Healthy Conversations

Genomics may seem like a field of study with minimal impact on our daily lives. But not for much longer — and certainly not to Dr. Deepak Srivastava, a cardiologist and president of the Gladstone Institutes. Rapid technological advances in this field are starting to surface across health care with significant and promising benefits. “The new world,” says Dr. Srivastava, “is going to be one where, as we identify the known genetic causes, we no longer have to accept that that mutation exists. We finally in medicine have the opportunity to think about curing disease.”The nonprofit Gladstone Institutes focuses on four key disease areas – the heart, brain (including Alzheimer’s and Parkinson’s), viral (like HIV and Covid), as well as immunologic disorders. On this episode of Healthy Conversations, Dr. Srivastava tells about advances like reprogramming support cells in the pancreas into new insulin-producing cells for diabetes: “So we can take skin or blood cells from any adult and turn those into cells that behave just like a human embryonic stem cell, which has the property that it can become once again any of our over 200 different cell types in the body.” The future may indeed be here, sooner than you think.    Learn more https://gladstone.org/

It’s been more than 20 years since the human genome was first sequenced.  And now, a new version that’s been updated with 47 men and women of diverse origins, including African Americans, East Asians, West Africans, and South Americans, among others, promises to benefit all people, regardless of their race, ethnicity or ancestry. This new version, called the “pangenome,” was announced earlier this month by the National Human Genome Research Institute, a government agency that funded the research.On this episode of Healthy Conversations, Trish Brown, the Genomics and Precision Medicine Program Director for CVS Health, details for Dr. Kraft how we can translate genomics into access to care, and what’s the human impact, going forward.  “So what we're capable of, now, in terms of isolating, finding DNA and what we can do with it at different stages is just incredible,” Trish notes.  “We have next generation sequencing testing platforms where if you wanted to, you could sequence the entire human genome and then you use bioinformatic filters to just pull out of that what you think is relevant. And so those sorts of technological advances have really dropped the cost and really allowed for a broader set of testing.” Learn more 6 Things to know about genetic testing  The value of genetic testing 

Are Americans underestimating their mental health struggles? A new study from CVS Health and Harris Poll found that nearly three in four Americans describe their mental health as “excellent” or “good,” and only one in 10 say their mental health has gotten worse in the last year. Yet nearly 60% of physicians report declining mental health among their patients. Why aren’t more people willing to talk about their feelings of anxiety, sadness, or the “blues”? In honor of Mental Health Awareness Month, we present a special episode from LinkedIn’s Anxious Achiever podcast featuring, Cara McNulty, President, Behavioral Health and Mental Well-being at CVS Health. “Mental well-being is part of our physical well-being, which is a part of our total well-being,” says Cara. “Instead of trying to pretend that our head is not attached to our bodies, let's reframe how we talk about mental well-being.” In the interview with host Morra Aarons-Mele, Cara traces her career path as a population scientist along with her personal and professional experience with mental health. Cara and Morra open up about their mental health challenges as mothers and talk about the persistent myths around mental illness in our culture and health care system.   “Mental illness just means a chronic condition that you're dealing with like schizophrenia, like bipolar,: explains Cara. “That doesn't mean you're broken. … We don't tell people who have colon cancer that they're broken.”Learn more  Mental health awareness guide for young adults (PDF) Mental health awareness guide for parents and caregivers (PDF) LinkedIn Presents: The Anxious Achiever 

A recent CDC study reported that one in 36 children in the United States is diagnosed with autism. Today’s guest, Temple Grandin, is one of the country’s most renowned voices on autism with an incredible ability to open up and share her perspective on the world with us. A professor of animal science at Colorado State University, Grandin has been a pioneer in improving the welfare of farm animals for decades. She is the author or co-author of more than 60 scientific papers on animal behavior and more than a dozen books that include the best-sellers “Thinking in Pictures” (which became an HBO movie starring Claire Danes) and “Animals in Translation.” Her latest book, “Visual Thinking,” explores neurodivergent thinking and the different ways our brains are wired. As she explains, “I didn't know until I was [in my] late thirties that other people thought in words. Everything [for me] comes up like snapshots and little mini-videos, and it was a shock for me to learn that other people were not visual thinkers.” In honor of Autism Acceptance Month, Temple spoke with Dr. Kraft about how the perception of autism has changed and how diversity of thinking makes us all stronger: “I think we need to have collaborations between the different kinds of thinkers, recognize that the different kinds of thinking exist and look at where there are complementary skills.”Learn moreTemple GrandinCVSHealth.com 

