Too good not to share…

The VMC Foundation is proud to support all sorts of efforts to improve the health of Silicon Valley – the “Re-Think Your Drink” campaign, the forthcoming Farmer’s Market on our campus, the Pediatric Healthy Lifestyle Center…

…and yet, we’re up against an enemy so powerful it often seems we cannot win.

The video created by a Canadian physician recently gives me a glimmer of hope. The fact that it was picked up by the Huffington Post brightens that glimmer.

Education is the key, and deterring the food industry from selling unhealthy food dressed up as healthy food is the lesson. But they won’t do it unless we demand it.

This is not only worth your time to watch, it’s worth your time to share with others. Please do.


For VMC, for our County: YES on Measure A.

It’s Friday, lunch-hour, and time for a little politics: No, not the Obama/Romney kind, but the local kind that will have a more immediate and direct impact on all of us who live in Santa Clara County.

The sad fact is this: Our county has faced ten years IN A ROW of budget cuts, and we just can’t count on Sacramento or Washington DC to come to the rescue. Our County Supervisors have met the challenge again and again, cutting, combining, employing technology – all while firefighters, doctors, nurses and staff accept cuts in pay and benefits.

But we just can’t cut anymore without risking vital services like VMC’s emergency/trauma care, law enforcement public safety, children’s health coverage and more. That’s why I hope you’ll join me in voting YES on Measure A in November.

It’s a simple 1/8 of a penny tax increase. ALL the money stays in the county and cannot be taken by the State. The funds raised go to the County general fund and support all those services I mentioned and more. It lasts ten years only.

This is a simple and powerful tool to strengthen our community. Learn more by clicking here, and join me and the VMC Foundation in supporting Measure A.

Moore Foundation grants 600k for VMC’s innovative heart failure treatment program

In one of the largest grants ever given to the VMC Foundation, the Gordon and Betty Irene Moore Foundation has pledged over $600,000 to significantly grow VMCs innovative heart failure treatment program.

If successful, the grant will help VMC improve care for heart failure patients,  reduce the risk of readmission to the hospital for the same reason, and potentially save the medical center hundreds of thousands of dollars.

The project is as straight-forward as it is high-stakes.  By creating “intervention teams” of doctors, nurses, pharmacists, social workers, health education specialists and others, patients will be provided with the best, personalized care during their hospital stay, and – just as importantly– be given the tools and support they need to maintain their own recovery at home.

Heart failure, after all, is a tricky business. Once discharged from the hospital, patients must manage complex (and confusing) dietary, exercise and medication regimes – all after going through a near-death experience.  For many patients – especially those in poor health to begin with – managing their disease at home proves a burden too much to bear.   Many of them end up right back at the hospital, often within 30 days, for more invasive (and expensive) treatment.  In 2011 alone, 23% of patients discharged for heart failure at VMC were readmitted within a month.  It’s a cycle that doesn’t make people well, and makes poor use of resources.

But with support from the Moore Foundation, VMC can expand an already successful program with the goal of reducing 30-day readmissions for heart failure patients by 30%.   The benefit to patients is obvious.  Better care at the hospital, better care for themselves at home.

The benefits for VMC as significant as well.  Thanks to healthcare reform, the days of a hospital billing for services provided regardless of the actual patient outcome will be a thing of the past.  Under the new model, hospitals that can’t keep heart failure patients out of the hospital won’t get paid for readmissions. And why should they when the tools and know-how exists to keep these patients well.   The incentive is now to focus on better treatment, prevention and education to help patients stay out of the hospital.   That’s better for patient healing and, by reducing unnecessary and expensive hospital visits, better for the bottom-line.

Thanks to a vote from the Santa Clara County Board of Supervisors, work is set to begin in November.  If successful, the county will have the option to continue the program on a permanent basis.

This is the third major grant awarded to the VMC Foundation by Moore since 2006.  Few private Foundations have done more to improve the quality of hospital care in the Bay Area.

