORY IS EXCELLENT EXAMPLE 

1403
00:58:37,320 --> 00:58:39,360
TAKING WHAT WE DO OUTSIDE OF 

1404
00:58:39,360 --> 00:58:41,120
PREGNANCY SAYING WHY DON'T WE DO

1405
00:58:41,120 --> 00:58:42,720
THAT WHILE PEOPLE ARE PREGNANT 

1406
00:58:42,720 --> 00:58:43,520
TOO?  

1407
00:58:43,520 --> 00:58:46,400
OUTSIDE OF PREGNANCY IS LONG 

1408
00:58:46,400 --> 00:58:48,160
ESTABLISHED THAT WE TREAT BLOOD 

1409
00:58:48,160 --> 00:58:52,160
PRESSURES GREATER OR EQUAL TO 

1410
00:58:52,160 --> 00:58:55,400
190 AND LIFESTYLE 

1411
00:58:55,400 --> 00:58:56,080
RECOMMENDATIONS RECOMMENDATIONS 

1412
00:58:56,080 --> 00:58:58,360
FROM EVERYONE AND LISTED 

1413
00:58:58,360 --> 00:59:00,600
AMERICAN COLLEGE OF CARD YOL AND

1414
00:59:00,600 --> 00:59:01,440
AMERICAN HEART ASSOCIATION AND 

1415
00:59:01,440 --> 00:59:03,360
DIE PETIES AND EVERY SOCIETY 

1416
00:59:03,360 --> 00:59:04,920
RECOMMENDS THESE; RIGHT?  

1417
00:59:04,920 --> 00:59:07,840
NEXT SLIDE.  DURING PREGNANCY 

1418
00:59:07,840 --> 00:59:10,520
PRIOR TO APRIL OF 2022 

1419
00:59:10,520 --> 00:59:11,240
RECOMMENDATION WAS TO ONLY TREAT

1420
00:59:11,240 --> 00:59:14,560
BLOOD PRESSURES IF GREATER OR 

1421
00:59:14,560 --> 00:59:17,880
EQUAL TO 160 OVER 110. 

1422
00:59:17,880 --> 00:59:20,800
THIS IS OUT OF CONCERN FOR FETAL

1423
00:59:20,800 --> 00:59:23,400
GROWTH RESTRICTION THAT HAD 

1424
00:59:23,400 --> 00:59:26,080
BLOOD PRESSURE CONTROL AND MILD 

1425
00:59:26,080 --> 00:59:27,680
HYPERTENSION AND OVER A 9 MONTH 

1426
00:59:27,680 --> 00:59:30,640
PERIOD ESSENTIALLY WAS UNLIKELY 

1427
00:59:30,640 --> 00:59:34,480
TO IMPACT MATERNAL OUTCOMES AND 

1428
00:59:34,480 --> 00:59:35,720
IMPROVING PREGNANCY OUTCOMES AND

1429
00:59:35,720 --> 00:59:36,880
NEXT SLIDE. 

1430
00:59:36,880 --> 00:59:38,280
ALLAN APPLIED FOR FUNDING 

1431
00:59:38,280 --> 00:59:40,800
THROUGH NHLBI AND RECEIVED IT 

1432
00:59:40,800 --> 00:59:43,680
FOR THIS STUDY TREATMENT OF 

1433
00:59:43,680 --> 00:59:47,720
CHRONIC MILD HYPERTENSION DURING

1434
00:59:47,720 --> 00:59:50,720
PREGNANCY.  NEXT SLIDE.  

1435
00:59:50,720 --> 00:59:53,320
THIS WAS AN OPEN LABEL RCT 

1436
00:59:53,320 --> 00:59:57,560
GREATER IT THAN OVER 70US 

1437
00:59:57,560 --> 01:00:01,480
CENTERS COORDINATING SIGHT AND 

1438
01:00:01,480 --> 01:00:03,920
IT WAS OPEN LABEL RANDOMIZED 

1439
01:00:03,920 --> 01:00:06,400
CONTROLLED TRIAL COMPARING 

1440
01:00:06,400 --> 01:00:09,880
TREATING WOMEN WITH BLOOD 

1441
01:00:09,880 --> 01:00:11,760
PRESSURES.  NEXT SLIDE, PLEASE 

1442
01:00:11,760 --> 01:00:13,720
ACHIEVING BLOOD PRESSURE LESS 

1443
01:00:13,720 --> 01:00:17,480
THAN 140 OR 90 CONTRIBUTING TO 

1444
01:00:17,480 --> 01:00:21,720
GREATER OVER 160 OVER 110. 

1445
01:00:21,720 --> 01:00:27,080
PRIMARY EVALUATING BENEFITS -- 

1446
01:00:27,080 --> 01:00:30,200
WE RANDOMIZED WOMEN WITH SINGLE 

1447
01:00:30,200 --> 01:00:33,000
TERM PREGNANCY PRIOR TO 23 WEEKS

1448
01:00:33,000 --> 01:00:36,080
AAND THEY HAD TO HAVE BLOOD 

1449
01:00:36,080 --> 01:00:39,800
PRESSURE OF 140 OVER 159 TO 90 

1450
01:00:39,800 --> 01:00:41,600
OVER 104 NEXT SLIDE TO GET INTO 

1451
01:00:41,600 --> 01:00:43,520
THE STUDY IF NOT TAKING 

1452
01:00:43,520 --> 01:00:45,440
MEDICATIONS AND TRIAL OF WOMEN 

1453
01:00:45,440 --> 01:00:46,960
WITH CHRONIC HYPERTENSION OR 

1454
01:00:46,960 --> 01:00:53,240
THEY HAD TO BE ON MEDICATIONS. 

1455
01:00:53,240 --> 01:00:57,960
NEXT SLIDE. 

1456
01:00:57,960 --> 01:01:01,680
I'M SORRY NEXT SLIDE. 

1457
01:01:01,680 --> 01:01:05,080
SO, ACTIVE ARM GOT TARGET BLOOD 

1458
01:01:05,080 --> 01:01:07,240
PRESSURE OF LESS THAN 140 OVER 

1459
01:01:07,240 --> 01:01:09,720
90 AND PROVIDED STUDY AND PEOPLE

1460
01:01:09,720 --> 01:01:11,640
COULD USE OTHER MEDICATIONS THEY

1461
01:01:11,640 --> 01:01:13,680
DESIRED AND MEDS TIGHT TREATED 

1462
01:01:13,680 --> 01:01:16,440
IF THEY WERE ADHERIENT TO BLOOD 

1463
01:01:16,440 --> 01:01:20,000
PRESSURES GREATER THAN 140 OVER 

1464
01:01:20,000 --> 01:01:21,880
90 AND STANDARD TREATMENT 

1465
01:01:21,880 --> 01:01:23,920
WITHHELD OR DISCONTINUED AND 

1466
01:01:23,920 --> 01:01:28,080
BLOOD PRESSURE GREATER THAN 160 

1467
01:01:28,080 --> 01:01:31,960
OR 105 AND BLOOD PRESSURE TIGHT 

1468
01:01:31,960 --> 01:01:37,360
TREATED AND PRIMARY OUTCOME WAS 

1469
01:01:37,360 --> 01:01:39,400
PREECOLLAPSE YA WITH SEVERE 

1470
01:01:39,400 --> 01:01:43,400
FEATURES AND LESS THAN 35 WEEKS 

1471
01:01:43,400 --> 01:01:47,840
ADRUPGS OR FETAL NEONATAL DEATH 

1472
01:01:47,840 --> 01:01:51,640
AND DIAGNOSED WITH PREECOLLAPSE 

1473
01:01:51,640 --> 01:01:54,200
YA AND YOU HAD TO HAVE 

1474
01:01:54,200 --> 01:01:56,880
PROCONTINUE URIA OR LABORATORY 

1475
01:01:56,880 --> 01:01:59,480
ABNORMALITY OR SOME SYMPTOMS AND

1476
01:01:59,480 --> 01:02:04,520
NEXT SLIDE AND LOT OF TIME 

1477
01:02:04,520 --> 01:02:07,560
ADJUDICATING OUTCOMES. 

1478
01:02:07,560 --> 01:02:10,320
LESS THAN 10TH PERCENTILE AND 

1479
01:02:10,320 --> 01:02:13,960
LESS THAN A FIFTH PERCENTILE.  

1480
01:02:13,960 --> 01:02:14,280
NEXT SLIDE. 

1481
01:02:14,280 --> 01:02:18,360
WE RANDOMIZED 2400 WOMEN AND 

1482
01:02:18,360 --> 01:02:21,240
1200 TO EACH GROUP WITH OUTCOMES

1483
01:02:21,240 --> 01:02:31,480
ON ALMOST EVERYONE 1170 AND THIS

1484
01:02:31,480 --> 01:02:34,640
WAS A PRIMARY STUDY AND 30% FROM

1485
01:02:34,640 --> 01:02:36,200
ACTIVE TREATMENT GROUP COMPARED 

1486
01:02:36,200 --> 01:02:39,120
TO 37% IN STANDARD TREATMENT 

1487
01:02:39,120 --> 01:02:41,640
GROUP AND NEXT SLIDE AND NUMBER 

1488
01:02:41,640 --> 01:02:43,560
TREATED FOR 14.7. 

1489
01:02:43,560 --> 01:02:44,160
NEXT SLIDE. 

1490
01:02:44,160 --> 01:02:46,760
SAFETY OUTCOME WAS REASSURING 

1491
01:02:46,760 --> 01:02:48,640
AND WAS NO DIFFERENCE FOR FETAL 

1492
01:02:48,640 --> 01:02:51,120
GROWTH RESTRICTION AT LESS THAN 

1493
01:02:51,120 --> 01:02:53,680
10TH PERCENTILE OR LESS THAN A 

1494
01:02:53,680 --> 01:02:54,920
FIFTH PERCENTILE. 

1495
01:02:54,920 --> 01:02:55,400
NEXT SLIDE. 

1496
01:02:55,400 --> 01:02:58,560
IN SUMMARY TREATING PERSONS WITH

1497
01:02:58,560 --> 01:02:59,880
CHRONIC HYPERIT INGRESS TO 

1498
01:02:59,880 --> 01:03:03,880
TARGET BLOOD PRESSURE OF 140 OR 

1499
01:03:03,880 --> 01:03:06,880
190 AND ADRUPGS AND PERINATAL 

1500
01:03:06,880 --> 01:03:09,280
DEATH OUTINCREASING SMALL 

1501
01:03:09,280 --> 01:03:14,080
GESTATIONAL AGE AND 14.7 AND 

1502
01:03:14,080 --> 01:03:14,360
NEXT SLIDE. 

1503
01:03:14,360 --> 01:03:16,080
WHERE DO WE GO FROM HERE?  

1504
01:03:16,080 --> 01:03:18,160
FIRST OF ALL WE HAVE TO GET 

1505
01:03:18,160 --> 01:03:20,760
WORDS OUT ABOUT THE STUDY AND 

1506
01:03:20,760 --> 01:03:22,560
ACOG AND [INDISCERNIBLE] WERE 

1507
01:03:22,560 --> 01:03:23,720
STATEMENTS ABOUT THIS 

1508
01:03:23,720 --> 01:03:25,280
RECOMMENDING CHANGING 

1509
01:03:25,280 --> 01:03:26,400
RECOMMENDATIONS OF WITHHOLDING 

1510
01:03:26,400 --> 01:03:27,520
TREATMENT AND RECOMMENDING 

1511
01:03:27,520 --> 01:03:30,640
TREATING TO LESS THAN 140 OVER 

1512
01:03:30,640 --> 01:03:33,120
90 AND A YEAR LATER NOT EVERYONE

1513
01:03:33,120 --> 01:03:35,440
HAS GOTTEN MEMO AND STILL NOT 

1514
01:03:35,440 --> 01:03:37,240
BEING IMPLEMENTED COMPLETELY AND

1515
01:03:37,240 --> 01:03:38,800
IS A LOT OF NEXT SLIDE.  THERE 

1516
01:03:38,800 --> 01:03:41,120
IS A LOT OF QUESTIONS THAT ARE 

1517
01:03:41,120 --> 01:03:43,520
ABOUT ACTUALLY A RE -- ARE WE 

1518
01:03:43,520 --> 01:03:46,760
GETTING TO RIGHT BLOOD PRESSURE 

1519
01:03:46,760 --> 01:03:49,400
NOW?  AMERICAN COLLEGE OF 

1520
01:03:49,400 --> 01:03:51,160
CARDIOLOGY CHANGED DEFINITION OF

1521
01:03:51,160 --> 01:03:53,840
STAGE 1 OF HYPERTENSION AND SOME

1522
01:03:53,840 --> 01:03:55,960
IN AUDIENCE THINK THAT HAPPENED 

1523
01:03:55,960 --> 01:03:58,200
A WHILE AGO IT TOOK A LONG TIME 

1524
01:03:58,200 --> 01:04:03,280
AND WAS HAPPENING AS WE STARTED 

1525
01:04:03,280 --> 01:04:03,520
NOW. 

1526
01:04:03,520 --> 01:04:04,720
QUESTION BECAME IS THERE BENEFIT

1527
01:04:04,720 --> 01:04:08,400
TO LESS THAN 130 OVER 80 IN 

1528
01:04:08,400 --> 01:04:08,800
PREGNANCY?  

1529
01:04:08,800 --> 01:04:10,160
NEXT SLIDE. 

1530
01:04:10,160 --> 01:04:13,440
HOW DO WE MEASURE BLOOD 

1531
01:04:13,440 --> 01:04:15,520
PRESSURES WE USE CLINICAL 

1532
01:04:15,520 --> 01:04:17,280
PRESSURES SOME DID MANUAL BLOOD 

1533
01:04:17,280 --> 01:04:19,040
PRESSURES AND SOME AUTOMATED 

1534
01:04:19,040 --> 01:04:21,320
BLOOD PRESSURES YOU MAY NOT 

1535
01:04:21,320 --> 01:04:24,040
REALIZE ONLY ONE AUTOMATED BLOOD

1536
01:04:24,040 --> 01:04:27,200
PRESSURE CUFF THAT I KNOW OF IS 

1537
01:04:27,200 --> 01:04:29,800
VALIDATED DURING PREGNANCY AND 

1538
01:04:29,800 --> 01:04:31,720
POSTPARTUM AND I FREQUENTLY GET 

1539
01:04:31,720 --> 01:04:33,320
QUESTIONS ABOUT PATIENT HAS 

1540
01:04:33,320 --> 01:04:35,040
WHOLE BLOOD PRESSURE CUFF AND 

1541
01:04:35,040 --> 01:04:36,960
THEY ARE ELEVATED AT HOME AND 

1542
01:04:36,960 --> 01:04:38,840
HIGH HERE AND NORMAL AT HOME AND

1543
01:04:38,840 --> 01:04:41,480
WHAT DO WE DO WITH THAT AND 

1544
01:04:41,480 --> 01:04:44,080
CONTINUOUS BLOOD PRESSURE 

1545
01:04:44,080 --> 01:04:46,160
MONITORING AND WEARABLE CUFFLESS

1546
01:04:46,160 --> 01:04:49,760
DEVICES AND NEXT SLIDE. 

1547
01:04:49,760 --> 01:04:52,120
THE BIG QUESTION THAT I GET 

1548
01:04:52,120 --> 01:04:57,280
ABOUT CHAP IS ARE WE MASKING 

1549
01:04:57,280 --> 01:04:59,240
PREECOLLAPSIA AND ADJUSTING 

1550
01:04:59,240 --> 01:05:01,280
MEDICINES AND GOING HOME AND HOW

1551
01:05:01,280 --> 01:05:05,640
DO WE DISTINGUISH PREECOLLAPSE 

1552
01:05:05,640 --> 01:05:07,720
YA FROM HYPERTENSION AND 

1553
01:05:07,720 --> 01:05:09,640
DESPERATE NEED OF TESTING IN 

1554
01:05:09,640 --> 01:05:11,720
CLINIC AND SHOULD WE TREAT BLOOD

1555
01:05:11,720 --> 01:05:15,160
PRESSURES GREATER THAN 140 OVER 

1556
01:05:15,160 --> 01:05:18,200
90 IN PREECOLLAPSIA?  WHAT DO WE

1557
01:05:18,200 --> 01:05:20,640
DO FOR PATIENTS AND WOULD THEY 

1558
01:05:20,640 --> 01:05:22,120
BENEFIT IN SOME WAY?  

1559
01:05:22,120 --> 01:05:24,800
IF TREATING BLOOD PRESSURES HOW 

1560
01:05:24,800 --> 01:05:28,240
DO WE DIAGNOSE PREECOLLAPSE YA 

1561
01:05:28,240 --> 01:05:31,120
WITH SEVERE FEATURES.  NEXT 

1562
01:05:31,120 --> 01:05:34,000
SLIDE.  AGAIN, DESPERATELY 

1563
01:05:34,000 --> 01:05:35,720
NEEDING TREATMENT FOR 

1564
01:05:35,720 --> 01:05:36,840
PREECOLLAPSIA THAN FORDELIVERY 

1565
01:05:36,840 --> 01:05:42,240
AND DON'T HAVE WAY TO TEMPERIZE 

1566
01:05:42,240 --> 01:05:43,880
PREECOLLAPSIA WITHOUT MATERNAL 

1567
01:05:43,880 --> 01:05:47,200
MORTALITY AND PATIENTS COME IN 

1568
01:05:47,200 --> 01:05:49,320
WITH SEVERE FEATURE AS NTD DON'T

1569
01:05:49,320 --> 01:05:50,880
HAVE ANYTHING FOR THEM EXCEPT 

1570
01:05:50,880 --> 01:05:53,240
FOR TIME AND BLOOD PRESSURE 

1571
01:05:53,240 --> 01:05:57,960
MANAGEMENT AND DOING TO TREAT 

1572
01:05:57,960 --> 01:05:59,440
PREECOLLAPSIA POSTPARTUM AND 

1573
01:05:59,440 --> 01:06:02,440
RECOMMENDATION TO MAINTAIN BLOOD

1574
01:06:02,440 --> 01:06:05,400
PRESSURE GREATER THAN 150 OVER 

1575
01:06:05,400 --> 01:06:09,120
100 AND WHY IS THIS GREATER 

1576
01:06:09,120 --> 01:06:13,800
POSTPARTUM THAN OUTSIDE OF 

1577
01:06:13,800 --> 01:06:14,320
PREGNANCY. 

1578
01:06:14,320 --> 01:06:16,080
NEXT SLIDE. 

1579
01:06:16,080 --> 01:06:20,520
AGAIN, DIAGNOSIS PREECOLLAPSIA 

1580
01:06:20,520 --> 01:06:21,640
POSTPARTUM CANDICE SAID A LOT 

1581
01:06:21,640 --> 01:06:23,480
AFTER THE DELIVERY SHE WAS SORT 

1582
01:06:23,480 --> 01:06:25,640
OF ON HER OWN AND WHERE LOTS OF 

1583
01:06:25,640 --> 01:06:28,480
THE MORBIDITY AND MORTALITY IS 

1584
01:06:28,480 --> 01:06:30,240
HAPPENING IS IN POSTPARTUM AND 2

1585
01:06:30,240 --> 01:06:32,720
TO 3 WEEKS AFTER DELIVERY AND 

1586
01:06:32,720 --> 01:06:35,120
HOW WE CAPTURE PATIENTS WE STOP 

1587
01:06:35,120 --> 01:06:37,040
SEEING THEM AND SEND THEM HOME 

1588
01:06:37,040 --> 01:06:39,440
WITH THE BABY AND SAY GOOD LUCK 

1589
01:06:39,440 --> 01:06:42,040
AND THOUGHT ABOUT MANAGEMENT ORE

1590
01:06:42,040 --> 01:06:45,160
MEDICATIONS FOR TREATING 

1591
01:06:45,160 --> 01:06:47,200
PREECOLLAPSIA AND BIG DEBATE AT 

1592
01:06:47,200 --> 01:06:51,360
HOSPITAL MAGNESIUM OR 

1593
01:06:51,360 --> 01:06:53,560
PREECOLLAPSIA WHEN DIAGNOSED 

1594
01:06:53,560 --> 01:06:57,800
WITH POSTPARTUM.  NEXT SLIDE. 

1595
01:06:57,800 --> 01:07:02,280
THANK YOU. 

1596
01:07:02,280 --> 01:07:06,960
>> ALL RIGHT.  NEXT UP IS
DR. 

1597
01:07:06,960 --> 01:07:10,840
ELIZA MILLER FROM COLUMBIA 

1598
01:07:10,840 --> 01:07:13,280
UNIVER

1599
01:07:13,280 --> 01:07:13,560
UNIVERSITY. 

1600
01:07:13,560 --> 01:07:15,560
>> HI.  THANK YOU.  HONOR
TO BE

1601
01:07:15,560 --> 01:07:18,800
HERE ELIZA MILLER VASCULAR 

1602
01:07:18,800 --> 01:07:20,520
NEUROLOGIST AND CLINICAL 

1603
01:07:20,520 --> 01:07:22,880
RESEARCHER AT COLUMBIA 

1604
01:07:22,880 --> 01:07:24,000
UNIVERSITY STUDYING MATERNAL 

1605
01:07:24,000 --> 01:07:27,040
STROKE AND RAISING QUESTIONS 

1606
01:07:27,040 --> 01:07:28,960
ABOUT PREDICTION AND PREVENTION 

1607
01:07:28,960 --> 01:07:32,120
OF THIS CATASTROPHIC EVENT NEXT 

1608
01:07:32,120 --> 01:07:35,440
SLIDE.  THIS IS FUNDING DON'T 

1609
01:07:35,440 --> 01:07:38,680
HAVE IRRELEVANT DISCLOSURES THIS

1610
01:07:38,680 --> 01:07:41,720
IS MATERNAL STROKE AND FOR THOSE

1611
01:07:41,720 --> 01:07:43,560
THAT DON'T LOOK AT CAT SCANS 

1612
01:07:43,560 --> 01:07:44,960
VERY OFTEN THEY ARE VERY 

1613
01:07:44,960 --> 01:07:46,360
TERRIBLE AND WHAT I WOULD POINT 

1614
01:07:46,360 --> 01:07:49,240
OUT IS THAT MANY OF THESE 

1615
01:07:49,240 --> 01:07:52,200
STROKES ARE HEM ORRAGIC.  IN 

1616
01:07:52,200 --> 01:07:55,280
GENERAL POPULATION ABOUT 15% OF 

1617
01:07:55,280 --> 01:07:57,240
STROKES ARE DUE TO HEMORRHAGE IN

1618
01:07:57,240 --> 01:08:00,640
THE BRAIN AND REST ARE DUE TO ES

1619
01:08:00,640 --> 01:08:02,800
KEEMIC OR CLOTTING EVENTS IN THE

1620
01:08:02,800 --> 01:08:05,200
BRAIN AND MATERNAL POPULATION, 

1621
01:08:05,200 --> 01:08:08,120
50% ARE HEMOAGIC AND THIS STROKE

1622
01:08:08,120 --> 01:08:12,200
CARIES VERY HIGH MORTALITY AND 

1623
01:08:12,200 --> 01:08:13,200
MORBIDITY.  NEXT SLIDE. 

1624
01:08:13,200 --> 01:08:16,960
STROKE IS ALWAYS ON THE LIST OF 

1625
01:08:16,960 --> 01:08:20,520
CAUSES OF MATERNAL MORTALITY AND

1626
01:08:20,520 --> 01:08:24,480
POINT THAT IT MIGHT BE 

1627
01:08:24,480 --> 01:08:25,600
UNDERESTIMATED AND MANY TIMES 

1628
01:08:25,600 --> 01:08:29,480
ACTUAL DIRECT CAUSE OF DEATH IN 

1629
01:08:29,480 --> 01:08:33,600
SOMEONE WITH PREECOLLAPSIA IS IN

1630
01:08:33,600 --> 01:08:35,520
CEREBRAL HEM RANL AND NO THE 

1631
01:08:35,520 --> 01:08:37,080
SURE IF IN EACH BOX AND DOESN'T 

1632
01:08:37,080 --> 01:08:39,600
PARTICULARLY MATTER AND WHAT IS 

1633
01:08:39,600 --> 01:08:42,440
NOT CAPTURED HERE ALSO IS MOST 

1634
01:08:42,440 --> 01:08:44,800
STROKES DON'T KILL YOU AND 

1635
01:08:44,800 --> 01:08:46,920
CEREBRAL HEM RANLS MOST ARE NOT 

1636
01:08:46,920 --> 01:08:48,400
FATAL BUT DISABLING AND 

1637
01:08:48,400 --> 01:08:50,120
DISABLING EVENT LIKE THIS EARLY 

1638
01:08:50,120 --> 01:08:52,960
IN LIFE IS JUST CATASTROPHIC FOR

1639
01:08:52,960 --> 01:08:54,640
THE PERSON THAT EXPERIENCES IT 

1640
01:08:54,640 --> 01:08:57,840
AND FOR THE FAMILY. 

1641
01:08:57,840 --> 01:08:58,720
NEXT SLIDE.  

1642
01:08:58,720 --> 01:09:01,000
THERE IS A LOT OF DIFFERENT 

1643
01:09:01,000 --> 01:09:02,080
REASONS PEOPLE CAN HAVE A STROKE

1644
01:09:02,080 --> 01:09:04,160
AND I WON'T GET INTO THE PANELO 

1645
01:09:04,160 --> 01:09:06,640
PHYSIOLOGY OF IT.  IT CAN BE 

1646
01:09:06,640 --> 01:09:07,840
VERY COMPLEX AND THERE IS 

1647
01:09:07,840 --> 01:09:11,280
DIFFERENT TYPES OF STROKES AND I

1648
01:09:11,280 --> 01:09:15,320
WILL FOCUS ON INTRACEREBRAL 

1649
01:09:15,320 --> 01:09:17,480
HEMORRHAGE IT IS MOST 

1650
01:09:17,480 --> 01:09:18,880
CATASTROPHIC AND MOST 

1651
01:09:18,880 --> 01:09:20,120
PREVENTIBLE, I THINK.  NEXT 

1652
01:09:20,120 --> 01:09:22,440
SLIDE.  QUESTION I WOULD LIKE TO

1653
01:09:22,440 --> 01:09:22,800
POSE:  

1654
01:09:22,800 --> 01:09:26,360
IS IT POSSIBLE TO PREDICT A RARE

1655
01:09:26,360 --> 01:09:29,720
AND CATASTROPHIC EVENT?  DOESN'T

1656
01:09:29,720 --> 01:09:31,520
HAPPEN THAT OFTEN BUT WHEN IT 

1657
01:09:31,520 --> 01:09:33,960
DOES IT IS A DISASTER AND COULD 

1658
01:09:33,960 --> 01:09:35,640
WE USE TECHNOLOGY TO PREDICT 

1659
01:09:35,640 --> 01:09:38,880
THIS BEFORE IT HAPPENS?  

1660
01:09:38,880 --> 01:09:40,480
LOOKING BACK AT CASES I 

1661
01:09:40,480 --> 01:09:42,600
PERSONALLY REVIEWED MANY, MANY 

1662
01:09:42,600 --> 01:09:44,280
CASES AND FOUND THAT LARGE 

1663
01:09:44,280 --> 01:09:47,240
PROPORTION OF CASES THERE ARE 

1664
01:09:47,240 --> 01:09:48,600
MISSED OPPORTUNITIES OR 

1665
01:09:48,600 --> 01:09:50,240
DIAGNOSTIC DELAYS THAT OCCUR 

1666
01:09:50,240 --> 01:09:52,120
BEFORE THE STROKE IS FINALLY 

1667
01:09:52,120 --> 01:09:53,640
DIAGNOSED AND IN CASE OF 

1668
01:09:53,640 --> 01:09:59,560
HEMORRHAGIC -- NATIONAL STROKE 

1669
01:09:59,560 --> 01:10:01,720
CONFERENCE THIS YEAR 50% HAD 

1670
01:10:01,720 --> 01:10:03,200
DELAYS IN DIAGNOSIS. 

1671
01:10:03,200 --> 01:10:05,040
NEXT SLIDE. 

1672
01:10:05,040 --> 01:10:07,440
HERE IS A EXAMPLE OF A CASE LIKE

1673
01:10:07,440 --> 01:10:10,160
THAT THIS PERSON PRESENTED ON 

1674
01:10:10,160 --> 01:10:12,760
POSTPARTUM DAY 4 WHAT WAS FAIRLY

1675
01:10:12,760 --> 01:10:17,520
HEALTHY PREGNANCY GENERALIZED 

1676
01:10:17,520 --> 01:10:19,360
SEIZURES DIAGNOSED WITH 

1677
01:10:19,360 --> 01:10:21,160
PRECOLLAPSIA AND FOUR DAYS 

1678
01:10:21,160 --> 01:10:23,960
LEADING UP TO THAT SEVERE 

1679
01:10:23,960 --> 01:10:24,720
HEADACHES AND BLOOD PRESSURE 

1680
01:10:24,720 --> 01:10:26,840
SOUGHT MEDICAL ATTENTION AND 

1681
01:10:26,840 --> 01:10:29,360
COUPLE MED ENCOUNTERS DIAGNOSED 

1682
01:10:29,360 --> 01:10:32,200
WITH MIGRAINE OR TOLD IT WAS AND

1683
01:10:32,200 --> 01:10:33,920
BLOOD PRESSURE WAS ATRIB UTD 

1684
01:10:33,920 --> 01:10:36,440
TODAY PAIN AND SHE WAS SENT 

1685
01:10:36,440 --> 01:10:36,640
HOME. 

1686
01:10:36,640 --> 01:10:38,080
SHE CAME IN WITH A SEIZURE WHAT 

1687
01:10:38,080 --> 01:10:40,280
WAS MORE CONCERNING IS SHE 

1688
01:10:40,280 --> 01:10:41,960
DIDN'T GET A SCAN IMMEDIATELY IT

1689
01:10:41,960 --> 01:10:46,120
WAS OH,ING MY GOSH SHE HAS 

1690
01:10:46,120 --> 01:10:47,520
ECOLLAPSIA RECEIVING TREATMENT 

1691
01:10:47,520 --> 01:10:50,080
FOR IT AND MAGNESIUM DRIP AND 

1692
01:10:50,080 --> 01:10:51,680
LOST CONSCIOUSNESS AND 

1693
01:10:51,680 --> 01:10:52,960
EVENTUALLY FOUND TO HAVE THIS 

1694
01:10:52,960 --> 01:10:55,320
AND SCANNING SOMEONE'S BRAIN AND

1695
01:10:55,320 --> 01:11:01,680
THIS IS NOT PART OF TYPICAL 

1696
01:11:01,680 --> 01:11:03,480
PREECLAPGSIA PROTOCOL. 

1697
01:11:03,480 --> 01:11:05,760
SEEMS A STRAIGHTFORWARD 

1698
01:11:05,760 --> 01:11:07,520
DIAGNOSIS AND DIDN'T HAVE A 

1699
01:11:07,520 --> 01:11:11,720
TERRIBLE OUTCOME.  NEXT SLIDE. 

1700
01:11:11,720 --> 01:11:15,120
WHEN -- HOW COULD WE PREDICT IT?

1701
01:11:15,120 --> 01:11:17,200
LOOKING BACK ANOTHER CASE SERIES

1702
01:11:17,200 --> 01:11:20,640
YOU CAN SEE A CLUSTER OF 

1703
01:11:20,640 --> 01:11:22,720
HEMORRHAGES AND HEMORRHAGIC 

1704
01:11:22,720 --> 01:11:26,080
STROKE IN FIRST COUPLE WEEKS 

1705
01:11:26,080 --> 01:11:28,080
POSTPARTUM AND SEEMS MAYBE FIRST

1706
01:11:28,080 --> 01:11:29,680
FEW DAYS POSTPARTUM ARE KEY TIME

1707
01:11:29,680 --> 01:11:32,720
AND IF WE FIND A PREDICTOR OR 

1708
01:11:32,720 --> 01:11:34,040
IDENTIFYING CHARACTERISTICS THAT

1709
01:11:34,040 --> 01:11:36,640
IS WHERE WE SHOULD LOOK.  NEXT 

1710
01:11:36,640 --> 01:11:36,960
SLIDE. 

1711
01:11:36,960 --> 01:11:39,360
THIS IS ANOTHER STUDY WE DID 

1712
01:11:39,360 --> 01:11:41,680
THAT LOOKED AT NATIONWIDE DATA 

1713
01:11:41,680 --> 01:11:44,120
AND FOUND MEDIAN TIME TO 

1714
01:11:44,120 --> 01:11:45,640
READMISSION FOR STROKE AFTER 

1715
01:11:45,640 --> 01:11:50,120
POSTPARTUM STROKES IS 8 DAYS AND

1716
01:11:50,120 --> 01:11:52,240
THAT FIRST COUPLE WEEKS SEEMS TO

1717
01:11:52,240 --> 01:11:55,280
BE HIGH YIELD PERIOD AND FOUND 

1718
01:11:55,280 --> 01:11:57,280
IN PEOPLE WITH HYPERTENSIVE 

1719
01:11:57,280 --> 01:11:59,000
DISORDERS AND PREGNANCY WE HEARD

1720
01:11:59,000 --> 01:12:02,480
ABOUT THAT IS HIGHEST RISK 

1721
01:12:02,480 --> 01:12:02,760
THROUGH. 

1722
01:12:02,760 --> 01:12:04,720
NEXT SLIDE.  

1723
01:12:04,720 --> 01:12:07,320
ONE QUESTION COULD WE USE BETTER

1724
01:12:07,320 --> 01:12:09,840
IMPLEMENTATION AND EDUCATION TO 

1725
01:12:09,840 --> 01:12:11,280
SO PEOPLE WOULD RECOGNIZE SIGNS 

1726
01:12:11,280 --> 01:12:12,920
OF STROKE?  

1727
01:12:12,920 --> 01:12:14,280
UNFORTUNATELY MOST PEOPLE DON'T 

1728
01:12:14,280 --> 01:12:15,880
HAVE NEUROLOGY TRAINING THAT IS 

1729
01:12:15,880 --> 01:12:18,040
NOT EVEN REQUIRED IN MEDICAL 

1730
01:12:18,040 --> 01:12:19,520
SCHOOL FOR MANY MEDICAL SCHOOLS 

1731
01:12:19,520 --> 01:12:23,360
AND PEOPLE GOING TO OGBYN NO 

1732
01:12:23,360 --> 01:12:26,480
REASON THERE IS NOT ELECTIVE 

1733
01:12:26,480 --> 01:12:27,760
NEUROLOGY AND DON'T RECEIVE ANY 

1734
01:12:27,760 --> 01:12:30,160
DURING PREGNANCY AND IS NOT 

1735
01:12:30,160 --> 01:12:31,760
THEIR FAULT THEY DON'T RECOGNIZE

1736
01:12:31,760 --> 01:12:35,120
RED FLAG FEATURES FOR EXAMPLE. 

1737
01:12:35,120 --> 01:12:37,320
I HAVE DONE WORK WITH A NEAT 

1738
01:12:37,320 --> 01:12:40,920
GROUP OBLS FUNDED BY HRQ THAT IS

1739
01:12:40,920 --> 01:12:45,120
DEVELOPING A CURRICULUM FOR ACLS

1740
01:12:45,120 --> 01:12:47,160
LIKE MATERNAL CARDIAC ARREST 

1741
01:12:47,160 --> 01:12:48,440
SYNDROME ADDING STROKE FOR THAT 

1742
01:12:48,440 --> 01:12:50,160
AND DEVELOPING TOOLS TO HELP 

1743
01:12:50,160 --> 01:12:51,840
PEOPLE THAT DON'T HAVE NEUROLOGY

1744
01:12:51,840 --> 01:13:00,560
TRAINING TO RECOGNIZE FEATURES. 

1745
01:13:00,560 --> 01:13:02,600
NEXT SLIDE.  THIS IS A TOOL WE 

1746
01:13:02,600 --> 01:13:05,000
DEVELOPED PNEUMONIC TO POINT OUT

1747
01:13:05,000 --> 01:13:07,240
RED FLAG FEATURES TO EXIST IF 

1748
01:13:07,240 --> 01:13:10,880
SOMEONE IS PRESENTING WITH 

1749
01:13:10,880 --> 01:13:16,160
HEADACHE IN POSTPARTUM FEATURES 

1750
01:13:16,160 --> 01:13:18,080
DOESN'T MEAN THAT NECESSARILY 

1751
01:13:18,080 --> 01:13:20,560
EVERYONE NEEDS A SCAN BUT STEP 

1752
01:13:20,560 --> 01:13:21,600
BACK AND THERE MIGHT BE 

1753
01:13:21,600 --> 01:13:23,240
SOMETHING ELSE GOING ON. 

1754
01:13:23,240 --> 01:13:23,840
NEXT SLIDE. 

1755
01:13:23,840 --> 01:13:25,800
SECOND QUESTION I WOULD POSE IS 

1756
01:13:25,800 --> 01:13:28,080
SAY WE WERE ABLE TO IDENTIFY A 

1757
01:13:28,080 --> 01:13:30,240
PERSON AT RISK.  RIGHT?  

1758
01:13:30,240 --> 01:13:33,040
DO WE DO ANYTHING TO PREVENT THE

1759
01:13:33,040 --> 01:13:33,640
STROKE?  

1760
01:13:33,640 --> 01:13:36,440
AND I WOULD SORT OF BUILD ON THE

1761
01:13:36,440 --> 01:13:38,680
LAST SPEAKER TO SAY THAT OUR 

1762
01:13:38,680 --> 01:13:40,200
BLOOD PRESSURE MANAGEMENT IN 

1763
01:13:40,200 --> 01:13:42,720
SETTING IN PERFECT EGG NANCY AND

1764
01:13:42,720 --> 01:13:48,760
POSTPARTUM IS ONE-SIZED FITS ALL

1765
01:13:48,760 --> 01:13:50,400
YOU CAN IMAGINE SOMEONE WITH 

1766
01:13:50,400 --> 01:13:52,360
BLOOD PRESSURE IS TYPICAL FOR 

1767
01:13:52,360 --> 01:13:55,000
YOUNG WOMEN LOTS OF THE TIME AND

1768
01:13:55,000 --> 01:13:57,960
GETTING TO 160 OVER 110 IS A BIG

1769
01:13:57,960 --> 01:14:00,320
CHANGE FOR THAT PERSON. 

1770
01:14:00,320 --> 01:14:01,840
NEXT SLIDE. 

1771
01:14:01,840 --> 01:14:04,360
THENALLY GET INTO THE WEEDS. 

1772
01:14:04,360 --> 01:14:05,760
I WON'T SPEND TOO MUCH TIME AND 

1773
01:14:05,760 --> 01:14:09,080
THERE IS A CONCEPT CALLED 

1774
01:14:09,080 --> 01:14:10,800
CEREBRAL AUTO REGULATION AND 

1775
01:14:10,800 --> 01:14:12,800
IDEA BEHIND THIS, EVERYBODY'S 

1776
01:14:12,800 --> 01:14:15,320
BRAIN LIKE A CONSTANT FLOW OF 

1777
01:14:15,320 --> 01:14:17,200
BLOOD THAT DOESN'T LIKE TOO MUCH

1778
01:14:17,200 --> 01:14:20,520
OR TOO LITTLE AND BLOOD PRESSURE

1779
01:14:20,520 --> 01:14:21,560
FLUCTUATES NORMALLY AND BRAIN 

1780
01:14:21,560 --> 01:14:27,520
HAS TO ADJUST FOR THAT CEREBRAL 

1781
01:14:27,520 --> 01:14:29,240
ARTERY REGULATION AND 

1782
01:14:29,240 --> 01:14:31,760
MAINTAINING CONSTANT FLOW. 

1783
01:14:31,760 --> 01:14:33,960
THERE IS A PLATEAU PERIOD IF 

1784
01:14:33,960 --> 01:14:36,520
BLOOD PRESSURE STAYS IN MIDDLE 

1785
01:14:36,520 --> 01:14:38,720
RANGE WHERE IT IS FLAT BRAIN CAN

1786
01:14:38,720 --> 01:14:41,440
HANDLE THAT, THOSE CHANGES AND 

1787
01:14:41,440 --> 01:14:44,040
IF YOU GET BELOW THAT IT CAN'T 

1788
01:14:44,040 --> 01:14:46,720
HANDLE THAT AND YOU DON'T GET 

1789
01:14:46,720 --> 01:14:49,400
ENOUGH BLOOD FLOW AND BELOW THAT

1790
01:14:49,400 --> 01:14:55,840
YOU COULD GET CEREBRAL EDEMA AND

1791
01:14:55,840 --> 01:14:56,440
HEMORRHAGE. 

1792
01:14:56,440 --> 01:14:58,520
SETTING OF CERTAIN CONDITIONS 

1793
01:14:58,520 --> 01:15:00,320
CEREBRAL AUTO REGULATION IS NOT 

1794
01:15:00,320 --> 01:15:02,560
WORKING LIKE THAT AND EXAMPLE ON

1795
01:15:02,560 --> 01:15:05,280
LEFT YOU SEE PLATEAU IS SMALL 

1796
01:15:05,280 --> 01:15:07,280
AND MIGHT BE YOU NEED TIGHTER 

1797
01:15:07,280 --> 01:15:09,520
RANGE OF BLOOD PRESSURE CONTROL 

1798
01:15:09,520 --> 01:15:11,720
TO AVOID CATASTROPHIC 

1799
01:15:11,720 --> 01:15:13,600
COMPLICATIONS AND RIGHT YOU SEE 

1800
01:15:13,600 --> 01:15:15,080
REGULATIONS COMPLETELY LOST AND 

1801
01:15:15,080 --> 01:15:17,760
IF BLOOD PRESSURE IS HIGHER 

1802
01:15:17,760 --> 01:15:21,000
BLOOD FLOW IS HIGHER AND SETTING

1803
01:15:21,000 --> 01:15:25,280
OF PREECOLLAPSIA COULD BE VERY 

1804
01:15:25,280 --> 01:15:26,520
CATASTROPHIC.  WHY TALKING ABOUT

1805
01:15:26,520 --> 01:15:27,120
THIS?  

1806
01:15:27,120 --> 01:15:29,240
NEXT SLIDE.  RESEARCH IDENTIFIED

1807
01:15:29,240 --> 01:15:31,920
IN FIRST WEEK POSTPARTUM THAT 

1808
01:15:31,920 --> 01:15:33,880
KREER EBB RAL AUTO REGULATION IS

1809
01:15:33,880 --> 01:15:35,880
NOORMAL IN POSTPARTUM 

1810
01:15:35,880 --> 01:15:37,680
INDIVIDUALS REGARDLESS WHAT 

1811
01:15:37,680 --> 01:15:38,880
BLOOD PRESSURE IS AND THIS IS 

1812
01:15:38,880 --> 01:15:42,440
UNDER REVIEW NOW AND WE PUT OUT 

1813
01:15:42,440 --> 01:15:43,920
PRELIMINARY RESULTS AND BRAIN 

1814
01:15:43,920 --> 01:15:46,040
BASICALLY DIDN'T SEEM TO BE 

1815
01:15:46,040 --> 01:15:48,080
CAPABLE OF DAMPENING SIGNAL IN 

1816
01:15:48,080 --> 01:15:50,040
WAY IT NORMALLY WOULD AND ANYONE

1817
01:15:50,040 --> 01:15:52,320
WHO IS POSTPARTUM WITHIN FIRST 7

1818
01:15:52,320 --> 01:15:54,760
DAYS AND YOU CAN IMAGINE IF YOU 

1819
01:15:54,760 --> 01:15:56,920
ADD ON A SPIKE IN BLOOD PRESSURE

1820
01:15:56,920 --> 01:15:58,200
IT HAS RESULTS. 

1821
01:15:58,200 --> 01:16:01,520
IS THERE ANYTHING WE COULD DO 

1822
01:16:01,520 --> 01:16:07,360
ABOUT THIS?  TO MANAGE BLOOD 

1823
01:16:07,360 --> 01:16:08,280
PRESSURE DIFFERENTLY?  

1824
01:16:08,280 --> 01:16:11,000
THIS IS A TRIAL I'M RUNNING 

1825
01:16:11,000 --> 01:16:13,720
FUNDED BY NHCID I'M EXCITED 

1826
01:16:13,720 --> 01:16:16,280
ABOUT AND EXCITE TODAY REPORT WE

1827
01:16:16,280 --> 01:16:17,440
ENROLLED FIRST PATIENT LAST 

1828
01:16:17,440 --> 01:16:20,880
THURSDAY AND REALLY EXCITING. 

1829
01:16:20,880 --> 01:16:24,840
PHASE 2 SMALL PILOT STUDY USING 

1830
01:16:24,840 --> 01:16:28,280
TECHNOLOGY THAT IS STICKERS ON 

1831
01:16:28,280 --> 01:16:30,280
HEAD THAT TELL SOMETHING ABOUT 

1832
01:16:30,280 --> 01:16:31,480
BLOOD FLOW AND CONTINUOUS BLOOD 

1833
01:16:31,480 --> 01:16:34,600
PRESSURE MONITORING NOT INVASIVE

1834
01:16:34,600 --> 01:16:37,560
WITH BLOOD PRESSURE CUFF YOU 

1835
01:16:37,560 --> 01:16:38,680
IDENTIFY TARGET BLOOD PRESSURE 

1836
01:16:38,680 --> 01:16:40,920
RANGE FOR THAT INDIVIDUAL PERSON

1837
01:16:40,920 --> 01:16:44,120
AT THAT MOMENT THAT IS WITHIN 

1838
01:16:44,120 --> 01:16:45,800
CEREBRAL AUTO REGULATORY 

1839
01:16:45,800 --> 01:16:47,000
[INDISCERNIBLE] AND IS THE GOAL 

1840
01:16:47,000 --> 01:16:48,440
WHAT WE WILL DO AND FIRST THAT 

1841
01:16:48,440 --> 01:16:51,520
IT IS SAFE TO DO THIS AND MANAGE

1842
01:16:51,520 --> 01:16:55,480
BLOOD PRESSURE THIS WAY AND 

1843
01:16:55,480 --> 01:16:57,800
SECOND TO SEE IF DIFFERENCE IN 

1844
01:16:57,800 --> 01:17:01,880
OUTCOMES AND TYPE OF WAYS THAT 

1845
01:17:01,880 --> 01:17:07,160
NEWER TECHNOLOGIES CAN HELP 

1846
01:17:07,160 --> 01:17:09,040
PREVENT STROKE AND NEXT SLIDE 

1847
01:17:09,040 --> 01:17:12,240
TAKING AWAY THIS IS A RARE AND 

1848
01:17:12,240 --> 01:17:14,640
CATASTROPHIC EVENT AND MOST BAD 

1849
01:17:14,640 --> 01:17:18,200
ONES OCCUR AT POSTPARTUM PERIOD 

1850
01:17:18,200 --> 01:17:19,560
AND HYPERTENSION ARE HIGHEST 

1851
01:17:19,560 --> 01:17:21,400
RISK WE COULD IDENTIFY PEOPLE 

1852
01:17:21,400 --> 01:17:24,000
PROBABLY AND PREVENT THESE IF WE

1853
01:17:24,000 --> 01:17:26,080
RECOGNIZE EARLY SIGNS AND THAT 

1854
01:17:26,080 --> 01:17:28,760
WE COULD PROBABLY MANAGE 

1855
01:17:28,760 --> 01:17:30,840
PEOPLE'S BLOOD PRESSURE IN 

1856
01:17:30,840 --> 01:17:32,280
DIFFERENT WAY RESULTING IN LESS 

1857
01:17:32,280 --> 01:17:34,440
NEUROLOGICAL AND WITH THAT I 

1858
01:17:34,440 --> 01:17:36,920
WILL STOP. 

1859
01:17:36,920 --> 01:17:44,720
NEXT SLIDE. 

1860
01:17:44,720 --> 01:17:48,840
>> HAPPY BIRTH DAY. 
GREAT.  

1861
01:17:48,840 --> 01:17:59,360
NEXT UP APOLOGIES GHADA FROM 

1862
01:18:01,200 --> 01:18:02,360
BROWN UNIVERSITY AND MIRIAM 

1863
01:18:02,360 --> 01:18:04,320
HOSPITAL. 

1864
01:18:04,320 --> 01:18:06,360
>> I WILL TALK ABOUT
SLEEP 

1865
01:18:06,360 --> 01:18:07,680
DISORDERED BREATHING AND 

1866
01:18:07,680 --> 01:18:10,400
FOCUSING ON IMPROVING SCREENING 

1867
01:18:10,400 --> 01:18:13,520
DIAGNOSIS AND MANAGEMENT. 

1868
01:18:13,520 --> 01:18:16,960
NEXT SLIDE.  

1869
01:18:16,960 --> 01:18:18,840
THESE ARE DISCLOSURES. 

1870
01:18:18,840 --> 01:18:19,280
NEXT SLIDE. 

1871
01:18:19,280 --> 01:18:23,560
LEFT SIDE, YOU CAN SEE A NORMAL 

1872
01:18:23,560 --> 01:18:25,560
AIRWAY THAT IS A QUICK OVERVIEW 

1873
01:18:25,560 --> 01:18:28,080
WHAT OBJECTIVE EVENTS WOULD LOOK

1874
01:18:28,080 --> 01:18:30,520
LIKE AND RIGHT SIDE YOU SEE 

1875
01:18:30,520 --> 01:18:31,880
OBSTRUCTION IN AIRWAY THAT COULD

1876
01:18:31,880 --> 01:18:35,480
HAPPEN AT ANY POINT IN HERE. 

1877
01:18:35,480 --> 01:18:36,280
NEXT SLIDE. 

1878
01:18:36,280 --> 01:18:39,880
WHAT THIS WILL RESULT IN IS 

1879
01:18:39,880 --> 01:18:43,440
THESE FLOW LIMITATION EVENTS 

1880
01:18:43,440 --> 01:18:45,520
ASSOCIATED WITH DROPS IN OXYGEN 

1881
01:18:45,520 --> 01:18:49,640
ASSOCIATION AND AROUSALS THAT WE

1882
01:18:49,640 --> 01:18:51,240
SEE ON THIS. 

1883
01:18:51,240 --> 01:18:53,440
NEXT SLIDE. 

1884
01:18:53,440 --> 01:18:55,400
OBJECTIVELY DEFINED SLEEP 

1885
01:18:55,400 --> 01:18:57,760
DISORDER BREATHING IS QUITE 

1886
01:18:57,760 --> 01:19:01,000
COMMON AND YOU SEE IT VARIES 

1887
01:19:01,000 --> 01:19:03,640
AMONG POPULATIONS AND LOW RISK 

1888
01:19:03,640 --> 01:19:07,520
POPULATIONS LIKE HERE AND EARLY 

1889
01:19:07,520 --> 01:19:09,320
PREGNANCY PREVALENCE OF SLEEP 

1890
01:19:09,320 --> 01:19:11,440
DISORDER BREATHING IS 5% OR SO 

1891
01:19:11,440 --> 01:19:14,480
AND LATER IN MID PREGNANCY IS 

1892
01:19:14,480 --> 01:19:16,320
ABOUT 9% WHEN WE START TO TALK 

1893
01:19:16,320 --> 01:19:17,960
ABOUT WOMEN WITH OBESITY OR 

1894
01:19:17,960 --> 01:19:20,600
WOMEN WITH GESTATIONAL DIABETES 

1895
01:19:20,600 --> 01:19:23,560
OR WOMEN WITH SMALL GESTATIONAL 

1896
01:19:23,560 --> 01:19:30,600
AGED BABIES YOU SEE PREVALENCE 

1897
01:19:30,600 --> 01:19:33,760
IS ELEVATED.  NEXT SLIDE. 

1898
01:19:33,760 --> 01:19:40,840
IT IS ASSOCIATED WITH ADVERSE 

1899
01:19:40,840 --> 01:19:41,400
[INDISCERNIBLE] AND SLEEP 

1900
01:19:41,400 --> 01:19:43,200
DISORDER BREATHING IN EARLY AND 

1901
01:19:43,200 --> 01:19:52,680
MID PREGNANCY IS ASSOCIATED WITH

1902
01:19:52,680 --> 01:19:54,640
TWO INCREASE AND NEXT SLIDE 

1903
01:19:54,640 --> 01:19:56,960
SIGNIFICANT ASSOCIATION WITH 

1904
01:19:56,960 --> 01:19:59,840
GESTATIONAL DIABETES AND DOSE 

1905
01:19:59,840 --> 01:20:01,120
RESPONSE RELATIONSHIP. 

1906
01:20:01,120 --> 01:20:02,800
NEXT SLIDE. 

1907
01:20:02,800 --> 01:20:05,640
POPULATION-BASED STUDIES AND 

1908
01:20:05,640 --> 01:20:07,400
NATIONAL STUDIES HAVE 

1909
01:20:07,400 --> 01:20:09,280
DEMONSTRATED SLEEP DISORDER 

1910
01:20:09,280 --> 01:20:11,640
BREATHING IS ASSOCIATED WITH 

1911
01:20:11,640 --> 01:20:16,880
CAUSES OF SEVERE MATERNAL 

1912
01:20:16,880 --> 01:20:27,160
MORBIDITY AND. 

1913
01:20:33,000 --> 01:20:37,000
HOPEFULLY WE CAN IMPACT THE 

1914
01:20:37,000 --> 01:20:42,280
EVENTS OF SEVERE MATERNAL 

1915
01:20:42,280 --> 01:20:45,960
MORBIDITY AND MORTALITY.  NEXT 

1916
01:20:45,960 --> 01:20:50,680
SLIDE.  GENERAL POPULATION 35% 

1917
01:20:50,680 --> 01:20:52,600
OF WOMEN SNORE AND TAKING 

1918
01:20:52,600 --> 01:20:54,920
SIMILAR POPULATIONS 90% OF WOMEN

1919
01:20:54,920 --> 01:20:57,200
END UP BEING DIAGNOSED WITH 

1920
01:20:57,200 --> 01:20:59,440
OBJECTIVELY DEFINED SLEEP 

1921
01:20:59,440 --> 01:21:01,320
DISORDER BREATHING AND 

1922
01:21:01,320 --> 01:21:03,040
PREDICTIVE TOOLS DEVELOPED 

1923
01:21:03,040 --> 01:21:06,200
OUTSIDE OF PREGNANCY PERFORMED 

1924
01:21:06,200 --> 01:21:07,840
INCONSISTENTLY IN PREGNANCY AND 

1925
01:21:07,840 --> 01:21:11,040
THOSE DEVELOPED IN PREGNANCY DO 

1926
01:21:11,040 --> 01:21:13,280
NOT SEEM TO PERFORM WELL IN HIGH

1927
01:21:13,280 --> 01:21:15,600
RISK PATIENTS AND STUDY LOOKING 

1928
01:21:15,600 --> 01:21:17,840
AT 8 DIFFERENT SCREENING TOOLS 

1929
01:21:17,840 --> 01:21:19,760
AND SEE SENSITIVITY AND 

1930
01:21:19,760 --> 01:21:22,320
SPECIFICITY IN EARLY AND LATE 

1931
01:21:22,320 --> 01:21:24,600
PREGNANCY IS NOT SO GREAT.  NEXT

1932
01:21:24,600 --> 01:21:24,840
SLIDE. 

1933
01:21:24,840 --> 01:21:26,880
REASON WHY THIS HAPPENS IS 

1934
01:21:26,880 --> 01:21:30,040
SCREENING QUESTIONNAIRE ISSUES 

1935
01:21:30,040 --> 01:21:32,680
AND POPULATION ISSUES AND 

1936
01:21:32,680 --> 01:21:35,080
DIAGNOSTIC TEST ISSUES LAND TALK

1937
01:21:35,080 --> 01:21:37,560
ABOUT DIAGNOSIS IN A BIT.  WE 

1938
01:21:37,560 --> 01:21:39,360
NEED BETTER OPPORTUNITIES AND 

1939
01:21:39,360 --> 01:21:43,720
TOOLS AND SLEEP MONITORING AND 

1940
01:21:43,720 --> 01:21:49,440
TRACKING MARKET IS 1.8 BILLION 

1941
01:21:49,440 --> 01:21:51,440
DOLLAR MARKET TO DOUBLE IN NEXT 

1942
01:21:51,440 --> 01:21:54,040
FEW YEARS AND ISSUE WE HAVE IS 

1943
01:21:54,040 --> 01:21:56,040
WEARABLES AND TECHNOLOGIES 

1944
01:21:56,040 --> 01:21:59,680
AVAILABLE ARE NOT CLOSELY MONTH 

1945
01:21:59,680 --> 01:22:03,760
N TORS ARE NOT REGULATED BY FDA 

1946
01:22:03,760 --> 01:22:05,600
AND PRESENT A GOOD OPPORTUNITY 

1947
01:22:05,600 --> 01:22:08,560
AND 35% OF WOMEN SNORE IN 

1948
01:22:08,560 --> 01:22:09,960
PREGNANCY AND NO ACCESS TO THEM 

1949
01:22:09,960 --> 01:22:12,400
WE CAN TRACK THEM USING SOME OF 

1950
01:22:12,400 --> 01:22:15,160
THESE AND NEED BETTER VALIDATION

1951
01:22:15,160 --> 01:22:16,800
AND MANY STUDIES ARE NOT 

1952
01:22:16,800 --> 01:22:18,800
VALIDATED OUTSIDE OF THE 

1953
01:22:18,800 --> 01:22:20,360
ORIGINAL COHORT WHEN THEY WERE 

1954
01:22:20,360 --> 01:22:24,160
DEVELOPED AND WE NEED TO WORK ON

1955
01:22:24,160 --> 01:22:27,160
THAT.  NEXT SLIDE.  

1956
01:22:27,160 --> 01:22:33,120
FROM A DIAGNOSTIC STANDPOINT, 

1957
01:22:33,120 --> 01:22:37,400
THAT IS THE APNEA AND HYPOXIA.  

1958
01:22:37,400 --> 01:22:41,240
NEXT.  WHETHER THAT APNEA HYPE 

1959
01:22:41,240 --> 01:22:44,360
OPNIA IS 5 EVENTS PER HOUR AND 

1960
01:22:44,360 --> 01:22:46,480
DEFINITION OF WHERE MILD SLEEP 

1961
01:22:46,480 --> 01:22:48,840
APNEA STARTS OR 15 EVENTS PER 

1962
01:22:48,840 --> 01:22:51,400
HOUR AND MEDICARE ALLOWS US TO 

1963
01:22:51,400 --> 01:22:53,120
STREET IF SOMEONE DOESN'T HAVE 

1964
01:22:53,120 --> 01:22:55,200
SYMPTOMS, NEXT.  OR WHETHER TO 

1965
01:22:55,200 --> 01:22:59,280
INCLUDE UPPER AIRWAY RESISTANCE 

1966
01:22:59,280 --> 01:23:02,680
OR SNORING IS LEFT TO BE 

1967
01:23:02,680 --> 01:23:04,280
DETERMINED AND WE DON'T KNOW 

1968
01:23:04,280 --> 01:23:07,520
WHERE TO DRAW THAT LINE TALKING 

1969
01:23:07,520 --> 01:23:09,920
ABOUT APNEA HYPE OP KNEE INDEX. 

1970
01:23:09,920 --> 01:23:12,520
NEXT SLIDE.  IT HAS BEEN 

1971
01:23:12,520 --> 01:23:13,760
CRITICIZED IN THE SECTION AND WE

1972
01:23:13,760 --> 01:23:16,120
COLLECT A TON OF DATA DURING A 

1973
01:23:16,120 --> 01:23:18,960
SLEEP STUDY AND WE CONDENSE ALL 

1974
01:23:18,960 --> 01:23:21,320
THESE DATA INTO ONE METRIC THAT 

1975
01:23:21,320 --> 01:23:25,800
IS APNEA AND HYPE OPNIA INDEX 

1976
01:23:25,800 --> 01:23:29,440
AND COUNT THEM AND DIVIDE BY 

1977
01:23:29,440 --> 01:23:31,840
TOTAL HOURS OF SLEEP AND LOOK AT

1978
01:23:31,840 --> 01:23:35,200
ANOTHER MARKER POST TRANSIT 

1979
01:23:35,200 --> 01:23:38,520
INDEX SURROGATE MARKER FOR 

1980
01:23:38,520 --> 01:23:41,400
PERIODIC ARTERIAL STIFF FENNING 

1981
01:23:41,400 --> 01:23:43,520
AND DROP HAPPENS AND ARTERIALS 

1982
01:23:43,520 --> 01:23:46,120
ARE STIFFENING AND WE TRY TO 

1983
01:23:46,120 --> 01:23:49,200
MEASURE THAT AND SAW THAT IN 

1984
01:23:49,200 --> 01:23:52,920
SNORERS HAVE APNEA HYPE OP KNEE 

1985
01:23:52,920 --> 01:23:54,840
INDEX -- HIGHER THAN IN CONTROLS

1986
01:23:54,840 --> 01:23:57,160
AND SAME HAPPENED IN SNORERS 

1987
01:23:57,160 --> 01:24:00,520
WITH APNEA HYPE OPNIA INDEX OVER

1988
01:24:00,520 --> 01:24:02,040
5 AND INTERESTING PIECE WAS THAT

1989
01:24:02,040 --> 01:24:04,640
WHEN WE LOOKED AT CATEGORIES OF 

1990
01:24:04,640 --> 01:24:07,640
POST TRANSIT TIME INDEX WE WERE 

1991
01:24:07,640 --> 01:24:10,520
ABLE TO SEE HIGHEST CATEGORY 

1992
01:24:10,520 --> 01:24:12,840
DEFINING 30 EVENTS PER HOUR AND 

1993
01:24:12,840 --> 01:24:15,280
VAST MAJORITY OF PAISHIENTS YOU 

1994
01:24:15,280 --> 01:24:18,280
SEE IN DARK BLUE DIDN'T MEET 

1995
01:24:18,280 --> 01:24:20,600
CRITERIA OR OBSTRUCTIVE APNEA 

1996
01:24:20,600 --> 01:24:23,480
AND HYPE OPNIA INDEX AND THERE 

1997
01:24:23,480 --> 01:24:29,320
IS PATHO BIOLOGY HAPPENING IN 

1998
01:24:29,320 --> 01:24:31,440
WOMEN AT RISK OR SNORING NOT 

1999
01:24:31,440 --> 01:24:33,640
CAPTURING THESE CRITERIA.  NEXT 

2000
01:24:33,640 --> 01:24:37,200
SLIDE.  PICTURE WHAT POLYSOM 

2001
01:24:37,200 --> 01:24:39,000
KNOW GRAM LOOKS LIKE YOU SEE 

2002
01:24:39,000 --> 01:24:41,520
TENS OF THOUSANDS OF DATA POINTS

2003
01:24:41,520 --> 01:24:44,200
WE COLLECT WITHIN 30 SECONDS OF 

2004
01:24:44,200 --> 01:24:45,320
MEASUREMENTS AND CONTINUE THEM 

2005
01:24:45,320 --> 01:24:47,640
IN ABOUT 6 TO 8 HOURS AND DURING

2006
01:24:47,640 --> 01:24:49,720
ENTIRE SLEEP AND RELYING ON 

2007
01:24:49,720 --> 01:24:51,680
HUMAN EYE TO DETECT PATTERNS AND

2008
01:24:51,680 --> 01:24:55,640
DEFINE ALL OF THE THINGS BY THAT

2009
01:24:55,640 --> 01:24:58,360
APNEA AND HYPE OP KNEE INDEX IS 

2010
01:24:58,360 --> 01:24:59,320
MISSING A HUGE OPPORTUNITY AND 

2011
01:24:59,320 --> 01:25:04,080
HAS TO BE BETTER WAYS BE IT 

2012
01:25:04,080 --> 01:25:07,000
MACHINE LEARNING AND DEEP NEURAL

2013
01:25:07,000 --> 01:25:09,360
NETWORKS LOOKING AT DATA POINTS 

2014
01:25:09,360 --> 01:25:11,360
DETECTING PATTERNS WE CAN'T 

2015
01:25:11,360 --> 01:25:13,560
DETECT AND PHENOTYPE WOMEN AND 

2016
01:25:13,560 --> 01:25:14,880
LINKING LOTS OF OUTCOMES TO 

2017
01:25:14,880 --> 01:25:16,840
OUTCOMES THAT MATTER TO US AND 

2018
01:25:16,840 --> 01:25:19,080
SEE WHETHER WE CAN PREDICT 

2019
01:25:19,080 --> 01:25:20,680
OUTCOMES LAND WE CAN TREAT THEM 

2020
01:25:20,680 --> 01:25:22,280
AND THAT IS SOMETHING THAT WE 

2021
01:25:22,280 --> 01:25:24,240
NEED TO STILL DO.  

2022
01:25:24,240 --> 01:25:25,160
NEXT SLIDE. 

2023
01:25:25,160 --> 01:25:27,520
TREATMENT IS ALSO COMPLICATED 

2024
01:25:27,520 --> 01:25:29,040
AND SO PREGNANT WOMEN ARE AMONG 

2025
01:25:29,040 --> 01:25:32,240
THE CATEGORY OF REPRODUCTIVE AGE

2026
01:25:32,240 --> 01:25:34,760
WOMEN THAT HAVE LOWEST ADHERENCE

2027
01:25:34,760 --> 01:25:38,160
TO CPAP THAT IS BEING GOLD 

2028
01:25:38,160 --> 01:25:40,040
STANDARD TREATMENT FOR SLEEP 

2029
01:25:40,040 --> 01:25:42,680
APNEA.  WHEN WE LOOKED AT SOME 

2030
01:25:42,680 --> 01:25:45,720
VERY FEW STUDIES LOOKING AT 

2031
01:25:45,720 --> 01:25:48,440
SLEEP APNEA ADHERENCE IS 50% OR 

2032
01:25:48,440 --> 01:25:50,120
SOME STUDIES IS SIGNIFICANTLY 

2033
01:25:50,120 --> 01:25:51,760
LOWER THAN THAT AND WE NEED TO 

2034
01:25:51,760 --> 01:25:53,960
DO BETTER THAN THAT AND GOT 

2035
01:25:53,960 --> 01:25:55,880
FUNDING FROM IMPROVE INITIATIVE 

2036
01:25:55,880 --> 01:25:59,160
TO LOOK AT QUALITATIVE DATA FROM

2037
01:25:59,160 --> 01:26:03,120
PREGNANT WOMEN INITIATED ON CPAP

2038
01:26:03,120 --> 01:26:05,120
DURING PREGNANCY AND SEE IN 

2039
01:26:05,120 --> 01:26:06,880
GREEN YOU SEE FACILITATORS AND 

2040
01:26:06,880 --> 01:26:08,520
LOTS OF THE WOMEN THAT WERE 

2041
01:26:08,520 --> 01:26:10,200
INTERESTED IN IMPROVING THEIR 

2042
01:26:10,200 --> 01:26:12,760
HEALTH AND HEALTH OF THEIR BABY 

2043
01:26:12,760 --> 01:26:16,640
THAT IS A DRIVING MOTIVATION FOR

2044
01:26:16,640 --> 01:26:18,120
CPAP AND YOU SEE THERE ARE LOTS 

2045
01:26:18,120 --> 01:26:19,840
OF BARRIERS THAT IS ANOTHER 

2046
01:26:19,840 --> 01:26:21,720
THING FOR WOMEN TO DO IF THEY 

2047
01:26:21,720 --> 01:26:25,000
HAVE GESTATIONAL DIABETES AND 

2048
01:26:25,000 --> 01:26:27,920
CHECKING BLOOD SUGAR TAKING 

2049
01:26:27,920 --> 01:26:28,840
INSULIN, ET CETERA.  ONE MORE 

2050
01:26:28,840 --> 01:26:30,920
THING TO DO BEFORE THEY GO TO 

2051
01:26:30,920 --> 01:26:33,480
BED.  SOME WOMEN SAID IT IS 

2052
01:26:33,480 --> 01:26:34,800
DISGUSTING AND POWER OF 

2053
01:26:34,800 --> 01:26:36,560
NARRATIVE WE TALKED ABOUT 

2054
01:26:36,560 --> 01:26:40,160
EARLIER AND WOMEN WERE CONCERNED

2055
01:26:40,160 --> 01:26:41,880
ABOUT INTIMACY DIDN'T WANT 

2056
01:26:41,880 --> 01:26:44,000
HUSBANDS OR PARTNERS TO SEE THEM

2057
01:26:44,000 --> 01:26:46,280
USING CPAP AND MANY WERE 

2058
01:26:46,280 --> 01:26:48,640
CONCERNED ABOUT BILLS AND COST 

2059
01:26:48,640 --> 01:26:50,760
OF THIS ESPECIALLY IF THE 

2060
01:26:50,760 --> 01:26:52,120
TREATMENT WAS ONLY COVERED 

2061
01:26:52,120 --> 01:26:54,360
DURING PREGNANCY AND NOT 

2062
01:26:54,360 --> 01:26:54,760
[INDISCERNIBLE]. 

2063
01:26:54,760 --> 01:26:55,600
NEXT SLIDE. 

2064
01:26:55,600 --> 01:26:58,160
SO, HOW CAN WE DO BETTER?  

2065
01:26:58,160 --> 01:27:00,720
WE NEED TO INCORPORATE EDUCATION

2066
01:27:00,720 --> 01:27:03,000
ABOUT SLEEP INTO PRENATAL CARE. 

2067
01:27:03,000 --> 01:27:06,880
IT IS A LOT TO EXPECT OF THE 

2068
01:27:06,880 --> 01:27:09,360
OBSTETRIC PROVIDERS AND HAS TO 

2069
01:27:09,360 --> 01:27:11,440
BE STANDARDIZED WAY TO TALK 

2070
01:27:11,440 --> 01:27:13,160
ABOUT SLEEP AND MAKE SURE WOMEN 

2071
01:27:13,160 --> 01:27:14,280
ARE HEARING MESSAGE AND WHETHER 

2072
01:27:14,280 --> 01:27:17,120
THAT HAPPENS DURING PRENATAL 

2073
01:27:17,120 --> 01:27:18,160
VISITS BECAUSE THOSE HAPPEN 

2074
01:27:18,160 --> 01:27:19,720
OFTEN OR WHETHER IT HAPPENS AS 

2075
01:27:19,720 --> 01:27:23,880
PART OF THE PRENATAL APPS THAT 

2076
01:27:23,880 --> 01:27:26,480
WOMEN MOSTLY NEW MOMS LOOK AT TO

2077
01:27:26,480 --> 01:27:28,480
SEE WHAT IS GOING ON WITH 

2078
01:27:28,480 --> 01:27:29,800
PREGNANCY THAT NEEDS TO BE 

2079
01:27:29,800 --> 01:27:31,360
DETERMINED OR WHETHER WE NEED TO

2080
01:27:31,360 --> 01:27:33,640
LOOK AT SOME ALTERNATIVE 

2081
01:27:33,640 --> 01:27:35,360
MEASURES AS WELL THAT LOOK AT 

2082
01:27:35,360 --> 01:27:37,640
AND IMPROVE SLEEP AND WE NEED TO

2083
01:27:37,640 --> 01:27:39,640
EXAMINE THAT AS WELL.  NEXT 

2084
01:27:39,640 --> 01:27:40,000
SLIDE. 

2085
01:27:40,000 --> 01:27:42,120
WE NEED TO HARNESS TECHNOLOGY TO

2086
01:27:42,120 --> 01:27:47,560
DO A BETTER JOB IN TERMS OF 

2087
01:27:47,560 --> 01:27:51,200
SCREENING TREATMENT AND 

2088
01:27:51,200 --> 01:27:55,120
DIAGNOSIS OF SLEEP APNEA AND 

2089
01:27:55,120 --> 01:27:56,840
REGULATE THOSE THINGS ON MARKET 

2090
01:27:56,840 --> 01:27:59,160
AND EDUCATION AND DIAGNOSIS AND 

2091
01:27:59,160 --> 01:28:01,200
SCREENING AND NEED TO MAKE SURE 

2092
01:28:01,200 --> 01:28:02,720
THAT INFORMATION IS VALIDATED IN

2093
01:28:02,720 --> 01:28:06,200
STUDIES PERFORMED BY SCIENTIFIC 

2094
01:28:06,200 --> 01:28:09,040
COMMUNITY AND HAVE TO BE 

2095
01:28:09,040 --> 01:28:11,120
PREPARED FOR HUGE INFLUX OF DATA

2096
01:28:11,120 --> 01:28:13,440
WE MIGHT HAVE WHEN WE START TO 

2097
01:28:13,440 --> 01:28:18,520
USE TECHNOLOGY AND SEE THAT IN 

2098
01:28:18,520 --> 01:28:20,680
ELECTRONIC HEALTH RECORDS SYSTEM

2099
01:28:20,680 --> 01:28:22,760
THAT COULD BE QUADRUPLED IN 

2100
01:28:22,760 --> 01:28:24,640
ISSUE AND SEEING THAT 

2101
01:28:24,640 --> 01:28:25,440
RECOMMENDATIONS ARE CULTURALLY 

2102
01:28:25,440 --> 01:28:26,800
APPROPRIATE BECAUSE THERE IS 

2103
01:28:26,800 --> 01:28:29,880
LOTS OF CULTURAL DIFFERENCES 

2104
01:28:29,880 --> 01:28:32,320
AROUND MOERJHOOD AND PREGNANCY 

2105
01:28:32,320 --> 01:28:34,400
AND MAKING SURE WE KEEP THEM IN 

2106
01:28:34,400 --> 01:28:36,720
MIND AND PATIENT EDUCATION IN 

2107
01:28:36,720 --> 01:28:37,920
MATERIALS OF THAT WE NEED 

2108
01:28:37,920 --> 01:28:40,000
EDUCATION ABOUT USING AND 

2109
01:28:40,000 --> 01:28:43,880
ADVISING ABOUT SLEEP AND SLEEP 

2110
01:28:43,880 --> 01:28:46,640
APNEA AND SLEEP DISORDER -- AND 

2111
01:28:46,640 --> 01:28:49,280
I DO THIS A LOT AND LOTS OF 

2112
01:28:49,280 --> 01:28:51,080
TIMES IT IS TOO MUCH INFORMATION

2113
01:28:51,080 --> 01:28:52,920
THAT I COULD NEVER COVER IN ONE 

2114
01:28:52,920 --> 01:28:54,960
VISIT AND IN TERMS OF 

2115
01:28:54,960 --> 01:28:57,600
PHARMACEUTICAL TRIALS WE DON'T 

2116
01:28:57,600 --> 01:28:59,080
REGULARLY TREAT SLEEP DISORDERED

2117
01:28:59,080 --> 01:29:01,400
BREATHING WITH TRIALS THAT THERE

2118
01:29:01,400 --> 01:29:04,640
ARE A FEW DRUGS BEING DEVELOPED 

2119
01:29:04,640 --> 01:29:09,360
AND HAVE TO ADVOCATE AGAINST 

2120
01:29:09,360 --> 01:29:12,400
SYSTEMATIC EXCLUSION OF 

2121
01:29:12,400 --> 01:29:12,840
[INDISCERNIBLE]. 

2122
01:29:12,840 --> 01:29:17,000
THANK YOU. 

2123
01:29:17,000 --> 01:29:20,120
>> THANK YOU.  FINAL
SPEAKER 

2124
01:29:20,120 --> 01:29:23,320
FOR SESSION IS LYDIA PECKER FROM

2125
01:29:23,320 --> 01:29:25,080
JOHNS HOPKINS MEDICINE. 

2126
01:29:25,080 --> 01:29:26,960
>> GOOD MORNING AND
PLEASURE TO

2127
01:29:26,960 --> 01:29:30,240
BE HERE WITH ALL OF YOU.  MY 

2128
01:29:30,240 --> 01:29:32,520
PLEASURE TO TALK ABOUT SICKLE 

2129
01:29:32,520 --> 01:29:35,480
CELL DISEASE WITH FIVE PANELISTS

2130
01:29:35,480 --> 01:29:38,560
WHO MIGHT BE NEW BEST FRIENDS TO

2131
01:29:38,560 --> 01:29:39,640
SICKLE CELL DISEASE AND THANKS 

2132
01:29:39,640 --> 01:29:41,440
FOR YOUR TALKS AND NEXT SLIDE 

2133
01:29:41,440 --> 01:29:43,120
THESE ARE MY DISCLOSURES AND 

2134
01:29:43,120 --> 01:29:44,520
NEXT SLIDE. 

2135
01:29:44,520 --> 01:29:46,720
I WILL GIVE A QUICK WALK THROUGH

2136
01:29:46,720 --> 01:29:48,920
SICKLE CELL DISEASE THAT IS 

2137
01:29:48,920 --> 01:29:50,960
AUTOSOMAL RECESSSIVE BLOOD 

2138
01:29:50,960 --> 01:29:52,120
DISORDERER AND GLOBALLY 3 

2139
01:29:52,120 --> 01:29:54,640
HUNDRED THOUSAND INUM NUMB 

2140
01:29:54,640 --> 01:29:56,800
BABIES BORN WITH SCD EACH YEAR 

2141
01:29:56,800 --> 01:29:58,440
AND IN THIS COUNTRY WE THINK 

2142
01:29:58,440 --> 01:30:01,040
ABOUT 1 HUNDRED THOUSAND INUM 

2143
01:30:01,040 --> 01:30:04,520
NUMB LIVE WITH SICKLE CELL 

2144
01:30:04,520 --> 01:30:08,920
DISEASE AND SURVIVAL INTO 

2145
01:30:08,920 --> 01:30:13,040
ADULTHOOD IS NEAR UNIVERSAL IN 

2146
01:30:13,040 --> 01:30:14,680
UNITED STATES AND -- ONE OF THE 

2147
01:30:14,680 --> 01:30:16,400
REASONS I'M HERE TODAY. 

2148
01:30:16,400 --> 01:30:19,400
THERE IS PERSISTENT HIGH 

2149
01:30:19,400 --> 01:30:20,440
MATERNAL MORBIDITY AND MORTALITY

2150
01:30:20,440 --> 01:30:22,320
FOR PEOPLE WITH SICKLE CELL 

2151
01:30:22,320 --> 01:30:24,320
DISEASE AND WANT TO MAKE 

2152
01:30:24,320 --> 01:30:26,120
SOMETHING CLEAR ABOUT WHO GETS 

2153
01:30:26,120 --> 01:30:28,600
SICKLE CELL DISEASE.  THIS IS A 

2154
01:30:28,600 --> 01:30:30,360
MAP OF DISTORTED PROJECTION 

2155
01:30:30,360 --> 01:30:31,360
WHERE PEOPLE WITH SICKLE CELL 

2156
01:30:31,360 --> 01:30:33,640
DISEASE ARE BORN IN THE WORLD 

2157
01:30:33,640 --> 01:30:36,040
AND HOPE YOU KNOW MOST BABIES 

2158
01:30:36,040 --> 01:30:38,520
WITH SICKLE CELL DISEASE ARE 

2159
01:30:38,520 --> 01:30:41,320
BORN IN SUB-SAHARAN AFRICA AND 

2160
01:30:41,320 --> 01:30:44,640
IN THE MIDDLE EAST AND INDIA AND

2161
01:30:44,640 --> 01:30:48,080
IT IS A HEALTH DISPARITY AND 

2162
01:30:48,080 --> 01:30:50,440
MOST THAT CAME HERE THEIR 

2163
01:30:50,440 --> 01:30:52,640
ANCESTORS CAME HERE WITH 

2164
01:30:52,640 --> 01:30:53,880
TRANSATLANTIC SLAVE TRADE OR 

2165
01:30:53,880 --> 01:30:57,640
FAMILIES MOVED HERE WITH NEW 

2166
01:30:57,640 --> 01:30:59,760
IMMIGRANT DIE ASS SPORAS AND 

2167
01:30:59,760 --> 01:31:02,760
PANEL OF PHYSIOLOGY OF SICKLE 

2168
01:31:02,760 --> 01:31:04,440
CELL DISEASE IS COMPLEX. 

2169
01:31:04,440 --> 01:31:09,040
IT INTERACTS WITH SICKLE CELL 

2170
01:31:09,040 --> 01:31:10,960
STRUCTURAL RACISM. 

2171
01:31:10,960 --> 01:31:14,040
YOU CAN I HOPE WALK THROUGH 

2172
01:31:14,040 --> 01:31:15,000
PATHOPHYSIOLOGY OF SICKLE CELL 

2173
01:31:15,000 --> 01:31:16,440
DISEASE YOU NEED TO KNOW ABOUT 

2174
01:31:16,440 --> 01:31:19,840
TO LEARN ABOUT HOW TO TREAT 

2175
01:31:19,840 --> 01:31:22,440
DISEASE IN -- THEY POLYMERIZE 

2176
01:31:22,440 --> 01:31:25,880
AND STICK TOGETHER AND GET 

2177
01:31:25,880 --> 01:31:29,160
STITCH AND LONG AND CAUSE 

2178
01:31:29,160 --> 01:31:32,520
VASCULAR -- IT LEADS TO 

2179
01:31:32,520 --> 01:31:33,800
DOWNSTREAM END ORGAN INJURY AND 

2180
01:31:33,800 --> 01:31:35,520
LOTS OF WHAT COLLEAGUES HAVE 

2181
01:31:35,520 --> 01:31:37,600
TALKED ABOUT IS REVELLENT FOR 

2182
01:31:37,600 --> 01:31:39,400
SICKLE CELL DISEASE AND TO 

2183
01:31:39,400 --> 01:31:41,960
HIGHLIGHT A FEW PLACES THAT ARE 

2184
01:31:41,960 --> 01:31:43,280
PARTICULARLY RELEVANT IN 

2185
01:31:43,280 --> 01:31:45,320
PREGNANCY AND BRAIN AND HEART 

2186
01:31:45,320 --> 01:31:47,320
AND LUNGS AND KIDNEYS AND 

2187
01:31:47,320 --> 01:31:52,640
OVARIES AND PLACENTA AND FETUS 

2188
01:31:52,640 --> 01:31:55,440
ARE -- PATHOPHYSIOLOGIES OF 

2189
01:31:55,440 --> 01:31:57,120
SICKLE CELL DISEASE IN PREG 

2190
01:31:57,120 --> 01:31:59,080
NANNY AND ANEMIA BECOMES 

2191
01:31:59,080 --> 01:32:01,200
MATERNAL ANEMIA AND THOSE IN 

2192
01:32:01,200 --> 01:32:02,080
AUDIENCE ARE FAMILIAR WITH 

2193
01:32:02,080 --> 01:32:03,920
SIGNIFICANCE OF THAT DIAGNOSIS 

2194
01:32:03,920 --> 01:32:07,840
AND BASAL ACOLLUSION IN PLACENTA

2195
01:32:07,840 --> 01:32:10,960
LEADS TO PLACENTAL INJURY AND 

2196
01:32:10,960 --> 01:32:13,480
EFFECT SICKLE CELL PREGNANCIES 

2197
01:32:13,480 --> 01:32:16,000
EXPANDING BLOOD VOLUMES PUTS 

2198
01:32:16,000 --> 01:32:17,000
ADDITIONAL STRESS ON ALREADY 

2199
01:32:17,000 --> 01:32:18,560
STRESSED SYSTEM AND PRONLEST 

2200
01:32:18,560 --> 01:32:22,840
TROEN LEADS TO PULMONARY 

2201
01:32:22,840 --> 01:32:24,240
VASCULAR RESISTANCE RISK FOR 

2202
01:32:24,240 --> 01:32:27,240
HYPERTENSION AND LEADING TO 

2203
01:32:27,240 --> 01:32:28,040
FURTHER ELEVATED RISK OF BLOOD 

2204
01:32:28,040 --> 01:32:29,920
CLOT THAT IS HIGH FOR PEOPLE 

2205
01:32:29,920 --> 01:32:32,120
WITH SICKLE CELL DISEASE AND 

2206
01:32:32,120 --> 01:32:35,520
EXPANDING UTERUS EVERYBODY THAT 

2207
01:32:35,520 --> 01:32:41,120
IS PREGNANT -- I JUST PUT THIS 

2208
01:32:41,120 --> 01:32:43,520
AND ALMOST UNBEARABLE MECHANISMS

2209
01:32:43,520 --> 01:32:45,640
IN SICKLE CELL DISEASE FOR YOU 

2210
01:32:45,640 --> 01:32:48,040
TO LOOK AT STUDIES FOR IT IS 

2211
01:32:48,040 --> 01:32:49,800
LEADING TO HOPE FOR US AND THREE

2212
01:32:49,800 --> 01:32:53,440
NEW DRUGS FDA APPROVED FOR THE 

2213
01:32:53,440 --> 01:32:54,760
DISEASE IN LAST FOUR YEARS AND 

2214
01:32:54,760 --> 01:32:58,920
HOPE MORE ARE ON THE WAY.  NEXT 

2215
01:32:58,920 --> 01:33:01,840
SLIDE. 

2216
01:33:01,840 --> 01:33:05,800
THERE IS AT PRESENT ONE 

2217
01:33:05,800 --> 01:33:08,760
TREATMENT FOR SICKLE CELL 

2218
01:33:08,760 --> 01:33:11,440
DISEASE AND PREGNANCY AND THAT 

2219
01:33:11,440 --> 01:33:12,520
IS BLOOD. 

2220
01:33:12,520 --> 01:33:14,680
GRIM SITUATION AND UNITED STATES

2221
01:33:14,680 --> 01:33:17,680
PRACTICE AT JOHNS HOPKINS -- 

2222
01:33:17,680 --> 01:33:20,760
THAT SHOWED TRANSFUSIONS WAS 

2223
01:33:20,760 --> 01:33:23,480
ASSOCIATED WITH REDUCED STAFF 

2224
01:33:23,480 --> 01:33:26,800
PAIN PULMONARY COMPLICATIONS 

2225
01:33:26,800 --> 01:33:29,040
PRETERM BIRTH AND DOWNSTREAM 

2226
01:33:29,040 --> 01:33:30,320
IMPLICATIONS OF TREATMENT HAVE 

2227
01:33:30,320 --> 01:33:32,240
NOT BEEN EXPLORED AND REDUCTION 

2228
01:33:32,240 --> 01:33:34,040
IN PAIN CRISIS WOULD BE 

2229
01:33:34,040 --> 01:33:35,800
ASSOCIATED WITH DECREASED RISK 

2230
01:33:35,800 --> 01:33:37,480
AND OPIOID EXPOSURE TO MOTHER 

2231
01:33:37,480 --> 01:33:40,080
AND FETUS AND WHEN WE CONSTITUTE

2232
01:33:40,080 --> 01:33:42,200
REDUCED RISK OF VOC FOR 

2233
01:33:42,200 --> 01:33:44,200
TRANSFUSIONS WITH PREGNANT 

2234
01:33:44,200 --> 01:33:45,680
PEOPLE WITH SICKLE CELL DISEASE 

2235
01:33:45,680 --> 01:33:47,600
WE DON'T TALK ABOUT THAT. 

2236
01:33:47,600 --> 01:33:49,600
ANY CASE JOHNS HOPKINS WE TAKE 

2237
01:33:49,600 --> 01:33:52,280
POSITION THAT IT IS A HIGH RISK 

2238
01:33:52,280 --> 01:33:53,720
STATE AND TRANSFUSE EVERYBODY 

2239
01:33:53,720 --> 01:33:55,360
WITH SS AND [INDISCERNIBLE] THAT

2240
01:33:55,360 --> 01:33:59,040
ARE MOST SEVERE FORMS OF SICKLE 

2241
01:33:59,040 --> 01:34:02,880
CELL DISEASE AND HOPEFULLY 

2242
01:34:02,880 --> 01:34:05,360
STATISTICS WILL HELP TELL YOU 

2243
01:34:05,360 --> 01:34:07,840
WHY.  NEXT SLIDE.  SOON TO BE 

2244
01:34:07,840 --> 01:34:10,280
DOCTOR NEXT WEEK.  PUT TOGETHER 

2245
01:34:10,280 --> 01:34:12,280
DATA FROM NATIONAL IN PATIENT 

2246
01:34:12,280 --> 01:34:14,160
SAMPLE RECENT FORMULAITION OF 

2247
01:34:14,160 --> 01:34:19,520
DATA 2012 TO 2018 LIST OF CDC 

2248
01:34:19,520 --> 01:34:21,320
SEVERE MATERNAL MORBIDITY AND 

2249
01:34:21,320 --> 01:34:23,080
INDEX AND ORIENTING YOU TO SLIDE

2250
01:34:23,080 --> 01:34:25,560
YOU SEE LABELS FOR SM QUALITIES 

2251
01:34:25,560 --> 01:34:30,160
AND MEASURES AND ONE ON THIS IS 

2252
01:34:30,160 --> 01:34:33,840
A NONBLACK PATIENT POPULATION IN

2253
01:34:33,840 --> 01:34:35,880
THE UNITED STATES PURPLE IS 

2254
01:34:35,880 --> 01:34:37,360
RISKS FOR BLACK IN THIS COUNTRY 

2255
01:34:37,360 --> 01:34:40,040
AND ORANGE AND RED ARE RISKS IN 

2256
01:34:40,040 --> 01:34:42,320
SICKLE CELL DISEASE AND HOPE YOU

2257
01:34:42,320 --> 01:34:45,480
SEE WITHOUT MUCH EFFORT 

2258
01:34:45,480 --> 01:34:46,800
CATASTROPHIC RISK OF SEVERE 

2259
01:34:46,800 --> 01:34:49,760
MORBIDITY AND OUTCOMES IF IN 

2260
01:34:49,760 --> 01:34:52,120
SICKLE CELL DISEASE AND STROKE 

2261
01:34:52,120 --> 01:34:55,120
AND PREECOLLAPSIA AND 

2262
01:34:55,120 --> 01:34:56,840
COLLAPSINGIA AND THESE RISKS 

2263
01:34:56,840 --> 01:35:00,760
EFFECT FETUS AND IUGR INCREASED 

2264
01:35:00,760 --> 01:35:03,520
WITH WOMEN WITH SICKLE CELL 

2265
01:35:03,520 --> 01:35:05,720
DISEASE AND EFFECTS ON FETUS 

2266
01:35:05,720 --> 01:35:07,280
WHEN BECOMING CHILDREN AND GROW 

2267
01:35:07,280 --> 01:35:09,400
UP IS ONE STUDY LOOKING AT 

2268
01:35:09,400 --> 01:35:10,680
DEVELOPMENTAL OUTCOMES AND 

2269
01:35:10,680 --> 01:35:12,240
CHILDREN BORN TO WOMEN WITH 

2270
01:35:12,240 --> 01:35:13,320
SICKLE CELL DISEASE AND THINK 

2271
01:35:13,320 --> 01:35:14,760
THAT POPULATION EXPOSED TO 

2272
01:35:14,760 --> 01:35:17,160
MULTIPLE DRULGS AND ALSO WITH 

2273
01:35:17,160 --> 01:35:20,480
NEAR UNIVERSAL MATERNAL ANEMIA 

2274
01:35:20,480 --> 01:35:24,160
AND IUGR COMPLETELY CONSIDERED 

2275
01:35:24,160 --> 01:35:27,640
RISKS FOR ADVERSE DEVELOPMENTAL 

2276
01:35:27,640 --> 01:35:29,440
OUTCOMES FOR THOSE WOMEN.  NEXT 

2277
01:35:29,440 --> 01:35:30,240
SLIDE, PLEASE. 

