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ACCP Report

At the Forefront of U.S. Health and Policy: The 2014–2016 National Academy of Medicine Pharmacy Fellowship

Written by Steven M. Smith, Pharm.D., MPH, BCPS

In the May 2014 ACCP Report, Dr. Samuel Johnson (now director of Health Policy and Interprofessional Affairs for ACCP) eloquently summarized his main activities during the inaugural Institute of Medicine (IOM) Anniversary Pharmacy Fellowship (see http://www.accp.com/report/index.aspx?iss=0514&art=8). I was privileged to follow in his footsteps as the 2014–2016 Fellow, in what is now called the National Academy of Medicine (NAM). In this report, I summarize my involvement with the NAM to date, together with personal reflections on the value of the fellowship, and, perhaps most importantly, my thanks to ACCP for supporting this activity.

Over the past 2 years, the IOM has undergone several changes, including rebranding as the NAM. These changes were part of a larger restructuring effort to align the health and medicine activities and operations within the existing infrastructure of the other academies (i.e., the National Academies of Science, Engineering, and Medicine as well as the National Research Council) and to increase collaboration between them. The main activities of the NAM were summarized in a previous ACCP Report (see http://www.accp.com/report/index.aspx?iss=0813&art=13), but briefly, they fall into two major categories. The first, often called the “gold standard” NAM activity, consists of consensus studies, which bring together leading experts for a defined period (1–2 years, on average) to develop recommendations on one or more related, specific research or policy questions. A noteworthy example is To Err Is Human: Building a Safer Health System (1999). The second are numerous roundtables and forums, which convene diverse stakeholder groups on a general topic to address specific issues within that topic through public workshops and other activities. One relevant example is the Global Forum on Innovation in Health Professional Education, which addresses issues within health professional education. An important distinction between these two sets of activities is that consensus studies use a rigorous research process and strict conflict of interest policies, and the resultant recommendations carry the imprimatur of the National Academies, whereas convening activities (i.e., roundtables, forums) do not develop a consensus or make formal recommendations, and summaries of their workshops serve only to document the opinions expressed by presenters, activity members, and other workshop attendees.

All NAM Fellows are invited to learn about ongoing NAM activities early in the fellowship and are given wide latitude to select one major activity (consensus study or roundtable/forum) on which to focus their 20% annual effort during the 2-year fellowship. Given my interests in public health and population health, I quickly gravitated toward the Roundtable on Population Health Improvement, which consists of a wide-ranging group of stakeholders, including physicians and health system administrators, behavioral scientists, economists, sociologists, and public health experts from academia, nonprofits, and industry. Beginning in early 2015, I participated in four or five workshops annually and served as moderator during breakout discussions within the public workshops. These discussions have been captured in some of our workshop summaries (e.g., Advancing the Science to Improve Population Health: Proceedings of a Workshop [2016]). In between workshops, I worked with the roundtable staff on program planning for future workshops and activities. I also served as a peer reviewer for workshop summaries (e.g., Collaboration Between Health Care and Public Health: Workshop Summary [2015]) and a series of population health case report perspectives published by the roundtable (see https://nam.edu/population-health-case-reports-perspective-series/).

This roundtable has also been significantly involved in the ongoing Vital Directions (2016) initiative, which is organized around the goals of better health and well-being, high-value health care, and strong science and technology and aims to inform the next U.S. president’s administrative agenda with nonpartisan, evidence-based analysis of health policy opportunities and priorities. One topic of ongoing interest to the roundtable, and one that I hope to continue working on over the next year, is how best to standardize and integrate population health curricula into health professional education programs. In addition to my activities on the Population Health Roundtable, I have been engaged with two NAM boards, the Board on Population Health and Public Health Practice and the Board on Health Sciences Policy, each of which meets twice a year to provide oversight and direction for the activities housed within each.

Perhaps because of my career in academia, I began with the hope of offering a unique perspective—as a pharmacist—on the activities I ultimately engaged in. I have had the opportunity to engage in several NAM activities that are helping to shape our nation’s health policy discussions. I have had one-on-one conversations with, and learned from, some of the most fascinating thought leaders in the world, from the NAM president, Dr. Victor Dzau, to the dedicated NAM staff and members, to the researchers, clinicians, and policy experts “in the trenches.” And, I have been reminded of the importance of working together, across disciplines, to achieve the common good—that is, improving the health and well-being of our patients. Now, more than ever, our profession has a tremendous opportunity to help lead these efforts.

I end this report by expressing my sincerest gratitude for the opportunity to represent ACCP and, more broadly, the pharmacy profession, within the NAM. This experience has been career-changing, to say the least.