The VMC Foundation congratulates the project steering committee who worked with the Moore Foundation to develop the project, including Aravind Swaminathan, Cathy Marlatt, Dionette Kelton, Jessica Song, Yi Chao Huang and Cliff Wang.  Special thanks to Nari Singh, Dave Manson, Michael Perry, Chanthavy Sivogxay, Jennifer Sprinkles, Mathew Harrington and Amy Carta for critical HHS support, and to Trudy Johnson, Rene Santiago and the Board of Supervisors for seeing this across the finish line.

Last but not least, our heartfelt thanks Liz Malcolm, MD, from the Gordon and Betty Moore Foundation.  Without her, none of this is possible.

Our Kids are Drowning in Sugar…

Produced by our coalition of agencies looking out for kids’ health, this image should be shared if it’s to succeed…please help!

Please help me spread the word about this…there’s NO WAY Valley Medical Center’s pediatricians should be seeing 4th graders with “adult onset” diabetes – but they are, every day. And please, don’t talk to me about the “nanny state” telling you what do drink. Do you think it’s awesome that billions of dollars in advertising have resulted in kids thinking they need soda, and otherwise well-meaning parents giving in to that pressure? Sorry – I get a little incensed about this, and if we don’t call out the enemy, we’ll never know who were fighting. The VMC Foundation is proud to have worked as fiscal sponsor of the “Re-Think Your Drink” campaign in Santa Clara County for the past few years…and I believe we’re making an impact. Share this info, and I’ll be right.

Get out of our hospital, and STAY out!

You may have seen yesterday’s Mercury News article about hospitals being penalized for having high patient readmission rates. The article reported that 30 Bay Area hospitals will forfeit a small percentage of Medicare funds this year due to their too-high rates of patient readmission.

While we’re proud to report that Santa Clara Valley Medical Center was NOT included on the list of hospitals with excessive readmissions, we want you to know that is an important issue VMC takes seriously. The leadership and providers at VMC have made concentrated efforts to improve patient outcomes, and those efforts are paying off!

Some say that penalizing hospitals who see a larger number of poor and uninsured patients isn’t fair, because they tend to have higher rates of readmissions… but I think we can all agree that ALL hospitals should be working as hard as they can for better patient outcomes, and at VMC, the proof is that it CAN be done – even in a medical center that sees the largest number of low-income, underinsured members of our community.

Every hospital is trying to curb unnecessary readmissions. There are a number of complex reasons a patient may be readmitted to the hospital within 30 days of discharge, including lack of a discharge plan or the quality of a patient’s post-discharge care. Whatever the reason, the federal government considers readmission rates to be an indication of the quality of care patients receive at a facility, and we want every patient who visits VMC to receive the best care possible.

Reducing readmission rates is critical to VMC receiving Medicare funding, but to the hardworking folks at VMC, it’s not just about the money. VMC’s providers are working to reduce patient readmission rates because it’s the right thing to do… and because it’s what’s best for patients.

If you haven’t had a chance yet, check out the article, and let us know what you think!

Healthcare Reform and VMC – game on!

As you probably heard this morning, the United States Supreme Court has upheld (nearly all of) the Affordable Care Act.

Nevermind the politics – from a policy perspective (and the “everyone needs access to affordable, quality healthcare perspective”), this is a very, very good thing.

Because here at Silicon Valley’s public medical center, we are on the front lines of America’s healthcare crisis. Doing nothing was never an option, no matter how the Supreme Court ruled.

Since that act was signed by President Obama in 2009, VMC has been hard at work planning for change. Part of the ACA that isn’t being tweeted about today is a big deal for VMC and other “Safety Net” medical centers. “Disproportionate Share” hospitals (those who serve more under/un-insured than hospitals around them) like ours get a reimbursement from the federal government today based on numbers: How many we serve, what procedures they get, etc. Under ACA, that’s changing, and for the better: We now must demonstrate that we’re improving their health, that patients are satisfied with their care, and that we’re able to measure those positive outcomes.