2278
01:35:30,240 --> 01:35:33,000
LAST 12 MONTHS TWO PAPERS ONE 

2279
01:35:33,000 --> 01:35:35,760
FROM LARGE CALIFORNIA DATABASE 

2280
01:35:35,760 --> 01:35:39,160
AND IN-PATIENT SAMPLE DRAWING 

2281
01:35:39,160 --> 01:35:41,000
SAME CONCLUSION AND PREGNANT 

2282
01:35:41,000 --> 01:35:43,520
PEOPLE WITH SICKLE CELL DISEASE 

2283
01:35:43,520 --> 01:35:44,680
IS STAGNANT FOR OVER THREE 

2284
01:35:44,680 --> 01:35:46,480
DECADES IN THE UNITED STATES. 

2285
01:35:46,480 --> 01:35:47,640
NEXT SLIDE, PLEASE. 

2286
01:35:47,640 --> 01:35:49,440
AS A CONSEQUENCE, THERE IS A 

2287
01:35:49,440 --> 01:35:51,800
NEED TO SYSTEMATICALLY INCLUDE 

2288
01:35:51,800 --> 01:35:53,360
PEOPLE WITH SICKLE CELL DISEASE 

2289
01:35:53,360 --> 01:35:55,400
WHEN DEVELOPING POLICY SOLUTIONS

2290
01:35:55,400 --> 01:35:57,120
AND CLINICAL INTERVENTIONS AND 

2291
01:35:57,120 --> 01:35:59,400
RESEARCH INNOVATIONS TO IMPROVE 

2292
01:35:59,400 --> 01:36:02,520
MAT TERN AM FETAL HEALTH. 

2293
01:36:02,520 --> 01:36:04,240
I HAVE A FEW THOUGHTS I WOULD 

2294
01:36:04,240 --> 01:36:06,560
LIKE TO SHARE WITH YOU IN THIS 

2295
01:36:06,560 --> 01:36:08,120
NEARLY WIDE OPENED FIELD FOR 

2296
01:36:08,120 --> 01:36:10,800
WHAT INNOVATIONS MIGHT REACH OUR

2297
01:36:10,800 --> 01:36:12,400
PATIENTS INTERESTING STUDY DONE 

2298
01:36:12,400 --> 01:36:14,440
BY COLLEAGUES IN BRAZIL LOOKING 

2299
01:36:14,440 --> 01:36:19,120
AT METHYLATION PATTERNS IN 

2300
01:36:19,120 --> 01:36:19,640
PLACENTAS. 

2301
01:36:19,640 --> 01:36:20,840
VEXING QUESTION IS WHY PEOPLE 

2302
01:36:20,840 --> 01:36:23,240
WITH SS AND [INDISCERNIBLE] ARE 

2303
01:36:23,240 --> 01:36:25,360
SEVERE FORMS OF SICKLE CELL AND 

2304
01:36:25,360 --> 01:36:28,200
S BETA PLUS THAT ARE CONSIDERED 

2305
01:36:28,200 --> 01:36:29,880
MILDER FORMS OF SICKLE CELL AND 

2306
01:36:29,880 --> 01:36:32,280
WHY TWO DISEASES LOOK SIMILAR IN

2307
01:36:32,280 --> 01:36:33,920
PREGNANCY AND I WAS INTRIGUED TO

2308
01:36:33,920 --> 01:36:35,800
NOTE AND HOPE YOU CAN SEE IT TOO

2309
01:36:35,800 --> 01:36:39,160
THAT SS AND SC PATIENTS 

2310
01:36:39,160 --> 01:36:40,320
METHYLATION PATTERNS LOOK 

2311
01:36:40,320 --> 01:36:44,120
SIMILAR AND ARE MARKERS OF 

2312
01:36:44,120 --> 01:36:46,480
HYPOXIA AND INFLAMMATION IN 

2313
01:36:46,480 --> 01:36:48,000
PLACENTA OF PATIENTS OPPORTUNITY

2314
01:36:48,000 --> 01:36:50,840
TO DEFINE DISEASE PATHOLOGY AND 

2315
01:36:50,840 --> 01:36:55,040
DEFINE SIMILARITIES ACROSS 

2316
01:36:55,040 --> 01:36:57,760
GENOTYPES.  NEXT SLIDE, PLEASE. 

2317
01:36:57,760 --> 01:37:00,400
NEW DIAGNOSTIC TEST CLEO 

2318
01:37:00,400 --> 01:37:02,000
CERTIFIED DON'T KNOW HOW MANY 

2319
01:37:02,000 --> 01:37:04,320
ARE USING IT GREAT TO ME 

2320
01:37:04,320 --> 01:37:07,800
INVASIVE PRENATAL TEST FOR 

2321
01:37:07,800 --> 01:37:09,720
SICKLE CELL DISEASE -- THIS IS 

2322
01:37:09,720 --> 01:37:12,080
THE KIND OF DIAGNOSTIC TOOL THAT

2323
01:37:12,080 --> 01:37:13,800
WOULD BE USEFUL NOT JUST FOR 

2324
01:37:13,800 --> 01:37:15,160
PEOPLE WITH SICKLE CELL DISEASE 

2325
01:37:15,160 --> 01:37:19,000
BUT THOSE AT RISK HAVING A CHILD

2326
01:37:19,000 --> 01:37:20,600
[INDISCERNIBLE] DISEASE AND HOPE

2327
01:37:20,600 --> 01:37:25,360
BY NEXT TIME THIS MEETING 

2328
01:37:25,360 --> 01:37:27,520
RECONVENES THAT COUNSELING IS 

2329
01:37:27,520 --> 01:37:29,520
REACHING FAMILIES TO ELECT AND 

2330
01:37:29,520 --> 01:37:32,200
HAVE TEST ON NEXT SLIDE, PLEASE.

2331
01:37:32,200 --> 01:37:35,160
DESPERATELYINOVATIONS AND SICKLE

2332
01:37:35,160 --> 01:37:36,960
CELL DISEASE TREATMENT NO 

2333
01:37:36,960 --> 01:37:38,320
TREATMENTS FOR SICKLE CELL 

2334
01:37:38,320 --> 01:37:40,000
DISEASE THAT HAVE BEEN STUDIED 

2335
01:37:40,000 --> 01:37:41,840
IN TRIALS AND EVER BEING STUDIED

2336
01:37:41,840 --> 01:37:44,320
FOR PREGNANT PEOPLE WITH SICKLE 

2337
01:37:44,320 --> 01:37:46,480
CELL DISEASE AND NEED 

2338
01:37:46,480 --> 01:37:48,520
PARTNERSHIP FROM TOXICOLOGY 

2339
01:37:48,520 --> 01:37:50,200
FOLKS NHLBI AND OTHERS TO 

2340
01:37:50,200 --> 01:37:51,880
ADVANCE THIS AND THIS IS GOING 

2341
01:37:51,880 --> 01:37:54,600
TO TAKE INNOVATIVE DESIGN AND 

2342
01:37:54,600 --> 01:37:56,840
RESEARCH COLLEAGUES AND HIV HAVE

2343
01:37:56,840 --> 01:37:58,040
LED WAY PARTNERING WITH PEOPLE 

2344
01:37:58,040 --> 01:38:00,040
TO DEFINE WHAT RISKS PREGNANT 

2345
01:38:00,040 --> 01:38:01,080
PEOPLE ARE WILLING TO ASSUME TO 

2346
01:38:01,080 --> 01:38:03,880
BE TREATED THAT IS NOT JUST 

2347
01:38:03,880 --> 01:38:05,840
RESEARCH IN PHARMACOLOGICAL 

2348
01:38:05,840 --> 01:38:07,680
RESEARCH NEEDED BUT NOVEL 

2349
01:38:07,680 --> 01:38:09,720
FORMULATION HOW WE PARTNER WITH 

2350
01:38:09,720 --> 01:38:11,280
PATIENTS MOVING CARE FORWARD.  

2351
01:38:11,280 --> 01:38:12,480
NEXT SLIDE, PLEASE. 

2352
01:38:12,480 --> 01:38:14,640
WEINOVATIONS AND DATA 

2353
01:38:14,640 --> 01:38:16,160
COLLECTIONS AND SOME THINGS ARE 

2354
01:38:16,160 --> 01:38:18,400
HAPPENING AND CDC COLLECTS DATA 

2355
01:38:18,400 --> 01:38:20,760
IN SEVERAL STATES IN COUNTRY 

2356
01:38:20,760 --> 01:38:22,600
SICKLE CELL DISEASE OUTCOMES WE 

2357
01:38:22,600 --> 01:38:24,600
NEED TO EXPAND SURVEILLANCE TO 

2358
01:38:24,600 --> 01:38:26,120
UNDERSTAND SICKLE CELL MORE 

2359
01:38:26,120 --> 01:38:28,760
BROADLY AND DON'T COLLECT DATA 

2360
01:38:28,760 --> 01:38:30,920
ON IN VITRO FERT WILLIZIZATION 

2361
01:38:30,920 --> 01:38:32,640
FOR SICKLE CELL DISEASE IN THE 

2362
01:38:32,640 --> 01:38:34,000
COUNTRY UNCLEAR WHETHER PEOPLE 

2363
01:38:34,000 --> 01:38:36,680
USE THIS PREVENTIVE APPROACH 

2364
01:38:36,680 --> 01:38:39,560
HAVING CHILD WITH SICKLE CELL 

2365
01:38:39,560 --> 01:38:41,480
DISEASE AND START OF CDC HAVE 

2366
01:38:41,480 --> 01:38:42,600
OPPORTUNITIES TO COLLECT DATA 

2367
01:38:42,600 --> 01:38:45,720
AND HOPE THAT TOOLS THAT ARE IN 

2368
01:38:45,720 --> 01:38:46,560
PHOENIX TOOLKIT YOU CAN CHECK 

2369
01:38:46,560 --> 01:38:48,320
OUT BEING DEVELOPED NOW TO 

2370
01:38:48,320 --> 01:38:50,360
MEASURE OUTCOMES PREGNANT PEOPLE

2371
01:38:50,360 --> 01:38:52,560
WITH SICKLE CELL DISEASE CAN BE 

2372
01:38:52,560 --> 01:38:56,440
USED TO DEVELOP THINGS LIKE RISK

2373
01:38:56,440 --> 01:38:58,760
PREVENTION TOOLS AND WAY -- HIGH

2374
01:38:58,760 --> 01:39:01,640
RISK PREGNANCY SITUATION.  NEXT 

2375
01:39:01,640 --> 01:39:02,600
SLIDE, PLEASE. 

2376
01:39:02,600 --> 01:39:04,640
WE NEED INNOVATIONS AND CLINICAL

2377
01:39:04,640 --> 01:39:07,560
AND AT HOME MONITORING DISEASE 

2378
01:39:07,560 --> 01:39:08,680
CHARACTERIZED BY [INDISCERNIBLE]

2379
01:39:08,680 --> 01:39:09,840
HALLMARK SYMPTOM AND DISEASE 

2380
01:39:09,840 --> 01:39:12,520
THAT IS DEFINED BY LOTS OF 

2381
01:39:12,520 --> 01:39:14,480
THROMBOSIS IN A PARTICULARLY IN 

2382
01:39:14,480 --> 01:39:17,160
PREGNANCY AND ALL KINDS OF AT 

2383
01:39:17,160 --> 01:39:18,520
HOME MONITORING AND SURVEILLANCE

2384
01:39:18,520 --> 01:39:21,120
PORE PATIENTS WOULD BE WELCOME 

2385
01:39:21,120 --> 01:39:22,920
MAKING TRIPS TO HOSPITAL AND ANY

2386
01:39:22,920 --> 01:39:25,720
COULD BE AVOIDED WITH AT HOME 

2387
01:39:25,720 --> 01:39:26,960
MONITORING THAT COULD BE GREAT. 

2388
01:39:26,960 --> 01:39:28,160
NEXT SLIDE, PLEASE. 

2389
01:39:28,160 --> 01:39:31,560
WEINOVATIONS AND CARE DELIVERY 

2390
01:39:31,560 --> 01:39:34,080
AND FAVORITE MAPS OF CARE 

2391
01:39:34,080 --> 01:39:34,840
DISTRIBUTION IN THE UNITED 

2392
01:39:34,840 --> 01:39:37,440
STATES AND OUTCOMES DIFFERENT 

2393
01:39:37,440 --> 01:39:38,880
FAVORITE AND STAIR AT THEM A 

2394
01:39:38,880 --> 01:39:42,000
MINUTE OVERLAYING YOUR FAVORITE 

2395
01:39:42,000 --> 01:39:43,880
MAP AND DISTRIBUTION A IS SICKLE

2396
01:39:43,880 --> 01:39:46,080
CELL IN THIS DISEASE AND 

2397
01:39:46,080 --> 01:39:47,200
DISTRIBUTION OF SICKLE CELL CARE

2398
01:39:47,200 --> 01:39:49,800
AND OTHER SIDE OF THE MAP IS 

2399
01:39:49,800 --> 01:39:50,960
DISTRIBUTION OF MATERNITY CARE 

2400
01:39:50,960 --> 01:39:53,880
AND HOPE YOU SEE OVERLAP BETWEEN

2401
01:39:53,880 --> 01:39:55,560
MATERNITY CARE DESERTS WHERE 

2402
01:39:55,560 --> 01:39:56,920
PEOPLE WITH SICKLE CELL DISEASE 

2403
01:39:56,920 --> 01:39:58,760
LIVE AND YOU CAN'T SEE ON MAP 

2404
01:39:58,760 --> 01:40:00,360
HOW MANY PEOPLE EXIST TO TAKE 

2405
01:40:00,360 --> 01:40:02,360
CARE OF PEOPLE WITH SICKLE CELL 

2406
01:40:02,360 --> 01:40:04,040
DISEASE HAS TO BE UNDERSTOOD AS 

2407
01:40:04,040 --> 01:40:06,960
PART OF DISPARITY TRANSFORMING 

2408
01:40:06,960 --> 01:40:08,880
OUTCOMES FOR PEOPLE WITH SICKLE 

2409
01:40:08,880 --> 01:40:10,560
CELL DISEASE AND WROTE DOWN.  I 

2410
01:40:10,560 --> 01:40:13,720
WANT TO GET IT RIGHT. 

2411
01:40:13,720 --> 01:40:17,680
THERE ARE 140 CENTERS TO CARE 

2412
01:40:17,680 --> 01:40:19,720
FOR 330,000 PEOPLE WITH 

2413
01:40:19,720 --> 01:40:21,600
HEMOFEELIA IN THE COUNTRY.  THEY

2414
01:40:21,600 --> 01:40:27,120
ARE FEDERALLY REGISTERED AND 280

2415
01:40:27,120 --> 01:40:29,680
CENTERS TO CARE FOR PEOPLE WITH 

2416
01:40:29,680 --> 01:40:32,760
CYSTIC FIBROSIS IN THE COUNTRY 

2417
01:40:32,760 --> 01:40:35,520
AND -- SO, KU NOT SEE THAT IN 

2418
01:40:35,520 --> 01:40:37,600
THIS LAYOUT OF MAPS AND OF 

2419
01:40:37,600 --> 01:40:39,600
COURSE THIS NEEDS TO CHANGE IF 

2420
01:40:39,600 --> 01:40:42,160
WE CHANGE OUTCOMES FOR PATIENT 

2421
01:40:42,160 --> 01:40:42,600
POPULATION. 

2422
01:40:42,600 --> 01:40:44,200
NEXT SLIDE, PLEASE. 

2423
01:40:44,200 --> 01:40:46,560
FINALLY, WE NEED INNOVATION AND 

2424
01:40:46,560 --> 01:40:49,440
PROBLEM FORMULATION AND LAST 

2425
01:40:49,440 --> 01:40:50,680
DECEMBER MATERNAL FETAL MEDICINE

2426
01:40:50,680 --> 01:40:54,680
DOCTOR LOOKING AT FAMOUS STAMP 

2427
01:40:54,680 --> 01:40:56,920
CELEBRATE AGO RIFLE OF SICKLE 

2428
01:40:56,920 --> 01:40:58,080
CELL DISEASE AND MOST PEOPLE 

2429
01:40:58,080 --> 01:41:00,760
LOOK AT THIS AND SEE THAT BABE 

2430
01:41:00,760 --> 01:41:03,520
IS UNIVERSALLY SCREENED FOR 

2431
01:41:03,520 --> 01:41:05,360
SICKLE CELL DISEASE DIDN'T OCCUR

2432
01:41:05,360 --> 01:41:07,080
TO ME BABY WAS [INDISCERNIBLE] 

2433
01:41:07,080 --> 01:41:09,480
FOR SICKLE CELL DISEASE AND NEED

2434
01:41:09,480 --> 01:41:11,600
THESE MULTI-DISCIPLINARY FORUMS 

2435
01:41:11,600 --> 01:41:13,640
TO MOVE FORWARD FOR PEOPLE WITH 

2436
01:41:13,640 --> 01:41:17,000
SICKLE CELL DISEASE AND OVENGSS 

2437
01:41:17,000 --> 01:41:21,000
WE MAKE IN MULTI-DISCIPLINARY 

2438
01:41:21,000 --> 01:41:22,480
COLLABORATIONS -- JOHNS HOPKINS 

2439
01:41:22,480 --> 01:41:27,600
LOOKING AT DATA MULTIDISCIPLINE 

2440
01:41:27,600 --> 01:41:29,640
COLLABORATIVE CARING FOR 

2441
01:41:29,640 --> 01:41:32,240
PREGNANT WOMEN WITH SICKLE CELL 

2442
01:41:32,240 --> 01:41:34,200
DISEASE -- IN OVER 20 YEARS AND 

2443
01:41:34,200 --> 01:41:36,800
SO IT SEEMS IT IS TIME TO ALSO 

2444
01:41:36,800 --> 01:41:38,360
CHANGE OUR PROBLEM FORMULATION 

2445
01:41:38,360 --> 01:41:39,800
ABOUT WHETHER THIS SHOULD BE A 

2446
01:41:39,800 --> 01:41:42,360
DISEASE THAT IS ASSOCIATED WITH 

2447
01:41:42,360 --> 01:41:45,560
INCREASED MATERNAL MORTALITY AT 

2448
01:41:45,560 --> 01:41:47,760
ALL OR PROBLEM OF CARE STRUCTURE

2449
01:41:47,760 --> 01:41:50,440
AND AABILITY TO DELIVER 

2450
01:41:50,440 --> 01:41:52,080
COMPREHENSIVE CARE FOR SICKLE 

2451
01:41:52,080 --> 01:41:54,120
CELL DISEASE.  NEXT SLIDE, 

2452
01:41:54,120 --> 01:41:54,440
PLEASE. 

2453
01:41:54,440 --> 01:41:56,440
IN CONCLUSION THERE IS URGENT 

2454
01:41:56,440 --> 01:41:58,080
NEED FOR EXISTING TECHNOLOGIES 

2455
01:41:58,080 --> 01:41:59,920
TO BE BROUGHT TO WOMEN WITH 

2456
01:41:59,920 --> 01:42:01,480
SICKLE CELL DISEASE AND ALL 

2457
01:42:01,480 --> 01:42:02,680
PEOPLE WITH SICKLE CELL DISEASE 

2458
01:42:02,680 --> 01:42:04,640
AND THINGS EXISTING FOR MY 

2459
01:42:04,640 --> 01:42:05,920
COMMUNITY ARE NOT REACHING 

2460
01:42:05,920 --> 01:42:08,160
PEOPLE WITH THIS DISEASE AND FOR

2461
01:42:08,160 --> 01:42:10,000
EXAMPLE ULTRASOUND TECHNOLOGY 

2462
01:42:10,000 --> 01:42:11,680
IDENTIFYING CHILDREN WITH 

2463
01:42:11,680 --> 01:42:12,800
INCREASED RISK OF STROKE WE 

2464
01:42:12,800 --> 01:42:14,640
HAVEN'T BEEN ABLE TO DELIVER ON 

2465
01:42:14,640 --> 01:42:16,680
THAT FOR EVERY CHILD LIVING WITH

2466
01:42:16,680 --> 01:42:18,000
SICKLE CELL DISEASE IN THE 

2467
01:42:18,000 --> 01:42:19,240
UNITED STATES AND THINKING OF 

2468
01:42:19,240 --> 01:42:24,600
KINDS OF INTERVENTIONS TO REACH 

2469
01:42:24,600 --> 01:42:26,160
PREGNANT PEOPLE WITH SICKLE CELL

2470
01:42:26,160 --> 01:42:28,240
DISEASE AND NEW TECHNOLOGIES ARE

2471
01:42:28,240 --> 01:42:30,160
NOT DEVELOPED BUT CAN REACH 

2472
01:42:30,160 --> 01:42:31,400
PEOPLE WHO NEED THEM MOST. 

2473
01:42:31,400 --> 01:42:32,680
NEXT SLIDE, PLEASE. 

2474
01:42:32,680 --> 01:42:34,920
THIS IS JUST 10 MINUTES. 

2475
01:42:34,920 --> 01:42:37,560
WE HAVE A WHOLE DAY DEDICATED TO

2476
01:42:37,560 --> 01:42:39,200
SICKLE CELL DISEASE PREGNANCY 

2477
01:42:39,200 --> 01:42:40,960
THIS FRIDAY ON THIS STAGE I 

2478
01:42:40,960 --> 01:42:42,960
BELIEVE.  WE ARE HAVING A 

2479
01:42:42,960 --> 01:42:44,320
CONFERENCE THURSDAY AND FRIDAY 

2480
01:42:44,320 --> 01:42:46,040
THAT IS A HYBRID MEETING SHOULD 

2481
01:42:46,040 --> 01:42:48,040
BE TERRIFIC AND YOU ARE INVITED 

2482
01:42:48,040 --> 01:42:49,000
TO JOIN US. 

2483
01:42:49,000 --> 01:42:52,720
THANK YOU SO MUCH FOR YOUR 

2484
01:42:52,720 --> 01:42:55,600
TIME. 

2485
01:42:55,600 --> 01:42:58,600
>> I WANT TO THANK
SPEAKERS FOR

2486
01:42:58,600 --> 01:43:00,440
INFORMATIVE LECTURES AND FOR 

2487
01:43:00,440 --> 01:43:01,640
SETTING THE STAGE FOR THE 

2488
01:43:01,640 --> 01:43:04,800
DISCUSSION REALLY WE HAVE JUST 

2489
01:43:04,800 --> 01:43:07,480
SCRATCHED THE SURFACE WITH A FEW

2490
01:43:07,480 --> 01:43:08,880
COGNITIONS THAT INCREASE 

2491
01:43:08,880 --> 01:43:10,320
MATERNAL HEALTH MORBIDITY AND 

2492
01:43:10,320 --> 01:43:12,360
ARE LOOKING FORWARD TO 

2493
01:43:12,360 --> 01:43:12,680
DISCUSSION. 

2494
01:43:12,680 --> 01:43:14,920
WHILE PEOPLE ARE COMING TO THE 

2495
01:43:14,920 --> 01:43:17,840
MICROPHONES OR WE ARE GATHERING 

2496
01:43:17,840 --> 01:43:22,000
THE QUESTIONS FROM ONLINE, I 

2497
01:43:22,000 --> 01:43:24,640
WANT TO WISH DR. MILLER HAPPY 

2498
01:43:24,640 --> 01:43:27,920
BIRTH DAY AND ASK HER THE FIRST 

2499
01:43:27,920 --> 01:43:28,200
QUESTION. 

2500
01:43:28,200 --> 01:43:32,040
ARE THERE ANY TECHNOLOGIES OR 

2501
01:43:32,040 --> 01:43:35,720
ANY APPROACHES NOT EVEN WITHOUT 

2502
01:43:35,720 --> 01:43:38,720
TECHNOLOGY TO DETERMINE AUTO 

2503
01:43:38,720 --> 01:43:40,280
REGULATION IN EACH PATIENT?  

2504
01:43:40,280 --> 01:43:44,320
IS IT DONE IN NONPREGNANT 

2505
01:43:44,320 --> 01:43:45,360
INDIVIDUALS?  

2506
01:43:45,360 --> 01:43:47,240
HOW?  

2507
01:43:47,240 --> 01:43:49,000
>> THANK YOU FOR THE
QUESTION 

2508
01:43:49,000 --> 01:43:50,680
AND BIRTH DAY WISHES.  I 

2509
01:43:50,680 --> 01:43:53,360
APPRECIATE IT.  LOTS OF DIFB 

2510
01:43:53,360 --> 01:43:56,800
WAYS TO MEASURE CEREBRAL AUTO 

2511
01:43:56,800 --> 01:43:58,000
REGULATION SOME ARE INVASIVE AND

2512
01:43:58,000 --> 01:44:01,320
I'M INTERESTED IN NON-INVASIVE 

2513
01:44:01,320 --> 01:44:03,760
WAYS ONE WAY IS TRANSCRANIAL 

2514
01:44:03,760 --> 01:44:06,040
DOPPLER THAW ARE ELUDING TO I 

2515
01:44:06,040 --> 01:44:08,400
BELIEVE AND SAME TYPE OF ULTRA 

2516
01:44:08,400 --> 01:44:10,120
SOUND WE USE IT ALL TIME IN 

2517
01:44:10,120 --> 01:44:13,080
SICKLE CELL KIDS THAT IS VERY 

2518
01:44:13,080 --> 01:44:17,040
EASY BEDSIDE ULTRASOUND 

2519
01:44:17,040 --> 01:44:19,720
PROCEDURE IF YOU MEASURE 

2520
01:44:19,720 --> 01:44:22,840
TRANSCRANIAL DOPPLAR BASED 

2521
01:44:22,840 --> 01:44:25,320
CEREBRAL BLOOD FLOW VELOCITY 

2522
01:44:25,320 --> 01:44:26,760
ALONG WITH CONTINUOUS BLOOD 

2523
01:44:26,760 --> 01:44:28,800
PRESSURE MONITORING WITH FINGER 

2524
01:44:28,800 --> 01:44:31,400
[INDISCERNIBLE] AND DON'T NEED 

2525
01:44:31,400 --> 01:44:33,160
ARTERIAL LINING WITH 

2526
01:44:33,160 --> 01:44:35,280
NON-INVASIVE YOU CAN CALCULATE 

2527
01:44:35,280 --> 01:44:37,640
REGULATION ON SIMULTANEOUS 

2528
01:44:37,640 --> 01:44:40,400
SIGNAL STREAMS AND NEAR INFRARED

2529
01:44:40,400 --> 01:44:41,640
SPECTROSCOPY I'M USING FOR THAT 

2530
01:44:41,640 --> 01:44:44,840
TRIAL THAT IS A LITTLE BIT -- 

2531
01:44:44,840 --> 01:44:49,040
THEY BOTH HAVE PROS AND CONS AND

2532
01:44:49,040 --> 01:44:50,760
NEAREST DATA IS NOISIER AND YOU 

2533
01:44:50,760 --> 01:44:53,240
NEED MORE DATA TO GET MORE 

2534
01:44:53,240 --> 01:44:55,280
ACCURATE RESULTS AND 

2535
01:44:55,280 --> 01:44:56,920
TRANSCRANIAL DOPPLAR YOU NEED 

2536
01:44:56,920 --> 01:44:58,600
GOOD ULTRA SOUND TECH AND NOT 

2537
01:44:58,600 --> 01:45:00,600
MANY PEOPLE KNOW HOW TO DO IT. 

2538
01:45:00,600 --> 01:45:04,520
MACHINES ARE, YOU KNOW, 

2539
01:45:04,520 --> 01:45:05,840
EXPENSIVE AND YOU NEED COMPANIES

2540
01:45:05,840 --> 01:45:09,840
TO KIND OF GET ON BOARD TO HELP 

2541
01:45:09,840 --> 01:45:12,600
DEVELOP TOOLS AND AS ONE EXAMPLE

2542
01:45:12,600 --> 01:45:17,280
IN POSTPARTUM POPULATION WE ARE 

2543
01:45:17,280 --> 01:45:18,400
DOG LITTLE TRIAL WE HAVE 

2544
01:45:18,400 --> 01:45:22,640
MODIFICATION AND WHOLE THING IS 

2545
01:45:22,640 --> 01:45:26,240
UNCOMFORTABLE AND IF ON 

2546
01:45:26,240 --> 01:45:33,280
MAGNESIUM PEOPLE ARE STICKY AND 

2547
01:45:33,280 --> 01:45:35,640
TAKING INTO ACCOUNT THIS WILL BE

2548
01:45:35,640 --> 01:45:37,280
KEY. 

2549
01:45:37,280 --> 01:45:38,640
>> THANK YOU.  YES.  

2550
01:45:38,640 --> 01:45:41,800
>> HI.  GOOD MORNING
CHELSEA 

2551
01:45:41,800 --> 01:45:45,520
FROM GET WELL AND WOULD LIKE TO 

2552
01:45:45,520 --> 01:45:47,640
SAY PRESENTATION FROM HOPKINS 

2553
01:45:47,640 --> 01:45:49,840
THANK YOU FOR YOUR ATTENTION TO 

2554
01:45:49,840 --> 01:45:52,440
YOUR SPECIFIC POPULATION THAT IS

2555
01:45:52,440 --> 01:45:53,880
IMPACTED BY SICKLE CELL AND TO 

2556
01:45:53,880 --> 01:45:56,680
THE REST OF THE PANELISTS I 

2557
01:45:56,680 --> 01:45:58,200
WOULD ASK WE ARE HERE TO TALK 

2558
01:45:58,200 --> 01:46:01,240
ABOUT INNOVATIONS TO ADDRESS 

2559
01:46:01,240 --> 01:46:03,960
MATERNAL HEALTH CARE AND KNOW 

2560
01:46:03,960 --> 01:46:05,520
DEFICIENCIES IN MATERNAL HEALTH 

2561
01:46:05,520 --> 01:46:07,680
CARE ARE IMPACTING BLACK AND 

2562
01:46:07,680 --> 01:46:09,480
BROWN BIRTHING PERSONS AND TO 

2563
01:46:09,480 --> 01:46:12,400
THE REST I WOULD SAY FABULOUS 

2564
01:46:12,400 --> 01:46:14,440
PRESENTATIONS WHAT IS WORK TO BE

2565
01:46:14,440 --> 01:46:18,120
DONE TO ENGAGE BLACK AND BROWN 

2566
01:46:18,120 --> 01:46:20,440
BIRTHING PERSONS IN AREAS 

2567
01:46:20,440 --> 01:46:23,480
SPECIFICALLY TO HYPERTENSION 

2568
01:46:23,480 --> 01:46:25,320
CONVERSATION AND PREECOLLAPSIA 

2569
01:46:25,320 --> 01:46:26,880
AND SLEEP APNEA AND 

2570
01:46:26,880 --> 01:46:28,880
UNDERSTANDING HOW TO GO ABOUT IN

2571
01:46:28,880 --> 01:46:30,840
RESEARCH WORKING WITH 

2572
01:46:30,840 --> 01:46:32,920
POPULATIONS THAT ARE MOSTLY 

2573
01:46:32,920 --> 01:46:34,720
UNDERSERVED IN PARTICULAR AREAS.

2574
01:46:34,720 --> 01:46:35,520
THANK YOU. 

2575
01:46:35,520 --> 01:46:40,800
>> THANK YOU SO MUCH. 

2576
01:46:40,800 --> 01:46:44,160
DO YOU HAVE A QUESTION?  

2577
01:46:44,160 --> 01:46:47,200
>> >> YES. 
SIMILARLY, I 

2578
01:46:47,200 --> 01:46:49,400
WANTED TO THANK YOU ALL.  

2579
01:46:49,400 --> 01:46:51,800
THIS -- 

2580
01:46:51,800 --> 01:46:54,880
>> GO AHEAD. 

2581
01:46:54,880 --> 01:46:57,000
>> THIS IS A REALLY GOOD
POINT.

2582
01:46:57,000 --> 01:47:00,200
WITH 10 MINUTES, IT IS HARD TO 

2583
01:47:00,200 --> 01:47:03,720
COVER ALL WE NEED TO DO. 

2584
01:47:03,720 --> 01:47:07,400
BLACK WOMEN HAVE WORSE SLEEP 

2585
01:47:07,400 --> 01:47:09,320
SYMPTOMS THAN WOMEN THAT ARE NOT

2586
01:47:09,320 --> 01:47:11,000
BLACK AND DATA THAT HAS LOOKED 

2587
01:47:11,000 --> 01:47:15,080
AT THEM THERE IS A LOT OF 

2588
01:47:15,080 --> 01:47:16,120
DISCREPANCIES AND BLACK PEOPLE 

2589
01:47:16,120 --> 01:47:20,080
IN GENERAL MIGHT HAVE LOWER 

2590
01:47:20,080 --> 01:47:21,720
ADHERENCE AND ACCESS TO CARE 

2591
01:47:21,720 --> 01:47:27,400
MIGHT BE HARDER ISSUE WE HAVE TO

2592
01:47:27,400 --> 01:47:31,360
GO EXAMINE OVENGSS AND 

2593
01:47:31,360 --> 01:47:33,640
[INDISCERNIBLE] MIGHT BE HIGHER 

2594
01:47:33,640 --> 01:47:35,040
IN BLACK INDIVIDUALS THAT ARE 

2595
01:47:35,040 --> 01:47:36,360
PRESENT AND DON'T HAVE DATA ON 

2596
01:47:36,360 --> 01:47:39,680
THAT AND NEED TO BETTER 

2597
01:47:39,680 --> 01:47:42,280
UNDERSTAND THAT. 

2598
01:47:42,280 --> 01:47:44,360
THERE IS NEED TO ADDRESS THAT IN

2599
01:47:44,360 --> 01:47:46,360
BLACK AND BROWN POPULATIONS ON 

2600
01:47:46,360 --> 01:47:48,560
SO MANY DIFFERENT LEVELS AND 

2601
01:47:48,560 --> 01:47:55,520
THIS IS ONE FOCUS FOR 

2602
01:47:55,520 --> 01:47:57,120
QUALITATIVE DATA AND COMPARING 

2603
01:47:57,120 --> 01:47:58,960
DATA FROM BLACK INDIVIDUALS TO 

2604
01:47:58,960 --> 01:48:01,760
NONBLACK INDIVIDUALS TO SEE IF 

2605
01:48:01,760 --> 01:48:04,120
THESE THINGS ARE DIFFERENT. 

2606
01:48:04,120 --> 01:48:06,120
WE DON'T HAVE FUNDING YET AND MY

2607
01:48:06,120 --> 01:48:08,120
NEXT PROJECT IS GOING TO FOCUS 

2608
01:48:08,120 --> 01:48:13,680
ON THAT POPULATION AS WELL.  

2609
01:48:13,680 --> 01:48:14,960
YOUR POINT IS WELL TAKEN AND 

2610
01:48:14,960 --> 01:48:16,760
THERE IS A NEED FOR THAT. 

2611
01:48:16,760 --> 01:48:19,160
>> SYSTEMATIC CLINICAL 

2612
01:48:19,160 --> 01:48:21,080
INVESTIGATIONS STANDPOINT HAS TO

2613
01:48:21,080 --> 01:48:22,680
BE WORK TO INCLUDE POPULATIONS 

2614
01:48:22,680 --> 01:48:23,680
THAT ARE REPRESENTATIVE OF THE 

2615
01:48:23,680 --> 01:48:25,600
DISEASE AND ALL OF THE STUDIES 

2616
01:48:25,600 --> 01:48:27,600
AND WE HAVE TO BE INCLUDING 

2617
01:48:27,600 --> 01:48:30,000
BLACK WOMEN IN STUDIES AND 

2618
01:48:30,000 --> 01:48:31,040
[INDISCERNIBLE] HAD AND I DIDN'T

2619
01:48:31,040 --> 01:48:33,160
LOOK AT NUMBER THIS MORNING BUT 

2620
01:48:33,160 --> 01:48:35,320
WAS 30 TO 40% BLACK POPULATION 

2621
01:48:35,320 --> 01:48:37,360
INCLUDED IN THE STUDY THAT IS A 

2622
01:48:37,360 --> 01:48:38,960
HUGE ACCOMPLISHMENT FOR US AND 

2623
01:48:38,960 --> 01:48:41,120
ONE THING WE PUT A FOCUS ON 

2624
01:48:41,120 --> 01:48:43,400
MAKING SURE THAT WE WERE 

2625
01:48:43,400 --> 01:48:45,080
ENROLLING IN DIVERSE POPULATIONS

2626
01:48:45,080 --> 01:48:47,720
AND THINK THAT IS A SYSTEMATIC 

2627
01:48:47,720 --> 01:48:49,520
EFFORT IN ALL CLINICAL TRIALS. 

2628
01:48:49,520 --> 01:48:54,360
>> I WILL JUST ADD ON 

2629
01:48:54,360 --> 01:48:55,360
PREECOLLAPSIA BIOMARKER MOVING 

2630
01:48:55,360 --> 01:48:56,960
FORWARD WITH IS SOMETHING WE 

2631
01:48:56,960 --> 01:48:59,200
DISCUSSED INCLUSION OF AFRICAN 

2632
01:48:59,200 --> 01:49:00,800
AMERICAN WOMEN IN THE COHORTS 

2633
01:49:00,800 --> 01:49:02,680
AND ONE -- THERE ARE DATA AROUND

2634
01:49:02,680 --> 01:49:06,040
THE BIOMARKERS IN EUROPE AND 

2635
01:49:06,040 --> 01:49:07,280
ASIA; RIGHT?  

2636
01:49:07,280 --> 01:49:09,120
A REASON TO QUALIFY THESE IN THE

2637
01:49:09,120 --> 01:49:10,880
UNITED STATES IS TO GET RACIALLY

2638
01:49:10,880 --> 01:49:12,240
DIVERSE POPULATIONS THAT IS 

2639
01:49:12,240 --> 01:49:14,080
SOMETHING THAT WE LOOKED AT 

2640
01:49:14,080 --> 01:49:15,840
PULLING TOGETHER COHORTS AND WE 

2641
01:49:15,840 --> 01:49:17,720
WOULD BE ABLE TO STUDY TO MAKE 

2642
01:49:17,720 --> 01:49:20,720
SURE THEY ARE HIGH ENRICHED FOR 

2643
01:49:20,720 --> 01:49:22,720
AFRICAN AMERICAN PREGNANCIES AND

2644
01:49:22,720 --> 01:49:24,760
OTHER GROUPS AS WELL.  I THINK 

2645
01:49:24,760 --> 01:49:26,960
WITH NIH HAT ON THIS IS ANOTHER 

2646
01:49:26,960 --> 01:49:28,920
REASON TO PUSH FOR INCLUSION IN 

2647
01:49:28,920 --> 01:49:31,160
ALL CLINICAL TRIALS AND STUDIES 

2648
01:49:31,160 --> 01:49:33,960
WE CONDUCT AT NIH THAT IS 

2649
01:49:33,960 --> 01:49:35,400
DEFINITELY VERY CLEAR THAT 

2650
01:49:35,400 --> 01:49:38,120
AFRICAN AMERICANS AND OTHER 

2651
01:49:38,120 --> 01:49:40,120
ETHNIC MINORITIES ARE NOT 

2652
01:49:40,120 --> 01:49:41,520
REPRESENTED WELL IN ENTIRE 

2653
01:49:41,520 --> 01:49:44,080
CLINICAL RESEARCH ENDEAVOR AND 

2654
01:49:44,080 --> 01:49:46,640
CONSIDERING GLOBAL RELIANCE ON 

2655
01:49:46,640 --> 01:49:49,040
US-PRODUCED DATA THAT IS MORE 

2656
01:49:49,040 --> 01:49:50,840
GLARING WE NEED TO DO THIS NOT 

2657
01:49:50,840 --> 01:49:53,120
JUST FOR THE UNITED STATES BUT 

2658
01:49:53,120 --> 01:49:57,080
FOR GLOBAL HEALTH AS WELL. 

2659
01:49:57,080 --> 01:50:03,960
>> >> THANK YOU. 
I'M 

2660
01:50:03,960 --> 01:50:06,280
CHRISTINE FROM THE UNIVERSITY OF

2661
01:50:06,280 --> 01:50:09,400
NORNL CAROLINA CHAPEL HILL AND 

2662
01:50:09,400 --> 01:50:11,440
QUESTION WAS TO APPLAUD YOU FOR 

2663
01:50:11,440 --> 01:50:12,880
EXCITING INNOVATION AND 

2664
01:50:12,880 --> 01:50:14,440
DISCOVERY AND DIAGNOSIS IN 

2665
01:50:14,440 --> 01:50:14,760
TREATMENT. 

2666
01:50:14,760 --> 01:50:18,080
I WONDERED IF YOU WOULD SHARE 

2667
01:50:18,080 --> 01:50:21,320
YOUR THOUGHTS ON STRUCTURAL 

2668
01:50:21,320 --> 01:50:24,240
REFORMS NEEDS TO ACCOMMODATE. 

2669
01:50:24,240 --> 01:50:26,520
DR. PECKER I ALSO -- YOU SAID 

2670
01:50:26,520 --> 01:50:30,360
PROBLEM IS INABILITY TO CARE FOR

2671
01:50:30,360 --> 01:50:32,200
PEOPLE. 

2672
01:50:32,200 --> 01:50:34,480
SIMILARLY NOT ONLY INCLUSION BUT

2673
01:50:34,480 --> 01:50:38,600
SYSTEM COULD BE ACCOMMODATING.  

2674
01:50:38,600 --> 01:50:39,520
THANK YOU.  

2675
01:50:39,520 --> 01:50:43,600
>> THANK YOU FOR
QUESTION.  

2676
01:50:43,600 --> 01:50:52,400
NICE YOU COME FROM UNC AND 

2677
01:50:52,400 --> 01:50:53,680
COMPREHENSIVE SICKLE CELL CENTER

2678
01:50:53,680 --> 01:50:58,920
AT UNIVERSITY OF NORNL CAROLINA 

2679
01:50:58,920 --> 01:51:01,320
ONE WAY TO -- THERE IS ONE KIND 

2680
01:51:01,320 --> 01:51:02,960
OF INNOVATION FOR YOU AND 

2681
01:51:02,960 --> 01:51:13,520
LETTING PANELISTS TAKE A SHOT.  

2682
01:51:25,160 --> 01:51:29,760
>> I THINK FROM A
PRACTICE 

2683
01:51:29,760 --> 01:51:31,680
PERSPECTIVE THOSE THAT HAVE NEUR

2684
01:51:31,680 --> 01:51:36,240
LOGIC COMPLICATIONS AND 

2685
01:51:36,240 --> 01:51:39,560
NEUROVASCULAR COMPLICATIONS THAT

2686
01:51:39,560 --> 01:51:41,280
IS IMBEDDED IN CENTER MOTHER 

2687
01:51:41,280 --> 01:51:43,840
CENTER IN COLUMBIA THAT IS A 

2688
01:51:43,840 --> 01:51:46,160
MEDICAL HOME FOR HIGH-RISK 

2689
01:51:46,160 --> 01:51:47,960
PREGNANCY AND THINK THAT IS 

2690
01:51:47,960 --> 01:51:49,200
REALLY HELPFUL.  

2691
01:51:49,200 --> 01:51:50,920
MY OFFICE IS THERE RIGHT NEXT TO

2692
01:51:50,920 --> 01:51:54,000
THE OFFICE OF MFMS AND PEOPLE 

2693
01:51:54,000 --> 01:51:55,000
CAN SEE US BOTH. 

2694
01:51:55,000 --> 01:51:59,480
IT MAKES IT EASIER TO PROVIDE 

2695
01:51:59,480 --> 01:52:01,880
COORDINATED COMPREHENSIVE CARE 

2696
01:52:01,880 --> 01:52:05,240
FOR HIGH-RISK PATIENTS. 

2697
01:52:05,240 --> 01:52:08,160
>> FROM A SYSTEMATIC
STANDPOINT

2698
01:52:08,160 --> 01:52:09,880
PROBLEM IS HUGE.  IT STARTS WITH

2699
01:52:09,880 --> 01:52:13,840
WE ARE TALKING ABOUT PREGNANCY 

2700
01:52:13,840 --> 01:52:14,800
COMPLICATIONS AND ACTUALLY 

2701
01:52:14,800 --> 01:52:16,720
STARTS PRIOR TO PREGNANCY AND IS

2702
01:52:16,720 --> 01:52:21,600
HELPFUL TO ME AS MATERNAL FETAL 

2703
01:52:21,600 --> 01:52:23,000
MEDICINE AND -- BLOOD PRESSURE 

2704
01:52:23,000 --> 01:52:25,360
OF 180 OVER 110 AND HAVING CARE 

2705
01:52:25,360 --> 01:52:27,920
AND ACCESS TO CARE AND UNIVERSAL

2706
01:52:27,920 --> 01:52:29,760
ACCESS TO CARE OUTSIDE OF 

2707
01:52:29,760 --> 01:52:31,680
PREGNANCY THROUGHOUT PREGNANCY 

2708
01:52:31,680 --> 01:52:35,080
CENTERS OF EXCELLENCE ARE 

2709
01:52:35,080 --> 01:52:38,200
WONDERFUL RESOURCES AND I'M 

2710
01:52:38,200 --> 01:52:41,320
HAPPY TO BE PART OF THEM AND 

2711
01:52:41,320 --> 01:52:42,080
MATERNAL MORTALITY IS HAPPENING 

2712
01:52:42,080 --> 01:52:45,560
WHERE CENTERS ARE NOT AND 

2713
01:52:45,560 --> 01:52:48,960
DESERTS AND MATERNITY CARE 

2714
01:52:48,960 --> 01:52:50,720
DESERTS AND HOW DO WE GET THIS 

2715
01:52:50,720 --> 01:52:52,080
LEVEL OF EXCELLENT CARE OUT TO 

2716
01:52:52,080 --> 01:52:54,400
THESE OTHER COMMUNITIES?  

2717
01:52:54,400 --> 01:52:56,400
>> I WILL ADD TO BUILD TO
THE 

2718
01:52:56,400 --> 01:52:58,000
COMMENT THAT IS ONE THING THAT I

2719
01:52:58,000 --> 01:52:59,440
THINK HOPEFULLY WE CAN TALK 

2720
01:52:59,440 --> 01:53:03,480
ABOUT TODAY IN TERMS OF DEVISES 

2721
01:53:03,480 --> 01:53:07,080
AND TECHNOLOGIES AND HOW WE GET 

2722
01:53:07,080 --> 01:53:09,480
CARE TO DELIVER IN ACADEMIC 

2723
01:53:09,480 --> 01:53:12,720
MEDICAL CENTERS OUT TO HEALTH 

2724
01:53:12,720 --> 01:53:16,840
CARE DESERTS AND INDIVIDUALS IN 

2725
01:53:16,840 --> 01:53:17,720
SOCIOECONOMIC STATUS THAT THEY 

2726
01:53:17,720 --> 01:53:19,520
CAN'T AFORWARD TO TAKE 2 OR 

2727
01:53:19,520 --> 01:53:21,680
THREE DAYS OWE OF TO GO FOR 

2728
01:53:21,680 --> 01:53:23,120
CLINICAL TRIAL AND STUDY AND 

2729
01:53:23,120 --> 01:53:26,880
THOSE PRESSURES AND GETTING 

2730
01:53:26,880 --> 01:53:31,520
TECHNOLOGY AND MEASURES OUT TO 

2731
01:53:31,520 --> 01:53:38,680
TH

2732
01:53:38,680 --> 01:53:38,880
THEM. 

2733
01:53:38,880 --> 01:53:41,120
>> WE HAVE TO CHANGE
STRUCTURES

2734
01:53:41,120 --> 01:53:44,640
TO PANEL AND UNDERRESTED IN 

2735
01:53:44,640 --> 01:53:46,520
MEDICINE AND YOUNG PEOPLE IN 

2736
01:53:46,520 --> 01:53:48,440
PIPELINES SO PATIENTS ARE SEEING

2737
01:53:48,440 --> 01:53:50,000
PEOPLE WHO LOOK LIKE THEM AND 

2738
01:53:50,000 --> 01:53:53,840
CARE FOR THEM AT EVERY LEVEL OF 

2739
01:53:53,840 --> 01:53:54,560
THE SYSTEM.  

2740
01:53:54,560 --> 01:53:58,920
>> >> WE HAVE
QUESTIONS 

2741
01:53:58,920 --> 01:53:59,240
ONLINE. 

2742
01:53:59,240 --> 01:54:01,600
>> YEAH.  I SEE A LOT OF 

2743
01:54:01,600 --> 01:54:03,080
QUESTIONS ON THE FLOOR AND THERE

2744
01:54:03,080 --> 01:54:05,400
IS A LOT ABOUT TECHNOLOGY THAT 

2745
01:54:05,400 --> 01:54:06,720
SPECIFICALLY IS REFERRING TO 

2746
01:54:06,720 --> 01:54:10,840
BLOOD PRESSURE MEASUREMENT AND 

2747
01:54:10,840 --> 01:54:13,480
DEVICE IF YOU KNOW THAT THEY ARE

2748
01:54:13,480 --> 01:54:16,640
SAYING THOSE DEVICE ARE NOT 

2749
01:54:16,640 --> 01:54:19,720
CALIBRATED FOR PREGNANT WOMEN 

2750
01:54:19,720 --> 01:54:20,840
AND ANYONE THAT HAS ANY ANSWER 

2751
01:54:20,840 --> 01:54:23,040
ABOUT HOW WE REALLY SEE THOSE 

2752
01:54:23,040 --> 01:54:27,040
BLOOD PRESSURE MEASUREMENTS 

2753
01:54:27,040 --> 01:54:29,880
BEING ACCURATE. 

2754
01:54:29,880 --> 01:54:33,200
>> YEAH.  THIS GOES BACK
TO 

2755
01:54:33,200 --> 01:54:34,680
INCLUDING PREGNANT WOMEN AT -- 

2756
01:54:34,680 --> 01:54:38,000
IN ALL THESE STUDIES OF THESE 

2757
01:54:38,000 --> 01:54:42,680
NEW MEDICATIONS AND SPEAKER HERE

2758
01:54:42,680 --> 01:54:45,680
THERE IS FOUR NEW MEDICATIONS 

2759
01:54:45,680 --> 01:54:49,560
AND -- NONE WILL BE USED IN 

2760
01:54:49,560 --> 01:54:51,160
PREGNANCY ANY TIME SOON AND 

2761
01:54:51,160 --> 01:54:53,600
DEVICES HAVE TO BE STUDIED 

2762
01:54:53,600 --> 01:54:56,800
DURING PREGNANCY AND HARD TO 

2763
01:54:56,800 --> 01:55:05,840
ENROLL 20 OR 30 WOMEN AND 

2764
01:55:05,840 --> 01:55:06,160
POSTPARTUM. 

2765
01:55:06,160 --> 01:55:10,280
>> SHOULD WE KEEP GOING? 

2766
01:55:10,280 --> 01:55:17,480
>> YES.  DR. AMRAN FROM
CITY OF

2767
01:55:17,480 --> 01:55:19,440
NEW YORK SCHOOL OF MED KRINL AND

2768
01:55:19,440 --> 01:55:21,400
THANK YOU FOR PRESENTATIONS AND 

2769
01:55:21,400 --> 01:55:24,320
QUESTION IS FOR THOSE WHO ARE 

2770
01:55:24,320 --> 01:55:26,200
PRACTICING IN LARGELY IN 

2771
01:55:26,200 --> 01:55:31,080
NONPREGNANT POPULATIONS IS THIS.

2772
01:55:31,080 --> 01:55:35,560
A VERY SIGNIFICANT NUMBER OF 

2773
01:55:35,560 --> 01:55:37,280
PREGNANCIES OCCUR IF INTENDED 

2774
01:55:37,280 --> 01:55:39,360
AND WANTED AND UNWANTED TLAPD IS

2775
01:55:39,360 --> 01:55:41,400
NO TIME FOR PRECONCEPTION CARE 

2776
01:55:41,400 --> 01:55:43,600
AND PRESENTATIONS THAT HAVE MADE

2777
01:55:43,600 --> 01:55:45,320
CLEAR, THERE IS A HUGE AMOUNT OF

2778
01:55:45,320 --> 01:55:51,520
WORK THAT NEEDS TO BE DONE ON 

2779
01:55:51,520 --> 01:55:55,240
PROVIDING APPROPRIATE CARE AND 

2780
01:55:55,240 --> 01:55:57,560
COUNSELING FOR RISK OF PREGNANCY

2781
01:55:57,560 --> 01:55:59,280
TO WOMEN OF HIGH RISK EVEN 

2782
01:55:59,280 --> 01:56:01,920
BEFORE THEY BECOME PREGNANT AND 

2783
01:56:01,920 --> 01:56:03,120
WHAT PRACTICES DO YOU THINK WE 

2784
01:56:03,120 --> 01:56:05,760
SHOULD ADOPT TO ENSURE THAT 

2785
01:56:05,760 --> 01:56:07,000
EVERY PREGNANCY THAT OCCURS 

2786
01:56:07,000 --> 01:56:10,360
OCCURS IN THE SETTING WHERE A 

2787
01:56:10,360 --> 01:56:11,440
WOMAN HAS APPROPRIATE KNOWLEDGE 

2788
01:56:11,440 --> 01:56:15,040
OF HER RISKS AND HER POTENTIAL 

2789
01:56:15,040 --> 01:56:18,160
CHILD'S RISKS BEFORE SHE GOES 

2790
01:56:18,160 --> 01:56:20,080
INTO PREGNANCY TO MAKE AN 

2791
01:56:20,080 --> 01:56:21,760
INFORMED AND ACTIVE DECISION 

2792
01:56:21,760 --> 01:56:23,960
THAT SHE CAN ACTUALLY IMPLEMENT 

2793
01:56:23,960 --> 01:56:28,040
WITH EXISTING SERVICES TO ENSURE

2794
01:56:28,040 --> 01:56:29,840
ANY PREGNANCY OCCURRING OCCURS 

2795
01:56:29,840 --> 01:56:32,440
IN THE SETTING SHE IS BEST 

2796
01:56:32,440 --> 01:56:35,160
SUITED TO CARRY IT TO A HEALTHY 

2797
01:56:35,160 --> 01:56:37,760
OUTCOME AND WE ARE PREVENTING 

2798
01:56:37,760 --> 01:56:40,480
THESE UNINTENDED PREGNANCIES AND

2799
01:56:40,480 --> 01:56:42,760
MANY LEAD TO HIGH RATES OF 

2800
01:56:42,760 --> 01:56:44,160
MATERNAL MORTALITY AND MORBIDITY

2801
01:56:44,160 --> 01:56:51,440
THAT WE ARE SEEING. 

2802
01:56:51,440 --> 01:56:54,480
>> THIS IS A GOOD POINT. 
LOTS 

2803
01:56:54,480 --> 01:56:57,720
OF THINGS WE -- AT LEAST FROM 

2804
01:56:57,720 --> 01:57:01,200
THINGS I PRACTICE IN PULL MONDAY

2805
01:57:01,200 --> 01:57:03,720
OLS AND SLEEP RESEARCHER AND 

2806
01:57:03,720 --> 01:57:06,000
LOTS HAPPENS BEFORE PREGNANCY 

2807
01:57:06,000 --> 01:57:07,920
AND MANY CONDITIONS CATCHING 

2808
01:57:07,920 --> 01:57:10,200
FIRST TIME BEFORE PREGNANCY 

2809
01:57:10,200 --> 01:57:12,320
BEFORE YOU INITIATE TREATMENT 

2810
01:57:12,320 --> 01:57:13,640
YOU HAVE ALREADY MISSED BOAT AND

2811
01:57:13,640 --> 01:57:20,120
IF I THINK I WANT TO PREVENT 

2812
01:57:20,120 --> 01:57:22,800
PREECOLLAPSIA IN SLEEP 

2813
01:57:22,800 --> 01:57:24,640
DISORDERED -- AND GET THEMMAC 

2814
01:57:24,640 --> 01:57:29,400
CLIMATED TO CPAP PLACENTA HAS 

2815
01:57:29,400 --> 01:57:33,080
PERFORMED BIOLOGY THAT PREDICTS 

2816
01:57:33,080 --> 01:57:33,960
PREECOLLAPSIA HAS HAPPENED AND 

2817
01:57:33,960 --> 01:57:36,800
IS LOTS OF WORK THAT NEEDS TO 

2818
01:57:36,800 --> 01:57:38,040
HAPPEN IN PRECONCEPTION PERIOD 

2819
01:57:38,040 --> 01:57:40,320
AND MAKE IT A POINT IN MY 

2820
01:57:40,320 --> 01:57:41,920
PRACTICE AND POINT WHERE I END 

2821
01:57:41,920 --> 01:57:45,360
WITH FELLOWS WHEN PRECEPT THEIR 

2822
01:57:45,360 --> 01:57:47,400
CLINIC AND EVERY WOMAN OF 

2823
01:57:47,400 --> 01:57:49,360
CHILDBEARING AGE I ASK WHAT IS 

2824
01:57:49,360 --> 01:57:51,520
SHE USING FOR CONTRACEPTION AND 

2825
01:57:51,520 --> 01:57:53,840
IS SHE PLANNING PREGNANCIES?  

2826
01:57:53,840 --> 01:57:55,520
IT IS NOT SOMETHING THAT PEOPLE 

2827
01:57:55,520 --> 01:57:57,120
THINK ABOUT ON A REGULAR BASIS A

2828
01:57:57,120 --> 01:57:59,040
LOT BUT SHOULD.  IT WOULD BE SO 

2829
01:57:59,040 --> 01:58:01,640
MUCH BETTER IF WE LOOK AT THIS. 

2830
01:58:01,640 --> 01:58:03,920
WE EVEN IDENTIFY THAT WOMEN WITH

2831
01:58:03,920 --> 01:58:08,000
SLEEP APNEA HAVE HIGHER INSULIN 

2832
01:58:08,000 --> 01:58:09,760
RESISTANCE IN FIRST TRIMESTER 

2833
01:58:09,760 --> 01:58:11,280
ALREADY.  BY TIME THEY GET TO 

2834
01:58:11,280 --> 01:58:14,120
THAT IT MIGHT BE TOO LATE AND 

2835
01:58:14,120 --> 01:58:14,920
PRECONCEPTION COUNSELING IS 

2836
01:58:14,920 --> 01:58:17,880
IMPORTANT TO DO AND WE HAVE TO 

2837
01:58:17,880 --> 01:58:18,960
INCORPORATE THAT IN CARE OF 

2838
01:58:18,960 --> 01:58:20,960
ANYBODY AND ANY MEDICAL 

2839
01:58:20,960 --> 01:58:22,880
SPECIALTY NOT JUST FOR PRIMARY 

2840
01:58:22,880 --> 01:58:24,680
CARE FOR INSTANCE AND 

2841
01:58:24,680 --> 01:58:26,400
RESPONSIBILITIES OF PRIMARY CARE

2842
01:58:26,400 --> 01:58:30,200
PHYSICIANS SEEM TO BE INCREASING

2843
01:58:30,200 --> 01:58:31,880
EVERY DAY.  

2844
01:58:31,880 --> 01:58:37,960
>> I WANT TO ADD TO THAT
I 

2845
01:58:37,960 --> 01:58:38,880
THINK POSTPARTUM PERIOD IS GREAT

2846
01:58:38,880 --> 01:58:40,840
TO ADDRESS THIS.  MANY PEOPLE 

2847
01:58:40,840 --> 01:58:42,520
HAVE MORE THAN ONE PREGNANCY. 

2848
01:58:42,520 --> 01:58:44,560
THAT MIGHT BE KIND OF AN 

2849
01:58:44,560 --> 01:58:48,160
OPPORTUNITY WHERE IF WE ARE ABLE

2850
01:58:48,160 --> 01:58:49,840
TO PROVIDE BETTER POSTPARTUM 

2851
01:58:49,840 --> 01:58:52,720
CARE YOU CAN THINK ABOUT 

2852
01:58:52,720 --> 01:58:54,440
INTERPREGNANCY INTERVAL AS AN 

2853
01:58:54,440 --> 01:58:59,400
OPPORTUNITY FOR PRECONCEPTION 

2854
01:58:59,400 --> 01:59:00,160
COUNSELING. 

2855
01:59:00,160 --> 01:59:00,680
>> YES?  

2856
01:59:00,680 --> 01:59:03,520
>> >> THANK YOU
FOR YOUR 

2857
01:59:03,520 --> 01:59:05,840
EXCELLENT PRESENTATION.  I WANT 

2858
01:59:05,840 --> 01:59:08,120
TO CALL OUT [INDISCERNIBLE] FOR 

2859
01:59:08,120 --> 01:59:11,400
THAT PHENOMENAL ACHIEVEMENT OF 

2860
01:59:11,400 --> 01:59:14,560
INCLUSION OF 30% OF PREGNANT 

2861
01:59:14,560 --> 01:59:16,480
WOMEN AND MY QUESTION IS 

2862
01:59:16,480 --> 01:59:19,480
DIRECTED TO [INDISCERNIBLE] AND 

2863
01:59:19,480 --> 01:59:20,520
YOU HAVE IMPORTANT RESULTS YOU 

2864
01:59:20,520 --> 01:59:22,680
ARE SEEING HERE AND WHAT ARE 

2865
01:59:22,680 --> 01:59:24,760
CHALLENGES AND WHAT YOU ARE DOG 

2866
01:59:24,760 --> 01:59:26,960
TO ENSURE OUTCAN REACH TO THE 

2867
01:59:26,960 --> 01:59:29,560
COMMUNITY THAT IS A RESOURCE 

2868
01:59:29,560 --> 01:59:32,360
THAT IS UNDERSTOOD FOR DESIRED 

2869
01:59:32,360 --> 01:59:35,520
OUTCOME GOING FOR?  

2870
01:59:35,520 --> 01:59:46,080
>> WE HAVE SEEN THESE
RESULTS, 

2871
01:59:49,320 --> 01:59:50,320
REALLY INTERESTING RESULTS. 

2872
01:59:50,320 --> 01:59:54,400
WHAT IS EFFORT YOU ARE MAKING 

2873
01:59:54,400 --> 01:59:55,600
FOR [INDISCERNIBLE] TO COMMUNITY

2874
01:59:55,600 --> 01:59:57,520
WHERE IMPACT IS [INDISCERNIBLE] 

2875
01:59:57,520 --> 02:00:01,720
SO THAT YOU CANNOT SHIFT DESIRED

2876
02:00:01,720 --> 02:00:04,480
OUTCOME LONG TERM AND WANTING 

2877
02:00:04,480 --> 02:00:06,600
RESULTS AND TO HAVE AVERAGES AND

2878
02:00:06,600 --> 02:00:08,600
EDUCATION AND CHANGING BEHAVIOR 

2879
02:00:08,600 --> 02:00:10,600
AND WHO HAVE DESIRED IMPACTS AND

2880
02:00:10,600 --> 02:00:12,960
WHAT IS EFFORT AND WHAT ARE 

2881
02:00:12,960 --> 02:00:14,000
CHALLENGES?  

2882
02:00:14,000 --> 02:00:19,960
HOW CAN WE ADDRESS THAT?  

2883
02:00:19,960 --> 02:00:24,080
>> I THIS I THAT
IMPLEMENTATION

2884
02:00:24,080 --> 02:00:26,520
IS ALWAYS A CHALLENGE AND 

2885
02:00:26,520 --> 02:00:28,520
BARRIER AND HAS ALWAYS SORT OF 

2886
02:00:28,520 --> 02:00:32,120
BEEN CONSIDERED A SEPARATE THING

2887
02:00:32,120 --> 02:00:36,160
FROM THE INITIAL TRIAL; RIGHT?  

2888
02:00:36,160 --> 02:00:38,360
NHLBI WAS VERY GENEROUS IN 

2889
02:00:38,360 --> 02:00:40,080
FUNDING AND SPENT A LOT OF MONEY

2890
02:00:40,080 --> 02:00:43,440
TO GET STUDIES ON 2400 WOMEN.  

2891
02:00:43,440 --> 02:00:45,560
THAT WAS OUR FOCUS AND THERE ARE

2892
02:00:45,560 --> 02:00:47,640
ONGOING STUDIES NOW TO DO FOLLOW

2893
02:00:47,640 --> 02:00:50,840
UP OF MOMS WHAT THEIR LONG-TERM 

2894
02:00:50,840 --> 02:00:54,320
OUTCOMES AND WHAT ARE LONG-TERM 

2895
02:00:54,320 --> 02:00:56,600
NEONATAL CHILDHOOD OUTCOMES 

2896
02:00:56,600 --> 02:00:58,880
ASSOCIATED WITH TREATMENT AND 

2897
02:00:58,880 --> 02:01:00,080
IMPLEMENTATION IS NEXT STEP.  I 

2898
02:01:00,080 --> 02:01:01,240
DON'T HAVE A GREAT ANSWER FOR 

2899
02:01:01,240 --> 02:01:04,960
YOU AND THINK THAT SUPPORT FROM 

2900
02:01:04,960 --> 02:01:08,720
SFM AND ACOG IS KEY AND LOTS ARE

2901
02:01:08,720 --> 02:01:10,160
CHANGING THEIR PRACTICE.  THERE 

2902
02:01:10,160 --> 02:01:13,280
IS STILL LOTS OF WORK TO DO 

2903
02:01:13,280 --> 02:01:15,280
AROUND THAT.  

2904
02:01:15,280 --> 02:01:16,560
>> THANK YOU.  

2905
02:01:16,560 --> 02:01:20,640
>> NEXT QUESTION ON THE
LEFT.  

2906
02:01:20,640 --> 02:01:23,080
CAN YOU PLEASE SPEAK LOUDER?  

2907
02:01:23,080 --> 02:01:23,880
>> YES. 

2908
02:01:23,880 --> 02:01:26,400
>> SPEAKERS ARE DIRECTED
TO THE

2909
02:01:26,400 --> 02:01:28,000
AUDIENCE.  WE ARE HAVING A HARD 

2910
02:01:28,000 --> 02:01:28,720
TIME HERE. 

2911
02:01:28,720 --> 02:01:30,240
>> CAN YOU HEAR ME. 

2912
02:01:30,240 --> 02:01:31,040
>> WHY HE. 

2913
02:01:31,040 --> 02:01:35,800
>> I'M A FAIRLY NEWLY
MINTED 

2914
02:01:35,800 --> 02:01:38,120
MFM FROM HOW WARD UNIVERSITY AND

2915
02:01:38,120 --> 02:01:41,320
WANT TO SAY THANK YOU FOR 

2916
02:01:41,320 --> 02:01:44,400
PUTTING THIS WHOLE THING 

2917
02:01:44,400 --> 02:01:46,080
TOGETHER.  IT IS INSPIRATIONAL 

2918
02:01:46,080 --> 02:01:47,720
FOR A NEW PHYSICIAN THAT IS 

2919
02:01:47,720 --> 02:01:51,440
TAKING CARE OF SUCH A POPULATION

2920
02:01:51,440 --> 02:01:54,800
THAT IS IN NEED. 

2921
02:01:54,800 --> 02:01:59,480
I -- MY QUESTION IS MORE FOR 

2922
02:01:59,480 --> 02:02:01,360
PROFESSIONALS TAKING CARE OF 

2923
02:02:01,360 --> 02:02:03,000
PATIENTS OUT IN THE COMMUNITY 

2924
02:02:03,000 --> 02:02:08,000
AND WHAT IS BEING DONE TO REALLY

2925
02:02:08,000 --> 02:02:10,440
ADDRESS I THINK THE NATIONAL 

2926
02:02:10,440 --> 02:02:13,560
ISSUE OF RESOURCES TO TAKE CARE 

2927
02:02:13,560 --> 02:02:15,840
OF WOMEN IN NEED?  

2928
02:02:15,840 --> 02:02:19,000
BECAUSE I HAVE FOUND AND WE ALL 

2929
02:02:19,000 --> 02:02:21,520
KNOW THAT MOST OF THE 

2930
02:02:21,520 --> 02:02:22,960
PATHOLOGICAL BURDEN IS IN 

2931
02:02:22,960 --> 02:02:24,960
INSTITUTIONS OR AREAS THAT DON'T

2932
02:02:24,960 --> 02:02:27,080
HAVE A LOT OF RESOURCES. 

2933
02:02:27,080 --> 02:02:30,120
SO, EXAMPLE TODAY, I -- I MEAN, 

2934
02:02:30,120 --> 02:02:32,000
I'M STILL ON SERVICE AND HAVE TO

2935
02:02:32,000 --> 02:02:34,520
GO AROUND ON MY PATIENT.  I HAVE

2936
02:02:34,520 --> 02:02:38,520
A SICKLE CELL PATIENT WITH A 

2937
02:02:38,520 --> 02:02:40,400
PULMONARY EMBOLUS LAST YEAR AND 

2938
02:02:40,400 --> 02:02:42,680
SHORT PREGNANCY AND PATIENT WITH

2939
02:02:42,680 --> 02:02:44,320
TIA AND SHE IS PREGNANT AGAIN 

2940
02:02:44,320 --> 02:02:47,160
AND SHE HAD TIA IN 2022.  I 

2941
02:02:47,160 --> 02:02:48,720
ACTUALLY HAVE A PATIENT NOW WHO 

2942
02:02:48,720 --> 02:02:52,360
IS 42 AND HAD TWO MIIS. 

2943
02:02:52,360 --> 02:02:53,800
SHE IS ABOUT TO DELIVER SOON. 

2944
02:02:53,800 --> 02:02:55,880
THESE ARE THE PANELOLOGIES THAT 

2945
02:02:55,880 --> 02:02:57,920
I DEAL WITH EVERY DAY.  

2946
02:02:57,920 --> 02:03:00,240
I DON'T HAVE THE RESOURCES, ONE,

2947
02:03:00,240 --> 02:03:04,480
TO DO THE RESEARCH.  I AM VERY 

2948
02:03:04,480 --> 02:03:05,040
INTERESTED IN. 

2949
02:03:05,040 --> 02:03:07,880
OR TWO, EVEN STAFFING TO HAVE 

2950
02:03:07,880 --> 02:03:10,040
SOMEBODY TO WRITE GRANTS FOR ME 

2951
02:03:10,040 --> 02:03:13,160
BECAUSE I'M TOO BUSY TAKING CARE

2952
02:03:13,160 --> 02:03:15,360
OF THOSE PATIENTS DAY IN AND DAY

2953
02:03:15,360 --> 02:03:17,600
OUT.  I'M LITERALLY IN THE 

2954
02:03:17,600 --> 02:03:17,880
TRENCHES. 

2955
02:03:17,880 --> 02:03:20,120
WHAT IS BEING DONE FROM A 

2956
02:03:20,120 --> 02:03:22,040
SYSTEMATIC PERSPECTIVE TO HELP 

2957
02:03:22,040 --> 02:03:26,200
SUPPORT INSTITUTIONS LIKE MY OWN

2958
02:03:26,200 --> 02:03:27,840
RIGHT HERE IN THE NATION'S 

2959
02:03:27,840 --> 02:03:30,880
CAPITAL AND NO THE TO MENTION 

2960
02:03:30,880 --> 02:03:34,680
I'M FROM RURAL TENNESSEE WE 

2961
02:03:34,680 --> 02:03:36,360
DIDN'T HAVE RURAL MATERNITY 

2962
02:03:36,360 --> 02:03:39,120
WARDS AND I HAVE HEART FOR 

2963
02:03:39,120 --> 02:03:42,120
RURALS AND WE CAN CALL THEM 

2964
02:03:42,120 --> 02:03:43,960
MATERNITY DESERTS OR 

2965
02:03:43,960 --> 02:03:45,520
INSTITUTIONS THAT DON'T HAVE 

2966
02:03:45,520 --> 02:03:49,680
FUNDING TO DO RESEARCH IN THE 

2967
02:03:49,680 --> 02:03:52,800
POPULATIONS THAT WE SERVE. 

2968
02:03:52,800 --> 02:03:57,880
>> BEFORE THE BREAK, I
WANT TO 

2969
02:03:57,880 --> 02:03:59,880
JUST SAY THAT WE CAME HERE TO 

2970
02:03:59,880 --> 02:04:00,720
DISCUSS TECHNOLOGY. 

2971
02:04:00,720 --> 02:04:03,640
IT IS OBVIOUS FROM THE QUESTIONS

2972
02:04:03,640 --> 02:04:05,800
THERE IS A LOT OF OTHER ISSUES 

2973
02:04:05,800 --> 02:04:06,560
TO DISCUSS.  THANK YOU FOR 

2974
02:04:06,560 --> 02:04:07,720
BRINGING UP THESE QUESTIONS AND 

2975
02:04:07,720 --> 02:04:08,320
HOPEFULLY WE CAN ANSWER SOME OF 

2976
02:04:08,320 --> 02:04:09,040
THEM. 

2977
02:04:09,040 --> 02:04:11,440
>> YEAH.  IF I CAN ADD
ONE 

2978
02:04:11,440 --> 02:04:13,920
THING GEORGE GOT INTO AND I 

2979
02:04:13,920 --> 02:04:15,240
DEFINITELY VERY MUCH HEAR YOU.  

2980
02:04:15,240 --> 02:04:17,560
WE ARE IN -- YOU TALKED ABOUT 

2981
02:04:17,560 --> 02:04:20,200
REALLY POINTS TO FACT WE ARE 

2982
02:04:20,200 --> 02:04:22,800
RESOURCE LIMITED IN WHAT WE CAN 

2983
02:04:22,800 --> 02:04:24,280
ACCOMPLISH OVERALL AND WE CAN 

2984
02:04:24,280 --> 02:04:26,880
TALK ABOUT VARIETY OF GRANT 

2985
02:04:26,880 --> 02:04:28,240
OPPORTUNITIES FOR PHYSICIAN 

2986
02:04:28,240 --> 02:04:28,880
SCIENTISTS THAT COULD PROTECT 

2987
02:04:28,880 --> 02:04:31,520
TIME AND THINGS LIKE THAT. 

2988
02:04:31,520 --> 02:04:33,920
WE CAN TALK ABOUT THAT. 

2989
02:04:33,920 --> 02:04:36,160
THERE IS HUGE SYSTEMIC ISSUES 

2990
02:04:36,160 --> 02:04:38,760
THAT NEED TO BE ADDRESSED AND 

2991
02:04:38,760 --> 02:04:40,280
TODAY TWO THINGS WE CAN THINK 

2992
02:04:40,280 --> 02:04:42,960
ABOUT IN TERMS OF INNOVATION AND

2993
02:04:42,960 --> 02:04:45,160
DEVICE, ONE, THINKING ABOUT 

2994
02:04:45,160 --> 02:04:46,640
INNOVATION AND DEVICES FROM DAY 

2995
02:04:46,640 --> 02:04:49,200
1 THINK ABOUT HOW THEY CAN BE 

2996
02:04:49,200 --> 02:04:50,600
ACCESSIBLE EVERYWHERE AND HOW 

2997
02:04:50,600 --> 02:04:52,640
THEY CAN HELP PEOPLE AND MAKING 

2998
02:04:52,640 --> 02:04:54,240
DEVICES USED BY PEOPLE GETTING 

2999
02:04:54,240 --> 02:04:56,120
TOP CARE; RIGHT?  

3000
02:04:56,120 --> 02:04:58,520
SECOND OF THAT IS CAN WE 

3001
02:04:58,520 --> 02:05:00,760
GENERATE DEVICES AND INNOVATION 

3002
02:05:00,760 --> 02:05:02,040
APPROACHES MAKING LIFE EASIER 

3003
02:05:02,040 --> 02:05:04,120
FOR PHYSICIANS TO ELIMINATE 

3004
02:05:04,120 --> 02:05:07,320
CERTAIN THINGS FOR USE OF 

3005
02:05:07,320 --> 02:05:09,840
DOPPLAR ULTRA SOUND AND AI 

3006
02:05:09,840 --> 02:05:11,360
APPROACHES THAT COULD MAKE THIS 

3007
02:05:11,360 --> 02:05:13,800
EASIER TO USE SO WE SDROEPT TO 

3008
02:05:13,800 --> 02:05:15,160
HAVE TRAINED TECHNICIANS TO MAKE

3009
02:05:15,160 --> 02:05:16,840
THIS MORE ACCESSIBLE AND 

3010
02:05:16,840 --> 02:05:18,720
BRINGING BACK SYSTEMIC ISSUES 

3011
02:05:18,720 --> 02:05:20,400
AND THINKING ABOUT HOW TO SOLVE 

3012
02:05:20,400 --> 02:05:21,320
THEM TODAY.  

3013
02:05:21,320 --> 02:05:23,160
THEY ARE VERY BIG PROBLEMS WABD 

3014
02:05:23,160 --> 02:05:27,560
THAT I KNOW WE WILL TAKE A BREAK

3015
02:05:27,560 --> 02:05:33,240
AND THANK YOU, EVERYBODY. 

3016
02:05:33,240 --> 02:05:37,040
>> ALL RIGHT.  I'M A PROGRAM 

3017
02:05:37,040 --> 02:05:43,240
DIRECTOR AT NATIONAL INSTITUTE 

3018
02:05:43,240 --> 02:05:45,200
BIOENGINEERING AND AWESOME TO BE

3019
02:05:45,200 --> 02:05:48,680
HERE WITH THE AWESOME TECHNOLOGY

3020
02:05:48,680 --> 02:05:52,960
PANEL AND -- THIS PANEL WILL 

3021
02:05:52,960 --> 02:05:56,960
FOCUS ON TECHNOLOGICAL GAP FOR 

3022
02:05:56,960 --> 02:06:00,120
THOSE TECHNOLOGY AND TOOLS 

3023
02:06:00,120 --> 02:06:01,800
DEVELOPMENT ALGORITHM AND SO ON.

3024
02:06:01,800 --> 02:06:04,160
WE HAVE ONE HOUR FOR THE PANEL 

3025
02:06:04,160 --> 02:06:06,120
DISCUSSION AND WILL HAVE A SHORT

3026
02:06:06,120 --> 02:06:08,080
TALK AND INTRODUCTION FROM 

3027
02:06:08,080 --> 02:06:10,200
PANELISTS FOLLOWED BY Q & A
AT 

3028
02:06:10,200 --> 02:06:17,280
THE END AND WANT TO BE AWARE OF 

3029
02:06:17,280 --> 02:06:22,240
GREAT PANELS INCLUDING 

3030
02:06:22,240 --> 02:06:27,440
INMREMENTATION [INDISCERNIBLE] 

3031
02:06:27,440 --> 02:06:33,320
MODERATOR TODAY IS DR. LAM FROM 

3032
02:06:33,320 --> 02:06:35,400
GEORGIA INSTITUTE OF TECHNOLOGY 

3033
02:06:35,400 --> 02:06:37,680
AND EMORY UNIVERSITY AND WITH 

3034
02:06:37,680 --> 02:06:42,240
THAT I WELCOME HIM ON BOARD.  

3035
02:06:42,240 --> 02:06:47,000
THANK YOU. 

3036
02:06:47,000 --> 02:06:49,960
>> THANK YOU.  WE WILL DO

3037
02:06:49,960 --> 02:06:53,600
DIFFERENTLY WITH OUR PANEL HERE 

3038
02:06:53,600 --> 02:06:55,520
LIGHTNING ROUNDS AND EACH 

3039
02:06:55,520 --> 02:06:56,440
PANELIST WILL TALK ABOUT 

3040
02:06:56,440 --> 02:06:58,120
TECHNOLOGY THEY ARE WORKING ON 

3041
02:06:58,120 --> 02:06:59,680
AND GO INTO PANEL DISCUSSIONS 

3042
02:06:59,680 --> 02:07:05,680
AND THIS IS THE TECHNOLOGY PA

3043
02:07:05,680 --> 02:07:06,280
PANEL. 

3044
02:07:06,280 --> 02:07:15,160
WE WILL GEEK OUT AND NERD OUT. 

3045
02:07:15,160 --> 02:07:17,400
PANELS WILL COME BACK AND 

3046
02:07:17,400 --> 02:07:18,160
TECHNOLOGY DEVELOPMENT CAN'T BE 

3047
02:07:18,160 --> 02:07:20,000
DONE IN ISOLATION OF THE ASPECTS

3048
02:07:20,000 --> 02:07:21,160
AND WE WILL SEE THAT. 

3049
02:07:21,160 --> 02:07:25,800
WITH THAT, WHAT WE WILL DO IS 

3050
02:07:25,800 --> 02:07:26,840
LIGHTNING ROUNDS AND SLIDES 

3051
02:07:26,840 --> 02:07:30,040
MAYBE SOMEONE CAN ADVANCE THE 

3052
02:07:30,040 --> 02:07:34,640
FIRST SLIDE.  

3053
02:07:34,640 --> 02:07:40,200
IT WILL BE A SURPRISE TO ALL TO 

3054
02:07:40,200 --> 02:07:50,520
POP UP FIRST.  

3055
02:07:50,520 --> 02:08:00,280
LOTS OF RESPONSES HERE.  OKAY.  

3056
02:08:00,280 --> 02:08:04,480
ARE THERE ANY SLIDES?  

3057
02:08:04,480 --> 02:08:07,200
OKAY.  

3058
02:08:07,200 --> 02:08:09,640
SO, WE HAVE TO WING IT THIS 

3059
02:08:09,640 --> 02:08:09,840
THEN. 

3060
02:08:09,840 --> 02:08:12,520
WHILE WE ARE FIGURING OUT, YOU 

3061
02:08:12,520 --> 02:08:14,640
KNOW, WHICH TECHNOLOGIES WILL BE

3062
02:08:14,640 --> 02:08:16,120
PRESENTED FIRST, THERE IS SOME 

3063
02:08:16,120 --> 02:08:18,120
GENERIC QUESTIONS THAT WE CAN 

3064
02:08:18,120 --> 02:08:21,400
EVEN START FROM THE GET-GO.  

3065
02:08:21,400 --> 02:08:25,040
WHAT WE HAVE ARE MAYBE WHAT WE 

3066
02:08:25,040 --> 02:08:26,920
WILL DO IS JUST A QUICK 30 

3067
02:08:26,920 --> 02:08:28,880
SECOND INTRO FOR EACH PANEL.  

3068
02:08:28,880 --> 02:08:33,200
SETTING THAT UP.  OKAY.  TA-DA. 

3069
02:08:33,200 --> 02:08:35,640
OKAY.  I WILL BE YOUR MODERATOR.

3070
02:08:35,640 --> 02:08:37,520
THESE ARE PANELISTS. 

3071
02:08:37,520 --> 02:08:39,480
LET'S JUMP AHEAD TO THE NEXT 

3072
02:08:39,480 --> 02:08:41,880
SLIDE IF YOU SEEM TO HAVE ONE 

3073
02:08:41,880 --> 02:08:45,120
POPPED UP.  IF NOT, I WILL LET 

3074
02:08:45,120 --> 02:08:47,920
EACH PANELIST DO A LITTLE BIT OF

3075
02:08:47,920 --> 02:08:51,040
AN INTRODUCTION AND WILL START 

3076
02:08:51,040 --> 02:08:52,760
MAYBE WITH DR. CHRISTIAN AND WE 

3077
02:08:52,760 --> 02:08:58,480
WILL GO DOWN 30 SECONDS. 

3078
02:08:58,480 --> 02:09:04,840
>> HI.  I'M AN ASSISTANT 

3079
02:09:04,840 --> 02:09:08,440
PROFESSOR OF MEDICINE AND AT 

3080
02:09:08,440 --> 02:09:10,440
UNIVERSITY OF PITTSBURGH AND 

3081
02:09:10,440 --> 02:09:11,080
CO-FOUNDER OF [INDISCERNIBLE] 

3082
02:09:11,080 --> 02:09:12,880
AND WILL TALK MORE ABOUT IT WHEN

3083
02:09:12,880 --> 02:09:14,960
SLIDES COME UP FOR COMPANIES 

3084
02:09:14,960 --> 02:09:18,520
FLAGSHIP PRODUCT DIGITAL 

3085
02:09:18,520 --> 02:09:24,280
PLATFORM TO -- 

3086
02:09:24,280 --> 02:09:28,120
>> BETH AN ANY?  

3087
02:09:28,120 --> 02:09:32,120
>> -- I WILL TALK A BIT
TODAY 

3088
02:09:32,120 --> 02:09:34,320
ABOUT SOME WORK IN RURAL RUE 

3089
02:09:34,320 --> 02:09:38,440
WANT DAH TO SUPPORT WOMEN WITH 

3090
02:09:38,440 --> 02:09:44,320
SIS SEERIAN DELIVERY. 

3091
02:09:44,320 --> 02:09:46,840
>> ASSISTANT PROFESSOR OF

3092
02:09:46,840 --> 02:09:49,160
BIOMEDICAL ENGINEERING AND 

3093
02:09:49,160 --> 02:09:51,720
GRADUATE PROGRAM DIRECTOR FOR 

3094
02:09:51,720 --> 02:09:54,440
JOHNS HOPKINS CENTER FOR DESIGN 

3095
02:09:54,440 --> 02:09:56,520
AND PROGRAM WITH 

3096
02:09:56,520 --> 02:09:57,760
MULTI-DISCIPLINARY TEAMS WITH 

3097
02:09:57,760 --> 02:10:00,040
STUDENTS AND CLINICIANS AND 

3098
02:10:00,040 --> 02:10:02,120
PUBLIC HEALTH PROFESSIONALS 

3099
02:10:02,120 --> 02:10:05,000
FOCUSING ON PROCESS OF MEDICAL 

3100
02:10:05,000 --> 02:10:07,480
INNOVATION AND SEVERAL EXAMPLES 

3101
02:10:07,480 --> 02:10:09,360
SHARING TODAY BRIEFLY IN 

3102
02:10:09,360 --> 02:10:11,160
MATERNAL HEALTH SPACE THAT HAVE 

3103
02:10:11,160 --> 02:10:13,880
NOW TRANSLATED INTO FOR AND 

3104
02:10:13,880 --> 02:10:15,360
NON-PROFIT COMPANIES AND 

3105
02:10:15,360 --> 02:10:20,280
PRODUCTS SERVING PATIENTS 

3106
02:10:20,280 --> 02:10:20,520
GLOBALLY. 

3107
02:10:20,520 --> 02:10:24,920
>> I'M ACTUALLY NEW TO
MATERNAL

3108
02:10:24,920 --> 02:10:26,680
HEALTH AND I'M CARDIAC SURGEON 

3109
02:10:26,680 --> 02:10:28,880
AND LONG-STANDING INTEREST IN 

3110
02:10:28,880 --> 02:10:32,440
PUBLIC HEALTH AND SINCE 2015 I 

3111
02:10:32,440 --> 02:10:35,200
LED JOINT TUFTS MEDICAL SCHOOL 

3112
02:10:35,200 --> 02:10:38,440
AND MITT COME UP WITH 

3113
02:10:38,440 --> 02:10:40,280
FUNDAMENTALLY DIFFERENT RATE TO 

3114
02:10:40,280 --> 02:10:41,480
MEASURE BLOOD PRESSURE AND WE 

3115
02:10:41,480 --> 02:10:43,640
ARE WORKING ON APPLYING 

3116
02:10:43,640 --> 02:10:45,280
TECHNOLOGY IN MATERNAL HEALTH 

3117
02:10:45,280 --> 02:10:47,040
AND PLEASURE TO BE HERE. 

3118
02:10:47,040 --> 02:10:48,840
>> GREAT.  THANK YOU. 

