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Interviewer: Healthiest nation by 2030. That's coming up next, on The Scope.

Announcer: Medical News and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: The American Public Health Association has announced for this year's National Public Health week, the emphasis is healthiest nation by 2030. We're talking to Dr. Kyle Bradford Jones, family physician at the University of Utah. So Dr. Jones, is that even a realistic goal?

Dr. Jones: You know, it's definitely an ambitious goal and it's the type of thing we should be shooting for. But we do face an uphill battle, it's going to take a lot of work. A number of studies have shown that when you look at developed countries, we're the lowest in infant mortality, obesity, heart disease, and what's called Healthy Life Expectancy at age 60, so the number of healthy years you can expect once you're age 60.

When the Commonwealth Fund did a study of 11 developed nations, we came in 11th. When the World Health Organization did a study, which has become quite famous, a number of years ago, we ranked 37th in the world in terms of our health. So we've got a long ways to go.

Interviewer: Even though, I feel like in the minds of most people, that the U.S. is just so high in ranking according to some of our health stats, I mean people come to the United States for health treatments, but that might not actually be the best idea, from the stats you're telling us. We're not doing a very good job.

Dr. Jones: Well we certainly have the best physicians in the world, and a lot of the best hospitals, and the best innovations. The problem is, that doesn't make it to all of our citizens. And part of the reason we're in this position, is because we're not focusing on the right things. So as a family physician, I can only do so much. So we've found that when you look at an individual's entire health, only about 10% of it is impacted by their health care.

Now obviously that's an important 10%, so over about 50% of what goes in towards a person's health has to do with their environment, and that's kind of the element of public health. Of focusing on those things that go around us both culturally as well as things like pollution, that really are the biggest impactors of our health.

Interviewer: So what are some of the methods and ways that we can actually improve our public health care system to reach that healthiest nation goal by 2030?

Dr. Jones: So there are a number of different avenues to do this. Basically it's going to take participation from everyone. If you look at it from the perspective of the health care system, there has been a lot of talk in the last few years about how do you properly bring together primary care and public health because obviously we have very complementary goals. But we each have different ways of going about those goals. So better working together can make a much bigger impact.

If you look at it from the perspective of as our society, we need some policies that focus a little more on health. So, for example, tackling pollution, tackling some of those things that greater impact us. Encouraging, on a local level, exercise and healthy food. So things like putting in bike lanes on local streets that encourage more exercise by citizens.

When you look at it from a business standpoint, a lot of employers are offering wellness plans which encourages better eating, better exercise, encourages people to take better care of themselves. Which leads us to individuals.

What can we do personally, and basically it's all the things that our mothers taught us. Eat your vegetables, have a healthy diet, get your exercise, get as much activity as you can, drink lots of water, avoid junk food. And even things like avoiding distracted driving. So don't text while driving, don't use your phone at all while driving; don't eat. All those things will take us away from that.

So if we're following some of these goals, if we're working towards becoming the healthiest nation by 2030, we're going to have to go about it by many different avenues.

Interviewer: This sounds like a lot of work, but if it's a lot of individual work coming together, like a team.

Dr. Jones: Exactly.

Interviewer: From what you've described so far about the methods and the goals to get there, it seems pretty simple. It seems like we're actually, supposedly, in that state right now but we've been kind of stuck. Why do you think that is?

Dr. Jones: That's true. The answers seem relatively simple, but there's so many cultural changes that we are kind of behind on in addressing some of these health issues. You know, as we know, politically it's hard to get anything done, whether it's logical or not. Individually it's hard to change our behaviors. So it's important for us to try to and work towards that but it's not an easy thing.

Interviewer: So what are some of the things then that we can take away, or we can learn from some of the other developed countries that are actually in higher ranking than we are in relations to public health.

Dr. Jones: It's a great question and something we should be focusing more on. A lot of it has to do with more emphasis by the society and culture on public health, and like we mentioned, more than half of our health has to do with our environment.

A lot of this is cultural. With cultural things in America, we follow a lot of fast food, we do things like that. Whereas in many other countries, they focus a little bit more on eating at home, cooking their food which is obviously a lot healthier. So those are different things we can move towards, here, to help us be healthier.