Like it or not, healthcare in America is still a competitive business. The advancements VMC is making will help us compete… As we prepare to open our new world-class hospital (the Sobrato Pavilion), it’s time to “turn the ocean liner.” That takes time and toil. But gone are the days when it’s enough to tally the uninsured we serve and what we do for them, report it to the Feds, and get reimbursed. VMC must compete for dollars by demonstrating better outcomes for all we serve.

With the Affordable Care Act punctuating the need for change, VMC must evolve past the “fee for service” model that’s been the norm, more or less, for 160 years. For its imperfections, Obamacare will make this easier, but it’s already happening and there is no going back.

And that’s not all. VMC is preparing to enroll and provide care to tens of thousands of local residents who will become eligible for Medi-Cal in 2014. And as the region’s largest teaching hospital (1 in 4 area physicians were trained at VMC, including all students at the Stanford University School of Medicine), VMC will play a critical role in training the healthcare workforce of the future that will need to rapidly expand to care for all these newly insured people.

The VMC Foundation is also playing a part, thanks to the help of innovative funders like the Moore Foundation, The Health Trust, El Camino Hospital District, Kaiser, the Sobrato family and more. We are proud to be promoting, working on, and raising funds for the most critical parts VMC’s transformation. And not to belabor the point, but these transformative programs aren’t a response to Congress or the courts; we’re doing them because it’s the way healthcare MUST change, because it’s better for VMC, and most importantly, better for the patients and community we serve. Here’s just a sample of the projects the VMC Foundation is supporting to make healthcare reform a reality at VMC –

  • Patients with congestive heart failure are being better prepared to leave the hospital and manage their conditions, thus reducing readmission rates.
  • System-wide campaigns to improve the patient experience – more quiet, more communication, more customer service.
  • Our Healthier Living Program helps diabetics control their disease, as you may have read about in the Wall Street Journal (yes, that was a boast).
  • Heard about the “medical home model?” It’s happening at a Valley Health Center near you. One door = a team of health pros with you at the center of the team.
  • Electronic health records? On-line link to your doctor, meds, history and appointments? We’re building it as I type.
  • Access to fresh fruit and veggies is hard for many VMC patients. Coming soon: Our on-campus Farmers’ Market!
  • You’ve heard of VMC’s renowned spinal cord injury rehab center? How about spinal cord injury CURE? We’re on the forefront of new technologies that are astounding and magical.

One more time: We’re doing all this anyway. But with today’s decision, it’s going to be easier.


Electronic medical records: It’s going to be Epic!

Jeff Scarafia of Epic, presenting June 5 to a group of county health leaders. His slide shows just a few of the medical centers using Epic.

Yesterday I got to learn a bit more about Epic, the system being implemented here at Valley Medical Center to catapult us into the 21st century!

That’s not even hyperbole: Epic is truly epic. Once it’s fully implemented, we’ll be part of a growing national network of medical systems using the same electronic medical record platform…and we’ll all benefit.

I’ll be able to make appointments or change them right from my computer at home or iPhone. Accessing lab results, re-ordering medications? All a snap. History of my constant, frustrating battle to lose weight? The info is at my fingertips.

But most importantly, if I’m visiting Epic’s HQ in Wisconsin, and I’m wandering through a field and get hit by a cow*, the local trauma center using Epic will have instant access to my medical history and know that I’m allergic to Bovinabutanol.**

This is technology that will truly save lives – maybe mine, maybe yours. And just another great innovative step being taken by our public hospital. Learn more at

* This is unlikely to happen.

** I totally made up that medication.

Amazing device improves patient/doctor communication!

Most medical devices can't be found at REI. This one can.

Dr. Gary Lee is Valley Medical Center’s director of palliative care, and he’s using a new high-tech wonder in his daily communication with his patients.