3119
02:10:48,840 --> 02:10:53,480
OKAY.  DO WE HAVE NEXT SLIDES?  

3120
02:10:53,480 --> 02:11:00,720
GREAT.  NEXT SLIDE.  

3121
02:11:00,720 --> 02:11:02,440
OKAY.  GREAT.  IT THIS IS MINE. 

3122
02:11:02,440 --> 02:11:05,200
I WILL TAKE IT.  PEDIATRIC 

3123
02:11:05,200 --> 02:11:06,920
HEMATOLOGIST CLINICALLY AND 

3124
02:11:06,920 --> 02:11:11,440
PROFESSOR OF BIOMEDICAL 

3125
02:11:11,440 --> 02:11:12,560
ENGINEERING AND TECHNOLOGY BORN 

3126
02:11:12,560 --> 02:11:17,920
IN LABORATORY I LEAD AND FULL 

3127
02:11:17,920 --> 02:11:19,640
DISCLOSURE HERE. 

3128
02:11:19,640 --> 02:11:21,080
WE WORK ON ARE SEVERAL 

3129
02:11:21,080 --> 02:11:22,840
TECHNOLOGIES THAT ARE RELATED TO

3130
02:11:22,840 --> 02:11:26,480
SOMETHING THAT IS VERY NEAR AND 

3131
02:11:26,480 --> 02:11:28,480
DEAR TO MY HEART IS ANEMIA THAT 

3132
02:11:28,480 --> 02:11:31,800
IS ASSOCIATED WITH MATERNAL 

3133
02:11:31,800 --> 02:11:33,360
HEALTH AS MANY KNOW THAT 

3134
02:11:33,360 --> 02:11:36,080
PREGNANT WOMEN WHO ARE ANEMIC 

3135
02:11:36,080 --> 02:11:37,800
HAVE HIGHER RISK OF 

3136
02:11:37,800 --> 02:11:38,360
COMPLICATIONS. 

3137
02:11:38,360 --> 02:11:39,960
GOING TO THE NEXT SLIDE. 

3138
02:11:39,960 --> 02:11:43,280
ONE TECHNOLOGY WE HAVE DEVELOPED

3139
02:11:43,280 --> 02:11:46,480
IS AN APP THAT CAN 

3140
02:11:46,480 --> 02:11:48,080
NON-INVASIVELY ESTIMATE 

3141
02:11:48,080 --> 02:11:51,080
HEMOGLOBIN VALUES DOING BY 

3142
02:11:51,080 --> 02:11:53,760
AI-BASED ALGORITHM AND DO A 

3143
02:11:53,760 --> 02:11:55,840
FINGER NAIL SELFIE AND CLINICIAN

3144
02:11:55,840 --> 02:11:58,320
NOSE WHEN PATIENT HAS ANEMIA 

3145
02:11:58,320 --> 02:12:00,320
DIFFERENT BODY PARTS GETTING 

3146
02:12:00,320 --> 02:12:02,680
MORE PAIL AND LOOKING AT ALL 

3147
02:12:02,680 --> 02:12:06,000
BODY PARTS AND COMING TO 

3148
02:12:06,000 --> 02:12:06,760
ACCESSIBILITY AND USABILITY 

3149
02:12:06,760 --> 02:12:09,520
FINNINGER NAILS ARE BETTER BODY 

3150
02:12:09,520 --> 02:12:12,840
PARTS TO CHOOSE FROM AND 

3151
02:12:12,840 --> 02:12:14,560
SANGUINA IS MOVING THIS FORWARD 

3152
02:12:14,560 --> 02:12:16,360
WITH DIFFERENT POPULATION GROUPS

3153
02:12:16,360 --> 02:12:19,760
AND MULTIPLE DIFFERENT AREAS OF 

3154
02:12:19,760 --> 02:12:21,200
THE WORLD TRYING TO MULTIPLY 

3155
02:12:21,200 --> 02:12:23,280
THIS AND MATERNAL HEALTH AND 

3156
02:12:23,280 --> 02:12:24,640
ROLE CURRENTLY EXPLORING THAT 

3157
02:12:24,640 --> 02:12:28,440
AND NEXT WE WILL GO DOWN. 

3158
02:12:28,440 --> 02:12:30,280
OKAY.  GREAT.  

3159
02:12:30,280 --> 02:12:32,960
WANT TO STAY THERE?  

3160
02:12:32,960 --> 02:12:36,720
YEAH.  I THINK YOU ARE -- MAKE 

3161
02:12:36,720 --> 02:12:39,360
SURE YOUR MIC IS ON. 

3162
02:12:39,360 --> 02:12:42,040
>> GREAT.  STANDARD OF
CARE 

3163
02:12:42,040 --> 02:12:45,400
MEASURING BLOOD PRESSURE AND 

3164
02:12:45,400 --> 02:12:49,600
USING AN AUTOMATIC OSLOMETRIC 

3165
02:12:49,600 --> 02:12:53,240
CUFF AND FUNDAMENTAL ISSUES WITH

3166
02:12:53,240 --> 02:12:56,200
IT AND STUDIES SHOW IN REAL LIFE

3167
02:12:56,200 --> 02:12:59,080
AS MUCH AS 10 MILLIMETERS IN 

3168
02:12:59,080 --> 02:13:00,760
MERCURY 50% OF THE TIME AND 

3169
02:13:00,760 --> 02:13:03,800
OTHER ISSUES PROVIDES SINGLE 

3170
02:13:03,800 --> 02:13:06,440
TIME MEASUREMENT BLOOD PRESSURE 

3171
02:13:06,440 --> 02:13:07,520
CHANGES MINUTE BY MINUTE AND 

3172
02:13:07,520 --> 02:13:09,680
WHAT IS THE ISSUE WITH THAT?  

3173
02:13:09,680 --> 02:13:11,880
PEOPLE OF CHRONIC HYPERTENSION 

3174
02:13:11,880 --> 02:13:14,400
ARE WRONGLY DATA IS CONSISTENT 

3175
02:13:14,400 --> 02:13:18,560
AND WRONGLY DIAGNOSIS 30% OF 

3176
02:13:18,560 --> 02:13:20,360
PEOPLE WITH MASS HYPERTENSION 

3177
02:13:20,360 --> 02:13:22,280
AND BLOOD PRESSURE NOT MEASURED 

3178
02:13:22,280 --> 02:13:24,480
AND RATE OF MORTALITY AND 

3179
02:13:24,480 --> 02:13:28,000
HOSPITALS LEADS TO MONITORING 

3180
02:13:28,000 --> 02:13:30,240
GAP AND CURRENTLY USING BLOOD 

3181
02:13:30,240 --> 02:13:32,280
PRESSURE AND KNOW ABOUT ISSUES 

3182
02:13:32,280 --> 02:13:34,560
FOR LAST 50 OR 60 YEARS AND ALL 

3183
02:13:34,560 --> 02:13:37,520
EXISTING METHODOLOGIES THAT TRY 

3184
02:13:37,520 --> 02:13:40,080
TO ADDRESS BLOOD PRESSURE USE 

3185
02:13:40,080 --> 02:13:42,280
PULSE TRANSIT TIME AND VOLUME 

3186
02:13:42,280 --> 02:13:45,240
CLAMP SO ON AND SO FORTH NEED A 

3187
02:13:45,240 --> 02:13:47,280
CUFF STILL TO CALIBRATE THEM AND

3188
02:13:47,280 --> 02:13:49,280
HAVE THOSE ISSUES PRIMARILY AND 

3189
02:13:49,280 --> 02:13:51,800
SECONDLY ARE BASED ON SKIN BLOOD

3190
02:13:51,800 --> 02:13:53,400
FLOW AND SKIN COLOR AND MANY 

3191
02:13:53,400 --> 02:13:56,320
OTHER THINGS THAT CAN EFFECT 

3192
02:13:56,320 --> 02:13:58,000
SKIN BLOOD FLOW AND MOTION 

3193
02:13:58,000 --> 02:13:59,880
ARTIFACT IS A MAJOR ISSUE 

3194
02:13:59,880 --> 02:14:01,720
ADDRESSING NIH CALL FOR AND 

3195
02:14:01,720 --> 02:14:03,200
FUNDING ONE OF THE TEAMS THAT 

3196
02:14:03,200 --> 02:14:03,840
WAS US. 

3197
02:14:03,840 --> 02:14:06,240
WE WENT BACK TO BASICS OF 

3198
02:14:06,240 --> 02:14:08,040
PHYSIOLOGY AND WAY TO UNDERSTAND

3199
02:14:08,040 --> 02:14:09,120
TECHNOLOGY AND FEELING THE 

3200
02:14:09,120 --> 02:14:12,080
PULSE, WHAT YOU FEEL IS FORCE 

3201
02:14:12,080 --> 02:14:13,440
TRANSMITTED FROM PRESSURE INSIDE

3202
02:14:13,440 --> 02:14:19,080
OF THE BLOOD PRESSURE AND 

3203
02:14:19,080 --> 02:14:20,720
OPTOMIC CAN CAL -- DOESN'T 

3204
02:14:20,720 --> 02:14:23,320
DIRECTLY LOOK AT SKIN BY PIECE 

3205
02:14:23,320 --> 02:14:26,720
OF POLYMER AND LOOKS AT POLYMER 

3206
02:14:26,720 --> 02:14:27,720
DEFAMATION AND SKIN COLOR WON'T 

3207
02:14:27,720 --> 02:14:32,600
BE ISSUE TAKING THIS DIRECTLY 

3208
02:14:32,600 --> 02:14:34,400
FROM LARGE VESSEL AND TAKING 

3209
02:14:34,400 --> 02:14:36,600
CONTINUOUS IMAGES NEXT SLIDE, 

3210
02:14:36,600 --> 02:14:37,320
PLEASE. 

3211
02:14:37,320 --> 02:14:39,280
OKAY.  THERE IS VIDEOS SUPPOSED 

3212
02:14:39,280 --> 02:14:42,640
TO PLAY.  ESSENTIALLY WE 

3213
02:14:42,640 --> 02:14:43,760
RECONSTRUCT THE PRESSURE WAVE 

3214
02:14:43,760 --> 02:14:46,560
AND FROM EACH PRESSURE WAVE WE 

3215
02:14:46,560 --> 02:14:48,680
FIGURE OUT WHAT IS THE -- 

3216
02:14:48,680 --> 02:14:51,160
DIRECTLY MEASURING MAXIMUM 

3217
02:14:51,160 --> 02:14:53,280
MEASURE THAT IS SYSTOLIC AND 

3218
02:14:53,280 --> 02:14:55,360
BASELINE PRESSURE THAT IS 

3219
02:14:55,360 --> 02:14:56,720
DIASTOLIC AND DO IT CONTINUE 

3220
02:14:56,720 --> 02:14:58,560
WOULD USUALLY AND DO IT WITHOUT 

3221
02:14:58,560 --> 02:15:01,800
GETTING DETAILS AND CARDIO 

3222
02:15:01,800 --> 02:15:04,880
OUTPUT AND CARDIAC PARAMETERS 

3223
02:15:04,880 --> 02:15:07,560
AND THRESHOLD RATE PARAMETERS 

3224
02:15:07,560 --> 02:15:09,800
AND OUTPATIENT STUDIES COMPARED 

3225
02:15:09,800 --> 02:15:12,040
TO GOLD STANDARD TECHNOLOGIES 

3226
02:15:12,040 --> 02:15:14,120
AND IT MEASURES BLOOD PRESSURE 

3227
02:15:14,120 --> 02:15:15,920
AND LOOKING AT BLOOD PRESSURE IN

3228
02:15:15,920 --> 02:15:18,880
LAST 100 YEARS REAL CHALLENGE IS

3229
02:15:18,880 --> 02:15:20,440
REAL WORLD BLOOD PRESSURE AND 

3230
02:15:20,440 --> 02:15:22,840
ONE THING TO ADDRESS REAL WORLD 

3231
02:15:22,840 --> 02:15:24,480
BLOOD PRESSURE HOW DO YOU DO IT 

3232
02:15:24,480 --> 02:15:27,480
ON SOMEBODY THAT IS ACTUALLY 

3233
02:15:27,480 --> 02:15:28,320
MOVING RISK AND [INDISCERNIBLE] 

3234
02:15:28,320 --> 02:15:29,880
SO ON AND SO FORTH?  

3235
02:15:29,880 --> 02:15:32,440
AS I SAID WE ARE TAKING 

3236
02:15:32,440 --> 02:15:34,760
CONTINUOUS IMAGES AND APPLYING 

3237
02:15:34,760 --> 02:15:36,960
LATEST IMAGE TECHNIQUES AND 

3238
02:15:36,960 --> 02:15:38,960
MISSION LEARNING MOVING RISK OF 

3239
02:15:38,960 --> 02:15:41,000
FINGER ABLE TO ISOLATE IT MOVING

3240
02:15:41,000 --> 02:15:43,600
IT FROM REAL TIME AND LOOKS LIKE

3241
02:15:43,600 --> 02:15:45,360
VIDEO IS NOT PLAYING.  NEXT 

3242
02:15:45,360 --> 02:15:46,360
SLIDE, PLEASE. 

3243
02:15:46,360 --> 02:15:49,480
THIS IS A REAL-LIFE SITUATION WE

3244
02:15:49,480 --> 02:15:52,360
SEE IN PATIENT TO ADDRESS MOTION

3245
02:15:52,360 --> 02:15:53,640
ARTIFACT AND WHAT WE ARE DOING 

3246
02:15:53,640 --> 02:15:56,080
IF NO YOU IS GOLD STANDARD 

3247
02:15:56,080 --> 02:15:56,760
AVAILABLE NOW IS 

3248
02:15:56,760 --> 02:15:57,160
[INDISCERNIBLE]. 

3249
02:15:57,160 --> 02:16:00,720
WE ARE DOING STUDIES IN PATIENTS

3250
02:16:00,720 --> 02:16:03,600
IN ICU AND OPERATING ROOMS 

3251
02:16:03,600 --> 02:16:04,240
COMPARED AGAINST [INDISCERNIBLE]

3252
02:16:04,240 --> 02:16:05,680
AND CENSOR IN OPPOSITE 

3253
02:16:05,680 --> 02:16:06,920
[INDISCERNIBLE] OF THE PATIENT 

3254
02:16:06,920 --> 02:16:08,280
THAT CAN MOVE AND IS NOT 

3255
02:16:08,280 --> 02:16:10,080
RESTRICTED AND WE ARE ABLE TO 

3256
02:16:10,080 --> 02:16:13,600
SHOW THAT WE CAN GET ACCURATE 

3257
02:16:13,600 --> 02:16:15,480
20-SECOND MEASUREMENTS IN 

3258
02:16:15,480 --> 02:16:16,760
PATIENT AND COMPARED TO 

3259
02:16:16,760 --> 02:16:17,160
[INDISCERNIBLE]. 

3260
02:16:17,160 --> 02:16:18,600
HAVING DONE THAT, WE HAVE TO 

3261
02:16:18,600 --> 02:16:22,880
SHOW THAT IT REALLY WORKS ACROSS

3262
02:16:22,880 --> 02:16:25,040
PATIENT POPULATIONS AND 

3263
02:16:25,040 --> 02:16:26,440
INITIATING MULTICENTERED TRIAL 

3264
02:16:26,440 --> 02:16:29,040
AND WHERE WE ARE LOOKING AT WAYS

3265
02:16:29,040 --> 02:16:32,280
AND BMI AND HEMODYNAMIC 

3266
02:16:32,280 --> 02:16:33,120
TRANSITIONS AND OTHER 

3267
02:16:33,120 --> 02:16:35,320
[INDISCERNIBLE] SO ON AND SO 

3268
02:16:35,320 --> 02:16:35,520
FORTH. 

3269
02:16:35,520 --> 02:16:38,240
SO, ONE GOAL FOR US IS TO BRING 

3270
02:16:38,240 --> 02:16:40,400
THIS EXPERIENCE INTO MATERNAL 

3271
02:16:40,400 --> 02:16:42,520
HEALTH THAT WE HAVE ACTUALLY 

3272
02:16:42,520 --> 02:16:47,080
INITIATED STUDY FUNDED BY NHLBI 

3273
02:16:47,080 --> 02:16:48,640
WHERE PREVIOUS PANELISTS SAID 

3274
02:16:48,640 --> 02:16:50,720
THAT FIRST OF ALL IT IS A 

3275
02:16:50,720 --> 02:16:51,840
DIFFERENT PHYSIOLOGY. 

3276
02:16:51,840 --> 02:16:55,320
IT MAY OR MAY NOT BE 

3277
02:16:55,320 --> 02:16:58,200
[INDISCERNIBLE] AND 

3278
02:16:58,200 --> 02:17:00,880
[INDISCERNIBLE] DEVICES LOOK AT 

3279
02:17:00,880 --> 02:17:06,320
OSCILLATION AND VASCULAR CHANGES

3280
02:17:06,320 --> 02:17:08,520
AND UNDERESTIMATES BLOOD 

3281
02:17:08,520 --> 02:17:11,760
PRESSURE AND WE HAVE HUGE 

3282
02:17:11,760 --> 02:17:13,240
VARIANCE IN [INDISCERNIBLE] 

3283
02:17:13,240 --> 02:17:14,560
VARIANCE IN BLOOD PRESSURE AND 

3284
02:17:14,560 --> 02:17:17,160
FOR REASONS TECHNOLOGY HAS TO BE

3285
02:17:17,160 --> 02:17:18,440
CALIBRATED TO PREGNANT MOTHERS 

3286
02:17:18,440 --> 02:17:21,320
THAT IS ONE THING WE ARE DOING. 

3287
02:17:21,320 --> 02:17:23,520
AND SECOND MAIN OBJECTIVE FOR S 

3288
02:17:23,520 --> 02:17:26,560
IS SHOWING TRUE BLOOD PRESSURE 

3289
02:17:26,560 --> 02:17:27,840
PROFILE IN PREGNANT AND PEOPLE 

3290
02:17:27,840 --> 02:17:31,960
WITH THAT.  YOU KNOW, 

3291
02:17:31,960 --> 02:17:33,680
HYPERTENSIVE DISEASE OF 

3292
02:17:33,680 --> 02:17:36,480
PREGNANCY AND GESTATIONAL 

3293
02:17:36,480 --> 02:17:39,240
HYPERTENSION AND PRECOLLAPSIA 

3294
02:17:39,240 --> 02:17:41,920
AND 24 HOUR BLOOD PRESSURE 

3295
02:17:41,920 --> 02:17:43,560
PROFILE AND SECOND MAJOR EFFORT 

3296
02:17:43,560 --> 02:17:45,640
AND THIRD IS CAN WE PREDICT AND 

3297
02:17:45,640 --> 02:17:47,560
HAVE DONE MISSION LEARNING 

3298
02:17:47,560 --> 02:17:49,600
MODELS IN CRITICAL CARE ABLE TO 

3299
02:17:49,600 --> 02:17:52,080
PREDICT ACUTE EVENTS AND CAN 

3300
02:17:52,080 --> 02:17:55,440
THAT EXPERIENCE BE BROADENED IN 

3301
02:17:55,440 --> 02:17:58,280
TERMS OF MATERNAL HEALTH?  

3302
02:17:58,280 --> 02:18:00,480
LASTLY MOST THING IS ABLE TO 

3303
02:18:00,480 --> 02:18:03,040
DIRECTLY WORK WITH OUR END 

3304
02:18:03,040 --> 02:18:04,680
CUSTOMERS THAT IS THE MOTHERS 

3305
02:18:04,680 --> 02:18:07,160
AND WE ARE GOING TO STUDY AND 

3306
02:18:07,160 --> 02:18:10,320
WORK WITH NEW YORK PUBLIC HEALTH

3307
02:18:10,320 --> 02:18:13,600
SYSTEMS AND WIDE RANGE OF ETHNIC

3308
02:18:13,600 --> 02:18:14,520
POPULATIONS AND PARTICULARLY 

3309
02:18:14,520 --> 02:18:16,440
BLACK MOTHERS AND ABLE TO WORK 

3310
02:18:16,440 --> 02:18:18,520
WITH THEM AND GET INPUTS WILL BE

3311
02:18:18,520 --> 02:18:21,120
REALLY CRITICAL FOR US. 

3312
02:18:21,120 --> 02:18:21,640
THANK YOU. 

3313
02:18:21,640 --> 02:18:24,080
>> GREAT.  

3314
02:18:24,080 --> 02:18:27,360
OKAY.  NEXT SLIDE, PLEASE?  

3315
02:18:27,360 --> 02:18:29,720
>> THANK YOU.  

3316
02:18:29,720 --> 02:18:33,280
YEAH.  SO, I -- I AM A PHYSICIAN

3317
02:18:33,280 --> 02:18:36,120
IN MY PAST LIFE AND BIOMEDICAL 

3318
02:18:36,120 --> 02:18:37,880
ENGINEERING BY TRAINER 

3319
02:18:37,880 --> 02:18:39,200
ANDOSMOSIS AND IS DIFFERENT 

3320
02:18:39,200 --> 02:18:41,320
TYPES OF PROJECTS THAT MY 

3321
02:18:41,320 --> 02:18:43,280
STUDENTS AND COLLABORATORS HAVE 

3322
02:18:43,280 --> 02:18:46,200
LOOKED AT IN OUR CENTER IN MY 

3323
02:18:46,200 --> 02:18:48,160
LAB AND RINGSIDE VIEW OF MORE OF

3324
02:18:48,160 --> 02:18:50,200
THE PROCESS HOW SOME THINGS HAVE

3325
02:18:50,200 --> 02:18:56,080
SUCCEEDED AND SOME ARE ON THE 

3326
02:18:56,080 --> 02:19:01,120
MARKET AND SOME ARE NOT AND 

3327
02:19:01,120 --> 02:19:04,520
STARTING WITH ONE WITH TEST THAT

3328
02:19:04,520 --> 02:19:09,240
IS SMALL AND PROJECT WORKED BY 

3329
02:19:09,240 --> 02:19:11,120
UNDERGRADUATE STUDENTS AT 

3330
02:19:11,120 --> 02:19:13,520
HOPKINS PART OF THE DESIGN CLASS

3331
02:19:13,520 --> 02:19:18,880
AND DESIGNED EXTREMELY EXPENSIVE

3332
02:19:18,880 --> 02:19:21,320
PROTEINURIA KID COULD BE TAKEN 

3333
02:19:21,320 --> 02:19:24,000
TO DOOR STEP OF -- INNOVATION 

3334
02:19:24,000 --> 02:19:27,480
THERE WAS REENGINEERED 

3335
02:19:27,480 --> 02:19:29,160
BIOCHEMISTRY OF DIP STICK AND 

3336
02:19:29,160 --> 02:19:31,080
PUT IN HIGH LIGHTER PEN AND 

3337
02:19:31,080 --> 02:19:33,200
COMMUNITY HEALTH WORKERS WOULD 

3338
02:19:33,200 --> 02:19:35,680
HIGHLIGHT THAT IN LANARD AND 

3339
02:19:35,680 --> 02:19:36,760
MANUFACTURER TEST STRIP AT POINT

3340
02:19:36,760 --> 02:19:39,640
OF LOCALLY AVAILABLE PIECE OF 

3341
02:19:39,640 --> 02:19:41,440
PAPER THAT WE GOT SIGNIFICANT 

3342
02:19:41,440 --> 02:19:47,040
FUNDING FROM USAID A DIV AWARD 

3343
02:19:47,040 --> 02:19:49,640
WINNER AND DID CLINICAL STUDY 

3344
02:19:49,640 --> 02:19:52,760
AND SHOWS IT ENDED UP HAVING 

3345
02:19:52,760 --> 02:19:56,480
HIGHER DENSITY SPECIFICITY THAN 

3346
02:19:56,480 --> 02:19:59,400
DIP STICKS FINDING AT PHARMACY 

3347
02:19:59,400 --> 02:20:02,720
AND 1/3% OF TEST THAT DIDN'T GET

3348
02:20:02,720 --> 02:20:03,320
TO MARKET. 

3349
02:20:03,320 --> 02:20:05,320
WAS ABOUT 10 YEARS AGO AND 

3350
02:20:05,320 --> 02:20:07,960
REASONS RELATE TODAY BUSINESS 

3351
02:20:07,960 --> 02:20:11,880
MODEL APPROPRIATENESS AND 

3352
02:20:11,880 --> 02:20:12,440
ERRONEOUSLY SELECTED 

3353
02:20:12,440 --> 02:20:13,640
MANUFACTURING PARTNER THAT IS 

3354
02:20:13,640 --> 02:20:16,480
NOT HELPING MOTHERS IN WORLD 

3355
02:20:16,480 --> 02:20:18,920
TODAY DESPITE SIGNIFICANTING 

3356
02:20:18,920 --> 02:20:21,000
FUNDING BEHIND IT AND CONTRAST 

3357
02:20:21,000 --> 02:20:25,640
THAT WITH ONE RIGHT BELOW THAT 

3358
02:20:25,640 --> 02:20:26,320
NON-INVASIVE HEMOGLOBINO METER 

3359
02:20:26,320 --> 02:20:28,320
THAT WE DEVELOPED STARTING BACK 

3360
02:20:28,320 --> 02:20:30,560
IN 2012 THAT IS, AGAIN, 

3361
02:20:30,560 --> 02:20:34,440
SIMILARLY WITH AIM OF TAKING 

3362
02:20:34,440 --> 02:20:36,000
MATERNAL ANEMIA SCREENING TO 

3363
02:20:36,000 --> 02:20:39,280
DOORSTEP OF RURAL WOMEN IN SUBIS

3364
02:20:39,280 --> 02:20:43,560
A HARRANT AFRICA AND 

3365
02:20:43,560 --> 02:20:44,480
[INDISCERNIBLE] ON A 

3366
02:20:44,480 --> 02:20:46,200
[INDISCERNIBLE] CENSOR AND 

3367
02:20:46,200 --> 02:20:49,240
CUSTOM TO DESIGN MACHINE 

3368
02:20:49,240 --> 02:20:51,640
LEARNING OUTCOMES FINALLY DOG 

3369
02:20:51,640 --> 02:20:54,280
THE TRICK AND ITERATIONS THAT 

3370
02:20:54,280 --> 02:20:56,840
WERE 5 OR 6 THAT WERE DEVELOPED 

3371
02:20:56,840 --> 02:20:59,680
IN THE LAB AND PARTNER WITH BOSH

3372
02:20:59,680 --> 02:21:03,200
THEY DEVELOPED SOME CUSTOM 

3373
02:21:03,200 --> 02:21:05,280
HARDWARE FOR CENSOR AND DEVICE 

3374
02:21:05,280 --> 02:21:09,000
YOU SEE INSET IN THE BOTTOM 

3375
02:21:09,000 --> 02:21:11,800
RIGHT OF THAT IS THIS HAS BEEN 

3376
02:21:11,800 --> 02:21:13,880
ANALYZED AND LAUNCHED IN INDIAN 

3377
02:21:13,880 --> 02:21:15,480
MARKET AND ABOUT TO BE LAUNCHED 

3378
02:21:15,480 --> 02:21:17,840
IN COUNTRIES IN AFRICA AND 

3379
02:21:17,840 --> 02:21:19,400
HOPEFULLY EVEN THOUGH IT IS -- 

3380
02:21:19,400 --> 02:21:22,000
IT HAS BEEN COMMERCIALLY 

3381
02:21:22,000 --> 02:21:23,440
INTRODUCED AND WHO KNOWS 

3382
02:21:23,440 --> 02:21:26,200
TECHNOLOGIES COMING OUT OF YOUR 

3383
02:21:26,200 --> 02:21:27,720
LAB SDR DISRUPTING THIS MIGHT 

3384
02:21:27,720 --> 02:21:30,160
NOT NEED A CENSOR BUT APP. 

3385
02:21:30,160 --> 02:21:32,560
>> MANY WAYS TO SKIN A
CAT; 

3386
02:21:32,560 --> 02:21:33,520
RIGHT?  

3387
02:21:33,520 --> 02:21:35,120
>> ABSOLUTELY.  I RAISE
POINT 

3388
02:21:35,120 --> 02:21:38,160
WITH BOSH LEADERSHIP TO BE 

3389
02:21:38,160 --> 02:21:40,080
PREPARED FOR DISRUPTION AS 

3390
02:21:40,080 --> 02:21:42,680
SCIENCE EVOLVES AND ONE ON TOP 

3391
02:21:42,680 --> 02:21:47,040
RIGHT OF THE SLIDE IS A PARTO 

3392
02:21:47,040 --> 02:21:49,000
GRAM AND THOSE IN OBSTETRICS 

3393
02:21:49,000 --> 02:21:52,360
KNOW WHAT A PARTO GRAM IS NOT 

3394
02:21:52,360 --> 02:21:54,400
COMMONLY USED IN UNITED STATES 

3395
02:21:54,400 --> 02:21:57,440
BUT REST OF THE WORLD OBSTETRICS

3396
02:21:57,440 --> 02:21:58,800
PRACTICE USES [INDISCERNIBLE] A 

3397
02:21:58,800 --> 02:22:02,000
PAPER TOOL USED BY DEVICE AND 

3398
02:22:02,000 --> 02:22:03,920
MOSTLY MIDWIVES AND NURSES TO 

3399
02:22:03,920 --> 02:22:05,920
MAKE APPROPRIATE DECISIONS IN 

3400
02:22:05,920 --> 02:22:07,320
MANAGEMENT OF LABOR THAT TRACKS 

3401
02:22:07,320 --> 02:22:11,960
12 OR 13 VARIABLES OF LABOR AND 

3402
02:22:11,960 --> 02:22:14,680
DELIVERY WITH MATERIAL WELLBEING

3403
02:22:14,680 --> 02:22:16,680
AND PROGRESS OF LABOR AND WORK 

3404
02:22:16,680 --> 02:22:19,400
WITH [INDISCERNIBLE] AND NGO AND

3405
02:22:19,400 --> 02:22:20,760
MATERNAL HEALTH AROUND THE WORLD

3406
02:22:20,760 --> 02:22:23,040
AND WORKING WITH THEM WE 

3407
02:22:23,040 --> 02:22:25,240
DEVELOPED LOW-COST ELECTRONIC 

3408
02:22:25,240 --> 02:22:27,800
VERSION OF THE PROGRAM WITH 

3409
02:22:27,800 --> 02:22:30,040
EPARTO GRAM, IF YOU WILL.  

3410
02:22:30,040 --> 02:22:33,080
SEVERAL ITERATIONS OF THAT, TWO 

3411
02:22:33,080 --> 02:22:35,680
ARE SHOWN IN-BETWEEN AND SHOWING

3412
02:22:35,680 --> 02:22:38,240
DESIGN OF PRODUCT IS ITERATIVE 

3413
02:22:38,240 --> 02:22:40,240
ALWAYS AND THERE IS A DINLTIZING

3414
02:22:40,240 --> 02:22:41,720
[INDISCERNIBLE] THAT COULD BE 

3415
02:22:41,720 --> 02:22:45,760
MADE FOR $10 AND CUSTOM MADE.  

3416
02:22:45,760 --> 02:22:47,840
YOU KNOW?  

3417
02:22:47,840 --> 02:22:48,800
EINK KINDLE VERSION OF 

3418
02:22:48,800 --> 02:22:50,720
[INDISCERNIBLE] AND FINALLY WE 

3419
02:22:50,720 --> 02:22:52,600
HAVE SOMETHING ON A SMARTPHONE 

3420
02:22:52,600 --> 02:22:55,120
THAT IS REALLY CHEAPER AND NOW 

3421
02:22:55,120 --> 02:22:58,280
HAS 7 OR 8 DIFFERENT VERSIONS 

3422
02:22:58,280 --> 02:22:59,040
AND MULTIORGANIZATIONS AROUND 

3423
02:22:59,040 --> 02:23:01,040
WORLD HAVE TAKEN THIS UP AND 

3424
02:23:01,040 --> 02:23:03,760
PUTTING OWN FLAVOR TO IT 

3425
02:23:03,760 --> 02:23:05,680
INCLUDING SEVERAL DIGITAL HEALTH

3426
02:23:05,680 --> 02:23:09,480
TECH AND THIS IS ALSO NOW IN -- 

3427
02:23:09,480 --> 02:23:11,320
UNDERGOING CLINICAL TRIALS 

3428
02:23:11,320 --> 02:23:13,320
PUBLISHED AND SOME WORK ON 

3429
02:23:13,320 --> 02:23:15,240
EFFECTIVENESS AND ELECTRONICS 

3430
02:23:15,240 --> 02:23:17,200
HAVE BEEN PUBLISHED BY 

3431
02:23:17,200 --> 02:23:19,480
[INDISCERNIBLE] AND WHO CHANGED 

3432
02:23:19,480 --> 02:23:22,120
MATERNAL HEALTH GUIDELINES AND 

3433
02:23:22,120 --> 02:23:24,400
SOME KNOW THAT A YEAR AGO.  ALL 

3434
02:23:24,400 --> 02:23:26,760
BASIS OF THIS PARTO GRAM NOW HAS

3435
02:23:26,760 --> 02:23:29,720
TO BE REDONE.  GLOBAL GUIDANCE 

3436
02:23:29,720 --> 02:23:32,640
OF HOW -- YOU KNOW, OF LABOR AND

3437
02:23:32,640 --> 02:23:34,840
TLIFRY SHOULD BE MANAGED IS 

3438
02:23:34,840 --> 02:23:37,680
CHANGED BY WHO RECENTLY AND 

3439
02:23:37,680 --> 02:23:38,920
TAKING INTEREST OF TIME AND LAST

3440
02:23:38,920 --> 02:23:43,080
ONE ON BOTTOM RIGHT.  THAT IS A 

3441
02:23:43,080 --> 02:23:44,520
DIGITAL HEALTH NON-PROFIT 

3442
02:23:44,520 --> 02:23:46,720
STARTED BY PHD STUDENT AND 

3443
02:23:46,720 --> 02:23:49,400
MYSELF AND A BUNCH OF OTHER 

3444
02:23:49,400 --> 02:23:52,080
STUDENTS AT THE CENTER THAT IS 

3445
02:23:52,080 --> 02:23:54,960
NOW CROSSED. 

3446
02:23:54,960 --> 02:23:56,960
BASIS IS LIKE [INDISCERNIBLE] 

3447
02:23:56,960 --> 02:23:59,240
SERIES FOR COMMUNITY HEALTH AND 

3448
02:23:59,240 --> 02:24:03,520
EXPORT ENABLED TELEMEDICINE 

3449
02:24:03,520 --> 02:24:06,600
PLATFORM TO AUTONOMOUSLY PERFORM

3450
02:24:06,600 --> 02:24:07,640
CERTAIN TASKS AND MEDICAL 

3451
02:24:07,640 --> 02:24:10,120
HISTORY AND DOING ANTI-NATAL 

3452
02:24:10,120 --> 02:24:13,000
VISIT THAT IS COMPLETING THAT 

3453
02:24:13,000 --> 02:24:14,800
AUTONOMOUSLY AND CONNECTING WITH

3454
02:24:14,800 --> 02:24:18,040
CLOUD NETWORK ABDUCTORS MINIMAL 

3455
02:24:18,040 --> 02:24:20,320
TIME OF EFFORT OF DOCTORS AND 

3456
02:24:20,320 --> 02:24:22,200
HIGH QUALITY BASE CARED FOR 

3457
02:24:22,200 --> 02:24:23,760
CLIENT AND COMPREHENSIVE PRIMARY

3458
02:24:23,760 --> 02:24:25,800
CARE AND THIS IS DEPLOYED IN 

3459
02:24:25,800 --> 02:24:27,880
MULTIPLE AREAS IN INDIA AND 

3460
02:24:27,880 --> 02:24:30,160
TRIBAL AREAS ESPECIALLY 

3461
02:24:30,160 --> 02:24:32,520
PARTICULARLY IN PHILIPPINES FOR 

3462
02:24:32,520 --> 02:24:35,720
ANTI-NATAL SERVICES THAT IS NOW 

3463
02:24:35,720 --> 02:24:40,040
ALSO IN SYRIA HELPING VARIOUS 

3464
02:24:40,040 --> 02:24:42,200
INTERN DISPLACED POPULATION AND 

3465
02:24:42,200 --> 02:24:45,080
EMPOWERS [INDISCERNIBLE] TO 

3466
02:24:45,080 --> 02:24:49,960
PERFORM AT CERTAIN LEVEL 

3467
02:24:49,960 --> 02:24:52,360
CROSSING LANDMARK FIRST PHD 

3468
02:24:52,360 --> 02:24:53,680
STUDENT FIRST START-UP PART OF 

3469
02:24:53,680 --> 02:24:56,360
THE PHD AND ONE LESSON FROM THAT

3470
02:24:56,360 --> 02:24:59,880
ONE IS OUR STUDENTS ACTUALLY 

3471
02:24:59,880 --> 02:25:02,600
WENT AND LIVED WITH COMMUNITY 

3472
02:25:02,600 --> 02:25:06,280
HEALTH WORKERS IN THEIR HOUSES 

3473
02:25:06,280 --> 02:25:09,200
JUST UNDERSTANDING PERSONA AND 

3474
02:25:09,200 --> 02:25:11,240
UNDERSTANDING HOW CARE BEHAVIOR 

3475
02:25:11,240 --> 02:25:13,400
PERCEPTIONS ARE.  NEXT SLIDE, 

3476
02:25:13,400 --> 02:25:13,640
PLEASE. 

3477
02:25:13,640 --> 02:25:15,320
VERY BRIEFLY, I WANT TO TALK 

3478
02:25:15,320 --> 02:25:16,840
ABOUT THE PROCESS. 

3479
02:25:16,840 --> 02:25:19,440
TAKING, YOU KNOW, SOLVING A 

3480
02:25:19,440 --> 02:25:21,600
CLINICAL PROBLEM AND COMING UP 

3481
02:25:21,600 --> 02:25:23,120
WITH ACTUAL TECHNOLOGY MAKING 

3482
02:25:23,120 --> 02:25:25,320
IMPACT ON PATIENTS IN LARGE 

3483
02:25:25,320 --> 02:25:28,640
NUMBERS REQUIRES THAT YOU 

3484
02:25:28,640 --> 02:25:31,640
NAVIGATE A RANGE OF ISSUES IN 

3485
02:25:31,640 --> 02:25:34,160
CLINICAL AND PUBLIC HEALTH 

3486
02:25:34,160 --> 02:25:36,800
DOMAIN RELATED TO PATIENT 

3487
02:25:36,800 --> 02:25:40,080
PERSPECTIVES AND PROVIDER 

3488
02:25:40,080 --> 02:25:41,800
ISSUES, ET CETERA IMPLEMENTATION

3489
02:25:41,800 --> 02:25:43,800
AND REGULATORY POLICY AND COULD 

3490
02:25:43,800 --> 02:25:46,440
BE DESIGN AND ACTUAL CORE 

3491
02:25:46,440 --> 02:25:47,720
TECHNOLOGY AND THE EVIDENCE THAT

3492
02:25:47,720 --> 02:25:50,000
NEEDS TO BE GENERATED OR COULD 

3493
02:25:50,000 --> 02:25:52,920
BE STRATEGIC FUNDRAISING TEAM, 

3494
02:25:52,920 --> 02:25:53,240
ET CETERA. 

3495
02:25:53,240 --> 02:25:54,360
NEXT SLIDE, PLEASE. 

3496
02:25:54,360 --> 02:25:56,280
PROCESS THAT WE FOLLOW IS WHAT I

3497
02:25:56,280 --> 02:25:58,040
WOULD LIKE TO LEAVE YOU WITH.  

3498
02:25:58,040 --> 02:26:01,280
IT IS IN EVERY SUCCESSFUL HEALTH

3499
02:26:01,280 --> 02:26:03,320
CARE TECHNOLOGY THAT HAS BEEN 

3500
02:26:03,320 --> 02:26:05,200
TRANSLATED YOU CAN START YOUR 

3501
02:26:05,200 --> 02:26:07,520
JOURNEY THROUGH WITH A CLINICAL 

3502
02:26:07,520 --> 02:26:09,160
PROBLEM LIKE IN CLINICAL 

3503
02:26:09,160 --> 02:26:10,960
QUADRANT OR COULD BE WITH NEW 

3504
02:26:10,960 --> 02:26:12,320
DISCOVERY HAPPENING IN A LAB 

3505
02:26:12,320 --> 02:26:16,080
THAT HAPPENS IN ACADEMIC 

3506
02:26:16,080 --> 02:26:17,560
MEDICINE DOING CLASSICAL BEFRNL 

3507
02:26:17,560 --> 02:26:20,560
TO BEDSIDE MODEL AND LARGE 

3508
02:26:20,560 --> 02:26:21,960
CORPORATION YOU MIGHT HAVE 

3509
02:26:21,960 --> 02:26:24,680
PRIORITIES WE ARE NO. 1 IN 

3510
02:26:24,680 --> 02:26:26,880
SUTURES WHAT IS NEXT WE CAN DO 

3511
02:26:26,880 --> 02:26:28,520
AND NO. 1 BLOOD PRESSURE COMPANY

3512
02:26:28,520 --> 02:26:31,400
WHAT IS NEXT THING WE CAN DO?  

3513
02:26:31,400 --> 02:26:33,680
POINT IS YOU HAVE TO INSTEAD OF 

3514
02:26:33,680 --> 02:26:35,600
TAKING LINEAR APPROACH WHERE YOU

3515
02:26:35,600 --> 02:26:38,640
EITHER SOLVE TECHNOLOGY FIRST 

3516
02:26:38,640 --> 02:26:42,760
AND THEN TRY TO FIND OR NAIL 

3517
02:26:42,760 --> 02:26:46,400
THAT NUMBER OR AS TYPICALLY IS 

3518
02:26:46,400 --> 02:26:49,360
DONE [INDISCERNIBLE] TO BEDSIDE 

3519
02:26:49,360 --> 02:26:51,120
MODEL YOU DO RESEARCH AND 

3520
02:26:51,120 --> 02:26:52,440
UNDERSTAND CLINICAL USE CASE AND

3521
02:26:52,440 --> 02:26:54,240
THINK ABOUT NOW HOW DO WE GET 

3522
02:26:54,240 --> 02:26:56,520
THROUGH FDA AND HOW DO WE 

3523
02:26:56,520 --> 02:26:58,040
GENERATE EVIDENCE FOR IT?  

3524
02:26:58,040 --> 02:27:00,640
A MODEL THAT HAS WORKED WELL AND

3525
02:27:00,640 --> 02:27:02,920
WHAT WE TEACH AT OUR CENTER TO A

3526
02:27:02,920 --> 02:27:05,520
NEW GENERATIONINO VATORS IS 

3527
02:27:05,520 --> 02:27:07,760
TAKING INNOVATIVE APPROACH AND 

3528
02:27:07,760 --> 02:27:09,600
ADDRESSING ALL ISSUES AT 

3529
02:27:09,600 --> 02:27:12,120
APPROPRIATE LEVEL OF DEPTH FOR 

3530
02:27:12,120 --> 02:27:13,600
INNOVATION IS AND DON'T IGNORE 

3531
02:27:13,600 --> 02:27:16,560
ISSUES AND WHEN THINKING OF NEED

3532
02:27:16,560 --> 02:27:20,800
AND OF A PROBLEM THINKING ABOUT 

3533
02:27:20,800 --> 02:27:23,560
REGULATORS AND SCIENTIFIC HURDLE

3534
02:27:23,560 --> 02:27:25,760
TO OVERCOME WHAT DOES EVIDENCE 

3535
02:27:25,760 --> 02:27:27,600
LOOK LIKE CLASS 2 ADVICE AND 

3536
02:27:27,600 --> 02:27:29,440
CLASS 2 ET CETERA, ET CETERA.  

3537
02:27:29,440 --> 02:27:32,080
TAKING NEXT STEP AND EACH 

3538
02:27:32,080 --> 02:27:34,080
ITERATION THINKING IF HYPOTHESES

3539
02:27:34,080 --> 02:27:37,720
HOLDS TRUE DO YOU MODIFY IT OR 

3540
02:27:37,720 --> 02:27:39,040
[INDISCERNIBLE] PROJECT AND 

3541
02:27:39,040 --> 02:27:41,120
EVOLVE AND LEARN AND HEART OF 

3542
02:27:41,120 --> 02:27:43,360
MOST SUCCESSINOVATIONS AS WELL 

3543
02:27:43,360 --> 02:27:45,680
AS LESSONS LEARNED FROM ME THAT 

3544
02:27:45,680 --> 02:27:47,560
ARE THINGS THAT DIDN'T GO TO 

3545
02:27:47,560 --> 02:27:49,400
MARKET IS WE YOU KNOW TRY TO PAY

3546
02:27:49,400 --> 02:27:52,240
ATTENTION TO ALL THESE ISSUES 

3547
02:27:52,240 --> 02:27:55,040
ITERATIVELY OPPOSED TO A LINEAR 

3548
02:27:55,040 --> 02:27:55,480
FASHION.  

3549
02:27:55,480 --> 02:27:57,800
THANK YOU. 

3550
02:27:57,800 --> 02:28:00,520
>> THANK YOU!  

3551
02:28:00,520 --> 02:28:01,080
>> GREAT. 

3552
02:28:01,080 --> 02:28:03,840
>> THANK YOU.  IT IS
ALMOST THE

3553
02:28:03,840 --> 02:28:05,360
PERFECT REAL-LIFE ILLUSTRATION 

3554
02:28:05,360 --> 02:28:06,400
OF YOUR LAST SLIDE. 

3555
02:28:06,400 --> 02:28:08,400
I THINK IT IS A GREAT 

3556
02:28:08,400 --> 02:28:08,880
TRANSITION.  

3557
02:28:08,880 --> 02:28:11,320
AS I MENTIONED, I WILL TALK A 

3558
02:28:11,320 --> 02:28:15,000
LITTLE ABOUT SOME OF OUR WORK IN

3559
02:28:15,000 --> 02:28:18,560
RWANDA SPECIFICALLY WORKER LED 

3560
02:28:18,560 --> 02:28:19,960
HOME-BASED CARE AND AFTER 

3561
02:28:19,960 --> 02:28:22,360
DELIVERY AND FOCUS ON CARE 

3562
02:28:22,360 --> 02:28:23,760
ACCESS AND OUTCOMES FOR WOMEN IN

3563
02:28:23,760 --> 02:28:26,160
VERY RURAL PARTS OF RWANDA AND 

3564
02:28:26,160 --> 02:28:27,680
RECOGNIZE THAT LOTS OF FOLKS HAD

3565
02:28:27,680 --> 02:28:31,240
HERE ARE FOCUSED ON US-BASED 

3566
02:28:31,240 --> 02:28:32,120
APPLICATIONS AND TALKING BEFORE 

3567
02:28:32,120 --> 02:28:35,560
PANEL STARTED ABOUT ALL DIGITAL 

3568
02:28:35,560 --> 02:28:38,240
INNOVATIONS HAPPENING IN SUBIS A

3569
02:28:38,240 --> 02:28:39,920
HARRANT AFRICA AND GLOBALLY AND 

3570
02:28:39,920 --> 02:28:41,960
LEARNING FROM US AND DIGITAL 

3571
02:28:41,960 --> 02:28:43,400
INNOVATIONS AND HAPPY TO SHARE 

3572
02:28:43,400 --> 02:28:45,040
THAT WORK WITH YOU.  

3573
02:28:45,040 --> 02:28:48,200
I WANT TO START WITH OUR TEAM A 

3574
02:28:48,200 --> 02:28:49,480
SNAPSHOT OF SCIENTIFIC 

3575
02:28:49,480 --> 02:28:51,920
LEADERSHIP THAT IS REPRESENTING 

3576
02:28:51,920 --> 02:28:54,320
A VERY BIG AND 

3577
02:28:54,320 --> 02:28:55,560
MULTI-DISCIPLINARY TEAM AND FOR 

3578
02:28:55,560 --> 02:28:56,520
ME, REASON IT IS IMPORTANT TO 

3579
02:28:56,520 --> 02:28:58,640
START WITH THE TEAM IS GOING 

3580
02:28:58,640 --> 02:29:01,120
BACK TO THE QUESTIONS AROUND 

3581
02:29:01,120 --> 02:29:02,200
IMPLEMENTATION AND TRANSLATION 

3582
02:29:02,200 --> 02:29:03,960
AND IMPACT. 

3583
02:29:03,960 --> 02:29:05,360
SO, I TRULY BELIEVE THAT THE 

3584
02:29:05,360 --> 02:29:07,560
REASON THAT WE ARE ON TO 

3585
02:29:07,560 --> 02:29:09,440
SOMETHING, A TECHNOLOGY 

3586
02:29:09,440 --> 02:29:11,240
INNOVATION THAT IS NOT ONLY 

3587
02:29:11,240 --> 02:29:12,400
INTERESTING FROM A TECHNOLOGY 

3588
02:29:12,400 --> 02:29:14,360
POINT OF VIEW, BUT ALSO HAS A 

3589
02:29:14,360 --> 02:29:17,000
REAL POTENTIAL TO INFLUENCE CARE

3590
02:29:17,000 --> 02:29:18,320
THAT WOMEN RECEIVE IS BECAUSE 

3591
02:29:18,320 --> 02:29:20,840
OUR TEAM IS SO 

3592
02:29:20,840 --> 02:29:22,560
MULTI-DISCIPLINARY.  

3593
02:29:22,560 --> 02:29:23,920
WE ARE NOT TECHNOLOGY LOOKING 

3594
02:29:23,920 --> 02:29:26,520
FOR A PROBLEM TO SOLVE BUT CAME 

3595
02:29:26,520 --> 02:29:29,160
AT THIS FROM A PROBLEM-CENTERED 

3596
02:29:29,160 --> 02:29:30,440
APPROACH.  NEXT SLIDE, PLEASE. 

3597
02:29:30,440 --> 02:29:32,200
WHAT IS THAT PROBLEM?  

3598
02:29:32,200 --> 02:29:34,480
WHAT ARE GAPS THAT WE ARE TRYING

3599
02:29:34,480 --> 02:29:36,480
TO ADDRESS?  

3600
02:29:36,480 --> 02:29:39,040
WOMEN AFTER CRESSARIAN DELIVERY 

3601
02:29:39,040 --> 02:29:41,000
HAVE HIGH RATES OF COMPLICATION 

3602
02:29:41,000 --> 02:29:44,200
AND HIGHER IN RURAL RWANDA IT 

3603
02:29:44,200 --> 02:29:46,280
THAN YOU WILL SEE IN MUCH OF THE

3604
02:29:46,280 --> 02:29:49,320
US AND COMPLICATION WE FOCUS ON 

3605
02:29:49,320 --> 02:29:51,760
MOST IS SURGICAL SITE INFECTIONS

3606
02:29:51,760 --> 02:29:54,520
OCCURRING IN 10% OF SESARIAN 

3607
02:29:54,520 --> 02:29:57,320
DELIVERIES IN CONTEXT WHERE I 

3608
02:29:57,320 --> 02:29:59,360
WORK AND COMPLICATIONS TRYING TO

3609
02:29:59,360 --> 02:30:01,480
ACKNOWLEDGE THAT MANY 

3610
02:30:01,480 --> 02:30:03,080
HIGHLIGHTED ON PREVIOUS PANEL 

3611
02:30:03,080 --> 02:30:04,800
AND SECOND CHALLENGE WE ARE 

3612
02:30:04,800 --> 02:30:06,800
TRYING TO ADDRESS IS POST-OP 

3613
02:30:06,800 --> 02:30:08,440
ITERATIVE CARE FOR WOMEN 

3614
02:30:08,440 --> 02:30:10,520
DELIVERING VIA C SECTION IS 

3615
02:30:10,520 --> 02:30:11,840
DIFFICULT FINANCIALLY AND 

3616
02:30:11,840 --> 02:30:13,000
PHYSICALLY FOR WOMEN TO GO BACK 

3617
02:30:13,000 --> 02:30:14,560
TO HOSPITALS TO RECEIVE THAT 

3618
02:30:14,560 --> 02:30:14,800
CARE. 

3619
02:30:14,800 --> 02:30:17,240
WHY WE ARE TRYING TO USE A 

3620
02:30:17,240 --> 02:30:18,560
DIGITAL TOOL TO SUPPORT 

3621
02:30:18,560 --> 02:30:21,280
COMMUNITY HEALTH WORKERS TO 

3622
02:30:21,280 --> 02:30:23,320
FOLLOW WOMEN IN THESE CONTEXTS, 

3623
02:30:23,320 --> 02:30:26,720
ONE, IT GIVES OPPORTUNITY TO DO 

3624
02:30:26,720 --> 02:30:28,680
TIMELY DIAGNOSIS OF 

3625
02:30:28,680 --> 02:30:31,040
COMPLICATIONS AND REMOVES 

3626
02:30:31,040 --> 02:30:32,760
WOMEN'S SPECIFIED BARRIERS OF 

3627
02:30:32,760 --> 02:30:34,480
GOING BACK TO HEALTH FACILITIES 

3628
02:30:34,480 --> 02:30:37,600
AND I THINK THAT THE LAST POINT 

3629
02:30:37,600 --> 02:30:39,200
IS IMPORTANT BECAUSE 

3630
02:30:39,200 --> 02:30:40,840
SPECIFICALLY TALKING ON POINTS 

3631
02:30:40,840 --> 02:30:42,560
WHAT DO WOMEN WANT AND WHAT TYPE

3632
02:30:42,560 --> 02:30:44,960
OF CARE THEY WANT TO RECEIVE AND

3633
02:30:44,960 --> 02:30:46,400
BELIEVE THAT THIS TYPE OF CARE 

3634
02:30:46,400 --> 02:30:49,840
IS PATIENT CENTERED AND FOCUSES 

3635
02:30:49,840 --> 02:30:52,080
ON DIRECT REQUEST FOR PATIENT'S 

3636
02:30:52,080 --> 02:30:54,480
CARE AND EXCITING TIME TO DO 

3637
02:30:54,480 --> 02:30:59,000
THIS IN RWANDA FOUR YEARS AGO 

3638
02:30:59,000 --> 02:31:00,080
LAUNCHED [INDISCERNIBLE] WHICH 

3639
02:31:00,080 --> 02:31:02,040
IS FIRST SMARTPHONE MADE ON 

3640
02:31:02,040 --> 02:31:04,360
AFRICAN CONTINENT AND MADE 

3641
02:31:04,360 --> 02:31:06,080
COMMITMENT TO GET SMARTPHONES IN

3642
02:31:06,080 --> 02:31:10,520
HANDS OF 60,000 HEALTH WORKERS 

3643
02:31:10,520 --> 02:31:11,680
IN RWANDA.  NEXT SLIDE. 

3644
02:31:11,680 --> 02:31:13,920
TWO EXAMPLES OF TECHNOLOGY 

3645
02:31:13,920 --> 02:31:15,000
INNOVATION IN THIS WORK. 

3646
02:31:15,000 --> 02:31:17,160
I DON'T THINK THAT ALL 

3647
02:31:17,160 --> 02:31:18,560
INNOVATION HAS TO BE TECHNOLOGY.

3648
02:31:18,560 --> 02:31:20,280
THIS IS A TECHNOLOGY PANEL AND I

3649
02:31:20,280 --> 02:31:21,920
WANT TO FOCUS ON THAT. 

3650
02:31:21,920 --> 02:31:24,280
FIRST ON THE LEFT IS TALKING 

3651
02:31:24,280 --> 02:31:27,600
ABOUT SURGICAL SITE INFECTION 

3652
02:31:27,600 --> 02:31:29,160
DIAGNOSTIC TOOLS AND OVER COURSE

3653
02:31:29,160 --> 02:31:31,920
OF SEVERAL STUDIES WE CONTINUE 

3654
02:31:31,920 --> 02:31:36,280
TO COLLECT WOUND IMAGES AND GP 

3655
02:31:36,280 --> 02:31:37,840
SURGICAL SITE INFECTION 

3656
02:31:37,840 --> 02:31:39,120
DIAGNOSIS BASED ON PHYSICAL 

3657
02:31:39,120 --> 02:31:41,880
EXAMS AND HAVE USED DATABASE OF 

3658
02:31:41,880 --> 02:31:45,600
IMAGES AND DIAGNOSIS TO DEVELOP 

3659
02:31:45,600 --> 02:31:47,120
IMAGE-BASED DIAGNOSTIC 

3660
02:31:47,120 --> 02:31:48,400
ALGORITHMS THAT CAN RUN ON 

3661
02:31:48,400 --> 02:31:50,280
MOBILE PHONES AND FIRST ON TOP 

3662
02:31:50,280 --> 02:31:52,320
IS USING PHONE IMBEDDED IN 

3663
02:31:52,320 --> 02:31:54,880
SMARTPHONES YOU TAKE PHOTO OF 

3664
02:31:54,880 --> 02:31:56,280
WOUND DEVELOPING COMPUTER VISION

3665
02:31:56,280 --> 02:31:57,800
TECHNOLOGY TO STANDARDIZE 

3666
02:31:57,800 --> 02:31:59,880
QUALITY AND ROTATION OF THE 

3667
02:31:59,880 --> 02:32:01,720
IMAGES AND USING IMAGE FROM THE 

3668
02:32:01,720 --> 02:32:03,680
PHONE THAT CAN GO ON WITH 

3669
02:32:03,680 --> 02:32:05,520
RELATIVELY HIGH ACCURACY 

3670
02:32:05,520 --> 02:32:06,920
PREDICTING WHETHER OR NOT THAT 

3671
02:32:06,920 --> 02:32:09,440
WOMAN IS HIGH RISK OF HAVING 

3672
02:32:09,440 --> 02:32:10,840
SURGICAL SITE INFECTION NEEDING 

3673
02:32:10,840 --> 02:32:12,400
TO REFER BACK TO CARE AND BOTTOM

3674
02:32:12,400 --> 02:32:15,280
ONE IS ONE WE ARE EXCITED ABOUT 

3675
02:32:15,280 --> 02:32:18,800
THAT REQUIRED A THERMAL CAMERA 

3676
02:32:18,800 --> 02:32:23,040
ADD-ON.  $200 PER DEVICE ADD-ON 

3677
02:32:23,040 --> 02:32:25,800
AND ACHIEVING HIGHER ACCURACY OF

3678
02:32:25,800 --> 02:32:28,040
SURGICAL SITE INFECTIONS AND 

3679
02:32:28,040 --> 02:32:29,800
EXCITED FOR THIS.  PREVIOUS 

3680
02:32:29,800 --> 02:32:31,520
ALGORITHM IS DEVELOPED FOR WOMEN

3681
02:32:31,520 --> 02:32:34,160
IN RURAL RWANDA THAT IS SPECIFIC

3682
02:32:34,160 --> 02:32:36,840
TO SKIN COLOR AND THERMAL IMAGE 

3683
02:32:36,840 --> 02:32:37,760
TECHNOLOGY GIVES OPPORTUNITY TO 

3684
02:32:37,760 --> 02:32:40,320
EXPAND TO OTHER SKIN COLORS 

3685
02:32:40,320 --> 02:32:42,040
BESIDES THOSE OF PATIENT 

3686
02:32:42,040 --> 02:32:43,960
POPULATION AND SECOND TECHNOLOGY

3687
02:32:43,960 --> 02:32:45,560
ON RIGHT IS LOW TECH INNOVATION 

3688
02:32:45,560 --> 02:32:48,000
THAT IS REALLY IMPORTANT AND 

3689
02:32:48,000 --> 02:32:49,760
TOOLS THAT SUPPORT COMMUNITY 

3690
02:32:49,760 --> 02:32:52,080
HEALTH WORKERS TO WALK WOMEN 

3691
02:32:52,080 --> 02:32:54,080
THROUGH CLINICAL DIAGNOSIS AND 

3692
02:32:54,080 --> 02:32:56,360
SUPPORTS ENGAGEMENT OF WOMEN IN 

3693
02:32:56,360 --> 02:32:58,640
TERMS OF COUNSELING AND AROUND 

3694
02:32:58,640 --> 02:33:01,680
POSTPARTUM DEPRESSION AND HAVING

3695
02:33:01,680 --> 02:33:03,200
CONVERSATIONS AROUND INTIMATE 

3696
02:33:03,200 --> 02:33:05,280
PARTNER VIOLENCE AND ISSUES THAT

3697
02:33:05,280 --> 02:33:07,320
COMMUNITY HEALTH WORKERS AND 

3698
02:33:07,320 --> 02:33:09,400
MOTHERS IDENTIFYING TO BE ISSUES

3699
02:33:09,400 --> 02:33:11,560
TO SUPPORT ADDRESSING AND LOOK 

3700
02:33:11,560 --> 02:33:13,760
FORWARD TO QUESTIONS AND ALSO 

3701
02:33:13,760 --> 02:33:15,360
HEARING MORE ABOUT OTHER 

3702
02:33:15,360 --> 02:33:15,720
TECHNOLOGIES. 

3703
02:33:15,720 --> 02:33:19,880
>> OKAY.  GREAT.  THANK
YOU.  

3704
02:33:19,880 --> 02:33:22,240
NEXT SLIDE, PLEASE. 

3705
02:33:22,240 --> 02:33:22,920
>> HI.  

3706
02:33:22,920 --> 02:33:23,920
>> WHENEVER YOU ARE
READY. 

3707
02:33:23,920 --> 02:33:26,720
>> SO, THIS IS MY HEALTHY

3708
02:33:26,720 --> 02:33:28,400
PREGNANCY DIGITAL HEALTH 

3709
02:33:28,400 --> 02:33:30,840
PLATFORM.  AS I MENTIONED, WE 

3710
02:33:30,840 --> 02:33:32,960
ARE AN EARLY STAGE SPIN OUT FROM

3711
02:33:32,960 --> 02:33:37,600
THE UNIVERSITY OF PITTSBURGH AND

3712
02:33:37,600 --> 02:33:38,760
CARNEGIE MELON UNIVERSITY AND 

3713
02:33:38,760 --> 02:33:40,520
YOU SEE ON THE LEFT PATIENT 

3714
02:33:40,520 --> 02:33:41,920
FACING [INDISCERNIBLE].  IT THIS

3715
02:33:41,920 --> 02:33:44,360
IS PRESCRIBED TO PREGNANT 

3716
02:33:44,360 --> 02:33:45,880
INDIVIDUALS AT THEIR FIRST 

3717
02:33:45,880 --> 02:33:47,000
PRENATAL APPOINTMENT BY HEALTH 

3718
02:33:47,000 --> 02:33:49,200
CARE PROVIDERS AND IT OFFERS 

3719
02:33:49,200 --> 02:33:51,160
KIND OF EDUCATION THAT IS 

3720
02:33:51,160 --> 02:33:54,720
TAILORED TO THEIR GESTATIONAL 

3721
02:33:54,720 --> 02:33:56,560
WEEK AND TO BASELINE RISK 

3722
02:33:56,560 --> 02:33:57,600
INFORMATION AND INFORMATION THEY

3723
02:33:57,600 --> 02:33:59,000
SHARE THROUGH THE APP THROUGHOUT

3724
02:33:59,000 --> 02:34:00,840
THE COURSE OF THEIR PREGNANCY 

3725
02:34:00,840 --> 02:34:02,600
AND CONNECTS THEM ALSO TO 

3726
02:34:02,600 --> 02:34:04,320
RESOURCES THAT ARE RESPONSIVE TO

3727
02:34:04,320 --> 02:34:07,760
RISKS IDENTIFIED IN THE TOOL.  

3728
02:34:07,760 --> 02:34:09,600
AND THEN WE ALSO USE THAT 

3729
02:34:09,600 --> 02:34:10,720
INFORMATION THAT IS SHARED 

3730
02:34:10,720 --> 02:34:14,480
THROUGH THE TOOLS TO DO BACKEND 

3731
02:34:14,480 --> 02:34:16,800
ALGORITHM MIC DEVELOPMENT TO DO 

3732
02:34:16,800 --> 02:34:17,960
EARLY RISK IDENTIFICATION AND 

3733
02:34:17,960 --> 02:34:19,640
WHAT YOU CAN SEE ON THE RIGHT 

3734
02:34:19,640 --> 02:34:22,920
THAT IS A PROVIDER PORTAL 

3735
02:34:22,920 --> 02:34:24,320
INTEGRATED INTO THE INDIVIDUAL'S

3736
02:34:24,320 --> 02:34:26,480
HEALTH RECORDS THAT ARE 

3737
02:34:26,480 --> 02:34:28,680
PROVIDERS THAT CAN GO IN AND SEE

3738
02:34:28,680 --> 02:34:30,400
SPECIFIC RISKS THAT ARE 

3739
02:34:30,400 --> 02:34:33,440
IDENTIFIED IN REAL TIME AS THEY 

3740
02:34:33,440 --> 02:34:35,040
HAVE.  SOMETHING TO NOTE IS 

3741
02:34:35,040 --> 02:34:37,760
DESIGN APPROACH THAT WE HAVE 

3742
02:34:37,760 --> 02:34:39,720
TAKEN WITH THIS IS WE DON'T ASK 

3743
02:34:39,720 --> 02:34:41,640
ANYBODY ANYTHING OR MONITOR ANY 

3744
02:34:41,640 --> 02:34:43,880
KIND OF RISK FACTOR THAT WE 

3745
02:34:43,880 --> 02:34:45,880
DON'T IMMEDIATELY GIVE THEM 

3746
02:34:45,880 --> 02:34:48,440
ACTION PACKED.  THEY ARE NOT 

3747
02:34:48,440 --> 02:34:50,560
ELIAANT ON A PROVIDER AND OFFERS

3748
02:34:50,560 --> 02:34:52,120
OPPORTUNITY TO PROVIDERS TO SEE 

3749
02:34:52,120 --> 02:34:54,280
ALSO WHAT IS HAPPENING WITH 

3750
02:34:54,280 --> 02:34:55,200
THEIR PATIENT. 

3751
02:34:55,200 --> 02:34:57,000
NEXT SLIDE, PLEASE. 

3752
02:34:57,000 --> 02:34:58,520
>> SO, OUR TEAM COULD
HAVE BEEN

3753
02:34:58,520 --> 02:35:00,960
KIND OF WORKING ON THIS IN THE 

3754
02:35:00,960 --> 02:35:05,400
ACADEMIC SPACE FOR A WHILE AND 

3755
02:35:05,400 --> 02:35:07,320
WE WANTED TO BUILD SOMETHING TO 

3756
02:35:07,320 --> 02:35:08,840
ADDRESS THREE KEY PROBLEMS WE 

3757
02:35:08,840 --> 02:35:12,440
SAW HAPPENING IN ENTIRE CYCLE OF

3758
02:35:12,440 --> 02:35:13,560
PREGNANCY CARE AND FIRST PROBLEM

3759
02:35:13,560 --> 02:35:15,920
IS REALLY ONE OF IDENTIFICATIONS

3760
02:35:15,920 --> 02:35:18,800
AND HOW DO WE IDENTIFY RISKS AS 

3761
02:35:18,800 --> 02:35:20,680
EARLY AS POSSIBLE IN BETWEEN 

3762
02:35:20,680 --> 02:35:22,760
ROUTINE PRENATAL VISIT SNZ. 

3763
02:35:22,760 --> 02:35:24,720
IDEALLY BEFORE THEY START TO 

3764
02:35:24,720 --> 02:35:25,240
MANIFEST?  

3765
02:35:25,240 --> 02:35:27,760
HOW CAN WE REALLY FOCUS ON RISK 

3766
02:35:27,760 --> 02:35:30,720
IDENTIFICATION WITH THE GOAL OF 

3767
02:35:30,720 --> 02:35:31,840
PREVENTIVE KAIR?  

3768
02:35:31,840 --> 02:35:33,560
NEXT PIECE WE FELT THAT WAS 

3769
02:35:33,560 --> 02:35:35,560
CRITICAL WAS REALLY TRYING TO 

3770
02:35:35,560 --> 02:35:37,480
ENGAGE BETTER WITH PATIENTS WHEN

3771
02:35:37,480 --> 02:35:39,600
WE ARE DOING THAT 

3772
02:35:39,600 --> 02:35:40,000
IDENTIFICATION. 

3773
02:35:40,000 --> 02:35:42,720
SO, IT IS NO GOOD TO IDENTIFY 

3774
02:35:42,720 --> 02:35:44,760
RISK IF YOU CAN'T REALLY WELL 

3775
02:35:44,760 --> 02:35:45,920
COMMUNICATE WHAT SHOULD BE DONE 

3776
02:35:45,920 --> 02:35:48,440
WITH RISKS AND WHAT PATIENT 

3777
02:35:48,440 --> 02:35:50,680
OPTIONS ARE AND NEXT STEPS ARE. 

3778
02:35:50,680 --> 02:35:52,600
THIS ENGAGEMENT IN TERMS OF 

3779
02:35:52,600 --> 02:35:54,520
COMMUNICATION AND IN TERMS OF 

3780
02:35:54,520 --> 02:35:55,280
TRUST BUILDING TOO. 

3781
02:35:55,280 --> 02:35:58,480
WE WANT IT TO BE ABLE TO 

3782
02:35:58,480 --> 02:35:59,560
INCORPORATE THAT INTO OUR 

3783
02:35:59,560 --> 02:36:01,240
PLATFORM AND LAST PIECE OF THE 

3784
02:36:01,240 --> 02:36:03,040
CYCLE OF CARE WE WANTED TO 

3785
02:36:03,040 --> 02:36:05,520
REALLY ADDRESS WITH THIS TOOL IS

3786
02:36:05,520 --> 02:36:07,960
CONNECTIONS AND IDENTIFYING RISK

3787
02:36:07,960 --> 02:36:09,320
TRAJECTORY AND COMMUNICATING 

3788
02:36:09,320 --> 02:36:10,600
SOMETHING TO THE INDIVIDUAL WHO 

3789
02:36:10,600 --> 02:36:12,200
MAY BE AT RISK. 

3790
02:36:12,200 --> 02:36:14,520
HOW DO WE THEN CONNECT THEM TO 

3791
02:36:14,520 --> 02:36:16,000
THE SERVICES THAT THEY NEED 

3792
02:36:16,000 --> 02:36:17,600
ESPECIALLY GIVEN THIS IS 

3793
02:36:17,600 --> 02:36:19,520
DISCUSSED ALREADY.  CONSTRAINTS 

3794
02:36:19,520 --> 02:36:21,600
THAT ARE WITH RESOURCES AND HOW 

3795
02:36:21,600 --> 02:36:23,280
WE STREAMLINE CARE TO MAKE SURE 

3796
02:36:23,280 --> 02:36:26,720
INDIVIDUALS THAT NEED IT MOST 

3797
02:36:26,720 --> 02:36:29,880
ARE ACTUALLY RECEIVING IT. 

3798
02:36:29,880 --> 02:36:33,040
ON RIGHT WHAT YOU CAN SEE IS 

3799
02:36:33,040 --> 02:36:35,080
INITIAL RESULTS FROM A RECENT 

3800
02:36:35,080 --> 02:36:37,560
BETA TEST WE DID WITH OUR TOOL 

3801
02:36:37,560 --> 02:36:42,760
IN UMPC HEALTH CARE SYSTEM FROM 

3802
02:36:42,760 --> 02:36:45,320
19,000 PATIENTS PRESCRIBED OUR 

3803
02:36:45,320 --> 02:36:48,800
APP AND ROLLED OUT AROUND MARCH 

3804
02:36:48,800 --> 02:36:51,600
OF 2020 THAT WAS AN INTERESTING 

3805
02:36:51,600 --> 02:36:52,840
ROLLOUT TIME AND TIME THAT LOTS 

3806
02:36:52,840 --> 02:36:54,760
OF PEOPLE WERE ENGAGING WITH 

3807
02:36:54,760 --> 02:36:56,760
DIGITAL TOOL AND TRANSITIONING 

3808
02:36:56,760 --> 02:36:58,200
TO TELEMEDICINE AND IN THAT 

3809
02:36:58,200 --> 02:37:00,680
SENSE WAS A REALLY GOOD LEARNING

3810
02:37:00,680 --> 02:37:02,080
EXPERIENCE TO TRY TO BE 

3811
02:37:02,080 --> 02:37:03,640
COLLECTING DATA DURING THAT 

3812
02:37:03,640 --> 02:37:03,960
TIME. 

3813
02:37:03,960 --> 02:37:06,520
WHAT WE FOUND IS FOCUSING ON 

3814
02:37:06,520 --> 02:37:08,520
KIND OF THREE KEY RISK FACTORS 

3815
02:37:08,520 --> 02:37:11,200
FOR MATERNAL MORTALITY THAT WE 

3816
02:37:11,200 --> 02:37:13,840
BELIEVE ARE MODIFIABLE AND 

3817
02:37:13,840 --> 02:37:16,000
ADDRESSABLE RESOURCES IN OUR 

3818
02:37:16,000 --> 02:37:18,160
SYSTEM AND FOUND WE ARE ABLE TO 

3819
02:37:18,160 --> 02:37:22,200
IDENTIFY SIZABLE NUMBER OF 

3820
02:37:22,200 --> 02:37:25,520
PATIENTS THAT WERE DEVELOPING 

3821
02:37:25,520 --> 02:37:29,000
DEPRESSION SYMPTOMS NO THE 

3822
02:37:29,000 --> 02:37:37,640
RECEIVING TREATMENT AND CARE -- 

3823
02:37:37,640 --> 02:37:42,440
LOTS OF OPTIONAL SCREENING TOOLS

3824
02:37:42,440 --> 02:37:45,440
IMBEDDED AT PLATFORM AND WANTING

3825
02:37:45,440 --> 02:37:48,080
TO BE CONNECTED TO CARE AND 

3826
02:37:48,080 --> 02:37:50,360
DESIGN AND GIVING PEOPLE OPTIONS

3827
02:37:50,360 --> 02:37:52,200
WHEN THEY WANT TO SEEK CARE AND 

3828
02:37:52,200 --> 02:37:55,400
SHARE AND DISCLOSE WITHOUT 

3829
02:37:55,400 --> 02:37:58,720
HAVING TO TAKE NEXT STEP. 

3830
02:37:58,720 --> 02:38:02,720
WE SEE ENGAGEMENT IN TOOL AND 

3831
02:38:02,720 --> 02:38:04,600
PARTICULARLY AMONG COLOR AND 

3832
02:38:04,600 --> 02:38:06,480
BENEFICIARIES OF MEDICAID AND 

3833
02:38:06,480 --> 02:38:08,880
AMONG FIRST-TIME MOMS AND 

3834
02:38:08,880 --> 02:38:12,080
ENGAGEMENT AMONG MOMS WITH 

3835
02:38:12,080 --> 02:38:13,520
HIGHER PREGNANCY COMPLICATION AS

3836
02:38:13,520 --> 02:38:15,000
WELL. 

3837
02:38:15,000 --> 02:38:16,760
WE HAVE BEEN FAIRLY SUCCESSFUL 

3838
02:38:16,760 --> 02:38:18,120
CONNECTING PEOPLE TO CARE FOR 

3839
02:38:18,120 --> 02:38:19,880
SPECIFIC RISKS AND WE HAVE 

3840
02:38:19,880 --> 02:38:22,920
LEARNED FROM TOOL THAT HELPED US

3841
02:38:22,920 --> 02:38:25,320
TO CHANGE OWN CARE PRACTICES AND

3842
02:38:25,320 --> 02:38:26,880
HEALTH CARE SYSTEM AND WHAT 

3843
02:38:26,880 --> 02:38:28,680
EMERGED ROLLING THIS OUT AND 

3844
02:38:28,680 --> 02:38:31,240
TESTING IT IS WE NEED TODAY 

3845
02:38:31,240 --> 02:38:34,480
REALLY DEVELOP A DEDICATED 

3846
02:38:34,480 --> 02:38:36,240
NURSING TEAM TO BE RESPONSIVE TO

3847
02:38:36,240 --> 02:38:38,000
THOSE SHARED IN THE TOOL AND 

3848
02:38:38,000 --> 02:38:41,040
PART OF THE BETA TESTING WE PUT 

3849
02:38:41,040 --> 02:38:42,960
THAT TEAM TOGETHER AND FOUND IT 

3850
02:38:42,960 --> 02:38:45,280
WAS A MUCH MORE EFFECTIVE WAY 

3851
02:38:45,280 --> 02:38:47,760
CONNECTING PATIENTS THAN HAVING 

3852
02:38:47,760 --> 02:38:48,720
PROVIDERS HAVE JUST ONE MORE 

3853
02:38:48,720 --> 02:38:52,160
TASK THAT IS ADDED TO THEIR LOAD

3854
02:38:52,160 --> 02:38:54,120
FOR MONITORING PATIENTS AND 

3855
02:38:54,120 --> 02:38:56,160
HAPPY TO TALK ABOUT THAT LATER 

3856
02:38:56,160 --> 02:38:57,080
TODAY.  

3857
02:38:57,080 --> 02:38:57,280
YEAH. 

3858
02:38:57,280 --> 02:38:58,600
>> GREAT.  THANK YOU. 

3859
02:38:58,600 --> 02:39:02,040
ALL PANELISTS HAVE TALKED ABOUT 

3860
02:39:02,040 --> 02:39:05,800
-- NOPE.  NO LUNCH YET.  ARE YOU

3861
02:39:05,800 --> 02:39:10,320
STAYING UNTIL 12:35 OR SO.  NOW 

3862
02:39:10,320 --> 02:39:12,120
YOU KNOW WHERE ALL PANELISTS ARE

3863
02:39:12,120 --> 02:39:13,840
COMING FROM IN TERMS OF 

3864
02:39:13,840 --> 02:39:14,720
TECHNOLOGIES AND WHAT WE WILL 

3865
02:39:14,720 --> 02:39:17,480
WORK ON AND DOING IN NEXT 15 

3866
02:39:17,480 --> 02:39:19,640
MINUTES OR SO IS DOING A 

3867
02:39:19,640 --> 02:39:21,240
DISCUSSION AMONGST OURSELVES AND

3868
02:39:21,240 --> 02:39:23,840
PRETEND YOU ARE WATCHING A TALK 

3869
02:39:23,840 --> 02:39:26,840
SHOW RIGHT NOW.  PRETEND I'M 

3870
02:39:26,840 --> 02:39:30,160
JERRY SPRINGER AND HE IS DEAD 

3871
02:39:30,160 --> 02:39:32,200
DON'T PRETEND THAT PRETEND I'M 

3872
02:39:32,200 --> 02:39:34,320
OPRAH AND I WILL OPEN PANELS AND

3873
02:39:34,320 --> 02:39:35,600
QUESTIONS AND ANYONE PLEASE KIND

3874
02:39:35,600 --> 02:39:38,000
OF CHIME IN AND AFTER 15 MINUTES

3875
02:39:38,000 --> 02:39:40,240
WE WILL TAKE Q & A FROM
AUDIENCE

3876
02:39:40,240 --> 02:39:44,440
AND IN PERSON AND ONLINE AS 

3877
02:39:44,440 --> 02:39:45,800
WELL. 

3878
02:39:45,800 --> 02:39:46,800
ANY PANELIST SNZ. 

3879
02:39:46,800 --> 02:39:52,480
PLEASE TALK ABOUT WHAT YOU THINK

3880
02:39:52,480 --> 02:39:55,720
ARE BIGGEST CHALLENGES AND GAPS 

3881
02:39:55,720 --> 02:39:57,720
DEVELOPING AND IMPLEMENTING 

3882
02:39:57,720 --> 02:40:00,360
TECHNOLOGY SPECIFIC FOR MATERNAL

3883
02:40:00,360 --> 02:40:02,560
HEALTH.  ANYONE, PLEASE CHIME 

3884
02:40:02,560 --> 02:40:03,160
IN.  

3885
02:40:03,160 --> 02:40:03,800
>> COME ON. 

3886
02:40:03,800 --> 02:40:06,200
>> I'M HAPPY TO TALK
ABOUT OUR 

3887
02:40:06,200 --> 02:40:06,520
EXPERIENCE. 

3888
02:40:06,520 --> 02:40:08,480
I THINK THAT THE BIGGEST ISSUE 

3889
02:40:08,480 --> 02:40:12,440
THAT WE FACED MOVING OUT OF 

3890
02:40:12,440 --> 02:40:14,360
ACADEMIA AND COMMERCIALIZING IS 

3891
02:40:14,360 --> 02:40:16,040
THINKING ABOUT HOW TO DO 

3892
02:40:16,040 --> 02:40:18,000
SCALABILITY IN OUR HEALTH CARE 

3893
02:40:18,000 --> 02:40:20,840
SYSTEM NATIONWIDE THAT IS VERY 

3894
02:40:20,840 --> 02:40:22,680
FRAGMENTED AND EVERY HEALTH CARE

3895
02:40:22,680 --> 02:40:24,800
SYSTEM MAKES THEIR OWN DECISION 

3896
02:40:24,800 --> 02:40:26,480
AND BRINGS ON OWN TOOLS AND JUST

3897
02:40:26,480 --> 02:40:28,920
REALLY YOU KNOW IT IS A HUGE 

3898
02:40:28,920 --> 02:40:31,280
LIFT TO GET INTEGRATED INTO ONE 

3899
02:40:31,280 --> 02:40:32,840
SYSTEM TO TAILOR WHAT YOU ARE 

3900
02:40:32,840 --> 02:40:34,200
DOING INTO ONE SYSTEM AND HOW 

3901
02:40:34,200 --> 02:40:36,560
YOU SCALE THAT UP TO A TOTALLY 

3902
02:40:36,560 --> 02:40:38,280
DIFFERENT SYSTEM. 

3903
02:40:38,280 --> 02:40:40,000
SO, FOR SOMETHING THAT IS 

3904
02:40:40,000 --> 02:40:41,360
COMMERCIAL TO BE SUSTAINABLE, 

3905
02:40:41,360 --> 02:40:43,880
YOU NEED TO REALLY BE IN SEVERAL

3906
02:40:43,880 --> 02:40:45,640
HEALTHCARE SYSTEMS AND NEED TO 

3907
02:40:45,640 --> 02:40:47,480
BALANCE THAT OUT WITH, YOU KNOW,

3908
02:40:47,480 --> 02:40:49,440
REALLY MAKING SURE WHAT YOU ARE 

3909
02:40:49,440 --> 02:40:52,720
OFFERING IS ADDRESSING PATIENTS 

3910
02:40:52,720 --> 02:40:55,440
NEEDS IN THAT SYSTEM AND BIG 

3911
02:40:55,440 --> 02:40:57,440
PROBLEM FOR US AND FOR 

3912
02:40:57,440 --> 02:40:57,720
TECHNOLOGY. 

3913
02:40:57,720 --> 02:40:59,320
>> SOMETIMES WE GIVE THIS
WITH 

3914
02:40:59,320 --> 02:41:01,480
DIGITAL HEALTH PLATFORMS SO EASY

3915
02:41:01,480 --> 02:41:03,480
TO SCALE AND DON'T HAVE TO MAKE 

3916
02:41:03,480 --> 02:41:05,320
ANYTHING AND DIGITAL PLATFORMS 

3917
02:41:05,320 --> 02:41:08,240
HAVE OWN SETS OF CHALLENGES IN 

3918
02:41:08,240 --> 02:41:09,120
TERMS OF SKILL. 

3919
02:41:09,120 --> 02:41:10,760
>> MY THOUGHT ON THAT WAS
AN 

3920
02:41:10,760 --> 02:41:12,200
EXTENSION OF YOUR COMMENT THAT 

3921
02:41:12,200 --> 02:41:14,560
IS JUST WHAT WE ARE ATTRACTED TO

3922
02:41:14,560 --> 02:41:18,320
FROM FUNDING PERSPECTIVES. 

3923
02:41:18,320 --> 02:41:22,160
SO, FUNDERS LOVE TO FUND BRIGHT 

3924
02:41:22,160 --> 02:41:24,200
AND SHINY OBJECTS AND LOTS OF 

3925
02:41:24,200 --> 02:41:26,600
WAYS COST FOR OUR WORK IS AROUND

3926
02:41:26,600 --> 02:41:28,240
COMMUNITY ENGAGEMENT COMPONENT 

3927
02:41:28,240 --> 02:41:30,280
THAT IS AROUND MAINTAINING 

3928
02:41:30,280 --> 02:41:32,520
SERVERS SO THEY CAN STILL RUN 

3929
02:41:32,520 --> 02:41:33,920
ALGORITHMS WE ARE TRYING TO RUN 

3930
02:41:33,920 --> 02:41:36,160
AND THERE IS A LOT OF RESOURCES 

3931
02:41:36,160 --> 02:41:38,840
HAVING TO GO INTO MAINTENANCE OR

3932
02:41:38,840 --> 02:41:39,200
ADAPTATION. 

3933
02:41:39,200 --> 02:41:42,120
AND, YOU KNOW, I GET GREAT 

3934
02:41:42,120 --> 02:41:43,760
REVIEWS SOMETIMES AND THEY SAY 

3935
02:41:43,760 --> 02:41:46,600
YOU HAVE DEVELOP AN ALGORITHM 

3936
02:41:46,600 --> 02:41:48,920
WORKING IN RWANDA NOT INNOVATIVE

3937
02:41:48,920 --> 02:41:50,720
TO SHOW IT COULD WORK AND 

3938
02:41:50,720 --> 02:41:52,400
ADAPTING FOR MEXICO AND THERE IS

3939
02:41:52,400 --> 02:41:54,280
AN ACTUAL REAL COST TO DO THAT 

3940
02:41:54,280 --> 02:41:56,160
AND WE AS A COLLECTIVE 

3941
02:41:56,160 --> 02:41:58,200
COMMUNITY, AS WE THINK ABOUT HOW

3942
02:41:58,200 --> 02:42:00,000
TO EXPAND THIS TO FOR MATERNAL 

3943
02:42:00,000 --> 02:42:02,200
HEALTH ADVOCATING FUNDERS 

3944
02:42:02,200 --> 02:42:05,800
RECOGNIZE THE FULL COST THAT IS 

3945
02:42:05,800 --> 02:42:08,080
INVOLVED IN THIS WORK. 

3946
02:42:08,080 --> 02:42:10,360
>> I WANT TO ADD TO THAT
MAKING

3947
02:42:10,360 --> 02:42:12,760
NOT FULLY THINKING THROUGH LATE 

3948
02:42:12,760 --> 02:42:15,640
STAGE FAILURE MODES AND BUSINESS

3949
02:42:15,640 --> 02:42:17,240
MODEL RELATED QUESTIONS AND 

3950
02:42:17,240 --> 02:42:18,680
IMPLEMENTATION RELATED QUESTIONS

3951
02:42:18,680 --> 02:42:20,600
SUCH AS COMMUNITY ENGAGEMENT AND

3952
02:42:20,600 --> 02:42:22,200
SUCH AS GETTING THROUGH 

3953
02:42:22,200 --> 02:42:24,080
REGULATION AND EVIDENCE 

3954
02:42:24,080 --> 02:42:25,640
GENERATION THAT WILL BE NEEDED 

3955
02:42:25,640 --> 02:42:27,440
WAY PAST REGULATION FOR 

3956
02:42:27,440 --> 02:42:29,240
ADOPTION, ET CETERA, ET CETERA. 

3957
02:42:29,240 --> 02:42:31,840
EARLY STAGE INNOVATORS IN 

3958
02:42:31,840 --> 02:42:33,480
ACADEMIA ESPECIALLY IS REALLY 

3959
02:42:33,480 --> 02:42:35,880
THINKING ABOUT HOW TO CREATE AND

3960
02:42:35,880 --> 02:42:39,360
HOW YOU PUBLISH PAPERS CREATING 

3961
02:42:39,360 --> 02:42:41,040
CUTTING ENL SCIENCE AND SOME HOW

3962
02:42:41,040 --> 02:42:43,360
YOU BUILD TECHNOLOGY AROUND IT. 

3963
02:42:43,360 --> 02:42:45,480
IT IS ALMOST MORE OFTEN THAN NOT

3964
02:42:45,480 --> 02:42:47,280
I HAVE SEEN WITH COLLEAGUES THAT

3965
02:42:47,280 --> 02:42:49,920
THEY ARE THINKING ABOUT LATE 

3966
02:42:49,920 --> 02:42:52,120
STAGE ISSUES A BIT LATER AND 

3967
02:42:52,120 --> 02:42:54,960
SOME SPECTACULAR FAILURES AFTER 

3968
02:42:54,960 --> 02:42:57,080
YOU BURN THROUGH MULTIPLE R01S 

3969
02:42:57,080 --> 02:42:59,000
OR YOU KNOW SOME TRANSITION TO 

3970
02:42:59,000 --> 02:43:02,040
SCALE GRANT FROM SAVING LIVES AT

3971
02:43:02,040 --> 02:43:05,040
BIRTH GRAND CHALLENGES THAT GOES

3972
02:43:05,040 --> 02:43:07,080
NOWHERE.  YOU REALIZE, OOPS.  

3973
02:43:07,080 --> 02:43:09,320
THIS IS A CLASS 3 DEVICE.  WHAT 

3974
02:43:09,320 --> 02:43:11,840
IS THAT?  