In part two of our conversation on clinical trials, we hear from two people directly involved in the effort to expand access to clinical trials in underserved communities. “There are challenges across the board, both in getting patients into studies and also getting them to stay in studies — what’s called retention,” says our first guest, Josh Rose, Vice President and Head of Clinical Trial Delivery, Site Solutions and Strategy for Clinical Trial Services at CVS Health. He explains how his team chose the 100 MinuteClinic sites to equip for clinical trials from among the more than 1,100 locations nationwide: “We specifically picked out those locations [near] the type of patient population that we were hoping to enroll – urban areas, areas with high patient density, areas with high diversity. That helps ensure that we are getting much more representation of the broader population.” Clinical Trial Services works with numerous trial sponsors, from large pharmaceutical companies like Moderna to smaller biotech firms like ProKidney, which is working on cell-based therapies to slow down and prevent kidney failure in order to help patients avoid the need for dialysis or a kidney transplant. Dr. Joseph Stavas, Senior Vice President of Global Clinical Development at ProKidney, explains how their innovative cell therapy approach harvests a patient’s own cells, which are then processed, formulated and reinjected. Chronic kidney disease, says Dr. Stavas, is predicted to be one of the largest global problems in the next 20 to 30 years. Their Phase 3 trial is targeting the two most common causes of chronic kidney disease — hypertension and type 2 diabetes. Learn moreCVS Health Clinical Trial Services ProKidney

Today, in the first of a two-part episode on increasing diversity in clinical trials, we hear from Dr. Owen Garrick, Chief Medical Officer of Clinical Trial Services at CVS Health. The unit, launched in 2021, is creating a network of clinical research sites by equipping certain HealthHUB and MinuteClinic locations with the staff and resources needed to conduct complex clinical trial protocols. The goal is to expand access to clinical trials in underserved communities and encourage a more diverse population to enroll, leading to more effective outcomes. “Historically, there has just been less diverse participation in studies,” notes Dr. Garrick. “The risk is, if we don’t solve this issue around lack of diversity in clinical trials, as we get to precision medicine, we’re only going to exacerbate health inequity.”This new model combines precision patient recruitment from a diverse population with trial delivery and real-world evidence generation. Dr. Garrick believes it will be successful because it breaks down several of the barriers to trial participation – outreach to know a trial exists, convenience and, importantly, trust. “You already know CVS Health because you go for part of your health care, whether that’s retail prescriptions or specialty prescriptions or over-the-counter meds or MinuteClinic. So, you have this relationship that already exists,” he says. “As we introduce clinical trials and additional health care services, there’s this built-in trust.” Learn moreCVS Health Clinical Trial Services

In part two of our conversation about the Clinical Entrepreneur Programme from England’s National Health Service, our host, Dr. Daniel Kraft, continues his discussion with Dr. Tony Young, the program’s founder. They talk about a number of innovations brought about through the program, including two aimed at addressing health disparities. CardMedic uses a collection of “digital flashcards” to help improve communication between health care staff and patients across barriers ranging from physical impairment to language to PPE. And Written Medicine’s software uses human-generated translations to provide medication labels in 11 languages – and counting. To encourage innovations like these, the entrepreneur program is building a “health inequalities tool” to help potential entrepreneurs answer questions like, “Am I bringing in unconscious bias? Is this going to make health equity worse?” In addition, Dr. Young offers a number of tips for potential physician entrepreneurs, including the importance of persistence and surrounding yourself with like-minded people. He encourages entrepreneurs to be open to change. “Don’t fall in love with your solution,” he says. “Too many people go, ‘I’ve got just the perfect answer for this,’ but it’s not. Actually, fall in love with the problem and really work that through. And then bring people onboard that share that problem and really want it solved.” Learn moreNHS Clinical Entrepreneur ProgrammeWritten MedicineCardMedic

Clinicians are problem solvers by nature but taking an idea for a new innovation from concept to commercial market is not a skill widely taught in medical school. In 2015, England’s National Health Service (NHS) launched a Clinical Entrepreneur Programme to help provide just that type of knowledge and expertise. Our host, Dr. Daniel Kraft, speaks with Dr. Tony Young, the founder of that program who is an avid entrepreneur himself. Young is helping the NHS retain some of their brightest talent by fostering an entrepreneurial spirit in his colleagues and making connections where he can. The program has trained more than 1,000 clinical entrepreneurs, who’ve founded more than 350 startups, raised more than $500 million pounds, and impacted more than 100 million patients and professionals in the UK and beyond. You’ll hear all about Dr. Young’s career journey and the incredible innovations his colleagues are bringing to operating rooms as well as remote parts of the world. However, “the greatest medical innovation of all time,” says Young, “are the people who work in our Health Services, because they help put everything into action.” Learn moreNHS Clinical Entrepreneur Programme  