Yes, I know it may not look that amazing. But consider: This portable, light-weight camping stool allows Gary to carry it wherever he goes, and when he’s ready to speak with a patient at the bedside, he unfolds it and sits at eye-level with the person in the bed.

Barbara Zahner, Chaplain here at VMC, puts it like this: “the presence of this simple, low cost piece of equipment changes the environment from clinical to remembrances of comforting campfires, cozy conversations, and the grandeur and spirit of nature and creation.”

Gary first read about this in the New England Journal of Medicine, and has found it a real game-changer: The national statistics are that a patient is interrupted by their doctor (at most) 18 seconds into being heard…and in Gary’s practice, that just won’t do.

You see, Gary’s work involves end-of-life discussions with patients and families, where listening is a critical part of delivering care. If done right, the alert reader of this blog will remember that palliative care can not only provide dignity, it can actually extend life.

A simple camping stool! How wonderful to slow that hurry-up dynamic between doctor and patient, letting both feel more present and “in the moment”. Anyone can do this, right Gary? “Well, it requires training”, he told me…and remember, VMC is the teaching hospital for Stanford: “We teach medical students that the most important part of the stethoscope is the six inches between the ear pieces. By the same token, the most important part of the camping stool is – well, you get the idea.”

We’ve all heard it before, and it’s so true: Before they care how much you know, they have to know how much you care.

Let’s make cigarettes OUTRAGEOUSLY expensive!

On the June ballot in California, Proposition 29 deserves your vote…and the campaign deserves our support.

The idea is simple, and we’ve done it before: Another tax on tobacco –  a dollar a pack this time – to support cancer research and other fine things.

Frankly, I don’t care as much about what the tax money does. Cigarettes kill a hundred Californians, EVERY. SINGLE. DAY. What I like is that cigarettes will be even more unaffordable, and that has proven to be a major reason why people finally quit.

And that’s the point: If you smoke, you just have to quit. For yourself, your family, for those around you…as hard as it is, and I know its miserable, you just have to get help and stop. Also, a dollar a pack more might keep one more 15-year-old from starting.

Visit to learn detials, and check out the video below featuring our own Public Health Officer Marty Fenstersheib, MD, and Supervisor Ken Yeager, on why Santa Clara County is behind Proposition 29.

The Verdict on Health Care Reform (the jury is still out)

It’s finally happened: I’m serving on a jury.

Disruptive? Sure – I’m a busy guy; most of us are. So I’ve quickly compiled a list of things that, as United States Citizens, we don’t have to do:

  1. Vote
  2. Join the Military (not now, anyway)
  3. Belong to a political party
  4. Pledge allegiance to the flag
  5. Worship one way or another
  6. Pay taxes (you can live in your buddy’s warehouse and eat burritos every day. Believe me – I know)
  7. Say only nice things about the government
  8. Limit the number of kids we have

I could make this list longer, but you get the point: About the only thing we MUST do, when called, is serve on a jury. That’s a pretty good deal, so as I try not to complain I also try not to be too angry with fellow prospective jurors who are obviously trying to get bounced.  After all, we’ve gotten used to a lot of free will in this great country.

And this may be why so many folks are still steamed up about Obama’s health care reforms. Some parts of them sound compulsory, like everyone paying into an insurance product of some kind…a lot of people heard that and freaked out, because it sounded MANDATORY. Americans don’t like mandatory.

But after reading today’s LA Times Op-Ed piece, it became clear about what also is mandatory: Cancer. If you have it, you can’t opt out. You can’t say “As an American, I choose not to have this disease.” As the author found out, sometimes your choices are terrifyingly limited…and that’s when options on health coverage and treatment start to sound a lot less political and a lot more life-saving.

The author apologizes to the President, which of course she didn’t have to do. If you have an opinion, feel free to share it. Or not; it’s a free country. I’ll reply, once I catch up after my service.