3975
02:43:11,840 --> 02:43:15,600
SO, I THINK FROM BATTLE SCARS, 

3976
02:43:15,600 --> 02:43:18,360
MY -- MY ADVICE TO MY STUDENTS 

3977
02:43:18,360 --> 02:43:20,360
THESE DAYS IS THINK ABOUT, YOU 

3978
02:43:20,360 --> 02:43:23,560
KNOW, ALL OF THE ISSUES FROM 

3979
02:43:23,560 --> 02:43:26,200
LATE STAGE TO EARLY STAGE AND 

3980
02:43:26,200 --> 02:43:28,280
TYPICALLY TRY TO HAVE 

3981
02:43:28,280 --> 02:43:30,160
MULTI-DISCIPLINARY PARTNERS ADD 

3982
02:43:30,160 --> 02:43:32,000
FROM THE TABLE FROM DAY 0. 

3983
02:43:32,000 --> 02:43:33,520
MOST PROJECTS WE WON'T 

3984
02:43:33,520 --> 02:43:35,440
COMMISSION A PROJECT UNLESS WE 

3985
02:43:35,440 --> 02:43:36,760
HAVE AND OF COURSE CLINICIANS 

3986
02:43:36,760 --> 02:43:39,000
AND ENGINEERS AND BASIC 

3987
02:43:39,000 --> 02:43:40,680
SCIENTISTS AT TABLE AND ALSO 

3988
02:43:40,680 --> 02:43:42,920
SOMEONE THAT IS REPRESENTING 

3989
02:43:42,920 --> 02:43:44,720
REGULATORY VOICE AND BUSINESS 

3990
02:43:44,720 --> 02:43:46,480
MODEL THINKING VOICE AND THEIR 

3991
02:43:46,480 --> 02:43:48,400
CONTRIBUTION TO THE PROJECT AT 

3992
02:43:48,400 --> 02:43:50,400
INITIAL STAGES MIGHT BE VERY 

3993
02:43:50,400 --> 02:43:52,920
LITTLE AND CONTRIBUTIONS 

3994
02:43:52,920 --> 02:43:54,560
INCREASE LATER ON AND FACT THEY 

3995
02:43:54,560 --> 02:43:57,960
ARE AT TABLE AT CONVERSATION 

3996
02:43:57,960 --> 02:44:00,880
THAT HELPS PREVENT CATASTROPHIC 

3997
02:44:00,880 --> 02:44:01,720
FAILURE MODES. 

3998
02:44:01,720 --> 02:44:04,080
>> ALL RIGHT.  SOMETIMES 

3999
02:44:04,080 --> 02:44:05,200
TECHNICAL PROBLEM SOMETIMES IS 

4000
02:44:05,200 --> 02:44:07,680
NOT BIGGEST PROBLEMS; RIGHT?  

4001
02:44:07,680 --> 02:44:09,480
WE SOMETIMES FORGET ABOUT THAT. 

4002
02:44:09,480 --> 02:44:11,960
YOU KNOW, THESE OTHER 

4003
02:44:11,960 --> 02:44:12,880
SURROUNDING ISSUES THAT CAN 

4004
02:44:12,880 --> 02:44:15,200
OFTEN BE EVEN GREATER.  WANT 

4005
02:44:15,200 --> 02:44:16,640
ANYTHING TO ADD?  

4006
02:44:16,640 --> 02:44:20,080
>> YEAH.  I CAN SPEAK TO
THIS 

4007
02:44:20,080 --> 02:44:21,720
FROM OUR OWN EXPERIENCE.  

4008
02:44:21,720 --> 02:44:25,520
AS I SAID, MY BACKGROUND IS MORE

4009
02:44:25,520 --> 02:44:27,560
ON CHRONIC HYPERTENSION OR 

4010
02:44:27,560 --> 02:44:30,840
IN-PATIENT CARE.  IT HAS BEEN A 

4011
02:44:30,840 --> 02:44:32,160
LEARNING EXPERIENCE TO EVEN 

4012
02:44:32,160 --> 02:44:34,080
UNDERSTAND WHAT IS A PROBLEM 

4013
02:44:34,080 --> 02:44:38,720
WHEN IT COMES TO HYPERTENSIVE 

4014
02:44:38,720 --> 02:44:40,240
DISEASES OF PREGNANCY AND ONE 

4015
02:44:40,240 --> 02:44:42,880
THING SHOCKING TO ME IS HOW 

4016
02:44:42,880 --> 02:44:45,440
LITTLE DATA IS OUT THERE IN 

4017
02:44:45,440 --> 02:44:46,600
TERMS OF LOOKING AT 

4018
02:44:46,600 --> 02:44:48,120
[INDISCERNIBLE] MEASUREMENTS AND

4019
02:44:48,120 --> 02:44:49,680
TO EVEN UNDERSTAND THE PROBLEM 

4020
02:44:49,680 --> 02:44:52,320
THAT IS NO. 1. 

4021
02:44:52,320 --> 02:44:53,960
SECOND, THERE -- ALSO MORE 

4022
02:44:53,960 --> 02:44:55,840
SURPRISING WAS VERY FEW DEVICES 

4023
02:44:55,840 --> 02:44:58,960
ACTUALLY LOOKED AT IT 

4024
02:44:58,960 --> 02:45:00,360
PARTICULARLY CALIBRATING IT.  

4025
02:45:00,360 --> 02:45:02,680
FOR US, IT HAS BEEN A CHALLENGE 

4026
02:45:02,680 --> 02:45:03,880
TO EVEN UNDERSTAND THE PROBLEM 

4027
02:45:03,880 --> 02:45:07,600
AND REASON TO COME HERE IS TO 

4028
02:45:07,600 --> 02:45:10,800
LEARN FROM AUDIENCE HERE.  

4029
02:45:10,800 --> 02:45:14,280
SECOND IS I COULD SEE CHALLENGE 

4030
02:45:14,280 --> 02:45:17,480
IS HOW YOU FUND A TECHNOLOGY 

4031
02:45:17,480 --> 02:45:21,280
LIKE THIS ADVANTAGE ON PLATFORM 

4032
02:45:21,280 --> 02:45:24,520
TECHNOLOGY AND SHOWING CRITICAL 

4033
02:45:24,520 --> 02:45:30,000
CARE MARKET HYPERTENSION MARKET 

4034
02:45:30,000 --> 02:45:33,160
GOING THROUGH TYPICAL VENTURE 

4035
02:45:33,160 --> 02:45:34,920
FUND EVERYONE WANTS TO BUILD A 

4036
02:45:34,920 --> 02:45:36,640
VARIABLE AND REASON TO DO THIS 

4037
02:45:36,640 --> 02:45:38,680
IS THROUGH GRANT FUNDING AND 

4038
02:45:38,680 --> 02:45:40,760
COULD SEE POTENTIAL CHALLENGES 

4039
02:45:40,760 --> 02:45:43,240
YOU HAVE IF MATERNAL HEALTH 

4040
02:45:43,240 --> 02:45:47,640
FOCUSED TECHNOLOGY TO GET THOSE 

4041
02:45:47,640 --> 02:45:50,800
COMMERCIALIZED AND FUNDING.  

4042
02:45:50,800 --> 02:45:56,360
>> DESIGNS AND GAPS AND 

4043
02:45:56,360 --> 02:45:57,480
CHALLENGES NOW AND NO SHORTAGE 

4044
02:45:57,480 --> 02:45:59,680
OF THEM COMING TO MATERNAL 

4045
02:45:59,680 --> 02:46:01,680
HEALTH AND CONTEXT OF 

4046
02:46:01,680 --> 02:46:04,320
UNDERSERVED POPULATION AND 

4047
02:46:04,320 --> 02:46:05,760
EXPERIENCE AND SOLUTIONS AND 

4048
02:46:05,760 --> 02:46:07,760
LESONES LEARNED IN HOW TO GET 

4049
02:46:07,760 --> 02:46:09,560
NEW TECHNOLOGIESINO VATTIVE AS 

4050
02:46:09,560 --> 02:46:11,440
THEY ARE TO PATIENT POPULATIONS 

4051
02:46:11,440 --> 02:46:13,400
NEEDING THEM THE MOST AND FROM 

4052
02:46:13,400 --> 02:46:16,400
YOUR OWN EXPERIENCE OR WORDS OF 

4053
02:46:16,400 --> 02:46:16,640
ADVICE?  

4054
02:46:16,640 --> 02:46:19,560
>> YEAH.  I ECHO KIND OF
HAVING

4055
02:46:19,560 --> 02:46:21,200
KEY STAKEHOLDERS INVOLVED FROM 

4056
02:46:21,200 --> 02:46:22,880
THE BEGINNING AND THINK THOSE 

4057
02:46:22,880 --> 02:46:27,120
ARE KEY STAKEHOLDERS WITH LIVED 

4058
02:46:27,120 --> 02:46:29,120
EXPERIENCE AND I THINK THAT TAKE

4059
02:46:29,120 --> 02:46:32,240
TG THROUGH DIGITAL PLATFORMS AND

4060
02:46:32,240 --> 02:46:33,840
TAKE TG FURTHER THAN PERSON 

4061
02:46:33,840 --> 02:46:35,160
CENTERED AND HUMAN CENTERED 

4062
02:46:35,160 --> 02:46:38,920
DESIGN AND HAVING REALLY YOUR 

4063
02:46:38,920 --> 02:46:41,360
DESIGN AND YOUR PURSUITS DRIVEN 

4064
02:46:41,360 --> 02:46:43,720
BY VOICES OF PEOPLE THAT ARE 

4065
02:46:43,720 --> 02:46:45,920
TRYING TO SERVE WITH THEM AND 

4066
02:46:45,920 --> 02:46:47,760
BECAUSE PEOPLE WON'T ENGAGE WITH

4067
02:46:47,760 --> 02:46:49,320
THINGS OR WANT THEM IF THEY 

4068
02:46:49,320 --> 02:46:51,520
DON'T REALIZE THEIR VALUE. 

4069
02:46:51,520 --> 02:46:53,440
SO, I THINK THAT HAS BEEN AN 

4070
02:46:53,440 --> 02:46:57,560
IMPORTANT PART OF OUR 

4071
02:46:57,560 --> 02:46:58,080
PHILOSOPHY. 

4072
02:46:58,080 --> 02:46:59,920
I THINK THERE IS A TECH PANEL 

4073
02:46:59,920 --> 02:47:02,360
THAT I THINK THERE IS A REALLY 

4074
02:47:02,360 --> 02:47:03,640
IMPORTANT KIND OF ELEMENT OF 

4075
02:47:03,640 --> 02:47:05,560
WORK AND INNOVATION TO BE DONE 

4076
02:47:05,560 --> 02:47:08,120
ON HUMAN SUPPORTS FOR TECH 

4077
02:47:08,120 --> 02:47:09,280
NAVIGATION AS WELL. 

4078
02:47:09,280 --> 02:47:12,120
SO, AS WE ARE INNOVATING WITH 

4079
02:47:12,120 --> 02:47:13,480
TECHNOLOGY WE NEED TO REALLY 

4080
02:47:13,480 --> 02:47:15,360
THINK ABOUT WHAT IS THE HUMAN 

4081
02:47:15,360 --> 02:47:17,000
INFRASTRUCTURE THAT IS NEEDED TO

4082
02:47:17,000 --> 02:47:20,400
HELP KIND OF GUIDE PEOPLE WITH 

4083
02:47:20,400 --> 02:47:21,920
TECHNOLOGY AND MAKE OR KEEP A 

4084
02:47:21,920 --> 02:47:23,680
CHECK ON TECHNOLOGY AND WHERE IT

4085
02:47:23,680 --> 02:47:26,400
IS GOING AND THAT IT IS ACTUALLY

4086
02:47:26,400 --> 02:47:28,240
SERVING PEOPLE'S NEEDS AND WHO 

4087
02:47:28,240 --> 02:47:30,240
IT IS INTENDED FOR IS ANOTHER 

4088
02:47:30,240 --> 02:47:33,680
PIECE WE HAVE BEEN THINKING 

4089
02:47:33,680 --> 02:47:35,680
ABOUT A LOT. 

4090
02:47:35,680 --> 02:47:38,280
>> OUR WORK IN RWANDA,
NONE 

4091
02:47:38,280 --> 02:47:42,160
STARTED OUT AS A TECHNOLOGY 

4092
02:47:42,160 --> 02:47:42,440
QUESTION. 

4093
02:47:42,440 --> 02:47:44,480
AND ALSO ALL OF THE DATA GOING 

4094
02:47:44,480 --> 02:47:46,960
INTO ALGORITHMS THAT WE ARE 

4095
02:47:46,960 --> 02:47:48,560
DEVELOPING WERE JUST BYPRODUCTS 

4096
02:47:48,560 --> 02:47:52,800
OF OTHER GRANTS THAT WE HAD.  

4097
02:47:52,800 --> 02:47:55,760
SO, VERY SPECIFIC SUGGESTION WE 

4098
02:47:55,760 --> 02:47:56,880
HAVE AND QUESTION AROUND 

4099
02:47:56,880 --> 02:47:58,400
PARTICULARLY ADDRESSING MATERNAL

4100
02:47:58,400 --> 02:48:00,440
HEALTH ISSUES USING TECHNOLOGY 

4101
02:48:00,440 --> 02:48:03,000
TO ADDRESS MATERNAL HEALTH 

4102
02:48:03,000 --> 02:48:05,000
ISSUES IN COMMUNITIES 

4103
02:48:05,000 --> 02:48:06,520
TRADITIONALLY NOT ENGAGE THE IN 

4104
02:48:06,520 --> 02:48:09,520
DATA COLLECTION WE NEED TO 

4105
02:48:09,520 --> 02:48:11,600
CALIBRATE VARIOUS TECHNOLOGIES 

4106
02:48:11,600 --> 02:48:13,840
IS RATHER THAN LOOK FOG R 

4107
02:48:13,840 --> 02:48:15,960
TECHNOLOGY GRANT LET'S GO TO 

4108
02:48:15,960 --> 02:48:18,120
SUCCESSFUL GRANTEES LEADING 

4109
02:48:18,120 --> 02:48:20,760
IMPACTFUL MATERNAL HEALTH 

4110
02:48:20,760 --> 02:48:22,360
PROJECTS IN COMMUNITIES 

4111
02:48:22,360 --> 02:48:23,960
UNDERSERVED THINKING ABOUT 

4112
02:48:23,960 --> 02:48:26,360
INNOVATIVE WAYS TO INTEGRATE 

4113
02:48:26,360 --> 02:48:28,040
TECHNOLOGY INTO EXISTING 

4114
02:48:28,040 --> 02:48:29,040
MECHANISMS WITH SUPPLEMENTAL 

4115
02:48:29,040 --> 02:48:31,680
FUNDING AVAILABLE TO DO THAT SO 

4116
02:48:31,680 --> 02:48:33,840
WE CAN SEE YOU HAVE THIS 

4117
02:48:33,840 --> 02:48:35,480
INCREDIBLE COMMUNITY CONNECTION 

4118
02:48:35,480 --> 02:48:37,520
AND I AS A TECHNOLOGIST 

4119
02:48:37,520 --> 02:48:39,880
SHOULDN'T MAKE A CONNECTION AND 

4120
02:48:39,880 --> 02:48:43,240
WORKING WITH YOU TO HEAR HOW 

4121
02:48:43,240 --> 02:48:44,680
COMMUNICATIONS COULD BE 

4122
02:48:44,680 --> 02:48:45,480
CALIBRATED WITH THAT AND 

4123
02:48:45,480 --> 02:48:46,960
OPPORTUNITY TO BE EFFICIENT TO 

4124
02:48:46,960 --> 02:48:52,160
HOW WE ARE SPENDING RESEARCH 

4125
02:48:52,160 --> 02:48:52,520
EFFICIENTLY. 

4126
02:48:52,520 --> 02:48:55,200
>> NOT MUCH TO ADD TO
THAT ALSO

4127
02:48:55,200 --> 02:48:56,600
BUT ADDING TO ECHO SOMETHING 

4128
02:48:56,600 --> 02:48:59,520
THAT YOU SAID ABOUT COMMUNITY 

4129
02:48:59,520 --> 02:49:01,520
ENGAGEMENT AND THINKING OF 

4130
02:49:01,520 --> 02:49:04,400
TECHNOLOGY TAKING AS A PACKAGE 

4131
02:49:04,400 --> 02:49:06,240
AND I HAVE SEEN A LOT OF VALUE 

4132
02:49:06,240 --> 02:49:08,760
IN THINKING ABOUT USER'S 

4133
02:49:08,760 --> 02:49:10,800
PERSPECTIVE AND THINKING ABOUT 

4134
02:49:10,800 --> 02:49:13,160
HUMAN CENTERED ISSUES THAT 

4135
02:49:13,160 --> 02:49:17,880
TYPICALLY AS ACADEMICS YOU KNOW 

4136
02:49:17,880 --> 02:49:21,320
SITTING IN A LAB AND ISSUES THAT

4137
02:49:21,320 --> 02:49:23,800
TAKE CARE LATER ON AND IS 

4138
02:49:23,800 --> 02:49:24,920
SURPRISING HOW LOTS OF 

4139
02:49:24,920 --> 02:49:27,680
MAINSTREAM FUNDERS ACTUALLY 

4140
02:49:27,680 --> 02:49:30,160
DON'T FULLY YET RECOGNIZE THAT. 

4141
02:49:30,160 --> 02:49:33,440
SO, IF YOU ARE -- IF PROPOSAL OR

4142
02:49:33,440 --> 02:49:37,040
PACKAGE THAT IS GOING IN IS VERY

4143
02:49:37,040 --> 02:49:39,640
HUMAN CENTERED DESIGN CENTRIC 

4144
02:49:39,640 --> 02:49:41,640
AND IS NOT A BIG AND SHINY THING

4145
02:49:41,640 --> 02:49:45,040
AND OBJECT THAT WE WILL PRACTICE

4146
02:49:45,040 --> 02:49:49,680
NEW LARGE LANGUAGE MODEL GPT 

4147
02:49:49,680 --> 02:49:51,600
MEETS SOME CENSOR IT IS NOT 

4148
02:49:51,600 --> 02:49:53,640
FUNDMENT AND TALKING ABOUT HUMAN

4149
02:49:53,640 --> 02:49:54,800
CENTERED DESIGN AND THAT IS TO 

4150
02:49:54,800 --> 02:49:56,920
PUT THAT OF P MANY OTHER 

4151
02:49:56,920 --> 02:50:02,840
POTENTIAL ISSUES HERE. 

4152
02:50:02,840 --> 02:50:05,320
>> AGAIN, FROM OUR
EXPERIENCE 

4153
02:50:05,320 --> 02:50:08,120
AND SO YOU KNOW WE HAVE -- AREA 

4154
02:50:08,120 --> 02:50:11,560
OF WORK IN HIGH BLOOD PRESSURE 

4155
02:50:11,560 --> 02:50:15,520
AND YOU SEE MAJOR POPULATIONS 

4156
02:50:15,520 --> 02:50:17,880
IMPACTED TO SERVE PARTICULARLY 

4157
02:50:17,880 --> 02:50:19,560
BLACK MOTHERS FOR US WHEN WE 

4158
02:50:19,560 --> 02:50:21,200
DECIDED TO WORK IN THE SPACE IS 

4159
02:50:21,200 --> 02:50:25,120
MADE SENSE TO WORK WITH US AND 

4160
02:50:25,120 --> 02:50:26,880
POPULATIONS AND IN OUR OWN 

4161
02:50:26,880 --> 02:50:28,560
EXPERIENCE WANTING TO WORK OR 

4162
02:50:28,560 --> 02:50:31,320
USED TO WORK WITH LARGE ACADEMIC

4163
02:50:31,320 --> 02:50:33,320
CENTERS IN BOSTON AREA WE ARE 

4164
02:50:33,320 --> 02:50:35,080
UNABLE TO REACH POPULATIONS AND 

4165
02:50:35,080 --> 02:50:37,640
GOING AHEAD AND SEEING WHERE WE 

4166
02:50:37,640 --> 02:50:39,600
COULD ACCESS POPULATIONS THESE 

4167
02:50:39,600 --> 02:50:43,000
ARE LARGE COMMUNITY HEALTH 

4168
02:50:43,000 --> 02:50:44,320
CENTERS THEY DON'T HAVE 

4169
02:50:44,320 --> 02:50:46,280
BANDWIDTH TO DO THAT RESEARCH OR

4170
02:50:46,280 --> 02:50:50,480
BE INVOLVED IN ANY TECHNOLOGY 

4171
02:50:50,480 --> 02:50:50,840
DEVELOPMENT. 

4172
02:50:50,840 --> 02:50:53,440
SO, CURRENTLY THEY ARE WORKING 

4173
02:50:53,440 --> 02:50:55,960
WITH NEW YORK CITY PUBLIC HEALTH

4174
02:50:55,960 --> 02:51:00,720
SYSTEM AND ABLE TO DO IT BECAUSE

4175
02:51:00,720 --> 02:51:02,760
I'M FROM MEDICAL FIELD AND CAN 

4176
02:51:02,760 --> 02:51:05,920
MAKE CONNECTIONS AND I THINK 

4177
02:51:05,920 --> 02:51:08,920
THAT IT IS IMPORTANT TO WORK 

4178
02:51:08,920 --> 02:51:10,440
WITH POPULATIONS WHERE NEED IS 

4179
02:51:10,440 --> 02:51:14,400
AND GETTING ACCESS TO THEM IS A 

4180
02:51:14,400 --> 02:51:14,760
CHALLENGE. 

4181
02:51:14,760 --> 02:51:16,480
>> THANKS.  ONE LAST
QUESTION 

4182
02:51:16,480 --> 02:51:19,360
FROM ME AND GOING TO Q & A
FROM 

4183
02:51:19,360 --> 02:51:21,200
AUDIENCE AND ONLINE.  THERE IS A

4184
02:51:21,200 --> 02:51:25,840
LOT OF TECHNOLOGY DEVELOPERS 

4185
02:51:25,840 --> 02:51:26,160
ONLINE. 

4186
02:51:26,160 --> 02:51:28,480
I THINK YOU MENTIONED AN ADDAGE 

4187
02:51:28,480 --> 02:51:30,600
WE TELL ENGINEERING COLLEAGUES 

4188
02:51:30,600 --> 02:51:34,040
AND TRAINEES DON'T BE THIS 

4189
02:51:34,040 --> 02:51:36,080
HAMMER LOOKING FOR A NAIL AND 

4190
02:51:36,080 --> 02:51:37,600
FIND OUT WHAT CLINICAL NEEDS ARE

4191
02:51:37,600 --> 02:51:39,880
AND FIND OUT WHAT POPULATIONS 

4192
02:51:39,880 --> 02:51:41,480
YOU ARE TRYING TO SERVE AND 

4193
02:51:41,480 --> 02:51:43,600
SERVE THE PROBLEM.  YOU ARE 

4194
02:51:43,600 --> 02:51:45,160
REALISTICALLY A HAMMER WITH A 

4195
02:51:45,160 --> 02:51:47,080
NAIL AND THAT IS WAY THINGS ARE 

4196
02:51:47,080 --> 02:51:48,600
SOMETIMES AND BASIC SCIENCE AND 

4197
02:51:48,600 --> 02:51:49,920
DEVELOPING NEW TECHNOLOGIES AND 

4198
02:51:49,920 --> 02:51:53,520
DEVELOP THIS.  NOW WHAT?  

4199
02:51:53,520 --> 02:51:55,840
RIGHT?  

4200
02:51:55,840 --> 02:51:57,840
WHAT IS OVERALL DEVICE FOR 

4201
02:51:57,840 --> 02:51:59,120
HAMMER SNZ. 

4202
02:51:59,120 --> 02:52:01,240
>> ITERATIVE APPROACH TO
IT.  

4203
02:52:01,240 --> 02:52:02,960
WE SAY BEST QUADRANT THINKING 

4204
02:52:02,960 --> 02:52:05,480
ABOUT FOUR QUADRANTS CLINICAL 

4205
02:52:05,480 --> 02:52:07,160
BUSINESS AND TECHNICAL AND 

4206
02:52:07,160 --> 02:52:09,000
STRATEGIC.  IT IS GREAT TO START

4207
02:52:09,000 --> 02:52:10,720
ON CLINICAL QUADRANT WITH A NEED

4208
02:52:10,720 --> 02:52:13,280
AND PROBLEM AND YOU COULD START 

4209
02:52:13,280 --> 02:52:14,800
WITH TECHNOLOGY BREAKTHROUGH OR 

4210
02:52:14,800 --> 02:52:17,640
NEW BIOMARKER LET'S SAY HAS BEEN

4211
02:52:17,640 --> 02:52:19,800
DISCOVERED OR SOMETHING; RIGHT? 

4212
02:52:19,800 --> 02:52:21,800
QUICKLY LOOK AT WHAT CLINICAL 

4213
02:52:21,800 --> 02:52:23,280
APPLICATIONS ARE FOR IT. 

4214
02:52:23,280 --> 02:52:24,640
YOU KNOW?  

4215
02:52:24,640 --> 02:52:26,600
WITH APPROPRIATE LEVEL OF DEPTH 

4216
02:52:26,600 --> 02:52:29,440
AND IF LOW RESOLUTION LOOK EVEN.

4217
02:52:29,440 --> 02:52:31,880
DON'T JUST GO WORK IN THE FIRST 

4218
02:52:31,880 --> 02:52:33,240
CLINICAL AREA YOU THINK IT WOULD

4219
02:52:33,240 --> 02:52:35,600
BE A COOL APPLICATION AND 

4220
02:52:35,600 --> 02:52:37,240
EVALUATE MULTIPLE POSSIBILITIES 

4221
02:52:37,240 --> 02:52:40,400
OF THAT APPLICATION AND LOOK AT 

4222
02:52:40,400 --> 02:52:42,800
PARALLEL BUSINESS MODELS AND 

4223
02:52:42,800 --> 02:52:44,560
STUDENTS WE HAVE THEM PROTOTYPE 

4224
02:52:44,560 --> 02:52:47,040
BUSINESS MODELS 18 TO 20 

4225
02:52:47,040 --> 02:52:49,360
BUSINESS MODELS FOR GIVEN 

4226
02:52:49,360 --> 02:52:51,120
TECHNOLOGY NOT JUST FIRST THAT 

4227
02:52:51,120 --> 02:52:53,880
COMES TO MIND PROTOTYPING 

4228
02:52:53,880 --> 02:52:55,000
MULTIPLE ENGINEERING APPROACHES 

4229
02:52:55,000 --> 02:52:57,640
TO SOLVE SAME PROBLEM DOING WITH

4230
02:52:57,640 --> 02:53:00,600
BUSINESS AND NOT STARTING IN 

4231
02:53:00,600 --> 02:53:04,280
CLINICAL QUADRANT AND BUSINESS 

4232
02:53:04,280 --> 02:53:06,640
QUADRANT AND IN TECH QUADRANT 

4233
02:53:06,640 --> 02:53:09,280
AND LAB DEEP DEMAIN EXPERTISE ON

4234
02:53:09,280 --> 02:53:11,160
SOMETHING 20 YEARS OF RESEARCH 

4235
02:53:11,160 --> 02:53:12,960
COME UP WITH SOMETHING AND SPEND

4236
02:53:12,960 --> 02:53:15,280
TIME THINKING ABOUT APPROPRIATE 

4237
02:53:15,280 --> 02:53:17,520
TRANSLATIONAL MODEL ITERATING ON

4238
02:53:17,520 --> 02:53:20,160
IT AND EVALUATING ALTERNATIVES 

4239
02:53:20,160 --> 02:53:22,240
NOT JUMPING AT FIRST 

4240
02:53:22,240 --> 02:53:23,960
COLLABORATOR THAT COMES YOUR 

4241
02:53:23,960 --> 02:53:24,160
WAY. 

4242
02:53:24,160 --> 02:53:24,840
>> ANYTHING TO ADD?  

4243
02:53:24,840 --> 02:53:30,800
>> YEAH.  I THINK WE NEED
A 

4244
02:53:30,800 --> 02:53:32,200
CULTURE SHIFT AND SHOULDN'T BE A

4245
02:53:32,200 --> 02:53:34,320
HAND LOOKING FOR A NAIL.  I 

4246
02:53:34,320 --> 02:53:36,080
WOULD SAY PEDAL IT BACK, 

4247
02:53:36,080 --> 02:53:36,360
ACTUALLY. 

4248
02:53:36,360 --> 02:53:39,960
I THINK THAT THERE HAS BEEN THIS

4249
02:53:39,960 --> 02:53:44,640
KIND OF FAIL FIRST MENTALITY IN 

4250
02:53:44,640 --> 02:53:47,280
SILICON VALLEY AND GET COOL IDEA

4251
02:53:47,280 --> 02:53:49,440
DOESN'T WORK OUT FINE GET 

4252
02:53:49,440 --> 02:53:51,640
ANOTHER ONE AND SELL DATE THAW 

4253
02:53:51,640 --> 02:53:55,120
IS TOXIC TO TRUST BUILDING AND 

4254
02:53:55,120 --> 02:53:57,320
COMMUNITY WORKWE HAVE BEEN 

4255
02:53:57,320 --> 02:53:58,800
TALKING ABOUT AND IN THIS 

4256
02:53:58,800 --> 02:54:00,080
POST-OPS WORLD WE ARE LIVING IN 

4257
02:54:00,080 --> 02:54:02,120
WE HAVE TO THINK REALLY 

4258
02:54:02,120 --> 02:54:05,520
CAREFULLY ABOUT WHAT IT MEANS TO

4259
02:54:05,520 --> 02:54:09,240
COLLECT INFORMATION FROM PEOPLE 

4260
02:54:09,240 --> 02:54:13,280
AND TREAT THINGS AND CUT A 

4261
02:54:13,280 --> 02:54:21,680
PROJECT OFTEN. 

4262
02:54:21,680 --> 02:54:25,960
>> IT IS ANOTHER ONE WITH

4263
02:54:25,960 --> 02:54:28,800
ACTUAL [INDISCERNIBLE]. 

4264
02:54:28,800 --> 02:54:30,240
GOING TO Q & A. 

4265
02:54:30,240 --> 02:54:34,000
FEEL FREE AUDIENCE JUMP IN WITH 

4266
02:54:34,000 --> 02:54:36,480
A MICROPHONE. 

4267
02:54:36,480 --> 02:54:41,840
WE CAN GO ONLINE DR. ANDERSON, 

4268
02:54:41,840 --> 02:54:46,480
ANYTHING ON CHAT THAT WE CAN 

4269
02:54:46,480 --> 02:54:48,880
MAYBE ONE HERE. 

4270
02:54:48,880 --> 02:54:58,240
WE WILL ALTERNATE. 

4271
02:54:58,240 --> 02:55:01,280
>> MY QUESTIONS TO YOU 

4272
02:55:01,280 --> 02:55:03,760
REGARDING THE DEVICE AND USING 

4273
02:55:03,760 --> 02:55:06,120
24 HOUR AND BLOOD PRESSURE 

4274
02:55:06,120 --> 02:55:08,560
DEVICES PREVIOUSLY AND RECENTLY 

4275
02:55:08,560 --> 02:55:12,040
MY TEAM IS COMPLETING 

4276
02:55:12,040 --> 02:55:14,040
METAANALYSIS ASSESSING ABILITY 

4277
02:55:14,040 --> 02:55:18,960
TO PREDICT HYPERTENSIVE 

4278
02:55:18,960 --> 02:55:22,040
DISORDERS INCLUDING PRECOLLAPSIA

4279
02:55:22,040 --> 02:55:25,280
AND COMPARED TO DEVICE AND 

4280
02:55:25,280 --> 02:55:29,120
COMPARING YOU STATED PREDICTS 

4281
02:55:29,120 --> 02:55:33,480
PRECOLLAPSIA AND WONDERING WHICH

4282
02:55:33,480 --> 02:55:35,960
TRIMESTER MEASUREMENT IS MOST 

4283
02:55:35,960 --> 02:55:37,520
PREDICTIVE AND TERMS WHICH 

4284
02:55:37,520 --> 02:55:40,400
PARAMETERS ARE BETTER IN TERMS 

4285
02:55:40,400 --> 02:55:43,000
OF PREDICTING PRECOLLAPSIA.  

4286
02:55:43,000 --> 02:55:44,760
THANK YOU. 

4287
02:55:44,760 --> 02:55:46,880
>> ANSWERING YOUR
QUESTION WE 

4288
02:55:46,880 --> 02:55:49,240
STARTED TO WORK ON THIS SPACE 

4289
02:55:49,240 --> 02:55:54,880
AND HAVING LOOKED AT IN TERMS OF

4290
02:55:54,880 --> 02:55:58,320
WHAT ARE CONTINUOUS BLOOD 

4291
02:55:58,320 --> 02:56:02,400
PRESSURE METRICS WHAT ARE BETTER

4292
02:56:02,400 --> 02:56:04,960
PREDICTORS?  

4293
02:56:04,960 --> 02:56:07,360
ONE IS 24 HOUR BLOOD PRESSURE 

4294
02:56:07,360 --> 02:56:10,360
AND GETTING A SNAPSHOT AND OTHER

4295
02:56:10,360 --> 02:56:12,760
IS NIGHTTIME BLOOD PRESSURE OR 

4296
02:56:12,760 --> 02:56:15,200
NIGHTTIME BLOOD PRESSURE 

4297
02:56:15,200 --> 02:56:17,560
VARIABILITY THAT IS GOOD 

4298
02:56:17,560 --> 02:56:19,840
PREDICTOR OF FUTURE MORTALITY 

4299
02:56:19,840 --> 02:56:22,520
COMING TO STROKE AND HEART 

4300
02:56:22,520 --> 02:56:24,440
ATTACKS AND OTHER AREA WORK WE 

4301
02:56:24,440 --> 02:56:30,920
ARE DOING IS LOOKING AT BLOOD 

4302
02:56:30,920 --> 02:56:32,280
PRESSURE VARIABILITY PRESSURE 

4303
02:56:32,280 --> 02:56:36,800
CHANGING IN DAY AND WEEK AND 

4304
02:56:36,800 --> 02:56:40,080
MONTH AND WORKING ON COGNITIVE 

4305
02:56:40,080 --> 02:56:41,680
DISFUNCTION AND LATER RISK FOR 

4306
02:56:41,680 --> 02:56:45,760
DEMENTIA AND IS LOTS OF DATA OUT

4307
02:56:45,760 --> 02:56:47,480
THERE ON CONTINUOUS BLOOD 

4308
02:56:47,480 --> 02:56:52,520
PRESSURE PARAMETER AND ABLE TO 

4309
02:56:52,520 --> 02:56:53,920
HAVE [INDISCERNIBLE] PARAMETERS 

4310
02:56:53,920 --> 02:56:56,960
ABLE TO COMBINE THIS AND SEE 

4311
02:56:56,960 --> 02:56:58,640
WHETHER THERE IS POTENTIAL 

4312
02:56:58,640 --> 02:57:01,760
BENEFIT COMING TO WHAT I HEARD 

4313
02:57:01,760 --> 02:57:08,320
TODAY IS CAN YOU MORE ACCURATELY

4314
02:57:08,320 --> 02:57:12,360
DIAGNOSE PREDICT VALUE IN 

4315
02:57:12,360 --> 02:57:13,920
HYPERTENSIVE [INDISCERNIBLE] 

4316
02:57:13,920 --> 02:57:15,720
VERSUS PREGNANCY AND WE ARE 

4317
02:57:15,720 --> 02:57:19,000
STARTING TO COLLECT THAT DATA. 

4318
02:57:19,000 --> 02:57:24,080
>> THANK YOU.  TAKING A 

4319
02:57:24,080 --> 02:57:26,280
QUESTION ONLINE?  

4320
02:57:26,280 --> 02:57:30,640
NO.  

4321
02:57:30,640 --> 02:57:31,760
>> GOT IT.  

4322
02:57:31,760 --> 02:57:34,440
>> FIRST QUESTION HOW IS 

4323
02:57:34,440 --> 02:57:37,280
OPERATION COST RUNNING SUCH APP 

4324
02:57:37,280 --> 02:57:45,560
AS AND WHAT ABOUT SETUP COSTS?  

4325
02:57:45,560 --> 02:57:52,080
>> [INDISCERNIBLE]. 

4326
02:57:52,080 --> 02:57:56,080
>> SURGICAL SITE
INFECTION 

4327
02:57:56,080 --> 02:58:00,040
DIAGNOSTIC ALGORITHM AND TOOL IF

4328
02:58:00,040 --> 02:58:03,160
THIS WASN'T ALREADY A PLAN IN 

4329
02:58:03,160 --> 02:58:10,800
PLACE AND RWANDA AND HANDS -- 

4330
02:58:10,800 --> 02:58:12,040
FEASIBLE INTERVENTION TO 

4331
02:58:12,040 --> 02:58:15,320
INTEGRATE INTO THE HEALTH CARE 

4332
02:58:15,320 --> 02:58:21,800
SETTING IN TERMS OF THE SYSTEM 

4333
02:58:21,800 --> 02:58:28,600
AS THERE IS NOW AND APP AND 

4334
02:58:28,600 --> 02:58:30,560
TESTING THIS YEAR COULD BE 

4335
02:58:30,560 --> 02:58:34,720
UPLOADED TO PHONES WITH 

4336
02:58:34,720 --> 02:58:35,880
RELATIVELY LOW COSTS WITH 

4337
02:58:35,880 --> 02:58:38,160
COMMUNITY INTERVENTIONS GOING TO

4338
02:58:38,160 --> 02:58:40,080
MOTHERS HOMES BUT IS STILL COST 

4339
02:58:40,080 --> 02:58:50,240
OF MAINTENANCE AND TALKING ABOUT

4340
02:58:50,240 --> 02:58:52,720
LONG TERM TECHNOLOGY UPGRADES 

4341
02:58:52,720 --> 02:58:54,600
AND REQUIRES A FEW PEOPLE 

4342
02:58:54,600 --> 02:58:56,560
FULL-TIME IN MINISTRY OF HEALTH 

4343
02:58:56,560 --> 02:58:59,440
TO MAKE SURE THIS APP IS 

4344
02:58:59,440 --> 02:59:01,160
FUNCTIONING WAY IT IS INTENDED 

4345
02:59:01,160 --> 02:59:02,960
TO FUNCTION AND WE ARE PURSUING 

4346
02:59:02,960 --> 02:59:04,440
THIS BECAUSE THERE WAS 

4347
02:59:04,440 --> 02:59:05,800
INFRASTRUCTURE IN PLACE TO 

4348
02:59:05,800 --> 02:59:09,440
INTEGRATE IT INTO TO KEEP IT LOW

4349
02:59:09,440 --> 02:59:12,640
CO

4350
02:59:12,640 --> 02:59:12,840
COST. 

4351
02:59:12,840 --> 02:59:15,040
>> I DON'T THINK IT
CAPTURES IT

4352
02:59:15,040 --> 02:59:18,800
WELL AND THINK SOMETHING LIKE A 

4353
02:59:18,800 --> 02:59:21,600
DIGITAL TOOL COMPARED TO HEAVY 

4354
02:59:21,600 --> 02:59:25,240
MEDICAL DEVICE AND YOU CAN START

4355
02:59:25,240 --> 02:59:29,680
LEAN AND YOU EVENTUALLY HAVE 

4356
02:59:29,680 --> 02:59:31,760
DONE THAT POINT PRELIMINARY 

4357
02:59:31,760 --> 02:59:33,400
TESTING SCALING BIG COSTS IN 

4358
02:59:33,400 --> 02:59:38,160
TERMS OF DATA SECURITY AND 

4359
02:59:38,160 --> 02:59:39,760
MAINTAINING UPDATES AND THINKING

4360
02:59:39,760 --> 02:59:41,560
ABOUT EXECUTIVE MANAGEMENT COSTS

4361
02:59:41,560 --> 02:59:43,600
THAT IS SOMETHING THAT IN MY 

4362
02:59:43,600 --> 02:59:44,880
ACADEMIC WORLD I NEVER REALLY 

4363
02:59:44,880 --> 02:59:46,640
THOUGHT ABOUT AND I WAS USED TO 

4364
02:59:46,640 --> 02:59:49,120
RUNNING A LAB AND THINKING ABOUT

4365
02:59:49,120 --> 02:59:50,760
HOW YOU START YOUR LAB.  I 

4366
02:59:50,760 --> 02:59:53,840
HADN'T REALLY THOUGHT ABOUT THE 

4367
02:59:53,840 --> 02:59:55,600
DIFFERENCES IN KIND OF STAFFING 

4368
02:59:55,600 --> 02:59:56,880
A COMPANY AND WHAT THOSE NEEDS 

4369
02:59:56,880 --> 02:59:58,520
LOOK LIKE.  SO, THAT IS 

4370
02:59:58,520 --> 03:00:01,080
SOMETHING THAT I THINK IT WAS 

4371
03:00:01,080 --> 03:00:02,160
MENTIONED ALREADY THINKING ABOUT

4372
03:00:02,160 --> 03:00:03,520
THAT BUSINESS PLAN BEFORE YOU 

4373
03:00:03,520 --> 03:00:04,800
EVEN START TO THINK ABOUT A 

4374
03:00:04,800 --> 03:00:07,480
BUSINESS WILL HELP YOU TO 

4375
03:00:07,480 --> 03:00:10,720
EVALUATE WHAT COSTS WILL BE AND 

4376
03:00:10,720 --> 03:00:12,440
WHEN THEY WILL HIT. 

4377
03:00:12,440 --> 03:00:13,880
>> QUESTION. 

4378
03:00:13,880 --> 03:00:17,240
>> GOOD AFTERNOON.  I'M
NOLA 

4379
03:00:17,240 --> 03:00:19,240
KOVINGTON AND STARTING A COUPLE 

4380
03:00:19,240 --> 03:00:21,000
START-UP COMPANIES AND ONE IS 

4381
03:00:21,000 --> 03:00:23,280
LOOKING PRIMARILY AT LOOKING AT 

4382
03:00:23,280 --> 03:00:25,000
DIVERSE PATIENTS IN CLINICAL 

4383
03:00:25,000 --> 03:00:26,760
TRIALS AND PARTICULARLY TRYING 

4384
03:00:26,760 --> 03:00:28,720
TO FOCUS ON COMMUNITIES AND 

4385
03:00:28,720 --> 03:00:30,800
OTHER IS A START-UP THAT REALLY 

4386
03:00:30,800 --> 03:00:34,560
LOOKS AT INTEGRATING A VARIETY 

4387
03:00:34,560 --> 03:00:36,840
OF DIFFERENT THERAPIES AND 

4388
03:00:36,840 --> 03:00:39,360
SOLUTIONS, IF WILL YOU, OVER AI 

4389
03:00:39,360 --> 03:00:40,560
DIGITAL PLATFORM AND WHY I'M 

4390
03:00:40,560 --> 03:00:41,600
SAYING THIS QUESTION. 

4391
03:00:41,600 --> 03:00:43,720
PART OF THE REASON THAT I WANT 

4392
03:00:43,720 --> 03:00:46,200
TO DO THIS AND BEEN TO MANY 

4393
03:00:46,200 --> 03:00:48,720
MEETINGS AND HAD WONDERFUL 

4394
03:00:48,720 --> 03:00:49,560
CONVERSATIONS AND WHAT FOLK YUTS

4395
03:00:49,560 --> 03:00:51,840
IS AND TRYING TO SERIOUSLY IN MY

4396
03:00:51,840 --> 03:00:55,360
OPINION ADDRESS ISSUES RELATING 

4397
03:00:55,360 --> 03:00:58,200
TO BLACK AND BROWN WOMEN IN 

4398
03:00:58,200 --> 03:00:59,720
PARTICULAR CHILD AND MATERNAL 

4399
03:00:59,720 --> 03:01:01,480
HEALTH AND I'M INTERESTED IN 

4400
03:01:01,480 --> 03:01:03,080
CHANGING THE PARADIGM AS YOU 

4401
03:01:03,080 --> 03:01:05,480
MENTIONED TO MAKE SURE THAT NOT 

4402
03:01:05,480 --> 03:01:06,520
ONLY COMMUNITIES ARE INVOLVED 

4403
03:01:06,520 --> 03:01:09,040
BUT MAKE SURE THAT DIVERSITY OF 

4404
03:01:09,040 --> 03:01:10,520
COMMUNITIES WITHIN DIVERSE 

4405
03:01:10,520 --> 03:01:10,920
COMMUNITIES. 

4406
03:01:10,920 --> 03:01:12,600
ARE INCLUDED AT EACH AND EVERY 

4407
03:01:12,600 --> 03:01:14,320
PART OF THE TECHNICAL BUILD OUT 

4408
03:01:14,320 --> 03:01:16,080
AND TALKING ABOUT GETTING 

4409
03:01:16,080 --> 03:01:17,880
OPINIONS AND ONCE IT IS DONE AND

4410
03:01:17,880 --> 03:01:21,400
IT IS TALKING ABOUT BUILDING THE

4411
03:01:21,400 --> 03:01:23,080
NEED INTO THE SOLUTIONS. 

4412
03:01:23,080 --> 03:01:25,040
AND THEN DRIVING THAT THROUGHOUT

4413
03:01:25,040 --> 03:01:27,440
EACH AND EVERY PART OF THE 

4414
03:01:27,440 --> 03:01:30,040
PROCESS SO IT IS NOT PATIENT 

4415
03:01:30,040 --> 03:01:31,240
CENTERED BUT PATIENT DRIVEN AND 

4416
03:01:31,240 --> 03:01:33,840
QUESTION TO YOU IS I LOVE MODEL 

4417
03:01:33,840 --> 03:01:38,080
THAT IS DONE INTERNATIONALLY AS 

4418
03:01:38,080 --> 03:01:39,840
WE TALK ABOUT THE FRAGMENTATION 

4419
03:01:39,840 --> 03:01:44,800
OF US SYSTEM IN PARTICULAR. 

4420
03:01:44,800 --> 03:01:47,160
WHAT ARE YOUR THOUGHTS HOW TO 

4421
03:01:47,160 --> 03:01:49,040
REALLY DRIVE THAT DIVERSITY 

4422
03:01:49,040 --> 03:01:51,800
COMMUNITY APPROACH INTO THE 

4423
03:01:51,800 --> 03:01:52,960
PROCESS RELATING TO TECHNOLOGY 

4424
03:01:52,960 --> 03:01:56,520
IN BUILDING OUT SOLUTIONS?  

4425
03:01:56,520 --> 03:01:57,280
THANK YOU. 

4426
03:01:57,280 --> 03:01:59,680
>> EXCELLENT QUESTION. 
MY 

4427
03:01:59,680 --> 03:02:01,240
RESPONSE WILL FALL SHORT FOR 

4428
03:02:01,240 --> 03:02:03,440
SURE.  WE WERE TALKING ABOUT TO 

4429
03:02:03,440 --> 03:02:07,240
SOME DEGREE MY WORK IN RWANDA 

4430
03:02:07,240 --> 03:02:09,640
MIGHT BE EASIER SINGLE NATIONAL 

4431
03:02:09,640 --> 03:02:11,720
HEALTH SYSTEM COMMUNITY HEALTH 

4432
03:02:11,720 --> 03:02:15,880
WORKERS ARE ALL ENGAGED IN THAT 

4433
03:02:15,880 --> 03:02:18,200
SYSTEM AND FOR ME OUR WORK IN 

4434
03:02:18,200 --> 03:02:20,320
RWANDA, THERE IS MULTIPLE WAYS 

4435
03:02:20,320 --> 03:02:22,720
WE DO THIS AND I THINK THAT SOME

4436
03:02:22,720 --> 03:02:25,280
OF THAT COULD BE TRANSLATED HERE

4437
03:02:25,280 --> 03:02:29,080
AND THINK THAT HAVING 

4438
03:02:29,080 --> 03:02:32,320
CONVERSATIONS IS A START. 

4439
03:02:32,320 --> 03:02:34,680
I THINK REALLY BEING AS CLOSE TO

4440
03:02:34,680 --> 03:02:36,320
COMMUNITY AS YOU CAN AND NOT -- 

4441
03:02:36,320 --> 03:02:38,880
YOU KNOW, THERE IS ONLY -- I MAY

4442
03:02:38,880 --> 03:02:41,720
NOT IDENTIFY WITH THE COMMUNITY 

4443
03:02:41,720 --> 03:02:43,640
BUT DIDN'T MEAN I CAN'T BE IN 

4444
03:02:43,640 --> 03:02:44,560
COMMUNITY; RIGHT?  

4445
03:02:44,560 --> 03:02:47,920
THAT IS A REALLY IMPORTANT 

4446
03:02:47,920 --> 03:02:48,960
COMPONENT AND ANOTHER WAY TO 

4447
03:02:48,960 --> 03:02:50,680
RESPOND TO YOUR QUESTION LOTS OF

4448
03:02:50,680 --> 03:02:53,600
WHAT I DO IN RWANDA IS ACTUALLY 

4449
03:02:53,600 --> 03:02:55,160
BRIDGING THE DIVIDE BETWEEN 

4450
03:02:55,160 --> 03:02:56,400
THOSE WHO HAVE SKILLS AND THOSE 

4451
03:02:56,400 --> 03:02:59,040
WHO DON'T HAVE SKILLS IF IN BOTH

4452
03:02:59,040 --> 03:03:00,000
DIRECTIONS; RIGHT?  

4453
03:03:00,000 --> 03:03:02,520
SO, YOU KNOW, I MIGHT HAVE -- 

4454
03:03:02,520 --> 03:03:04,760
I'M A BIOSTATISTICIAN AND TRAIN 

4455
03:03:04,760 --> 03:03:07,120
FOR DECADES TO DO STATISTICS 

4456
03:03:07,120 --> 03:03:10,080
THAT IS NOT A SKILL THAT I CAN'T

4457
03:03:10,080 --> 03:03:11,880
SHARE WITH OTHER PEOPLE AND 

4458
03:03:11,880 --> 03:03:12,480
CHANGING THAT.  

4459
03:03:12,480 --> 03:03:14,920
I'M ALSO NOT A COMMUNITY HEALTH 

4460
03:03:14,920 --> 03:03:17,400
WORKER.  THERE IS ALL KINDS OF 

4461
03:03:17,400 --> 03:03:18,200
UNDERSTANDING HOW TO DELIVER 

4462
03:03:18,200 --> 03:03:20,080
CARE AND COMMUNITIES TO BE 

4463
03:03:20,080 --> 03:03:22,560
TRAINED ON AND REALLY DEVELOPING

4464
03:03:22,560 --> 03:03:25,080
MODELS WHERE WE SHARED SKILLS 

4465
03:03:25,080 --> 03:03:26,680
AND KNOWLEDGE TO REALLY LEVEL 

4466
03:03:26,680 --> 03:03:29,240
WHAT DO WE VALUE AND HOW DO WE 

4467
03:03:29,240 --> 03:03:33,120
GET VOICES TO THE TABLE IS A 

4468
03:03:33,120 --> 03:03:34,760
STRATEGY WE ARE ADOPTING THAT 

4469
03:03:34,760 --> 03:03:36,640
COULD BE DONE WITH PROJECT 

4470
03:03:36,640 --> 03:03:40,040
HERE'S AND I'M SURE FOLKS DO US 

4471
03:03:40,040 --> 03:03:43,200
CENTRIC WORK THAT COULD OFFER 

4472
03:03:43,200 --> 03:03:44,080
BETTER RESPONSES. 

4473
03:03:44,080 --> 03:03:46,000
>> THANK YOU.  WONDERFUL 

4474
03:03:46,000 --> 03:03:48,520
QUESTION AND MY RESPONSE WILL 

4475
03:03:48,520 --> 03:03:50,200
PROBABLY FALL QUITE SHORT.  I 

4476
03:03:50,200 --> 03:03:51,800
WANT TO IN RESPONSE TO YOUR 

4477
03:03:51,800 --> 03:03:53,520
QUESTION ECHO SOMETHING THAT THE

4478
03:03:53,520 --> 03:03:55,600
SPEAKER FROM THIS MORNING SAID 

4479
03:03:55,600 --> 03:03:59,360
VERY ELOQUENTLY EMPATHY THAT IS 

4480
03:03:59,360 --> 03:04:02,480
ONE WAY TO GET TO THAT OUTCOME 

4481
03:04:02,480 --> 03:04:04,280
THAT YOU ARE MENTIONING. 

4482
03:04:04,280 --> 03:04:06,960
SO, WE TRIED TO DO THAT IN 

4483
03:04:06,960 --> 03:04:08,800
SEVERAL OF OUR GLOBAL PROJECT 

4484
03:04:08,800 --> 03:04:10,720
WHERE'S STUDENTS HAVE TO 

4485
03:04:10,720 --> 03:04:13,000
ACTUALLY SPEND.  THEY ARE ALL 

4486
03:04:13,000 --> 03:04:14,400
YOUNG INNOVATORS THAT ARE FRESH 

4487
03:04:14,400 --> 03:04:16,480
OUT OF UNDERGRAD AND GRAD SCHOOL

4488
03:04:16,480 --> 03:04:19,680
AND IN THE COMMUNITIES TRYING TO

4489
03:04:19,680 --> 03:04:21,760
BE PART OF THEM AND 

4490
03:04:21,760 --> 03:04:23,120
UNDERSTANDING AND DEVELOPING 

4491
03:04:23,120 --> 03:04:26,640
THAT EMPATHY AND NOT SYMPATHY 

4492
03:04:26,640 --> 03:04:29,160
BUT EMPANELY ARE DIFFERENT 

4493
03:04:29,160 --> 03:04:30,200
THINGS; RIGHT?  

4494
03:04:30,200 --> 03:04:32,600
OTHER IS SOMETHING YOU 

4495
03:04:32,600 --> 03:04:33,840
MENTIONED.  I GUESS HUMILITY 

4496
03:04:33,840 --> 03:04:36,240
THAT WE ARE -- WE DON'T KNOW IT 

4497
03:04:36,240 --> 03:04:37,640
ALL.  WE JUST KNOW SOME THINGS 

4498
03:04:37,640 --> 03:04:40,440
IN SILOS AND THERE IS A LOT TO 

4499
03:04:40,440 --> 03:04:40,640
LEARN. 

4500
03:04:40,640 --> 03:04:45,320
WHEN STUDENTS GO ABROAD OR IN 

4501
03:04:45,320 --> 03:04:47,080
PROJECTS HERE WE HAVE DONE MANY 

4502
03:04:47,080 --> 03:04:53,000
IN BALTIMORE FOR INSTANCE. 

4503
03:04:53,000 --> 03:04:55,120
TO BE OPEN TO LEARNING NOT JUST 

4504
03:04:55,120 --> 03:04:57,320
SOLVING A PROBLEM YOU ARE 

4505
03:04:57,320 --> 03:04:59,560
HELICOPTERED INTO AND THINK YOU 

4506
03:04:59,560 --> 03:05:03,040
HAVE MAGIC PROCESS AND WAND BUT 

4507
03:05:03,040 --> 03:05:05,560
HAVE HUMILITY YOU ARE HERE TO 

4508
03:05:05,560 --> 03:05:08,760
SERVE AND CONTRIBUTE IN MANY 

4509
03:05:08,760 --> 03:05:10,800
WAYS AND LEARN A LOT FROM 

4510
03:05:10,800 --> 03:05:12,400
EXPERIENCES IN LIFE DON'T 

4511
03:05:12,400 --> 03:05:14,320
OVERLAP WITH YOUR EXPERIENCES 

4512
03:05:14,320 --> 03:05:16,360
AND THOSE ARE TWO SMALL DATAS. 

4513
03:05:16,360 --> 03:05:16,800
>> THANK YOU. 

4514
03:05:16,800 --> 03:05:19,080
>> I IT THINK WE HAVE
ONLY TIME

4515
03:05:19,080 --> 03:05:20,480
FOR ONE QUESTION AND WE WILL DO 

4516
03:05:20,480 --> 03:05:23,280
IT ONLINE AND YOU HAVE TWO MORE 

4517
03:05:23,280 --> 03:05:26,760
QUESTIONS HERE AND PANELISTS 

4518
03:05:26,760 --> 03:05:31,320
WILL STICK AROUND ONLINE. 

4519
03:05:31,320 --> 03:05:32,640
>> QUESTION ABOUT TIMING
AND 

4520
03:05:32,640 --> 03:05:35,160
FOR EXAMPLE EARLY DETECTION. 

4521
03:05:35,160 --> 03:05:38,440
HOW TECHNOLOGIES CAN BE USED TO 

4522
03:05:38,440 --> 03:05:41,800
ANSWER THESE TIMING ISSUES AND 

4523
03:05:41,800 --> 03:05:43,960
PERTAINING TO ANOTHER QUESTION 

4524
03:05:43,960 --> 03:05:46,280
THAT IS FOR EXAMPLE DIGITAL 

4525
03:05:46,280 --> 03:05:48,720
HEALTH THAT IS HOW DIFFICULT IT 

4526
03:05:48,720 --> 03:05:50,920
IS TIMING TO KEEP PATIENT ENGAGE

4527
03:05:50,920 --> 03:05:54,280
THE IN CARE AND RESEARCH THAT IS

4528
03:05:54,280 --> 03:05:55,880
INVOLVING TECHNOLOGIES THAT IT 

4529
03:05:55,880 --> 03:05:59,400
FALLS IN ISSUE OF TIMING. 

4530
03:05:59,400 --> 03:06:04,120
>> ANYONE WANTING TO JUMP
IN?  

4531
03:06:04,120 --> 03:06:05,400
>>. 

4532
03:06:05,400 --> 03:06:06,800
>> I COULDN'T HEAR
QUESTION 

4533
03:06:06,800 --> 03:06:07,000
WELL. 

4534
03:06:07,000 --> 03:06:08,160
>> COULD YOU REPEAT
QUESTION. 

4535
03:06:08,160 --> 03:06:10,360
>> YEAH.  SO, IT SORT OF
FALLS 

4536
03:06:10,360 --> 03:06:12,160
INTO THE SAME CATEGORY AND ONE 

4537
03:06:12,160 --> 03:06:15,880
IS HOW DEVICES COULD BE USED FOR

4538
03:06:15,880 --> 03:06:17,320
EARLY DIAGNOSIS. 

4539
03:06:17,320 --> 03:06:19,240
AND THEN TIMING LIKE WE HEARD 

4540
03:06:19,240 --> 03:06:21,840
FROM THE CLINICAL PANEL AND 

4541
03:06:21,840 --> 03:06:24,040
POSTPARTUM PERIOD OR HOW EARLY 

4542
03:06:24,040 --> 03:06:27,480
THAT FIRST TWO WEEKS IS 

4543
03:06:27,480 --> 03:06:31,040
IMPORTANT HOW YOU CAN DO DEVICES

4544
03:06:31,040 --> 03:06:32,920
TO ANSWER THOSE AND HOW 

4545
03:06:32,920 --> 03:06:34,960
TECHNOLOGIES COULD BE FOR 

4546
03:06:34,960 --> 03:06:38,000
EXAMPLE YOUR APP COULD EXTEND TO

4547
03:06:38,000 --> 03:06:39,000
POSTPARTUM PERIOD AND DIFFICULT 

4548
03:06:39,000 --> 03:06:41,720
TIME TO KEECH PATIENTS ENGAGED 

4549
03:06:41,720 --> 03:06:45,520
IN CARE AND RESEARCH THAT IS 

4550
03:06:45,520 --> 03:06:47,840
INVOLVING TECHNOLOGIES. 

4551
03:06:47,840 --> 03:06:51,560
>> MAYBE I CAN TAKE A
CRACK AT 

4552
03:06:51,560 --> 03:06:51,760
IT.  

4553
03:06:51,760 --> 03:06:54,440
>> ONE OVERARCHING THEME
COULD 

4554
03:06:54,440 --> 03:06:57,880
BE FOR US HEALTH CARE SYSTEM 

4555
03:06:57,880 --> 03:07:01,560
WITH SO MUCH COSTS AND 

4556
03:07:01,560 --> 03:07:03,560
UNSUSTAINABILITY LOOMING ON 

4557
03:07:03,560 --> 03:07:05,080
HORIZON USING TECHNOLOGY SMART 

4558
03:07:05,080 --> 03:07:07,280
WAY FOR SETTING OF CARE AND 

4559
03:07:07,280 --> 03:07:13,840
SETTING TO LESSER SKILL SETTING 

4560
03:07:13,840 --> 03:07:17,680
THAT IS HOW IT IS DONE IN 

4561
03:07:17,680 --> 03:07:22,080
SEVERAL LOW AND MIDDLE INCOME 

4562
03:07:22,080 --> 03:07:29,280
CLASSES AND PROGRAMS ARE GREAT 

4563
03:07:29,280 --> 03:07:30,520
LEARNING OPPORTUNITY AND 

4564
03:07:30,520 --> 03:07:32,280
HEALTHCARE SYSTEM CAN LEARN LOTS

4565
03:07:32,280 --> 03:07:34,080
FROM THAT AND HEALTH CARE HAS 

4566
03:07:34,080 --> 03:07:37,800
ROLE IN EARLY DETECTION AND 

4567
03:07:37,800 --> 03:07:41,720
MANAGEMENT PATIENT ENGAGEMENT ND

4568
03:07:41,720 --> 03:07:43,680
BEHAVIOR AND ADHERENCE TO 

4569
03:07:43,680 --> 03:07:45,360
MANAGEMENT PLANS AND ALL THAT 

4570
03:07:45,360 --> 03:07:50,480
DEVELOPING SMART THINGS USING 

4571
03:07:50,480 --> 03:07:52,680
MULTI-DISCIPLINARY APPROACH 

4572
03:07:52,680 --> 03:07:57,400
SHIFTING ONUS IN HOME CARE 

4573
03:07:57,400 --> 03:07:57,680
SETTINGS. 

4574
03:07:57,680 --> 03:07:58,400
>> 

4575
03:07:58,400 --> 03:08:04,320
>> JUST TO ADD TO THAT IS
EARLY

4576
03:08:04,320 --> 03:08:06,600
DIAGNOSIS IS POINT OF CARE 

4577
03:08:06,600 --> 03:08:08,760
QUESTIONS FOR WHICH AT LEAST 

4578
03:08:08,760 --> 03:08:11,920
ACCURACY OF MISSION IS VERY 

4579
03:08:11,920 --> 03:08:12,200
CRITICAL. 

4580
03:08:12,200 --> 03:08:15,600
NEEDS TO BE ACTIONABLE IS ONE 

4581
03:08:15,600 --> 03:08:15,840
POINT. 

4582
03:08:15,840 --> 03:08:17,440
SECOND ANYTHING YOU DO HAS TO BE

4583
03:08:17,440 --> 03:08:19,840
ALIGN THE WITH DELIVERY RATE 

4584
03:08:19,840 --> 03:08:22,560
CAN'T BE STANDALONINOVATION IN 

4585
03:08:22,560 --> 03:08:25,200
HEALTH CARE DLIFYS AS WELL AND 

4586
03:08:25,200 --> 03:08:26,680
PARTICULAR TO THIS COUNTRY IS 

4587
03:08:26,680 --> 03:08:29,680
PAYMENT AND HAS TO BE ALIGNED 

4588
03:08:29,680 --> 03:08:30,440
WITH PAYMENT. 

4589
03:08:30,440 --> 03:08:34,360
THESE ARE CHALLENGES COMING TO 

4590
03:08:34,360 --> 03:08:34,520
IT. 

4591
03:08:34,520 --> 03:08:36,640
>> OKAY.  

4592
03:08:36,640 --> 03:08:39,960
>> YEAH.  SO, TO THAT
FIRST 

4593
03:08:39,960 --> 03:08:41,680
QUESTION AROUND TIMING I HAD 

4594
03:08:41,680 --> 03:08:44,600
MADE ACTUALLY A NOTE AND ELIZA 

4595
03:08:44,600 --> 03:08:48,680
IT WAS YOUR TALK THAT IS ABOUT 

4596
03:08:48,680 --> 03:08:54,080
HOW IMPORTANT IT IS TO DIAGNOSE 

4597
03:08:54,080 --> 03:08:56,600
THINGS EARLY AND EARLY DIAGNOSED

4598
03:08:56,600 --> 03:08:58,760
SURGICAL INFECTIONS ARE EASY TO 

4599
03:08:58,760 --> 03:09:00,800
TREAT AND PROGRESSED INFECTIONS 

4600
03:09:00,800 --> 03:09:03,240
ARE IMPOSSIBLE TO TREAT AND 

4601
03:09:03,240 --> 03:09:04,920
LEADING CONTRIBUTOR TO MORTALITY

4602
03:09:04,920 --> 03:09:08,320
IN LEADING CONTEXT AND IS SO 

4603
03:09:08,320 --> 03:09:08,640
IMPORTANT. 

4604
03:09:08,640 --> 03:09:10,640
TO A LARGE DEGREE IT REQUIRES 

4605
03:09:10,640 --> 03:09:12,600
DATA AND WE ARE ABOUT TO DO 

4606
03:09:12,600 --> 03:09:16,080
VALIDATION OF 10 DAY SCREENING 

4607
03:09:16,080 --> 03:09:18,480
TOOL TO PREDICT 10 DAY DIAGNOSED

4608
03:09:18,480 --> 03:09:22,960
INFECTIONS AND DOING THAT WE GET

4609
03:09:22,960 --> 03:09:25,440
DAY 3 IMAGES THAT WOULD GIVE US 

4610
03:09:25,440 --> 03:09:28,720
MAYBE ANOTHER PATIENT POPULATION

4611
03:09:28,720 --> 03:09:33,160
TO MONITOR CLOSELY HUGE AND 

4612
03:09:33,160 --> 03:09:36,880
IMPORTANT AREA NEEDING 

4613
03:09:36,880 --> 03:09:40,640
INVESTMENT AND HIGH RISK AND 

4614
03:09:40,640 --> 03:09:44,760
MOST OF WORK IS IN POSTPARTUM 

4615
03:09:44,760 --> 03:09:52,240
CARE AND IS SO NEGLECTED AND 

4616
03:09:52,240 --> 03:09:54,240
INCUBATOR OF BABY NOT WHAT 

4617
03:09:54,240 --> 03:09:57,640
HAPPENS TO MOTHER WEEKS AND 

4618
03:09:57,640 --> 03:10:00,760
MONTHS AFTER AND IS IT WAS 

4619
03:10:00,760 --> 03:10:02,600
COMPLEX PREGNANCY ITSELF AND 

4620
03:10:02,600 --> 03:10:04,560
THINKING ABOUT FOLLOWING WOMEN 

4621
03:10:04,560 --> 03:10:14,600
THROUGH PREGNANCY ADD IING COST 

4622
03:10:14,600 --> 03:10:16,040
AND THINKING OF STUDIES TO 

4623
03:10:16,040 --> 03:10:20,120
SUPPORT THEM IN WAYS DURING 

4624
03:10:20,120 --> 03:10:25,280
POSTPARTUM PERIOD. 

4625
03:10:25,280 --> 03:10:27,440
>> ADDING TO THAT CALL TO

4626
03:10:27,440 --> 03:10:32,080
FUNDERS POSTPARTUM PERIOD IS 

4627
03:10:32,080 --> 03:10:35,280
NEGLEC

4628
03:10:35,280 --> 03:10:35,560
NEGLECTED. 

4629
03:10:35,560 --> 03:10:36,920
>> YOU LEAVE PLACE YOU
GIVE 

4630
03:10:36,920 --> 03:10:38,440
BIRTH AND GO HOME AND ARE ON 

4631
03:10:38,440 --> 03:10:40,720
YOUR WAY IN A RISKY TIME WHEN 

4632
03:10:40,720 --> 03:10:43,200
RISK IDENTIFICATION YOU ARE ALL 

4633
03:10:43,200 --> 03:10:43,480
IN. 

4634
03:10:43,480 --> 03:10:45,160
YOU WOULD BE ABLE TO SHARE 

4635
03:10:45,160 --> 03:10:46,640
SYMPTOMS AND YOU ARE AWARE WHAT 

4636
03:10:46,640 --> 03:10:48,760
IS HAPPENING AND YOU ARE HOME 

4637
03:10:48,760 --> 03:10:50,440
ALONE WITH THIS BABY AND TAPPED 

4638
03:10:50,440 --> 03:10:53,640
IF INTO YOUR BODY AT THAT TIME. 

4639
03:10:53,640 --> 03:10:55,800
WE HAVE BEEN WORKING ON FINALLY 

4640
03:10:55,800 --> 03:10:59,440
WORKING IN PARTNERSHIP WITH 

4641
03:10:59,440 --> 03:11:01,640
COMMON WEALTH OF PENNSYLVANIA TO

4642
03:11:01,640 --> 03:11:03,400
EXTEND MODEL TO POSTPARTUM 

4643
03:11:03,400 --> 03:11:04,920
PERIOD AND TO FUNDERS THIS IS 

4644
03:11:04,920 --> 03:11:06,480
SOMETHING WE TRIED AND TRIED AND

4645
03:11:06,480 --> 03:11:12,120
TRIED TO GET FUNDED AS WELL. 

4646
03:11:12,120 --> 03:11:13,760
GIVEN THERE IS NOT A GOOD 

4647
03:11:13,760 --> 03:11:15,200
BUSINESS MODEL IN COMMERCIAL 

4648
03:11:15,200 --> 03:11:17,280
SPACE TO ADDRESS THIS EARLY KIND

4649
03:11:17,280 --> 03:11:20,000
OF FIRST 6 WEEKS OR FIRST YEAR 

4650
03:11:20,000 --> 03:11:23,800
POSTPARTUM THAT I THINK THAT IS 

4651
03:11:23,800 --> 03:11:28,280
SOMETHING THAT WOULD BE AN IDEAL

4652
03:11:28,280 --> 03:11:34,400
FOCUS FOR NIH TO THINK ABOUT. 

4653
03:11:34,400 --> 03:11:37,960
WE WILL GET STARTED WITH THE 

4654
03:11:37,960 --> 03:11:43,840
COMMUNITY ENGAGEMENT MANL  

4655
03:11:43,840 --> 03:11:46,120
PANEL.  I'M EXCITED TO SHARE THE

4656
03:11:46,120 --> 03:11:48,840
WONDERFUL SPEAKERS WE HAVE THE 

4657
03:11:48,840 --> 03:11:54,120
COMMUNITY ENGAGEMENT PANEL I I'M

4658
03:11:54,120 --> 03:11:57,480
JOIA AND WE HAVE A WONDERFUL 

4659
03:11:57,480 --> 03:11:59,080
PANEL THAT IS READY FOR YOU 

4660
03:11:59,080 --> 03:12:02,120
TODAY AND THEIR DISCUSSION WILL 

4661
03:12:02,120 --> 03:12:03,880
FOCUS ON SOCIAL AND STRUCTURAL 

4662
03:12:03,880 --> 03:12:07,240
DETERMINANTS OF HEALTH THAT 

4663
03:12:07,240 --> 03:12:10,080
CONTRIBUTE TO MATERNAL HEALTH 

4664
03:12:10,080 --> 03:12:11,840
DISPARITIES AND WHAT ARE HEALTH 

4665
03:12:11,840 --> 03:12:15,720
TECHNOLOGIES WE CAN USE TO 

4666
03:12:15,720 --> 03:12:18,680
DEVELOP AND IMPLEMENT AND 

4667
03:12:18,680 --> 03:12:21,000
ADDRESS THOSE DISPARITIES AND WE

4668
03:12:21,000 --> 03:12:28,800
HAVE A WONDERFUL MODERATOR DR. 

4669
03:12:28,800 --> 03:12:30,480
JOIACREAR-PERRY WHO IS A 

4670
03:12:30,480 --> 03:12:33,000
PHYSICIAN AND ADVOCATE FOR 

4671
03:12:33,000 --> 03:12:34,800
TRANSFORMATIONAL DUSTIS AND 

4672
03:12:34,800 --> 03:12:38,120
FOUNDER OF NATIONAL HEALTH 

4673
03:12:38,120 --> 03:12:38,880
COLLABORATIVE EQUITY.  I'M 

4674
03:12:38,880 --> 03:12:41,240
DELIGHTED TO HAVE HER HERE.  SHE

4675
03:12:41,240 --> 03:12:44,080
WILL GUIDE THIS FACILITATED 

4676
03:12:44,080 --> 03:12:45,320
DISCUSSION WITH OUR PANEL AND 

4677
03:12:45,320 --> 03:12:47,800
THAT IS BY FOCUSING ON TWO 

4678
03:12:47,800 --> 03:12:49,440
THEMES, FIRST WILL BE ROLE OF 

4679
03:12:49,440 --> 03:12:52,400
COMMUNITY ENGAGEMENT TO ADDRESS 

4680
03:12:52,400 --> 03:12:54,080
MATERNAL HEALTH DISPARITIES AND 

4681
03:12:54,080 --> 03:12:56,000
SECOND THEME WOULD BE HOW 

4682
03:12:56,000 --> 03:12:57,560
TECHNOLOGY COULD UTILIZE AN 

4683
03:12:57,560 --> 03:13:01,840
EQUITY LENS TO ADDRESS MATERNAL 

4684
03:13:01,840 --> 03:13:04,360
HEALTH DISPARITIES AND WILL HAND

4685
03:13:04,360 --> 03:13:07,800
IT TO DR. JOIA WHO WILL KICK OFF

4686
03:13:07,800 --> 03:13:09,920
INTRODUCTIONS BY PANELS SHARING 

4687
03:13:09,920 --> 03:13:12,240
WITH YOU HER WORK AND COMMUNITY 

4688
03:13:12,240 --> 03:13:12,640
ENGAGEMENTS. 

4689
03:13:12,640 --> 03:13:13,720
THANK YOU SO MUCH. 

4690
03:13:13,720 --> 03:13:15,920
>> HEY.  GOOD AFTERNOON. 
HOW 

4691
03:13:15,920 --> 03:13:18,080
ARE YOU FEELING?  HOW ARE WE 

4692
03:13:18,080 --> 03:13:19,840
FEELING ALL RIGHT TODAY?  GOOD? 

4693
03:13:19,840 --> 03:13:21,160
OKAY.  GOOD.  WE WILL START WITH

4694
03:13:21,160 --> 03:13:23,640
MY SLIDES IF YOU DON'T MIND.  

4695
03:13:23,640 --> 03:13:27,600
NEXT SLIDE, PLEASE, WHOEVER IS 

4696
03:13:27,600 --> 03:13:37,880
MANAGING THEM. 

4697
03:13:40,200 --> 03:13:41,880
>> THIS IS OUR OBJECTIVE
AND 

4698
03:13:41,880 --> 03:13:44,800
THIS IS ME AS MODERATOR AND OUR 

4699
03:13:44,800 --> 03:13:46,680
ORGANIZATION NATIONAL BIRTH 

4700
03:13:46,680 --> 03:13:48,640
EQUITY COLLABORATIVE WE ARE 8 

4701
03:13:48,640 --> 03:13:51,640
YEARS OLD AND STARTED WITH 

4702
03:13:51,640 --> 03:13:53,600
ROBERT WOOD FOUNDATION AND IT IS

4703
03:13:53,600 --> 03:13:55,800
HARD TO GET PRIME WITH YOU ALL. 

4704
03:13:55,800 --> 03:13:57,120
LETTING YOU KNOW.  NEXT SLIDE. 

4705
03:13:57,120 --> 03:13:59,120
THIS IS THE MISSION THAT I NEED 

4706
03:13:59,120 --> 03:14:01,080
TO READ.  WE KEEP EXPANDING IT. 

4707
03:14:01,080 --> 03:14:03,640
I HAVE BRILLIANT, 40 DIFFERENT 

4708
03:14:03,640 --> 03:14:05,080
BLACK AND BROWN WOMEN WORKING 

4709
03:14:05,080 --> 03:14:06,440
FOR OUR ORGANIZATION COMING UP 

4710
03:14:06,440 --> 03:14:10,880
WITH AMAZING NEW IDEAS ALL THE 

4711
03:14:10,880 --> 03:14:13,400
TIME AND SEXUAL REPRODUCTIVE 

4712
03:14:13,400 --> 03:14:15,040
HEALTH AND WELLBEING THAT IS NOT

4713
03:14:15,040 --> 03:14:18,480
JUST HEALTH ABOUT MENTAL AND 

4714
03:14:18,480 --> 03:14:19,840
PHYSICAL WELLBEING OF BIRTHING 

4715
03:14:19,840 --> 03:14:22,000
PEOPLE AND WORLDWIDE THAT 

4716
03:14:22,000 --> 03:14:24,280
CREATES TRANSNATIONAL SOLUTIONS 

4717
03:14:24,280 --> 03:14:26,640
OPTIMIZING BLACK MATERNAL HEALTH

4718
03:14:26,640 --> 03:14:29,200
NOT JUST SURVIVE BUT THRIVE AND 

4719
03:14:29,200 --> 03:14:32,960
OPTIMIZE AND BLACK MATERNAL 

4720
03:14:32,960 --> 03:14:33,800
HEALTH TRANSNATIONAL NOT GLOBAL 

4721
03:14:33,800 --> 03:14:36,560
YOU SEPARATE GLOBAL FROM US AND 

4722
03:14:36,560 --> 03:14:38,640
INFANT SEXUAL REPRODUCTIVE 

4723
03:14:38,640 --> 03:14:40,680
WELLBEING AND SHIFT SYSTEMS AND 

4724
03:14:40,680 --> 03:14:42,480
CULTURE THROUGH TRAINING AND 

4725
03:14:42,480 --> 03:14:43,720
RESEARCH TECHNICAL ASSISTANCE 

4726
03:14:43,720 --> 03:14:45,800
POLICY ADVOCACY AND COMMUNITY 

4727
03:14:45,800 --> 03:14:47,320
CENTERED COLLABORATION.  WE DO 

4728
03:14:47,320 --> 03:14:50,800
ALL IT.  THAT WE WANT BLACK 

4729
03:14:50,800 --> 03:14:52,560
MAMAS AND BABIES TO THRIVE.  

4730
03:14:52,560 --> 03:14:53,480
NEXT SLIDE, PLEASE. 

4731
03:14:53,480 --> 03:14:55,960
THIS IS THE DEFINITION OF BIRTH 

4732
03:14:55,960 --> 03:14:57,720
EQUITY THAT IS CREATED ABOUT 8 

4733
03:14:57,720 --> 03:15:00,440
YEARS AGO.  IT IS ASSURANCES AND

4734
03:15:00,440 --> 03:15:02,960
JOB IS NOT TO BLAME AND SHAME 

4735
03:15:02,960 --> 03:15:03,960
COMMUNITIES ABOUT WHAT THEY DO 

4736
03:15:03,960 --> 03:15:05,720
AND DON'T DO AND RESEARCHERS 

4737
03:15:05,720 --> 03:15:07,960
PEOPLE WITH POWER SITTING IN 

4738
03:15:07,960 --> 03:15:10,200
INSTITUTION IS PROVIDING 

4739
03:15:10,200 --> 03:15:11,720
ASSURANCES FOR OPTIMAL VERSE 

4740
03:15:11,720 --> 03:15:12,960
PUTTING TOGETHER BIG POLICIES 

4741
03:15:12,960 --> 03:15:14,600
BIG P AND WHO YOU DECIDE AND 

4742
03:15:14,600 --> 03:15:17,320
FUND AND WORK WITH AND WHO YOU 

4743
03:15:17,320 --> 03:15:19,360
LISTEN TO OR LITTLE P AND IF 

4744
03:15:19,360 --> 03:15:21,600
ENSURE THERE IS ACCESS TO 

4745
03:15:21,600 --> 03:15:22,800
COMMUNITY FOR OPPORTUNITIES AND 

4746
03:15:22,800 --> 03:15:24,080
GRANT OPPORTUNITIES AND BOTH 

4747
03:15:24,080 --> 03:15:26,160
HAVE TO DO WITH A SUSTAINED 

4748
03:15:26,160 --> 03:15:28,520
EFFORT AND WE LOVE GETTING A 

4749
03:15:28,520 --> 03:15:30,120
THREE YEAR GRANT WE WON'T END 

4750
03:15:30,120 --> 03:15:35,320
RACISM IF IN THREE YEARS.  NEXT 

4751
03:15:35,320 --> 03:15:37,520
SLIDE MRAF I GET TO COME FROM 

4752
03:15:37,520 --> 03:15:44,080
MOVEMENT OF REPRODUCTIVE JUS

4753
03:15:44,080 --> 03:15:44,360
JUSTICE. 

4754
03:15:44,360 --> 03:15:46,560
ANYBODY HEARD ABOUT IT?  IN 

4755
03:15:46,560 --> 03:15:48,200
RIGHT ROOM FOUNDED BY BLACK 

4756
03:15:48,200 --> 03:15:51,160
WOMEN IN 1926 AND AT POINT WE 

4757
03:15:51,160 --> 03:15:53,360
HAVECISM RIGHTS AND YOU HAVE 

4758
03:15:53,360 --> 03:15:54,560
REPRODUCTIVE RIGHTS AND ALSO 

4759
03:15:54,560 --> 03:15:56,120
JUSTICE WORK. 

4760
03:15:56,120 --> 03:15:57,880
THIS IS A COMPILATION OF ALL 

4761
03:15:57,880 --> 03:15:59,160
THOSE THINGS AND UNDERSTAND 

4762
03:15:59,160 --> 03:16:00,360
THERE SAY RIGHT TO OWN PEOPLE 

4763
03:16:00,360 --> 03:16:02,680
AND IS A RIGHT IN THIS COUNTRY 

4764
03:16:02,680 --> 03:16:04,680
TO ENSLAVE PEOPLE GIVING A RIGHT

4765
03:16:04,680 --> 03:16:06,440
TO SOMETHING DOESN'T MEAN IT IS 

4766
03:16:06,440 --> 03:16:09,080
JUST OR FAIR AND TENANTS OF 

4767
03:16:09,080 --> 03:16:10,320
REPRODUCTIVE JUSTICE HAVING 

4768
03:16:10,320 --> 03:16:12,720
ABILITY TO HAVE PERSONAL BODILY 

4769
03:16:12,720 --> 03:16:14,520
AUTONOMY AND IF I DON'T WANT TO 

4770
03:16:14,520 --> 03:16:16,040
LARK YOU CAN'T MAKE ME WANT TO 

4771
03:16:16,040 --> 03:16:18,360
LARK.  I CAN CONTROL MY OWN BODY

4772
03:16:18,360 --> 03:16:20,040
AND HAVE RIGHT TO HAVE CHILDREN 

4773
03:16:20,040 --> 03:16:22,160
AND IF I WANT TO HAVE 12 KIDS I 

4774
03:16:22,160 --> 03:16:25,120
GET TO.  IF I WANT TO HAVE NO 

4775
03:16:25,120 --> 03:16:27,480
KIDS I HAVE RIGHT TO HAVE NO 

4776
03:16:27,480 --> 03:16:29,160
CHILDREN.  I'M VALUABLE BECAUSE 

4777
03:16:29,160 --> 03:16:33,720
I EXIST NOT HERE TO REPRODUCE 

4778
03:16:33,720 --> 03:16:35,960
CHILDREN TO KEEP THE FARM GOING 

4779
03:16:35,960 --> 03:16:37,880
AND THOSE DAYS GREW UP ON FARMS 

4780
03:16:37,880 --> 03:16:41,880
I LOVE FARMS DON'T HAVE MUCH 

4781
03:16:41,880 --> 03:16:44,800
ROOM FOR THAT ANYMORE AND 

4782
03:16:44,800 --> 03:16:47,840
UNDERSTANDING WE HAVE TO BE ABLE

4783
03:16:47,840 --> 03:16:50,640
TO RAISE CHILDREN IN SAFE AND 

4784
03:16:50,640 --> 03:16:52,480
SUSTAINABLE COMMUNITIES AND NOT 

4785
03:16:52,480 --> 03:16:54,720
WORRYING IF COMMUNITIES ARE SAFE

4786
03:16:54,720 --> 03:16:57,360
AND SUSTAINABLE THIS COUNTRY HAS

4787
03:16:57,360 --> 03:17:00,440
WORST HEALTH OUTCOMES OF ANY 

4788
03:17:00,440 --> 03:17:02,040
INDUSTRIAL NATION AND ABILITY TO

4789
03:17:02,040 --> 03:17:03,840
HAVE SAFE AND SUSTAINABLE 

4790
03:17:03,840 --> 03:17:05,800
COMMUNITY AND IS FUTURE AND 

4791
03:17:05,800 --> 03:17:07,360
WHERE TECHNOLOGY IS GREAT 

4792
03:17:07,360 --> 03:17:09,440
OPPORTUNITY FOR US NOT ALL DOOM 

4793
03:17:09,440 --> 03:17:10,760
AND GLOOM AND SMART PEOPLE 

4794
03:17:10,760 --> 03:17:12,080
THINKING THROUGH HOW TO USE 

4795
03:17:12,080 --> 03:17:14,000
TECHNOLOGY TO ENSURE WE MEET 

4796
03:17:14,000 --> 03:17:15,160
THESE AND THESE ARE FRAMEWORK 

4797
03:17:15,160 --> 03:17:17,120
THAT BIRTH AND EQUITY COMES FROM

4798
03:17:17,120 --> 03:17:18,880
AND LOTS OF FRAMEWORK YOU COULD 

4799
03:17:18,880 --> 03:17:21,680
HAVE EUGENICS FRAMEWORK AND 

4800
03:17:21,680 --> 03:17:23,480
WHITE SUPREMACY FRAMEWORK AND 

4801
03:17:23,480 --> 03:17:24,600
REPRODUCTIVE JUSTICE FRAMEWORK 

4802
03:17:24,600 --> 03:17:26,160
AND LOOK AT RESEARCH AND DECIDE 

4803
03:17:26,160 --> 03:17:27,400
WHERE IT LIES. 

4804
03:17:27,400 --> 03:17:28,360
NEXT SLIDE, PLEASE. 

4805
03:17:28,360 --> 03:17:30,640
THIS IS THE POINT OF THIS, 

4806
03:17:30,640 --> 03:17:30,880
REALLY. 

4807
03:17:30,880 --> 03:17:32,640
YOU PICK INDICATORS AND 

4808
03:17:32,640 --> 03:17:34,720
INDICATOR COULD BE HOW MANY 

4809
03:17:34,720 --> 03:17:36,720
C-SECTIONS A PERSON HAD OR 

4810
03:17:36,720 --> 03:17:39,320
PLACENTA IS IN THE RIGHT PLACE 

4811
03:17:39,320 --> 03:17:41,600
AND RESEARCH RESIDENT CREA-10 

4812
03:17:41,600 --> 03:17:43,120
NEEN LEVELS OF BLACK WOMEN AND 

4813
03:17:43,120 --> 03:17:46,640
HOW IT HAS TO DO WITH 

4814
03:17:46,640 --> 03:17:48,000
PREECOLLAPSIA AND LOOK BACK ON 

4815
03:17:48,000 --> 03:17:50,760
RESEARCH 20 YEARS AGO WHAT IS 

4816
03:17:50,760 --> 03:17:53,080
EVERYONE THINKING ABOUT BLACK 

4817
03:17:53,080 --> 03:17:55,480
CREAT ANYONE OR ACTIVITY WHY 

4818
03:17:55,480 --> 03:17:59,320
WOULD THAT MAKE ANY LOGICAL 

4819
03:17:59,320 --> 03:18:05,200
SCIENTIFIC SENSE?  SPENT A YEAR 

4820
03:18:05,200 --> 03:18:07,320
WHY DOES IT MAKE SENSE AND 

4821
03:18:07,320 --> 03:18:08,320
INDICATOR AND THINKING OF 

4822
03:18:08,320 --> 03:18:10,480
SCIENCE THAT IS MEASUREMENT 

4823
03:18:10,480 --> 03:18:13,400
LIMITED BY CURRENT UNDERSTANDING

4824
03:18:13,400 --> 03:18:16,600
OF SCIENCE SINCE WE KNOW NO 

4825
03:18:16,600 --> 03:18:19,880
BLACK GENE OR KIDNEY OR HEART OR

4826
03:18:19,880 --> 03:18:23,160
BLACK LUNGS IF STUDYING THEM 

4827
03:18:23,160 --> 03:18:25,280
STUDYING SOMETHING THAT DOESN'T 

4828
03:18:25,280 --> 03:18:26,880
MAKE BIOLOGICAL SENSE AND 

4829
03:18:26,880 --> 03:18:28,320
PRODUCT OF CURRENT UNDERSTANDING

4830
03:18:28,320 --> 03:18:30,440
OF PUBLIC HEALTH AND SCIENCE. 

4831
03:18:30,440 --> 03:18:32,160
WE UNDERSTAND PUBLIC HEALTH 

4832
03:18:32,160 --> 03:18:34,400
AFTER COVID NEEDS A LOT MORE 

4833
03:18:34,400 --> 03:18:36,600
INFRASTRUCTURE AND LISTENING TO 

4834
03:18:36,600 --> 03:18:39,000
COMMUNITY AND YOU WOULD 

4835
03:18:39,000 --> 03:18:40,800
REIMAGINE INDICATOR YOU ARE 

4836
03:18:40,800 --> 03:18:42,240
USING TO DO YOUR WORK AND 

4837
03:18:42,240 --> 03:18:47,440
SYSTEMS OF POWER AND OF SYSTEMS 

4838
03:18:47,440 --> 03:18:51,480
IN YOUR HOUSE AND SYSTEMS 

4839
03:18:51,480 --> 03:18:52,520
EVERYWHERE CURRENT INDICATORS 

4840
03:18:52,520 --> 03:18:54,960
THEY ARE USING AND GO TO PLACES 

4841
03:18:54,960 --> 03:18:59,120
COW PLEASE STOP MEASURING BLACK 

4842
03:18:59,120 --> 03:18:59,320
URINE. 