Interviewer: So do you think this is realistic? Realistically talking, by 2030?

Dr. Jones: Maybe. Like I said, it's going to take a lot of work, but it's an appropriate goal. It's what we should be shooting for.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.

Interviewer: At large institutions it can tough to know what's going on with everyone else, you know, as far as research or innovation is concerned. And interesting solution to that problem we'll examine that next on The Scope.

Announcer: Medical news and research from University Utah physicians and specialists you can use for a happier, healthier life. You're listening to The Scope.

Interviewer: This is an interesting concept, librarians helping to create content and not just curate content. We're talking with Jean Shipman, who is Director of the Spencer S. Eccles Health Sciences Library, about a brand new creation called the e-Channel. This is your baby?

Dr. Shipman: That's it, and we are so excited to be launching e-Channel.

Interviewer: Tell me a little bit about e-Channel, and what challenges were you trying to overcome, or what problems were you trying to solve when this came into being?

Dr. Shipman: We've been dealing for a long time with the idea of how long it takes to get information to the public. Our CTSA is an example of how to get research from the bench to bedside quicker.

Interviewer: And what is CTSA?

Dr. Shipman: CTSA is Clinical Translational Science Award, this whole government-funded initiative to push research faster to patient care.

Interviewer: Okay, so the physicians are getting it faster, so patients can access it faster.

Dr. Shipman: Exactly. And yet the traditional journal is not going any faster. So we were struggling with our publishers, our authors here at the University. How can we get this information out to the public faster?

Interviewer: Traditional channels; how long does it take for a journal article to be published?

Dr. Shipman: It can take nine months at the fastest to probably a year and a half.

Interviewer: And at one point maybe 50 or 60 years ago that was fine.

Dr. Shipman: Right, but now today, when things are happening so rapidly, healthcare transformation causes things to happen overnight, so you can't wait for nine months to get the latest information.

Interviewer: What was the holdup on the traditional journals?

Dr. Shipman: Well everyone wants quality, so there's a lot of review of the material that's being published. In a statistical review there's a lot of accuracy checks on editing, and it just takes awhile. But there is now also a chance for conversation. You hit this print item and there it is 2D.

Interviewer: There you go, right?

Dr. Shipman: 2D, whether you can understand it or not.

Interviewer: Yeah.

Dr. Shipman: Whereas with today's media, you can do all kinds of fascinating 3D, as I call it, conversation with blogs, with chat rooms, with videos, you name it, it's possible.

Interviewer: The goal is to create conversation it sounds like.

Dr. Shipman: Conversation, but also rapid release of information.

Interviewer: Aren't you worried about the accuracy then if you're speeding up the process?

Dr. Shipman: Well you can be, but if you think about all the peer eyes that are looking at this content, it's almost more editing availability than what you'd have in a print where you have two or three reviewers.

Interviewer: It's kind of like, I know Wikipedia takes a lot of flack, but it's pretty decent really for what it is. Right?

Dr. Shipman: It is, because you have the whole universe of experts kind of looking at a topic or idea.

Interviewer: Gotcha. So that's why an alternative to the traditional journal article is speed and it creates some conversation.

Dr. Shipman: That, and also we recognize with different disciplines. There are different uptakes for journal articles, too. And working with innovators, we found that the traditional journal is not something that they go to. How do you publish a medical device? How do you replicate the effort that went into that in a traditional journal article?
So innovators want to a place to also have a voice in how their disseminating their results successfully as well as their failures. And that's something you don't see in journal articles.

Interviewer: Yeah, but it's a very valuable learning lesson. Anybody that's ever learned probably has learned from failure more than success.

Dr. Shipman: Exactly, and with innovation you can get a failure and then build on that and have a major success results.

Interviewer: So the e-Channel; the traditional journal format is written, is the e-Channel written the same way as a more of a blog format, or is it going to be multimedia?

