Dr. Oluwadamilola “Lola” Fayanju, a 2001 “Project Health” alum and Health Leads supporter, has dedicated her career to ensuring that our medical system is working equitably for everyone who encounters it. As a surgical oncologist and researcher, specializing in breast cancer, her priorities are increasing the value of medical care while reducing costs and reducing disparities in the quality of care and outcomes particularly for women of color. We were lucky to sit down with Dr. Fayanju this month to learn more about how she is championing care in her community. Here are a few snapshots from our conversation!

*responses have been edited for simplicity*

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What is it that keeps you inspired about your work in medicine?

My patients are what inspire me. As a surgeon you have an intimacy with your patients – they are revealing to you their fears and how their diagnosis is changing their lives –and they are giving you permission to operate on them. There is a sense of awe that patients trust you in that way. The strengthen that people and families bring to this disease is inspiring. If people can find that strength, we owe it to them to address things from the other end – research, advocacy, and policy.

What inequities do you see in your work?

Women of color, particularly Hispanic women, continue to be connected to care later than white women — they are starting treatment later and this is contributing to disparities in outcomes.

There is also and underappreciation of non-traditional support networks in healthcare. Even though they typically have more stressors, minority groups often report less distress with their illnesses. That resiliency is often rooted in their faith or deep community connections.  When patients say they aren’t stressed, there are two sides of the coin to be explored. They are either under reporting or are extremely resilient. Healthcare needs to understand this better.

What values are most important to do community-centered work well?

Community-centered care begins by recognizing the diversity of the community around you and that you cannot impose an agenda community. Listening is the most important thing; your assumptions are often wrong.

There are three values integral to doing this work well.

• Being Available: My patients have my number and can call me at any time. They know that they can have faith in me and that they will have a direct line to a physician if they need it.
• Taking Action: You need to be willing to translate this knowledge and trust into action. Get out and pound the pavement. Go to community events when invited.
• Being Humble: You don’t always need acknowledgment and credit for the work that you are doing

So much that happens in the community is happening off the internet. If we rely solely on the EHR and internet to network with the community, we miss a huge swath of the population. We, as physicians and healthcare, need to connect with the community networks spreading events. We need to learn how to get invited into that space.

Why do you choose to support Health Leads?

My experience with Project Health helped set me on my path in life. Working at Boston Medical Center I saw that wellness and illness don’t exist in a vacuum, life will absolutely impact outcomes.

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In her approach to her work – and meaningful connections to her patients – Dr. Fayanju truly embodies what it means to redefine health and champion quality care. Thank you for championing a world where every person can live with health, dignity, and well-being.

Beginning with weekly strategy meetings over coffee and bagels in 2004, Dr. Margaret Siber, a retired pediatrician, has been integral in shaping the success of Health Leads. At a time when Health Leads was first beginning to encounter and navigate the challenges of connecting patients with essential resources in a fragmented healthcare system, Dr. Siber would meet with our founder, Rebecca Onie, to provide insights and guidance from her deep experience serving medically and socially underserved children.  From launching a student-run storefront health clinic in Montreal (recently celebrating its 50^th year!) and several decades as a pediatrician to her volunteer work today reading with and to kindergarteners in a school on the south side of Chicago, Dr. Siber has always striven to ensure all children are given the opportunity to thrive. Her support was essential to shaping Health Leads into the organization it is today.  We were incredibly fortunate to get to ask Dr. Siber a few questions about her journey with Health Leads and her extraordinary medical career. Here’s just a snapshot of the wisdom she shared.

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Why do you continue to contribute to Health Leads?

If I were to try to design a program that exactly mirrored my concept of the promotion and provision of health and wellness, Health Leads would be the result. I support Health Leads because of its holistic approach to health.

What led you to first connect with Health Leads?

While I was a second-year medical student in Montreal, I joined six other classmates in launching a student health organization, (SHO), in Pointe St.Charles. The clinic was student-run with supplies donated by teaching hospitals and our teachers would regularly come down to the clinic to see patients. One of my roles was reaching out to all our professors and asking them to give some of their time to the clinic. I remember being so nervous AND so surprised by how quickly they said yes. I’m so proud of the fact that what started as a storefront clinic in a low-income neighborhood in Montreal, became the flagship medical clinic of the Quebec healthcare system, now known as Clinique Communautaire de Pointe St.Charles.