4843
03:18:59,320 --> 03:19:00,720
IT IS HARD TO STOP THEY HAVE 

4844
03:19:00,720 --> 03:19:03,040
BEEN DOING IT 20 YEARS YOU CAN 

4845
03:19:03,040 --> 03:19:04,960
STOP I PROMISE AND WHAT IS A 

4846
03:19:04,960 --> 03:19:05,560
FRAMEWORK?  

4847
03:19:05,560 --> 03:19:07,640
IT COULD BE A VISION AND WAY FOR

4848
03:19:07,640 --> 03:19:09,320
US TO THINK ABOUT WHAT WE WOULD 

4849
03:19:09,320 --> 03:19:11,320
DO DIFFERENTLY AND HOW COULD WE 

4850
03:19:11,320 --> 03:19:12,560
EXPAND IT AND WHAT WOULD YOU 

4851
03:19:12,560 --> 03:19:14,800
MEASURE IF YOU WANT JUSTICE AND 

4852
03:19:14,800 --> 03:19:16,440
JOY FOR ALL PEOPLE IF YOU TRULY 

4853
03:19:16,440 --> 03:19:18,240
UNDERSTAND AND TRANSNATIONAL 

4854
03:19:18,240 --> 03:19:19,680
COMMUNITY DEPENDING UPON PEOPLE 

4855
03:19:19,680 --> 03:19:21,400
HOW YOU WOULD DO YOUR RESEARCH 

4856
03:19:21,400 --> 03:19:23,360
AND THINK ABOUT DOING YOUR 

4857
03:19:23,360 --> 03:19:24,640
TECHNOLOGY FUNDAMENTALLY 

4858
03:19:24,640 --> 03:19:25,480
DIFFERENTLY?  

4859
03:19:25,480 --> 03:19:27,200
ALLOWING US TO THINK ABOUT NEW 

4860
03:19:27,200 --> 03:19:28,800
LANGUAGE AND COULD SAY THINGS 

4861
03:19:28,800 --> 03:19:31,320
LIKE WHITE SUPREMACY AND I'M NOT

4862
03:19:31,320 --> 03:19:33,080
CALLING YOU BAD NAME AND 

4863
03:19:33,080 --> 03:19:36,080
WHITENESS WITH SKIN COLOR AND 

4864
03:19:36,080 --> 03:19:38,560
FROM NEW ORLEANS THIS IS NOT 

4865
03:19:38,560 --> 03:19:40,520
ABOUT SKIN COLOR BUT BELIEF AND 

4866
03:19:40,520 --> 03:19:43,000
HIERARCHY OF HUMAN VALUE BASED 

4867
03:19:43,000 --> 03:19:44,760
ON THINGS LIKE SKIN COLOR AND 

4868
03:19:44,760 --> 03:19:46,440
COUNTRY OF ORIGIN LIKE LANGUAGE 

4869
03:19:46,440 --> 03:19:50,240
AND GEOGRAPHY AND END BELIEF 

4870
03:19:50,240 --> 03:19:51,600
HIERARCHY OF SKIN COLOR AND 

4871
03:19:51,600 --> 03:19:54,480
GENDER AND RACE AND GEOGRAPHY 

4872
03:19:54,480 --> 03:19:56,400
ENSURING WE ARE ALL ONE HUMAN 

4873
03:19:56,400 --> 03:19:58,440
RACE AND QUESTIONING HISTORICAL 

4874
03:19:58,440 --> 03:19:59,520
CONSTRUCTION HOW WE DWOT HERE 

4875
03:19:59,520 --> 03:20:02,120
AND HOW NIH GOT HERE AND HOW WE 

4876
03:20:02,120 --> 03:20:05,880
DECIDED ON ALL OF US LOOKING ON 

4877
03:20:05,880 --> 03:20:07,320
GENETICS FOR THE CURE NOT SOCIAL

4878
03:20:07,320 --> 03:20:10,280
DETERMINANTS OF HEALTH?  

4879
03:20:10,280 --> 03:20:11,320
SO, NEXT SLIDE, PLEASE. 

4880
03:20:11,320 --> 03:20:13,120
THAT IS END OF WHO I AM AND WHAT

4881
03:20:13,120 --> 03:20:15,680
WE ARE DOING AND WOULD LIKE 

4882
03:20:15,680 --> 03:20:17,200
PANELISTS TO INTRODUCE 

4883
03:20:17,200 --> 03:20:20,000
THEMSELVES STARTING WITH NATALIE

4884
03:20:20,000 --> 03:20:20,800
HERNANDEZ, MY FRIEND. 

4885
03:20:20,800 --> 03:20:23,840
>> HI.  THANK YOU, JOIA. 

4886
03:20:23,840 --> 03:20:26,360
JUST A LITTLE ABOUT ME.  I WILL 

4887
03:20:26,360 --> 03:20:28,360
LATER TALK ABOUT HOW I DO MY 

4888
03:20:28,360 --> 03:20:33,360
WORK AND I'M A CISGENDER 

4889
03:20:33,360 --> 03:20:35,080
APHRO-LATINA WOMAN AND MOTHER OF

4890
03:20:35,080 --> 03:20:37,680
TWO EXPERIENCING POSTPARTUM 

4891
03:20:37,680 --> 03:20:41,200
DEPRESSION AND PERINATAL ANXIETY

4892
03:20:41,200 --> 03:20:42,760
GROWING UP IN SOUTH-BRONX NEW 

4893
03:20:42,760 --> 03:20:44,600
YORK ONE OF THE POOREST COUNTIES

4894
03:20:44,600 --> 03:20:46,240
IN THE UNITED STATES AND FAMILY 

4895
03:20:46,240 --> 03:20:50,040
WHERE EVERY SINGLE WOMAN HAD A 

4896
03:20:50,040 --> 03:20:51,280
P

4897
03:20:51,280 --> 03:20:53,320
PRETERM BIRTH AND PRIOR TO 

4898
03:20:53,320 --> 03:20:57,440
RESEARCH WORKED FOR CIVIL RIGHTS

4899
03:20:57,440 --> 03:21:01,120
ADVOCACY AND WORKING A LOT WITH 

4900
03:21:01,120 --> 03:21:04,680
COMMUNITY HEALTH WORKERS AND 

4901
03:21:04,680 --> 03:21:09,080
THROUGH EXPERIENCES I BECAME 

4902
03:21:09,080 --> 03:21:12,200
FRUSTRATED WITH HOW RESEARCH WAS

4903
03:21:12,200 --> 03:21:15,480
CONDUCTED AND -- REPRODUCTIVE 

4904
03:21:15,480 --> 03:21:16,880
HEALTH AND THUS SHAPING HAD HOW 

4905
03:21:16,880 --> 03:21:18,800
I DO MY RESEARCH AND I HAVE 

4906
03:21:18,800 --> 03:21:20,480
TAKEN THIS AS A FOUNDING 

4907
03:21:20,480 --> 03:21:22,880
EXECUTIVE DIRECTOR OF CENTER FOR

4908
03:21:22,880 --> 03:21:25,120
MATERNAL HEALTH EQUITY. 

4909
03:21:25,120 --> 03:21:27,080
AT MOORE HOUSE SCHOOL OF 

4910
03:21:27,080 --> 03:21:28,200
MEDICINE AND INSIDER 

4911
03:21:28,200 --> 03:21:29,840
POSITIONALITY IS HOW I FORMULATE

4912
03:21:29,840 --> 03:21:33,680
RESEARCH QUESTIONS AND HOW I 

4913
03:21:33,680 --> 03:21:36,080
INCORPORATE COMMUNITY ORGANIZING

4914
03:21:36,080 --> 03:21:37,520
AND SOCIAL JUSTICE APPROACHES TO

4915
03:21:37,520 --> 03:21:39,920
WORK I DO AND HOW I VALUE 

4916
03:21:39,920 --> 03:21:42,960
CENTERING OF LIVED EXPERIENCES 

4917
03:21:42,960 --> 03:21:45,160
IN ALL MY WORK. 

4918
03:21:45,160 --> 03:21:47,240
AGAIN, HOW I DISSEMINATE MY WORK

4919
03:21:47,240 --> 03:21:49,880
AS WELL.  THAT IS A LITTLE ABOUT

4920
03:21:49,880 --> 03:21:55,920
DR. NATALIE D HERNANDEZ AND 

4921
03:21:55,920 --> 03:21:58,280
NAMING IS BIRTH AS WELL, BY THE 

4922
03:21:58,280 --> 03:21:58,480
WAY. 

4923
03:21:58,480 --> 03:22:01,000
>> GOOD AFTERNOON,
EVERYONE.  

4924
03:22:01,000 --> 03:22:07,280
I'M INGER BROOU NET SDIGLER AND 

4925
03:22:07,280 --> 03:22:10,800
CLINICAL PSYCHOLOGIST AND. 

4926
03:22:10,800 --> 03:22:13,280
IN ADDITION TO MY ROLE AS A 

4927
03:22:13,280 --> 03:22:15,280
FACULTY MEMBER IN THE 

4928
03:22:15,280 --> 03:22:16,920
DEPARTMENT, I AM ALSO AN 

4929
03:22:16,920 --> 03:22:19,600
ADVOCATE FOR EQUITY AND MENTAL 

4930
03:22:19,600 --> 03:22:22,720
HEALTH PARTICULARLY IN BLACK 

4931
03:22:22,720 --> 03:22:23,840
COMMUNITIES. 

4932
03:22:23,840 --> 03:22:27,520
ADDITIONALLY I HAVE DIRECT LIVED

4933
03:22:27,520 --> 03:22:31,680
EXPERIENCES WITH THE MATERNAL 

4934
03:22:31,680 --> 03:22:33,480
HEALTH CONDITIONS EXPERIENCED BY

4935
03:22:33,480 --> 03:22:36,920
SO MANY BLACK WOMEN HAVING 

4936
03:22:36,920 --> 03:22:41,240
EXPERIENCE OF PREECOLLAPSING OF 

4937
03:22:41,240 --> 03:22:46,400
COLLAPSIA WITH SO -- MY WORK IS 

4938
03:22:46,400 --> 03:22:48,320
REALLY CENTERED AROUND 

4939
03:22:48,320 --> 03:22:50,920
DEVELOPING CULTURALLY TAILORED 

4940
03:22:50,920 --> 03:22:52,880
INTERVENTIONS THAT ARE RELEVANT 

4941
03:22:52,880 --> 03:22:55,560
TO DIVERSE COMMUNITIES 

4942
03:22:55,560 --> 03:22:57,560
PARTICULARLY BLACK WOMEN AND 

4943
03:22:57,560 --> 03:23:00,880
IMPLEMENTED IN COMMUNITY-BASED 

4944
03:23:00,880 --> 03:23:07,000
HEALTH CENTER SETTINGS. 

4945
03:23:07,000 --> 03:23:08,720
>> GOOD AFTERNOON,
EVERYONE.  

4946
03:23:08,720 --> 03:23:12,080
HONOR TO BE HERE AND PROBABLY 

4947
03:23:12,080 --> 03:23:14,320
ONLY NONSCIENTIST ACADEMIC 

4948
03:23:14,320 --> 03:23:19,280
CLINICIAN IN THE ROOM.  I'M 

4949
03:23:19,280 --> 03:23:21,840
VANESSA POLARD. 

4950
03:23:21,840 --> 03:23:28,120
I ALSO CO-CHAIR OUR GLOBAL LIFE 

4951
03:23:28,120 --> 03:23:29,600
SCIENCES PRACTICE AND FOOD AND 

4952
03:23:29,600 --> 03:23:30,960
DRUG LAWYER AND HELPING HEALTH 

4953
03:23:30,960 --> 03:23:39,920
CARE PROVIDERS ON ASPECTS 

4954
03:23:39,920 --> 03:23:43,760
RELATED TO REGULATIONS AND 

4955
03:23:43,760 --> 03:23:45,160
TECHNOLOGY SOFTWARE SOLUTIONS TO

4956
03:23:45,160 --> 03:23:48,080
THE MARKET AND I'M FOUNDING 

4957
03:23:48,080 --> 03:23:51,880
MEMBER AND BOARD MEMBER TO MED 

4958
03:23:51,880 --> 03:23:56,080
TECH COLOR A NON-PROFIT FOUNDED 

4959
03:23:56,080 --> 03:24:00,200
5 YEARS AGO WITH GOAL 

4960
03:24:00,200 --> 03:24:02,440
DIVERSIFYING TECH I'M A MOTHER 

4961
03:24:02,440 --> 03:24:09,920
AND PATIENT AND CONSUMER ARE 

4962
03:24:09,920 --> 03:24:12,680
ECONVENIENT SHAL TO HOW I AND WE

4963
03:24:12,680 --> 03:24:16,520
LIVE AND IS A PLEASURE TO ALL OF

4964
03:24:40,160 --> 03:24:40,280
US. 

4965
03:24:40,280 --> 03:24:45,000
>> ABIGAIL IS JOINING ON
ZOOM 

4966
03:24:45,000 --> 03:24:48,880
AND DON'T KNOW IF YOU CAN BRING 

4967
03:24:48,880 --> 03:24:59,120
HER ON THE -- 

4968
03:25:01,120 --> 03:25:08,720
>> LAST PANEL WAS AMAZING
AND 

4969
03:25:08,720 --> 03:25:11,920
EXCITED TO BUILD ON THAT.  

4970
03:25:11,920 --> 03:25:20,800
QUESTION NO. 1. 

4971
03:25:20,800 --> 03:25:31,360
>> A HEALTH CENTER IN
SEATTLE, 

4972
03:25:31,640 --> 03:25:33,160
WASHINGTON AND INDIAN HEALTH 

4973
03:25:33,160 --> 03:25:35,920
CARE SERVICE AND CLINICAL 

4974
03:25:35,920 --> 03:25:38,960
PROVIDER FOR URBAN INDIANS IN 

4975
03:25:38,960 --> 03:25:41,920
SEATTLE POOUNL ET SOUND AREA AND

4976
03:25:41,920 --> 03:25:43,080
CISGENDERED WOMAN WITH TWO 

4977
03:25:43,080 --> 03:25:44,520
CHILDREN WHO HAD BLESSING TO 

4978
03:25:44,520 --> 03:25:47,760
SHAPE MY ADVOCACY IN WORK AND 

4979
03:25:47,760 --> 03:25:50,920
MATERNAL CHILD HEALTH BASED ON 

4980
03:25:50,920 --> 03:25:53,240
EXPERIENCES OF EXPERIENCING 

4981
03:25:53,240 --> 03:25:56,080
BLASANT RACISM IMPACTING 

4982
03:25:56,080 --> 03:26:00,440
DELIVERY OF BOTH MY CHILDREN AND

4983
03:26:00,440 --> 03:26:02,520
BLESSED TO SEE DIFFERENCE IN 

4984
03:26:02,520 --> 03:26:04,600
COMMUNITY ENGAGEMENT IN 

4985
03:26:04,600 --> 03:26:08,280
PROVIDING RESOURCES IN 

4986
03:26:08,280 --> 03:26:11,080
CULTURALLY SPECIFIC WAYS 

4987
03:26:11,080 --> 03:26:13,280
SPENDING MUCH OF CAREER IN 

4988
03:26:13,280 --> 03:26:16,840
RESEARCH AND PROVIDING DIRECT 

4989
03:26:16,840 --> 03:26:20,400
RESEARCH AND HAPPY TO BE HERE 

4990
03:26:20,400 --> 03:26:22,360
WITH BRILLIANT VOICES. 

4991
03:26:22,360 --> 03:26:26,880
>> I LEARN FROM ABIGAIL. 
WHAT 

4992
03:26:26,880 --> 03:26:30,280
A TREAT.  -- TO ADDRESS MATERNAL

4993
03:26:30,280 --> 03:26:32,320
HEALTH DISPARITIES.  NATALIE CAN

4994
03:26:32,320 --> 03:26:34,920
YOU TAKE FIVE MINUTES TO LET US 

4995
03:26:34,920 --> 03:26:37,080
KNOW AND PULL UP HER SLIDES. 

4996
03:26:37,080 --> 03:26:39,160
>> IF YOU CAN PULL UP MY 

4997
03:26:39,160 --> 03:26:40,280
SLIDES, THANK YOU.  

4998
03:26:40,280 --> 03:26:42,200
AS THEY GET PULLED UP, I WILL 

4999
03:26:42,200 --> 03:26:44,520
TELL YOU ABOUT THE CENTER FOR 

5000
03:26:44,520 --> 03:26:46,520
MATERNAL HEALTH EQUITY AND WE 

5001
03:26:46,520 --> 03:26:50,120
WERE FOUNDED IN 2019 THROUGH 

5002
03:26:50,120 --> 03:26:53,000
ADVOCACY EFFORTS AND DIRECT 

5003
03:26:53,000 --> 03:26:55,600
RESPONSE TO INEQUITIES STATE OF 

5004
03:26:55,600 --> 03:27:00,640
JORNL YA FACED AROUND MATERNAL 

5005
03:27:00,640 --> 03:27:03,280
MORTALITY AND SEVERE MA THE 

5006
03:27:03,280 --> 03:27:06,000
TERNAL MORBIDITY IN THE NATION 

5007
03:27:06,000 --> 03:27:07,160
AND COMPARABLE TO OTHER 

5008
03:27:07,160 --> 03:27:09,680
COUNTRIES AROUND THE WORLD AND 

5009
03:27:09,680 --> 03:27:12,160
WE DO OUR WORK IN -- OUR MISSION

5010
03:27:12,160 --> 03:27:17,520
IS PURSUING EQUITY IN MATERNAL 

5011
03:27:17,520 --> 03:27:19,000
MORBIDITY AND MORTALITY AND 

5012
03:27:19,000 --> 03:27:20,720
LOCALLY AND NATIONALLY. 

5013
03:27:20,720 --> 03:27:22,680
>> NEXT SLIDE, PLEASE. 

5014
03:27:22,680 --> 03:27:23,200
>> SORRY. 

5015
03:27:23,200 --> 03:27:25,840
>> THERE WE GO.  

5016
03:27:25,840 --> 03:27:26,400
>> NEXT SLIDE. 

5017
03:27:26,400 --> 03:27:31,200
>> NEXT SLIDE.  I HAVE NO

5018
03:27:31,200 --> 03:27:31,520
DISCLOSURES. 

5019
03:27:31,520 --> 03:27:35,320
NEXT SLIDE.  YEAH.  THAT IS A 

5020
03:27:35,320 --> 03:27:38,640
LITTLE MOR HOUSE SCHOOL OF 

5021
03:27:38,640 --> 03:27:39,240
MEDICINE HISTORICALLY BLACK 

5022
03:27:39,240 --> 03:27:40,960
MEDICAL COLLEGE GOING ON IFFIST 

5023
03:27:40,960 --> 03:27:43,000
YEARS AND HAVE ONLY BEEN AROUND 

5024
03:27:43,000 --> 03:27:44,320
THAT LONG OF A TIME. 

5025
03:27:44,320 --> 03:27:46,240
YOU WILL SEE HOW MUCH WORK WE 

5026
03:27:46,240 --> 03:27:48,600
HAVE BEEN ABLE TO ACCOMPLISH IN 

5027
03:27:48,600 --> 03:27:49,840
THE LAST THREE YEARS 

5028
03:27:49,840 --> 03:27:53,120
PARTICULARLY WITH OUR CORRECTOR.

5029
03:27:53,120 --> 03:27:55,200
NEXT SLIDE. 

5030
03:27:55,200 --> 03:27:56,960
A LITTLE OF OUR VISION THERE WAS

5031
03:27:56,960 --> 03:27:58,960
A PANEL TALKING ABOUT 

5032
03:27:58,960 --> 03:28:00,280
PRECONCEPTION AND WE KNOW WE 

5033
03:28:00,280 --> 03:28:01,760
HAVE TO GO BEYOND THAT AND 

5034
03:28:01,760 --> 03:28:04,520
VISION IS TO END HEALTH 

5035
03:28:04,520 --> 03:28:06,000
INEQUITIES ACHIEVING LIBERATION 

5036
03:28:06,000 --> 03:28:08,880
IN WOMEN'S HEALTH ACROSS THE 

5037
03:28:08,880 --> 03:28:09,160
LIFESPAN. 

5038
03:28:09,160 --> 03:28:10,000
NEXT SLIDE. 

5039
03:28:10,000 --> 03:28:11,640
WE DO OUR WORK IN THREE 

5040
03:28:11,640 --> 03:28:16,280
DIFFERENT WAYS AND YEAH.  

5041
03:28:16,280 --> 03:28:18,640
ANOTHER IMPACT AND WITH RESEARCH

5042
03:28:18,640 --> 03:28:23,200
AND SO WE REALLY DO WORK ACROSS 

5043
03:28:23,200 --> 03:28:24,160
TRANS DISCIPLINES FROM VERY 

5044
03:28:24,160 --> 03:28:26,600
BASIC SCIENCE WHERE WE HAVE 

5045
03:28:26,600 --> 03:28:28,160
INVESTIGATORS LOOKING AT 

5046
03:28:28,160 --> 03:28:30,080
PLACENTAS ALL THE WAY TO 

5047
03:28:30,080 --> 03:28:32,320
POPULATION HEALTH AND SOCIAL 

5048
03:28:32,320 --> 03:28:34,120
BEHAVIORAL SCIENTIST AND WORK IS

5049
03:28:34,120 --> 03:28:35,280
CENTERED AROUND POPULATION 

5050
03:28:35,280 --> 03:28:37,800
HEALTH AND CENTERING LIVED 

5051
03:28:37,800 --> 03:28:39,320
EXPERIENCES AND QUALITATIVE 

5052
03:28:39,320 --> 03:28:41,400
RESEARCH AND DEVELOPMENT AND 

5053
03:28:41,400 --> 03:28:43,000
TESTING OF INTERVENTIONS AND 

5054
03:28:43,000 --> 03:28:44,960
HAVE NUMEROUS CLINICAL TRIALS 

5055
03:28:44,960 --> 03:28:46,720
TESTING TYPES OF INNOVATIONS WE 

5056
03:28:46,720 --> 03:28:50,080
ARE TALKING ABOUT HERE TODAY AND

5057
03:28:50,080 --> 03:28:51,720
BIG FOCAL POINT AND WHAT CENTERS

5058
03:28:51,720 --> 03:28:54,440
THE CENTER IS OUR COMMUNITY 

5059
03:28:54,440 --> 03:28:54,840
ENGAGEMENT WORK. 

5060
03:28:54,840 --> 03:28:58,800
WE SEE OURSELVES AS A RESOURCE 

5061
03:28:58,800 --> 03:29:00,680
HUB FOR OUR COMMUNITIES AND IS 

5062
03:29:00,680 --> 03:29:03,360
SO MUCH INFORMATION THAT GETS 

5063
03:29:03,360 --> 03:29:05,920
OUT THERE.  NONE IS A WAY THAT 

5064
03:29:05,920 --> 03:29:07,560
RESONATES WITH COMMUNITIES WE 

5065
03:29:07,560 --> 03:29:09,400
SERVE AND WE ENSURE THAT, THAT 

5066
03:29:09,400 --> 03:29:11,520
INFORMATION IS A WAY THAT IS 

5067
03:29:11,520 --> 03:29:13,560
PALATABLE TO THEM AND IS 

5068
03:29:13,560 --> 03:29:15,080
CULTURALLY RELEVANT AND 

5069
03:29:15,080 --> 03:29:16,800
RESONATES WITH THEM AND CENTERS 

5070
03:29:16,800 --> 03:29:18,840
THEIR LIVED EXPERIENCES AND 

5071
03:29:18,840 --> 03:29:22,640
THROUGH COMMUNITY ENGAGEMENT 

5072
03:29:22,640 --> 03:29:24,080
ENSURE THAT RESEARCH TRANSLATES 

5073
03:29:24,080 --> 03:29:26,440
INTO ACTION WITH COMMUNITIES AND

5074
03:29:26,440 --> 03:29:32,240
INFORMS POLICY AND POLICY 

5075
03:29:32,240 --> 03:29:36,240
INITIATIVES AND RESEARCH PROJECT

5076
03:29:36,240 --> 03:29:39,320
MATERNAL NEAR MISS STORYTELLER 

5077
03:29:39,320 --> 03:29:41,200
PROJECT AND STORIES USED AS 

5078
03:29:41,200 --> 03:29:44,880
TESTIMONIES TO PAST POSTPARTUM 

5079
03:29:44,880 --> 03:29:46,880
MEDICAID EXTENSION IN THE STATE 

5080
03:29:46,880 --> 03:29:53,560
OF GEORGIA WE DO CAPACITY 

5081
03:29:53,560 --> 03:29:56,200
BUILDING AND WE KNOW THAT 

5082
03:29:56,200 --> 03:29:58,720
COMMUNITIES HAVE HAD ANSWERS FOR

5083
03:29:58,720 --> 03:30:02,680
A LONG TIME AND NIH EVIDENCE AND

5084
03:30:02,680 --> 03:30:04,800
THEY NEED PILOT STUDIES AND THEY

5085
03:30:04,800 --> 03:30:06,920
NEED FUNDING AND PROVIDE 

5086
03:30:06,920 --> 03:30:08,280
TECHNICAL ASSISTANCE AND 

5087
03:30:08,280 --> 03:30:10,920
CAPACITY BUILDING SO INNOVATIONS

5088
03:30:10,920 --> 03:30:13,360
AND TECHNOLOGIES AND INNOVATION 

5089
03:30:13,360 --> 03:30:16,160
AND INTERVENTIONS CAN GET TO THE

5090
03:30:16,160 --> 03:30:16,920
NEXT LEVEL. 

5091
03:30:16,920 --> 03:30:19,400
WHERE MEDICAL SCHOOLS, WE ARE 

5092
03:30:19,400 --> 03:30:23,040
ONE AND WE HAVE A VARIETY OF 

5093
03:30:23,040 --> 03:30:25,800
TRAINING PROGRAMS AND DO 

5094
03:30:25,800 --> 03:30:26,840
INTERDISCIPLINARY LEARNING AND 

5095
03:30:26,840 --> 03:30:29,040
TRAIN THE TRAINER AND DEVELOP 

5096
03:30:29,040 --> 03:30:32,240
COMMUNITY BASED PERINATAL 

5097
03:30:32,240 --> 03:30:34,920
PATIENT NAVIGATION PROGRAM 

5098
03:30:34,920 --> 03:30:37,120
NIHR01 TESTING CLINICAL 

5099
03:30:37,120 --> 03:30:37,960
EFFECTIVENESS OF THAT AND LOTS 

5100
03:30:37,960 --> 03:30:40,840
OF WAYS OF TRAINING WITHIN OUR 

5101
03:30:40,840 --> 03:30:41,440
INSTITUTION. 

5102
03:30:41,440 --> 03:30:42,840
NEXT SLIDE. 

5103
03:30:42,840 --> 03:30:44,280
MEANINGFUL COMMUNITY ENGAGEMENT,

5104
03:30:44,280 --> 03:30:46,160
HOW DO WE DO THAT?  

5105
03:30:46,160 --> 03:30:48,520
BY CENTERING JOY AND PAIN AND 

5106
03:30:48,520 --> 03:30:50,960
CENTERING VOICES OF COMMUNITIES 

5107
03:30:50,960 --> 03:30:52,800
THAT ARE MOST EFFECTED BY THE 

5108
03:30:52,800 --> 03:30:54,800
ISSUE AND CENTERING EXPERIENCE 

5109
03:30:54,800 --> 03:30:56,040
PARTICULARLY OF BLACK WOMEN WHO 

5110
03:30:56,040 --> 03:30:58,320
IS MOST EFFECTED BY THE ISSUE IS

5111
03:30:58,320 --> 03:31:00,240
AN OPPORTUNITY TO RETHINK 

5112
03:31:00,240 --> 03:31:02,440
CONVENTIONAL RESEARCH PRACTICES 

5113
03:31:02,440 --> 03:31:05,400
THRU BY IDENTIFYING PATHWAYS TO 

5114
03:31:05,400 --> 03:31:06,800
CONTRIBUTE KNOWLEDGE ASSOCIATED 

5115
03:31:06,800 --> 03:31:10,040
WITH MATERNAL HEALTH. 

5116
03:31:10,040 --> 03:31:12,400
IN PARTICULAR OUR STUDIES 

5117
03:31:12,400 --> 03:31:15,240
UNDERSCORE VALUE OF GRASSROOTS 

5118
03:31:15,240 --> 03:31:16,080
EMPOWERMENT OPPORTUNITIES FOR 

5119
03:31:16,080 --> 03:31:17,680
WOMEN TO UNDERSTAND HUMAN RIGHTS

5120
03:31:17,680 --> 03:31:21,040
AS THEY RECLEAT TO SYSTEMIC 

5121
03:31:21,040 --> 03:31:23,200
INEQUITIES POWER DYNAMICS AND 

5122
03:31:23,200 --> 03:31:24,760
SOCIAL STRUCTURAL CONTEXT AND WE

5123
03:31:24,760 --> 03:31:27,240
WANT TO ALSO MENTION THAT WE 

5124
03:31:27,240 --> 03:31:29,760
RECOGNIZE THAT WOMEN'S LIVED 

5125
03:31:29,760 --> 03:31:32,160
EXPERIENCES ARE LEGITIMATE 

5126
03:31:32,160 --> 03:31:34,440
SOURCES OF DATA THAT WE CAN 

5127
03:31:34,440 --> 03:31:36,360
UPLIFT THEM; RIGHT?  

5128
03:31:36,360 --> 03:31:39,560
WE ARE A QUANTITATIVE SORT OF 

5129
03:31:39,560 --> 03:31:40,840
FIELD OR WAY THAT PEOPLE THINK 

5130
03:31:40,840 --> 03:31:42,760
ABOUT PUBLIC HEALTH AND WHY LOTS

5131
03:31:42,760 --> 03:31:45,720
OF INTERVENTIONS AND RESOURCES 

5132
03:31:45,720 --> 03:31:47,120
WE SPEND HAVE NOT REACHED DOWN 

5133
03:31:47,120 --> 03:31:49,440
TO THE COMMUNITY AND WHY WE 

5134
03:31:49,440 --> 03:31:52,040
HAVEN'T REALLY MADE DENTS TO 

5135
03:31:52,040 --> 03:31:53,600
MORTALITY AND MORBIDITY RATES 

5136
03:31:53,600 --> 03:31:55,880
AND OTHER THING WE DO PART OF 

5137
03:31:55,880 --> 03:31:57,120
COMMUNITY AND OPERATIONALIZING 

5138
03:31:57,120 --> 03:31:59,760
COMMUNITY FOR US IS 

5139
03:31:59,760 --> 03:32:02,800
MULTI-FACETED AND WE ALSO 

5140
03:32:02,800 --> 03:32:05,240
CENTRALIZE BIPOC RESEARCHERS AND

5141
03:32:05,240 --> 03:32:06,920
HAVE KNOWLEDGE AND EXPERTISE 

5142
03:32:06,920 --> 03:32:10,400
THEY ARE OFTEN LEFT OUT OF THE 

5143
03:32:10,400 --> 03:32:14,240
TABLE AND SOME ADVISORY CAPACITY

5144
03:32:14,240 --> 03:32:20,000
AND FULL WELL -- THAT EXIST AND 

5145
03:32:20,000 --> 03:32:21,400
EXECUTIONS OF SOLUTIONS AS 

5146
03:32:21,400 --> 03:32:24,080
INDICATED WITH LIMITED FUNDING 

5147
03:32:24,080 --> 03:32:25,320
AND SOMETIMES CONDITIONAL 

5148
03:32:25,320 --> 03:32:28,800
FUNDING THAT WE RECEIVE IN 

5149
03:32:28,800 --> 03:32:31,200
ACADEMIC SPACES AND FOR US 

5150
03:32:31,200 --> 03:32:32,640
WORKING WITH COMMUNITY IN 

5151
03:32:32,640 --> 03:32:34,320
MEANINGFUL WAYS ALLOWS US TO 

5152
03:32:34,320 --> 03:32:36,800
MOVE AWAY FROM A RESCUE 

5153
03:32:36,800 --> 03:32:38,680
NARRATIVE THAT HAS PERPETUATED 

5154
03:32:38,680 --> 03:32:41,000
LOTS OF RESEARCH THAT EXISTS AND

5155
03:32:41,000 --> 03:32:42,680
WHERE LOTS OF THE SCHOLARSHIP 

5156
03:32:42,680 --> 03:32:45,240
EXISTS THAT IS AIMED AT 

5157
03:32:45,240 --> 03:32:46,280
MARGINALIZED WOMEN AND OTHERS 

5158
03:32:46,280 --> 03:32:48,480
COMING IN SAYING THEY WILL 

5159
03:32:48,480 --> 03:32:50,000
RESCUE US.  WE CAN RESCUE 

5160
03:32:50,000 --> 03:32:51,840
OURSELVES AND COMMUNITIES HAVE 

5161
03:32:51,840 --> 03:32:53,480
BEEN RESCUING THEMSELVES FOR A 

5162
03:32:53,480 --> 03:32:55,120
LONG TIME.  YOU KNOW, LOTS OF 

5163
03:32:55,120 --> 03:32:57,920
WHAT WE DO, AGAIN, IS 

5164
03:32:57,920 --> 03:32:59,280
DECENTERING THE INDIVIDUALS AND 

5165
03:32:59,280 --> 03:33:01,080
COMMUNITY AND RATHER THAN USING 

5166
03:33:01,080 --> 03:33:04,400
RISK FRAMEWORKS AS DR. JOIA 

5167
03:33:04,400 --> 03:33:05,880
POINTED OUT. 

5168
03:33:05,880 --> 03:33:07,800
WE FOCUS ON FRAMEWORKS THAT 

5169
03:33:07,800 --> 03:33:10,440
CHALLENGE STEREOTYPES AND 

5170
03:33:10,440 --> 03:33:12,360
EMPLOYING FRAMEWORKS LIKE 

5171
03:33:12,360 --> 03:33:15,480
INTERSECTIONALITY AND 

5172
03:33:15,480 --> 03:33:16,800
REPRODUCTIVE JUSTICE 

5173
03:33:16,800 --> 03:33:18,360
[INDISCERNIBLE] SYNDROME AND 

5174
03:33:18,360 --> 03:33:20,000
CRITICAL RACE THEORY GIVING 

5175
03:33:20,000 --> 03:33:21,920
POWER TO WOMEN AND ATTENTION TO 

5176
03:33:21,920 --> 03:33:24,440
VOICES THAT ARE PRIVILEGED IN 

5177
03:33:24,440 --> 03:33:25,400
PRODUCTION OF SCHOLARSHIP AND 

5178
03:33:25,400 --> 03:33:28,680
ARE PICTURES OF COMMUNITY EVENTS

5179
03:33:28,680 --> 03:33:31,520
WE HAVE DONE AND GRADUATING OUR 

5180
03:33:31,520 --> 03:33:34,000
FIRST COHORT.  NEXT SLIDE. 

5181
03:33:34,000 --> 03:33:35,800
SO, LESSONS LEARNED IN DOING 

5182
03:33:35,800 --> 03:33:36,440
THIS WORK.  

5183
03:33:36,440 --> 03:33:39,280
YOU KNOW, WE HAVE TO SET CLEAR 

5184
03:33:39,280 --> 03:33:40,480
DEFINITIONS AND SOMETIMES LOTS 

5185
03:33:40,480 --> 03:33:42,400
OF US GET INTO AGREEMENTS WHEN 

5186
03:33:42,400 --> 03:33:44,240
WORKING WITH COMMUNITIES AND 

5187
03:33:44,240 --> 03:33:47,040
SOMEONE MENTIONED IT AND WE DO 

5188
03:33:47,040 --> 03:33:48,080
HELICOPTER APPROACHES. 

5189
03:33:48,080 --> 03:33:51,200
WHEN WORKING IN COMMUNITIES YOU 

5190
03:33:51,200 --> 03:33:53,680
HAVE TO SET CLEAR BOUNDARIES 

5191
03:33:53,680 --> 03:33:55,520
DEFINING WHAT IT LOOKS LIKE AND 

5192
03:33:55,520 --> 03:33:56,360
ADDITIONALLY BUILDING THAT 

5193
03:33:56,360 --> 03:33:58,040
TRUST.  YOU KNOW, IT TAKES A 

5194
03:33:58,040 --> 03:33:59,960
WHILE TO DO IT AND WHY WHEN WE 

5195
03:33:59,960 --> 03:34:01,560
TALK ABOUT FUNDING WE NEED MORE 

5196
03:34:01,560 --> 03:34:03,720
THAN ONE YEAR OR THREE YEARS OF 

5197
03:34:03,720 --> 03:34:05,760
FUNDING AND IN TWO YEARS IT 

5198
03:34:05,760 --> 03:34:07,080
TAKES TIME TO BUILD TRUST AND 

5199
03:34:07,080 --> 03:34:08,880
REPOIRE WITH COMMUNITIES WE ARE 

5200
03:34:08,880 --> 03:34:11,880
WORKING WITH ENGAGING WITH AND I

5201
03:34:11,880 --> 03:34:13,000
CAN'T EVEN SEE. 

5202
03:34:13,000 --> 03:34:15,240
BE FLEXIBLE.  YEAH.  YOU HAVE TO

5203
03:34:15,240 --> 03:34:17,280
BE FLEXIBLE.  THIS WORK IS NOT 

5204
03:34:17,280 --> 03:34:20,400
EASY AND THERE ARE TIMES WE ARE 

5205
03:34:20,400 --> 03:34:23,160
MEETING AT 11 O'CLOCK AT NIGHT 

5206
03:34:23,160 --> 03:34:25,360
AND IS ONLY TIME WE CAN MEET OR 

5207
03:34:25,360 --> 03:34:27,880
7 IN THE MORNING.  WE WANT TO BE

5208
03:34:27,880 --> 03:34:31,200
FLEXIBLE IN HOW WE WORK 

5209
03:34:31,200 --> 03:34:33,800
TOGETHER.  PLANNING TO BE IN IT 

5210
03:34:33,800 --> 03:34:36,560
FOR THE LONG HALL AND WORKING 

5211
03:34:36,560 --> 03:34:38,480
WITH COMMUNITIES AGAIN THERE IS 

5212
03:34:38,480 --> 03:34:41,360
SO MUCH DISTRUST AND HAVING TIME

5213
03:34:41,360 --> 03:34:42,960
AND WE ARE FLEXIBLE AND IN IT 

5214
03:34:42,960 --> 03:34:46,040
NOT DOING WHAT COMMUNITY CALLS 

5215
03:34:46,040 --> 03:34:49,120
DRIVE BY RESEARCH THAT IS 

5216
03:34:49,120 --> 03:34:52,520
CONVENIENT FOR YOU TO COME IN 

5217
03:34:52,520 --> 03:34:54,520
AND DIP OUT WHEN IT ENDS AND 

5218
03:34:54,520 --> 03:34:55,640
WORKING WITH COMMUNITIES TO 

5219
03:34:55,640 --> 03:34:57,440
CREATE THINGS THAT ARE SUSTAIN 

5220
03:34:57,440 --> 03:34:59,280
THE AND I WILL STOP THERE.  I 

5221
03:34:59,280 --> 03:35:09,840
HAVE FIVE MINUTES.  THANK YOU.  

5222
03:35:24,840 --> 03:35:26,400
>> IT IS WELL UNDERSTOOD
THAT 

5223
03:35:26,400 --> 03:35:28,560
-- NEXT SLIDE, PLEASE. 

5224
03:35:28,560 --> 03:35:31,120
OOPS.  THAT DIDN'T WORK RIGHT.  

5225
03:35:31,120 --> 03:35:32,760
GO BACK.  

5226
03:35:32,760 --> 03:35:34,320
IT IS WELL UNDERSTOOD THAT 

5227
03:35:34,320 --> 03:35:36,080
SOCIAL DETERMINANTS INCLUDING 

5228
03:35:36,080 --> 03:35:38,720
INCOME AND POVERTY AND STRESSORS

5229
03:35:38,720 --> 03:35:42,080
AND RISK TO TRAUMA.  

5230
03:35:42,080 --> 03:35:43,280
NEIGHBORHOOD VIOLENCE AND ACCESS

5231
03:35:43,280 --> 03:35:46,920
TO HEALTH CARE AND INSURANCE ARE

5232
03:35:46,920 --> 03:35:50,160
ALL KEY SOCIAL DETERMINANTS AND 

5233
03:35:50,160 --> 03:35:51,520
MY INTEREST IS PARTICULARLY IN 

5234
03:35:51,520 --> 03:35:54,400
THE ROLE OF STRESS, RACISM AND 

5235
03:35:54,400 --> 03:35:57,080
EXPOSURE TO TRAUMATIC STRESS AND

5236
03:35:57,080 --> 03:35:59,680
A NUMBER OF NATIONAL 

5237
03:35:59,680 --> 03:36:00,880
EPIDEMIOLOGIC STUDIES 

5238
03:36:00,880 --> 03:36:02,040
DEMONSTRATE THAT BLACK WOMEN 

5239
03:36:02,040 --> 03:36:04,480
HAVE EQUAL RATES AS A NUMBER -- 

5240
03:36:04,480 --> 03:36:06,480
TO A NUMBER OF MENTAL HEALTH 

5241
03:36:06,480 --> 03:36:07,720
CONDITIONS SUCH AS DEPRESSION 

5242
03:36:07,720 --> 03:36:11,680
AND ANXIETY AND WE KNOW THAT 

5243
03:36:11,680 --> 03:36:15,520
THEY CARRY DISPROPORTIONATE 

5244
03:36:15,520 --> 03:36:16,800
BURDEN OF STRESS THAT INCREASES 

5245
03:36:16,800 --> 03:36:19,440
THEIR RISK FACTORS FOR A NUMBER 

5246
03:36:19,440 --> 03:36:21,960
OF POOR MENTAL HEALTH OUTCOMES 

5247
03:36:21,960 --> 03:36:27,200
AND MAINLY BLACK WOMEN HAVE HYER

5248
03:36:27,200 --> 03:36:29,200
RATES OF UNEMPLOYMENT AND HIGHER

5249
03:36:29,200 --> 03:36:31,840
RATES OF POVERTY AND EXPOSURE TO

5250
03:36:31,840 --> 03:36:34,440
STRESS RACISM AND DISCRIMINATION

5251
03:36:34,440 --> 03:36:39,160
AND HIGHER RATES ARE ENSURED AND

5252
03:36:39,160 --> 03:36:42,320
DE-STRESSORS FOR BLACK WOMEN 

5253
03:36:42,320 --> 03:36:44,640
INCREASE NEED FOR MENTAL HEALTH.

5254
03:36:44,640 --> 03:36:47,520
NEXT SLIDE, PLEASE. 

5255
03:36:47,520 --> 03:36:52,360
DISPROPORTIONATE BURDEN OF 

5256
03:36:52,360 --> 03:36:53,960
STRESS -- WHEREBY BLACK WOMEN 

5257
03:36:53,960 --> 03:36:57,080
HAVE GREATER RISKS FOR -- OH, MY

5258
03:36:57,080 --> 03:36:59,640
GOSH.  I CAN'T SEE.  

5259
03:36:59,640 --> 03:37:03,280
>> EARLY HEALTH
DETERIORATION 

5260
03:37:03,280 --> 03:37:06,680
AND DIABETES AND CARDIOVASCULAR 

5261
03:37:06,680 --> 03:37:10,760
DISEASE AND POOR MATERNAL HEALTH

5262
03:37:10,760 --> 03:37:15,560
OUTCOMES ACCELERATED AGING AND 

5263
03:37:15,560 --> 03:37:18,920
LIFE EXPECTANCY AND LOOKING AT 

5264
03:37:18,920 --> 03:37:20,960
ROLE AND LIVES OF BLACK WOMEN 

5265
03:37:20,960 --> 03:37:24,720
AND TARGETING STRESS AND 

5266
03:37:24,720 --> 03:37:26,880
INTERVENTION TO IMPROVE OUTCOMES

5267
03:37:26,880 --> 03:37:30,800
FOR MENTAL HEALTH AS WELL AS 

5268
03:37:30,800 --> 03:37:31,800
PHYSICAL HEALTH. 

5269
03:37:31,800 --> 03:37:33,400
I CONSIDER MYSELF TO BE A 

5270
03:37:33,400 --> 03:37:37,760
SCHOLAR THAT IS FOCUSED ON 

5271
03:37:37,760 --> 03:37:41,600
EFFECTIVENESS IMPLEMENTATION 

5272
03:37:41,600 --> 03:37:43,320
RESEARCH THAT CENTERS SQUARELY 

5273
03:37:43,320 --> 03:37:45,280
ON COMMUNITY PARTNERSHIP AND I 

5274
03:37:45,280 --> 03:37:47,680
WOULD LIKE TO TALK BRIEFLY ABOUT

5275
03:37:47,680 --> 03:37:50,080
TWO COMMUNITY ENGAGED RESEARCH 

5276
03:37:50,080 --> 03:37:51,640
PROJECTS I HAVE CARRIED OUT FOR 

5277
03:37:51,640 --> 03:37:53,560
THE LAST COUPLE OF YEARS AND ONE

5278
03:37:53,560 --> 03:37:55,600
PROJECT IS FUNDED WITH SUPPORT 

5279
03:37:55,600 --> 03:37:58,840
OF NIMHD THAT HAS BEEN A 

5280
03:37:58,840 --> 03:38:01,160
FIVE-YEAR RANDOMIZED CONTROLLED 

5281
03:38:01,160 --> 03:38:03,320
TRIAL TO TEST EFFECTIVENESS AND 

5282
03:38:03,320 --> 03:38:06,080
IMPLEMENTATION OF A MINDFULNESS 

5283
03:38:06,080 --> 03:38:08,200
BASED INTERVENTION DELIVERED TO 

5284
03:38:08,200 --> 03:38:09,880
WOMEN WITH SYMPTOMS OF 

5285
03:38:09,880 --> 03:38:12,240
DEPRESSION IN A FEDERALLY 

5286
03:38:12,240 --> 03:38:14,120
QUALIFIED HEALTH CENTER THAT IS 

5287
03:38:14,120 --> 03:38:17,800
CALLED NEAR NORTH THAT IS A 

5288
03:38:17,800 --> 03:38:21,240
NETWORK OF 8 HEALTH CENTER AS 

5289
03:38:21,240 --> 03:38:23,520
CROSS CHICAGO LAND AREA 

5290
03:38:23,520 --> 03:38:25,320
PROVIDING HEALTH CARE SERVICES 

5291
03:38:25,320 --> 03:38:28,240
TO MOST UNDERSERVED ACROSS THE 

5292
03:38:28,240 --> 03:38:30,960
CITY AND MAJORITY OF PATIENTS 

5293
03:38:30,960 --> 03:38:33,360
NEAR NORTH LIVE AT OR BELOW 

5294
03:38:33,360 --> 03:38:35,840
FEDERAL POVERTY LEVEL AND MANY 

5295
03:38:35,840 --> 03:38:37,840
HAVING UNMET MENTAL HEALTH NEEDS

5296
03:38:37,840 --> 03:38:39,880
AND IN THIS WORK WE HAVE 

5297
03:38:39,880 --> 03:38:42,320
MULTIPLE AIMS AND ONE IS TO BE 

5298
03:38:42,320 --> 03:38:45,320
ABLE TO DELIVER A CULTURALLY 

5299
03:38:45,320 --> 03:38:47,520
COMPETENT EVIDENCE-BASED MENTAL 

5300
03:38:47,520 --> 03:38:50,200
HEALTH INTERVENTION FOR BLACK 

5301
03:38:50,200 --> 03:38:51,520
WOMEN IN COMMUNITY. 

5302
03:38:51,520 --> 03:38:55,000
TWO, TO BE ABLE TO TRAIN 

5303
03:38:55,000 --> 03:38:57,120
IMBEDDED HEALTH PROVIDERS TO 

5304
03:38:57,120 --> 03:38:59,880
DELIVER THE INTERVENTION 

5305
03:38:59,880 --> 03:39:00,920
UNDERSTANDING THAT WHILE 

5306
03:39:00,920 --> 03:39:02,920
RESEARCHERS COME IN AND OFFER A 

5307
03:39:02,920 --> 03:39:04,560
HIGH QUALITY INTERVENTION THEY 

5308
03:39:04,560 --> 03:39:06,640
OFTEN LEAVE AND TAKE KNOWLEDGE 

5309
03:39:06,640 --> 03:39:07,360
GAINED WITH THEM. 

5310
03:39:07,360 --> 03:39:13,440
PART OF THIS WORK WAS TO BE ABLE

5311
03:39:13,440 --> 03:39:15,880
TO DEVELOP SKILLS IN COMMUNITY 

5312
03:39:15,880 --> 03:39:18,800
SO THEY COULD REMAIN IN 

5313
03:39:18,800 --> 03:39:20,840
COMMUNITY AND BE IN THE HEALTH 

5314
03:39:20,840 --> 03:39:24,120
CENTER AND COMMUNITY AT LARGE 

5315
03:39:24,120 --> 03:39:28,640
AND WE SOUGHT TO EXPLORE 

5316
03:39:28,640 --> 03:39:31,200
EFFECTIVENESS OF IT ITSELF AND 

5317
03:39:31,200 --> 03:39:33,040
IMPLEMENTATION FACTORS IN 

5318
03:39:33,040 --> 03:39:34,320
FEDERALLY QUALIFIED HEALTH 

5319
03:39:34,320 --> 03:39:37,240
CENTER CONTEXT LOOKING AT THINGS

5320
03:39:37,240 --> 03:39:41,360
LIKE TRAINING OF PROVIDERS AND 

5321
03:39:41,360 --> 03:39:47,720
LOOKING AT THINGS LIKE HOURS 

5322
03:39:47,720 --> 03:39:49,000
WHERE INTERVENTION COULD BE 

5323
03:39:49,000 --> 03:39:51,440
PROVIDED OR BARRIERS TO PROVIDE 

5324
03:39:51,440 --> 03:39:54,440
IN SERVICES LIKE THIS LIKE 

5325
03:39:54,440 --> 03:39:55,480
TRANSPORTATION AND CHILDCARE AND

5326
03:39:55,480 --> 03:39:57,040
THE LIKE AND ARE CURRENTLY IN 

5327
03:39:57,040 --> 03:40:00,040
YEAR 5 OF 5 OF THIS STUDY AND 

5328
03:40:00,040 --> 03:40:03,480
HAVE SUCCESSFULLY ENROLLED OVER 

5329
03:40:03,480 --> 03:40:13,960
250 PARTICIPANTS AND TRAINED 

5330
03:40:15,360 --> 03:40:22,880
FIVE HEALTH EDUCATORS AND BY 

5331
03:40:22,880 --> 03:40:28,600
FORCE OF COVID AND IN PERSON 

5332
03:40:28,600 --> 03:40:31,200
DELIVERY OF INTERVENTION. 

5333
03:40:31,200 --> 03:40:34,040
NEXT SLIDE, PLEASE. 

5334
03:40:34,040 --> 03:40:37,760
>> SO I'M SUMMARIZING
FROM 

5335
03:40:37,760 --> 03:40:40,480
MEMORY AND NEXT PARTNERSHIP I 

5336
03:40:40,480 --> 03:40:43,120
WOULD LIKE TO SHARE IS 

5337
03:40:43,120 --> 03:40:45,400
PARTNERSHIP BETWEEN NORTHWESTERN

5338
03:40:45,400 --> 03:40:46,440
UNIVERSITY AND COMMUNITY 

5339
03:40:46,440 --> 03:40:49,080
ORGANIZATION THAT IS CALLED 

5340
03:40:49,080 --> 03:40:50,640
PACPI CALLED THE MOTHER AND 

5341
03:40:50,640 --> 03:40:53,640
CHILD ALLIANCE AND THIS 

5342
03:40:53,640 --> 03:40:54,960
COMMUNITY-BASED ORGANIZATION 

5343
03:40:54,960 --> 03:40:57,000
PROVIDES ENHANCED CASE 

5344
03:40:57,000 --> 03:40:58,760
MANAGEMENT TO PREGNANT AND 

5345
03:40:58,760 --> 03:41:02,040
PARENTING WOMEN LIVING WITH H 

5346
03:41:02,040 --> 03:41:12,320
ICHI

5347
03:41:20,960 --> 03:41:30,240
SIMILAR TO MODEL. 

5348
03:41:30,240 --> 03:41:35,160
IN ORDER TO ADDRESS UNIQUE NEEDS

5349
03:41:35,160 --> 03:41:39,560
OF BLACK WOMEN AND PREGNANT AND 

5350
03:41:39,560 --> 03:41:41,080
PARENTING BLACK WOMEN WITH 

5351
03:41:41,080 --> 03:41:43,960
COMORBID CHRONIC HEALTH 

5352
03:41:43,960 --> 03:41:44,280
CONDITION. 

5353
03:41:44,280 --> 03:41:49,840
PART OF WORK WE RECEIVED 

5354
03:41:49,840 --> 03:41:51,960
FEEDBACK FROM WOMEN THEMSELVES 

5355
03:41:51,960 --> 03:41:53,360
WHAT PARTS OF INTERVENTION WERE 

5356
03:41:53,360 --> 03:41:55,440
MOST HELPFUL AND CRITICAL 

5357
03:41:55,440 --> 03:41:59,800
ELEMENTS THEY NEEDED HELP WITH 

5358
03:41:59,800 --> 03:42:01,480
ADDRESSING STRESSORS AND WHAT 

5359
03:42:01,480 --> 03:42:06,080
THEY NEEDED FROM CULTURES OR 

5360
03:42:06,080 --> 03:42:08,240
TRAINERS DELIVERING INTERVENTION

5361
03:42:08,240 --> 03:42:11,040
TO THEM. 

5362
03:42:11,040 --> 03:42:13,640
PART OF THE WORK WE WERE ABLE TO

5363
03:42:13,640 --> 03:42:16,480
GIVE FEEDBACK FROM KAIS WORKERS 

5364
03:42:16,480 --> 03:42:17,920
THEMSELVES AND IMPLEMENTATION 

5365
03:42:17,920 --> 03:42:20,600
PIECE WHAT IT TAKES FOR SYSTEMIC

5366
03:42:20,600 --> 03:42:22,880
PERSPECTIVE WHAT IT TAKES TO 

5367
03:42:22,880 --> 03:42:24,120
SUCCESSFULLY IMPLEMENT SUSTAIN 

5368
03:42:24,120 --> 03:42:26,000
AND DISSEMINATE THIS 

5369
03:42:26,000 --> 03:42:28,360
INTERVENTION IN COMMUNITY BASE 

5370
03:42:28,360 --> 03:42:31,400
ENHANCEMENT COMMUNICATION 

5371
03:42:31,400 --> 03:42:41,920
PROGRAM.  NEXT SLIDE, PLEASE. 

5372
03:42:50,560 --> 03:42:52,240
RESEARCHERS COME IN WITH 

5373
03:42:52,240 --> 03:42:53,760
PRIORITIES THAT ARE MISALIGNED 

5374
03:42:53,760 --> 03:43:02,160
WITH COMMUNITY AND PARTICULARLY 

5375
03:43:02,160 --> 03:43:04,520
OVERWHELMED AND STRETCHED HEALTH

5376
03:43:04,520 --> 03:43:07,000
CENTERS THOSE PRIORITIES ARE IN 

5377
03:43:07,000 --> 03:43:08,720
LINE AND KEY TO SUCCESSFUL 

5378
03:43:08,720 --> 03:43:11,400
RESEARCH PARTNERSHIP THAT WILL 

5379
03:43:11,400 --> 03:43:15,240
HAVE MEANINGFUL OUTCOMES IN THE 

5380
03:43:15,240 --> 03:43:21,120
COMMUN

5381
03:43:21,120 --> 03:43:21,440
COMMUNITY. 

5382
03:43:21,440 --> 03:43:23,080
I WILL CLOSE SIGHING THAT 

5383
03:43:23,080 --> 03:43:23,720
COMMUNICATION IS IMPORTANT 

5384
03:43:23,720 --> 03:43:25,280
PARTICIPATING ACTIVELY IN THE 

5385
03:43:25,280 --> 03:43:27,240
COMMUNITY NOT SHOWING UP TO DO 

5386
03:43:27,240 --> 03:43:31,040
YOUR RESEARCH AND ATTENDING 

5387
03:43:31,040 --> 03:43:34,640
COMMUNITY EVENTS OFFERING 

5388
03:43:34,640 --> 03:43:36,680
RESEARCHERS AND SERVICE TO THE 

5389
03:43:36,680 --> 03:43:40,640
COMMUNITY ARE FACTORS HELPING TO

5390
03:43:40,640 --> 03:43:46,400
BUILD TRUST AND OUTCOMES. 

5391
03:43:46,400 --> 03:43:51,480
>> MARIE, THANK YOU. 

5392
03:43:51,480 --> 03:44:01,640
MARIE?  

5393
03:44:07,360 --> 03:44:09,200
>> NEXT SLIDE.  THANK
YOU. 

5394
03:44:09,200 --> 03:44:13,520
THIS WAS TAKEN AFTER FIRST 

5395
03:44:13,520 --> 03:44:16,000
APPOINTMENT 15 YEARS AGO AND 

5396
03:44:16,000 --> 03:44:17,560
TOLD DOCTOR RIGHT AWAY I'M NOT 

5397
03:44:17,560 --> 03:44:19,480
FEELING LIKE MYSELF BUT FEELING 

5398
03:44:19,480 --> 03:44:22,960
REALLY SAD AND WITHOUT MISSING A

5399
03:44:22,960 --> 03:44:25,680
BEAT SHE SAID I SHOULD BE HAPPY 

5400
03:44:25,680 --> 03:44:29,400
I WAS HAVING A BABY AND AT THAT 

5401
03:44:29,400 --> 03:44:33,920
MOMENT I FELT I WAS WAVING A RED

5402
03:44:33,920 --> 03:44:34,360
FLAG. 

5403
03:44:34,360 --> 03:44:36,160
SHE LET ME GO I WOULD PROCEED TO

5404
03:44:36,160 --> 03:44:38,840
GO TO 29 DIFFERENT PROVIDER 

5405
03:44:38,840 --> 03:44:40,760
OFFICERS THERAPISTS AND CALLING 

5406
03:44:40,760 --> 03:44:42,720
HEALTH INSURANCE BEFORE I WAS 

5407
03:44:42,720 --> 03:44:49,800
ABLE TO GET HELP 190 DAYS IN MY 

5408
03:44:49,800 --> 03:44:50,920
PREGNANCY AT THIS POINT I DIDN'T

5409
03:44:50,920 --> 03:44:53,240
KNOW WHAT WAS GOING ON IN HEALTH

5410
03:44:53,240 --> 03:44:54,600
SYSTEM AND THEY DIDN'T KNOW WHAT

5411
03:44:54,600 --> 03:44:56,520
TO DO WITH ME.  FAST FORWARD A 

5412
03:44:56,520 --> 03:44:58,080
COUPLE YEARS AND THOUGHT WAS 

5413
03:44:58,080 --> 03:44:59,520
THIS JUST MY STORY?  

5414
03:44:59,520 --> 03:45:04,320
WAS I UNIQUE?  I PICKED UP A 

5415
03:45:04,320 --> 03:45:07,400
VIDEO CAMERA AND I SPOKE WITH 

5416
03:45:07,400 --> 03:45:13,560
WOMEN ACROSS US AND DOCTORS AND 

5417
03:45:13,560 --> 03:45:16,560
RESEARCHERS THAT LAID WORK FOR 

5418
03:45:16,560 --> 03:45:23,840
CREATING MAMMHA FEMME TECH AND I

5419
03:45:23,840 --> 03:45:25,440
WORKED WITH NATIONAL COALITION 

5420
03:45:25,440 --> 03:45:28,120
FOR MATERNAL HEALTH AND LED 

5421
03:45:28,120 --> 03:45:29,400
NATIONAL AWARENESS CAMPAIGNS AND

5422
03:45:29,400 --> 03:45:32,680
IN THAT MOMENT SITTING IN 

5423
03:45:32,680 --> 03:45:34,720
CONFERENCES WITH PEOPLE WHO HAD 

5424
03:45:34,720 --> 03:45:37,120
LOST THEIR WIVE AND PARTNERS AND

5425
03:45:37,120 --> 03:45:39,520
DAUGHTERS AND THAT YOU GET THIS 

5426
03:45:39,520 --> 03:45:45,280
MOMENT WHERE YOU ARE LIKE A 

5427
03:45:45,280 --> 03:45:47,040
CHANGE IN KNOWLEDGE IS NOT 

5428
03:45:47,040 --> 03:45:48,440
ALWAYS EQUAL TO CHANGE IN 

5429
03:45:48,440 --> 03:45:51,840
BEHAVIOR AND COULD RAISE 

5430
03:45:51,840 --> 03:45:55,520
AWARENESS UNTIL COWS CAME HOME 

5431
03:45:55,520 --> 03:46:06,080
WOULDN'T CHANGE -- I WAS A MOM 

5432
03:46:13,720 --> 03:46:15,120
TRYING TO FIGURE THIS OUT SET TO

5433
03:46:15,120 --> 03:46:17,920
WORK IN THE UN AND LIFE WAS 

5434
03:46:17,920 --> 03:46:18,960
DISRUPTED I DON'T KNOW WHY I'M 

5435
03:46:18,960 --> 03:46:20,640
HERE I HAVE TO MAKE IT BETTER.  

5436
03:46:20,640 --> 03:46:22,720
ONE WAS LIKE TO WHAT EXTENT 

5437
03:46:22,720 --> 03:46:24,800
COULD WE INCREASE PHYSICIAN 

5438
03:46:24,800 --> 03:46:26,280
SCREENING HITTING FAILURE POINTS

5439
03:46:26,280 --> 03:46:31,000
WHY THEY WEREN'T SCREENING?  

5440
03:46:31,000 --> 03:46:33,040
COULD INCREASE IDENTIFICATION 

5441
03:46:33,040 --> 03:46:34,840
KNOWING WHAT WE KNOW BY TALKING 

5442
03:46:34,840 --> 03:46:39,280
TO DOCTORS AND WOMEN?  

5443
03:46:39,280 --> 03:46:42,480
SECOND PIECE HAD TO KNOW TO DO 

5444
03:46:42,480 --> 03:46:44,840
SCREENING PIECE THAT WAS EASY 

5445
03:46:44,840 --> 03:46:46,440
AND SECOND HOW YOU GET WOMEN 

5446
03:46:46,440 --> 03:46:48,400
INTO CARE AND TO WHAT EXTENT 

5447
03:46:48,400 --> 03:46:49,680
COULD TECHNOLOGY CLOSE THESE 

5448
03:46:49,680 --> 03:46:52,640
GAPS AND BE AN EQUALIZER HELPING

5449
03:46:52,640 --> 03:46:55,200
PHYSICIANS AND WOMEN?  

5450
03:46:55,200 --> 03:46:58,280
NEXT SLIDE, PLEASE. 

5451
03:46:58,280 --> 03:47:02,840
SO WE CREATED MOMMA THAT IS A 

5452
03:47:02,840 --> 03:47:04,080
STREAMLINED PHYSICIAN STARTING 

5453
03:47:04,080 --> 03:47:06,160
WITH PHYSICIANS ENDING WITH 

5454
03:47:06,160 --> 03:47:07,760
MOTHERS AND NOW FATHERS AND 

5455
03:47:07,760 --> 03:47:09,840
STARTING TO CATCH FATHERS IF IN 

5456
03:47:09,840 --> 03:47:11,120
THE NICU. 

5457
03:47:11,120 --> 03:47:13,880
THANK YOU.  WITH VERY HIGH 

5458
03:47:13,880 --> 03:47:16,400
SUICIDALITY WHICH IS CHANGING MY

5459
03:47:16,400 --> 03:47:18,160
PARADIGM COMPLETELY. 

5460
03:47:18,160 --> 03:47:20,920
SO, WE HELPED PHYSICIANS SCREEN 

5461
03:47:20,920 --> 03:47:22,840
AND THEY GET SCORES BACK COMES 

5462
03:47:22,840 --> 03:47:26,320
WITH TALKING POINTS IF SHE 

5463
03:47:26,320 --> 03:47:28,360
SCREENS POSITIVE MOMA CARE 

5464
03:47:28,360 --> 03:47:29,560
COORDINATOR IS THERE FOLLOWING 

5465
03:47:29,560 --> 03:47:31,600
UP ON SPOT WITH THAT PHYSICIAN 

5466
03:47:31,600 --> 03:47:34,200
AND PATIENT AND LIKE CANDICE AND

5467
03:47:34,200 --> 03:47:36,120
THAT MOTHER WE HEARD HER STORY 

5468
03:47:36,120 --> 03:47:38,760
TODAY SHE WAS LET GO WITH THAT 

5469
03:47:38,760 --> 03:47:40,200
PHOTOCOPIED PIECE OF PAPER THAT 

5470
03:47:40,200 --> 03:47:42,240
NEVER HAPPENS WITH THIS SOLUTION

5471
03:47:42,240 --> 03:47:45,280
AND MOMA IS ALWAYS FOLLOWING UP 

5472
03:47:45,280 --> 03:47:49,160
100% NO WOMANLE IS EVER LOST TO 

5473
03:47:49,160 --> 03:47:54,400
A FILE AND SENT ON HER WAY AND 

5474
03:47:54,400 --> 03:47:56,240
WE KNOW AND CREATED THIS AND 

5475
03:47:56,240 --> 03:47:59,160
WERE WOMEN IN THIS SITUATION AND

5476
03:47:59,160 --> 03:48:01,360
INVITED ONE WOMAN 18 TIMES TO A 

5477
03:48:01,360 --> 03:48:02,920
SUPPORT GROUP.  SHE NEVER CAME 

5478
03:48:02,920 --> 03:48:05,320
AND CAME THAT 18TH TIME AND SHE 

5479
03:48:05,320 --> 03:48:05,880
NEVER LEFT. 

5480
03:48:05,880 --> 03:48:10,320
SHE SAID, YOU KNOW, I FINALLY 

5481
03:48:10,320 --> 03:48:12,440
FEEL I'M NOT ALONE.  WE DIDN'T 

5482
03:48:12,440 --> 03:48:15,280
GIVE UP WE UNDERSTAND DEPRESSION

5483
03:48:15,280 --> 03:48:17,920
AND ANXIETY AND NEW MOERNL HOOD 

5484
03:48:17,920 --> 03:48:19,560
AND UNDERSTAND THAT TERRIBLE 

5485
03:48:19,560 --> 03:48:24,200
THING THAT HAPPEN AND WITH MOMA 

5486
03:48:24,200 --> 03:48:26,480
WOMEN ARE 5 TIMES MORE LIKELY TO

5487
03:48:26,480 --> 03:48:27,960
ENGAGE WITH CARE AND SOME ARE 

5488
03:48:27,960 --> 03:48:29,480
SLIPPING THROUGH THE GAPS AND 

5489
03:48:29,480 --> 03:48:32,040
ABLE TO UP THAT AND PHYSICIAN 

5490
03:48:32,040 --> 03:48:35,000
SCREENING WE KNOW THROUGH HEATUS

5491
03:48:35,000 --> 03:48:37,080
SCORES LESS THAN 20% OF 

5492
03:48:37,080 --> 03:48:38,600
PHYSICIANS ARE SCREENING 

5493
03:48:38,600 --> 03:48:40,360
PATIENTS AND FELT IDENTIFICATION

5494
03:48:40,360 --> 03:48:42,760
IN WOMEN IN PERINATAL PERIOD IS 

5495
03:48:42,760 --> 03:48:45,400
IMPORTANT TO GET THEM TO CARE. 

5496
03:48:45,400 --> 03:48:49,120
WE INCREASED THEM 40% AND 

5497
03:48:49,120 --> 03:48:50,480
INCREASED PHYSICIAN SCREENING 

5498
03:48:50,480 --> 03:48:53,320
NOW BY 83 OR 88% AND MADE IT 

5499
03:48:53,320 --> 03:48:54,680
EASIER AND THEY NEVER HAVE TO 

5500
03:48:54,680 --> 03:48:56,240
LIKE I DON'T KNOW WHAT TO DO 

5501
03:48:56,240 --> 03:48:56,880
WITH HER. 

5502
03:48:56,880 --> 03:48:58,560
WE WILL TAKE CARE OF EVERYTHING 

5503
03:48:58,560 --> 03:49:03,920
AFTER THAT POSITIVE SCREEN.  

5504
03:49:03,920 --> 03:49:06,040
NEXT SLIDE, PLEASE. 

5505
03:49:06,040 --> 03:49:08,920
THIS IS MORE IS STUFF WE LEARNED

5506
03:49:08,920 --> 03:49:11,120
AND YOU KNOW BIGGEST THING IS 

5507
03:49:11,120 --> 03:49:13,120
THAT WE THOUGHT THAT WOMEN JUST 

5508
03:49:13,120 --> 03:49:16,000
NEEDED TO BE PUT INTO THERAPY.  

5509
03:49:16,000 --> 03:49:18,920
ONLY 40% OF WOMEN THAT SCREEN 

5510
03:49:18,920 --> 03:49:21,760
POSITIVE WENT INTO THERAPY.  16%

5511
03:49:21,760 --> 03:49:24,720
ENDED UP GETTING ON MEDICINE AND

5512
03:49:24,720 --> 03:49:29,280
16% TO SUPPORT GROUPS AND 90% 

5513
03:49:29,280 --> 03:49:31,040
ENGAGED WITH MOMA CARE 

5514
03:49:31,040 --> 03:49:33,560
COORDINATOR WITH 67 WEEKS WITH 

5515
03:49:33,560 --> 03:49:34,760
INTERACTIONS BACK AND FORTH THEY

5516
03:49:34,760 --> 03:49:36,840
WERE NEVER ALONE AND SOMEONE WAS

5517
03:49:36,840 --> 03:49:38,440
ALWAYS CHECKING IN ON THEM HOW 

5518
03:49:38,440 --> 03:49:40,200
ARE YOU DOING AND SLEEPING?  HOW

5519
03:49:40,200 --> 03:49:41,360
IS YOUR MOOD?  

5520
03:49:41,360 --> 03:49:44,200
WE FOUND LOOKING AT OTHER HEALTH

5521
03:49:44,200 --> 03:49:45,560
SYSTEMS AND SOLUTIONS AROUND THE

5522
03:49:45,560 --> 03:49:48,040
WORLD THERE IS LOW MENTAL HEALTH

5523
03:49:48,040 --> 03:49:49,480
PARITY THAT WE COULD LEARN IF 

5524
03:49:49,480 --> 03:49:52,400
YOU TOOK SOME SKILLS LIKE COPING

5525
03:49:52,400 --> 03:49:54,720
SKILLS AND COGNITIVE BEHAVIORAL 

5526
03:49:54,720 --> 03:49:56,960
THERAPY SKILLS AND GAVE TO PEER 

5527
03:49:56,960 --> 03:49:58,480
SUPPORT SPECIALISTS WOMEN WITH 

5528
03:49:58,480 --> 03:50:00,320
LIVED EXPERIENCES WE COULD KEEP 

5529
03:50:00,320 --> 03:50:01,920
WOMEN OUT OF THERAPY AND HELP 

5530
03:50:01,920 --> 03:50:05,840
THEM FEEL BETTER FASTER THAT IS 

5531
03:50:05,840 --> 03:50:11,800
A LOT FASTER AND GOING FOR 

5532
03:50:11,800 --> 03:50:15,000
EMPLOYERS AND GOING FOR WOMEN 

5533
03:50:15,000 --> 03:50:18,160
WHO CAN PAY OUT OF POCKET FOR 

5534
03:50:18,160 --> 03:50:20,160
THIS AND LESSON IS STICK TO WHAT

5535
03:50:20,160 --> 03:50:24,760
GOAL IS.  WE -- IT IS A VERY 

5536
03:50:24,760 --> 03:50:28,240
LONG PATH.  WE HAVE BEEN 

5537
03:50:28,240 --> 03:50:30,120
COMMITTED THIS IS A SOLUTION FOR

5538
03:50:30,120 --> 03:50:31,720
ALL WOMEN NOT JUST SOME WOMEN 

5539
03:50:31,720 --> 03:50:33,760
AND IN IT FOR LONG GAME AND 

5540
03:50:33,760 --> 03:50:34,880
COLLEAGUE UP HERE SAID THAT I 

5541
03:50:34,880 --> 03:50:36,600
REALLY LOVE THAT IS WHAT WE ARE 

5542
03:50:36,600 --> 03:50:38,520
HERE FOR AND OTHER THING THAT 

5543
03:50:38,520 --> 03:50:40,000
GUIDED US IS THAT YOUR TOOL 

5544
03:50:40,000 --> 03:50:41,840
MIGHT NO THE BE BEST SOLUTION TO

5545
03:50:41,840 --> 03:50:43,520
MY PROBLEM AND THINK THAT IS WHY

5546
03:50:43,520 --> 03:50:46,400
THIS WORKS SO WELL.  IT IS BUILT

5547
03:50:46,400 --> 03:50:48,080
BY MOTHERS AND PHYSICIANS 

5548
03:50:48,080 --> 03:50:49,800
TOGETHER AND WHY IT WORKS.  

5549
03:50:49,800 --> 03:50:50,720
THANKS SO MUCH. 

5550
03:50:50,720 --> 03:50:53,280
>> THAT IS BEAUTIFUL. 
YAY!  

5551
03:50:53,280 --> 03:50:54,680
OKAY.  LAST BUT NOT LEAST, WE 

5552
03:50:54,680 --> 03:50:56,880
HAVE -- WE ARE MOVING TO NEXT 

5553
03:50:56,880 --> 03:50:59,080
QUESTION.  SORRY THANK YOU THEME

5554
03:50:59,080 --> 03:51:00,760
ONE.  THEME 2, THANK YOU. 

5555
03:51:00,760 --> 03:51:02,240
QUESTION IS WHAT IS YOUR VISION 

5556
03:51:02,240 --> 03:51:04,040
HOW TECHNOLOGY COULD UTILIZE 

5557
03:51:04,040 --> 03:51:07,160
EQUITY LENS TO ADDRESS MATERNAL 

5558
03:51:07,160 --> 03:51:10,040
HEALTH DISPARITIES AND WE HAVE 

5559
03:51:10,040 --> 03:51:12,200
ABIGAIL HERE SHE IS.  IF YOU 

5560
03:51:12,200 --> 03:51:13,240
COULD REMEMBER TO SAY NEXT SLIDE

5561
03:51:13,240 --> 03:51:15,120
AND WE CAN KEEP IT GOING. 

5562
03:51:15,120 --> 03:51:17,760
>> ALL RIGHT.  NEXT
SLIDE.  

5563
03:51:17,760 --> 03:51:20,760
GOOD AFTERNOON, EVERYONE.  IN 

5564
03:51:20,760 --> 03:51:22,880
ADDITION TO MY WORK AS EXECUTIVE

5565
03:51:22,880 --> 03:51:26,760
VICE PRESIDENT OF SEATTLE HEALTH

5566
03:51:26,760 --> 03:51:30,040
BOARD TRIBAL EPIDEMIOLOGY CENTER

5567
03:51:30,040 --> 03:51:35,280
IN COUNTRY IT FOCUSES ON URBAN 

5568
03:51:35,280 --> 03:51:37,000
DWELLING ALASKA NATIVES THAT 

5569
03:51:37,000 --> 03:51:39,480
ISSEST% OF NATIVES LIVE OFF 

5570
03:51:39,480 --> 03:51:41,400
RESERVATION AREAS AND LARGE 

5571
03:51:41,400 --> 03:51:43,280
URBAN SETTINGS ACROSS THE UNITED

5572
03:51:43,280 --> 03:51:46,320
STATES AND I WORK ACROSS TRIBAL 

5573
03:51:46,320 --> 03:51:47,720
NATIONS IN ADDITION AND STARTING

5574
03:51:47,720 --> 03:51:49,640
TO TALK ABOUT WHAT CURRENT 

5575
03:51:49,640 --> 03:51:53,080
STATUS OF MATERNAL MORBIDITY AND

5576
03:51:53,080 --> 03:51:55,120
AMERICAN INDIANS AND ALASKA 

5577
03:51:55,120 --> 03:51:56,600
NATIVES AND WHAT WAS PRESENT 

5578
03:51:56,600 --> 03:51:58,320
FORD BLACK SISTERS AND THOSE WHO

5579
03:51:58,320 --> 03:52:00,480
BIRTH AND WE EXPERIENCE WHAT ARE

5580
03:52:00,480 --> 03:52:02,560
CALLED VERY HIGH RATES OF SOCIAL

5581
03:52:02,560 --> 03:52:04,440
DETERMINANTS OF HEALTH I DON'T 

5582
03:52:04,440 --> 03:52:06,040
CALL THEM THAT.  OUR FRIEND 

5583
03:52:06,040 --> 03:52:08,040
MENTIONED EARLIER THAT WE HAVE 

5584
03:52:08,040 --> 03:52:10,640
TO ADDRESS IMBEDDED RACISM AND 

5585
03:52:10,640 --> 03:52:13,440
WHITE SUPREMACY THAT DIRECTLY 

5586
03:52:13,440 --> 03:52:15,000
IMPACTED ABILITY OF PEOPLE TO 

5587
03:52:15,000 --> 03:52:17,160
BIRTH BABIES IN WAYS THAT THEY 

5588
03:52:17,160 --> 03:52:19,720
WERE MEANT TO AND CALL THEM 

5589
03:52:19,720 --> 03:52:22,240
COLONIAL DETERMINANTS OF HEALTH 

5590
03:52:22,240 --> 03:52:24,000
LOOKING AT SOCIETAL DETERMINANTS

5591
03:52:24,000 --> 03:52:25,760
OF RELATIVES AND PEOPLE OF 

5592
03:52:25,760 --> 03:52:28,120
TRIBAL NATIONS WE HAVE 

5593
03:52:28,120 --> 03:52:29,560
INCREDIBLE BEAUTIFUL CULTURE AND

5594
03:52:29,560 --> 03:52:31,240
COMMUNITY CAN'T BE ASSOCIATED 

5595
03:52:31,240 --> 03:52:33,640
WITH IMBEDDED RACIST SYSTEMS 

5596
03:52:33,640 --> 03:52:35,720
THAT ARE CURRENTLY HARMING US 

5597
03:52:35,720 --> 03:52:37,440
AND TERM THEM COLONIAL 

5598
03:52:37,440 --> 03:52:39,280
DETERMINANTS OF HEALTH THAT 

5599
03:52:39,280 --> 03:52:41,120
DIRECTLY IMPACTED HIGH RATES OF 

5600
03:52:41,120 --> 03:52:43,720
POVERTY AND HIGH RATES OF 

5601
03:52:43,720 --> 03:52:45,840
UNEMPLOYMENT AND HIGH RATES OF 

5602
03:52:45,840 --> 03:52:48,080
SUBSTANCE MISUSE AND OTHER 

5603
03:52:48,080 --> 03:52:49,280
THINGS THAT ARE OFTEN JUST 

5604
03:52:49,280 --> 03:52:51,800
DIRECT SYMPTOMS OF ONGOING 

5605
03:52:51,800 --> 03:52:52,960
COLONIALISM THAT EXIST HERE IN 

5606
03:52:52,960 --> 03:52:54,280
THE UNITED STATES AND WE CAN'T 

5607
03:52:54,280 --> 03:52:56,000
TALK ABOUT TECHNOLOGY AND 

5608
03:52:56,000 --> 03:52:59,200
ABILITY FOR S TO MAKE CHANGES 

5609
03:52:59,200 --> 03:53:00,040
WITHOUT TALKING ABOUT RACISM 

5610
03:53:00,040 --> 03:53:01,640
THAT CURRENTLY EXISTS AND 

5611
03:53:01,640 --> 03:53:03,080
LOOKING AT TECHNOLOGY AND 

5612
03:53:03,080 --> 03:53:04,600
BRINGING EXPERIENCE OF WORKING 

5613
03:53:04,600 --> 03:53:08,960
ON MORE THAN 26NIH-FUNDED 

5614
03:53:08,960 --> 03:53:11,160
PREDOMINANTLY LARGE R01S AND 

5615
03:53:11,160 --> 03:53:12,760
WORKING ACROSS TRIBAL NATIONS 

5616
03:53:12,760 --> 03:53:14,840
AND URBAN INDIAN COMMUNITIES ONE

5617
03:53:14,840 --> 03:53:17,000
SITUATION WE HAD TO DO WAS TO 

5618
03:53:17,000 --> 03:53:19,720
FIGURE OUT HOW TO ACTUALLY MAKE 

5619
03:53:19,720 --> 03:53:21,600
OUR IMBEDDED KNOWLEDGE SYSTEMS 

5620
03:53:21,600 --> 03:53:23,360
THAT WERE ONLY WAY THAT WE WERE 

5621
03:53:23,360 --> 03:53:25,520
GOING TO IMPROVE HEALTH AND WELL

5622
03:53:25,520 --> 03:53:27,320
BEING OF COMMUNITIES WORK WITHIN

5623
03:53:27,320 --> 03:53:30,560
STRUCTURE OF BUREAUCRACY AND 

5624
03:53:30,560 --> 03:53:32,080
IMBEDDED STRUCTURAL RACISM THAT 

5625
03:53:32,080 --> 03:53:35,080
IS WHAT NIH GRANTS ARE AND AS WE

5626
03:53:35,080 --> 03:53:37,640
LOOK AT EVEN NOW EXPANSION OF 

5627
03:53:37,640 --> 03:53:42,120
FOCUSING ON BRINGING FORWARD 

5628
03:53:42,120 --> 03:53:43,440
TECHNOLOGY SDOOE VICES AND 

5629
03:53:43,440 --> 03:53:45,120
RESEARCH ASSOCIATED WITH THAT 

5630
03:53:45,120 --> 03:53:46,520
COMING FROM FRAMEWORK PEOPLE OF 

5631
03:53:46,520 --> 03:53:48,280
COLOR ARE A PROBLEM TO SOLVE AND

5632
03:53:48,280 --> 03:53:52,080
WHEN YOU START WITH US AS A 

5633
03:53:52,080 --> 03:53:53,880
PROBLEM TO SOLVE YOU ARE 

5634
03:53:53,880 --> 03:53:55,880
IMMEDIATELY STARTING WITH 

5635
03:53:55,880 --> 03:53:59,240
IMBEDDED RACISM THAT SEES US AS 

5636
03:53:59,240 --> 03:54:01,640
A PROBLEM NOT OF ANSWERS AND 

5637
03:54:01,640 --> 03:54:03,120
DIRECT RESULT OF THAT TECHNOLOGY

5638
03:54:03,120 --> 03:54:06,360
SOLUTIONS HARMED COMMUNITIES AND

5639
03:54:06,360 --> 03:54:07,880
MOVE FORWARD HEALTH AND WELL 

5640
03:54:07,880 --> 03:54:10,000
BEING AND I WILL TALK ABOUT DATE

5641
03:54:10,000 --> 03:54:12,040
THAW COULD BE APPLIED IN VARIETY

5642
03:54:12,040 --> 03:54:15,280
OF DIFFERENT THINGS AND KNOW 

5643
03:54:15,280 --> 03:54:17,200
WHETHER IT BE MACHINE LEARNING 

5644
03:54:17,200 --> 03:54:20,440
AND LOOKING AT AI NOW AND WAY 

5645
03:54:20,440 --> 03:54:23,080
THAT DATA IS COLLECTED AND KNOW 

5646
03:54:23,080 --> 03:54:24,920
DEVICES FOR EXAMPLE ON CERTAIN 

5647
03:54:24,920 --> 03:54:27,000
SKILL COLOR DOESN'T WORK WELL 

5648
03:54:27,000 --> 03:54:28,720
WITHIN HOSPITAL SYSTEMS RESEARCH

5649
03:54:28,720 --> 03:54:30,880
WASN'T DONE THAT WAY AND LOOK AT

5650
03:54:30,880 --> 03:54:33,400
WAY WE ARE MADE INVISIBLE AND 

5651
03:54:33,400 --> 03:54:34,960
TECHNOLOGY IS PUT FORWARD.  THEY

5652
03:54:34,960 --> 03:54:36,600
ARE LIKE IT DIDN'T WORK. 

5653
03:54:36,600 --> 03:54:38,480
YOU DIDN'T USE IT.  WE WEREN'T 

5654
03:54:38,480 --> 03:54:39,960
GIVEN ACCESS TO IT. 

5655
03:54:39,960 --> 03:54:41,320
THINKING ABOUT RESEARCH AND WAY 

5656
03:54:41,320 --> 03:54:45,440
IT IS DONE AND ALSO DATE THAW IS

5657
03:54:45,440 --> 03:54:47,520
PRODUCED BY PRINCIPLE 

5658
03:54:47,520 --> 03:54:49,360
INVESTIGATORS FOR AMERICAN 

5659
03:54:49,360 --> 03:54:52,280
INDIANS AND ALASKA NATIVES HAS 

5660
03:54:52,280 --> 03:54:53,640
UNIQUE EFFECT NEXT SLIDE. 

5661
03:54:53,640 --> 03:54:55,440
UNIQUE EFFECT IS THAT WE ARE 

5662
03:54:55,440 --> 03:54:57,240
LEGALLY UNDER TREATIES THAT ARE 

5663
03:54:57,240 --> 03:54:59,480
A RESULT OF STOLEN LAND THAW SIT

5664
03:54:59,480 --> 03:55:01,240
ON RIGHT NOW TODAY. 

5665
03:55:01,240 --> 03:55:03,640
OUR TREATIES MANDATE THAT UNITED

5666
03:55:03,640 --> 03:55:07,360
STATES GOVERNMENT GIVES US 

5667
03:55:07,360 --> 03:55:08,680
RESOURCES FOR QUALITY 

5668
03:55:08,680 --> 03:55:10,520
FISSION-LED HEALTH CARE IN 

5669
03:55:10,520 --> 03:55:12,680
ADDITION TO SOCIOECONOMIC 

5670
03:55:12,680 --> 03:55:14,000
RESOURCES DIRECT RESULT OF LOSS 

5671
03:55:14,000 --> 03:55:17,640
OF LAND IN TREATIES AND THOSE 

5672
03:55:17,640 --> 03:55:19,400
TREATIES ARE APPLIED BY HAVING 

5673
03:55:19,400 --> 03:55:19,880
DATA. 

5674
03:55:19,880 --> 03:55:22,000
SO, WHEN YOU HAVE RESEARCH 

5675
03:55:22,000 --> 03:55:23,800
STUDIES THAT ARE NOT INCLUSIVE 

5676
03:55:23,800 --> 03:55:26,720
OF AMERICAN INDIANS AND ALASKA 

5677
03:55:26,720 --> 03:55:28,520
NATIVES AND SMALL SAMPLE SIZE 

5678
03:55:28,520 --> 03:55:30,240
YOU DON'T REPORT OUT DATA 

5679
03:55:30,240 --> 03:55:30,520
CORRECTLY. 

5680
03:55:30,520 --> 03:55:32,120
THAT IS USED BECAUSE I SEE IT 

5681
03:55:32,120 --> 03:55:34,080
ALL THE TIME AND FIGHT IT ALL 

5682
03:55:34,080 --> 03:55:35,280
THE TIME BY UNITED STATES 

5683
03:55:35,280 --> 03:55:37,320
GOVERNMENT TO JUSTIFY NOT GIVING

5684
03:55:37,320 --> 03:55:39,680
RESOURCES WE NEED TO ADDRESS 

5685
03:55:39,680 --> 03:55:42,720
CRISIS OF MATERNAL MORBIDITY AND

5686
03:55:42,720 --> 03:55:44,240
MORTALITY THAT, THAT GOVERNMENT 

5687
03:55:44,240 --> 03:55:44,520
CREATED. 

5688
03:55:44,520 --> 03:55:46,320
I WILL GIVE AN EXAMPLE. 

5689
03:55:46,320 --> 03:55:48,600
RECENTLY ASKED TO CONSULT ON A 

5690
03:55:48,600 --> 03:55:51,240
VERY LARGE NATIONAL BEHAVIORAL 

5691
03:55:51,240 --> 03:55:53,880
HEALTH STUDY SPECIFICALLY FOR 

5692
03:55:53,880 --> 03:55:55,840
YOUTH WHY IMPORTANT WHEN 

5693
03:55:55,840 --> 03:56:00,760
THINKING OF MATERNAL MORBIDITY 

5694
03:56:00,760 --> 03:56:02,400
AND AVERAGE AGE AND LIFESPAN IS 

5695
03:56:02,400 --> 03:56:04,720
51 YEARS OLD AND 25 IS 

5696
03:56:04,720 --> 03:56:06,240
CONSIDERED MIDDLE AGE IN THAT 

5697
03:56:06,240 --> 03:56:07,920
COMMUNITY AND WE HAVE A LARGE 

5698
03:56:07,920 --> 03:56:10,160
NUMBER OF YOUTH WHO HAVE BABIES 

5699
03:56:10,160 --> 03:56:12,400
EARLY ON, YOU KNOW?  