Dr. Shipman: Definitely multimedia, probably print very little. In fact we're not trying to replicate the traditional journal article, in which a lot of libraries are going in that direction. But we're trying to make it the lively, electronic, eclectic, entrepreneurial channel, thus E. And also it just happens to stand for Eccles.

Interviewer: Okay, entrepreneurial and Eccles...

Dr. Shipman: And extraordinary.

Interviewer: And extraordinary, right. And it's also that would be a very powerful, because it allows the person talking about whatever it is they're talking about to use the medium that can best communicate that. Sometimes the written word is not it. Sometimes it's a 15-second video.

Dr. Shipman: Exactly, it came really clear as our Chief of Pediatrics said, "I've written one editorial of 900 words five times in nine months in order to make it clearly relevant and current. And I need more conversation, because I'm worried about health care reform in pediatric hospitals."
A 900 word editorial; how many people see it and how many people relate to it, think about it. But if you see me as a person, as the Chief of Pediatric Hospital here, talking about it, it's much more vivid and more lively.

Interviewer: Yes, you're creating that sense of community.

Dr. Shipman: Yes, and recognition and all kinds. So he can't wait to get this shoe to drop, is what his editorial is about.

Interviewer: What are some of the content that's currently available?

Dr. Shipman: We just are starting out, so we have had four cohorts of lean training projects here at the University that were sponsored by Dr. Vivian Lee that were sponsored by Dr. Vivian Lee. And we have captured all of the templates that have come out of those projects; so all the best of the evidence of our efforts at creating lean or projects are available to the general public.
And we're hoping that everyone will contribute to that repository so that we can even build on the best of the evidence and kind of analyze it and come up with let's say three institutions to do the same kind of project. Why should the fourth institution start from scratch? Why not build on the effort and the knowledge gained by those first three?

Interviewer: Yeah, so the e-Channel is for other academic medical centers, because that's a big topic right now, lean process. But it's a big topic in business, too, so who knows somebody from outside of medicine might be able to contribute to this and give us an idea you never thought of.

Dr. Shipman: And that's really what this is all about, that interdisciplinary, interprofessional conversation. And then we are adding Dr. Clark's videos, which he will also be talking about. He had about ten videos done. We walk through the Pediatric Hospital with him and he really talked about where healthcare reform could come into play.

Interviewer: What do you hope that this e-Channel will ultimately become?

Dr. Shipman: I'm hoping it's the first place people will go to when they are having their breakfast. But that's a pretty [inaudible 00:06:25].

Interviewer: It sure is.

Dr. Shipman: But I'm hoping it will be a place where our university personnel who really want to get information about their innovations, their research, their latest medical therapeutic technologies could have a place to share that information.

Interviewer: Share that information and start the conversation.

Dr. Shipman: Exactly, and get recognition for it, because they also have to go up for promotion and tenure at the university, and traditional journal articles have been usually the metric used to analyze your impact. Here we're hoping that e-Channel will be given as much recognition and time to our promotion.

Interviewer: That's going to be a tall challenge isn't it, to establish that kind of credibility?

Dr. Shipman: It is, but I think with peer reviewing in we can look at different tiers of information on e-Channel. We can get to the level of public interest, too, and internal interest, and to world interest is our hope.
So we will be working with the medical therapeutic entities in the Garden Level Library, to capture all of their output. Our EAE Program here, our Entertainment Arts and Engineering, is one of the best in the world creating gains and medical therapeutics. And they have no place to really put that information out. So we're going to be collecting all of their gains and describing them and creating an opportunity for them to get back to their work as well.

Interviewer: Gotcha. Anything that we left out or any final thoughts?

Dr. Shipman: Well, as soon as we get e-Channel up we're hoping that you'll review it, give us your comments, and input, and think about ideas of what you'd like to contribute to e-Channel.

Interviewer: And how can someone find it?

Dr. Shipman: They will be at our Eccles Health Sciences Library page. There will be an e-Channel URL available and I'll link you to it. But we'll also be putting it out on Algorithms for Innovation on different sites at the university.

Announcer: We're your daily dose of science, conversation, medicine; this is The Scope, the University of Utah Health Sciences Radio.