The children served by the clinic were small, undernourished, and in need of far more than addressing their illnesses. Their needs were both medical and social.  For the first time in my education, I realized that medical and social needs could not be separated. It was a real “eureka” moment for me.

Many years later, back in Boston, I was introduced to Rebecca Onie by a good friend Judith Kurland. Rebecca would often bring coffee and bagels to my condo to discuss the many ramifications and challenges of running the clinic at Boston Medical Center (formerly Boston City Hospital). These conversations enlarged the vision I had had while establishing the Pointe St.Charles Clinic. I felt like my involvement with Project Health was destined to happen.

What were some of the challenges you and Rebecca wrestled with in the early days of Project Health? One of the many conversations I had with Rebecca that sticks in my mind was about the importance of data collection and metrics. We both understood that documenting and publishing outcomes would be crucial to shifting the healthcare sector towards addressing social needs and changing the conversation about health. Many outcomes could be recorded – the number of patients seen, diagnoses, use of the Help Desk while at a clinic visit, follow up by student volunteers – the challenge was computerizing all the relevant data to track over time. At the time they were just laying initial plans to digitize the data. It is amazing to me that what started as simple data collection has gone on to become the Reach platform and is now informing new data partnership efforts. Data collection and analysis are critically important in determining the most productive medical/social practices for improving health.

What inspired you to pursue a career in medicine?

Unlike most physicians, I cannot pinpoint the exact time or event that inspired me to go to medical school. I had no direct role models in my family or community. Looking back, however, there were many people who influenced my eventual decision. My high school biology teacher, David Smith, first sparked my interest in biology. He had a way of teaching students about the human body that was both fascinating and encouraged exploration. I went on to become the first person in my family to go to college – studying biology and chemistry at Bishop’s University in Quebec.

Shortly after college, I moved to Vancouver looking for adventure and ended up working as a nanny for the young family of Dr. Lehman, an orthopedic surgeon. Dr. Lehman was a quiet, kind man with a reassuring demeanor. He became an inspiration to me as a doctor and I was honored when he wrote a letter of recommendation to me to medical school.

A second physician whom I met in Vancouver, Dr. Kenneth Nickerson, had an enormous impact on my decision to become a physician myself. Dr. Nickerson was an extraordinarily respected physician who always took the time to get to know his patients as people, not just medical conditions.   He was incredibly supportive of my decision to go to medical school – facilitating my taking of the MCATs and writing letters of reference for me.

To my great excitement, I was accepted into the McGill Medical School Class of 1970 – one of only ten women accepted to the program that year!

What are some of the inequities you still see in the healthcare system? What excites you about the future of healthcare?

It’s almost impossible to ignore the roles that race and racism play in the inequities of our healthcare system. Through my volunteer work, reading to kindergarteners of color in Chicago, I have become acutely aware of the violence that young black children may witness in their neighborhood.  The families of these children may be deeply suspicious of white people and whiteness.  Also, too often I see a person of color whose presence is unacknowledged by privileged white people.  Through these personal experiences since I retired, my understanding and consciousness regarding systemic racism has evolved. I have become very concerned about accessibility, or lack thereof, to the health care system. I’ve learned how important it is to have conversations with persons of another color – and not letting the fear of saying something wrong keep you from speaking. I’ve learned that the best thing to do is apologize if I accidentally cause harm and to learn from those experiences.  It is essential that all health care providers, POC or white, clearly acknowledge the worth and humanity of all persons. The feeling of invisibility due to race, income, or education is disempowering and impacts the ability of a patient to navigate the confusing health care system.

I also worry about women’s experience of healthcare. The US infant mortality rate is higher than that of any other similarly developed country. A low-income woman may not see a physician until she is pregnant and only at her first visit will she discover that she has undetected high blood pressure, kidney disease, or another serious medical condition that could be detrimental to not only her health but also the health of the fetus.  And that is only if she has access to the healthcare system. There are so many obstacles to receiving care – from scheduling appointments, travel, finding a doctor, insurance questions. If you don’t have someone you know to show you how to make these connections it can be incredibly confusing.