5700
03:56:12,400 --> 03:56:14,840
AND IN THEIR EARLY TO LATE TEENS

5701
03:56:14,840 --> 03:56:16,520
BECAUSE OF THE SOCIETAL 

5702
03:56:16,520 --> 03:56:18,200
CONDITIONS THAT HAVE BEEN 

5703
03:56:18,200 --> 03:56:19,920
CREATED BY COLONIAL DETERMINANTS

5704
03:56:19,920 --> 03:56:21,760
OF HEALTH THAT IS VERY IMPORTANT

5705
03:56:21,760 --> 03:56:24,600
TO ME TO LOOK AT WHAT WE WANT TO

5706
03:56:24,600 --> 03:56:26,960
LOOK AT PERINATAL PERIODS 

5707
03:56:26,960 --> 03:56:29,600
SITTING OUT ASKING WE HAVE A 

5708
03:56:29,600 --> 03:56:31,640
SMALL SAMPLE SIZE LAST TIME WE 

5709
03:56:31,640 --> 03:56:34,680
DID LARGE NATIONAL STUDY DOING 

5710
03:56:34,680 --> 03:56:37,080
OVERSAMPLE LOOKING AT HOW THEY 

5711
03:56:37,080 --> 03:56:38,360
CALCULATED THEIR DATA AND ASKED 

5712
03:56:38,360 --> 03:56:42,080
WHY ARE YOU ONLY USING SINGLE 

5713
03:56:42,080 --> 03:56:44,080
RACE AMERICAN INDIANS AND ALASKA

5714
03:56:44,080 --> 03:56:47,520
NATIVES HAS IMBEDDED IN HOSPITAL

5715
03:56:47,520 --> 03:56:50,040
EHR SYSTEMS IMBEDDED IN WAY THAT

5716
03:56:50,040 --> 03:56:52,160
CLINICAL INVESTIGATORS AND 

5717
03:56:52,160 --> 03:56:54,120
OTHERS ARE GATHERING DATA AND 

5718
03:56:54,120 --> 03:56:55,840
ASKED WHY ARE YOU USING SINGLE 

5719
03:56:55,840 --> 03:56:57,360
RACE?  WHAT DOES IT MEAN?  

5720
03:56:57,360 --> 03:56:59,280
ANSWER OF VERY LARGE WON'T SAY 

5721
03:56:59,280 --> 03:57:01,120
NAME OF WHO IT WAS FEDERAL 

5722
03:57:01,120 --> 03:57:04,000
AGENCY, IT THIS AIS WAY WE HAVE 

5723
03:57:04,000 --> 03:57:04,720
ALWAYS DONE IT. 

5724
03:57:04,720 --> 03:57:06,240
SCIENCE ON THAT, THERE IS NO 

5725
03:57:06,240 --> 03:57:06,840
SCIENCE. 

5726
03:57:06,840 --> 03:57:08,920
IT IS JUST WAY IT ALWAYS HAS 

5727
03:57:08,920 --> 03:57:11,680
BEEN DONE AND WHY DOES IT 

5728
03:57:11,680 --> 03:57:14,800
MATTER?  USE OF SINGLE RACE 

5729
03:57:14,800 --> 03:57:16,600
AMERICAN INDIANS AND ALASKA 

5730
03:57:16,600 --> 03:57:18,960
NATIVES IF WE INTERMARRY AND 

5731
03:57:18,960 --> 03:57:20,800
BECOME INTERCULTURAL WE 

5732
03:57:20,800 --> 03:57:22,040
DISAPPEAR INTO MELTING BOT A 

5733
03:57:22,040 --> 03:57:23,360
REAL THING IN THE UNITED STATES 

5734
03:57:23,360 --> 03:57:25,480
AND DIRECT RESULT OF THAT DATA 

5735
03:57:25,480 --> 03:57:27,240
DOESN'T EXIST THAT WOULD BE USE 

5736
03:57:27,240 --> 03:57:29,440
THE TO ALLOCATE RESOURCES OF 

5737
03:57:29,440 --> 03:57:32,040
TRIBAL COMMUNITIES ADDRESSING 

5738
03:57:32,040 --> 03:57:36,440
COLONIAL DETERMINANTS OF HEALTH 

5739
03:57:36,440 --> 03:57:39,200
IMPROVING YOUTH THAT WILL BIRTH 

5740
03:57:39,200 --> 03:57:41,120
BABIES IN EARLIER AGES BECAUSE 

5741
03:57:41,120 --> 03:57:43,520
THEY DON'T LIVE PAST AGE OF 51. 

5742
03:57:43,520 --> 03:57:46,480
DIRECT IMPACT SINGLE RACE 

5743
03:57:46,480 --> 03:57:47,880
AMERICAN INDIANS AND ALASKA 

5744
03:57:47,880 --> 03:57:50,760
NATIVES ARE A HOLD OVER OF BLOOD

5745
03:57:50,760 --> 03:57:51,600
QUANTITIUM THAT FEDERAL 

5746
03:57:51,600 --> 03:57:53,040
GOVERNMENT CREATED WITH 

5747
03:57:53,040 --> 03:57:55,840
INTENTION OF MAKING SURE WE WERE

5748
03:57:55,840 --> 03:57:57,200
ELIMINATED IN DATA AND LIST OF 

5749
03:57:57,200 --> 03:57:59,560
OTHER WAYS THAT DATA IS USE THE 

5750
03:57:59,560 --> 03:58:03,760
TO ELIMINATE US AND TEAMS GOING 

5751
03:58:03,760 --> 03:58:04,840
ACROSS HOSPITALS AND EITHER 

5752
03:58:04,840 --> 03:58:06,800
DON'T HAVE A BOX FOR OUR PEOPLE 

5753
03:58:06,800 --> 03:58:08,800
TO CHECK THEY ARE AMERICAN 

5754
03:58:08,800 --> 03:58:10,640
INDIAN OR ALASKA NATIVE NOT 

5755
03:58:10,640 --> 03:58:12,240
BEING GATHERED SAME WITH 

5756
03:58:12,240 --> 03:58:13,840
CLINICAL RESEARCH STUDIES IF 

5757
03:58:13,840 --> 03:58:15,560
BEING GATHERED IT IS NOT BEING 

5758
03:58:15,560 --> 03:58:17,880
DONE IN WAY THAT COUNTS AS 

5759
03:58:17,880 --> 03:58:19,360
MULTICULTURAL PEOPLE AND 

5760
03:58:19,360 --> 03:58:21,920
DIRECTLY ELIMINATES US AND THIS 

5761
03:58:21,920 --> 03:58:24,920
IS THE NEXT SLIDE AND PHENOMENON

5762
03:58:24,920 --> 03:58:27,920
I CALL DATA GENOCIDE AND COIN 

5763
03:58:27,920 --> 03:58:30,080
THIS TERM SPECIFICALLY DIRECTLY 

5764
03:58:30,080 --> 03:58:32,480
RESULTING IN DEATHS OF RELATIVES

5765
03:58:32,480 --> 03:58:35,200
I SERVE EVERY DAY AND HEALTH 

5766
03:58:35,200 --> 03:58:37,600
BOARD PAYS FOR FUNERALS I PAY 

5767
03:58:37,600 --> 03:58:39,920
FOR COUGHINS OF 2 MONTH YEAR 

5768
03:58:39,920 --> 03:58:42,520
OLDS AND COUGHINS OF MOTHER AND 

5769
03:58:42,520 --> 03:58:44,720
HER TWINS THAT DIED AS A DIRECT 

5770
03:58:44,720 --> 03:58:46,320
RESULT OF COLONIAL DETERMINANTS 

5771
03:58:46,320 --> 03:58:48,520
OF HEALTH AND TECHNOLOGY THAT 

5772
03:58:48,520 --> 03:58:49,760
DIDN'T ENGAGE CORRECTLY WITH 

5773
03:58:49,760 --> 03:58:51,000
HER.  IT HAD NEVER ASSUMED THAT 

5774
03:58:51,000 --> 03:58:56,080
SHE WOULD BE PART OF IT. 

5775
03:58:56,080 --> 03:58:58,320
INDIGENOUS DATA GENOCIDE IS A 

5776
03:58:58,320 --> 03:58:59,520
DIRECT RESULT OF THAT WHAT 

5777
03:58:59,520 --> 03:59:01,320
HAPPENS RESOURCES OF FEDERAL 

5778
03:59:01,320 --> 03:59:03,120
GOVERNMENT THAT IS SUPPOSED TO 

5779
03:59:03,120 --> 03:59:05,440
ALLOCATE TO US DON'T COME 

5780
03:59:05,440 --> 03:59:07,560
BECAUSE WE WEREN'T INCLUDED AND 

5781
03:59:07,560 --> 03:59:08,440
TECHNOLOGY HAS OPPORTUNITY NOW 

5782
03:59:08,440 --> 03:59:10,320
TO CHAFK THAT.  NEXT SLIDE. 

5783
03:59:10,320 --> 03:59:12,600
ONE KEY THING WE LEARNED IS MOST

5784
03:59:12,600 --> 03:59:14,800
FOLKS DON'T KNOW THAT IS WHAT 

5785
03:59:14,800 --> 03:59:16,400
STRUCTURAL RACISM DOES AT ITS 

5786
03:59:16,400 --> 03:59:20,080
BEST YOU ARE PARTICIPATING IN 

5787
03:59:20,080 --> 03:59:22,440
SYSTEM OF INDIGENOUS DATA 

5788
03:59:22,440 --> 03:59:23,720
GENOCIDE AND NEED TO POINT 

5789
03:59:23,720 --> 03:59:25,280
DIRECTION WHAT CHANGE CAN LOOK 

5790
03:59:25,280 --> 03:59:26,680
LIKE AND RESEARCH HAS A KEY PART

5791
03:59:26,680 --> 03:59:31,280
OF DOING THAT WHEN DONE WELL. 

5792
03:59:31,280 --> 03:59:33,520
I WORKED AND DID A STUDY SOME 

5793
03:59:33,520 --> 03:59:35,920
YEARS AGO WE LOOKEDALITY MORE 

5794
03:59:35,920 --> 03:59:38,160
THAN A VERY LARGE PACIFIC 

5795
03:59:38,160 --> 03:59:40,960
NORTHWEST LOOKING AT CLINICAL 

5796
03:59:40,960 --> 03:59:42,800
INVESTIGATORS WITH R01 LEVEL 

5797
03:59:42,800 --> 03:59:44,840
GRANTS AND ASKED HOW MANY HAD 

5798
03:59:44,840 --> 03:59:46,440
COMMUNITY ENGAGEMENT WITH 

5799
03:59:46,440 --> 03:59:48,800
SPECIFICALLY SET ASIDE RESOURCES

5800
03:59:48,800 --> 03:59:51,680
COMMUNITY ENGAGEMENT IN 5 YEAR 

5801
03:59:51,680 --> 03:59:53,760
R01S AND OUT OF THAT NUMBER 

5802
03:59:53,760 --> 03:59:55,440
PROBABLY 66 ONLY ONE DID THAT 

5803
03:59:55,440 --> 03:59:58,280
WAS SPECIFIC TOWARDS COMMUNITIES

5804
03:59:58,280 --> 04:00:00,440
EXPERIENCING WORST DISPARITIES, 

5805
04:00:00,440 --> 04:00:03,000
ONE ORGANIZATION AND ONE 

5806
04:00:03,000 --> 04:00:05,120
PRINCIPLE INVESTIGATORS AND NEED

5807
04:00:05,120 --> 04:00:07,720
TO SEE STRATEGIC CHANGES AND 

5808
04:00:07,720 --> 04:00:09,160
OPPORTUNITIES AND RESOURCES AND 

5809
04:00:09,160 --> 04:00:11,800
FUNDING TO ENSURE TO ENGAGE 

5810
04:00:11,800 --> 04:00:13,080
FOLKS IN TECHNOLOGY IN WAY THAT 

5811
04:00:13,080 --> 04:00:15,240
IS ENGAGING COMMUNITIES THAT ARE

5812
04:00:15,240 --> 04:00:18,160
MOST IMPACTED.  TECHNOLOGY IS IF

5813
04:00:18,160 --> 04:00:20,000
NOT FOR US OR BY US IT WON'T 

5814
04:00:20,000 --> 04:00:22,320
HAVE IMPACT WE NEED TO SEE AND 

5815
04:00:22,320 --> 04:00:26,240
ANOTHER ISSUE WE HAVE TO STAY 

5816
04:00:26,240 --> 04:00:29,120
VIL VIGILANT FOR UNINTENDED 

5817
04:00:29,120 --> 04:00:31,160
CONSEQUENCES OF GOOD INTENTIONS 

5818
04:00:31,160 --> 04:00:33,200
AND SIT DOWN WITH INVESTIGATORS 

5819
04:00:33,200 --> 04:00:35,640
WITH GOOD INTENTIONS AND RACIST 

5820
04:00:35,640 --> 04:00:37,000
OUTCOMES NOT PROBLEM TO SOLVE 

5821
04:00:37,000 --> 04:00:38,880
ALL ANSWERS HAS TO BE INCLUDED 

5822
04:00:38,880 --> 04:00:40,720
IN TECHNOLOGY IN WAY WE LOOK AT 

5823
04:00:40,720 --> 04:00:42,280
WHETHER IT IS COLLECTING DATA 

5824
04:00:42,280 --> 04:00:45,160
YOU TO DOING RESEARCH ON NEW 

5825
04:00:45,160 --> 04:00:46,960
DEVICES TO MACHINE LEARNING AND 

5826
04:00:46,960 --> 04:00:49,200
AI AND WITHOUT THAT TECHNOLOGY 

5827
04:00:49,200 --> 04:00:50,960
WILL PERPETUATE INSTEAD OF 

5828
04:00:50,960 --> 04:00:52,320
CHANGE AND NOW IS THE TIME AND 

5829
04:00:52,320 --> 04:00:55,160
NOW IS THE TIME FOR OPPORTUNITY 

5830
04:00:55,160 --> 04:00:56,920
FOR TRUE ENGAGEMENT AND 

5831
04:00:56,920 --> 04:00:59,400
COMMUNITIES ARE WAITING AND WHAT

5832
04:00:59,400 --> 04:01:02,040
WILL YOUR ANSWER BE TO THEM. 

5833
04:01:02,040 --> 04:01:05,240
>> LAST BUT NOT LEAST. 

5834
04:01:05,240 --> 04:01:09,320
>> IS. 

5835
04:01:09,320 --> 04:01:13,720
>> I'M GOING TO TALK
ABOUT AND 

5836
04:01:13,720 --> 04:01:15,520
TRY TO BRING TOGETHER ALL THEMES

5837
04:01:15,520 --> 04:01:19,760
WE HEARD TODAY THAT ARE SO 

5838
04:01:19,760 --> 04:01:23,000
POWERFULLY DELIVER TODAY 

5839
04:01:23,000 --> 04:01:24,120
REGULATE REGULATORY INITIATIVES 

5840
04:01:24,120 --> 04:01:26,400
AND COMMUNITY PARTNERSHIPS AND 

5841
04:01:26,400 --> 04:01:28,080
INNOVATION TO DRIVE DIVERSITY 

5842
04:01:28,080 --> 04:01:31,080
AND INCLUSION AND JUSTICE IN MED

5843
04:01:31,080 --> 04:01:32,440
TECH ECOSYSTEM. 

5844
04:01:32,440 --> 04:01:35,400
IN TERMS OF DISCLOSURES ON BOARD

5845
04:01:35,400 --> 04:01:38,080
OF MED TECH COLOR AND DON'T 

5846
04:01:38,080 --> 04:01:38,960
RECEIVE COMPENSATION FOR ROLE 

5847
04:01:38,960 --> 04:01:43,360
AND NIH IS A FINANCIAL DONOR AND

5848
04:01:43,360 --> 04:01:45,520
GRANTOR OF MED TECH COLOR AND 

5849
04:01:45,520 --> 04:01:48,000
PARTICIPATING IN INITIATIVES AND

5850
04:01:48,000 --> 04:01:49,400
NEXT SLIDE. 

5851
04:01:49,400 --> 04:01:51,000
WHAT ALL OUR SPEAKERS HAVE 

5852
04:01:51,000 --> 04:01:53,040
TALKED ABOUT TODAY IS SORT OF 

5853
04:01:53,040 --> 04:01:58,360
ILLUSTRATED ON THIS SLIDE.  I 

5854
04:01:58,360 --> 04:02:00,800
HAVE BEEN A MEDICAL DEVICE 

5855
04:02:00,800 --> 04:02:03,280
LAWYER FOR 23 YEARS OF PRACTICE 

5856
04:02:03,280 --> 04:02:07,240
AS A LAWYER AND ROLE AT FDA 

5857
04:02:07,240 --> 04:02:09,040
ASSOCIATE CHIEF COUNCIL AND HAVE

5858
04:02:09,040 --> 04:02:11,320
SEEN EVOLUTION IN MED TECH AND 

5859
04:02:11,320 --> 04:02:13,200
HEALTH CARE ECOSYSTEM AND WHAT I

5860
04:02:13,200 --> 04:02:15,600
LIKE TO CALL A CONNECTED PATIENT

5861
04:02:15,600 --> 04:02:17,640
AND THIS SLIDE ILLUSTRATES 

5862
04:02:17,640 --> 04:02:21,120
PATIENT OR CONSUMER INCREASINGLY

5863
04:02:21,120 --> 04:02:23,280
USING MOBILE APPS AND WEARABLES 

5864
04:02:23,280 --> 04:02:25,280
AND OTHER SOFTWARE THAT IS 

5865
04:02:25,280 --> 04:02:27,160
COLLECTING LARGE AMOUNTS OF 

5866
04:02:27,160 --> 04:02:29,040
DEMOGRAPHIC AND BIOMETRIC DATA 

5867
04:02:29,040 --> 04:02:32,240
AND IN CASES THESE DEVICES ARE 

5868
04:02:32,240 --> 04:02:35,120
DIAGNOSING DISEASE AND 

5869
04:02:35,120 --> 04:02:36,240
PROGRAMMING WEARABLE DRUG 

5870
04:02:36,240 --> 04:02:39,400
DELIVERY DEVICES OR MONITORING 

5871
04:02:39,400 --> 04:02:40,000
CARE. 

5872
04:02:40,000 --> 04:02:43,400
INSIDE OF THIS ECOSYSTEM IS MANY

5873
04:02:43,400 --> 04:02:45,120
DIFFERENT STAKEHOLDERS WHO ARE 

5874
04:02:45,120 --> 04:02:47,040
LOOKING TO LEVERAGE DATA SETS 

5875
04:02:47,040 --> 04:02:49,680
FOR DIFFERENT PURPOSES AND YOU 

5876
04:02:49,680 --> 04:02:51,480
HAVE HEALTH CARE PROVIDERS 

5877
04:02:51,480 --> 04:02:53,920
LOOKING TO LEVERAGE IT FOR TELLE

5878
04:02:53,920 --> 04:02:57,240
MEDICINE AND FOR TOOLS LIKE MOMA

5879
04:02:57,240 --> 04:03:00,200
AND SIMILAR TOOLS AND CAREGIVERS

5880
04:03:00,200 --> 04:03:03,160
LOOKING TO LEVERAGE PATIENT DATA

5881
04:03:03,160 --> 04:03:07,320
TO CARE FOR PATIENTS THAT MIGHT 

5882
04:03:07,320 --> 04:03:10,360
BE VULNERABLE ELDERLY OR 

5883
04:03:10,360 --> 04:03:12,040
PEDIATRIC PATIENTS WORKING 

5884
04:03:12,040 --> 04:03:14,640
THROUGH MENTAL HEALTH ISSUES TO 

5885
04:03:14,640 --> 04:03:15,840
MONITOR THEIR CARE. 

5886
04:03:15,840 --> 04:03:18,160
WE HAVE RESEARCHERS IN MED TECH 

5887
04:03:18,160 --> 04:03:20,720
AND BIOTECH INDUSTRY LOOKING TO 

5888
04:03:20,720 --> 04:03:22,600
LEVERAGE DATA SETS FOR RESEARCH 

5889
04:03:22,600 --> 04:03:25,720
AND WE HAVE EMPLOYERS AND PAYERS

5890
04:03:25,720 --> 04:03:27,640
AND OTHERS WHO ARE MAKING 

5891
04:03:27,640 --> 04:03:29,840
DECISIONS ABOUT CARE THAT ARE 

5892
04:03:29,840 --> 04:03:31,880
LEVERAGING THESE DATA SETS AND 

5893
04:03:31,880 --> 04:03:34,960
DATA IN MED TECH HAS REALLY 

5894
04:03:34,960 --> 04:03:37,480
BECOME THE COMMODITY. 

5895
04:03:37,480 --> 04:03:40,000
AS ABIGAIL POINTED OUT IT HAS 

5896
04:03:40,000 --> 04:03:42,280
POTENTIAL TO CREATE INEQUITY AND

5897
04:03:42,280 --> 04:03:45,240
OFFERS US THE POWER TO TRY TO 

5898
04:03:45,240 --> 04:03:47,040
MITIGATE AND ELIMINATE SOME 

5899
04:03:47,040 --> 04:03:50,640
HARMS AND DISPARITIES. 

5900
04:03:50,640 --> 04:03:51,400
NEXT SLIDE. 

5901
04:03:51,400 --> 04:03:54,680
AS A LAWYER, I ALWAYS ENCOURAGE 

5902
04:03:54,680 --> 04:03:56,600
PEOPLE WHO ARE WORKING IN 

5903
04:03:56,600 --> 04:04:00,360
JUSTICE EQUITY, INCLUSION AND 

5904
04:04:00,360 --> 04:04:01,920
INNOVATION TO UNDERSTAND 

5905
04:04:01,920 --> 04:04:02,440
REGULATORY LANDSCAPE. 

5906
04:04:02,440 --> 04:04:05,360
I WILL FOCUS A LITTLE ON FDA. 

5907
04:04:05,360 --> 04:04:07,160
WHAT I ALWAYS EMPHASIZE IS IN 

5908
04:04:07,160 --> 04:04:10,600
ORDER TO REALLY MOVE THE NEEDLE,

5909
04:04:10,600 --> 04:04:12,160
IT IS VERY IMPORTANT TO 

5910
04:04:12,160 --> 04:04:15,280
UNDERSTAND YOU HAVE ALL THESE 

5911
04:04:15,280 --> 04:04:17,200
DIFFERENT REGULATORS WHO HAVE 

5912
04:04:17,200 --> 04:04:20,880
EITHER EXPRESS AUTHORITY OVER 

5913
04:04:20,880 --> 04:04:23,680
MED TECH SOFTWARE AND INNOVATIVE

5914
04:04:23,680 --> 04:04:25,920
TECHNOLOGIES OR HAVE TREMENDOUS 

5915
04:04:25,920 --> 04:04:29,120
AMOUNT OF INFLUENCE HOW PRODUCTS

5916
04:04:29,120 --> 04:04:30,680
GET TO MARKET. 

5917
04:04:30,680 --> 04:04:32,280
A KEY IS UNDERSTANDING THEIR 

5918
04:04:32,280 --> 04:04:34,160
INTEREST THAT IS OFTEN DIVERGENT

5919
04:04:34,160 --> 04:04:35,760
AND NOT ALWAYS TALKING TO EACH 

5920
04:04:35,760 --> 04:04:37,680
OTHER AND HOW YOU CAN LEVERAGE 

5921
04:04:37,680 --> 04:04:39,640
THEIR PRIORITIES AND POLICIES 

5922
04:04:39,640 --> 04:04:43,040
AND INITIATIVES TO SOLVE SOME 

5923
04:04:43,040 --> 04:04:46,360
PROBLEMS THAT WERE ADDRESSED 

5924
04:04:46,360 --> 04:04:46,840
TODAY. 

5925
04:04:46,840 --> 04:04:48,800
NEXT SLIDE. 

5926
04:04:48,800 --> 04:04:51,680
I WILL FOCUS ON FDA I'M A 

5927
04:04:51,680 --> 04:04:54,360
MEDICAL DEVICE LAWYER AND FDA IS

5928
04:04:54,360 --> 04:04:56,920
INCREASINGLY FOCUSED ON PATIENT 

5929
04:04:56,920 --> 04:04:59,400
CENTERED PRODUCT DEVELOPMENT AND

5930
04:04:59,400 --> 04:05:02,880
IN PARTICULAR HOW DEVELOPERS AND

5931
04:05:02,880 --> 04:05:04,360
REGULATORS CAN LEVERAGE REAL 

5932
04:05:04,360 --> 04:05:06,720
WORLD DATA AND TECHNOLOGY TO 

5933
04:05:06,720 --> 04:05:08,920
DRIVE INCLUSIVITY AND BETTER 

5934
04:05:08,920 --> 04:05:10,520
OUTCOMES AND WHEN WE ARE TALKING

5935
04:05:10,520 --> 04:05:12,400
ABOUT MATERNAL HEALTH AND 

5936
04:05:12,400 --> 04:05:14,520
DEVELOPMENT OF PRODUCTS AND 

5937
04:05:14,520 --> 04:05:16,400
SOLUTIONS TO CLOSE GAPS AND 

5938
04:05:16,400 --> 04:05:19,560
SOLVE PROBLEMS, I LIKE TO 

5939
04:05:19,560 --> 04:05:21,720
EMPHASIZE GETTING TO KNOW YOUR 

5940
04:05:21,720 --> 04:05:23,800
REGULATOR AND WITH FDA THERE IS 

5941
04:05:23,800 --> 04:05:26,400
OFFICE OF WOMEN'S HEALTH THAT IS

5942
04:05:26,400 --> 04:05:28,880
ACTUALLY OVERSEEING RESEARCH AND

5943
04:05:28,880 --> 04:05:30,640
INITIATIVES TO FORCE AND 

5944
04:05:30,640 --> 04:05:34,040
ENCOURAGE DEVELOPERS TO BE MORE 

5945
04:05:34,040 --> 04:05:36,600
INCLUSIVE TO INCLUDE WOMEN AND 

5946
04:05:36,600 --> 04:05:38,400
CHILDREN AND PEOPLE OF COLOR IN 

5947
04:05:38,400 --> 04:05:41,400
THEIR RESEARCH INITIATIVES AND 

5948
04:05:41,400 --> 04:05:42,680
PRODUCT DEVELOPMENT. 

5949
04:05:42,680 --> 04:05:45,960
AGENCY ALSO HAS A DIVISION OF 

5950
04:05:45,960 --> 04:05:47,320
PEDIATRICS AND MATERNAL HEALTH 

5951
04:05:47,320 --> 04:05:50,160
THAT IS FOCUSED ON DRUG 

5952
04:05:50,160 --> 04:05:52,800
DEVELOPMENT AND ENSURING 

5953
04:05:52,800 --> 04:05:54,040
LABELING INSTRUCTIONS FOR USE 

5954
04:05:54,040 --> 04:05:56,760
AND DATA DRIVING DRUG AND 

5955
04:05:56,760 --> 04:05:58,600
BIOLOGICS DEVELOPMENT THAT IS 

5956
04:05:58,600 --> 04:06:00,400
INCLUSIVE AND INCREASINGLY 

5957
04:06:00,400 --> 04:06:02,520
BECAUSE HEALTH CARE HAS BECOME 

5958
04:06:02,520 --> 04:06:05,000
DIGITAL, FDA HAS AN OFFICE OR 

5959
04:06:05,000 --> 04:06:07,480
DIGITAL HEALTH CENTER OF 

5960
04:06:07,480 --> 04:06:09,040
EXCELLENCE THAT WORKS WITH ALL 

5961
04:06:09,040 --> 04:06:13,080
DIFFERENT CENTERS WITHIN FDA AS 

5962
04:06:13,080 --> 04:06:15,440
WELL AS EXTERNAL STAKEHOLDERS IN

5963
04:06:15,440 --> 04:06:17,800
DRIVING POLICIES AND SOLUTIONS 

5964
04:06:17,800 --> 04:06:20,960
TO BRING SOFTWARES AND MEDICAL 

5965
04:06:20,960 --> 04:06:23,240
DEVICE AND OTHER INNOVATIVE 

5966
04:06:23,240 --> 04:06:26,080
TECHNOLOGIES TO MARKET AND DO IN

5967
04:06:26,080 --> 04:06:27,080
CONJUNCTION WITH OFFICE OF 

5968
04:06:27,080 --> 04:06:28,880
SCIENCE AND ENGINEERING 

5969
04:06:28,880 --> 04:06:30,400
LABORATORIES THAT IS LOOKING AT 

5970
04:06:30,400 --> 04:06:32,960
THINGS LIKE DIVERSITY AND BIAS 

5971
04:06:32,960 --> 04:06:35,760
THAT IS BUILT INTO AI AND 

5972
04:06:35,760 --> 04:06:37,240
PROMULGATING STANDARDS AND 

5973
04:06:37,240 --> 04:06:38,400
REQUIREMENTS TO TRY TO SOLVE 

5974
04:06:38,400 --> 04:06:42,480
THOSE ISSUES AND THERE IS A LOT 

5975
04:06:42,480 --> 04:06:43,280
GOING ON. 

5976
04:06:43,280 --> 04:06:47,040
WE ARE AWARE OF PROBLEMS AND 

5977
04:06:47,040 --> 04:06:49,520
ENGAGING WITH REGULATORS THROUGH

5978
04:06:49,520 --> 04:06:51,520
DIFFERENT INITIATIVES IS A WAY 

5979
04:06:51,520 --> 04:06:54,080
TO START TO DRIVE SOLUTIONS AND 

5980
04:06:54,080 --> 04:06:57,760
USE REGULATORY PROCESSES TO 

5981
04:06:57,760 --> 04:06:58,720
FORCE CHANGE. 

5982
04:06:58,720 --> 04:06:59,640
NEXT SLIDE. 

5983
04:06:59,640 --> 04:07:02,680
THAT BRINGS ME TO MED TECH COLOR

5984
04:07:02,680 --> 04:07:04,800
THAT IS MY PASSION AND MED TECH 

5985
04:07:04,800 --> 04:07:06,600
COLOR HAS THREE PROGRAM AREAS.  

5986
04:07:06,600 --> 04:07:08,840
ONE IS FOCUSED ON BUILDING 

5987
04:07:08,840 --> 04:07:11,640
COMMUNITY FOR PROFESSIONALS AND 

5988
04:07:11,640 --> 04:07:13,200
EXECUTIVES IN MED TECH AND OTHER

5989
04:07:13,200 --> 04:07:14,840
WE HAVE A PITCH COMPETITION WE 

5990
04:07:14,840 --> 04:07:17,600
GIVE AWAY A QUARTER OF A MILLION

5991
04:07:17,600 --> 04:07:22,800
DOLLARS IN MONEY AND SERVICES TO

5992
04:07:22,800 --> 04:07:23,960
EARLY STAGE MED TECH COMPANIES 

5993
04:07:23,960 --> 04:07:32,800
THAT ARE LED OR FOUNDED BY BLACK

5994
04:07:32,800 --> 04:07:36,400
OR LATINX FOUNDERS 7ING THOSE 

5995
04:07:36,400 --> 04:07:40,040
COMMUNITIES AND FDA INITIATED 

5996
04:07:40,040 --> 04:07:42,560
PROGRAM SEVERAL YEARS AGO CALLED

5997
04:07:42,560 --> 04:07:45,280
COLLABORATIVE COMMUNITIES ANY 

5998
04:07:45,280 --> 04:07:50,680
GROUP OR PERSON THAT IS SOLVING 

5999
04:07:50,680 --> 04:07:53,920
PROBLEM -- MED TECH COLOR 

6000
04:07:53,920 --> 04:07:56,120
COLLABORATIVE COMMUNITY IS FOCUS

6001
04:07:56,120 --> 04:07:58,560
THE ON HOW WE CAN SOLVE ISSUE OF

6002
04:07:58,560 --> 04:08:01,880
LACK OF INCLUSIVITY AND LACK OF 

6003
04:08:01,880 --> 04:08:06,200
AWARENESS OF DIVERSE COMMUNITIES

6004
04:08:06,200 --> 04:08:07,840
IN PRODUCT DEVELOPMENT AND 

6005
04:08:07,840 --> 04:08:09,920
CLINICAL RESEARCH AND FOUR 

6006
04:08:09,920 --> 04:08:11,720
INITIATIVES AND ONE IS DISEASE 

6007
04:08:11,720 --> 04:08:13,240
AWARENESS SUB-COMMITTEE AND 

6008
04:08:13,240 --> 04:08:16,040
SIGNATURE PROGRAMS IS A HEART TO

6009
04:08:16,040 --> 04:08:18,560
HEART PROGRAM.  WE CONDUCTED A 

6010
04:08:18,560 --> 04:08:20,880
SERIES OF FOCUS GROUPS ACROSS 

6011
04:08:20,880 --> 04:08:22,480
SEVERAL STATES BLACK WOMEN 

6012
04:08:22,480 --> 04:08:24,200
SUFFERING FROM CARDIAC DISEASES 

6013
04:08:24,200 --> 04:08:27,560
AND TO ALL POINTS ON PANEL 

6014
04:08:27,560 --> 04:08:29,120
INCLUDING NATALIE'S WE ARE NOT 

6015
04:08:29,120 --> 04:08:31,440
JUST GETTING DATA FROM WOMEN ON 

6016
04:08:31,440 --> 04:08:33,640
HOW THIS DISEASE IMPACTS THEIR 

6017
04:08:33,640 --> 04:08:35,320
HEALTH JOURNEY AND ONE THING WE 

6018
04:08:35,320 --> 04:08:39,000
FOUND IS TRANSPORTATION OR LACK 

6019
04:08:39,000 --> 04:08:42,320
OF IT IS ACTUALLY A BIG FACTOR 

6020
04:08:42,320 --> 04:08:44,200
IN DISEASE PROGRESSION AND LACK 

6021
04:08:44,200 --> 04:08:46,680
OF ACCESS TO CARE.  WE GOT DATA 

6022
04:08:46,680 --> 04:08:49,880
AND WE PROVIDED A GRANT THAT IS 

6023
04:08:49,880 --> 04:08:53,160
SPECIFICALLY FOCUSED ENSURING 

6024
04:08:53,160 --> 04:08:55,600
THAT WOMEN CAN HAVE GREATER 

6025
04:08:55,600 --> 04:08:57,080
ACCESS TO TRANSPORTATION AND IS 

6026
04:08:57,080 --> 04:08:59,120
NOT JUST ABOUT TAKING FROM 

6027
04:08:59,120 --> 04:08:59,920
COMMUNITIES GETTING INFORMATION 

6028
04:08:59,920 --> 04:09:02,040
BUT THINKING ABOUT ALSO HOW WE 

6029
04:09:02,040 --> 04:09:04,760
POOR BACK INTO THEM AND WE HAVE 

6030
04:09:04,760 --> 04:09:06,160
RECRUITMENT AND RETENTION 

6031
04:09:06,160 --> 04:09:08,040
COMMITTEE THAT IS FOCUSED ON HOW

6032
04:09:08,040 --> 04:09:11,840
TO GET MORE DIVERSE PIS IN 

6033
04:09:11,840 --> 04:09:14,000
CLINICAL RESEARCH STUDIED FOR 

6034
04:09:14,000 --> 04:09:15,440
DEVICES AND SOLUTIONS THAT ARE 

6035
04:09:15,440 --> 04:09:17,040
BEING DEVELOPED AND DOING IT IN 

6036
04:09:17,040 --> 04:09:19,120
A COUPLE WAYS AND WE HAVE TO 

6037
04:09:19,120 --> 04:09:20,480
FIND THEM AND ADDRESS THE FACT 

6038
04:09:20,480 --> 04:09:22,360
THAT SOMETIMES THEY DON'T HAVE 

6039
04:09:22,360 --> 04:09:23,840
RESOURCES AND TRAINING AND 

6040
04:09:23,840 --> 04:09:25,720
FUNDING SO THAT THE DRUG AND 

6041
04:09:25,720 --> 04:09:28,720
DEVICE COMPANIES WILL ACTUALLY 

6042
04:09:28,720 --> 04:09:30,280
ACCEPT THEM.  WE ARE TRYING TO 

6043
04:09:30,280 --> 04:09:32,920
FIGURE OUT HOW TO CLOSE THAT 

6044
04:09:32,920 --> 04:09:34,560
GAP.  EVIDENCE DEVELOPMENT, WE 

6045
04:09:34,560 --> 04:09:37,040
ARE TRYING TO UNDERSTAND DISEASE

6046
04:09:37,040 --> 04:09:39,320
PATHWAYS AND MORBIDITIES FOR 

6047
04:09:39,320 --> 04:09:40,760
COMMUNITIES OF COLOR AND WE WANT

6048
04:09:40,760 --> 04:09:42,560
TO HEAR FROM THEM.  

6049
04:09:42,560 --> 04:09:44,160
SO, WITHIN OUR COLLABORATIVE, WE

6050
04:09:44,160 --> 04:09:47,120
HAVE PATIENT GROUPS AND NIH AND 

6051
04:09:47,120 --> 04:09:50,960
CMS AND FDA AND MED TECH COLOR 

6052
04:09:50,960 --> 04:09:53,800
HAS 2500 INDIVIDUALS OR ENTITIES

6053
04:09:53,800 --> 04:09:55,640
THAT ARE CONNECTED TO US. 

6054
04:09:55,640 --> 04:09:58,200
THEY ARE TRYING TO SOLVE SOME OF

6055
04:09:58,200 --> 04:10:01,000
THESE PROBLEMS AND WE ARE ALSO 

6056
04:10:01,000 --> 04:10:03,240
LOOKING AT HOW WE CAN SOLVE THE 

6057
04:10:03,240 --> 04:10:05,720
PROBLEM THAT WAS IDENTIFIED BY 

6058
04:10:05,720 --> 04:10:08,120
ABIGAIL AND NATALIE AND MANY 

6059
04:10:08,120 --> 04:10:11,320
OTHERS AND MANY DEVICES USED TO 

6060
04:10:11,320 --> 04:10:12,600
DIAGNOSE PEOPLE OF COLOR OR 

6061
04:10:12,600 --> 04:10:14,240
TREATING PEOPLE OF COLOR ARE 

6062
04:10:14,240 --> 04:10:17,920
NEVER TESTED OR DEVELOPED WITH 

6063
04:10:17,920 --> 04:10:21,080
US IN MIND. 

6064
04:10:21,080 --> 04:10:23,680
THAT IS 4TH AREA WE ARE WORKING 

6065
04:10:23,680 --> 04:10:24,800
ON AND THERE ARE SOLUTIONS AND 

6066
04:10:24,800 --> 04:10:27,120
WE ARE FOCUSED ON FINDING 

6067
04:10:27,120 --> 04:10:28,680
SOLUTIONS AND INVITE YOU AND 

6068
04:10:28,680 --> 04:10:30,960
EVERYONE IN YOUR COHORT TO GET 

6069
04:10:30,960 --> 04:10:31,240
INVOLVED. 

6070
04:10:31,240 --> 04:10:35,280
THANK YOU VERY MUCH.  

6071
04:10:35,280 --> 04:10:38,280
>> ALL RIGHT.  WE STARTED
A 

6072
04:10:38,280 --> 04:10:39,880
LITTLE LATE AND TOOK -- WE HAVE 

6073
04:10:39,880 --> 04:10:41,840
A LITTLE TIME AND HOPE THAT DR. 

6074
04:10:41,840 --> 04:10:43,840
BETA FOR QUESTIONS FROM THE 

6075
04:10:43,840 --> 04:10:44,920
AUDIENCE. 

6076
04:10:44,920 --> 04:10:46,120
GREAT.  THANK YOU. 

6077
04:10:46,120 --> 04:10:48,360
DR. KIESHA I WAS GOING TO CALL 

6078
04:10:48,360 --> 04:10:50,160
YOU OUT.  TO MY PARTNER OUT 

6079
04:10:50,160 --> 04:10:51,960
THERE HOW ARE YOU DOING, LOVE?  

6080
04:10:51,960 --> 04:10:55,000
WANT TO GO TO MICROPHONE AND ASK

6081
04:10:55,000 --> 04:10:56,200
QUESTIONS WHILE PEOPLE ARE 

6082
04:10:56,200 --> 04:10:58,320
COMING?  I KNOW YOU ARE NOT SHY 

6083
04:10:58,320 --> 04:11:00,200
COME TO MICS PLEASE.  GOOD.  YOU

6084
04:11:00,200 --> 04:11:03,640
ARE COMING UP.  I CAN MAKE UP 

6085
04:11:03,640 --> 04:11:03,840
ONE. 

6086
04:11:03,840 --> 04:11:05,320
>> CAN YOU HEAR ME OKAY. 

6087
04:11:05,320 --> 04:11:05,720
>> YES. 

6088
04:11:05,720 --> 04:11:09,400
>> I'M PETER AND
CO-FOUNDER AND

6089
04:11:09,400 --> 04:11:12,840
CEO OF IVANA HEALTH AND QUESTION

6090
04:11:12,840 --> 04:11:15,440
FOR LIFE SCIENCES 

6091
04:11:15,440 --> 04:11:16,120
ENTREPRENEURSHIP DEVELOPMENT 

6092
04:11:16,120 --> 04:11:17,960
SIDE OF THINGS I COULDN'T AGREE 

6093
04:11:17,960 --> 04:11:19,200
MORE WITH IMPORTANCE OF 

6094
04:11:19,200 --> 04:11:21,960
COMMUNITY ENGAGEMENT AND 

6095
04:11:21,960 --> 04:11:23,760
PATIENT-DRIVEN AS SOMEONE SAID 

6096
04:11:23,760 --> 04:11:25,400
EARLIER DEVELOPMENT PANELS.  

6097
04:11:25,400 --> 04:11:26,840
WHAT IS APPROPRIATE RESPECTFUL 

6098
04:11:26,840 --> 04:11:28,560
TIME TO START TO ENGAGE ON THAT 

6099
04:11:28,560 --> 04:11:30,840
SIDE WHEN TRANSLATING FROM SAY 

6100
04:11:30,840 --> 04:11:32,960
PRECLINICAL I WORK IN 

6101
04:11:32,960 --> 04:11:33,280
THERAPEUTICS. 

6102
04:11:33,280 --> 04:11:35,760
THERE IS LOTS OF RESEARCH 

6103
04:11:35,760 --> 04:11:37,560
AROUND THERAPEUTIC DOING WHAT I 

6104
04:11:37,560 --> 04:11:40,240
THINK IT WILL DO AND BRINGING TO

6105
04:11:40,240 --> 04:11:43,200
COMMUNITIES SOONER AND COULD BE 

6106
04:11:43,200 --> 04:11:45,520
RESPECTFUL BEING TOO EARLY AND 

6107
04:11:45,520 --> 04:11:47,320
NAVIGATING THAT AND CASH 

6108
04:11:47,320 --> 04:11:48,600
STRAPPED PERSPECTIVE BEING 

6109
04:11:48,600 --> 04:11:50,440
RESPECTFUL TO ASK COMMUNITY 

6110
04:11:50,440 --> 04:11:54,040
MEMBERS TO BE GIVING TIME AND BE

6111
04:11:54,040 --> 04:11:55,720
RESPECTFUL OF IT BUDGET CAN'T 

6112
04:11:55,720 --> 04:11:57,960
KEEP TO PROGRESS AND SERVE 

6113
04:11:57,960 --> 04:11:59,440
PATIENT LATER AND QUESTION HOW 

6114
04:11:59,440 --> 04:12:01,040
YOU THINK THROUGH WHEN TO ENGAGE

6115
04:12:01,040 --> 04:12:04,760
AND HOW TO NAVIGATE THAT STAGE 

6116
04:12:04,760 --> 04:12:06,000
APPROPRIATENESS MAKING SURE YOU 

6117
04:12:06,000 --> 04:12:08,160
MANAGE YOUR BUDGET AND YOU ARE 

6118
04:12:08,160 --> 04:12:09,120
RESPECTFUL TO PEOPLE ACTUALLY 

6119
04:12:09,120 --> 04:12:11,760
HELPING YOU ALONG THE WAY TOO.  

6120
04:12:11,760 --> 04:12:12,960
THANK YOU. 

6121
04:12:12,960 --> 04:12:13,440
>> GREAT QUESTION. 

6122
04:12:13,440 --> 04:12:15,160
FOR [INDISCERNIBLE] IS PART OF 

6123
04:12:15,160 --> 04:12:16,880
THE REASON WE EXIST AND FINDING 

6124
04:12:16,880 --> 04:12:19,000
COMMUNITY MEMBERS AND SAY IT 

6125
04:12:19,000 --> 04:12:20,120
DOESN'T WORK LIKE THAT.  WE HAVE

6126
04:12:20,120 --> 04:12:21,320
TO ACTUALLY SEE WHAT IS 

6127
04:12:21,320 --> 04:12:22,720
HAPPENING AND WOULD LOVE TO HEAR

6128
04:12:22,720 --> 04:12:24,400
FROM PANELISTS BEFORE I TAKE IT 

6129
04:12:24,400 --> 04:12:26,120
OVER AND THINKING ABOUT WHEN TO 

6130
04:12:26,120 --> 04:12:27,760
ENGAGE AND HOW AND IF SOMEONE IS

6131
04:12:27,760 --> 04:12:29,360
SHOWING UP AND THEY HAVE A 

6132
04:12:29,360 --> 04:12:31,200
PRODUCT WE NEED PRODUCTS THAT 

6133
04:12:31,200 --> 04:12:32,800
ARE ALREADY BUILT AND MIGHT HAVE

6134
04:12:32,800 --> 04:12:35,320
BEEN BUILT SAY INJECTION FOR 

6135
04:12:35,320 --> 04:12:36,720
PRETERM LABOR WITHOUT HAVING 

6136
04:12:36,720 --> 04:12:38,520
COMMUNITY ENGAGED AND WHAT IT 

6137
04:12:38,520 --> 04:12:42,920
LOOKS LIKE POST ENGAGEMENT. 

6138
04:12:42,920 --> 04:12:46,120
>> IS IT OKAY IF I START?

6139
04:12:46,120 --> 04:12:48,240
ALL RIGHT.  REALLY GREAT 

6140
04:12:48,240 --> 04:12:48,480
QUESTION. 

6141
04:12:48,480 --> 04:12:50,560
>> LIFE CYCLE AND LOTS OF

6142
04:12:50,560 --> 04:12:52,040
COMPANIES BEFORE THEY DEVELOP A 

6143
04:12:52,040 --> 04:12:53,920
TECHNOLOGY OR WHEN THEY ARE 

6144
04:12:53,920 --> 04:12:55,440
TRYING TO DETERMINE WHAT TO DO 

6145
04:12:55,440 --> 04:12:57,200
WITH A MOLECULE THAT THEY MAY 

6146
04:12:57,200 --> 04:13:00,200
HAVE A LICENSE TO, THEY DO VOICE

6147
04:13:00,200 --> 04:13:04,080
OF CUSTOMER RESEARCH WITH 

6148
04:13:04,080 --> 04:13:06,160
CLINIC

6149
04:13:06,160 --> 04:13:06,480
CLINICIANS. 

6150
04:13:06,480 --> 04:13:08,080
VERY FEW OF THEM I FIND 

6151
04:13:08,080 --> 04:13:10,880
REPLICATE THAT CUSTOMER PARADIGM

6152
04:13:10,880 --> 04:13:11,920
WITH PATIENTS. 

6153
04:13:11,920 --> 04:13:14,240
THAT IS A VERY SIMPLE WAY TO TRY

6154
04:13:14,240 --> 04:13:16,920
TO CREATE PARITY EARLY ON AND 

6155
04:13:16,920 --> 04:13:18,680
WHENEVER DOING VOICE OF CUSTOMER

6156
04:13:18,680 --> 04:13:20,000
ENGAGEMENT WITH CLINICIANS TO 

6157
04:13:20,000 --> 04:13:21,880
FIND OUT WHAT YOU NEED AND WHAT 

6158
04:13:21,880 --> 04:13:23,840
YOUR PATIENTS NEED AND WOULD YOU

6159
04:13:23,840 --> 04:13:27,240
USE THIS TECHNOLOGY, I THINK 

6160
04:13:27,240 --> 04:13:29,120
BUILDING TO THAT EARLY 

6161
04:13:29,120 --> 04:13:31,240
DEVELOPMENT CYCLE AND PATIENT 

6162
04:13:31,240 --> 04:13:32,880
ENGAGEMENT AND USEE WAYS TO DO 

6163
04:13:32,880 --> 04:13:34,840
IT, YOU KNOW, REACH OUT TO 

6164
04:13:34,840 --> 04:13:35,880
EVERYBODY ON THIS PANEL AND 

6165
04:13:35,880 --> 04:13:39,520
PEOPLE IN THIS ROOM TO HELP THEM

6166
04:13:39,520 --> 04:13:42,640
HELP YOU FIND CONNECTIONS AND 

6167
04:13:42,640 --> 04:13:45,600
FROM A FINANCIAL STANDPOINT, 

6168
04:13:45,600 --> 04:13:48,240
SOMETIMES INDIVIDUALS OR GROUPS 

6169
04:13:48,240 --> 04:13:51,200
HAVE GRANT RESOURCES THAT ARE 

6170
04:13:51,200 --> 04:13:54,640
ABLE TO PARTNER YOU WITH WAYS TO

6171
04:13:54,640 --> 04:13:56,680
PROVIDE INCENTIVE FOR PATIENTS 

6172
04:13:56,680 --> 04:13:59,480
TO REACH TO TALK TO. 

6173
04:13:59,480 --> 04:14:01,280
>> YEAH.  

6174
04:14:01,280 --> 04:14:05,080
>> YEAH.  MY EXPERIENCE I

6175
04:14:05,080 --> 04:14:07,440
WORKED IN EVERYTHING GENETICS TO

6176
04:14:07,440 --> 04:14:11,000
GENOMICS SITTING ON NIH TRIBAL 

6177
04:14:11,000 --> 04:14:13,120
ADVISORY FOR [INDISCERNIBLE] 

6178
04:14:13,120 --> 04:14:16,800
INITIATIVE TO SOCIAL LIFE 

6179
04:14:16,800 --> 04:14:19,800
SCIENCES BECAUSE I'M -- I SERVE 

6180
04:14:19,800 --> 04:14:21,840
MY COMMUNITY IN ANY WAY THEY 

6181
04:14:21,840 --> 04:14:25,360
NEED TO AND INDIGENOUS 

6182
04:14:25,360 --> 04:14:27,840
RESEARCHER PERSPECTIVE -- GATHER

6183
04:14:27,840 --> 04:14:29,800
INFORMATION FROM AMERICAN INDIAN

6184
04:14:29,800 --> 04:14:31,440
ALASKA NATIVE PEOPLE AND THOSE 

6185
04:14:31,440 --> 04:14:34,160
THAT SERVE THEM I MAKE THEM QUIT

6186
04:14:34,160 --> 04:14:36,160
CALLING THEM PATIENTS AND ONLY 

6187
04:14:36,160 --> 04:14:37,720
CALL PEOPLE THAT ACCESS 

6188
04:14:37,720 --> 04:14:38,960
RESOURCES RELATIVE AND SHIFTING 

6189
04:14:38,960 --> 04:14:40,160
WAYS TALKING ABOUT GETTING 

6190
04:14:40,160 --> 04:14:41,920
INFORMATION FROM A RELATIVE THAT

6191
04:14:41,920 --> 04:14:45,280
CHANGES WAY THAT YOU THINK ABOUT

6192
04:14:45,280 --> 04:14:49,000
IT I HAVE SEEN A SHIFT IN WAY 

6193
04:14:49,000 --> 04:14:50,920
THOSE THAT ENGAGE WITH OUR 

6194
04:14:50,920 --> 04:14:52,160
COMMUNITY HAVE TO THINK ABOUT 

6195
04:14:52,160 --> 04:14:53,920
AND ENGAGE WITH PEOPLE AS 

6196
04:14:53,920 --> 04:14:56,160
RELATIVES IT CHANGES THE WAY 

6197
04:14:56,160 --> 04:14:58,160
THAT THEY DO THAT. 

6198
04:14:58,160 --> 04:14:58,880
COMMUNITY ENGAGEMENT IS 

6199
04:14:58,880 --> 04:15:00,400
CONTINUOUS AND CAN'T BE 

6200
04:15:00,400 --> 04:15:02,880
DEPENDENT ON A BUDGET I WORK AD 

6201
04:15:02,880 --> 04:15:04,520
CROSS EVERY NIH GRANT THERE IS 

6202
04:15:04,520 --> 04:15:06,720
AND AT THIS TIME WILL IS 16 

6203
04:15:06,720 --> 04:15:07,920
INSTITUTES AND IF WE ONLY THINK 

6204
04:15:07,920 --> 04:15:09,640
ABOUT COMMUNITY ENGAGEMENT BASED

6205
04:15:09,640 --> 04:15:10,760
IN BUDGET I UNDERSTAND WHAT YOU 

6206
04:15:10,760 --> 04:15:13,400
ARE TALKING ABOUT IN TERMS OF 

6207
04:15:13,400 --> 04:15:14,160
INCENTIVES, ET CETERA. 

6208
04:15:14,160 --> 04:15:16,360
COMMUNITY NEEDS TO SEE YOU 

6209
04:15:16,360 --> 04:15:17,360
CONTINUOUSLY SHOW UP AND HIRE 

6210
04:15:17,360 --> 04:15:19,520
PEOPLE WHO ARE REPRESENTATIVE OF

6211
04:15:19,520 --> 04:15:20,680
THE COMMUNITIES AND 

6212
04:15:20,680 --> 04:15:24,800
REPRESENTATION MATTERS SO YOU 

6213
04:15:24,800 --> 04:15:26,400
ENGAGED COMMUNITY PERSPECTIVE.  

6214
04:15:26,400 --> 04:15:28,240
WE ARE SCIENTISTS AND HAVE 

6215
04:15:28,240 --> 04:15:30,240
KNOWLEDGE AND LOTS OF TIMES 

6216
04:15:30,240 --> 04:15:34,080
BASED ON STRUCTURAL RACISM AND 

6217
04:15:34,080 --> 04:15:35,480
REASON WE DON'T EXIST ON TEAMS 

6218
04:15:35,480 --> 04:15:37,560
HIRING IS DONE IS NOT ENGAGING 

6219
04:15:37,560 --> 04:15:42,160
US IN APPROPRIATE WAY TO TRULY 

6220
04:15:42,160 --> 04:15:44,320
PARTICIPATE RECOGNIZING 

6221
04:15:44,320 --> 04:15:46,400
COMMUNITY ENGAGEMENT IS LONG 

6222
04:15:46,400 --> 04:15:50,080
TERM NOT BASED ON 3 OR 5 YEAR 

6223
04:15:50,080 --> 04:15:51,160
GRANT. 

6224
04:15:51,160 --> 04:15:56,720
I HELPED TO START ONE VERY FIRST

6225
04:15:56,720 --> 04:16:03,640
GRANT RESEARCH PROJECT CAME FROM

6226
04:16:03,640 --> 04:16:06,480
REQUEST SERVE YEARS PRIOR AND 

6227
04:16:06,480 --> 04:16:10,080
WORKING WITH ACUTELY SUICIDAL 

6228
04:16:10,080 --> 04:16:11,880
AMERICAN INDIANS AND ALASKA 

6229
04:16:11,880 --> 04:16:13,440
NATIVES LONG TERM ENGAGEMENT 

6230
04:16:13,440 --> 04:16:16,000
PROMISE TO COMMUNITY DOING IN 

6231
04:16:16,000 --> 04:16:17,400
WAY THAT WAS APPROPRIATE TO THEM

6232
04:16:17,400 --> 04:16:19,440
WAS PART OF THAT AND BUILDING 

6233
04:16:19,440 --> 04:16:21,800
LONG TERM COMMUNITY RIGHT NOW 

6234
04:16:21,800 --> 04:16:23,160
I'M WORKING WITH FOLKS WHO THEY 

6235
04:16:23,160 --> 04:16:25,640
HAVE BEEN VESTED SO LONG TERM 

6236
04:16:25,640 --> 04:16:28,040
AND DR. PERRY SAID THERE IS A 

6237
04:16:28,040 --> 04:16:30,000
DEVICE ALREADY CREATED AND ABLE 

6238
04:16:30,000 --> 04:16:31,160
TO GO AND GATHER INFORMATION IN 

6239
04:16:31,160 --> 04:16:33,640
LESS THAN A COUPLE MONTHS 

6240
04:16:33,640 --> 04:16:35,040
BECAUSE OF LONG TERM 

6241
04:16:35,040 --> 04:16:37,040
RELATIONSHIP THEY ESTABLISHED 

6242
04:16:37,040 --> 04:16:40,080
AND BE READY AND KNOW THERE IS 

6243
04:16:40,080 --> 04:16:41,920
INCREDIBLE OUTCOMES AS A RESULT 

6244
04:16:41,920 --> 04:16:43,880
OF PUTTING IN LONG TERM 

6245
04:16:43,880 --> 04:16:45,360
ENGAGEMENT AND THAT RESULTS IN 

6246
04:16:45,360 --> 04:16:49,000
WHAT WE ARE ALL HOPING TO SEE 

6247
04:16:49,000 --> 04:16:52,040
AND WON'T HAPPEN QUICKLY. 

6248
04:16:52,040 --> 04:16:53,120
>> MIC NO. 1. 

6249
04:16:53,120 --> 04:16:53,960
>> OKAY. 

6250
04:16:53,960 --> 04:17:00,200
>> HI.  MY NAME IS
ADRIANA SOTO

6251
04:17:00,200 --> 04:17:02,960
AND FOUNDER OF MINE PLUS A 

6252
04:17:02,960 --> 04:17:06,320
START-UP IN MIAMI AND HAVE BLACK

6253
04:17:06,320 --> 04:17:09,320
AND BROWN WOMAN WITH HIGH RISK 

6254
04:17:09,320 --> 04:17:11,360
PREGNANCIES WITH MENTAL HEALTH 

6255
04:17:11,360 --> 04:17:14,720
FOCUS AND MY EXPERIENCE WORKING 

6256
04:17:14,720 --> 04:17:17,800
WITH UNDERSERVED POPULATIONS AND

6257
04:17:17,800 --> 04:17:22,720
QUESTION IS ABOUT HOW YOU COULD 

6258
04:17:22,720 --> 04:17:28,400
GUARANTEE OTHERANCE AND 

6259
04:17:28,400 --> 04:17:30,160
SUSTAINABILITY OVER TIME WITH 

6260
04:17:30,160 --> 04:17:33,520
POPULATION THAT DOESN'T HAVE 

6261
04:17:33,520 --> 04:17:36,120
SMARTPHONES OR WEARABLES AND 

6262
04:17:36,120 --> 04:17:40,120
EVERYTHING LOOKS SUPER NICE AND 

6263
04:17:40,120 --> 04:17:42,200
PROBLEM AND I DON'T HAVE ENOUGH 

6264
04:17:42,200 --> 04:17:45,040
SPACE AND SMARTPHONE IS SUPER 

6265
04:17:45,040 --> 04:17:49,400
OLD AND DON'T HAVE WI-FI AND 

6266
04:17:49,400 --> 04:17:50,800
EVERYBODY HAS APPS AND DOESN'T 

6267
04:17:50,800 --> 04:17:53,040
CARE ABOUT THIS FUNDAMENTAL 

6268
04:17:53,040 --> 04:18:00,960
PROBLEM AND GO BACK AND MAKE WEB

6269
04:18:00,960 --> 04:18:02,360
APP FOR EXAMPLE. 

6270
04:18:02,360 --> 04:18:04,520
NOT JUST YOU AND OTHER PANELISTS

6271
04:18:04,520 --> 04:18:09,800
ARE SHOWING VERY BEAUTIFUL APPS.

6272
04:18:09,800 --> 04:18:11,040
YOU KNOW?  

6273
04:18:11,040 --> 04:18:14,240
HOW DEAL WITH THAT?  

6274
04:18:14,240 --> 04:18:16,480
>> BROADBAND AND RURAL
AMERICA 

6275
04:18:16,480 --> 04:18:18,200
AND GETTING WI-FI. 

6276
04:18:18,200 --> 04:18:20,280
>> PANEL, WE HAVE COME
ACROSS 

6277
04:18:20,280 --> 04:18:23,680
THAT AND DEVELOPED APP PM3 FOR 

6278
04:18:23,680 --> 04:18:26,480
ME PART OF POSTPARTUM APP AND A 

6279
04:18:26,480 --> 04:18:29,720
LOT IS DOG WEB DESIGN AND 

6280
04:18:29,720 --> 04:18:32,880
ENSURING IF YOU DON'T HAVE 

6281
04:18:32,880 --> 04:18:35,600
BROADBAND ACCESS STHAU HAVE AND 

6282
04:18:35,600 --> 04:18:38,480
CAN ACCESS RESOURCES AND TOOLS 

6283
04:18:38,480 --> 04:18:42,400
FOR IT AND GOING GLOBAL USING 

6284
04:18:42,400 --> 04:18:49,240
THE WEB AND BUILDING IN RESEARCH

6285
04:18:49,240 --> 04:18:51,240
BUILDING IN INFRASTRUCTURE TO 

6286
04:18:51,240 --> 04:18:53,760
PURCHASE PHONES AND THINGS 

6287
04:18:53,760 --> 04:18:56,680
COMMUNITIES NEED THAT IS BIG 

6288
04:18:56,680 --> 04:18:57,520
INCENTIVE FOR THEM TO 

6289
04:18:57,520 --> 04:18:59,760
PARTICIPATE IN RESEARCH AND 

6290
04:18:59,760 --> 04:19:01,120
SUSTAINING THAT THEY ACTUALLY 

6291
04:19:01,120 --> 04:19:08,160
GET SOMETHING OUT OF AS WELL. 

6292
04:19:08,160 --> 04:19:10,440
THOSE ARE TWO EXAMPLES AND 

6293
04:19:10,440 --> 04:19:11,920
PANELISTS THAT ARE FELLOWS MIGHT

6294
04:19:11,920 --> 04:19:13,040
HAVE SOME AS WELL. 

6295
04:19:13,040 --> 04:19:18,760
>> I'M IN MIAMI TOO.  WE
NEED 

6296
04:19:18,760 --> 04:19:19,080
TO CONNECT. 

6297
04:19:19,080 --> 04:19:20,640
>> WE UTILIZE WEB AND APP
AND 

6298
04:19:20,640 --> 04:19:23,680
WE HAVE PHONE CALLS AND TEXTING 

6299
04:19:23,680 --> 04:19:26,080
AND WE USE MULTIPLE PATHWAYS TO 

6300
04:19:26,080 --> 04:19:28,960
REACH WOMEN IN A NUMBER OF WAYS.

6301
04:19:28,960 --> 04:19:31,240
WHICHEVER IS EASIEST FOR THEM TO

6302
04:19:31,240 --> 04:19:33,800
ACCESS CARE AND NAVIGATION AND 

6303
04:19:33,800 --> 04:19:36,240
SUPPORT AND THAT.  WE USE ALL OF

6304
04:19:36,240 --> 04:19:36,440
IT.  

6305
04:19:36,440 --> 04:19:41,360
>> I THINK SHE MENTIONED
THAT 

6306
04:19:41,360 --> 04:19:42,040
PERSISTENCE. 

6307
04:19:42,040 --> 04:19:44,160
PEOPLE'S PHONES GET CUT OFF AND 

6308
04:19:44,160 --> 04:19:46,080
FIGURE OUT AND CALL CUZZIN AND 

6309
04:19:46,080 --> 04:19:49,080
TOLD TO WRAP UP AND APOLOGIZE. 

6310
04:19:49,080 --> 04:19:54,200
WE WILL BE AUP HERE FOR 

6311
04:19:54,200 --> 04:19:55,760
QUESTIONS AND BROUGHT YOU TO 

6312
04:19:55,760 --> 04:19:57,280
INFORMATION TO FEEL COMFORTABLE 

6313
04:19:57,280 --> 04:19:59,080
WITH AND THESE WORDS ARE NOT 

6314
04:19:59,080 --> 04:20:02,320
COMMONLY SAID IN HOMES I'M AWARE

6315
04:20:02,320 --> 04:20:04,680
OF THAT I OPEN MY MOUTH IN ANY 

6316
04:20:04,680 --> 04:20:06,240
SETTING AND I'M CLEARLY AWARE 

6317
04:20:06,240 --> 04:20:07,960
THIS IS NO THE SOMETHING 

6318
04:20:07,960 --> 04:20:09,960
HAPPENING FREQUENTLY WITH 

6319
04:20:09,960 --> 04:20:10,920
NATIONAL INSTITUTES OF HEALTH 

6320
04:20:10,920 --> 04:20:13,280
AND FOR US TO THRIVE WE 

6321
04:20:13,280 --> 04:20:14,360
RECOGNIZE OUR CURRENT MOMENT AND

6322
04:20:14,360 --> 04:20:15,760
WORLD WE ARE IN AND THOSE THAT 

6323
04:20:15,760 --> 04:20:17,480
WE NEED TO BE ABLE TO SAY 

6324
04:20:17,480 --> 04:20:19,600
WITHOUT FEELING SHAMED OR GUILD 

6325
04:20:19,600 --> 04:20:22,600
AND TRUTHFULLY WE ARE RELATIVES 

6326
04:20:22,600 --> 04:20:24,520
AS MY SISTER ABIGAIL SAID AND 

6327
04:20:24,520 --> 04:20:26,200
ONE HUMAN RACE AND FOR US TO 

6328
04:20:26,200 --> 04:20:28,560
THRIVE WE HAVE TO BE ABLE TO 

6329
04:20:28,560 --> 04:20:30,320
UNDERSTAND ROOT CAUSES OF 

6330
04:20:30,320 --> 04:20:32,000
INEQUITY OF HEALTH AND WORK 

6331
04:20:32,000 --> 04:20:34,160
TOGETHER SO SECNOLOGY IS NOT 

6332
04:20:34,160 --> 04:20:38,520
USED TO HARM US BUT TO ENSURE WE

6333
04:20:38,520 --> 04:20:39,120
CAN ALL THRIVE.  THANKS VERY 

6334
04:20:39,120 --> 04:21:03,200
MUCH.  

6335
04:21:03,200 --> 04:21:05,480
>> OBJECTIVE OF PANEL IS
TO 

6336
04:21:05,480 --> 04:21:08,200
DISCUSS IMPORTANCE OF TECHNOLOGY

6337
04:21:08,200 --> 04:21:14,920
AND USING IMPLEMENTATION OF 

6338
04:21:14,920 --> 04:21:17,600
SCIENCE AND THIS PANEL CAME OUT 

6339
04:21:17,600 --> 04:21:21,200
OF A RECOGNIZED NEED AS 

6340
04:21:21,200 --> 04:21:24,120
TECHNOLOGY DEVELOPERS AND 

6341
04:21:24,120 --> 04:21:29,600
BUILDING PRODUCTS IN REAL WORLD 

6342
04:21:29,600 --> 04:21:32,280
-- EXIST FOR WIDESCALE UPTAKE 

6343
04:21:32,280 --> 04:21:33,800
AND TECHNOLOGY AND PANEL 

6344
04:21:33,800 --> 04:21:35,760
DISCUSSION WILL INCLUDE HOW TO 

6345
04:21:35,760 --> 04:21:37,000
USE IMPLEMENTATION SCIENCE AND 

6346
04:21:37,000 --> 04:21:38,840
TECHNOLOGY FOR MATERNAL HEALTH 

6347
04:21:38,840 --> 04:21:40,760
AND DIVERSE POPULATIONS AND LOOK

6348
04:21:40,760 --> 04:21:42,120
FORWARD TO ENGAGING PANEL THAT 

6349
04:21:42,120 --> 04:21:45,280
WILL BE MODERATED BY DAVE CLARK 

6350
04:21:45,280 --> 04:21:46,520
CHIEF IMPLEMENTATION SCIENCE 

6351
04:21:46,520 --> 04:21:50,600
BRANCH AT NATIONAL HEART, LUNG, 

6352
04:21:50,600 --> 04:21:51,760
AND BLOOD INSTITUTE AND DAVE HAS

6353
04:21:51,760 --> 04:21:54,240
A LONG HISTORY WORKING IN NUMBER

6354
04:21:54,240 --> 04:22:04,760
OF PROJECTS AND PROGRAMS AND WE 

6355
04:22:10,200 --> 04:22:12,440
LOOK FORWARD TO HEARING FROM OUR

6356
04:22:12,440 --> 04:22:15,240
PANELIST SGLZ THANK YOU CO-LEAD 

6357
04:22:15,240 --> 04:22:17,600
WITH KAREN IN THE PANEL AND 

6358
04:22:17,600 --> 04:22:20,680
GREETINGS, EVERYONE.  THANK YOU 

6359
04:22:20,680 --> 04:22:22,320
FOR STICKING AROUND. 

6360
04:22:22,320 --> 04:22:24,760
BEFORE INTRODUCE PANEL MEMBERS A

6361
04:22:24,760 --> 04:22:26,920
FEW THINGS TO KICK OFF AND FIRST

6362
04:22:26,920 --> 04:22:28,800
FOR ORGANIZERS AND OPPORTUNITY 

6363
04:22:28,800 --> 04:22:30,280
TO PRESENT WITH AMAZING PANEL 

6364
04:22:30,280 --> 04:22:32,880
TODAY AND THANK YOU TO THE 

6365
04:22:32,880 --> 04:22:34,840
AUDIENCE FOR OUTSTANDING 

6366
04:22:34,840 --> 04:22:36,160
IMPLEMENTATION SCIENCE QUESTIONS

6367
04:22:36,160 --> 04:22:38,400
YOU ASKED ALREADY AND THUMBS UP 

6368
04:22:38,400 --> 04:22:40,760
TO YOU AND THANKS TO THE 

6369
04:22:40,760 --> 04:22:45,680
PREVIOUS PANEL FOR PILOT TESTING

6370
04:22:45,680 --> 04:22:55,880
THE KINKS. 

6371
04:22:56,640 --> 04:22:58,400
WE WILL HAVE TWO QUICK PANELS 

6372
04:22:58,400 --> 04:23:00,480
FROM THE PANELISTS TO CALIBRATE 

6373
04:23:00,480 --> 04:23:02,040
THE SESSION AND QUESTION OF 

6374
04:23:02,040 --> 04:23:03,720
SESSIONS TO POSE TO PANEL AND 

6375
04:23:03,720 --> 04:23:05,360
WILL DO BEST TO MAKE SURE TO 

6376
04:23:05,360 --> 04:23:07,280
SAVE TIME AT END FOR QUESTIONS 

6377
04:23:07,280 --> 04:23:09,120
FROM AUDIENCE BOTH PHYSICAL AND 

6378
04:23:09,120 --> 04:23:11,040
VIRTUAL AND I WILL START GIVING 

6379
04:23:11,040 --> 04:23:14,120
A FEW SUPER BRIEF INTRODUCTIONS 

6380
04:23:14,120 --> 04:23:15,760
FOR THE PANEL AND FULL AND 

6381
04:23:15,760 --> 04:23:24,640
AMAZING BIOS ARE FOUND IN 

6382
04:23:24,640 --> 04:23:25,280
MEETING MATERIALS AND SHAMEFUL 

6383
04:23:25,280 --> 04:23:29,280
TRUTH COMES OUT AND BIOFOR DR. 

6384
04:23:29,280 --> 04:23:30,200
ACCEPT UL VEDA IS OUTDATED AND 

6385
04:23:30,200 --> 04:23:32,760
WHEN SHE IS WORKING ON DOCTORATE

6386
04:23:32,760 --> 04:23:35,880
AND GRADUATING 2017 I HAVE GOOD 

6387
04:23:35,880 --> 04:23:36,760
NEWS AND CONGRATULATIONS AND I 

6388
04:23:36,760 --> 04:23:39,960
WILL TALK ABOUT THAT MORE IN A 

6389
04:23:39,960 --> 04:23:40,440
MOMENT. 

6390
04:23:40,440 --> 04:23:42,920
SO, FIRST OF ALL LET ME START I 

6391
04:23:42,920 --> 04:23:44,440
WILL RANDOMIZE AND DECIDE TO GO 

6392
04:23:44,440 --> 04:23:46,320
IN THE ORDER THAT IS GIVEN TO ME

6393
04:23:46,320 --> 04:23:48,680
AND FIRST I WILL START 

6394
04:23:48,680 --> 04:23:50,080
INTRODUCING KATE WHO IS 

6395
04:23:50,080 --> 04:23:54,120
PROFESSOR OF OBSTETRICS AND 

6396
04:23:54,120 --> 04:23:57,360
GYNECOLOGY AT UNIVERSITY OF 

6397
04:23:57,360 --> 04:23:58,360
NORTH CAROLINA IN SCHOOL OF 

6398
04:23:58,360 --> 04:23:59,880
MEDICINE AND HAVE PRIVILEGE OF 

6399
04:23:59,880 --> 04:24:02,680
WORKING WITH HER AND HER TEAM IN

6400
04:24:02,680 --> 04:24:06,560
HER WORK AND WELCOME, KATE.  

6401
04:24:06,560 --> 04:24:11,560
NEXT UP IS APPLE ACCEPT UL VEDA 

6402
04:24:11,560 --> 04:24:14,120
PROFESSOR AND VICE CHAIR FOR 

6403
04:24:14,120 --> 04:24:16,480
EQUITY AND INCLUSION AT 

6404
04:24:16,480 --> 04:24:18,200
UNIVERSITY OF SCHOOL OF 

6405
04:24:18,200 --> 04:24:22,120
MEDICINE, APPLE.  APPLE IS AN 

6406
04:24:22,120 --> 04:24:24,640
OCCUPATIONAL THERAPIST WHO 

6407
04:24:24,640 --> 04:24:30,120
BRANCHED OUT SHE IS A PEDIATRIC 

6408
04:24:30,120 --> 04:24:32,880
OCCUPATIONAL THERAPIST AND IS 

6409
04:24:32,880 --> 04:24:37,120
CURRENTLY AS WE KNOW ONE PHD IS 

6410
04:24:37,120 --> 04:24:44,480
NEVER ENOUGH. 

6411
04:24:44,480 --> 04:24:46,600
WELCOME, APPLE.  NEXT UP IS 

6412
04:24:46,600 --> 04:24:52,760
SONYA WHO IS DIRECTOR OF RENÉ --

6413
04:24:52,760 --> 04:24:54,920
RESEARCH FOCUSES CULTIVATING 

6414
04:24:54,920 --> 04:25:01,040
MATERNAL HEALTH AND WELLNESS ENL

6415
04:25:01,040 --> 04:25:03,400
ENGAGING CAPACITIES FOR LEARNED 

6416
04:25:03,400 --> 04:25:06,400
COMMUNITIES AND WELCOME AND 

6417
04:25:06,400 --> 04:25:08,720
SAVING BEST FOR LAST PERHAPS AND

6418
04:25:08,720 --> 04:25:12,880
NEXT IS ELIZABETH WHO IS 

6419
04:25:12,880 --> 04:25:15,480
HARRISON DISTINGUISHED PROFESSOR

6420
04:25:15,480 --> 04:25:20,560
AND CHAIR OF DEPARTMENT AND 

6421
04:25:20,560 --> 04:25:27,040
OBSTETRICS OF. 

6422
04:25:27,040 --> 04:25:32,080
I'M HAPPY FOR THE CHANCE TO HAVE

6423
04:25:32,080 --> 04:25:34,240
HER AND THAT BEING SAID WE WILL 

6424
04:25:34,240 --> 04:25:36,320
KICK OFF FIRST TALK AND WILL 

6425
04:25:36,320 --> 04:25:42,480
HAVE DR. MENARD TO GIVE A BRIEF 

6426
04:25:42,480 --> 04:25:45,600
INTRODUCTION TO CAL BRAELT US ON

6427
04:25:45,600 --> 04:25:48,520
IMPLEMENTATION SCIENCE IN 

6428
04:25:48,520 --> 04:25:52,120
CONTEXT OF MATERNAL HEALTH.  

6429
04:25:52,120 --> 04:25:55,960
>> COULD YOU PLEASE BRING
UP MY

6430
04:25:55,960 --> 04:25:58,560
SLIDES FOR ME?  

6431
04:25:58,560 --> 04:26:00,080
>> THAFRMGS YOU FOR
INVITING ME

6432
04:26:00,080 --> 04:26:01,960
TO BE HERE.  GOING TO NEXT 

6433
04:26:01,960 --> 04:26:03,040
SLIDE, PLEASE. 

6434
04:26:03,040 --> 04:26:06,080
STARTING WITH DISCLOSURES AND 

6435
04:26:06,080 --> 04:26:08,600
ASKED TO GIVE BRIEF ON 

6436
04:26:08,600 --> 04:26:10,240
INMREMENTATION SCIENCE BUT NOT 

6437
04:26:10,240 --> 04:26:11,720
EXPERT IN IMPLEMENTATION SCIENCE

6438
04:26:11,720 --> 04:26:13,440
AND STUDENT OF THIS WORK AND 

6439
04:26:13,440 --> 04:26:16,320
VERY MUCH A FAN OF THIS WAY OF 

6440
04:26:16,320 --> 04:26:18,400
THINKING.  I'M A CONVERT AND 

6441
04:26:18,400 --> 04:26:19,400
WORKING IN IMPLEMENTATION 

6442
04:26:19,400 --> 04:26:22,880
SCIENCE AND SPACE IN MY ENTIRE 

6443
04:26:22,880 --> 04:26:25,960
CAREER FOCUSING ON SUPPORTING 

6444
04:26:25,960 --> 04:26:27,600
SYSTEMS FOR EFFECTIVE MATERNITY 

6445
04:26:27,600 --> 04:26:29,520
CARE AND QUALITY IMPROVEMENT IN 

6446
04:26:29,520 --> 04:26:32,160
PAST FIVE OR SO YEARS THAT I 

6447
04:26:32,160 --> 04:26:33,280
HAVE COME TO APPRECIATE VALUE 

6448
04:26:33,280 --> 04:26:35,720
AND RIGOR THAT IMPLEMENTATION 

6449
04:26:35,720 --> 04:26:37,440
SCIENCE BRINGS AND PERHAPS AN 

6450
04:26:37,440 --> 04:26:39,560
OKAY PERSON TO INTRODUCE TO 

6451
04:26:39,560 --> 04:26:41,320
FOLKS WHO DON'T REALLY WORK IN 

6452
04:26:41,320 --> 04:26:42,560
THIS SPACE AND WANT TO LEARN 

6453
04:26:42,560 --> 04:26:43,600
ABOUT IT.  

6454
04:26:43,600 --> 04:26:46,080
THOSE THAT DO, CHECK E-MAIL OR 

6455
04:26:46,080 --> 04:26:47,080
SOMETHING AND COME BACK TO ME IN

6456
04:26:47,080 --> 04:26:50,720
EIGHT MINUTES WHEN I TELL YOU 

6457
04:26:50,720 --> 04:26:54,800
ABOUT OUR PROJECT. 

6458
04:26:54,800 --> 04:26:56,400
YOU MIGHT READ NEXT SLIDE, 

6459
04:26:56,400 --> 04:26:56,720
PLEASE. 

6460
04:26:56,720 --> 04:26:58,360
ONE MIGHT READ A NUMBER THAT I 

6461
04:26:58,360 --> 04:27:01,560
WILL GO OVER AMD IT IS A FEW 

6462
04:27:01,560 --> 04:27:04,600
DEFINITIONS AND A LITTLE ABOUT 

6463
04:27:04,600 --> 04:27:14,840
OUR PROJECT. 

6464
04:27:28,640 --> 04:27:30,400
CONDITIONS TO SUCCESSFULLY 

6465
04:27:30,400 --> 04:27:31,800
IMPLEMENT AND SUSTAIN NEW 

6466
04:27:31,800 --> 04:27:34,840
PROGRAMS AND INNOVATIONS AND 

6467
04:27:34,840 --> 04:27:37,360
OPERATIVE WORSE IS A PROCESS 

6468
04:27:37,360 --> 04:27:38,880
RESULTING IN SUSTAINABLE CHANGE 

6469
04:27:38,880 --> 04:27:40,840
AND NEXT SLIDE.  IT HAS BEEN 

6470
04:27:40,840 --> 04:27:42,720
WIDELY REPORTED THAT 

6471
04:27:42,720 --> 04:27:43,960
EVIDENCE-BASED PRACTICES TAKE 

6472
04:27:43,960 --> 04:27:46,440
AVERAGE OF 17 YEARS TO BE 

6473
04:27:46,440 --> 04:27:47,640
INCORPORATED INTO ROUTINE 

6474
04:27:47,640 --> 04:27:49,160
GENERAL PRACTICE AND HEALTH CARE

6475
04:27:49,160 --> 04:27:51,160
AND CAN'T WORK WITH THAT AND 

6476
04:27:51,160 --> 04:27:53,080
EVEN WITH THAT TIMEFRAME, A 

6477
04:27:53,080 --> 04:27:55,160
SMALL FRACTION ARE REALLY FULLY 

6478
04:27:55,160 --> 04:27:56,600
IMPLEMENTED FOR POPULATION 

6479
04:27:56,600 --> 04:27:59,920
BENEFIT IN SUSTAINABLE MANNER 

6480
04:27:59,920 --> 04:28:01,720
AND THIS DIAGRAM TAKES IF THERE 

6481
04:28:01,720 --> 04:28:06,160
IS 100% EFFECTIVE EVIDENCE-BASED

6482
04:28:06,160 --> 04:28:08,680
INTERVENTION ABOUT 50% OF 

6483
04:28:08,680 --> 04:28:11,440
PROVIDERS IN ORGANIZATIONS 

6484
04:28:11,440 --> 04:28:11,760
ADOPTED. 

6485
04:28:11,760 --> 04:28:16,440
NOW WE ARE DOWN TO 50 AND 50% OF

6486
04:28:16,440 --> 04:28:18,000
THOSE ADOPTED DO IT WITH 

6487
04:28:18,000 --> 04:28:20,240
FEDELITY AND DO IT RIGHT AND ARE

6488
04:28:20,240 --> 04:28:23,720
DOWN TO 25 AND 50% OF THOSE 

6489
04:28:23,720 --> 04:28:25,240
REACH DOWN TO POPULATION THAT 

6490
04:28:25,240 --> 04:28:27,120
NEED IT MOST AND NOW WE ARE DOWN

6491
04:28:27,120 --> 04:28:32,800
TO 6 THAT IS ABYSMAL IN COMES 

6492
04:28:32,800 --> 04:28:34,720
IMPLEMENTATION SCIENCE TO 

6493
04:28:34,720 --> 04:28:38,120
IMPROVE ON ABYSMAL 6% FULL 

6494
04:28:38,120 --> 04:28:38,520
IMPLEMENTATION. 

6495
04:28:38,520 --> 04:28:39,480
NEXT SLIDE. 

6496
04:28:39,480 --> 04:28:41,920
SO, WHAT IS IMPLEMENTATION 

6497
04:28:41,920 --> 04:28:42,880
SCIENCE?  

6498
04:28:42,880 --> 04:28:44,280
IMPLEMENTATION SCIENCE IS, 

6499
04:28:44,280 --> 04:28:48,000
AGAIN, YOU WILL HEAR DIFFERENT 

6500
04:28:48,000 --> 04:28:50,800
DEFINITIONS THAT IS A SYSTEMATIC

6501
04:28:50,800 --> 04:28:53,080
STUDY OF VARIABLES AND 

6502
04:28:53,080 --> 04:28:54,480
CONDITIONS LEADING TO FULL AND 

6503
04:28:54,480 --> 04:28:57,480
EFFECTIVE USE OF EVIDENCE-BASED 

6504
04:28:57,480 --> 04:28:58,640
PROGRAMS AND EFFECTIVE 

6505
04:28:58,640 --> 04:29:00,640
INTERVENTIONS IN TYPICAL HUMAN 

6506
04:29:00,640 --> 04:29:02,640
SETTINGS STUDYING THINGS IN A 

6507
04:29:02,640 --> 04:29:05,440
FISH BOWL AND CLINICAL TRIAL 

6508
04:29:05,440 --> 04:29:06,600
LABORATORY SORT OF SETTING AND 

6509
04:29:06,600 --> 04:29:08,760
FIGURING OUT HOW TO GET INTO A 

6510
04:29:08,760 --> 04:29:13,320
TYPICAL KIND OF HUMAN SERVICE 

6511
04:29:13,320 --> 04:29:13,600
SETTING. 

6512
04:29:13,600 --> 04:29:14,560
NEXT SLIDE. 

6513
04:29:14,560 --> 04:29:16,880
THIS IS A REAL SIMPLE WAY OF 

6514
04:29:16,880 --> 04:29:19,280
THINKING ABOUT IT.  CLEAR AND 

6515
04:29:19,280 --> 04:29:22,000
BASIC ACHIEVING WHY WHICH IS 

6516
04:29:22,000 --> 04:29:24,200
IMPROVED MATERNAL CHILD AND 

6517
04:29:24,200 --> 04:29:26,640
FAMILY COMMUNITY OUTCOMES THEN 

6518
04:29:26,640 --> 04:29:29,360
WE NEED THE WHAT THAT IS 

6519
04:29:29,360 --> 04:29:30,760
EFFECTIVE INTERVENTION 

6520
04:29:30,760 --> 04:29:31,960
EVIDENCE-BASED INTERVENTION AND 

6521
04:29:31,960 --> 04:29:34,320
WE NEED EFFECTIVE IMPLEMENTATION

6522
04:29:34,320 --> 04:29:36,680
AND THAT IS THE HOW.  HOW WE GO 

6523
04:29:36,680 --> 04:29:39,520
ABOUT DOING IT AND WE NEED 

6524
04:29:39,520 --> 04:29:41,080
ENABLING CONTEXT WHO AND WHERE 

6525
04:29:41,080 --> 04:29:44,400
AND IF ANY BOXES IN PURPLE ARE 

6526
04:29:44,400 --> 04:29:47,640
ZERO AND IF WE DON'T HAVE HOW OR

6527
04:29:47,640 --> 04:29:49,840
AN EFFECTIVE HOUSE OR DON'T HAVE

6528
04:29:49,840 --> 04:29:51,160
EFFECTIVE IMPLEMENTATION CONTEXT

6529
04:29:51,160 --> 04:29:54,320
AND THOSE ARE 0S, WHY IS 0.  IF 

6530
04:29:54,320 --> 04:29:57,440
ANY IS SMALL OR MARGINALLY 

6531
04:29:57,440 --> 04:29:59,320
OPERATIVE, WE HAVE A VERY SMALL 

6532
04:29:59,320 --> 04:30:01,880
MAGNITUDE OF THE WHY.  

6533
04:30:01,880 --> 04:30:05,360
SO THIS IS WHERE IMPLEMENTATION 

6534
04:30:05,360 --> 04:30:07,880
SCIENCE COMES IN TO KIND OF MAKE

6535
04:30:07,880 --> 04:30:09,960
MIDDLE BOXES NICE AND ROBUST.  

6536
04:30:09,960 --> 04:30:11,280
NEXT SLIDE, PLEASE. 

6537
04:30:11,280 --> 04:30:14,560
THERE IS A LOT OF DIFFERENT VERY

6538
04:30:14,560 --> 04:30:16,320
THOUGHTFUL AND PROVEN FRAMEWORKS

6539
04:30:16,320 --> 04:30:18,720
FOR IMPLEMENTATION SCIENCE AND 

6540
04:30:18,720 --> 04:30:20,560
PRACTICE AND CUT MY TEETH ON 

6541
04:30:20,560 --> 04:30:23,120
ACTIVE IMPLEMENTATION FRAMEWORK 

6542
04:30:23,120 --> 04:30:25,160
WHICH IS DESCRIBED BYTISMED 

6543
04:30:25,160 --> 04:30:26,000
[INDISCERNIBLE] AND COLLEAGUES 

6544
04:30:26,000 --> 04:30:30,600
AT UNC AND IN THIS KIND OF 

6545
04:30:30,600 --> 04:30:32,920
PROVIDING DIAGRAMISTS COMPLEX 

6546
04:30:32,920 --> 04:30:36,440
AND SIMPLE AT SAME TIME 

6547
04:30:36,440 --> 04:30:36,720
STRUCTURE. 

6548
04:30:36,720 --> 04:30:39,080
HERE INCLUDES A LOT OF DETAIL 

6549
04:30:39,080 --> 04:30:40,800
TAKING USABLE INTERVENTION ON 

6550
04:30:40,800 --> 04:30:42,800
FAR LEFT DESCRIBING IT WELL AND 

6551
04:30:42,800 --> 04:30:44,720
GOING THROUGH A STAGE-BASED 

6552
04:30:44,720 --> 04:30:46,640
PROCESS OF PUTTING IT INTO 

6553
04:30:46,640 --> 04:30:49,080
PRACTICE AND IS ONE OF MANY 

6554
04:30:49,080 --> 04:30:49,480
FRAMEWORKS. 

6555
04:30:49,480 --> 04:30:50,520
NEXT SLIDE. 

6556
04:30:50,520 --> 04:30:55,320
AT THE CORE, AT LEAST IN MY 

6557
04:30:55,320 --> 04:30:59,160
VIEW, VARIOUS FRAMEWORKS ARE ALL

6558
04:30:59,160 --> 04:31:01,160
SIMILAR AND THE [INDISCERNIBLE] 

6559
04:31:01,160 --> 04:31:02,560
ARE DIFFERENT AND BUILD UPON 

6560
04:31:02,560 --> 04:31:04,400
EACH OTHER AND IMPLEMENTATION 

6561
04:31:04,400 --> 04:31:06,680
SCIENCE ONE BEGINS WITH 

6562
04:31:06,680 --> 04:31:07,520
EVIDENCE-BASED INTERVENTION, 

6563
04:31:07,520 --> 04:31:09,560
ALWAYS THAT.  THAT IS THE WHAT; 

6564
04:31:09,560 --> 04:31:10,040
RIGHT?  

