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The Value of Collaboration: IOM’s Role as a Convener The Institute of Medicine (IOM) has a singular capacity to bring together various stakeholders to work together on health problems of shared inter- est. Through both its ongoing roundtables, sometimes called forums, and through unique partnerships, the IOM shapes the conversation around health and health care. Partnerships with outside organizations bring com- plementary strengths and enable the IOM to amplify the size and character of its audience and the impact of its work. The IOM has pursued a number of such new opportunities with outside organizations in recent years. HBO Obesity Project In association with the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), the IOM has entered into an innovative collaboration with HBO Documentary Films aimed at helping to slow, arrest, and reverse the disturbing trend toward obesity in our country. The collaboration, titled The Weight of the Nation, is part of IOM’s continuing commitment to ameliorate the nation’s obesity epi- demic. The IOM’s work in this area began with the landmark 2005 study, Preventing Childhood Obesity: Health in the Balance. The expected spring 2012 publication Accelerating Progress in Obesity Prevention will add to this considerable body of work. The Weight of the Nation is expected to generate unprecedented national impact through the production, airing, and dissemination of five documentary films in 2012, along with com- panion publications, a video-rich website and social network presence, 139

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140 INFORMING THE FUTURE: Critical Issues in Health and the free distribution of 40,000 screening kits to enable communities to screen the film locally. The Health Data Initiative The Health Data Initiative, launched by the IOM and the Department of Health and Human Services (HHS) in June 2010, is a public-private collab- oration that encourages innovators to use health data to help power appli- cations and services that can improve health and health care. Last year’s launch, attended by 350 stakeholders, featured new “apps” that demon- strated highly innovative ways to employ community-level health data to improve health. This year the IOM and HHS enlarged the program, with a second meeting held in June 2011. The forum, held at the Natcher Con- ference Center at the NIH, was attended by more than 550 participants from information technology firms, healthcare delivery systems, academia, business, social sectors, public health communities, and all levels of gov- Kathleen Sebelius, Secretary of the Department of Health and Human Services, addresses the Health Data Initiative Forum, June 9, 2011. SOURCE: The National Academies.

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141 The Value of Collaboration ernment. It also was webcast nationally to more than 350 individuals and viewed by another 250 people at 10 satellite locations. The forum included an extensive “expo” and highlighted the work of nearly 50 companies and other organizations as well as the winning apps from the Collegiate Chal- lenge, a national contest for college students to design a health app. Forums, roundtables, and symposia In the role of partner and convener, the IOM serves as a neutral meeting place where diverse groups of people can come together to share informa- tion and advance knowledge. Although creating common ground can occur through formal committees with specific objectives and areas of study, it often takes place through forums, roundtables, and symposia that provide opportunities for serendipitous discovery, mutual exchange, and critical, cross-disciplinary thinking. The IOM holds symposia, sometimes called summits or workshops, to foster awareness or focus attention on important issues, or to help broaden awareness about a recently released IOM report. In July 2010, for example, the IOM held a 2-day public workshop on emerging research needs for the Special Supplemental Nutrition Program for Women, Infants, and Children (commonly referred to as the WIC Program), in response to a request from the USDA’s Food and Nutrition Service. In another example, the IOM assembled thought leaders in October 2010 to examine the critical needs and gaps in understanding prevention, amelioration, and resolution of Lyme disease and other tick-borne diseases. Forums and roundtables offer a different approach, by drawing together an array of stakeholders interested in a broad area of health sci- ence or public policy for a long-term, dialogue. Members of forums and roundtables typically include experts from the scientific and practice com- munities; leaders from government, academia, and industry; and represen- tatives of consumer and public interest groups, among others. These gatherings are intended to illuminate issues through discus- sion and debate across sectors and institutions rather than to resolve a particular issue or make specific, actionable recommendations. Bringing together these individuals can create the shared knowledge, trust, and understanding necessary to foster progress in the most contentious areas of health and science policy.