I am very concerned about the lack of awareness and the shamefulness that still surrounds discussion of sexual abuse in healthcare. Statistics are very hard to come by but approximately 20% of girls and 8% of boys under the age of 18 experience some form of sexual abuse which results in long-lasting trauma and has an enormous detrimental effect on health and wellness. The #MeToo movement has highlighted the pervasiveness of sexual harassment, abuse, and rape.  Health care professionals must address the possibility of sexual abuse on every health and wellness encounter, allowing children and teens permission and encouragement to feel comfortable in revealing sexual abuse. Such discussions are still considered taboo in too many healthcare discussions. We need to get to a place where sexual abuse is not only destigmatized but where it is documented in health records and where providers feel comfortable discussing these experiences.

However, I think we do have an opportunity at this moment to rethink how local organizations work together and allocate resources to improve health outcomes. I have every confidence that Health Leads can lead the way.

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Through her relentless commitment to improving care to underserved children, Dr. Siber has truly redefined what it means to deliver quality healthcare and transformed thousands of lives. THANK YOU for helping to create a world in which every person, regardless of their zipcode, can live with health, well-being, and dignity.

Every once in a while, you meet someone whose excitement about the future of healthcare is so contagious you can’t help thinking about the conversation for days on end. That’s how I felt after meeting Bryan Adams. Bryan is a Project HEALTH alum, the Chief Commercial Officer at GreatCall, and a Health Leads supporter. Through his work in healthcare technologies, he has been a continual advocate for the critical importance of helping aging seniors access not only medical care, but all the social supports necessary for health – food, transportation, and social connections. In his role at GreatCall, he is leveraging remote technologies to help aging adults stay in their homes by bringing great care to their fingertips. Mr. Adams recently spoke to us about how he is creating a more age-friendly healthcare system. Here is a snapshot of that conversation

*responses have been edited for clarity and simplicity*

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Why do you choose to support Health Leads?

During my time at Project HEALTH, I heard something at a reflection session that has stuck with me. While the work we were doing was important, what was more important was what we were taking from the work. Because of these efforts, there is a generation of leaders that has health equity in their DNA. I want to make sure that people continue to have that experience.

How did you first become involved with Project HEALTH and how has that influenced your career since?

I was actually back at MIT earlier today and walked by the old room we used during the Project HEALTH days, which reminded me how far I’ve come. I got involved in Project HEALTH back in 2003-2004 when I was a Ph.D. student at MIT interested in getting involved in public service. At the time I got involved, Project HEALTH at MIT was refurbishing computers and MIT students were teaching the community how to use the computers to support their health goals. I wouldn’t have gotten into this space without Rebecca’s leadership.

After graduating, I worked for iRobot and helped launch their healthcare group before joining Healthsense. At the time, Healthsense was building technologies for remotely monitoring seniors. We knew that if you could leverage technology to better monitor their activities and their needs, you can provide better care to seniors and enable people to live in their own homes longer. Healthsense was eventually acquired by GreatCall, inventors of the Jitterbug phone, an easy-to-use mobile phone designed for seniors.  As Chief Commercial Officer at GreatCall, I get to ensure that our products are meeting the needs of the market, with a focus on dually eligible seniors – seniors on Medicaid. In part, that means taking the technologies we have and advancing our social mission of helping low-income seniors connect to everything they need for their health.

Part of what attracted me to this line of business is the reality that people who have limited economic means have worse health outcomes. My wife, who is a physician, works primarily with senior citizens as well. We both see that there is a whole community of seniors who have worse outcomes because they don’t have access to food or transportation, or you can’t reach them because their phone plans have run out of minutes. When you hear transcripts of the conversations social workers have with seniors through our systems, it’s so obvious that a person’s social needs are no less important to their health than when that person needs medical care. This is where I believe that technology has a role in helping to fill some of these gaps.

How have you seen healthcare change since your time at Health Leads?

The thing that I really appreciated about Project HEALTH was the extent to which addressing social needs was a totally novel concept in the day – even if it is completely accepted right now. The recognition of social needs as essential to health and wellness is really among the biggest changes in the sector. And, the introduction of value-based payments is accelerating innovation in the space.

