Executive Officer’s Report: 2016 Reflections from J. Michael McGinnis

FRIENDS … Turning the calendar to 2017 marked for me a year as your NAM Executive Officer, as well as the first full calendar year of the National Academy of Medicine. This is a natural point at which to take stock, and below are some highlights from our work throughout 2016, together with colleagues from HMD, the other Academies Divisions, and throughout the field.

FIELD LEADERSHIP

• Global Health Risk Framework Initiative: The year 2016 began with the release of the NAM-stewarded publication, The Neglected Dimension of Global Security, to sustained media coverage, through press releases, interviews, briefings, op-eds, and journal publications (e.g., in Lancet, NEJM, JAMA, Nature). In addition, meetings and briefings were held with senior decision makers in the health, finance, and global security communities, including panel discussions at major international meetings, such as the World Economic Forum, World Health Assembly, G7 Health Experts meeting, and WB/IMF Spring Meetings.
• Vital Directions Initiative: With the guidance of a Steering Committee co-chaired by Victor along with Mark McClellan, 150 experts from across the nation assessed the most critical issues and opportunities facing the new Administration health, health care, and biomedical science. Their 19 papers were web-posted in prepublication form this fall and summarized in the October 25^th issue of JAMA. A synthesis paper will be released in March.
• Learning Health System Initiative: Beginning with the 2007 IOM meeting publication, The Learning Health System, activities enlisting partners from key stakeholder sectors have worked to foster science, informatics, incentives, and culture aligned for continuous improvement and innovation. There are now 15 publications in the Learning Health System Series, and important related developments in 2016 came from FDA (e.g. NEJM), NIH (e.g. Common Rule), and ONC (e.g. Interoperability Roadmap).
• Culture of Health Initiative: The first 5-year phase of NAM Culture of Health Program quickened its pace during 2016, with the formation and guidance of a highly knowledgeable program advisory committee,  initiation of comprehensive literature review, completion and release last week of the HMD consensus study on Community Based Solutions to Promote Health Equity, and preparation for a stakeholder meeting next week on engaging allies in the culture of health movement.
• NAM Perspectives: Through the Perspectives platform, the NAM presents invited contributions from field experts and leaders, collections of such contributions, and summaries of NAM-sponsored symposia. They serve to inform and stimulate discussion around issues of importance to progress in health, medicine, science, and policy. In 2016, we initiated an exploration of ways to strengthen and extend the reach of the series.

STRATEGIC LEADERSHIP ACTIVITIES

• Clinician resilience & well-being: The NAM Action Collaborative on Clinician Resilience & Well-Being was launched in 2016, with about 50 organizations working together to understand and reduce the occurrence and impact of clinician stress and burnout.
• Human gene editing: The NAS/NAM consensus study of the research, medical, ethical, and social implications of Human Genome Editing was conducted by the committee throughout 2016, following the International Summit convened in late 2015. Release is expected soon.
• Accelerating clinical research: NAM held five meetings bringing together leaders of health care systems, clinical researchers, clinicians, and IT around strategies to advance real-world research, contributing to papers and policies noted above under the learning health system.
• Digital health transformation: In addition to the IT work on evidence generation, in 2016 a series of NAM meetings was convened for ONC on accelerating implementation of clinical decision support systems, and a project was begun on HCO standard for interoperability.
• Improving value in health care: Through the Vital Directions initiative, the Leadership Consortium, and the Value Incentives & Systems Innovation Collaborative, and Discussion Papers, NAM 2016 activities focused on payments rewarding value and better health.
• Core health metrics: Building on the recommendations in the IOM report, Vital Signs, throughout 2016 NAM has provided assistance to efforts by several HCOs, states, and the pediatric community to pilot implementation of harmonized, streamlined measures.
• Person-engaged care: An NAM-commissioned science panel in 2016 completed assessment of the evidence base in support of various aspects of patient & care partner engaged care, leading to development of a common conceptual model by key stakeholder groups.
• Care of high need patients: On behalf of partner organizations (NAM, Harvard, Bipartisan Policy Center, Peterson Center for Health, Commonwealth Fund) NAM hosted a 2016 meeting series on best practices in managing high need patients. Publication forthcoming.
• Early childhood development: NAM-facilitated state-based quality improvement strategies for the birth to 3 workforce were completed in 5 states in 2016, and comparable efforts were begun in an additional 3 states.
• Longevity grand challenge: A series of conversations held throughout 2016 with potential funders, researchers, and other experts in aging, has set the stage for an NAM-led effort to advance understanding and progress related to longevity.