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142 INFORMING THE FUTURE: Critical Issues in Health Food Forum Since 1993, the Food Forum of the Food and Nutrition Board has engaged scientists, administrators, and policy makers from academia, government, industry, and public sectors on an ongoing basis to discuss problems and issues related to food, food safety, and regulation, as well as identifying possi- ble approaches for addressing those problems and issues. The dialogue established during meetings deals with emerging issues in the broad areas of food science, food safety, and nutrition, including tech- nologies and regulations. Most recently, the forum has held workshops on diverse issues including the safety of imported foods and the effect that techno- logical advances in the food system could have on obesity. Forum on Drug Discovery, Development, and Translation The Forum on Drug Discovery, Development, and Translation, created in 2005 by the Board on Health Sciences Policy, provides an opportunity for leaders from government, academia, industry, and other stakeholder groups to discuss ongoing and emerging issues in pharmacology. The forum brings ongoing attention and visibility to important issues in drug development; explores new approaches for resolving problem areas; helps define the scope of the field and thus sets the stage for future policy action; provides a catalyst for collaboration on top- ics where there is synergy among potential partners; and elevates the general understanding of drug dis- covery, development, and translation among the research, public policy, and broader communities. The forum recently has considered a vast array of issues, ranging from drug regulation and regulatory decision making to medical countermeasures dur- ing public health emergencies. In addition, the forum is collaborating with the National Institute of Allergy and Infectious Diseases (NIAID) of the NIH to develop a series of international meetings on multidrug-resistant tubercu- losis. Meetings in Russia and South Africa took place in 2010, and a meeting took place in India in April 2011.

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143 The Value of Collaboration Forum on Global Violence Prevention Violence—for example, child abuse, intimate partner violence, elder abuse, sexual violence, gang violence, and suicide—is a major public health problem worldwide. In 2001, violence accounted for 45 mil- lion disability-adjusted life years (DALYs) lost, with low- and middle-income countries bearing the largest burden. But violence can be prevented. The IOM’s Forum on Global Violence Prevention, estab- lished in 2010, works to reduce violence worldwide by promoting research on both protective and risk factors and encouraging evidence-based preven- tion efforts. The forum aims to facilitate dialogue and exchange by bringing together experts from all areas of violence prevention, including behavioral scientists, policy makers, criminal justice profes- sionals, social service providers, economists, legal experts, journalists, philanthropists, faith-based organizations, and corporate social responsibility officers. Recent workshops have explored the social and economic costs of violence as well as violence against women and children. Forum on Medical and Public Health Preparedness for Catastrophic Events The Forum on Medical and Public Health Preparedness for Catastrophic Events, established in 2007, focuses on strengthening the nation’s medical and public health preparedness for acts of terror- ism or natural disasters by improving communi- cation and the coordination of activities among federal, state, and local government agencies as well as private-sector groups. Most recently, the forum held workshops that considered the 2009 H1N1 pandemic vaccination campaign, examined medical and public health prepared- ness and response in rural and frontier settings, and, in a workshop cosponsored with the Forum on Drug Discovery, Development, and Transla- tion, discussed methods to improve how medi- cal countermeasures are developed, tested, and approved.

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144 INFORMING THE FUTURE: Critical Issues in Health Forum on Microbial Threats The Forum on Microbial Threats—formerly called the Forum on Emerging Infections, which was established in 1996—consid- ers issues related to the prevention, detection, and management of infectious diseases. The forum’s membership includes individuals from a range of disciplines and organizations in the public and private sectors, including the public health, medi- cal, pharmaceutical, veterinarian, plant pathol- ogy, academic science, agricultural, national secu- rity, and environmental communities. In recent years, forum dialogues have illuminated priorities in infectious disease research and public health policy; the use of new scientific and policy tools; and opportunities for more effective collaboration between the private and the public sectors. Recent workshops have focused on the science and policy implications of neglected tropical diseases, the recent emergence of multi- drug-resistant “superbugs,” and the threat of fungal diseases. Forum on Neuroscience and Nervous System Disorders Established in 2006, the Forum on Neuroscience and Nervous System Disor- ders brings together leaders from private-sector sponsors and users of bio- medical and clinical research, federal agencies sponsoring and regulating research, private foundations, the academic community, and public and con- sumer groups. The forum focuses on building part- nerships to understand the brain and nervous system and disorders in their structure and function, as well as sharing effective clinical prevention and treatment strategies. The forum concentrates on six main areas: nervous system disorders, mental illness and addic- tion, the genetics of nervous system disorders, cog- nition and behavior, modeling and imaging, and ethi- cal and social issues. Recent workshops have focused on a diverse array of topics, including the implica- tions of recent cutbacks by top pharmaceutical com- panies in drug development for central nervous sys- tem disorders, and growth opportunities for the field,