One in four people in the U.S. has been diagnosed with a gastrointestinal (GI) condition, says the co-founder and CEO of Oshi Health, Sam Holliday. The patient journey to diagnosis is costly and long—often two to four years—and filled with tests, examinations and waiting rooms. Oshi Health is a startup and CVS Health Ventures partner that uses an integrated virtual care model to scale access to care and innovation for patients struggling with GI diseases such as irritable bowel syndrome, Crohn’s disease and ulcerative colitis. There’s an emerging understanding that the signaling between the gut and the brain can get dysregulated and trigger symptoms, notes Holliday. Oshi’s approach is to calm that signaling with a combination of FDA-approved digital therapeutics and a multidisciplinary care team that includes a dietician, psychologist, nurse practitioner and gastroenterologist. Learn moreOshi Health CVS Health Ventures

In Part 2 of the Healthy Conversations discussion with Dr. Brennan Spiegel, professor of medicine and public health at Cedar Sinai Health System, gastroenterologist, and VR pioneer, lets us peak into the future, and see some of the many ways VR is getting “real-er” – as he puts it: “You can experience life as someone with a disability, or as a different race, or with certain physical or visual handicaps. And that can give clinicians a bit of insight to what their patients are experiencing continuously.”

In the first of a 2-part episode on Healthy Conversations, Dr. Brennan Spiegel, a professor of medicine and public health at Cedars-Sinai Health System, gastroenterologist, and VR pioneer, discusses the exciting possibilities of virtual reality in terms of its affecting the human mind, as well as chronic diseases. As he puts it, "Rather than always bringing patients to the clinic, what if we can bring the clinic to the patient?"

In the second of a two-part episode about suicide, Dr. Seth Feuerstein, the CEO of Oui Therapeutics, discusses the exciting potential of digital therapeutics in preventing suicide.  As he says, “So we can use software to tackle problems where we already have lots of prescription options, but -- the thing that really excites me is where can we use software to solve problems that were not previously solvable.

Dr. Seth Feuerstein, the CEO of Oui Therapeutics, dispels misconceptions about suicide in the first of a 2-part episode of Healthy Conversations.

Where do things stand now in terms of COVID, Long – and even Medium COVID?  What have we learned after the past three years, and what should we, going forward?  On the latest Healthy Conversations episode, Dr. Kirsten Anderson, senior medical director for New England for Aetna and CVS Health, shares insights with Daniel, and tells why she feels the role of public health is more important than ever before now.

Listening to Brad Bostic, founder, chairman, and CEO of HC1 -- and Daniel’s latest guest -- you can’t help but be excited about the future: “We've got this incredible opportunity that's once in multiple generations to advance the ball, and it's because you've got access to medical information that's digital unlike you've ever had, and you've got this access to compute, and you have a collection of really intelligent, committed people working on these different areas of innovation. You put all those things together and there could not be a better time to accelerate in healthcare.”  He explains how the use of digital twins, and being able to be predictive sooner, can help.

This episode features Dr. James Allen, the founder and CEO of Health Systems Thinkers. Dr. Allen went from being a small-town physician in upstate New York, to working for a company in Borneo and later Bangladesh. In the process, he became one of the foremost authorities on community medicine. Being in a remote small town made him see the workplace as part of the community.

In this episode, first released in the fall of 2021, Daniel sits down with Dr. Patrick Hines, the founder and CEO at Functional Fluidics and the leading Sickle Cell Disease (SCD) researcher at Wayne State University in Detroit, where he set up a transformational study on defining the health of red blood cells. Dr. Hines also introduces us to exciting new therapies — recently approved — and the importance of being proactive with SCD.

Tim Blake, the founder and managing director of Semantic Consulting, helps organizations grapple with digital change and digital disruption. And he talks with Daniel about the challenges and potential of digital healthcare – as well as what he learned as the chief information officer of the Tasmanian Health System, such as, “Sometimes problems can be far simpler than we think they are when you ask the communities that really genuinely own those problems.”

Dr. James Stoller is the Chairman of the Education Institute at Cleveland Clinic, a pulmonary critical care physician, and author of Exception to the Rule. Daniel and James sat down to discuss deficit-based thinking, medicine being a team sport, and the simple fact that "doctors, like everyone else that join organizations, expect to grow over the course of their career."

In clinical settings, we often suppress our emotions, ignoring what is now considered a valuable professional dataset – yet harnessing the power of our emotional life helps improve so many aspects of our work from job satisfaction to patient outcomes. It’s only a matter of time until the industry pivots away from this seemingly learned habit. Dr. Marc Brackett, Director of the Yale Center for Emotional Intelligence and author of 'Permission to Feel,' explains how to tap into the crucial ability to use our emotions wisely. And the very real price we pay when we don’t.