PARTNER SYNERGY

• Academies’ Divisions: In addition to linking interested funders with Divisions appropriate to the conduct of consensus studies, NAM routinely worked in 2016 to inform, engage, and support Division staff involvement in the various NAM activities.
• Patients & their care partners: In 2016, the NAM-supported Patient & Family Leadership Network has helped in the evidence review noted above, as well as to the revision of the Resource Compendium assembled to strengthen patient initiative at the HCO level.
• Clinical organization leaders: Active outreach efforts in 2016 recruited the involvement of health professions organizations for the clinician resilience collaborative, as well as the Care Culture & Decision-making Innovation Collaborative.
• Health system executives: The NAM Executive Leadership Network of CEOs of large health systems contributed in 2016 to various efforts: the FDA EvGen initiative, the NAM/PCORI research infrastructure initiative, and the NAM Perspective on measures burden relief.
• Clinical researchers: We have had active guidance and leadership from broadly throughout the public, private, and academic clinical research communities for our many 2016 activities aimed at fostering evidence generation throughout the routine care experience.
• Information technology experts:  Similarly, as NAM work has geared up in 2016 for the projects in clinical decision support, interoperability, and building the health care infrastructure for real-world evidence generation, the IT community is actively involved.
• Health insurers & payers: Officials from CMS and health insurers (e.g. Aetna, Anthem, Cigna, UnitedHealth Group, Blue Cross/Blue Shield) have participated in 2016 in NAM convened discussions of value- and population-based payment models, care of high need patients, accelerated evidence generation, patient-generated data, and care transparency.
• Health product manufacturers: In particular for cooperative work on clinical research, scientific leaders and personnel from several large companies participated in 2016 in NAM discussions and projects on Open Science, the Common Rule, Future of Clinical Research.
• Federal health agencies: In addition to meetings convened in 2016 at the request of federal health agencies, officials and scientists from about a dozen agencies have participated in about two dozen NAM-sponsored meetings on various topics, and have served as co-authors for various NAM discussion papers.
• Governors and other state leaders: NAM work with the National Governors Association in 2016 has provided guidance for their work with individual states around health care transformation, use of core measures, and the challenges of the opioid epidemic.

LEADERSHIP CULTIVATION

• In-residence health policy fellows: Eight new RWJF Health Policy Fellows arrived in 2016, completed their orientation, and are beginning their Legislative and Executive Branch assignments. Since the program began in 1973, a total of 273 Fellows have been trained.
• Visiting health policy fellows: Three new NAM Fellows were selected and are engaging with various activities in NAM, HMD, and other Divisions. Beginning in 2005 as the Anniversary Fellows Program, 25 Fellows have now been hosted by NAM.
• Regulatory science fellows: In 2016, another four Fellows started the NAM tobacco regulatory science fellows program, bringing the total since 2012 to 20. In addition, a 2016 agreement with FDA extends the program through 2020.
• Nurse scholars: In 2016, Suzanne Bakken from Columbia University completed her tenure as the NAM Nurse Scholar, bringing the total Nurse Scholars to close to 20 since the program’s 2002 inception.
• Emerging leaders program: At our 2016 Annual Meeting, the initial meeting piloting the NAM Emerging Leaders Program brought together accomplished up-and-coming leaders from different fields to explore ways NAM might foster communication and synergy.

MEMBER SERVICES

• New director: In 2016, Meg McCoy was appointed Director of Member & Council Services, bringing extensive experience from her work as IOM Senior Program Officer.
• Capacity upgrade: The NAM membership office added two new positions, setting stage for expanded member engagement, services, and programs.
• Website upgrade: A new NAM website was launched in 2016, with single sign-on, allowing members to log in just once to access a substantial proportion of the website.
• Ethics policy: NAM members voted in 2016 to approve two bylaw amendments defining expectations of NAM members and circumstances for rescinding membership.

OPERATIONS

• New director: Adrienne Anzanello was appointed Director of Finance & Administration in 2016, coming to NAM from similar responsibilities at Brookings.
• Financial management: With helpful assistance from HMD, new processes emphasize transparency in budget management, which will close at just under $11 million for 2016.
• Endowment stewardship:  Preliminary numbers indicate that the NAM endowment increased 4.6% over 2016, to $79.8 million.
• Personnel: Robust recruitment activity saw 12 new staff joining NAM in 2016, including 5 new positions for administration and communication, bringing the NAM total staff to 32.
• Strategic planning: A planning committee was assembled in 2016 to propose revised NAM mission and vision statements, interviews were conducted by IBM consultants, and the discussions will be held at an NAM retreat at the time of the Academies meetings in Irvine.

It’s an impressive record, and each of you should take pride in the breadth and quality of your contributions over the past year. Moreover, and most importantly, these are activities undertaken in close collaboration with, and on behalf of, our colleagues across the Academies and throughout the nation.  Together, we are establishing the strong foundation required for our important leadership mission as we move into 2017.

Thanks to each of you for commitment, good work, and the continued progress we should anticipate for the year ahead.

–J. Michael McGinnis, MD, MPP
Leonard D. Schaeffer Executive Officer