Mount Sinai Leaders Discuss the Future of Medicine and Health Care Delivery at the 2017 Aspen Ideas Festival
Experts offer advice on staying healthy and provide on-site complimentary skin cancer and heart screenings
The future of medicine and health care delivery, the opioid epidemic, and the intersection of climate and health were among the topics highlighted by leaders of the Mount Sinai Health System during the 2017 Aspen Ideas Festival held in Aspen, Colorado. Presented by the Aspen Institute and The Atlantic, the festival is unique in is dedication to the global exchange of ideas.
Efforts in Washington to repeal the Affordable Care Act took center stage. Mount Sinai CEO and President, Kenneth L. Davis, MD, said, "For a health system with seven hospitals and a large ambulatory network, we know first-hand the devastating impact the Senate and House bills will have on our patients. Millions of people will become uninsured and hospitals will be pushed to the brink, especially those who treat Medicaid patients.”
"Rather than derail Medicaid, which is an essential part of the social fabric of this country, we should focus on improving the health care exchanges - which might garner bipartisan support," said Dr. Davis.
Dr. Davis says the real issues in health care are how to make the system more efficient and less costly. "What we have to do is change the way we deliver care. We need to move away from fee-for-service medicine move toward value, population management, and risk."
Mount Sinai experts at the Festival reported on breakthroughs in medicine and science. "We are seeing a revolution in medicine, using technology that we never thought was possible. Twenty-five years down the line, we will see compatible electronic medical records that interface with a super computer which examines and stores information from an app on your body in order to make an automated diagnosis. This will truly change the way we diagnose patients and revolutionize medicine," said Dr. Davis.
Yasmin Hurd, PhD, Professor of Psychiatry, Neuroscience, and Pharmacological Sciences at Mount Sinai Health System and the Director of the Addiction Institute and Ward-Coleman Chair in Translational Research at the Icahn School of Medicine at Mount Sinai, spoke about research regarding the brain and opioid addiction. "Opioids are particularly addictive because they enter and leave the brain so quickly. Genetics play a role in why some people get more addicted than others, despite being given the same opioid." Dr. Hurd explained that current research focuses on finding non-opioid treatments which would result in treating large numbers of people more effectively.
Samuel Gandy, MD, PhD, Professor of Neurology and Psychiatry at the Icahn School of Medicine and Director of the Center for Cognitive Health at Mount Sinai, said the most promising research underway to treat Alzheimer's disease focuses on reducing tangles in the brain, as well as inflammation. "So far, research focused on treating plaques, the abnormal clusters of proteins called beta amyloid that build up between nerve cells, has been unsuccessful," said Dr. Gandy. "However, there is now one active medicine that has been shown to reduce tangles—which occur inside dying nerve cells—in mice. We are also working on vaccines that can prevent inflammation so that tangles are minimized.”
Robert Wright, MD, System Chair of Environmental Medicine and Public Health and Professor of Pediatrics, pointed out the intersections between climate change and health: "We know that air pollution causes climate change, but it can also result in bad health. Air pollution can alter the environment of allergies in the air, which can set off asthma and other pulmonary conditions. It can also affect cognitive function and obesity." Dr. Wright recommended monitoring changes in air pollution, temperature, and humidity in order to better analyze the consequences of health and climate change.
When it comes to pandemics and global security, Prabhjot Singh, MD, PhD, Director of The Arnhold Institute for Global Health and Chair of the Department of Health System and Design and Global Health, said health care workers can effectively intervene to respond to disease outbreaks such as Ebola and can be part of the solution, especially in rural areas. Through the Institute’s ATLAS project, he is bringing together machine-learning technology and satellites to create maps that can identify regions or zones where resources can be deployed during a pandemic.
In a panel called "The Power of Good Health," experts from Mount Sinai discussed how nutrition, sleep, and the environment can affect well-being. The Director of Mount Sinai Heart, Valentin Fuster, MD, said: "Cardiovascular diseases are acquired and largely preventable. The vast majority arise due to one or more of seven risk factors, which are high cholesterol, diabetes, obesity, high blood pressure, nutrition, smoking, and lack of exercise." Dr. Fuster explained that these risk factors can be prevented or reduced with daily lifestyle and behavior modification.
"Clean air and safe drinking water are critical for children’s health. Children need also to be protected against other hazards in the environment such as lead and pesticides," said Philip Landrigan, MD, Dean for Global Health and Professor of Preventive Medicine Environmental Medicine and Public Health, and Pediatrics, at the Icahn School of Medicine at Mount Sinai. Dr. Landrigan, who was centrally involved in the Environmental Protection Agency (EPA's) 1976 decision to remove lead from gasoline, added, "Eating organic can lower your risk of eating pesticides by 90 percent."
"The average amount of sleep needed is seven to eight hours per night, but that varies a great deal," said David M. Rapoport, MD, Director of the Sleep Medicine Research Program at the Icahn School of Medicine at Mount Sinai. "The best way to find out what you need is to wake up without an alarm clock."
With a focus on prevention and a move away from fee-for-service medicine, Mount Sinai is committed to good health. "There is going to be a sea change around health care and wellness," adds Dr. Davis. “It is essential that we move forward to a model in health are where providers are paid to keep people healthy."
For the duration of the Festival, Mount Sinai Heart experts provided 571 complimentary blood pressure and cholesterol screenings. A team of dermatologists from Mount Sinai’s Kimberly and Eric J. Waldman Department of Dermatology also provided 748 skin cancer screenings — identifying 35 possible melanomas, 13 basal cell carcinomas and 2 squamous cell carcinomas.
About the Mount Sinai Health System
The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.