6565
04:31:10,040 --> 04:31:12,200
HOW IS IT IMPLEMENTED?  

6566
04:31:12,200 --> 04:31:15,960
THIS IS ADAPTED FROM 

6567
04:31:15,960 --> 04:31:17,080
[INDISCERNIBLE] FRAMEWORK HOW IT

6568
04:31:17,080 --> 04:31:19,000
IS IMPLEMENTED DEFINES 

6569
04:31:19,000 --> 04:31:20,480
STRATEGIES HOW IT IS IMPLEMENTED

6570
04:31:20,480 --> 04:31:22,920
IN THE REAL WORLD AND STRATEGIES

6571
04:31:22,920 --> 04:31:24,240
ARE RIGOROUSLY MEASURED ALONG 

6572
04:31:24,240 --> 04:31:26,240
THE WAY AND WE KNOW WE ARE 

6573
04:31:26,240 --> 04:31:27,400
IMPLEMENTING IT IN REAL WORLD 

6574
04:31:27,400 --> 04:31:29,160
AND IS COMPLIANCE WITH 

6575
04:31:29,160 --> 04:31:30,560
MEDICATION, IF WILL YOU, ALONG 

6576
04:31:30,560 --> 04:31:32,760
THE WAY AND FOR THOSE THAT DO 

6577
04:31:32,760 --> 04:31:34,600
CLINICAL DRUG TRIALS THAT IS ALL

6578
04:31:34,600 --> 04:31:35,920
CENTRAL TO THE WORK. 

6579
04:31:35,920 --> 04:31:39,040
IT -- IN THE END, WE HAVE 

6580
04:31:39,040 --> 04:31:41,160
IMPLEMENTATION OUTCOMES THAT ARE

6581
04:31:41,160 --> 04:31:42,800
MEASURED AND ULTIMATELY 

6582
04:31:42,800 --> 04:31:46,560
EFFECTIVE OUTCOMES AND NEXT 

6583
04:31:46,560 --> 04:31:48,000
SLIDE. 

6584
04:31:48,000 --> 04:31:51,000
SO, IN ADDITION TO BEING 

6585
04:31:51,000 --> 04:31:53,920
EFFECTIVE INTERVENTIONS NEED TO 

6586
04:31:53,920 --> 04:31:55,880
REACH INTENDED PATIENTS AND 

6587
04:31:55,880 --> 04:31:57,520
POPULATIONS AND NEED TO BE 

6588
04:31:57,520 --> 04:31:59,760
ADOPTED BY PROVIDERS AND 

6589
04:31:59,760 --> 04:32:02,720
PRACTICE SETTINGS AND NEED TO BE

6590
04:32:02,720 --> 04:32:04,280
IMPLEMENTED WITH FIDELITY AS 

6591
04:32:04,280 --> 04:32:05,680
DESIGNED AND NEED TO BE 

6592
04:32:05,680 --> 04:32:07,720
MAINTAINED OVER TIME THAT IS 

6593
04:32:07,720 --> 04:32:09,400
REAIM FRAMEWORK.  NEXT SLIDE.  

6594
04:32:09,400 --> 04:32:11,680
IF WE WANT TO REALLY TALK ABOUT 

6595
04:32:11,680 --> 04:32:13,960
HEALTH DISPARITIES, 

6596
04:32:13,960 --> 04:32:15,800
IMPLEMENTATION OF HEALTH 

6597
04:32:15,800 --> 04:32:17,040
DISPARITIES, REACH IS POPULATION

6598
04:32:17,040 --> 04:32:19,040
YOU ARE REACHING REPRESENTATIVE 

6599
04:32:19,040 --> 04:32:20,280
OF INTENDED POPULATION AND 

6600
04:32:20,280 --> 04:32:23,680
IMPORTANTLY IF LOOKING AT HAEMTH

6601
04:32:23,680 --> 04:32:25,000
DISPARITIES ARE YOU REACHING 

6602
04:32:25,000 --> 04:32:27,280
THOSE AT GREATEST RISK?  

6603
04:32:27,280 --> 04:32:29,360
ADOPTION ARE SETTINGS AND 

6604
04:32:29,360 --> 04:32:30,880
PROVIDERS ADOPTING OR 

6605
04:32:30,880 --> 04:32:32,240
REPRESENTATIVE OF OVERALL 

6606
04:32:32,240 --> 04:32:32,960
POPULATION?  

6607
04:32:32,960 --> 04:32:35,080
AGAIN, IF WE LOOK AT 

6608
04:32:35,080 --> 04:32:37,920
DISPARITIES, ARE PROVIDERS AND 

6609
04:32:37,920 --> 04:32:39,440
SETTINGS WHO WORK WITH THOSE 

6610
04:32:39,440 --> 04:32:42,160
GREATEST RISK ADOPTING THE 

6611
04:32:42,160 --> 04:32:42,680
INTERVENTION?  

6612
04:32:42,680 --> 04:32:44,800
ARE THEY ABLE TO ADOPT 

6613
04:32:44,800 --> 04:32:48,040
INTERVENTION AND RESOURCES TO 

6614
04:32:48,040 --> 04:32:49,800
ADOPT INTERVENTION?  NEXT SLIDE,

6615
04:32:49,800 --> 04:32:50,040
PLEASE. 

6616
04:32:50,040 --> 04:32:52,800
WE HAVE A BIT OF CONVERSATION 

6617
04:32:52,800 --> 04:32:57,280
ABOUT COMMUNITY ENGAGEMENT AND 

6618
04:32:57,280 --> 04:32:59,200
THIS IS THE CORE TO ADDRESSING 

6619
04:32:59,200 --> 04:33:02,560
HEALTH DISPARITIES ISSUES AND 

6620
04:33:02,560 --> 04:33:05,120
ACUTE ENGAGEMENT WE HEARD FROM 

6621
04:33:05,120 --> 04:33:07,480
COLLEAGUES TODAY NEEDS TO BE 

6622
04:33:07,480 --> 04:33:08,800
ENTWINED THROUGHOUT AND 

6623
04:33:08,800 --> 04:33:10,560
COMMUNITY ENGAGEMENT WHEN YOU DO

6624
04:33:10,560 --> 04:33:13,000
IT AND WHEN YOU DO THAT YOU ARE 

6625
04:33:13,000 --> 04:33:14,320
IDENTIFYING THE PROBLEM FROM THE

6626
04:33:14,320 --> 04:33:15,800
VERY START AND SELECTING 

6627
04:33:15,800 --> 04:33:18,440
INTERVENTION TO TARGET THE 

6628
04:33:18,440 --> 04:33:20,840
PROBLEM ENGAGING COMMUNITY WHEN 

6629
04:33:20,840 --> 04:33:22,400
ASSESSING INTERVENTION WHERE IT 

6630
04:33:22,400 --> 04:33:24,960
WILL FIT WITH PRACTICE CONTEXT. 

6631
04:33:24,960 --> 04:33:27,560
ENGAGE THE COMMUNITY WHEN YOU 

6632
04:33:27,560 --> 04:33:29,240
SELECT, FINALLY SELECT 

6633
04:33:29,240 --> 04:33:30,680
IMPLEMENTATION STRATEGIES 

6634
04:33:30,680 --> 04:33:32,680
DEVELOPING IMPLEMENTATION PLAN 

6635
04:33:32,680 --> 04:33:34,520
AND CONTINUE TO ENGAGE COMMUNITY

6636
04:33:34,520 --> 04:33:37,440
WHEN YOU EVALUATE IMPLEMENTATION

6637
04:33:37,440 --> 04:33:38,920
AND EFFECTIVENESS OUTCOMES. 

6638
04:33:38,920 --> 04:33:40,280
NEXT SLIDE. 

6639
04:33:40,280 --> 04:33:42,240
I WILL TAKE A FEW MINUTES TO 

6640
04:33:42,240 --> 04:33:44,520
TALK ABOUT THE PROJECT THAT WE 

6641
04:33:44,520 --> 04:33:45,680
ARE WORKING ON. 

6642
04:33:45,680 --> 04:33:50,080
IT WAS A COALITION IN NORTH 

6643
04:33:50,080 --> 04:33:51,200
CAROLINA ACHIEVE PRODUCT 

6644
04:33:51,200 --> 04:33:53,280
STANDING FOR ADVANCING COMMUNITY

6645
04:33:53,280 --> 04:33:56,440
AND CLINICAL CARE FOR CHILDBIRTH

6646
04:33:56,440 --> 04:33:58,880
RELATED HYPERTENSION ENGAGEMENT 

6647
04:33:58,880 --> 04:34:00,800
AND VALUING EQUITY AND WHERE 

6648
04:34:00,800 --> 04:34:05,280
THIS STARTED I WORK WITH NORTH 

6649
04:34:05,280 --> 04:34:08,400
CAROLINA MATERNAL HEALTH 

6650
04:34:08,400 --> 04:34:09,640
INNOVATIONS GRANT AND FOR REGION

6651
04:34:09,640 --> 04:34:11,960
FAR BEFORE RFA CAME OUT AND WE 

6652
04:34:11,960 --> 04:34:14,160
WERE TASKED WITH GOING TO 

6653
04:34:14,160 --> 04:34:15,880
PRACTICES IN OUR REGION TO ASK 

6654
04:34:15,880 --> 04:34:18,120
WHAT CAN WE DO IN THE COMMUNITY 

6655
04:34:18,120 --> 04:34:20,400
AND NOW IN CLINICS AND 

6656
04:34:20,400 --> 04:34:22,560
OUTPATIENT SETTING WHAT WE CAN 

6657
04:34:22,560 --> 04:34:25,240
DO TO IMPACT MATERNAL MORBIDITY 

6658
04:34:25,240 --> 04:34:27,680
AND MORTGAGE ALET THAT CLOSE THE

6659
04:34:27,680 --> 04:34:30,960
GAP WE SEE IN NORTH CAROLINA IN 

6660
04:34:30,960 --> 04:34:32,560
ADVERSE OUTCOMES AND THEME WE 

6661
04:34:32,560 --> 04:34:34,880
HEARD IS THAT WE NEED TO FIGURE 

6662
04:34:34,880 --> 04:34:37,040
OUT HOW TO TREAT HYPERTENSION 

6663
04:34:37,040 --> 04:34:39,840
BETTER IDENTIFYING PREELAMBSIA 

6664
04:34:39,840 --> 04:34:41,560
AND TREATING IN TIMELY MANNER WE

6665
04:34:41,560 --> 04:34:45,680
HAVE TO DO BETTER AND RESONATED 

6666
04:34:45,680 --> 04:34:46,080
WITH ME. 

6667
04:34:46,080 --> 04:34:48,560
I HAVE WORKED WITH QUALITY 

6668
04:34:48,560 --> 04:34:51,640
IMPROVEMENT FOR A WHILE NOW 

6669
04:34:51,640 --> 04:34:53,600
INCLUDING IMPLEMENTING AIMED 

6670
04:34:53,600 --> 04:34:56,600
HYPERTENSION BUNDLE IN OUR STATE

6671
04:34:56,600 --> 04:34:58,720
AND ACROSS THE COUNTRY AND 

6672
04:34:58,720 --> 04:35:00,400
MOVING INTO OUTPATIENT SETTING 

6673
04:35:00,400 --> 04:35:02,120
IS A COMPLETELY DIFFERENT STORY.

6674
04:35:02,120 --> 04:35:05,080
I HAD -- I WAS ENLIGHTENED BY 

6675
04:35:05,080 --> 04:35:07,480
MENTORS AND OTHERS AT UNC TO 

6676
04:35:07,480 --> 04:35:09,040
KNOW IT WASN'T GOING TO BE SAME 

6677
04:35:09,040 --> 04:35:11,280
AND WE NEEDED TO KIND OF THINK 

6678
04:35:11,280 --> 04:35:13,360
ABOUT ADAPTING IT AND APPLYING 

6679
04:35:13,360 --> 04:35:16,160
DIFFERENT PERFECT INSIMS TO DO 

6680
04:35:16,160 --> 04:35:18,760
IN OUTPATIENT SETTING AND NEEDED

6681
04:35:18,760 --> 04:35:21,080
COMMUNITY ENGAGEMENT TO DO IT AS

6682
04:35:21,080 --> 04:35:25,360
WELL.  CAME GRANT FROM NHLBI TO 

6683
04:35:25,360 --> 04:35:28,640
DO MATERNAL HEALTH ENGAGEMENT 

6684
04:35:28,640 --> 04:35:29,760
IMPLEMENTATION PROJECT AND LET'S

6685
04:35:29,760 --> 04:35:32,400
GO FOR IT AND RFA CAME TO 

6686
04:35:32,400 --> 04:35:33,520
ATTENTION AND SEEMED LIKE PLACE 

6687
04:35:33,520 --> 04:35:35,640
WE ARE MEANT TO BE AND APPLIED 

6688
04:35:35,640 --> 04:35:37,720
AND GRANTED PHASE 1 AND THIS IS 

6689
04:35:37,720 --> 04:35:39,800
ILLUSTRATION WE DECIDED TO DO IN

6690
04:35:39,800 --> 04:35:42,640
PHASE 1.  ASSEMBLED COULD HE 

6691
04:35:42,640 --> 04:35:44,400
ALISTING OF ALREADY ESTABLISHED 

6692
04:35:44,400 --> 04:35:46,520
COMMUNITY PARTNERS PROVIDING 

6693
04:35:46,520 --> 04:35:48,920
HIGH RISK CARE IN FCS FOR 

6694
04:35:48,920 --> 04:35:50,360
REGIONS FOR MANY YEARS AND HAD 

6695
04:35:50,360 --> 04:35:51,920
IN BEGINNING OF TRUST AND DIDN'T

6696
04:35:51,920 --> 04:35:54,280
DO LOTS OF RESEARCH IN THAT 

6697
04:35:54,280 --> 04:35:56,360
COMMUNITY AND WE HAD ALREADY A 

6698
04:35:56,360 --> 04:35:58,200
TRUSTED RELATIONSHIP. 

6699
04:35:58,200 --> 04:36:01,320
WE -- WE -- THESE WERE FEDERALLY

6700
04:36:01,320 --> 04:36:03,440
QUALIFIED HEALTH CLINICS THAT WE

6701
04:36:03,440 --> 04:36:05,400
DID KEY INFORMATIVE INTERVIEWS 

6702
04:36:05,400 --> 04:36:07,640
WITH PRENATAL CARE PROVIDERS IN 

6703
04:36:07,640 --> 04:36:10,760
THREE CLINICS AND FOCUS GROUPS 

6704
04:36:10,760 --> 04:36:12,840
THAT BOTH HAVE BLACK GROUPS AND 

6705
04:36:12,840 --> 04:36:15,880
WITH SPANISH-SPEAKING GROUPS AND

6706
04:36:15,880 --> 04:36:18,320
PATIENTS AND THEIR RELATIVES AND

6707
04:36:18,320 --> 04:36:19,880
DECIDED WITH INPUT THEN DECIDED 

6708
04:36:19,880 --> 04:36:22,280
TO FOCUS IMPLEMENTATION 

6709
04:36:22,280 --> 04:36:24,320
STRATEGIES WITHIN THE BUNDLE 

6710
04:36:24,320 --> 04:36:26,280
CERTAIN ELEMENTS OF THE BUNDLE 

6711
04:36:26,280 --> 04:36:28,120
TAKING BLOOD PRESSURE PROPERLY 

6712
04:36:28,120 --> 04:36:30,160
AND GOOD TECHNIQUE MAKING SURE 

6713
04:36:30,160 --> 04:36:32,400
EARLY WARNING SIGNS AND 

6714
04:36:32,400 --> 04:36:33,080
RECOGNITIONING WITH WELL 

6715
04:36:33,080 --> 04:36:35,440
UNDERSTOOD AND EVALUATION AND 

6716
04:36:35,440 --> 04:36:36,960
TREATMENT WAS APPROPRIATE AND 

6717
04:36:36,960 --> 04:36:38,280
ESCALATION WAS BEING DONE PRO 

6718
04:36:38,280 --> 04:36:40,240
EPTLY AND THIS WOULD BE FIRST 

6719
04:36:40,240 --> 04:36:42,120
STEP AND NOT ALL INCLUSIVE AND 

6720
04:36:42,120 --> 04:36:43,280
WAS REALLY THROUGH THE COURSE OF

6721
04:36:43,280 --> 04:36:45,280
YOU COULD SEE ACROSS THE BOTTOM 

6722
04:36:45,280 --> 04:36:48,200
WE ENGAGE COMMUNITY ALL ACROSS 

6723
04:36:48,200 --> 04:36:48,560
THAT.  

6724
04:36:48,560 --> 04:36:50,480
WHAT WE LEARNED FROM THIS GROUP 

6725
04:36:50,480 --> 04:36:53,600
IS IT WASN'T ENOUGH AND WE 

6726
04:36:53,600 --> 04:36:55,320
REALLY NEEDED TO DO IN THE 

6727
04:36:55,320 --> 04:36:57,320
CONTEXT OF DOING THIS, WE NEEDED

6728
04:36:57,320 --> 04:36:59,520
TO MAKE SURE WE WERE DOING IT 

6729
04:36:59,520 --> 04:37:01,240
COMPLETELY IN -- IN -- YOU KNOW,

6730
04:37:01,240 --> 04:37:03,760
IN CONTEXT OF PROVIDING 

6731
04:37:03,760 --> 04:37:05,760
RESPECTFUL CARE IN MANNER 

6732
04:37:05,760 --> 04:37:07,640
ACCEPTABLE TO THOSE OF GREATEST 

6733
04:37:07,640 --> 04:37:09,480
RISK AND NEEDED TO MAKE SURE WE 

6734
04:37:09,480 --> 04:37:11,200
WEREN'T MISSING MARK AND HEARD 

6735
04:37:11,200 --> 04:37:12,680
LOUD AND CLEAR FROM THE 

6736
04:37:12,680 --> 04:37:14,440
COMMUNITY INPUT AND INCORPORATED

6737
04:37:14,440 --> 04:37:20,560
THAT INTO OUR PHASE 2 PLAN.  

6738
04:37:20,560 --> 04:37:21,680
NEXT SLIDE. 

6739
04:37:21,680 --> 04:37:24,000
AT END OF PHASE 1 COALITION CAME

6740
04:37:24,000 --> 04:37:25,960
TOGETHER THAT IS AN ILLUSTRATION

6741
04:37:25,960 --> 04:37:27,440
OF THAT CONVERSATION. 

6742
04:37:27,440 --> 04:37:29,840
IF I HAD A POINTER, I WOULD 

6743
04:37:29,840 --> 04:37:32,440
POINT YOU TO THE MIDDLE OF PINK 

6744
04:37:32,440 --> 04:37:35,160
SORT OF LOWER AREA IT SAYS 

6745
04:37:35,160 --> 04:37:37,000
ENGAGE GENUINELY AND WHAT WE 

6746
04:37:37,000 --> 04:37:38,520
HEARD FROM OUR COALITION AND 

6747
04:37:38,520 --> 04:37:40,560
WHAT WAS WORKING AND WE NEEDED 

6748
04:37:40,560 --> 04:37:42,440
TO CONTINUE TO DO. 

6749
04:37:42,440 --> 04:37:45,200
WE NEEDED TO QUOTE MOVE AT SPEED

6750
04:37:45,200 --> 04:37:48,440
OF TRUST, UPPER RIGHT-HAND 

6751
04:37:48,440 --> 04:37:50,960
CORNER.  IN DOING SO GO BEYOND 

6752
04:37:50,960 --> 04:37:53,720
PATIENTS AND FAMILIES AND DARKER

6753
04:37:53,720 --> 04:37:56,520
BLUE UPPER SECTION GOING BEYOND 

6754
04:37:56,520 --> 04:37:58,400
FAMILIES ENGAGING CAREGIVERS AND

6755
04:37:58,400 --> 04:38:00,080
FAMILIES AND NEEDED TO ENGAGE 

6756
04:38:00,080 --> 04:38:02,400
WHERE PEOPLE WERE IN THE 

6757
04:38:02,400 --> 04:38:04,720
COMMUNITY INCLUDING CHURCHES AND

6758
04:38:04,720 --> 04:38:06,800
SO ON AND IMPORTANTLY RIGHT 

6759
04:38:06,800 --> 04:38:08,480
LOWER QUADRANT WE NEEDED TO 

6760
04:38:08,480 --> 04:38:10,880
CHANGE THE SYSTEM NOT PEOPLE. 

6761
04:38:10,880 --> 04:38:13,040
SO, THIS IS SORT OF INSPIRATION 

6762
04:38:13,040 --> 04:38:16,760
FOR US TO MOVE INTO PHASE 2.  

6763
04:38:16,760 --> 04:38:18,680
NEXT SLIDE, PLEASE. 

6764
04:38:18,680 --> 04:38:20,440
THIS IS KIND OF A SNAPSHOT WHAT 

6765
04:38:20,440 --> 04:38:22,640
WE ARE DOING IN PHASE 2.  

6766
04:38:22,640 --> 04:38:24,440
PLANNING FOR YOU -- CALLING ON 

6767
04:38:24,440 --> 04:38:27,320
PHASE 1 LEARNINGS WE ARE TESTING

6768
04:38:27,320 --> 04:38:31,240
STRATEGIES IN 20 CLINICS IN OUR 

6769
04:38:31,240 --> 04:38:33,360
REGION AND WITH PATIENT AND 

6770
04:38:33,360 --> 04:38:35,000
PROVIDER LEVEL AND BROADER 

6771
04:38:35,000 --> 04:38:36,000
COMMUNITY INPUT THROUGHOUT WE 

6772
04:38:36,000 --> 04:38:38,840
ARE PROVIDING CLINIC WITH 

6773
04:38:38,840 --> 04:38:40,480
TRAINING COACHING STIM YOU'LL 

6774
04:38:40,480 --> 04:38:42,720
ACE ON RECOGNITION RESPONSES TO 

6775
04:38:42,720 --> 04:38:45,040
SEVERE HYPERTENSION AND PATIENT 

6776
04:38:45,040 --> 04:38:46,640
INFORMED EDUCATION PROCESSES AND

6777
04:38:46,640 --> 04:38:51,400
PATIENT INFORMED EFFORTS TO 

6778
04:38:51,400 --> 04:38:54,160
DELIVER RESPECTFUL CARE AND PLAN

6779
04:38:54,160 --> 04:38:56,080
TO RIGOROUSLY DO IMPLEMENTATION 

6780
04:38:56,080 --> 04:38:58,120
OUTCOMES AND SUCCESS IN HOW WE 

6781
04:38:58,120 --> 04:38:59,240
ENGAGE COMMUNITY AND DIFFERENCE 

6782
04:38:59,240 --> 04:39:01,960
THAT CAN MAKE AND YOU SEE ON 

6783
04:39:01,960 --> 04:39:03,080
RIGHT-HAND SIDE THAT OUR -- WE 

6784
04:39:03,080 --> 04:39:05,200
HAVE IMPLEMENTATION OUTCOMES 

6785
04:39:05,200 --> 04:39:06,560
LISTED THERE AND OUR CLINICAL 

6786
04:39:06,560 --> 04:39:08,320
OUTCOMES IN THE YELLOW BOX. 

6787
04:39:08,320 --> 04:39:10,480
AND TIME IS LIMITED.  I WILL 

6788
04:39:10,480 --> 04:39:11,320
STOP THERE.  

6789
04:39:11,320 --> 04:39:15,480
I WILL GO TO THE NEXT PANELIST. 

6790
04:39:15,480 --> 04:39:17,640
>> THANKS SO MUCH, 

6791
04:39:17,640 --> 04:39:24,520
KATE.  THAT WAS FANTASTIC.  NOW 

6792
04:39:24,520 --> 04:39:26,120
ON TO THE NEXT SPECTACULAR 

6793
04:39:26,120 --> 04:39:28,360
PRESENTATION AND TURNING THINGS 

6794
04:39:28,360 --> 04:39:31,920
OVER TO DR. SEP UL VEDA FOR 

6795
04:39:31,920 --> 04:39:33,640
IMPLEMENTATION ON TECHNOLOGY AND

6796
04:39:33,640 --> 04:39:34,200
IMPLEMENTATION SCIENCE. 

6797
04:39:34,200 --> 04:39:35,800
>> THANK YOU.  HI,
EVERYONE.  

6798
04:39:35,800 --> 04:39:37,640
SUCH AN HONOR TO BE HERE TODAY 

6799
04:39:37,640 --> 04:39:40,360
AND THANKS FOR THE INSIGHT.  

6800
04:39:40,360 --> 04:39:42,720
NEXT SLIDE, PLEASE. 

6801
04:39:42,720 --> 04:39:46,920
SO, MATERNAL DEPRESSION IS A 

6802
04:39:46,920 --> 04:39:50,680
VERY COMMON OBSTETRIC 

6803
04:39:50,680 --> 04:39:52,680
COMPLICATION AND 20% OF 

6804
04:39:52,680 --> 04:39:54,720
PHYSICIANS SCREEN FOR DEPRESSION

6805
04:39:54,720 --> 04:39:57,280
HOWEVER 15% OF WOMEN THAT ARE 

6806
04:39:57,280 --> 04:39:59,280
SCREENED ONLY GET ACCESS TO 

6807
04:39:59,280 --> 04:40:00,400
CARE. 

6808
04:40:00,400 --> 04:40:03,720
I'M NOT A PHYSICIAN BUT AN 

6809
04:40:03,720 --> 04:40:06,840
OCCUPATIONAL THERAPIST AND HAVE 

6810
04:40:06,840 --> 04:40:08,600
OPPORTUNITY TO ACCESS WOMEN THAT

6811
04:40:08,600 --> 04:40:13,360
ARE DEPRESSED THAT HAVE MISSED 

6812
04:40:13,360 --> 04:40:16,040
SCREENINGS FROM PEDIATRICIANS 

6813
04:40:16,040 --> 04:40:20,120
AND OUR INNOVATION IS MAMA.  YOU

6814
04:40:20,120 --> 04:40:22,080
HEARD MAUREEN TALK ABOUT THIS 

6815
04:40:22,080 --> 04:40:23,960
SCREENING AND REFERRAL AND 

6816
04:40:23,960 --> 04:40:26,080
ONGOING SUPPORT TOOL THAT 

6817
04:40:26,080 --> 04:40:28,160
STREAMLINES MATERNAL DEPRESSION 

6818
04:40:28,160 --> 04:40:29,960
SCREENING AND NOTIFIES PROVIDERS

6819
04:40:29,960 --> 04:40:32,720
ABOUT THE RESULTS OF THIS 

6820
04:40:32,720 --> 04:40:36,000
SCREENING AND PROVIDES THEM 

6821
04:40:36,000 --> 04:40:39,200
TALKING POINTS AND TRIAGE 

6822
04:40:39,200 --> 04:40:41,080
NUMBERS TO HELP THESE IN CASE 

6823
04:40:41,080 --> 04:40:45,640
THEY NEED CONSULTATIONS AND ALSO

6824
04:40:45,640 --> 04:40:51,480
THESE MAMA HAS CARE COORDINATORS

6825
04:40:51,480 --> 04:40:54,880
TO LINK MOTHERS TO REFERRALS AND

6826
04:40:54,880 --> 04:40:57,720
PROVIDE PSYCHOEDUCATIONAL 

6827
04:40:57,720 --> 04:40:59,720
SUPPORT AND PROVIDES WARM 

6828
04:40:59,720 --> 04:41:02,680
HAND-OFF TO MENTAL HEALTH 

6829
04:41:02,680 --> 04:41:03,960
PROVIDERS IF NEEDED. 

6830
04:41:03,960 --> 04:41:05,120
NEXT SLIDE, PLEASE. 

6831
04:41:05,120 --> 04:41:09,760
YES.  THAT IS OUR INNOVATION. 

6832
04:41:09,760 --> 04:41:12,600
AND SO MOMA HAS BEEN IMPLEMENTED

6833
04:41:12,600 --> 04:41:16,960
IN NICUS AND OBGYN CLINICS AND 

6834
04:41:16,960 --> 04:41:18,520
I'M NOT A PHYSICIAN. 

6835
04:41:18,520 --> 04:41:22,520
I'M AN EARLY INTERVENTION 

6836
04:41:22,520 --> 04:41:24,480
OCCUPATIONAL THERAPIST THAT 

6837
04:41:24,480 --> 04:41:27,680
SERVES FAMILIES OF CHILDREN WITH

6838
04:41:27,680 --> 04:41:28,880
DEVELOPMENTAL DISABILITIES AND 

6839
04:41:28,880 --> 04:41:30,880
THESE ARE FAMILIES THAT ARE 

6840
04:41:30,880 --> 04:41:32,920
COMING FROM THE NICU AND THESE 

6841
04:41:32,920 --> 04:41:35,640
MOMS THAT ARE VERY -- THEY ARE 

6842
04:41:35,640 --> 04:41:37,400
EXPERIENCING LOTS OF STRESS 

6843
04:41:37,400 --> 04:41:39,560
BECAUSE THEIR BABIES ARE AT RISK

6844
04:41:39,560 --> 04:41:44,320
FOR DEVELOPMENTAL DELAYS OR HAVE

6845
04:41:44,320 --> 04:41:48,640
PREMATURITY OR ANY CONGENITAL 

6846
04:41:48,640 --> 04:41:50,960
DISORDERS.  

6847
04:41:50,960 --> 04:41:56,560
NEXT SLIDE, PLEASE. 

6848
04:41:56,560 --> 04:42:00,000
I USE IMPLEMENTATION FRAMEWORK 

6849
04:42:00,000 --> 04:42:03,040
AND IMPLEMENTATION SCIENCE TO 

6850
04:42:03,040 --> 04:42:07,800
LEVERAGE USE OF MOMMA IN EARLY 

6851
04:42:07,800 --> 04:42:09,920
INTERVENTION MOMMA UTILIZES A 

6852
04:42:09,920 --> 04:42:13,360
MINDFUL APPLICATION OF 

6853
04:42:13,360 --> 04:42:19,520
IMPLEMENTATION FRAMEWORKS WHICH 

6854
04:42:19,520 --> 04:42:20,400
INTEGRATES KNOWLEDGE CREATION 

6855
04:42:20,400 --> 04:42:22,760
AND ACTION CYCLES TO TAILOR TO 

6856
04:42:22,760 --> 04:42:25,160
NEEDS OF POPULATION THAT IS THE 

6857
04:42:25,160 --> 04:42:26,640
PATIENTS IN EARLY INTERVENTION 

6858
04:42:26,640 --> 04:42:32,880
SETTINGS THAT ALSO USES 

6859
04:42:32,880 --> 04:42:35,960
CONSOLIDATED FRAMEWORK FOR 

6860
04:42:35,960 --> 04:42:37,720
IMPLEMENTATION RESEARCH THAT IS 

6861
04:42:37,720 --> 04:42:39,320
DETERMINED FRAMEWORK TO GIVE 

6862
04:42:39,320 --> 04:42:41,640
LOTS OF INFORMATION ABOUT 

6863
04:42:41,640 --> 04:42:44,920
FACTORS THAT INFLUENCE USE OR 

6864
04:42:44,920 --> 04:42:46,560
IMPLEMENTATION OF INNOVATION AND

6865
04:42:46,560 --> 04:42:50,080
WE USE BEHAVIOR-CHANGED THEORIES

6866
04:42:50,080 --> 04:42:52,880
TO INFORM US OF IMPLEMENTATION 

6867
04:42:52,880 --> 04:42:55,640
MODULES THAT ARE SUCH AS 

6868
04:42:55,640 --> 04:42:56,160
BEHAVIORAL CHANGE AND 

6869
04:42:56,160 --> 04:42:57,800
[INDISCERNIBLE] DIFFUSIONS OF 

6870
04:42:57,800 --> 04:43:00,040
INNOVATIONS AND WE WILL FINALLY 

6871
04:43:00,040 --> 04:43:01,880
CONSIDER REAIM FRAMEWORK AS KATE

6872
04:43:01,880 --> 04:43:05,240
WAS TALKING ABOUT TO EVALUATE 

6873
04:43:05,240 --> 04:43:08,000
OUTCOMES AND TODAY I WILL 

6874
04:43:08,000 --> 04:43:10,680
DISCUSS IN DETAIL THIS C FOR 

6875
04:43:10,680 --> 04:43:15,080
MODEL CONSOLIDATED FRAMEWORK FOR

6876
04:43:15,080 --> 04:43:19,120
IMPLEMENTATION RESEARCH.  

6877
04:43:19,120 --> 04:43:23,920
SO, CONSOLIDATED FRAMEWORK FOR 

6878
04:43:23,920 --> 04:43:26,640
IMPLEMENTATION RESEARCH OR C FOR

6879
04:43:26,640 --> 04:43:29,360
IS DETERMINATING FRAMEWORK THAT 

6880
04:43:29,360 --> 04:43:31,240
INFLUENCES IMPLEMENTATION OF 

6881
04:43:31,240 --> 04:43:34,160
INNOVATIONS AND ILLUSTRATES A 

6882
04:43:34,160 --> 04:43:35,480
ROADMAP THAT ORGANIZES 

6883
04:43:35,480 --> 04:43:37,480
CONSTRUCTS WITHIN DOMAINS THAT 

6884
04:43:37,480 --> 04:43:39,920
IDENTIFY AND EXPLAIN FACTORS AND

6885
04:43:39,920 --> 04:43:42,160
JOINING FROM 19 THEORIES AND 

6886
04:43:42,160 --> 04:43:46,760
MODELS AND FRAMEWORKS AND C FOR 

6887
04:43:46,760 --> 04:43:49,480
HAS FIVE MAJOR DOMAINS THAT ARE 

6888
04:43:49,480 --> 04:43:50,640
INTERVENTION AND OUTER SETTING 

6889
04:43:50,640 --> 04:43:53,360
AND INNER SETTING AND INDIVIDUAL

6890
04:43:53,360 --> 04:43:55,920
CHARACTERISTICS AND PROCESS AND 

6891
04:43:55,920 --> 04:43:58,400
I PARTICULARLY USE C FOR TO 

6892
04:43:58,400 --> 04:44:00,800
IDENTIFY BARRIERS AND 

6893
04:44:00,800 --> 04:44:03,360
FACILITATORS OF UPTAKE OF MOMA 

6894
04:44:03,360 --> 04:44:04,840
WITH EARLIER INTERVENTION 

6895
04:44:04,840 --> 04:44:07,880
TALKING TO STAKEHOLDERS AND 

6896
04:44:07,880 --> 04:44:10,080
POTENTIAL USERS OF MOMMA AND 

6897
04:44:10,080 --> 04:44:13,000
CURRENT USERS AND WE DETERMINE 

6898
04:44:13,000 --> 04:44:14,760
THE THAT THERE ARE DIFFERENT 

6899
04:44:14,760 --> 04:44:19,080
FACILITATORS AND BARRIERS WITHIN

6900
04:44:19,080 --> 04:44:22,320
5 CONSTRUCTS AND SO FOR 

6901
04:44:22,320 --> 04:44:24,160
INTERVENTION CHARACTERISTICS WE 

6902
04:44:24,160 --> 04:44:25,920
FOUND THAT COMPLEXITY AND COSTS 

6903
04:44:25,920 --> 04:44:28,560
ARE DETERMINANTS AND IT IS SO 

6904
04:44:28,560 --> 04:44:30,080
COMPLEX THAT EARLIER 

6905
04:44:30,080 --> 04:44:31,960
INTERVENTION PROVIDERS SCREEN 

6906
04:44:31,960 --> 04:44:33,280
FOR DEPRESSION BECAUSE WE ARE 

6907
04:44:33,280 --> 04:44:35,600
NOT PROVIDERS FOR MOTHERS AND WE

6908
04:44:35,600 --> 04:44:40,040
ARE PROVIDERS FOR CHILDREN AND 

6909
04:44:40,040 --> 04:44:44,680
IN OCCUPATIONAL THERAPIES WE ARE

6910
04:44:44,680 --> 04:44:48,040
VERY CHILD FOCUSED AND TALKING 

6911
04:44:48,040 --> 04:44:50,480
ABOUT CHILD'S MOM'S MENTAL 

6912
04:44:50,480 --> 04:44:53,160
HEALTH MAKES THERAPISTS APP 

6913
04:44:53,160 --> 04:44:54,200
REHENCESIVE AND HAVE TO 

6914
04:44:54,200 --> 04:44:55,520
DETERMINE THAT BARE WHIER TO 

6915
04:44:55,520 --> 04:44:59,160
SCREENING AND COST AND WE GO BY 

6916
04:44:59,160 --> 04:45:00,880
FEE-FOR-SERVICE MODEL.  THERE IS

6917
04:45:00,880 --> 04:45:05,080
NO REIMBURSEMENT FOR SCREENING 

6918
04:45:05,080 --> 04:45:06,560
FOR POSTPARTUM DEPRESSION AMONG 

6919
04:45:06,560 --> 04:45:08,600
EARLY INTERVENTION CLIENTS AND 

6920
04:45:08,600 --> 04:45:10,720
FOUND IN OUTER SETTINGS PEER 

6921
04:45:10,720 --> 04:45:12,000
PRESSURE AND EXTERNAL POLICIES 

6922
04:45:12,000 --> 04:45:16,440
AND INCENTIVES ARE BARRIERS. 

6923
04:45:16,440 --> 04:45:18,880
NO ONE ELSE IS DOING IT AND NO 

6924
04:45:18,880 --> 04:45:23,520
PEER PRESSURE TO SCREEN FOR 

6925
04:45:23,520 --> 04:45:24,840
DEPRESSION AMONG CHILDREN WITH 

6926
04:45:24,840 --> 04:45:26,560
DISABILITIES RECEIVING EARLY 

6927
04:45:26,560 --> 04:45:27,800
INTERVENTION AND IS NO POLICIES 

6928
04:45:27,800 --> 04:45:29,800
IN PLACE AND WE FOUND IT AS A 

6929
04:45:29,800 --> 04:45:31,480
BARRIER.  WE WERE USED TO 

6930
04:45:31,480 --> 04:45:33,600
BUSINESS AS USUAL AND THIS IS 

6931
04:45:33,600 --> 04:45:35,640
HOW CARE IS PROVIDED AND WHY WE 

6932
04:45:35,640 --> 04:45:37,520
NEED TO CHANGE IT AND ANOTHER 

6933
04:45:37,520 --> 04:45:40,200
INDIVIDUAL CHARACTERISTICS UNDER

6934
04:45:40,200 --> 04:45:41,680
CONTRACTS OF INDIVIDUAL 

6935
04:45:41,680 --> 04:45:44,800
CHARACTERISTICS WE FOUND THAT 

6936
04:45:44,800 --> 04:45:47,640
FACILITATORS ARE MOTIVATION OF 

6937
04:45:47,640 --> 04:45:49,520
PROVIDERS AND ALSO BELIEF THAT 

6938
04:45:49,520 --> 04:45:52,960
SCREENING IS GOOD.  

6939
04:45:52,960 --> 04:45:54,360
SCREENING PARENTS ALSO HELPS 

6940
04:45:54,360 --> 04:45:56,280
BABIES AND SO THEY -- THESE -- 

6941
04:45:56,280 --> 04:46:00,120
THE PROVIDERS THAT SCREEN ARE 

6942
04:46:00,120 --> 04:46:02,320
VERY MOTIVATED TO HELP THESE 

6943
04:46:02,320 --> 04:46:04,240
PARENTS AND BLEF THAT EARLY 

6944
04:46:04,240 --> 04:46:06,080
INTERVENTION MODEL IS MORE 

6945
04:46:06,080 --> 04:46:09,360
FAMILY CENTERED VERSUS CHILD 

6946
04:46:09,360 --> 04:46:11,520
CENTERED AND WE FOUND OUT THAT 

6947
04:46:11,520 --> 04:46:13,920
IN CONSTRUCTS OF INNER SETTING 

6948
04:46:13,920 --> 04:46:17,040
IMPLEMENTATION CLIMATE IS VERY, 

6949
04:46:17,040 --> 04:46:21,400
VERY IMPORTANT AND IS DEGREE OF 

6950
04:46:21,400 --> 04:46:24,680
RECEPTIVENESS OR SUPPORT THAT 

6951
04:46:24,680 --> 04:46:25,440
PROVIDERS RECEIVE WITHIN 

6952
04:46:25,440 --> 04:46:26,680
ORGANIZATION HOW MUCH SUPPORT 

6953
04:46:26,680 --> 04:46:29,680
THE ORGANIZATION GIVES TO THEM 

6954
04:46:29,680 --> 04:46:31,080
IS VERY, VERY IMPORTANT IN 

6955
04:46:31,080 --> 04:46:33,520
SETTING UP THE, YOU KNOW, THE 

6956
04:46:33,520 --> 04:46:35,240
INNOVATION TO MAKE SURE THAT 

6957
04:46:35,240 --> 04:46:38,040
INNOVATION IS IMPLEMENTED AND 

6958
04:46:38,040 --> 04:46:40,440
SUCCESSFUL AND LASTLY IN PROCESS

6959
04:46:40,440 --> 04:46:43,360
CONSTRUCT IS IMPORTANT ENGAGE 

6960
04:46:43,360 --> 04:46:46,720
USERS IN PLANNING, ENGAGING, 

6961
04:46:46,720 --> 04:46:50,280
EXECUTING AND IN EVALUATION AND 

6962
04:46:50,280 --> 04:46:52,720
REFLECTION OF LEARN IING EVERY Y

6963
04:46:52,720 --> 04:46:55,560
THEY PRACTICE THIS EARLY 

6964
04:46:55,560 --> 04:46:56,880
INTERVENTION PROVIDERS ARE 

6965
04:46:56,880 --> 04:46:59,760
OCCUPATIONAL THERAPISTS DOING 

6966
04:46:59,760 --> 04:47:01,680
THIS WORK ARE NOT VERY 

6967
04:47:01,680 --> 04:47:03,480
COMFORTABLE WITH JUST THIS 

6968
04:47:03,480 --> 04:47:06,320
SCREENING THAT ALONE IS USING 

6969
04:47:06,320 --> 04:47:07,440
THE APP.  

6970
04:47:07,440 --> 04:47:09,920
IN THAT SENSE, THAT IS HOW I USE

6971
04:47:09,920 --> 04:47:14,240
THE IMPLEMENTATION FRAMEWORK TO 

6972
04:47:14,240 --> 04:47:19,360
HELP P ME INFORM WHAT ARE 

6973
04:47:19,360 --> 04:47:23,600
FACTORS THAT INFLUENCE 

6974
04:47:23,600 --> 04:47:25,040
IMPLEMENTATION OF THE APP AND 

6975
04:47:25,040 --> 04:47:26,280
NEXT SLIDE, PLEASE. 

6976
04:47:26,280 --> 04:47:27,960
USING SAME FRAMEWORK WE 

6977
04:47:27,960 --> 04:47:29,760
IMPLEMENT GOALS AND 

6978
04:47:29,760 --> 04:47:30,960
IMPLEMENTATION STRATEGIES THAT 

6979
04:47:30,960 --> 04:47:34,520
IS VERY STRATEGIC AND 

6980
04:47:34,520 --> 04:47:34,840
SYSTEMATIC. 

6981
04:47:34,840 --> 04:47:37,720
WE DETERMINE THAT GOALS ARE TO 

6982
04:47:37,720 --> 04:47:40,560
GARNER BUY-IN TO EDUCATE MORE 

6983
04:47:40,560 --> 04:47:41,800
PROVIDERS ABOUT IMPORTANCE OF 

6984
04:47:41,800 --> 04:47:43,960
FAMILY CENTERED CARE AND NOT 

6985
04:47:43,960 --> 04:47:46,960
FOCUSING REALLY ON JUST THE MOM 

6986
04:47:46,960 --> 04:47:48,640
OR CHILD BUT MORE OF THE FAMILY 

6987
04:47:48,640 --> 04:47:51,520
AND ENGAGING IN OTHER POLICY 

6988
04:47:51,520 --> 04:47:53,280
LEADERS ABOUT ALTERNATIVE WAYS 

6989
04:47:53,280 --> 04:47:55,520
TO INCENTIVIZE EARLY 

6990
04:47:55,520 --> 04:47:59,400
INTERVENTION PROVIDERS AND SO 

6991
04:47:59,400 --> 04:48:03,040
THAT THEY CAN USE SCREEN MORE OR

6992
04:48:03,040 --> 04:48:04,520
USE OF APP MORE. 

6993
04:48:04,520 --> 04:48:05,880
NEXT SLIDE, PLEASE. 

6994
04:48:05,880 --> 04:48:08,400
USING THE PROCTORS TAXONOMY, WE 

6995
04:48:08,400 --> 04:48:12,400
ARE ABLE TO ALSO IMPLEMENT, USE 

6996
04:48:12,400 --> 04:48:14,120
IMPLEMENTATION STRATEGIES AND 

6997
04:48:14,120 --> 04:48:15,880
IMPLEMENTATION OUTCOMES THAT IS 

6998
04:48:15,880 --> 04:48:17,520
VERY, VERY IMPORTANT IN 

6999
04:48:17,520 --> 04:48:18,600
TECHNOLOGY.  IT IS IMPORTANT 

7000
04:48:18,600 --> 04:48:21,640
THAT TECHNOLOGIES ARE LATER 

7001
04:48:21,640 --> 04:48:24,000
ADOPTED VERSUS SUSTAINABLE AND 

7002
04:48:24,000 --> 04:48:29,080
IT IS PENETRATED IN USE FOR 

7003
04:48:29,080 --> 04:48:32,720
ROUTINE PRACTICE.  NEXT SLIDE, 

7004
04:48:32,720 --> 04:48:33,320
PLEASE. 

7005
04:48:33,320 --> 04:48:35,160
NEXT STEPS AS EARLY RESEARCHER 

7006
04:48:35,160 --> 04:48:37,680
IS USING MIXED METHODS DESIGNED 

7007
04:48:37,680 --> 04:48:40,880
TO USABILITY AND ACCEPTABILITY 

7008
04:48:40,880 --> 04:48:43,280
OF MOMMA IN DEPRESSION SCREENING

7009
04:48:43,280 --> 04:48:47,720
REFERRAL AND SUPPORT IN EARLY 

7010
04:48:47,720 --> 04:48:48,080
INTERVENTION. 

7011
04:48:48,080 --> 04:48:51,480
THANK YOU. 

7012
04:48:51,480 --> 04:48:53,960
>> THANK YOU SO MUCH FOR
A 

7013
04:48:53,960 --> 04:48:54,840
FANTASTIC PRESENTATION.  SO, WE 

7014
04:48:54,840 --> 04:48:59,440
ARE GOING TO JUMP INTO QUESTIONS

7015
04:48:59,440 --> 04:49:02,120
THAT I HAVE DONE IN ADVANCE THAT

7016
04:49:02,120 --> 04:49:03,880
CIRCULATED THAT WILL BRING 

7017
04:49:03,880 --> 04:49:05,040
ENTIRE PANEL AND DO START TO 

7018
04:49:05,040 --> 04:49:08,120
THINK ABOUT QUESTIONS FROM THE 

7019
04:49:08,120 --> 04:49:09,320
STUDIO AUDIENCE AND FIRST 

7020
04:49:09,320 --> 04:49:12,720
QUESTION TO POSE IS HOW DO YOU 

7021
04:49:12,720 --> 04:49:13,440
INTEGRATE COMMUNITY ORGANIZATION

7022
04:49:13,440 --> 04:49:15,880
AND COMMUNITY PERSPECTIVE INTO 

7023
04:49:15,880 --> 04:49:18,360
WHAT YOU DO?  

7024
04:49:18,360 --> 04:49:19,800
SUBQUESTION TO THAT IS OUR WAY 

7025
04:49:19,800 --> 04:49:22,520
OF IMBEDDING EQUITY TO WORK FOR 

7026
04:49:22,520 --> 04:49:24,960
ROLLOUT OF PROJECTS?  

7027
04:49:24,960 --> 04:49:26,240
ELIZABETH, WOULD YOU MIND 

7028
04:49:26,240 --> 04:49:28,000
TERRIBLY IF I STARTED WITH SNU. 

7029
04:49:28,000 --> 04:49:30,320
>> NO.  THANK YOU SO MUCH
FOR 

7030
04:49:30,320 --> 04:49:31,400
INCLUDING ME THIS AFTERNOON. 

7031
04:49:31,400 --> 04:49:33,920
IT WAS A PLEASURE TO HEAR BOTH 

7032
04:49:33,920 --> 04:49:37,360
PRIOR SPEAKERS AND LEARNED A LOT

7033
04:49:37,360 --> 04:49:40,920
FROM DR. MENARD.  I'M NOT AN 

7034
04:49:40,920 --> 04:49:42,440
IMPLEMENTATION SCIENTIST BUT A 

7035
04:49:42,440 --> 04:49:44,040
BEGINNER AND APPRECIATE WORK I 

7036
04:49:44,040 --> 04:49:46,160
SEE MY COLLEAGUES HERE DO AT PEN

7037
04:49:46,160 --> 04:49:47,520
AND IN THIS SPACE AND WHEN I 

7038
04:49:47,520 --> 04:49:48,880
THINK ABOUT THIS AND YOU ASKED 

7039
04:49:48,880 --> 04:49:51,400
ME AND I'M THINKING ABOUT 

7040
04:49:51,400 --> 04:49:52,720
MATERNAL HEALTH COMMUNITY 

7041
04:49:52,720 --> 04:49:53,680
ORGANIZATIONS AND TECHNOLOGY AND

7042
04:49:53,680 --> 04:49:55,320
HOW WE THINK ABOUT THIS AND MAKE

7043
04:49:55,320 --> 04:49:56,880
SURE THAT COMMUNITY IS PART OF 

7044
04:49:56,880 --> 04:49:57,800
THE PROCESS. 

7045
04:49:57,800 --> 04:50:00,760
I'M A HEALTH SERVICES RESEARCHER

7046
04:50:00,760 --> 04:50:03,080
AND SORT OF THINK ABOUT MATERNAL

7047
04:50:03,080 --> 04:50:05,360
HEALTH WITH A SORT OF ROOT 

7048
04:50:05,360 --> 04:50:07,200
CAUSES OF STRUCTURAL RACISM AND 

7049
04:50:07,200 --> 04:50:08,400
THINK ABOUT THE PATIENT 

7050
04:50:08,400 --> 04:50:09,760
CLINICIAN AND COMMUNITY AND 

7051
04:50:09,760 --> 04:50:11,640
SYSTEM FACTORS AND WANT TO JUST 

7052
04:50:11,640 --> 04:50:13,560
POINT OUT THAT IN EACH OF THE 

7053
04:50:13,560 --> 04:50:15,320
STAGES THAT WHEN WE THINK OF 

7054
04:50:15,320 --> 04:50:18,160
UNDERLYING FACTORS CAUSING 

7055
04:50:18,160 --> 04:50:19,680
MATERNAL HEALTH IN EQUITIES, 

7056
04:50:19,680 --> 04:50:22,920
THERE IS A ROLE OR A PLACE FOR 

7057
04:50:22,920 --> 04:50:24,200
COMMUNITY AND COMMUNITY 

7058
04:50:24,200 --> 04:50:26,080
ORGANIZATIONS TO BE PART OF 

7059
04:50:26,080 --> 04:50:28,680
THAT.  AND TO HELP OUR 

7060
04:50:28,680 --> 04:50:30,120
UNDERSTANDING.  AT ANY POINT YOU

7061
04:50:30,120 --> 04:50:32,160
CAN THINK ABOUT PATIENT LEVEL 

7062
04:50:32,160 --> 04:50:34,080
FACTORS AND EDUCATION AND RACE 

7063
04:50:34,080 --> 04:50:35,680
ETHNICITY AND OTHER THINGS TO 

7064
04:50:35,680 --> 04:50:38,080
THINK ABOUT AND NEIGHBORHOODS 

7065
04:50:38,080 --> 04:50:39,800
WHICH PEOPLE LIVE AND 

7066
04:50:39,800 --> 04:50:42,960
COMMUNITIES WHICH THEY LIVE AND 

7067
04:50:42,960 --> 04:50:44,920
CLINICIAN BIAS AND THEY ALL FORM

7068
04:50:44,920 --> 04:50:47,840
SORT OF THE STATUS OF A BIRTHING

7069
04:50:47,840 --> 04:50:49,640
PERSON WHETHER OR NOT THEY HAVE 

7070
04:50:49,640 --> 04:50:51,840
DEPRESSION OR NOT OR HAVE 

7071
04:50:51,840 --> 04:50:53,640
ANOTHER COMORBIDITY AND GET TO 

7072
04:50:53,640 --> 04:50:55,080
FINAL OUTCOME AND KEY POINT TO 

7073
04:50:55,080 --> 04:50:58,920
MAKE HERE IS AROUND THE CARE 

7074
04:50:58,920 --> 04:51:01,280
CONTINUUM AND PRECONCEPTION 

7075
04:51:01,280 --> 04:51:03,680
ANTI-NATAL AND POSTPARTUM ARE 

7076
04:51:03,680 --> 04:51:05,760
TIMES THAT WE CAN INTERVENE AND 

7077
04:51:05,760 --> 04:51:07,560
HAVING PERSPECTIVE ON 

7078
04:51:07,560 --> 04:51:08,880
INTERVENTION FROM TIME POINT 

7079
04:51:08,880 --> 04:51:10,760
FROM COMMUNITY ORGANIZATIONS AND

7080
04:51:10,760 --> 04:51:13,520
PATIENT VOIZE IS INCREDIBLY 

7081
04:51:13,520 --> 04:51:15,800
IMPORTANT AND THEMES TO BRING IN

7082
04:51:15,800 --> 04:51:17,920
HERE, ONE, QUALITY OF CARE IS SO

7083
04:51:17,920 --> 04:51:20,680
CRITICAL AND WHETHER OPTIMIZING 

7084
04:51:20,680 --> 04:51:22,120
PRECONCEPTION HELP OR 

7085
04:51:22,120 --> 04:51:24,480
STANDARDIZING LABOR AND DELIVERY

7086
04:51:24,480 --> 04:51:26,000
PRACTICES WITH BUNDLES YOU HEARD

7087
04:51:26,000 --> 04:51:28,720
ABOUT OR OTHER FACTORS OR 

7088
04:51:28,720 --> 04:51:29,080
SIMULATIONS. 

7089
04:51:29,080 --> 04:51:31,240
WHATEVER WAY QUALITY OF CARE IS 

7090
04:51:31,240 --> 04:51:32,520
REALLY IMPORTANT AND LAST FACTOR

7091
04:51:32,520 --> 04:51:33,920
I WANTED TO MAKE SURE WE THINK 

7092
04:51:33,920 --> 04:51:35,280
ABOUT THINKING ABOUT 

7093
04:51:35,280 --> 04:51:38,360
TECHNOLOGIES ROLE IN THIS SPACE 

7094
04:51:38,360 --> 04:51:42,800
IS SOCIAL DETERMINANTS OF HEALTH

7095
04:51:42,800 --> 04:51:44,680
AND ADDRESSING PRACTURED CARE 

7096
04:51:44,680 --> 04:51:46,960
YOU ARE EXPERIENCING AND HOUSING

7097
04:51:46,960 --> 04:51:48,600
AND TRANSPORTATION BARRIERS AND 

7098
04:51:48,600 --> 04:51:52,760
ALL THOSE THINGS AND YOU HEARD A

7099
04:51:52,760 --> 04:51:55,640
POWERFUL PANEL BEFORE COMMUNITY 

7100
04:51:55,640 --> 04:51:57,680
ORGANIZATIONS AND HEARING FROM 

7101
04:51:57,680 --> 04:52:00,440
DR. MENARD THINKING ABOUT IT 

7102
04:52:00,440 --> 04:52:02,880
FROM VERY BEGINNING HOW I GO 

7103
04:52:02,880 --> 04:52:07,680
ABOUT THIS AND THINKING OF TWO 

7104
04:52:07,680 --> 04:52:13,120
DIFFERENT FRAMEWORKS DEPARTMENT 

7105
04:52:13,120 --> 04:52:14,720
CLINICAL HEALTH FIRST AND 

7106
04:52:14,720 --> 04:52:17,680
FOREMOST IS PATIENT'S VOICE AND 

7107
04:52:17,680 --> 04:52:19,600
COMMUNITY ORGANIZATIONS AND SO I

7108
04:52:19,600 --> 04:52:24,200
WILL START WITH REALLY QUICKLY A

7109
04:52:24,200 --> 04:52:27,360
EXAMPLE ON RESEARCH SIDE AND HOW

7110
04:52:27,360 --> 04:52:28,960
WE MIGHT THINK ABOUT THIS. 

7111
04:52:28,960 --> 04:52:31,640
STARTING A STUDY AND HAVING IT 

7112
04:52:31,640 --> 04:52:33,480
ONGOING FUNDED BY NIH AND 

7113
04:52:33,480 --> 04:52:35,600
CALLING IT VIBE STUDY LOOKING AT

7114
04:52:35,600 --> 04:52:38,520
STRUCTURAL RACISM AND COVID 

7115
04:52:38,520 --> 04:52:39,880
PANDEMIC AND PARTICULARLY 

7116
04:52:39,880 --> 04:52:41,960
ECONOMIC STRESS AND POSTPARTUM 

7117
04:52:41,960 --> 04:52:43,480
OUTCOMES AND ARE UTILIZING 

7118
04:52:43,480 --> 04:52:45,560
TECHNOLOGY AND WAY TO HEALTH 

7119
04:52:45,560 --> 04:52:48,000
PLATFORM TEXTING BLOOD PRESSURE 

7120
04:52:48,000 --> 04:52:50,520
MEASUREMENT AND OUTCOME IS BLOOD

7121
04:52:50,520 --> 04:52:52,720
TRAJECTORIES IN LAST FEW MONTHS 

7122
04:52:52,720 --> 04:52:54,240
AND BROUGHT COMMUNITY PARTNERS 

7123
04:52:54,240 --> 04:52:55,600
IN FROM VERY BEGINNING AND 

7124
04:52:55,600 --> 04:52:58,400
STARTED BY SORT OF HAVING A 

7125
04:52:58,400 --> 04:52:59,960
MOMENT OF REFLECTION FOR ALL OF 

7126
04:52:59,960 --> 04:53:02,200
US ABOUT WHO WE ARE AND WHERE WE

7127
04:53:02,200 --> 04:53:03,480
COME FROM. 

7128
04:53:03,480 --> 04:53:06,680
YOU ARE HEARING ABOUT 

7129
04:53:06,680 --> 04:53:08,280
POSITIONALITY AND UNDERSTANDING 

7130
04:53:08,280 --> 04:53:13,040
CONTEXT OF THE PEOPLE TRYING TO 

7131
04:53:13,040 --> 04:53:14,840
ROLL OUT INTERVENTION AND 

7132
04:53:14,840 --> 04:53:17,000
UNDERSTANDING EVERYONE AN THE 

7133
04:53:17,000 --> 04:53:18,200
TABLE TALKING ABOUT 

7134
04:53:18,200 --> 04:53:20,400
UNDERSTANDING BUY IN AND RIGHT 

7135
04:53:20,400 --> 04:53:21,960
PROBLEM THEY CARE ABOUT THIS 

7136
04:53:21,960 --> 04:53:23,760
ISSUE AND WANT TO WORK ON IT 

7137
04:53:23,760 --> 04:53:24,760
WITH YOU. 

7138
04:53:24,760 --> 04:53:27,600
EXPRESSING THOSE, YOU KNOW, 

7139
04:53:27,600 --> 04:53:29,040
HAVING EVERYONE TALK ABOUT IT.  

7140
04:53:29,040 --> 04:53:31,000
WE STARTED OUR PROCESS THAT WAY 

7141
04:53:31,000 --> 04:53:33,840
AND HAD ACTUALLY A COUPLE 

7142
04:53:33,840 --> 04:53:34,520
POWERFUL SESSIONS THAT WAY AND 

7143
04:53:34,520 --> 04:53:37,680
WE MOVED ON TO MAKING SURE THE 

7144
04:53:37,680 --> 04:53:40,040
COMMUNITY -- OUR COMMUNITY 

7145
04:53:40,040 --> 04:53:41,680
REPRESENTATIVES LOOKED AT ALL 

7146
04:53:41,680 --> 04:53:46,360
OUR SCALES WE HAD ON RACISM AND 

7147
04:53:46,360 --> 04:53:48,000
MICRO AGGRESSIONS, ET CETERA.  

7148
04:53:48,000 --> 04:53:50,520
DID THEY BUY THEM OR NOT?  WE 

7149
04:53:50,520 --> 04:53:52,480
DID WORK IN THAT SPACE AND NOW 

7150
04:53:52,480 --> 04:53:53,560
MOVING THROUGH COLLECTION OF 

7151
04:53:53,560 --> 04:53:55,680
DATA AND DOING ANALYSIS WE 

7152
04:53:55,680 --> 04:53:57,760
CONTINUE TO SHAIR DATA GETTING 

7153
04:53:57,760 --> 04:54:00,000
IMPACT LAND BE WORKING WITH THEM

7154
04:54:00,000 --> 04:54:01,680
FOR DISSEMINATION AND THIS IS A 

7155
04:54:01,680 --> 04:54:05,000
RESEARCH STUDY NOT ALL ABOUT 

7156
04:54:05,000 --> 04:54:05,800
IMPLEMENTATION SCIENCE AND 

7157
04:54:05,800 --> 04:54:07,200
MESSAGE STARTING FROM BEGINNING 

7158
04:54:07,200 --> 04:54:09,520
HAVING INPUT WORKING WITH YOU ON

7159
04:54:09,520 --> 04:54:11,880
EACH STAGE MAKING SURE YOU GET 

7160
04:54:11,880 --> 04:54:14,440
INVOLVED ABOUT CONTEXT IN WHICH 

7161
04:54:14,440 --> 04:54:15,360
USERS WILL BE OR YOUR POPULATION

7162
04:54:15,360 --> 04:54:20,920
THAT YOU ARE TRYING TO SERVE. 

7163
04:54:20,920 --> 04:54:23,640
WHO ARE THEY AND WHAT ARE THEIR 

7164
04:54:23,640 --> 04:54:24,760
NEEDS IS AN IMPORTANT PART OF 

7165
04:54:24,760 --> 04:54:26,560
THE PROCESS.  I WILL STOP THERE 

7166
04:54:26,560 --> 04:54:28,400
AND WILL ANSWER MORE QUESTIONS 

7167
04:54:28,400 --> 04:54:29,520
ON THIS LATER.  

7168
04:54:29,520 --> 04:54:31,560
>> THANK YOU SO MUCH. 
KATE, 

7169
04:54:31,560 --> 04:54:32,920
WANT TO JUMP IN?  

7170
04:54:32,920 --> 04:54:38,200
>> YEAH.  BRIEFLY I THINK
SHE 

7171
04:54:38,200 --> 04:54:42,160
DID A GREAT JOB EXPLAINING HER 

7172
04:54:42,160 --> 04:54:45,520
PERSPECTIVE ON THIS AND THINK I 

7173
04:54:45,520 --> 04:54:47,520
TOUCHED ON IT IN MY PRESENTATION

7174
04:54:47,520 --> 04:54:51,600
ALREADY AND BEGINNING TO END AND

7175
04:54:51,600 --> 04:54:58,880
ANSWER TO HOW DOING IT TAKING 

7176
04:54:58,880 --> 04:55:03,480
TIME WITH RELATIONSHIPS AND 

7177
04:55:03,480 --> 04:55:05,240
STARTING WITH ACHIEVED PROJECT 

7178
04:55:05,240 --> 04:55:09,800
AND PROPOSAL AND PROVIDERS IN 

7179
04:55:09,800 --> 04:55:12,320
FQHCS WE COULDN'T WORKING OUT OF

7180
04:55:12,320 --> 04:55:14,040
UNIVERSITY OUR EXPERIENCE WAS 

7181
04:55:14,040 --> 04:55:16,520
DIFFERENT THAN WORKING IN FQHC 

7182
04:55:16,520 --> 04:55:18,880
AND STARTED DEFINING THAT AS OUR

7183
04:55:18,880 --> 04:55:22,280
COMMUNITY AND COMMUNITY 

7184
04:55:22,280 --> 04:55:23,800
PROVIDERS WOULD HELP SELECT 

7185
04:55:23,800 --> 04:55:25,600
WHICH ELEMENTS OF BUNDLE TO 

7186
04:55:25,600 --> 04:55:27,720
FIRST IMPLEMENT AND SO ON AND 

7187
04:55:27,720 --> 04:55:29,960
SAME TIME NO, NO, NO.  WE CAN'T.

7188
04:55:29,960 --> 04:55:32,960
THAT IS NOT ENOUGH AND WE NEED 

7189
04:55:32,960 --> 04:55:34,960
TO ENGAGE INDIVIDUALS AND 

7190
04:55:34,960 --> 04:55:36,680
PREGNANT INDIVIDUALS WE ARE 

7191
04:55:36,680 --> 04:55:38,200
CARING FOR IN THE CONVERSATION 

7192
04:55:38,200 --> 04:55:40,200
AND WE PIVOTED AND WENT TO SAY 

7193
04:55:40,200 --> 04:55:42,240
AND THEY WANTED TO TALK ABOUT 

7194
04:55:42,240 --> 04:55:45,240
RESPECTFUL CARE AND WE ASKED 

7195
04:55:45,240 --> 04:55:47,640
PATIENTS IN FOCUS GROUPS WHAT 

7196
04:55:47,640 --> 04:55:48,840
RESPECTFUL CARE MEANS TO YOU AND

7197
04:55:48,840 --> 04:55:52,680
ASKED PROVIDERS IF FQHCS WHAT 

7198
04:55:52,680 --> 04:55:54,360
RESPECTFUL CARE MEANS TO YOU AND

7199
04:55:54,360 --> 04:55:56,400
LEARNING THAT AND MAGICALLY 

7200
04:55:56,400 --> 04:55:59,520
THERE WAS SOME OVERLAP AND ALSO 

7201
04:55:59,520 --> 04:56:00,840
SOME LEARN THAGZ CAME OUT OF 

7202
04:56:00,840 --> 04:56:02,560
THAT. 

7203
04:56:02,560 --> 04:56:04,880
SO, IF NOW IN THE SECOND STAGE 

7204
04:56:04,880 --> 04:56:07,880
PHASE 2 OF PROJECT WE HAVE 

7205
04:56:07,880 --> 04:56:09,640
COMMUNITY PROVIDERS AS DEFINING 

7206
04:56:09,640 --> 04:56:11,800
COMMUNITY THAT WAY THEY ARE 

7207
04:56:11,800 --> 04:56:13,800
COMMUNITIES SO DIFFERENT THAN 

7208
04:56:13,800 --> 04:56:17,360
UNIVERSITY-BASED RESEARCHERS. 

7209
04:56:17,360 --> 04:56:18,640
WE HAVE PREGNANT INDIVIDUALS 

7210
04:56:18,640 --> 04:56:21,360
THEY ARE CARING FOR AND 

7211
04:56:21,360 --> 04:56:22,840
POSTPARTUM INDIVIDUALS AND HAVE 

7212
04:56:22,840 --> 04:56:24,760
BROADER COMMUNITY INFLUENCERS 

7213
04:56:24,760 --> 04:56:28,080
AND COMMUNITY-BASED 

7214
04:56:28,080 --> 04:56:28,440
ORGANIZATIONS. 

7215
04:56:28,440 --> 04:56:33,920
>> THANK YOU SO MUCH.  

7216
04:56:33,920 --> 04:56:35,880
>> MOVING TO SECOND
QUESTION IF

7217
04:56:35,880 --> 04:56:37,680
YOU HAVE OTHER PANELISTS THAT 

7218
04:56:37,680 --> 04:56:42,720
WOULD LIKE TO JUMP IN RAISE 

7219
04:56:42,720 --> 04:56:43,960
VIRTUAL OR PHYSICAL HAND AND LET

7220
04:56:43,960 --> 04:56:45,800
ME KNOW AND WE WILL PAUSE TO 

7221
04:56:45,800 --> 04:56:47,880
MAKE TIME FOR YOU.  NEXT 

7222
04:56:47,880 --> 04:56:49,600
QUESTION WHAT IMPLEMENTATION 

7223
04:56:49,600 --> 04:56:51,840
STEPS ARE CRITICAL TO ADJUST AND

7224
04:56:51,840 --> 04:56:54,240
INCLUDE FOR THOSE IN LOW 

7225
04:56:54,240 --> 04:56:56,120
RESOURCE AND UNDERSERVED 

7226
04:56:56,120 --> 04:56:57,000
SETTINGS. 

7227
04:56:57,000 --> 04:56:58,640
APPLE COULD I TAG YOU FIRST?  

7228
04:56:58,640 --> 04:57:02,120
>> YES.  THANK YOU. 
ISSUE IS 

7229
04:57:02,120 --> 04:57:03,880
UNDERSERVED OR UNDERRESOURCED 

7230
04:57:03,880 --> 04:57:08,200
ARE USING TECHNOLOGIES OR 

7231
04:57:08,200 --> 04:57:10,120
INNOVATIONS THAT ARE DEVELOPED 

7232
04:57:10,120 --> 04:57:13,760
AND EVALUATED WITHOUT THEM 

7233
04:57:13,760 --> 04:57:15,760
TAKING PART IN RESEARCH AND 

7234
04:57:15,760 --> 04:57:18,080
EFFICACY RESEARCH IS NOT 

7235
04:57:18,080 --> 04:57:20,840
REACHING REALLY THE UNDERSERVED 

7236
04:57:20,840 --> 04:57:24,120
AND SO I RECOMMEND THAT REALLY 

7237
04:57:24,120 --> 04:57:26,000
FOCUSING ON REACH AND REACH 

7238
04:57:26,000 --> 04:57:28,640
THOSE UNDERSERVED COMMUNITIES 

7239
04:57:28,640 --> 04:57:30,480
BEFORE YOU DO RESEARCH. 

7240
04:57:30,480 --> 04:57:32,680
DESIGN RESEARCH WITH 

7241
04:57:32,680 --> 04:57:34,880
IMPLEMENTATION IN MIND. 

7242
04:57:34,880 --> 04:57:35,680
RIGHT?  

7243
04:57:35,680 --> 04:57:37,080
THAT THINK ABOUT THE HOW.  IS 

7244
04:57:37,080 --> 04:57:39,720
THIS GOING TO BE ADAPTABLE?  

7245
04:57:39,720 --> 04:57:42,040
CAN THIS BE TAILORED IN 

7246
04:57:42,040 --> 04:57:44,520
DIFFERENT CONTEXT?  

7247
04:57:44,520 --> 04:57:48,040
ALSO DO PARTICIPATE -- 

7248
04:57:48,040 --> 04:57:49,880
COMMUNITY-BASED PARTICIPATORY 

7249
04:57:49,880 --> 04:57:51,680
RESEARCH AND LET COMMUNITY 

7250
04:57:51,680 --> 04:57:53,240
PARTICIPATE IN ASKING RIGHT 

7251
04:57:53,240 --> 04:57:56,000
QUESTIONS AND LET THEM HELP YOU 

7252
04:57:56,000 --> 04:57:57,200
FORMULATE QUESTION AND HAVE 

7253
04:57:57,200 --> 04:57:58,440
THEIR OWN SOLUTION AND MAYBE 

7254
04:57:58,440 --> 04:58:02,120
THEY ARE NOT RESEARCHERS ABOUT 

7255
04:58:02,120 --> 04:58:05,080
YOU HAVE LIVED EXPERIENCE AND 

7256
04:58:05,080 --> 04:58:07,280
CAN HELP YOU GENERATE SOLUTIONS 

7257
04:58:07,280 --> 04:58:11,120
AND ALSO BALANCING BETWEEN 

7258
04:58:11,120 --> 04:58:13,440
EFFICACY AND EFFECTIVENESS, 

7259
04:58:13,440 --> 04:58:16,280
RESEARCHERS ARE FOCUS OF EVERY 

7260
04:58:16,280 --> 04:58:20,120
RESEARCHER IS THIS INNOVATION 

7261
04:58:20,120 --> 04:58:21,560
EFFECTIVE AND EFFICACIOUS AND 

7262
04:58:21,560 --> 04:58:23,520
NOT REALLY THINKING ABOUT HOW 

7263
04:58:23,520 --> 04:58:27,600
AND AS WELL IF THIS IS EFFECTED 

7264
04:58:27,600 --> 04:58:28,200
OR NOT. 

7265
04:58:28,200 --> 04:58:30,640
>> FANTASTIC.  THANK YOU,

7266
04:58:30,640 --> 04:58:31,640
APPLE.  

7267
04:58:31,640 --> 04:58:33,240
ELIZABETH, ANYTHING TO ADD TO 

7268
04:58:33,240 --> 04:58:33,680
THIS?  

7269
04:58:33,680 --> 04:58:35,840
>> POINTS ARE WELL TAKEN
AND 

7270
04:58:35,840 --> 04:58:38,240
REALLY IMPORTANT TO THINK ABOUT 

7271
04:58:38,240 --> 04:58:41,720
HOW AND HAVE THAT VOICED FROM 

7272
04:58:41,720 --> 04:58:44,600
THE BEGINNING AND YOU KNOW I 

7273
04:58:44,600 --> 04:58:48,400
DON'T HAVE MUCH TO ADD.  I WAS 

7274
04:58:48,400 --> 04:58:50,920
GOING TO GO DOWN SAME PATH 

7275
04:58:50,920 --> 04:58:52,040
THINKING ABOUT THIS AND THINK 

7276
04:58:52,040 --> 04:58:56,360
THAT LOTS OF COMMUNITIES HAVE A 

7277
04:58:56,360 --> 04:58:58,960
RESILIENCE FACTOR AND SUCCESS IN

7278
04:58:58,960 --> 04:59:00,080
REALLY LEARNING THOSE FACTORS 

7279
04:59:00,080 --> 04:59:01,600
COMING IN WITH TRYING TO 

7280
04:59:01,600 --> 04:59:04,200
UNDERSTAND THAT SIDE OF THE COIN

7281
04:59:04,200 --> 04:59:05,360
THAT IS ANOTHER IMPORTANT PART 

7282
04:59:05,360 --> 04:59:07,320
OF THE PROCESS TRYING TO THINK 

7283
04:59:07,320 --> 04:59:09,400
ABOUT FACILITATORS TO SORT OF 

7284
04:59:09,400 --> 04:59:11,080
MAKING SURE THAT WHAT YOU ARE 

7285
04:59:11,080 --> 04:59:15,240
TRYING TO IMPLEMENT CAN ACTUALLY

7286
04:59:15,240 --> 04:59:15,440
WORK. 

7287
04:59:15,440 --> 04:59:18,640
>> GREAT.  THANK YOU, 

7288
04:59:18,640 --> 04:59:20,600
ELIZABETH.  

7289
04:59:20,600 --> 04:59:23,880
NEXT QUESTION, FOR DIGITAL 

7290
04:59:23,880 --> 04:59:26,920
PROGRAMS AND APPS AND WEARABLE 

7291
04:59:26,920 --> 04:59:28,560
DEVICES AND EMERGING 

7292
04:59:28,560 --> 04:59:29,960
TECHNOLOGIES WHAT ARE BENEFITS 

7293
04:59:29,960 --> 04:59:32,160
FOR IMPLEMENTATION SCIENCE IN 

7294
04:59:32,160 --> 04:59:34,800
EARLY AND LATE STAGES FOR 

7295
04:59:34,800 --> 04:59:37,520
PROGRAM TECH DEVELOPMENT.  SONIA

7296
04:59:37,520 --> 04:59:40,560
COULD I TAG YOU FIRST?  

7297
04:59:40,560 --> 04:59:43,160
>> SURE.  FIRST OF ALL,
THANK 

7298
04:59:43,160 --> 04:59:45,720
YOU FOR THE INVITATION TO BE 

7299
04:59:45,720 --> 04:59:48,480
HERE AND WELCOME, EVERYONE AND 

7300
04:59:48,480 --> 04:59:50,480
FOR WONDERFUL PRESENTATIONS TO 

7301
04:59:50,480 --> 04:59:51,280
KICK US OFF. 

7302
04:59:51,280 --> 04:59:53,120
MY THOUGHTS AND RESPONSE TO THIS

7303
04:59:53,120 --> 04:59:54,520
QUESTION IS REALLY INFORMED BY 

7304
04:59:54,520 --> 04:59:57,760
THE WORK I HAVE DONE IN PART 

7305
04:59:57,760 --> 04:59:59,000
FOCUS ON PREVENTION AND 

7306
04:59:59,000 --> 05:00:01,520
TREATMENT OF DEPRESSION DURING 

7307
05:00:01,520 --> 05:00:04,720
PERINATAL PERIOD AND RESEARCH 

7308
05:00:04,720 --> 05:00:06,880
PROGRAM IN PARTICULAR MINDFUL 

7309
05:00:06,880 --> 05:00:08,800
MOOD BALANCE THAT IS ESSENTIAL 

7310
05:00:08,800 --> 05:00:10,000
TO CONSIDER IMPLEMENTATION 

7311
05:00:10,000 --> 05:00:12,440
SCIENCE IN EARLY AND LATE STAGES

7312
05:00:12,440 --> 05:00:14,000
OF THIS WORK AND ALL MIDDLE 

7313
05:00:14,000 --> 05:00:17,000
STAGES TOO.  

7314
05:00:17,000 --> 05:00:23,480
SO, IT IS NOT AN EITHER OR ANLTD

7315
05:00:23,480 --> 05:00:25,400
PREFACE IT FORTUNATE TO WORK 

7316
05:00:25,400 --> 05:00:29,280
WITH A GREAT TEAM OF PEOPLE AND 

7317
05:00:29,280 --> 05:00:30,040
[INDISCERNIBLE] AT KAISER 

7318
05:00:30,040 --> 05:00:32,920
INSTITUTE FOR HEALTH RESEARCH 

7319
05:00:32,920 --> 05:00:35,680
AND LAUREL HICKS AT INSTITUTE 

7320
05:00:35,680 --> 05:00:37,200
AND STARTED WORK WITH QUESTION 

7321
05:00:37,200 --> 05:00:39,200
WHAT PEOPLE ACTUALLY WANT TO 

7322
05:00:39,200 --> 05:00:40,960
SUPPORT THEIR MENTAL HEALTH 

7323
05:00:40,960 --> 05:00:42,400
DURING PERINATAL PERIOD AND IN 

7324
05:00:42,400 --> 05:00:46,240
SOME WAYS GOING TO POINTS DR. 

7325
05:00:46,240 --> 05:00:49,160
SEP UL VEDA RAISED TAKING 

7326
05:00:49,160 --> 05:00:51,240
PARTICIPATORY APPROACHES AND 

7327
05:00:51,240 --> 05:00:52,880
FRAMEWORKS AND HEALTH CARE 

7328
05:00:52,880 --> 05:00:54,440
SYSTEMS RESPOND TO PROBLEM OF 

7329
05:00:54,440 --> 05:00:56,600
DEPRESSION DURING PERINATAL 

7330
05:00:56,600 --> 05:00:59,440
PERIOD PRIMARILY DESCRIBING 

7331
05:00:59,440 --> 05:01:00,880
ANTIDEPRESSANT P MEDICATION AND 

7332
05:01:00,880 --> 05:01:02,720
EARLY WORK SHOWED THAT IS NOT 

7333
05:01:02,720 --> 05:01:06,000
WHAT IN EARLY STUDY IS FOCUSING 

7334
05:01:06,000 --> 05:01:09,880
ON NEW AND EXPECTANT MOTHERS AND

7335
05:01:09,880 --> 05:01:12,440
80% WANTED NON-PHARMACOLOGICAL 

7336
05:01:12,440 --> 05:01:14,840
OPTIONS AND WHAT WE LOOKED AT IS

7337
05:01:14,840 --> 05:01:17,160
WHAT ARE BEST AVAILABLE 

7338
05:01:17,160 --> 05:01:18,440
EVIDENCE-BASED APPROACHES AND 

7339
05:01:18,440 --> 05:01:21,080
ONE IN PARTICULAR THAT BLENDED 

7340
05:01:21,080 --> 05:01:22,840
MINDFULNESS WAS COGNITIVE 

7341
05:01:22,840 --> 05:01:24,400
BEHAVIORAL THERAPY STUDYING WITH

7342
05:01:24,400 --> 05:01:26,320
THOUSANDS OF PEOPLE MULTIPLE 

7343
05:01:26,320 --> 05:01:28,280
COUNTRIES MINDFULNESS BASED 

7344
05:01:28,280 --> 05:01:30,160
COGNITIVE THERAPY AND LOOKED AT 

7345
05:01:30,160 --> 05:01:32,120
IMPLEMENTING IN PRENATAL CARE 

7346
05:01:32,120 --> 05:01:35,040
SETTINGS THINKING ABOUT ULTIMATE

7347
05:01:35,040 --> 05:01:37,840
USE CONTEXTS AND DELIVERING THIS

7348
05:01:37,840 --> 05:01:39,480
INITIALLY IS IN-PERSON PROGRAM 

7349
05:01:39,480 --> 05:01:41,280
AND BEING REALLY EXCITED ABOUT 

7350
05:01:41,280 --> 05:01:44,600
FINDINGS IN TERMS OF CAPACITY TO

7351
05:01:44,600 --> 05:01:47,640
HELP NEW AND EXPECTANT MOTHERS 

7352
05:01:47,640 --> 05:01:49,520
PREVENT DEPRESSION RELAPSE FOR 

7353
05:01:49,520 --> 05:01:52,560
PEOPLE AT ELEVATED RISKS HAVING 

7354
05:01:52,560 --> 05:01:53,520
EXPERIENCED DEPRESSION IN THE 

7355
05:01:53,520 --> 05:01:55,360
PAST AND WE WERE REALLY EXCITED 

7356
05:01:55,360 --> 05:01:57,840
ABOUT FINDINGS AND WHAT WE 

7357
05:01:57,840 --> 05:01:59,480
UNFORTUNATELY ALSO FOUND BY 

7358
05:01:59,480 --> 05:02:01,520
ATTENDING SOME IMPLEMENTATION 

7359
05:02:01,520 --> 05:02:04,280
SCIENCE FRAMEWORKS AND 

7360
05:02:04,280 --> 05:02:06,760
CONSTRUCTS WAS THAT BARRIERS 

7361
05:02:06,760 --> 05:02:09,760
WERE TOO HIGH WITH THAT APPROACH

7362
05:02:09,760 --> 05:02:12,440
WITH REGARDS TO FIDELITY AND 

7363
05:02:12,440 --> 05:02:13,800
REQUIREMENT FOR TRAINING 

7364
05:02:13,800 --> 05:02:15,440
PROVIDERS AND APPROACH AND 

7365
05:02:15,440 --> 05:02:16,840
SUSTAINING IT AND EFFORT TO KEEP

7366
05:02:16,840 --> 05:02:19,280
A PROGRAM GOING WHEN SETTINGS 

7367
05:02:19,280 --> 05:02:21,520
DIDN'T SEE IT AS CORE PRIMARY 

7368
05:02:21,520 --> 05:02:23,160
MANDATE AND IF MAYBE WE WILL 

7369
05:02:23,160 --> 05:02:25,400
TALK LATER ABOUT REQUIREMENTS ON

7370
05:02:25,400 --> 05:02:26,760
INDIVIDUAL NEW AND EXPECTED 

7371
05:02:26,760 --> 05:02:30,960
APPEARANCE IN TERMS OF THEIR 

7372
05:02:30,960 --> 05:02:31,720
ENGAGEMENT. 

7373
05:02:31,720 --> 05:02:35,320
DIGITAL PROGRAM MINDFUL MOOD 

7374
05:02:35,320 --> 05:02:37,440
BALANCE ESSENTIALLY DEVELOPED 

7375
05:02:37,440 --> 05:02:41,600
CORE SKILLS AND PRACTICES IN 

7376
05:02:41,600 --> 05:02:42,960
SELF-GUIDED COACH AND SUPPORTED 

7377
05:02:42,960 --> 05:02:44,960
WAY THAT WE DESIGN WITH A TEAM 

7378
05:02:44,960 --> 05:02:46,960
OF NEW AND EXPECTED PARENTS 

7379
05:02:46,960 --> 05:02:48,560
WORKING CLOSELY AS DESIGN 

7380
05:02:48,560 --> 05:02:50,960
PARTNERS WITH US AND ARE 

7381
05:02:50,960 --> 05:02:53,320
STUDYING THAT NOW IN LATER 

7382
05:02:53,320 --> 05:02:55,280
PHASES OF THIS WORK FOCUSING 

7383
05:02:55,280 --> 05:02:58,200
DIRECTLY ON EFFECTIVENESS OF 

7384
05:02:58,200 --> 05:02:58,840
IMPLEMENTATION OUTCOMES SOOND 

7385
05:02:58,840 --> 05:03:00,720
THAT IS ONE EXAMPLE THAT I THINK

7386
05:03:00,720 --> 05:03:04,720
IS OF HOW THESE FRAMEWORKS AND 

7387
05:03:04,720 --> 05:03:07,160
CONSTRUCTS AND METRICS ARE 

7388
05:03:07,160 --> 05:03:10,880
RELEVANT AT ALL PHASES OF THE 

7389
05:03:10,880 --> 05:03:11,720
RESEARCH PROCESS. 

7390
05:03:11,720 --> 05:03:14,800
>> GREAT.  THANK YOU SO
MUCH.  

7391
05:03:14,800 --> 05:03:15,920
APPLE, ANYTHING TO ADD?  

7392
05:03:15,920 --> 05:03:18,320
>> I WOULD LIKE TO ADD
ONE MORE

7393
05:03:18,320 --> 05:03:18,520
THING. 

7394
05:03:18,520 --> 05:03:21,160
IN EARLY STAGES OF INNOVATION OF

7395
05:03:21,160 --> 05:03:23,360
TECHNOLOGY IT IS IMPORTANT TO 

7396
05:03:23,360 --> 05:03:24,600
INTEGRATE IMPLEMENTATION 

7397
05:03:24,600 --> 05:03:27,000
RESEARCH.  IT HELPS YOU MAKE 

7398
05:03:27,000 --> 05:03:29,000
SURE THAT THESE -- YOUR 

7399
05:03:29,000 --> 05:03:31,800
INNOVATION IS ACCEPTABLE OR 

7400
05:03:31,800 --> 05:03:32,040
FEASIBLE. 

7401
05:03:32,040 --> 05:03:33,480
OR USABLE. 

7402
05:03:33,480 --> 05:03:36,120
THEN IN LATER STAGES, YOU KNOW, 

7403
05:03:36,120 --> 05:03:38,960
AS YOU GO AND IMPLEMENTATION 

7404
05:03:38,960 --> 05:03:42,200
RESEARCH IN EVERY STAGE AND 

7405
05:03:42,200 --> 05:03:43,600
LATER STAGES COW IMPLEMENTATION 

7406
05:03:43,600 --> 05:03:45,440
RESEARCH YOU COULD USE TO MAKE 

7407
05:03:45,440 --> 05:03:47,160
SURE THERE IS COST EFFECTIVE AND

7408
05:03:47,160 --> 05:03:49,320
IT IS SUSTAINABLE AND ADAPTABLE 

7409
05:03:49,320 --> 05:03:51,040
TO DIFFERENT POPULATIONS ACROSS 

7410
05:03:51,040 --> 05:03:51,840
THE BOARD. 

7411
05:03:51,840 --> 05:03:54,960
SO, THAT IS WHY IT IS VERY 

7412
05:03:54,960 --> 05:03:57,000
IMPORTANT TO THINK ABOUT THAT. 

7413
05:03:57,000 --> 05:03:58,520
>> GREAT.  THANK YOU. 

7414
05:03:58,520 --> 05:04:00,760
I'M ON TO MY LAST QUESTION AND 

7415
05:04:00,760 --> 05:04:02,480
DOING A QUICK TIME CHECK.  HOW 

7416
05:04:02,480 --> 05:04:04,880
ARE WE -- PERFECT.  AS I GET TO 

7417
05:04:04,880 --> 05:04:07,080
THE LAST QUESTION, IF YOU THINK 

7418
05:04:07,080 --> 05:04:09,040
OF YOUR SUPER AWESOME QUESTIONS 

7419
05:04:09,040 --> 05:04:10,800
IN THE AUDIENCE TYPE THEM INTO 

7420
05:04:10,800 --> 05:04:13,520
THE ZOOM CHAT OR IF YOU WANT TO 

7421
05:04:13,520 --> 05:04:15,800
MAYBE GET IN CUE FOR MICROPHONES

7422
05:04:15,800 --> 05:04:17,600
THIS WILL BE LAST FORMAL 

7423
05:04:17,600 --> 05:04:19,040
QUESTION AND WE WOULD LOVE TO 

7424
05:04:19,040 --> 05:04:21,120
GET TO YOUR QUESTIONS AS WELL 

7425
05:04:21,120 --> 05:04:22,320
AND LAST QUESTION FOR THE PANEL 

7426
05:04:22,320 --> 05:04:25,160
IS WHAT DO YOU THINK ARE KEY 

7427
05:04:25,160 --> 05:04:29,360
CHALLENGES AND IN IMPLEMENTING 

7428
05:04:29,360 --> 05:04:30,840
TECHNOLOGY-BASED SOLUTIONS FOR 

7429
05:04:30,840 --> 05:04:32,000
MATERNAL HEALTH?  