Years ago, many people agreed that passive remote monitoring could improve health outcomes, but no one agreed on who should have to pay for it. With the growth of value-based care, services outside of medical treatment are an active part of the conversation. There will always be a role for mission-driven organizations to drive the overall conversations, but there are also massive opportunities to make health care better when economic gains align with the interests of the patient. Now that you have a fair payment options, we have created an environment where everyone is incentivized to keep people in their homes. Conversations that bring everyone into the same room to talk about the healthcare we want for ourselves and our loved ones are rare, but they are much easier when the profit motive works for, not against, the senior’s needs.

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Through his relentless commitment to ensuring that aging seniors receive the care that we would want for ourselves and our loved ones, Bryan is truly redefining how health is practiced around the world and expanding access to human-centered, quality care. Thank YOU for helping to create a world in which every person can live with health, well-being, and dignity.

Dr. Gabriella Rosen Kellerman, a Project HEALTH alum and current Health Leads supporter, has dedicated her career to expanding access to quality health care. As an expert in behavioral science and digital health technologies, much of her work is focused on using technology to spread personalized care across the globe. In her current role as Chief Innovation Officer at BetterUp, Gabriella is continuing to apply her passions to exploring how to deliver human-centered, quality wellness and coaching programs at scale. Dr. Kellerman recently spoke to us about how she is using her entrepreneurial skills to increase the quality of care both in her own community and globally.

*responses have been edited for clarity and simplicity*

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Why do you choose to support Health Leads?

Project HEALTH was one of the first experiences I had where I could identify a challenge, formulate a solution, and then bring it to life in healthcare. For healthcare to continue evolving to provide better care to more people, we need to encourage young people to come into the field with an entrepreneurial spirit. They need to know that they have the power to design and build new solutions to improve how healthcare is practiced.

How did you first become involved with Project HEALTH and how has that influenced your career since?

As an undergrad, I knew that I wanted to pursue a career in medicine, but I wasn’t sure I was going to go the MD route. Project HEALTH felt like a great way to do some volunteer work and connect with the local communities in Boston. I first worked on a program in the maternity ward where we would talk to mothers right as they were having their babies to connect them with social resources. We quickly learned that new mothers were too overwhelmed to connect with social resources – no new mother wants to change houses right after the birth of their child.

I helped make the case for starting a new program in the women’s clinic, where expecting mothers had their prenatal visits.  This allowed us to connect with expecting mothers when it would be easier for them to access and act on the resources. That was one of the first times I got to experience what it felt to build something from the ground up. It showed me that you can be innovative in the health care space. I was very grateful for that experience.

After graduating I went on to Mt. Sinai School of Medicine where I focused on the science of emotional well-being in the brain. The plan was to become a researcher and clinician, but when I got into the practice of psychiatry I didn’t feel like I had the space for the level of innovation that I desired. I felt restricted to the tools that already existed – mainly a few classes of medications which have been around for 60 years now. So I began exploring what else I might do.

What is it about health technology that you find most exciting?

I am really excited about the way technology is being used to deliver virtual care and virtual medicine. The challenge of scaling personalized care is figuring out how to scale the human components. If we want to serve everyone globally, we have to figure out what parts of the interaction are critically human, and what parts we can replace with software. There is something fundamentally important about the human to human aspect of care, but much of what care providers spend time doing today could be automated without sacrificing that experience. Through machine learning, we are learning about the most impactful parts of that human connection and making decisions about what can be replaced.

What are some of the potential drivers of health inequities you encounter in your work and what do you see as ways to overcome them?

One of the lightbulb moments for me was when I was working in a community health center doing outpatient psychiatry. They had started to use telemedicine to serve outlying rural areas, where clinics had been shut down, even though at the time the mechanics of the technology were super clunky. I realized that only because of that technology were we still able to deliver care to those in need.

There is a huge opportunity to use mobile medicine to increase access to care for underserved populations and make better care available to more people. For example, telemedicine is enabling access to specialists when specialists don’t exist in your region. We also need to better enable providers to focus on making the emotional connections – make people feel heard and seen as human beings – that their patients crave. Technology can help ensure they have the time to do so.

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Through her relentless commitment to increasing access, Dr. Kellerman is truly redefining how health is practiced around the world and expanding access to human-centered, quality care. Thank YOU for helping to create a world in which every person can live with health, well-being, and dignity.