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145 The Value of Collaboration including Representative Patrick Kennedy’s “moon shot” effort to increase the funding and coordination of neuroscience research. National Cancer Policy Forum The National Cancer Policy Forum was established in 2005 to succeed the National Cancer Policy Board, which was formed in 1997. The forum considers a range of issues in science, clinical medicine, public health, and public policy relevant to the goals of preventing, palliating, and curing cancer. Its objectives are to identify emerging high-priority policy issues in the nation’s effort to combat cancer and to examine those issues through convening activities that pro- mote discussion about potential opportunities for action. These activities inform stakeholders about critical policy issues through published reports, and they often provide input for planning formal IOM consensus committee studies. The forum has held recent workshops on patient-centered cancer treatment planning and on technological advances in cancer research and care delivery. Roundtable on Environmental Health Sciences, Research, and Medicine Established in 1998, the Roundtable on Environmental Health Sciences, Research, and Medicine brings together stakeholders from government, academia, industry, and environmental groups to discuss sensitive and dif- ficult issues related to environmental health. Since its inception, the round- table has focused on the state of environmental health science, research gaps, and policy implications. The roundtable has moved toward an increas- ingly global perspective in its discussions on nanotechnology, the inter- relationship between trade and health, and corporate social responsibil- ity in environmental health. It is currently examining issues of domestic and international importance such as climate change, sustainable drinking water, transportation-related energy use, and environmental health decision making.

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146 INFORMING THE FUTURE: Critical Issues in Health Roundtable on Health Literacy The Roundtable on Health Literacy was created in 2004, in response to the IOM report Health Literacy: A Prescription to End Confusion, which found that nearly half of all American adults—90 million people—have difficulty understanding and using health information. The roundtable’s mission is to support the evolution of the field of health literacy by translating research findings to practical strate- gies that can be implemented. To achieve this mis- sion, the roundtable brings together leaders from academia, industry, government, foundations, and patient and consumer groups who have an inter- est and role in improving health literacy to dis- cuss challenges facing health literacy practice and research, and to identify approaches to promote health literacy through mechanisms and partner- ships in both the public and private sectors. Recent workshops have included a discussion on the Food and Drug Administra- tion’s Safe Use Initiative as well as a workshop to discuss how research and information technology can help improve health literacy. Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities The Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities focuses on issues related to the visibility of racial and ethnic disparities in health and health care as a national problem, the development of programs and strategies to reduce disparities, and the need to encourage new leadership in a variety of fields. Roundtable members include experts from the health and social sciences, industry, and the community. Recent roundtable workshops included a discussion of the factors that influence life expec- tancy in the United States and a workshop on the effects of healthcare reform and the need for a more diverse healthcare workforce to serve the expected influx of patients from underserved communities of color.

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147 The Value of Collaboration Roundtable on Translating Genomic-Based Research for Health The Roundtable on Translating Genomic-Based Research for Health brings together leaders from academia, industry, government, founda- tions, and associations who have a mutual interest in the translation of genomic-based research. The mission of the roundtable is to advance the field of genomics and improve the translation of research findings to health care, education, and policy. Translating genomic innovations involves many disciplines, and it takes place within different eco- nomic, social, and cultural contexts, necessitating a need for increased communication and under- standing across these fields. The ramifications of genomic innovations extend to clinical utility, eco- nomic implications, equal access, and public per- spectives. The roundtable fosters dialogue across sectors and institutions and fosters collaboration among stakeholders. Roundtable on Value & Science-Driven Health Care The Roundtable on Value & Science-Driven Health Care, established in 2006 as the Roundtable on Evidence-Based Medicine, provides a trusted venue for national leaders in health care to work cooperatively toward their common commitment to effective, innovative health care that consis- tently adds value to patients and society. Members include clinicians, patients, healthcare organiza- tions, employers, manufacturers, insurers, health information technologists, researchers, and policy makers. As leaders in their fields, roundtable members work with their colleagues to identify and engage the key challenges and opportunities for achieving better outcomes and greater value in health care. They then marshal the energy and resources of their respective sectors to work for sustained public-private cooperation. The work of the roundtable is conducted through two types of activ- ities. The first type is accelerating understanding and progress toward

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148 INFORMING THE FUTURE: Critical Issues in Health the roundtable’s vision of a learning health system, in which science, informatics, incentives, and culture are aligned for continuous improve- ment and innovation—with best practices seamlessly embedded in the delivery process and new knowledge captured as an integral by-product of the delivery experience. The second type of activity is the fostering of cooperative projects through the work of five stakeholder innovation col- laboratives focused on (1) best clinical practices, (2) communication of medical evidence, (3) clinical effectiveness research, (4) health information technology, and (5) incentives for value in health care.