7430
05:04:32,000 --> 05:04:33,600
KATE, CAN I START WITH YOU ON 

7431
05:04:33,600 --> 05:04:36,360
THIS ONE?  

7432
05:04:36,360 --> 05:04:38,800
>> YOU CAN.  I WANTED TO
ALMOST

7433
05:04:38,800 --> 05:04:40,240
TAKE THIS TO THAT SAFER 

7434
05:04:40,240 --> 05:04:42,000
FRAMEWORK IF YOU WANTED TO.  YOU

7435
05:04:42,000 --> 05:04:43,560
KNOW, WHEN YOU THINK ABOUT -- I 

7436
05:04:43,560 --> 05:04:46,000
THINK IF YOU THINK ABOUT OUTER 

7437
05:04:46,000 --> 05:04:49,960
SETTING ISSUES, IT -- WITH 

7438
05:04:49,960 --> 05:04:52,000
TECHNOLOGY AND IN PARTICULAR 

7439
05:04:52,000 --> 05:04:54,520
THAT INCLUDES RESOURCE NAZ IS 

7440
05:04:54,520 --> 05:04:55,920
BROADBAND AND AVAILABILITY OF 

7441
05:04:55,920 --> 05:04:58,960
THAT AND INCLUDING POLICIES AND 

7442
05:04:58,960 --> 05:05:00,680
EXTERNAL POLICIES TO MAKE THAT 

7443
05:05:00,680 --> 05:05:02,120
BILLING AND PAYMENT POLICIES AND

7444
05:05:02,120 --> 05:05:03,680
THAT SORT OF THING THAT WILL 

7445
05:05:03,680 --> 05:05:04,880
MAKE IT DIFFICULT. 

7446
05:05:04,880 --> 05:05:07,240
I THINK THAT ADOPTION OF MANY OF

7447
05:05:07,240 --> 05:05:11,320
THESE TECHNOLOGIES WILL REQUIRE 

7448
05:05:11,320 --> 05:05:14,040
US FOR BROADBAND TO BE LIKE 

7449
05:05:14,040 --> 05:05:16,840
CLEAN WATER IF OUR SOCIETY, YOU 

7450
05:05:16,840 --> 05:05:19,200
KNOW, TO REALLY GET IT OUT THERE

7451
05:05:19,200 --> 05:05:23,160
KIND OF EQUITABLY AND INNER 

7452
05:05:23,160 --> 05:05:24,720
SETTING READINESS AND CULTURE 

7453
05:05:24,720 --> 05:05:26,440
AND THE COMMUNICATIONS SYSTEMS 

7454
05:05:26,440 --> 05:05:28,560
AND INNER SETTING, YOU NEED 

7455
05:05:28,560 --> 05:05:32,120
PEOPLE WHO ARE -- YOU KNOW, WHO 

7456
05:05:32,120 --> 05:05:34,160
ARE -- THEY NEED TO BE READY TO 

7457
05:05:34,160 --> 05:05:35,760
DO THAT AND HAVE -- THERE ARE 

7458
05:05:35,760 --> 05:05:36,960
OTHER PRIORITIES THAT ARE 

7459
05:05:36,960 --> 05:05:38,800
GETTING IN THE WAY AND THAT 

7460
05:05:38,800 --> 05:05:41,320
OFTEN IS AN ISSUE GENERALLY WITH

7461
05:05:41,320 --> 05:05:43,200
WOMEN'S HEALTH INITIATIVES AND 

7462
05:05:43,200 --> 05:05:45,480
THINKING ABOUT HEALTH SYSTEMS 

7463
05:05:45,480 --> 05:05:47,600
PRIORITIZING OTHER THINGS 

7464
05:05:47,600 --> 05:05:49,120
UNFORTUNATELY WE ARE NOT ALWAYS 

7465
05:05:49,120 --> 05:05:51,200
AT THE TOP OF THE LIST AND NEED 

7466
05:05:51,200 --> 05:05:54,000
TO BE THERE AND ARE DOING BETTER

7467
05:05:54,000 --> 05:05:56,800
IN THAT AREA AND CHARACTERISTICS

7468
05:05:56,800 --> 05:05:58,720
WITH INDIVIDUALS AND 

7469
05:05:58,720 --> 05:06:01,000
SELF-EFFICACY AND MOTIVATION AND

7470
05:06:01,000 --> 05:06:03,440
GENERATIONAL GAPS FOCUSING ON 

7471
05:06:03,440 --> 05:06:04,960
PEOPLE OF BIRTHING AGE AND THAT 

7472
05:06:04,960 --> 05:06:05,920
SORT OF THING AND TECHNOLOGY 

7473
05:06:05,920 --> 05:06:07,960
WILL BE PICKED UP VERY QUICKLY 

7474
05:06:07,960 --> 05:06:09,560
AND MAYBE FOR SOME PROVIDERS 

7475
05:06:09,560 --> 05:06:10,960
THAT WON'T PICK IT UP AS FAST 

7476
05:06:10,960 --> 05:06:12,440
AND SOME OF THOSE THINGS THOSE 

7477
05:06:12,440 --> 05:06:15,000
ARE THINGS THAT I HAVE SEEN IN 

7478
05:06:15,000 --> 05:06:17,960
ADOPTION OF APPS AND DIFFERENT 

7479
05:06:17,960 --> 05:06:19,360
COMPUTER APPLICATIONS AND THINGS

7480
05:06:19,360 --> 05:06:22,560
LIKE THAT, THAT HAVE COME ALONG.

7481
05:06:22,560 --> 05:06:24,960
>> THANK YOU, KATE. 

7482
05:06:24,960 --> 05:06:26,680
>> CAN I CALL ON YOU
NEXT?  

7483
05:06:26,680 --> 05:06:30,160
>> SURE.  THERE IS A
NUMBER OF 

7484
05:06:30,160 --> 05:06:31,160
IMPORTANT CHALLENGES TO CONSIDER

7485
05:06:31,160 --> 05:06:34,520
AND ONE IS IT IS COSTLY TO 

7486
05:06:34,520 --> 05:06:40,360
DESIGN AND UPDATE AND MAINTAIN 

7487
05:06:40,360 --> 05:06:42,920
UPDATES OF PROGRAMS AND RELATING

7488
05:06:42,920 --> 05:06:46,200
TO THAT IS THINKING CRITICALLY 

7489
05:06:46,200 --> 05:06:47,680
ABOUT INTERSECTION OF TECHNOLOGY

7490
05:06:47,680 --> 05:06:50,560
AND COMMUNITY ENGAGEMENT AND 

7491
05:06:50,560 --> 05:06:53,240
TAKES TIME AND HAS BEEN 

7492
05:06:53,240 --> 05:06:55,120
EMPHASIZED REPEATEDLY AND 

7493
05:06:55,120 --> 05:06:57,240
NEEDING TO BE EMPHASIZED AGAIN 

7494
05:06:57,240 --> 05:06:59,800
AND INSTITUTE THAT I DIRECTED 

7495
05:06:59,800 --> 05:07:02,880
OUR DESIGN CYCLE IS GROUNDED IN 

7496
05:07:02,880 --> 05:07:05,560
BUILDING TRUSTED TEAMS THAT IS 

7497
05:07:05,560 --> 05:07:08,000
NOT SOMETHING TO BE RUCHED AND 

7498
05:07:08,000 --> 05:07:09,400
THINKING CRITICALLY ABOUT HOW 

7499
05:07:09,400 --> 05:07:11,800
THE TWO INTERSECT WITH EACH 

7500
05:07:11,800 --> 05:07:14,760
OTHER AND OTHER THING IN 

7501
05:07:14,760 --> 05:07:17,360
ADDITION TO DR. MENARD MENTIONED

7502
05:07:17,360 --> 05:07:19,840
ISSUE OF ACCESS WE HAVE TO THINK

7503
05:07:19,840 --> 05:07:22,240
CRITICALLY ABOUT ENGAGEMENT 

7504
05:07:22,240 --> 05:07:24,720
FACTORS AND USE AND ACCESS ARE 

7505
05:07:24,720 --> 05:07:25,600
NOT SAME THING. 

7506
05:07:25,600 --> 05:07:28,640
SO I THINK THAT I WOULD GO BACK 

7507
05:07:28,640 --> 05:07:30,240
TO ACTUALLY ONE THING YOU SAID 

7508
05:07:30,240 --> 05:07:32,480
IN THE BEGINNING ABOUT WHAT 

7509
05:07:32,480 --> 05:07:33,480
IMPLEMENTATION SCIENCE IS ABOUT 

7510
05:07:33,480 --> 05:07:36,360
AND IT IS ABOUT STRUCTURE AND 

7511
05:07:36,360 --> 05:07:39,320
CONDITIONS NECESSARY TO 

7512
05:07:39,320 --> 05:07:42,920
SUCCESSFULLY IMPLEMENT PROGRAMS 

7513
05:07:42,920 --> 05:07:44,160
AND LOOKING AT IN PARTICULAR 

7514
05:07:44,160 --> 05:07:47,240
RATES OF ENGAGEMENT AND NEW AND 

7515
05:07:47,240 --> 05:07:49,360
EXPECTED APPEARANCE WITH SOME 

7516
05:07:49,360 --> 05:07:51,360
DIGITAL PROGRAMS IS SYSTEM THAT 

7517
05:07:51,360 --> 05:07:55,200
IS PLACED WHERE WE NEED TO SEE 

7518
05:07:55,200 --> 05:07:57,040
IMPROVEMENTS AND NEED TO SEE 

7519
05:07:57,040 --> 05:07:58,600
INCREASES IN LEVEL OF ENGAGEMENT

7520
05:07:58,600 --> 05:08:01,560
THAT WE OFTEN FOCUS ON THE 

7521
05:08:01,560 --> 05:08:02,920
INDIVIDUAL IN THIS CASE AND WE 

7522
05:08:02,920 --> 05:08:05,560
HAVE TO HAVE EQUAL ATTENTION TO 

7523
05:08:05,560 --> 05:08:06,960
WHAT IS THE CONTEXT AND WOULD 

7524
05:08:06,960 --> 05:08:08,880
SAY WHEN WE PAY ATTENTION TO 

7525
05:08:08,880 --> 05:08:11,200
REALITY OF CONTINUED LACK OF 

7526
05:08:11,200 --> 05:08:13,040
PARENTAL LEAVE AND LACK OF 

7527
05:08:13,040 --> 05:08:14,720
AFFORDABLE CHILDCARE AND LACK OF

7528
05:08:14,720 --> 05:08:16,600
PAID SICK LEAVE AND LACK OF 

7529
05:08:16,600 --> 05:08:18,160
REASONABLE OPTIONS FOR ELDER 

7530
05:08:18,160 --> 05:08:20,280
CARE WE HAVE A BROAD CONTEXT 

7531
05:08:20,280 --> 05:08:22,320
THAT DEVALUES WORK OF CARING IN 

7532
05:08:22,320 --> 05:08:26,280
OUR COUNTRY AND WHEN WE EXPECT 

7533
05:08:26,280 --> 05:08:28,960
PEOPLE TO ENGAGE IN 

7534
05:08:28,960 --> 05:08:30,960
INTERVENTIONS THAT DO TAKE TIME 

7535
05:08:30,960 --> 05:08:34,720
TO LEARN, IT IS WITHIN THE 

7536
05:08:34,720 --> 05:08:38,480
CONTEXT WHERE TIME IS SUCH A 

7537
05:08:38,480 --> 05:08:40,040
PRECIOUS AND RESOURCE THAT IS 

7538
05:08:40,040 --> 05:08:42,080
ALSO -- IT HAS A LOT OF 

7539
05:08:42,080 --> 05:08:44,480
INEQUALITY IN TERMS OF 

7540
05:08:44,480 --> 05:08:46,160
AVAILABILITY AND DISTRIBUTION 

7541
05:08:46,160 --> 05:08:48,800
AND WE NEED TO ATTEND TO BOTH 

7542
05:08:48,800 --> 05:08:50,720
NATURE OF PROGRAM AND EXPERIENCE

7543
05:08:50,720 --> 05:08:52,920
OF PEOPLE ENGAGING WITH THESE 

7544
05:08:52,920 --> 05:08:55,320
PROGRAMS AND BROADER CONTEXT OF 

7545
05:08:55,320 --> 05:08:58,040
THE LIVES OF NEW AND EXPECTANT 

7546
05:08:58,040 --> 05:09:02,200
PARENTS IN OUR COUNTRY. 

7547
05:09:02,200 --> 05:09:03,000
THANK YOU. 

7548
05:09:03,000 --> 05:09:04,480
>> THANK YOU.  WE REALLY 

7549
05:09:04,480 --> 05:09:06,160
APPRECIATE THAT.  THAT CONCLUDES

7550
05:09:06,160 --> 05:09:07,840
QUESTIONS THAT I HAD.  WE WILL 

7551
05:09:07,840 --> 05:09:10,080
OPEN IT TO QUESTIONS FOR THE 

7552
05:09:10,080 --> 05:09:11,720
AUDIENCE AND PLEASE FEEL FREE IF

7553
05:09:11,720 --> 05:09:13,480
PHYSICALLY HERE TO COME UP TO 

7554
05:09:13,480 --> 05:09:14,560
THE MICROPHONE. 

7555
05:09:14,560 --> 05:09:16,520
KAREN, DO WE HAVE QUESTIONS IN 

7556
05:09:16,520 --> 05:09:17,880
THE Q & A?  

7557
05:09:17,880 --> 05:09:21,960
>> I CAN GET STARTED WITH
ONE 

7558
05:09:21,960 --> 05:09:22,400
REALLY QUICK. 

7559
05:09:22,400 --> 05:09:23,200
SO S

7560
05:09:23,200 --> 05:09:25,800
SO, THINKING OUTSIDE OF THE MANY

7561
05:09:25,800 --> 05:09:28,200
VARIABLES OF DIFFERENT TYPES OF 

7562
05:09:28,200 --> 05:09:29,720
TECHNOLOGY THAT WITH WOULD 

7563
05:09:29,720 --> 05:09:30,960
IMPLEMENTED SO MUCH TO THINK 

7564
05:09:30,960 --> 05:09:33,240
ABOUT AS FAR AS POPULATION AND 

7565
05:09:33,240 --> 05:09:34,640
PHYSICAL IMPLEMENTATION SPACE 

7566
05:09:34,640 --> 05:09:36,760
FOR PROVIDERS DELIVERING AND 

7567
05:09:36,760 --> 05:09:38,720
DIFFERENT STAGES OF 

7568
05:09:38,720 --> 05:09:41,000
PRECONCEPTION AND PREGNANCY 

7569
05:09:41,000 --> 05:09:44,440
POSTPARTUM THERE IS A LOT TO 

7570
05:09:44,440 --> 05:09:46,160
LEAD TO CONTEXT SPECIFIC FACTORS

7571
05:09:46,160 --> 05:09:48,360
AND WHAT ADVISE TO GIVE TO 

7572
05:09:48,360 --> 05:09:51,000
NOVICE TRYING TO INCORPORATE 

7573
05:09:51,000 --> 05:09:53,040
IMPLEMENTATION SCIENCE INTO 

7574
05:09:53,040 --> 05:09:58,960
THEIR RESEARCH. 

7575
05:09:58,960 --> 05:10:03,560
>> I SEE YOU ARE ALL
SUPER 

7576
05:10:03,560 --> 05:10:06,880
ANXIOUS TO ANSWER THE QUESTION 

7577
05:10:06,880 --> 05:10:07,280
FIRST. 

7578
05:10:07,280 --> 05:10:09,080
DO YOU HAVE ANY THOUGHTS ON 

7579
05:10:09,080 --> 05:10:09,960
THIS, KATE?  

7580
05:10:09,960 --> 05:10:11,880
>> JUST IN A NUTSHELL
QUESTION 

7581
05:10:11,880 --> 05:10:15,160
OF HOW DO YOU -- HOW DOES A 

7582
05:10:15,160 --> 05:10:16,640
NOVICE INCORPORATE 

7583
05:10:16,640 --> 05:10:18,200
IMPLEMENTATION SCIENCE INTO 

7584
05:10:18,200 --> 05:10:18,600
THEIR WORK. 

7585
05:10:18,600 --> 05:10:19,080
>> YES. 

7586
05:10:19,080 --> 05:10:20,960
>> WELL, I THINK PROBABLY
GOING

7587
05:10:20,960 --> 05:10:23,280
BACK TO -- IF YOU HAVE THE 

7588
05:10:23,280 --> 05:10:25,040
EVIDENCE BASED INTERVENTION, YOU

7589
05:10:25,040 --> 05:10:26,760
HAVE TO START THERE; RIGHT?  

7590
05:10:26,760 --> 05:10:30,280
IF YOU HAVE EVIDENCE-BASED 

7591
05:10:30,280 --> 05:10:33,520
INTERVENTION, I THINK THAT IN 

7592
05:10:33,520 --> 05:10:35,200
DESIGNING AN IMPLEMENTATION 

7593
05:10:35,200 --> 05:10:37,200
PRACTICE IT MAY BE THE FIRST 

7594
05:10:37,200 --> 05:10:39,000
THING TO DO AND HAVING OR 

7595
05:10:39,000 --> 05:10:42,280
MAPPING OUT PRACTICE WHERE YOU 

7596
05:10:42,280 --> 05:10:45,240
THINK ABOUT THE HOW AND WHO AND 

7597
05:10:45,240 --> 05:10:48,040
WHERE TO GET YOUR OUTCOMES AND 

7598
05:10:48,040 --> 05:10:49,760
THEN YOU BUILD AROUND THAT YOU 

7599
05:10:49,760 --> 05:10:51,480
BUILD SCIENCE OF TESTING THOSE 

7600
05:10:51,480 --> 05:10:53,840
AND MEASURING OUTCOMES THAT IS 

7601
05:10:53,840 --> 05:10:56,600
FOR A NOVICE THAT IS A STEPWISE 

7602
05:10:56,600 --> 05:11:00,520
APPROACH TO COMING AND INTO 

7603
05:11:00,520 --> 05:11:04,400
IMPLEMENTATION PRACTICE FLASH 

7604
05:11:04,400 --> 05:11:06,680
IMPLEMENTATION SCIENTIST.  MAKE 

7605
05:11:06,680 --> 05:11:06,960
SENSE?  

7606
05:11:06,960 --> 05:11:09,000
>> CAN I ADD I THINK IT
IS 

7607
05:11:09,000 --> 05:11:10,000
REALLY IMPORTANT TO THINK ABOUT 

7608
05:11:10,000 --> 05:11:12,680
THE DOING OF THE SCIENCE AS A 

7609
05:11:12,680 --> 05:11:15,240
COMMUNITY ACTIVITY AND EFFORT ON

7610
05:11:15,240 --> 05:11:18,080
ITS OWN AND IN ITSELF AND SO TO 

7611
05:11:18,080 --> 05:11:19,840
KNOW THAT IN GETTING. 

7612
05:11:19,840 --> 05:11:22,560
[START OF CLASS]ED, THINK ABOUT 

7613
05:11:22,560 --> 05:11:23,960
WHO CAN BRING COLLABORATIVE 

7614
05:11:23,960 --> 05:11:25,200
EXPERTISE THAT DOESN'T HAVE TO 

7615
05:11:25,200 --> 05:11:27,600
ALL BE YOU IN TERMS OF GETTING 

7616
05:11:27,600 --> 05:11:29,800
STARTED.  IT IS REALLY ABOUT 

7617
05:11:29,800 --> 05:11:31,960
DESIGNING A TEAM AND BRINGING 

7618
05:11:31,960 --> 05:11:34,560
PEOPLE WITH MULTIPLE VOICES AND 

7619
05:11:34,560 --> 05:11:36,080
SOURCES OF EXPERTISE THAT CAN 

7620
05:11:36,080 --> 05:11:38,800
WORK TOGETHER THAT MAKES THE 

7621
05:11:38,800 --> 05:11:42,680
PROCESS MUCH LESS DAUNTING AND A

7622
05:11:42,680 --> 05:11:44,680
LOT MORE FUN 

7623
05:11:44,680 --> 05:11:46,920
>> GREAT.  THANK YOU AND
THANK 

7624
05:11:46,920 --> 05:11:48,400
YOU, KATE. 

7625
05:11:48,400 --> 05:11:50,200
SO, WE HAVE A QUESTION. 

7626
05:11:50,200 --> 05:11:51,400
PLEASE JUMP IN. 

7627
05:11:51,400 --> 05:11:54,880
>> YEAH.  HI.  CHRISTINE
ROWEN 

7628
05:11:54,880 --> 05:11:59,600
AND CEO OF BASO WATCH A START-UP

7629
05:11:59,600 --> 05:12:02,880
DEVELOPING CLINICAL SUPPORT 

7630
05:12:02,880 --> 05:12:08,240
SYSTEM FOR REDUCING RISK FOR 

7631
05:12:08,240 --> 05:12:10,760
POSTPARTUM HEM RANL AND NO ONE 

7632
05:12:10,760 --> 05:12:13,960
MENTIONED ER INTEGRATION AS 

7633
05:12:13,960 --> 05:12:16,240
BARRIER TO IMPLEMENTATION 

7634
05:12:16,240 --> 05:12:17,520
SUCCESS.  WHEN THINKING OF EASE 

7635
05:12:17,520 --> 05:12:20,720
OF CLINICIAN USE TAKING AWAY 

7636
05:12:20,720 --> 05:12:22,600
SOME PAPE ERR WORK SEEMS LIKE 

7637
05:12:22,600 --> 05:12:23,880
LOGICAL BARRIERS AND HAVE BEEN 

7638
05:12:23,880 --> 05:12:26,120
TOLD WHERE YOU HAVE TO GET IN 

7639
05:12:26,120 --> 05:12:28,480
LINE AND EVIDENCE-BASED SOLUTION

7640
05:12:28,480 --> 05:12:30,280
DON'T HAVE TO GET INTEGRATED 

7641
05:12:30,280 --> 05:12:33,640
INTO EHR AND WHAT IT DOES FOR 

7642
05:12:33,640 --> 05:12:35,920
CHANCES OF SUCCESS AND CONTEXTS 

7643
05:12:35,920 --> 05:12:43,040
THAT YOU COULD GIVE US?  

7644
05:12:43,040 --> 05:12:48,720
>> I WILL COME ON THAT. 
YOU 

7645
05:12:48,720 --> 05:12:50,760
ARE ABSOLUTELY RIGHT.  

7646
05:12:50,760 --> 05:12:52,200
INTEGRATION IS A BARRIER AND 

7647
05:12:52,200 --> 05:12:54,200
MANY INNOVATIONS THAT WE -- THAT

7648
05:12:54,200 --> 05:12:58,640
WE ARE TALKING ABOUT ACTUALLY 

7649
05:12:58,640 --> 05:13:01,000
WORK AROUND THAT.  IT HAS BEEN 

7650
05:13:01,000 --> 05:13:03,840
SO HARD IN A LOT OF SENSES TO 

7651
05:13:03,840 --> 05:13:04,960
INTEGRATE THEM AND SOME HAVE 

7652
05:13:04,960 --> 05:13:07,760
BEEN SUCCESSFUL BRINGING FOR 

7653
05:13:07,760 --> 05:13:09,520
EXAMPLE HOMEOWNER BLOOD 

7654
05:13:09,520 --> 05:13:11,560
PRESSURES AND MONITORING 

7655
05:13:11,560 --> 05:13:12,680
DIABETES AND THAT SORT OF THING 

7656
05:13:12,680 --> 05:13:17,160
INTO HR THAT IS AN UPHILL 

7657
05:13:17,160 --> 05:13:19,040
BATTLE.  

7658
05:13:19,040 --> 05:13:23,760
>> DO I HAVE A SOLUTION? 
I 

7659
05:13:23,760 --> 05:13:29,120
HAVE TO SAY WE HAVE TRIED AND I 

7660
05:13:29,120 --> 05:13:29,360
DON'T. 

7661
05:13:29,360 --> 05:13:30,800
>> THANK YOU. 

7662
05:13:30,800 --> 05:13:35,280
>> SOMEBODY ELSE CHIME IN
NOT 

7663
05:13:35,280 --> 05:13:36,400
DEBBIE DOWNER. 

7664
05:13:36,400 --> 05:13:39,680
THAT IS A HARD ONE. 

7665
05:13:39,680 --> 05:13:41,240
>> GREAT.  

7666
05:13:41,240 --> 05:13:45,520
>> MALIA HAS A QUESTION
IN THE 

7667
05:13:45,520 --> 05:13:45,720
BACK. 

7668
05:13:45,720 --> 05:13:47,720
>> CAN YOU HEAR ME,
KAREN?  

7669
05:13:47,720 --> 05:13:48,960
>> YES.  THANK YOU.

7670
05:13:48,960 --> 05:13:50,480
>> QUESTION WHERE HEALTH 

7671
05:13:50,480 --> 05:13:52,680
ECONOMICS FITS INTO 

7672
05:13:52,680 --> 05:13:54,520
IMPLEMENTATION SCIENCE AND HOW 

7673
05:13:54,520 --> 05:13:56,360
MOMMA DEFINES COST 

7674
05:13:56,360 --> 05:13:56,920
EFFECTIVENESS?  

7675
05:13:56,920 --> 05:13:58,880
>> THAT IS A VERY GOOD 

7676
05:13:58,880 --> 05:14:01,600
QUESTION.  WE ARE STILL 

7677
05:14:01,600 --> 05:14:03,280
DETERMINING COST EFFECTIVENESS. 

7678
05:14:03,280 --> 05:14:05,600
RIGHT NOW WE ARE PILOTING AN 

7679
05:14:05,600 --> 05:14:08,440
EARLIER INTERVENTION AND WE ARE 

7680
05:14:08,440 --> 05:14:10,960
NOT BILLING FOR SCREENING AND WE

7681
05:14:10,960 --> 05:14:13,560
ARE LUCKILY HAVING A PARTNERSHIP

7682
05:14:13,560 --> 05:14:17,880
WITH MOMMA AND DO IT WITH NO 

7683
05:14:17,880 --> 05:14:19,920
LONG COST THAT IS SUSTAINABLE 

7684
05:14:19,920 --> 05:14:22,640
AND NEXT PLAN TO FIGURE OUT HOW 

7685
05:14:22,640 --> 05:14:25,080
WE CAN GET THIS SUSTAINABLE SO 

7686
05:14:25,080 --> 05:14:29,160
EVERYBODY COULD USE IT.  RIGHT 

7687
05:14:29,160 --> 05:14:31,400
NOW MOMMA IS BEING PILOTED AT 

7688
05:14:31,400 --> 05:14:33,800
EARLY INTERVENTION SETTINGS FOR 

7689
05:14:33,800 --> 05:14:35,800
STATE OF MAINE AND ARE CONTRACTS

7690
05:14:35,800 --> 05:14:40,000
TO BE DEVELOPED BUT IT IS NOT 

7691
05:14:40,000 --> 05:14:41,400
SUSTAINABLE AND WHAT OUR GOAL 

7692
05:14:41,400 --> 05:14:44,440
IS, IS TO REALLY JUST BUILD AN 

7693
05:14:44,440 --> 05:14:47,480
INFRASTRUCTURE AND TEST IT AND 

7694
05:14:47,480 --> 05:14:50,800
THEN IMPLEMENTATION SCIENCE USE 

7695
05:14:50,800 --> 05:14:53,360
IT TO BUILD COST EFFECTIVENESS 

7696
05:14:53,360 --> 05:14:56,520
MEASURES WHETHER OR NOT STUDY 

7697
05:14:56,520 --> 05:14:59,760
OUTCOMES OF DEVELOPMENT OF 

7698
05:14:59,760 --> 05:15:02,120
CHILDREN OR HAVE MOMS AND LESS 

7699
05:15:02,120 --> 05:15:07,840
VISITS TO ER AS MEASURES FOR 

7700
05:15:07,840 --> 05:15:08,960
REIMBURSEMENTS BECAUSE THE 

7701
05:15:08,960 --> 05:15:11,200
SYSTEM IS BROKEN AND IT IS A 

7702
05:15:11,200 --> 05:15:15,320
VERY HARD PROBLEM TO FIX.  

7703
05:15:15,320 --> 05:15:17,560
>> I WOULD ADD IN GENERAL

7704
05:15:17,560 --> 05:15:20,160
MATERNAL HEALTH IS HARD TO TALK 

7705
05:15:20,160 --> 05:15:22,440
ABOUT COST EFFECTIVENESS STUDIES

7706
05:15:22,440 --> 05:15:25,040
WE DON'T INCORPORATE LONG-TERM 

7707
05:15:25,040 --> 05:15:27,440
IMPACTS AND IF WE CONTROL BLOOD 

7708
05:15:27,440 --> 05:15:29,320
PRESSURE POSTPARTUM NOT ONLY CAN

7709
05:15:29,320 --> 05:15:32,560
WE POTENTIALLY INTRODUCE 

7710
05:15:32,560 --> 05:15:34,560
EMISSIONS IN FIRST YEAR OR WORSE

7711
05:15:34,560 --> 05:15:37,480
OUTCOMES AND LONG TERM HEALTH OF

7712
05:15:37,480 --> 05:15:39,960
WOMAN AND CARDIOVASCULAR 

7713
05:15:39,960 --> 05:15:42,320
RESEARCH LONG TERM MIGHT BE 

7714
05:15:42,320 --> 05:15:44,760
IMPACTED GESTATIONAL DIABETES 

7715
05:15:44,760 --> 05:15:46,800
AND DON'T DO WELL THINKING OF 

7716
05:15:46,800 --> 05:15:48,520
LONG TERM OUTCOMES AND CURRENT 

7717
05:15:48,520 --> 05:15:51,880
INTERVENTIONS THAT ARE ACTUALLY 

7718
05:15:51,880 --> 05:15:52,400
IMPACTING THEM. 

7719
05:15:52,400 --> 05:15:54,400
>> GREAT.  THANK YOU
APPLE AND 

7720
05:15:54,400 --> 05:15:57,480
ELIZABETH AND WE HAVE TIME FOR 

7721
05:15:57,480 --> 05:15:59,520
ONE MORE QUESTION. 

7722
05:15:59,520 --> 05:16:01,680
MALIA, HAVE ONE?  

7723
05:16:01,680 --> 05:16:05,680
>> YES.  SHAUNA, TO KEEP
A 

7724
05:16:05,680 --> 05:16:08,920
PROGRAM GOING DO YOU THINK IT 

7725
05:16:08,920 --> 05:16:10,080
COULD BECOME A [INDISCERNIBLE]? 

7726
05:16:10,080 --> 05:16:13,520
>> I THINK THAT IT IS --
I LOVE

7727
05:16:13,520 --> 05:16:14,840
THE QUESTION.  

7728
05:16:14,840 --> 05:16:20,920
I ABSOLUTELY THINK THAT POLICY 

7729
05:16:20,920 --> 05:16:23,800
AND LEGISLATIVE CHANGES HAS A 

7730
05:16:23,800 --> 05:16:26,080
CRITICAL ROLE IN CREATING BROAD 

7731
05:16:26,080 --> 05:16:28,520
AND SYSTEMIC AND STRUCTURAL 

7732
05:16:28,520 --> 05:16:30,320
CHANGES THAT WE WANT TO SEE 

7733
05:16:30,320 --> 05:16:32,920
EMERGE FROM SCIENCE WE ARE 

7734
05:16:32,920 --> 05:16:33,560
DOING. 

7735
05:16:33,560 --> 05:16:38,920
I THINK IT IS A GREAT QUESTION. 

7736
05:16:38,920 --> 05:16:41,240
>> OKAY.  ALL RIGHT. 
THANKS TO

7737
05:16:41,240 --> 05:16:43,720
OUR INCREDIBLE PANEL MEMBERS AND

7738
05:16:43,720 --> 05:16:47,440
TO AUDIENCE FOR FANTASTIC 

7739
05:16:47,440 --> 05:16:48,640
QUESTIONS AND BELIEVE WE WILL 

7740
05:16:48,640 --> 05:16:50,480
WRAP IT UP AND CALL THIS SESSION

7741
05:16:50,480 --> 05:16:56,040
OVER.  THANK YOU ALL OF YOU!  

7742
05:16:56,040 --> 05:17:04,160
>> EVERYBODY, WE WILL GO
INTO A

7743
05:17:04,160 --> 05:17:05,360
10-MINUTE BREAK AND NEXT SESSION

7744
05:17:05,360 --> 05:17:07,720
WON'T BE IN HERE AND WILL BE 

7745
05:17:07,720 --> 05:17:09,120
CONCURRENT SESSIONS THAT ARE 

7746
05:17:09,120 --> 05:17:10,880
MEETING ACROSS THE HALL IN 

7747
05:17:10,880 --> 05:17:13,720
MEETING ROOMS AND IN MEETING 

7748
05:17:13,720 --> 05:17:16,480
ROOM E1/E2 WE HAVE IDENTIFYING 

7749
05:17:16,480 --> 05:17:19,000
AND OVERCOMING INNOVATION 

7750
05:17:19,000 --> 05:17:22,680
BARRIERS FOR MATERNAL HEALTH 

7751
05:17:22,680 --> 05:17:25,200
HEART LUNG AND SLEEP HEALTH AND 

7752
05:17:25,200 --> 05:17:28,240
WE HAVE IDENTIFYING GAPS AND 

7753
05:17:28,240 --> 05:17:30,080
OPPORTUNITIES IN INNOVATIVE 

7754
05:17:30,080 --> 05:17:32,040
TECHNOLOGIES TO IMPROVE MENTAL 

7755
05:17:32,040 --> 05:17:35,120
HEALTH AND SUBSTANCE USE 

7756
05:17:35,120 --> 05:17:36,000
DISORDER DIAGNOSTICS AND 

7757
05:17:36,000 --> 05:17:36,800
TREATMENTS AND PLEASE MEET IN 

7758
05:17:36,800 --> 05:17:38,920
ONE OF THE ROOMS IN 10 MINUTES 

7759
05:17:38,920 --> 05:17:41,520
AND WILL MEET BACK HERE AT END 

7760
05:17:41,520 --> 05:17:44,680
OF THE DAY AT AROUND 5:10 P.M. 

7761
05:17:44,680 --> 05:17:46,440
AND WILL HAVE MODERATORS FROM 

7762
05:17:46,440 --> 05:17:48,560
EACH OF THE SESSIONS COME UP AND

7763
05:17:48,560 --> 05:17:50,480
GIVE MAIN POINTS THAT WERE 

7764
05:17:50,480 --> 05:17:52,160
DISCUSSED AND HAVE WRAP UP 

7765
05:17:52,160 --> 05:17:54,360
BEFORE TOMORROW.  THANK YOU ALL 

7766
05:17:54,360 --> 05:17:55,120
VERY MUCH. 

7767
05:17:55,120 --> 05:17:56,000
>> THANK YOU EVERYONE FOR
BEING

7768
05:17:56,000 --> 05:17:58,160
HERE UNTIL THE VERY END.  WE 

7769
05:17:58,160 --> 05:18:00,600
WILL START A VERY QUICK WRAP-UP 

7770
05:18:00,600 --> 05:18:04,560
SESSION.  YES, YES, YES.  I WILL

7771
05:18:04,560 --> 05:18:05,520
CALL YOU -- 

7772
05:18:05,520 --> 05:18:07,040
THANK YOU EVERYONE FOR STAYING 

7773
05:18:07,040 --> 05:18:10,040
UNTIL THE VERY END.  WE WILL DO 

7774
05:18:10,040 --> 05:18:12,960
A QUICK WRAP-UP SESSION WHERE 

7775
05:18:12,960 --> 05:18:14,880
MODERATORS FROM THE DEEP DIVE 

7776
05:18:14,880 --> 05:18:15,920
AND CONCURRENT SESSIONS WILL 

7777
05:18:15,920 --> 05:18:20,080
REPORT OUT THE KEY POINTS THAT 

7778
05:18:20,080 --> 05:18:22,280
WERE DISCUSSED DURING THE PANELS

7779
05:18:22,280 --> 05:18:24,560
AND FIRST WILL CALL UP THE 

7780
05:18:24,560 --> 05:18:27,360
MODERATOR FROM CONCURRENT 

7781
05:18:27,360 --> 05:18:29,960
SESSION 1, PAULINE TO COME 

7782
05:18:29,960 --> 05:18:33,160
REPORT OUT TO THE GROUP WHAT KEY

7783
05:18:33,160 --> 05:18:37,160
MAIN POINTS WERE THAT CAME UP. 

7784
05:18:37,160 --> 05:18:44,560
>>. 

7785
05:18:44,560 --> 05:18:45,640
>> THANK YOU, EVERYONE.  
NOW 

7786
05:18:45,640 --> 05:18:46,600
THAT WE ARE WAITING FOR THE 

7787
05:18:46,600 --> 05:18:47,640
SLIDE TO POP UP ON THE SCREEN, 

7788
05:18:47,640 --> 05:18:48,040
WE WILL WAIT FOR THAT.  WHAT A 

7789
05:18:48,040 --> 05:18:50,480
GREAT SESSION WE HAD.  DR. SAADE

7790
05:18:50,480 --> 05:18:51,160
JOINED ME.  

7791
05:18:51,160 --> 05:18:55,440
YEAH.  WE FOCUSED ON INNOVATION 

7792
05:18:55,440 --> 05:18:57,520
BARRIERS SPECIFICALLY RELATED TO

7793
05:18:57,520 --> 05:18:59,960
HEART, LUNG, BLOOD AND SLEEP 

7794
05:18:59,960 --> 05:19:01,280
INNOVATION AND HAD A VERY 

7795
05:19:01,280 --> 05:19:03,280
THOROUGH CONVERSATION RELATED TO

7796
05:19:03,280 --> 05:19:05,200
WHAT ARE THE KEY CHALLENGES AND 

7797
05:19:05,200 --> 05:19:06,800
WHO ARE CRITICAL STAKEHOLDERS 

7798
05:19:06,800 --> 05:19:08,400
THAT ARE NEEDED AND MOVING TO 

7799
05:19:08,400 --> 05:19:10,000
THE NEXT SLIDE AND QUICK 

7800
05:19:10,000 --> 05:19:11,480
INTRODUCTION AS TO WHO I AM AND 

7801
05:19:11,480 --> 05:19:12,520
FOR THOSE THAT DON'T KNOW ME I'M

7802
05:19:12,520 --> 05:19:13,480
MOLINE.  THANK YOU, GEORGE.  I'M

7803
05:19:13,480 --> 05:19:15,720
PROFESSIONALLY AN INNOVATION 

7804
05:19:15,720 --> 05:19:17,160
ENABLER AND CAREER EXPERT AND 

7805
05:19:17,160 --> 05:19:19,080
DOING THAT MORE THAN 15 YEARS 

7806
05:19:19,080 --> 05:19:22,120
AND PERSONALLY I'M VERY EFFECTED

7807
05:19:22,120 --> 05:19:24,120
BY THIS TOPIC AS MANY OF US ARE.

7808
05:19:24,120 --> 05:19:26,280
PERSONALLY FOR ME I HAD A 

7809
05:19:26,280 --> 05:19:28,440
PRETERM BIRTH AT 23 WEEKS 

7810
05:19:28,440 --> 05:19:30,400
COMPLETELY UNEXPECTED AND AFTER 

7811
05:19:30,400 --> 05:19:33,440
5.5 MONTHS IN THE NICU LOST MY 

7812
05:19:33,440 --> 05:19:37,160
SON.  I REMEMBER SITTING IN THE 

7813
05:19:37,160 --> 05:19:39,160
KANGAROOING CHAIR, WHAT CAN I DO

7814
05:19:39,160 --> 05:19:43,360
AS A MOTHER, AS A PATIENT TO 

7815
05:19:43,360 --> 05:19:46,080
HELP ENABLE MEDICAL INNOVATION 

7816
05:19:46,080 --> 05:19:49,720
AND SWITCHED GEARS FOCUSING 100%

7817
05:19:49,720 --> 05:19:52,160
IN MEDICAL INNOVATION AND OUR 

7818
05:19:52,160 --> 05:19:55,440
TEAM ADVISORS HELPING ENABLE 

7819
05:19:55,440 --> 05:19:56,760
INNOVATORS AND PROGRAM MANAGERS 

7820
05:19:56,760 --> 05:19:58,360
TO THINK ABOUT HOW TO NAVIGATE 

7821
05:19:58,360 --> 05:20:01,280
THE COMPLEXITY THAT IS 

7822
05:20:01,280 --> 05:20:02,120
INNOVATION?  

7823
05:20:02,120 --> 05:20:04,200
SPECIFICALLY IN THE HEALTH CARE 

7824
05:20:04,200 --> 05:20:04,480
SPACE?  

7825
05:20:04,480 --> 05:20:07,560
I WAS CO-MODERATED WITH DR. 

7826
05:20:07,560 --> 05:20:09,280
GEORGE SAADE.  

7827
05:20:09,280 --> 05:20:13,480
>> I'M MATERNAL FETAL
MEDICAL 

7828
05:20:13,480 --> 05:20:14,760
SPECIALIST AND CLINICIAN ANDEND 

7829
05:20:14,760 --> 05:20:16,960
USER OF ALL OF THE INNOVATIONS. 

7830
05:20:16,960 --> 05:20:20,520
WE WILL GET RIGHT INTO SOME 

7831
05:20:20,520 --> 05:20:22,240
HIGHLIGHTS AND SUMMARIES OF OUR 

7832
05:20:22,240 --> 05:20:24,240
PANEL.  GOING TO THE NEXT SLIDE,

7833
05:20:24,240 --> 05:20:26,200
ONE OF THE BIGGEST QUESTIONS WE 

7834
05:20:26,200 --> 05:20:27,800
ASK IS WHAT ARE THE DIFFERENT 

7835
05:20:27,800 --> 05:20:29,800
ROLES AND WHAT ARE THE DIFFERENT

7836
05:20:29,800 --> 05:20:31,160
STAKEHOLDERS THAT ARE NEEDED?  

7837
05:20:31,160 --> 05:20:33,160
THERE IS A LOT LISTED ON THE 

7838
05:20:33,160 --> 05:20:35,520
PAGE THAT IS MEANT TO BE 

7839
05:20:35,520 --> 05:20:36,480
INTIMIDATING.  THIS IS 

7840
05:20:36,480 --> 05:20:38,560
ROOETALITY WHETHER YOU ARE AN 

7841
05:20:38,560 --> 05:20:42,240
INNOVATOR OR SUPPORTING 

7842
05:20:42,240 --> 05:20:43,640
INNOVATION.  SO MANY INDIVIDUALS

7843
05:20:43,640 --> 05:20:46,720
WERE PRESENT ON THE PANEL TO 

7844
05:20:46,720 --> 05:20:48,200
REPRESENT DIFFERENT STAKEHOLDERS

7845
05:20:48,200 --> 05:20:50,200
AND ARE SOME EXAMPLES AND SOME 

7846
05:20:50,200 --> 05:20:52,280
NOT LISTED ON SLIDE ARE PRIVATE 

7847
05:20:52,280 --> 05:20:56,800
PAIRS AND PUBLIC PAIRS AND 

7848
05:20:56,800 --> 05:20:58,360
NURSES AND BEDSIDE CLINICIANS 

7849
05:20:58,360 --> 05:21:00,280
AND SO MANY PEOPLE ARE INVOLVED 

7850
05:21:00,280 --> 05:21:03,120
IN ORDER TO CREATE AND INNOVATE 

7851
05:21:03,120 --> 05:21:06,520
AND HELP ADOPT AND IMPLEMENT NEW

7852
05:21:06,520 --> 05:21:10,080
INNOVATIONS WITHIN HEART, LUNG, 

7853
05:21:10,080 --> 05:21:11,400
BLOOD AND SLEEP.  

7854
05:21:11,400 --> 05:21:13,400
NEXT SLIDE.  THIS IS THE VISUAL.

7855
05:21:13,400 --> 05:21:17,880
WE UNDERSTAND AND REALIZE IT IS 

7856
05:21:17,880 --> 05:21:18,920
VERY INTIMIDATING COMPLAEVENLD 

7857
05:21:18,920 --> 05:21:20,880
AND MUCH OF THE CONCURRENT 

7858
05:21:20,880 --> 05:21:22,760
CONVERSATION SESSIONS WAS ABOUT 

7859
05:21:22,760 --> 05:21:25,000
NAVIGATING DIFFERENT 

7860
05:21:25,000 --> 05:21:26,560
COMPLEXITIES AS WELL AS ENGAGING

7861
05:21:26,560 --> 05:21:28,680
AND LEVERAGING PEOPLE AT AN 

7862
05:21:28,680 --> 05:21:31,480
EARLIER STAGE THAT YOU MIGHT 

7863
05:21:31,480 --> 05:21:31,760
ANTICIPATE. 

7864
05:21:31,760 --> 05:21:32,960
NEXT SLIDE. 

7865
05:21:32,960 --> 05:21:37,520
CAPTURED HERE, LOTS OF WORDS. 

7866
05:21:37,520 --> 05:21:40,960
WE HAD THREE MINUTES TO FINALIZE

7867
05:21:40,960 --> 05:21:42,440
SLIDES BETWEEN THE SESSIONS AND 

7868
05:21:42,440 --> 05:21:44,000
GO OVER KEY LESSONS LEARN THE 

7869
05:21:44,000 --> 05:21:46,640
AND CONVERSATIONS AND PANELISTS 

7870
05:21:46,640 --> 05:21:48,240
SHARED WITH AUDIENCE AND THEIR 

7871
05:21:48,240 --> 05:21:50,000
DIFFERENT LEARNED EXPERIENCES 

7872
05:21:50,000 --> 05:21:51,880
AND A COUPLE KEY THEMES 

7873
05:21:51,880 --> 05:21:53,920
POPULATED OUT.  ONE OF WHICH IS 

7874
05:21:53,920 --> 05:21:56,160
RELATED TO MULTIPLE STAKEHOLDERS

7875
05:21:56,160 --> 05:21:58,480
REQUIRED IN ORDER TO COLLABORATE

7876
05:21:58,480 --> 05:21:59,960
AND REACH SUCCESS. 

7877
05:21:59,960 --> 05:22:03,240
ONE OF THE BIGGEST TAKEAWAYS IS 

7878
05:22:03,240 --> 05:22:05,240
PULLING IN THOSE REPRESENTATIVE 

7879
05:22:05,240 --> 05:22:07,120
PERSPECTIVES AT AN EARLY STAGE 

7880
05:22:07,120 --> 05:22:08,560
AND ONE AUDIENCE MEMBER CAME UP 

7881
05:22:08,560 --> 05:22:10,440
AND ASKED BY THE TIME I ENGAGE 

7882
05:22:10,440 --> 05:22:13,360
THE COMMUNITY, IT IS ALREADY AN 

7883
05:22:13,360 --> 05:22:15,920
END PRODUCT AND PUSHED BACK 

7884
05:22:15,920 --> 05:22:17,960
SAYING IT IS NEVER TOO EARLY TO 

7885
05:22:17,960 --> 05:22:21,040
ENGAGE PERSPECTIVES FROM THE 

7886
05:22:21,040 --> 05:22:23,600
COMMUNITY WHETHER CLINICIANS OR 

7887
05:22:23,600 --> 05:22:25,000
PATIENT ADVOCACY GROUPS OR 

7888
05:22:25,000 --> 05:22:26,760
INDIVIDUALS THAT IMPACT ADOPTION

7889
05:22:26,760 --> 05:22:28,480
AND IMPLEMENTATION AND CONCEPT 

7890
05:22:28,480 --> 05:22:30,720
OF HUMAN CENTERED DESIGN WAS 

7891
05:22:30,720 --> 05:22:32,640
TOUCHED UPON AND ENGAGING END 

7892
05:22:32,640 --> 05:22:35,360
USERS EARLY AND HAVING 

7893
05:22:35,360 --> 05:22:37,040
INTEGRATED PARTNERS IN TERMS OF 

7894
05:22:37,040 --> 05:22:38,960
STAKEHOLDERS AND SAW FROM THE 

7895
05:22:38,960 --> 05:22:39,560
PREVIOUS SLIDE ALL DIFFERENT 

7896
05:22:39,560 --> 05:22:41,160
PEOPLE YOU NEED TO THINK ABOUT 

7897
05:22:41,160 --> 05:22:43,280
TO IMPROVE CHANCES FOR YOUR 

7898
05:22:43,280 --> 05:22:45,400
INNOVATION TO BE IMPLEMENTED AND

7899
05:22:45,400 --> 05:22:47,240
ADOPTED AND A BIG TOPIC ON 

7900
05:22:47,240 --> 05:22:49,040
RETURN ON INVESTMENT ALSO CAME 

7901
05:22:49,040 --> 05:22:49,800
UP AS WELL. 

7902
05:22:49,800 --> 05:22:51,880
WHEN YOU SAY RETURN ON 

7903
05:22:51,880 --> 05:22:54,600
INVESTMENT, WE ELABORATED ON THE

7904
05:22:54,600 --> 05:22:57,600
FACT IS NOT JUST FINANCIAL ROI 

7905
05:22:57,600 --> 05:23:00,120
BUT OFTEN TIMES SOCIAL IMPACT 

7906
05:23:00,120 --> 05:23:02,080
ESTABLISHING MESSAGE AS TO IF 

7907
05:23:02,080 --> 05:23:03,600
THE INNOVATION DIDN'T EXIST, 

7908
05:23:03,600 --> 05:23:04,880
WHAT IS THE DIFFERENCE?  

7909
05:23:04,880 --> 05:23:08,280
OTHER THINGS THAT WERE ALSO 

7910
05:23:08,280 --> 05:23:11,080
HIGHLIGHTED TOO IS IMPORTANCE OF

7911
05:23:11,080 --> 05:23:14,080
ELABORATING AS INNOVATOR FROM 

7912
05:23:14,080 --> 05:23:15,520
STAKEHOLDERS TO AGENCY 

7913
05:23:15,520 --> 05:23:16,480
STANDPOINT TOO THAT WAS 

7914
05:23:16,480 --> 05:23:18,200
HIGHLIGHTED IN TERMS OF USING 

7915
05:23:18,200 --> 05:23:20,080
MULTIPLE PROGRAMS CROSS-CUTTING 

7916
05:23:20,080 --> 05:23:22,320
ACROSS MULTIPLE AGENCIES AND NIH

7917
05:23:22,320 --> 05:23:25,320
AND FDA FOR EXAMPLE HAD SEVERAL 

7918
05:23:25,320 --> 05:23:28,240
PROGRAM AND INITIATIVES 

7919
05:23:28,240 --> 05:23:29,520
SUPPORTIVE FOR HELPING 

7920
05:23:29,520 --> 05:23:30,520
INDIVIDUAL AND IN GENERAL NEVER 

7921
05:23:30,520 --> 05:23:34,280
TOO EARLY TO START AND IS 

7922
05:23:34,280 --> 05:23:35,600
COMPLEX AND DON'T BE INTIMIDATED

7923
05:23:35,600 --> 05:23:36,880
BECAUSE OF THE COMPLEXITY AND 

7924
05:23:36,880 --> 05:23:38,280
YOU DON'T HAVE TO BE THE ONE 

7925
05:23:38,280 --> 05:23:41,400
THAT KNOWS IT ALL AND TEAM UP 

7926
05:23:41,400 --> 05:23:42,760
WITH PEOPLE WHO HAVE 

7927
05:23:42,760 --> 05:23:45,040
COMPLEMENTARY SKILLSETS TO HELP 

7928
05:23:45,040 --> 05:23:48,400
OFFSET INNOVATION CHALLENGES YOU

7929
05:23:48,400 --> 05:23:49,400
MIGHT BE FACING. 

7930
05:23:49,400 --> 05:23:51,000
>> GEORGE, I WOULD LIKE
TO ADD 

7931
05:23:51,000 --> 05:23:52,760
WE SHOULD BE THINKING OF WHY IT 

7932
05:23:52,760 --> 05:23:56,160
IS SO HARD TO INNOVATE IN 

7933
05:23:56,160 --> 05:23:59,840
PREGNANCY AND MATERNAL HEALTH 

7934
05:23:59,840 --> 05:24:01,520
COMPARED TO OTHER FIELDS AND 

7935
05:24:01,520 --> 05:24:03,600
START TO DESTROY AND BRING DOWN 

7936
05:24:03,600 --> 05:24:06,000
SOME OF THE WALLS AND DECREASE 

7937
05:24:06,000 --> 05:24:08,360
BURDEN OF INNOVATION AND 

7938
05:24:08,360 --> 05:24:09,920
MATERNAL HEALTH AND THINK THERE 

7939
05:24:09,920 --> 05:24:12,080
IS FOR A LONG TIME HAVE BEEN A 

7940
05:24:12,080 --> 05:24:14,640
LOT OF BURDEN AND LOTS OF 

7941
05:24:14,640 --> 05:24:17,040
BURDENS IN INNOVATION AND 

7942
05:24:17,040 --> 05:24:18,720
MATERNAL HEALTH AND WE SHOULDN'T

7943
05:24:18,720 --> 05:24:20,560
HAVE THEM. 

7944
05:24:20,560 --> 05:24:22,520
SO, WE THOUGHT THAT EVERYBODY 

7945
05:24:22,520 --> 05:24:23,960
SHOULD WORK TOGETHER. 

7946
05:24:23,960 --> 05:24:26,800
DECREASE THESE HURDLED AND BE IT

7947
05:24:26,800 --> 05:24:29,720
REGULATORY AND BE IT COST AND BE

7948
05:24:29,720 --> 05:24:32,480
IT REIMBURSEMENT FOR INNOVATIONS

7949
05:24:32,480 --> 05:24:36,200
AND I THINK THAT IT IS TIME THAT

7950
05:24:36,200 --> 05:24:38,680
WE ADDRESS THEM FROM A 

7951
05:24:38,680 --> 05:24:40,680
LEGISLATIVE ASPECT AS WELL AS 

7952
05:24:40,680 --> 05:24:45,480
FROM A SCIENTIFIC ASPECT. 

7953
05:24:45,480 --> 05:24:55,760
>> THANK YOU.  

7954
05:24:58,960 --> 05:25:05,600
>> THANK YOU VERY MUCH. 
NOW WE

7955
05:25:05,600 --> 05:25:08,640
WILL HAVE PATRICIA CARVOS COME 

7956
05:25:08,640 --> 05:25:11,200
UP AND GIVE THE SUMMARY OF THE 

7957
05:25:11,200 --> 05:25:13,160
CONCURRENT SESSION THAT SHE 

7958
05:25:13,160 --> 05:25:17,320
MODERATED.  THANK YOU SO MUCH.  

7959
05:25:17,320 --> 05:25:26,120
>>. 

7960
05:25:26,120 --> 05:25:28,560
>> HI, EVERYONE.  I'M
PATTY AND

7961
05:25:28,560 --> 05:25:31,280
PROFESSOR OF PSYCHIATRY AT 

7962
05:25:31,280 --> 05:25:33,880
WASHINGTON UNIVERSITY SCHOOL OF 

7963
05:25:33,880 --> 05:25:36,400
MEDICINE AND WATCHING THEMES 

7964
05:25:36,400 --> 05:25:38,360
COME UP WITH INTRODUCTION AND 

7965
05:25:38,360 --> 05:25:40,240
WHAT IS DRIVING THIS AND BEING 

7966
05:25:40,240 --> 05:25:41,960
ABLE TO MODERATE SESSION AND 

7967
05:25:41,960 --> 05:25:44,320
HEARING INNOVATIVE WORK THAT IS 

7968
05:25:44,320 --> 05:25:46,960
HAPPENING IS INSPIRING TO ME AND

7969
05:25:46,960 --> 05:25:48,960
HUMBLED TO BE ABLE TO MODERATE 

7970
05:25:48,960 --> 05:25:50,920
THE SESSION AND WORK WITH SOME 

7971
05:25:50,920 --> 05:25:54,240
COLLEAGUES OVER COURSE OF WEEKS 

7972
05:25:54,240 --> 05:25:57,600
TO PLAN THIS SESSION OUT. 

7973
05:25:57,600 --> 05:25:59,720
TOPIC OF THE SESSION IS A BIG 

7974
05:25:59,720 --> 05:26:01,640
GOAL.  WE ARE GIVEN THE TASK TO 

7975
05:26:01,640 --> 05:26:03,520
IDENTIFY GAPS AND OPPORTUNITIES 

7976
05:26:03,520 --> 05:26:05,200
AND DEVELOPMENT AND 

7977
05:26:05,200 --> 05:26:08,520
IMPLEMENTATION OF INNOVATIVE 

7978
05:26:08,520 --> 05:26:11,040
TECHNOLOGIES THAT ARE FOCUSED ON

7979
05:26:11,040 --> 05:26:14,600
ADDRESSING MATERNAL HEALTH AND 

7980
05:26:14,600 --> 05:26:16,440
SUBSTANCE USE DISORDERS AND ABLE

7981
05:26:16,440 --> 05:26:18,560
TO MODERATE THE SESSION AND 

7982
05:26:18,560 --> 05:26:21,240
WORKING CLOSELY WITH DR. JULIAN 

7983
05:26:21,240 --> 05:26:24,920
AND KEESHER FROM NIH TO PLAN THE

7984
05:26:24,920 --> 05:26:26,080
SESSION OUT.  NEXT SLIDE. 

7985
05:26:26,080 --> 05:26:27,960
WE HAVE A LOT OF PANELISTS IN 

7986
05:26:27,960 --> 05:26:29,880
OUR SESSION AND WANT TO GIVE 

7987
05:26:29,880 --> 05:26:33,240
SPECIAL THANKS TO EACH OF YOU.  

7988
05:26:33,240 --> 05:26:34,680
I KNOW WE WORK TOGETHER AND HAD 

7989
05:26:34,680 --> 05:26:36,360
SEVERAL MEETINGS TODAY AND 

7990
05:26:36,360 --> 05:26:39,040
REALLY TO KIND OF QUICKLY AND 

7991
05:26:39,040 --> 05:26:40,480
CONCISELY DESCRIBE YOUR 

7992
05:26:40,480 --> 05:26:41,800
INNOVATION AND WHAT PROBLEM 

7993
05:26:41,800 --> 05:26:43,840
AREAS AND SOLUTIONS AND WANT TO 

7994
05:26:43,840 --> 05:26:45,720
THANK ALL PANELISTS AND SOME 

7995
05:26:45,720 --> 05:26:47,640
OTHER FOLKS WHO CHIMED IN AS 

7996
05:26:47,640 --> 05:26:50,400
WELL TO TALK ABOUT CUTTING EDGE 

7997
05:26:50,400 --> 05:26:52,640
INNOVATIONS ADDRESSING MATERNAL 

7998
05:26:52,640 --> 05:26:54,280
HEALTH AND SUBSTANCE USE 

7999
05:26:54,280 --> 05:26:55,600
DISORDERS AND NEXT SLIDE, 

8000
05:26:55,600 --> 05:26:55,840
PLEASE. 

8001
05:26:55,840 --> 05:26:58,000
IN TERMS OF SOME OF THE THEMES 

8002
05:26:58,000 --> 05:27:00,280
THAT CAME OUT AND OPPORTUNITIES 

8003
05:27:00,280 --> 05:27:03,080
FOR DEVELOPING INNOVATIVE 

8004
05:27:03,080 --> 05:27:04,440
TECHNOLOGIES, THINKING ABOUT THE

8005
05:27:04,440 --> 05:27:06,360
USE OF ARTIFICIAL INTELLIGENCE 

8006
05:27:06,360 --> 05:27:12,560
TO PROVIDE REMINDERS TO INCREASE

8007
05:27:12,560 --> 05:27:13,760
SUSTAINABILITY AND WE HEARD SOME

8008
05:27:13,760 --> 05:27:16,040
TECH DISCUSSED TODAY WE HAVE A 

8009
05:27:16,040 --> 05:27:17,600
HUMAN COMPONENT WHETHER A PEER 

8010
05:27:17,600 --> 05:27:20,520
RECOVERY COACH AND COUNSELOR AND

8011
05:27:20,520 --> 05:27:22,000
PROVIDER AND OPPORTUNITIES TO 

8012
05:27:22,000 --> 05:27:24,800
LEVERAGE AI TO DELIVER SOME 

8013
05:27:24,800 --> 05:27:25,160
INTERVENTIONS. 

8014
05:27:25,160 --> 05:27:28,160
IN ORDER TO BE MORE EFFICIENT OR

8015
05:27:28,160 --> 05:27:29,480
COST EFFECTIVE. 

8016
05:27:29,480 --> 05:27:31,640
WE DON'T ALSO WANT TO LOSE THAT 

8017
05:27:31,640 --> 05:27:32,800
HUMAN TOUCH AND IT CAME OUT 

8018
05:27:32,800 --> 05:27:34,200
THROUGHOUT THE COURSE OF THE DAY

8019
05:27:34,200 --> 05:27:37,200
AND IN TERMS OF POWER AND 

8020
05:27:37,200 --> 05:27:38,640
EMPATHY IS BEING AN IMPORTANT 

8021
05:27:38,640 --> 05:27:40,200
THEME; RIGHT?  

8022
05:27:40,200 --> 05:27:43,600
USING AI AND ALSO NATURAL 

8023
05:27:43,600 --> 05:27:44,560
LANGUAGE PROCESSING AND SKILL 

8024
05:27:44,560 --> 05:27:46,560
BASIS TO HELP WORK WE DO AND NOT

8025
05:27:46,560 --> 05:27:48,640
REALLY TAKE AWAY THE HUMAN 

8026
05:27:48,640 --> 05:27:51,000
COMPONENT AND IN TERMS OF 

8027
05:27:51,000 --> 05:27:52,800
NATURAL LANGUAGE PROCESSING, 

8028
05:27:52,800 --> 05:27:55,640
THERE IS AN IDEA THAT CAME OUT 

8029
05:27:55,640 --> 05:27:57,400
ABOUT EFFICIENTLY RECOGNIZING 

8030
05:27:57,400 --> 05:28:00,960
WARNING SIGNS AND HOW WE CAN BE 

8031
05:28:00,960 --> 05:28:02,880
PREVENTIVE AND PROACTIVE AND HOW

8032
05:28:02,880 --> 05:28:05,080
TECHNOLOGIES COULD LEAD TO 

8033
05:28:05,080 --> 05:28:06,600
BETTER SCREENING AND MORE 

8034
05:28:06,600 --> 05:28:07,960
EFFICIENT SCREENING PRACTICES 

8035
05:28:07,960 --> 05:28:09,800
AND IDENTIFYING CLIENTS AT RISK 

8036
05:28:09,800 --> 05:28:12,280
AND WORK TO TAILOR THE 

8037
05:28:12,280 --> 05:28:13,920
INTERVENTION AND ALERT PROVIDER 

8038
05:28:13,920 --> 05:28:15,560
TO CARE ONE NEEDS IN THE MOMENT 

8039
05:28:15,560 --> 05:28:17,760
THAT THEY NEED IT AND GOAL 

8040
05:28:17,760 --> 05:28:19,360
REALLY TO REFER BIRTHING PEOPLE 

8041
05:28:19,360 --> 05:28:21,160
INTO CARE.  AGAIN, AT THE TIME 

8042
05:28:21,160 --> 05:28:22,960
THAT THEY REALLY NEED IT AND 

8043
05:28:22,960 --> 05:28:24,600
ADDRESSING SYMPTOMS THAT THEY 

8044
05:28:24,600 --> 05:28:26,280
ARE EXPRESSING AND ARE WAYS THAT

8045
05:28:26,280 --> 05:28:28,240
WE CAN KIND OF MOVE OUR 

8046
05:28:28,240 --> 05:28:30,240
TECHNOLOGY FORWARD IN THAT WAY. 

8047
05:28:30,240 --> 05:28:32,440
ALSO, THE THOUGHT ABOUT CREATING

8048
05:28:32,440 --> 05:28:35,920
DIGITAL PEER SUPPORT COMMUNITIES

8049
05:28:35,920 --> 05:28:37,720
AND WE HEARD IN THE PANEL AND 

8050
05:28:37,720 --> 05:28:39,680
THROUGHOUT THE COURSE OF THE DAY

8051
05:28:39,680 --> 05:28:41,840
IMPORTANT EMOTIONAL AND RECOVERY

8052
05:28:41,840 --> 05:28:43,280
SUPPORT FOR INDIVIDUALS WITH 

8053
05:28:43,280 --> 05:28:45,560
MENTAL HEALTH PROBLEMS AND 

8054
05:28:45,560 --> 05:28:47,280
SUBSTANCE USE DISORDERS AND 

8055
05:28:47,280 --> 05:28:48,760
TECHNOLOGIES COULD BE USE THE TO

8056
05:28:48,760 --> 05:28:50,400
SUPPLEMENT TRADITIONAL CARE AND 

8057
05:28:50,400 --> 05:28:51,960
CAN'T EMPHASIZE ENOUGH HOW MANY 

8058
05:28:51,960 --> 05:28:54,720
PEOPLE WITH THESE PROBLEMS AND 

8059
05:28:54,720 --> 05:28:57,120
STRUGGLES FEEL STIGMATIZED.  

8060
05:28:57,120 --> 05:28:59,480
THAT REALLY WORKS AGAINST THE 

8061
05:28:59,480 --> 05:29:00,720
CARE THAT THEY SHOULD BE 

8062
05:29:00,720 --> 05:29:01,320
RECEIVING. 

8063
05:29:01,320 --> 05:29:03,680
SO, HOW CAN WE LEVERAGE 

8064
05:29:03,680 --> 05:29:05,120
TECHNOLOGIES TO REDUCE STIGMA 

8065
05:29:05,120 --> 05:29:06,520
AND GET PEOPLE INTO THE CARE 

8066
05:29:06,520 --> 05:29:08,880
THAT THEY NEED?  

8067
05:29:08,880 --> 05:29:10,360
ALSO, DELIVERING PEER SUPPORT 

8068
05:29:10,360 --> 05:29:12,040
AND USING TECHNOLOGIES TO DO 

8069
05:29:12,040 --> 05:29:14,440
THAT AND THINKING EARLIER TO THE

8070
05:29:14,440 --> 05:29:15,840
SPEAKER THIS MORNING WHERE ONE 

8071
05:29:15,840 --> 05:29:19,240
OF THE KEY FACTORS TO HER 

8072
05:29:19,240 --> 05:29:21,000
REMOVING FORWARD IN HER RECOVERY

8073
05:29:21,000 --> 05:29:23,320
WAS NOT FEELING ALONE.  THAT IS 

8074
05:29:23,320 --> 05:29:26,960
A CRITICAL ASPECT OF HER FEELING

8075
05:29:26,960 --> 05:29:27,240
SUPPORTED. 

8076
05:29:27,240 --> 05:29:29,280
HOW CAN WE LEVERAGE TECHNOLOGIES

8077
05:29:29,280 --> 05:29:30,320
FOR THAT?  

8078
05:29:30,320 --> 05:29:33,400
IN TERMS OF EVIDENCE-BASED 

8079
05:29:33,400 --> 05:29:34,520
INTERVENTIONS, WE CAN'T FORGET 

8080
05:29:34,520 --> 05:29:36,200
SCIENCE THAT WE HAVE ALL 

8081
05:29:36,200 --> 05:29:38,680
CONTRIBUTED TO; RIGHT?  

8082
05:29:38,680 --> 05:29:42,560
CAN WE USE TECHNOLOGY TO DELIVER

8083
05:29:42,560 --> 05:29:43,680
EVIDENCE-BASED INTERVENTIONS?  

8084
05:29:43,680 --> 05:29:46,520
THERE IS POTENTIAL FOR THAT WHEN

8085
05:29:46,520 --> 05:29:48,720
SYMPTOM IS BEING EXPERIENCED 

8086
05:29:48,720 --> 05:29:51,600
DELIVERING RIGHT EVIDENCE-BASED 

8087
05:29:51,600 --> 05:29:52,280
INTERVENTION AT THAT MOMENT THAT

8088
05:29:52,280 --> 05:29:53,800
SOMEONE IS FEELING THAT WAY AND 

8089
05:29:53,800 --> 05:29:57,360
ACCESS TO MENTAL HEALTH IS LOW 

8090
05:29:57,360 --> 05:30:00,040
AND DEVASTATING STATISTICS ARE 

8091
05:30:00,040 --> 05:30:01,920
REPORTED FOR PEOPLE GETTING 

8092
05:30:01,920 --> 05:30:04,560
MENTAL HEALTH CARE WHEN NEEDED 

8093
05:30:04,560 --> 05:30:06,280
AND TECHNOLOGY USED TO DELIVER 

8094
05:30:06,280 --> 05:30:08,080
TREATMENTS AND THINKING ABOUT 

8095
05:30:08,080 --> 05:30:10,520
ADAPTING THESE INNOVATIONS AND 

8096
05:30:10,520 --> 05:30:14,280
IN A CULTURALLY MINDFUL WAY AND 

8097
05:30:14,280 --> 05:30:18,080
WE NEED TO BE CONSCIOUS OF 

8098
05:30:18,080 --> 05:30:18,920
INTERVENTIONS, THEY WEREN'T 

8099
05:30:18,920 --> 05:30:21,920
DESIGNED FOR END USERS AND WE 

8100
05:30:21,920 --> 05:30:24,240
NEED TO THINK ABOUT CULTURAL 

8101
05:30:24,240 --> 05:30:25,880
ADAPTATION AND BE CAREFUL AND 

8102
05:30:25,880 --> 05:30:27,680
MINDFUL OF THAT.  THERE IS 

8103
05:30:27,680 --> 05:30:29,560
RESEARCH COMING OUT AND LET'S 

8104
05:30:29,560 --> 05:30:31,560
ADAPT ACCORDINGLY AND 

8105
05:30:31,560 --> 05:30:33,600
EFFICIENTLY IN A TIMELY WAY AND 

8106
05:30:33,600 --> 05:30:34,840
THINKING ABOUT WHAT END USERS 

8107
05:30:34,840 --> 05:30:36,680
ARE TELLING US INCLUDING BOTH 

8108
05:30:36,680 --> 05:30:40,200
CLIENTS AND PROVIDERS. 

8109
05:30:40,200 --> 05:30:42,000
NEXT SLIDE. 

8110
05:30:42,000 --> 05:30:44,480
THERE ARE OPPORTUNITIES FOR 

8111
05:30:44,480 --> 05:30:47,600
IMPLEMENTATION AND 

8112
05:30:47,600 --> 05:30:50,680
COMMERCIALIZATIONINOO  -- 

8113
05:30:50,680 --> 05:30:52,560
INNOVATIVE TECHNOLOGIES THAT ARE

8114
05:30:52,560 --> 05:30:54,520
DESCRIBED IN THE PANEL.  I WOULD

8115
05:30:54,520 --> 05:30:56,240
SAY ALMOST 10 OF THEM THAT TO 

8116
05:30:56,240 --> 05:30:59,600
ME, AGAIN, ARE INNOVATIVE WAYS 

8117
05:30:59,600 --> 05:31:01,360
TO DELIVER EFFECTIVE AND TIMELY 

8118
05:31:01,360 --> 05:31:03,920
CARE.  WE CAN, FOR EXAMPLE, 

8119
05:31:03,920 --> 05:31:06,200
USING DIGITAL TECHNOLOGIES TO 

8120
05:31:06,200 --> 05:31:08,640
EDUCATE PHYSICIANS FOR EARLY 

8121
05:31:08,640 --> 05:31:11,000
SCREENING FOR PERINATAL 

8122
05:31:11,000 --> 05:31:12,560
DEPRESSION AND IMPACT NOT ONLY 

8123
05:31:12,560 --> 05:31:15,240
CLIENTS BUT ALSO PHYSICIANS IN 

8124
05:31:15,240 --> 05:31:18,240
ADDITION PROVIDING IMMEDIATE 

8125
05:31:18,240 --> 05:31:19,800
CONNECTIONS TO HEALTH 

8126
05:31:19,800 --> 05:31:20,680
SPECIALISTS THROUGH MOBILE APPS 

8127
05:31:20,680 --> 05:31:22,400
AND OPPORTUNITIES WE HAVE TO 

8128
05:31:22,400 --> 05:31:23,920
SHIFT CLINICAL CARE AND HAVE TO 

8129
05:31:23,920 --> 05:31:25,560
THINK ABOUT MOVING TECHNOLOGIES 

8130
05:31:25,560 --> 05:31:27,120
INTO THE REAL WORLD AND THINK 

8131
05:31:27,120 --> 05:31:28,840
ABOUT TECHNOLOGIES NOT ONLY 

8132
05:31:28,840 --> 05:31:31,320
HELPING CLIENTS BUT PROVIDERS 

8133
05:31:31,320 --> 05:31:34,280
AND A KEY QUESTION CAME UP WITH 

8134
05:31:34,280 --> 05:31:36,000
COMMERCIALIZATION AND SEEMS TO 

8135
05:31:36,000 --> 05:31:38,760
BE POTENTIAL FOR 

8136
05:31:38,760 --> 05:31:40,440
COMMERCIALIZATION AND NO CLEAR 

8137
05:31:40,440 --> 05:31:44,040
PATHWAY AND HOW DO WE MOVE IN 

8138
05:31:44,040 --> 05:31:46,920
THIS DIRECTION?  

8139
05:31:46,920 --> 05:31:49,920
CAME UP AND THESE ARE A FEW MORE

8140
05:31:49,920 --> 05:31:52,640
INTERVENTIONS DESCRIBED USING 

8141
05:31:52,640 --> 05:31:55,880
ECOLOGICAL MOMENTARY ASSESSMENT 

8142
05:31:55,880 --> 05:31:59,600
TO REDUCE STIGMA AND KEEPING 

8143
05:31:59,600 --> 05:32:01,120
PREGNANT AND POSTPARTUM PEOPLE 

8144
05:32:01,120 --> 05:32:03,880
IN TREATMENT AND HAVE THEM 

8145
05:32:03,880 --> 05:32:04,840
INITIATING AND RETAINING 

8146
05:32:04,840 --> 05:32:06,560
TREATMENT AND NEED TO THINK 

8147
05:32:06,560 --> 05:32:10,040
ABOUT FOLKS THAT ARE RULE AREAS 

8148
05:32:10,040 --> 05:32:13,200
AND ARE AS A TEAM DEVELOPING 

8149
05:32:13,200 --> 05:32:15,000
TECHNOLOGY TO SUPPORT CARE 

8150
05:32:15,000 --> 05:32:18,760
DELIVERY IN REMOTE AND RURAL 

8151
05:32:18,760 --> 05:32:20,840
AREAS AND USE OF DIFFERENT 

8152
05:32:20,840 --> 05:32:22,720
TECHNOLOGIES ARTIFICIAL 

8153
05:32:22,720 --> 05:32:25,440
INTELLIGENCE AND MACHINE 

8154
05:32:25,440 --> 05:32:27,080
LEARNING AND NATURAL LANGUAGE 

8155
05:32:27,080 --> 05:32:29,400
PROCESSING AND IDEA OF SUPER 

8156
05:32:29,400 --> 05:32:31,160
APPS THAT ARE HARD TO NAVIGATE 

8157
05:32:31,160 --> 05:32:33,720
THEMSELVES AND GOING ONLINE TO 

8158
05:32:33,720 --> 05:32:35,240
FIND RESOURCES THAT IS HARD FOR 

8159
05:32:35,240 --> 05:32:37,680
US SOMETIMES AND THINKING OF 

8160
05:32:37,680 --> 05:32:38,880
CLIENTS UNDER STRESS AND DON'T 

8161
05:32:38,880 --> 05:32:41,160
HAVE LOTS OF TIME AND CAN WE 

8162
05:32:41,160 --> 05:32:43,800
DEVELOP APPS THAT ARE USER 

8163
05:32:43,800 --> 05:32:45,280
FRIENDLY WITH COMPREHENSIVE 

8164
05:32:45,280 --> 05:32:47,080
INFORMATION TO ADDRESS NEEDS OF 

8165
05:32:47,080 --> 05:32:50,160
OUR CLIENTS?  

8166
05:32:50,160 --> 05:32:53,840
NEXT SLIDE. 

8167
05:32:53,840 --> 05:32:55,240
THINKING ABOUT NEXT STEPS WHERE 

8168
05:32:55,240 --> 05:32:56,240
DO WE GO NEXT?  

8169
05:32:56,240 --> 05:32:58,080
I WILL START WITH IT THIS IS A 

8170
05:32:58,080 --> 05:33:00,880
VERY GOOD CONVERSATION AND THERE

8171
05:33:00,880 --> 05:33:02,480
WASN'T ENOUGH TIME FOR SURE AND 

8172
05:33:02,480 --> 05:33:03,840
THINKING ABOUT SUSTAINABLE THE 

8173
05:33:03,840 --> 05:33:05,560
FOR TECHNOLOGIES IS CHALLENGING 

8174
05:33:05,560 --> 05:33:07,640
FOR US TO RELY ON GRANTS AND 

8175
05:33:07,640 --> 05:33:08,680
SPOKE TO MANY COLLEAGUES 

8176
05:33:08,680 --> 05:33:10,080
THROUGHOUT THE COURSE OF THE DAY

8177
05:33:10,080 --> 05:33:12,120
AND IN SECTIONS THINKING ABOUT 

8178
05:33:12,120 --> 05:33:14,000
GRANTS, GRANTS, GRANTS AND 

8179
05:33:14,000 --> 05:33:16,840
THINKING OF SCALING UP 

8180
05:33:16,840 --> 05:33:18,160
SUSTAINABILITY REIMBURSEMENT 

8181
05:33:18,160 --> 05:33:20,280
MODELS PAYERS GETTING IN THE 

8182
05:33:20,280 --> 05:33:22,480
ROOM HAVING THEM COLLABORATE 

8183
05:33:22,480 --> 05:33:24,080
WITH US AND THERE HAS BEEN 

8184
05:33:24,080 --> 05:33:25,800
SUCCESS IN THIS AND IT TAKES I 

8185
05:33:25,800 --> 05:33:27,360
HAVE HEARD SOMETIMES IT COULD 

8186
05:33:27,360 --> 05:33:29,000
TAKE YEARS FOR THIS AND WE NEED 

8187
05:33:29,000 --> 05:33:30,880
TO DO THIS AND MOVE THIS MORE 

8188
05:33:30,880 --> 05:33:32,560
QUICKLY IN TERMS OF DEVELOPING 

8189
05:33:32,560 --> 05:33:34,080
NEW AND EFFICIENT BUSINESS 

8190
05:33:34,080 --> 05:33:36,560
MODELS AND THINKING HOW TO FUND 

8191
05:33:36,560 --> 05:33:39,280
THIS TECHNOLOGY BEYOND GRANTS. 

8192
05:33:39,280 --> 05:33:41,320
UNFORTUNATELY, WHAT I HEARD A 

8193
05:33:41,320 --> 05:33:43,720
LOT WAS CHALLENGES WITH BUSINESS

8194
05:33:43,720 --> 05:33:46,000
MODELS THAT CURRENTLY EXIST.  

8195
05:33:46,000 --> 05:33:47,520
AND, AGAIN, ANOTHER THING I 

8196
05:33:47,520 --> 05:33:48,960
HEARD WAS THAT WE DIDN'T HAVE 

8197
05:33:48,960 --> 05:33:51,040
ENOUGH PEOPLE IN THE ROOM.  IT 

8198
05:33:51,040 --> 05:33:53,760
WAS AN ELVANT IN THE ROOM THAT 

8199
05:33:53,760 --> 05:33:56,400
IS IDEA OF PAYERS AND HAVING 

8200
05:33:56,400 --> 05:33:58,560
EXPERTISE TO EVEN HELP TO GET 

8201
05:33:58,560 --> 05:34:00,640
THESE TECHNOLOGIES REIMBURSED 

8202
05:34:00,640 --> 05:34:02,640
AND IS NOT A CLEAR PATHWAY AND 

8203
05:34:02,640 --> 05:34:04,040
THERE IS NOT ENOUGH 

8204
05:34:04,040 --> 05:34:06,000
COLLABORATION WITH STATE 

8205
05:34:06,000 --> 05:34:07,680
AGENCIES AND/OR THE PAIR 

8206
05:34:07,680 --> 05:34:09,240
COMMUNITY AND RECOGNIZING THAT 

8207
05:34:09,240 --> 05:34:11,160
THIS COLLABORATIONS WILL TAKE 

8208
05:34:11,160 --> 05:34:11,680
TIME.  

8209
05:34:11,680 --> 05:34:15,440
THERE SHOULD BE AN INCENTIVE FOR

8210
05:34:15,440 --> 05:34:18,440
PAYERS TO MAKE CHANGE AND 

8211
05:34:18,440 --> 05:34:20,200
INTEGRATE REIMBURSEMENT MODELS 

8212
05:34:20,200 --> 05:34:22,960
AND WAY TO MOVE THE NEEDLE FOR 

8213
05:34:22,960 --> 05:34:24,920
US TO WORK AND UNDERSTAND AND 

8214
05:34:24,920 --> 05:34:29,120
INFORM AND UPDATE THE REGULATORY

8215
05:34:29,120 --> 05:34:32,520
LANDSCAPE.  TECHNOLOGIES WE NEED

8216
05:34:32,520 --> 05:34:37,160
THEM FOR PAYMENT PROCESS FOR 

8217
05:34:37,160 --> 05:34:39,600
TOOLS TO THRIVE AND SURVIVE AND 

8218
05:34:39,600 --> 05:34:41,600
WRAPPING UP QUICKLY WITH 

8219
05:34:41,600 --> 05:34:43,080
PARTNERSHIP FOR COMMUNITY TAIK 

8220
05:34:43,080 --> 05:34:45,200
HOLDERS HAVE TO TRUST 

8221
05:34:45,200 --> 05:34:45,880
COMMUNITIES THAT THEY KNOW 

8222
05:34:45,880 --> 05:34:47,600
ANSWERS AND THINKING ABOUT 

8223
05:34:47,600 --> 05:34:49,120
MEANINGFUL COMMUNITY ENGAGEMENT 

8224
05:34:49,120 --> 05:34:53,320
AROUND ITERATING TECHNOLOGY SO 

8225
05:34:53,320 --> 05:35:00,160
USES END USERNAMES AND NEEDS 

8226
05:35:00,160 --> 05:35:01,320
THAT IS IMPORTANT FOR 

8227
05:35:01,320 --> 05:35:02,760
TECHNOLOGIES TO HAVE END USERS 

8228
05:35:02,760 --> 05:35:04,680
IN MIND AND WE NEED TO 

8229
05:35:04,680 --> 05:35:07,000
RECOGNIZE, AGAIN APPS CAN BE 

8230
05:35:07,000 --> 05:35:09,640
OVERWHELMING TO NAVIGATE AND 

8231
05:35:09,640 --> 05:35:10,840
PERSON CENTERED AND HUMAN 

8232
05:35:10,840 --> 05:35:12,920
CENTERED DESIGN AND WANT TO MAKE

8233
05:35:12,920 --> 05:35:14,480
TECHNOLOGY ACCESSIBLE FOR THOSE 

8234
05:35:14,480 --> 05:35:16,880
WHO NEED THAT INCLUDES BLACK AND

8235
05:35:16,880 --> 05:35:19,200
BROWN BIRTHING PEOPLE AND THIS 

8236
05:35:19,200 --> 05:35:22,640
THEME CAME UP CONSISTENTLY AND 

8237
05:35:22,640 --> 05:35:24,000
MY IMPRESSION IS IT WILL 

8238
05:35:24,000 --> 05:35:25,840
CONTINUE TO COME UP IF IN TERMS 

8239
05:35:25,840 --> 05:35:28,080
OF MAKING TECHNOLOGIES 

8240
05:35:28,080 --> 05:35:29,560
ACCESSIBLE FOR THOSE WHO MOST 

8241
05:35:29,560 --> 05:35:32,960
NEED IT OR TECHNOLOGY HAS STRONG

8242
05:35:32,960 --> 05:35:35,200
POTENTIAL TO DO GREAT.  TO SOLVE

8243
05:35:35,200 --> 05:35:38,440
BIG PROBLEMS AND DON'T WANT 

8244
05:35:38,440 --> 05:35:44,080
TECHNOLOGIES TO CAUSE HARM OR BE

8245
05:35:44,080 --> 05:35:46,440
VIGILANT OF TECHNOLOGIES AND 

8246
05:35:46,440 --> 05:35:50,080
DON'T PERP PETTATE OR ASS 

8247
05:35:50,080 --> 05:35:51,720
HERBATE HEALTH TECHNOLOGIES THAT

8248
05:35:51,720 --> 05:35:53,560
IS BY US AND FOR US AND LOVE 

8249
05:35:53,560 --> 05:35:55,320
THAT PHRASE I HEARD TODAY AND 

8250
05:35:55,320 --> 05:35:57,120
ENCOURAGE ALL OF US TO LIVE BY 

8251
05:35:57,120 --> 05:35:58,680
THAT PHRASE I KNOW I WILL FROM 

8252
05:35:58,680 --> 05:36:00,760
NOW ON AND TECHNOLOGY WE NEED TO

8253
05:36:00,760 --> 05:36:05,560
HAVE IT AND BE BIASED AND FOR 

8254
05:36:05,560 --> 05:36:06,080
US. 

8255
05:36:06,080 --> 05:36:16,280
THANK YOU. 

8256
05:36:19,560 --> 05:36:23,080
>> THANKS SO MUCH TO ALL
OF THE

8257
05:36:23,080 --> 05:36:24,360
MODERATORS FOR BEING ABLE TO SUM

8258
05:36:24,360 --> 05:36:27,440
THAT UP NICELY AND QUICKLY ON 

8259
05:36:27,440 --> 05:36:29,800
THE SLIDES AND FELT I GAVE YOU 

8260
05:36:29,800 --> 05:36:30,960
ANNOYING SCHOOL PROJECTS YOU 

8261
05:36:30,960 --> 05:36:33,520
HAVE 10 MINUTES TO PUT SOMETHING

8262
05:36:33,520 --> 05:36:34,560
TOGETHER AND APPRECIATE YOU 

8263
05:36:34,560 --> 05:36:37,080
DOING THAT SO NICELY FOR ALL OF 

8264
05:36:37,080 --> 05:36:37,960
US. 

8265
05:36:37,960 --> 05:36:41,240
THANK YOU TO THOSE WHO CAME 

8266
05:36:41,240 --> 05:36:42,600
TODAY IN PERSON AND THOSE 

8267
05:36:42,600 --> 05:36:44,560
JOINING VIRTUALLY OVER ZOOM.  WE

8268
05:36:44,560 --> 05:36:46,080
WILL BEGIN AGAIN TOMORROW 

8269
05:36:46,080 --> 05:36:48,040
MORNING AT 9 A.M. AND TOMORROW 

8270
05:36:48,040 --> 05:36:50,600
FOCUS WILL BE ON TRANSLATION OF 

8271
05:36:50,600 --> 05:36:51,840
INNOVATIONS AND TO THAT END WE 

8272
05:36:51,840 --> 05:36:53,680
WILL HAVE PANELS ON GOVERNMENT 

8273
05:36:53,680 --> 05:36:55,680
FUNDING AND NAVIGATING 

8274
05:36:55,680 --> 05:36:58,600
REGULATORY PATH FROM MATERNAL 

8275
05:36:58,600 --> 05:37:00,880
HEALTH SOLUTIONS INTRODUCING 

8276
05:37:00,880 --> 05:37:02,320
INNOVATIONS FROM MATERNAL HEALTH

8277
05:37:02,320 --> 05:37:06,200
ROLE OF PAYERS AND MATERNAL 

8278
05:37:06,200 --> 05:37:08,360
HEALTH SOLUTIONS INVESTOR 

8279
05:37:08,360 --> 05:37:09,640
PERSPECTIVE AND FOUR SESSIONS OF

8280
05:37:09,640 --> 05:37:12,160
PITCH TALKS TO GIVE INSIGHTS TO 

8281
05:37:12,160 --> 05:37:14,440
MATERNAL HEALTH INNOVATIONS 

8282
05:37:14,440 --> 05:37:16,080
CURRENTLY BEING DEVELOPED AND 

8283
05:37:16,080 --> 05:37:17,920
BEING TOLD TO ANNOUNCE EVERYONE 

8284
05:37:17,920 --> 05:37:21,280
COMING ON SHUTTLE BUSES FROM 

8285
05:37:21,280 --> 05:37:23,240
HOTEL TOMORROW TOMORROW MORNING 

8286
05:37:23,240 --> 05:37:26,040
SHUTTLE BUSS WILL RUN AT 715 AND

8287
05:37:26,040 --> 05:37:28,560
745 A.M. IF YOU MISS THE SECOND 

8288
05:37:28,560 --> 05:37:29,920
SHUTTLE BUS YOU HAVE TO MAKE 

8289
05:37:29,920 --> 05:37:32,640
YOUR OWN WAY HERE AND WE WILL 

8290
05:37:32,640 --> 05:37:35,200
BEGIN TO START PROMPTLY TOMORROW

8291
05:37:35,200 --> 05:37:38,440
AT 9 A.M..  THANK YOU SO MUCH 

8292
05:37:38,440 --> 05:37:40,240
FOR JOINING AND LOOKING FORWARD 

8293
05:37:40,240 --> 00:00:00,000
TO SEEING YOU ALL AGAIN AT DAY
TWO