The COVID-19 pandemic is transforming the global economy and significantly shifting workforce demand, requiring quick, adaptive responses. The pandemic has revealed the vulnerabilities of many organizations and regional economies, and it has accelerated trends that could lead to significant improvements in productivity, performance, and resilience, which will enable organizations and regions to thrive in the "next normal." To explore how communities around the United States are addressing workforce issues laid bare by the COVID-19 pandemic and how they are taking advantage of local opportunities to expand their science, technology, engineering, mathematics, and medicine (STEMM) workforces to position them for success going forward, the Board of Higher Education and Workforce of the National Academies of Sciences, Engineering, and Medicine convened a series of workshops to identify immediate and near-term regional STEMM workforce needs in the wake of the COVID-19 pandemic. The workshop planning committee identified five U.S. cities and their associated metropolitan areas - Birmingham, Alabama; Boston, Massachusetts; Richmond, Virginia; Riverside, California; and Wichita, Kansas - to host workshops highlighting promising practices that communities can use to respond urgently and appropriately to their STEMM workforce needs. A sixth workshop discussed how the lessons learned during the five region-focused workshops could be applied in other communities to meet STEMM workforce needs. This proceedings of a virtual workshop series summarizes the presentations and discussions from the six public workshops that made up the virtual workshop series and highlights the key points raised during the presentations, moderated panel discussions and deliberations, and open discussions among the workshop participants. Table of Contents Front Matter 1 Introduction 2 Birmingham, Alabama 3 Boston, Massachusetts 4 Richmond, Virginia 5 Riverside, California 6 Wichita, Kansas 7 Regional Observations with National Implications References Appendix A: Statement of Task Appendix B: Workshop Agendas Appendix C: Planning Committee Biographies

In the last few decades great strides have been made in chemistry at the nanoscale, where the atomic granularity of matter and the exact positions of individual atoms are key determinants of structure and dynamics. Less attention, however, has been paid to the mesoscale-it is at this scale, in the range extending from large molecules (10 nm) through viruses to eukaryotic cells (10 microns), where interesting ensemble effects and the functionality that is critical to macroscopic phenomenon begins to manifest itself and cannot be described by laws on the scale of atoms and molecules alone. To further explore how knowledge about mesoscale phenomena can impact chemical research and development activities and vice versa, the Chemical Sciences Roundtable of the National Research Council convened a workshop on mesoscale chemistry in November 2014. With a focus on the research on chemical phenomena at the mesoscale, participants examined the opportunities that utilizing those behaviors can have for developing new catalysts, adding new functionality to materials, and increasing our understanding of biological and interfacial systems. The workshop also highlighted some of the challenges for analysis and description of mesoscale structures. This report summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Growing (Up) from the Nanoscale to the Mesoscale 3 Catalysis 4 Membrane Behavior and Microchemical Systems 5 Biomineralization and Geochemical Processes 6 Computational/Chemical Processes in Self-Assembly References Appendix A: Workshop Agenda Appendix B: About the Chemical Sciences Roundtable Appendix C: Biographical Sketches of Workshop Speakers and Organizing Committee Members Appendix D: Workshop Attendees

Disasters tend to cross political, jurisdictional, functional, and geographic boundaries. As a result, disasters often require responses from multiple levels of government and multiple organizations in the public and private sectors. This means that public and private organizations that normally operate independently must work together to mount an effective disaster response. To identify and understand approaches to aligning health care system incentives with the American public's need for a health care system that is prepared to manage acutely ill and injured patients during a disaster, public health emergency, or other mass casualty event, the National Academies of Sciences, Engineering, and Medicine hosted a 2-day public workshop on March 20 and 21, 2018. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Perspectives on the Nation's Capacity to Respond to Threats to Health, Safety, and Security 3 Learning from Experience 4 ASPR's New Vision for a Regional Health Response System 5 Looking to the Future 6 Exploring Opportunities to Improve Private-Sector Investment in Capacity Building 7 Final Thoughts References Appendix A: Workshop Agenda Appendix B: Statement of Task Appendix C: Speaker Biographies

The COVID-19 pandemic has highlighted existing weaknesses in the United States health care system, while creating a new set of challenges related to caring for people with serious illness. The National Academy of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a three-part workshop to explore the initial responses to the pandemic by health care teams providing care to people with serious illness, the impact of the pandemic on the health care workforce, the use of telehealth, issues related to clearly communicating with the public about health emergencies, and policy opportunities to improve care for people with serious illness. Issues related to health equity were discussed throughout the three webinars. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementia?often for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost. To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

The increasingly diverse ethnic composition of the United States population has created a profound and ongoing demographic shift, and public health and health care organizations face many challenges as they move to address and adapt to this change. To better understand how the public health and health care communities can meet the challenges of serving an increasingly diverse population, the Roundtable on Health Literacy conducted a public workshop on facilitating health communication with immigrant, refugee, and migrant populations through the use of health literate approaches. The goal of the workshop was to identify approaches that will enable organizations that serve these ethnically and culturally diverse populations in a manner that allows all members of these communities to obtain, process, and understand basic health information and the services needed to make appropriate health and personal decisions. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Issues and Challenges in Facilitating Health Communication with Immigrant, Refugee, and Migrant Populations 3 Accessing and Using Health Care Services 4 Health Literacy Considerations for Outreach 5 Application of Health Literacy to Communication with Immigrants, Refugees, and Migrants 6 Where Do We Go from Here? References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Moderators, Speakers, and Panelists

The Department of Homeland Security's (DHS's) BioWatch program aims to provide an early indication of an aerosolized biological weapon attack. The first generation of BioWatch air samplers were deployed in 2003. The current version of this technology, referred to as Generation 2 (Gen-2), uses daily manual collection and testing of air filters from each monitor, a process that can take 12 to 36 hours to detect the presence of biological pathogens. Until April 2014, DHS pursued a next-generation autonomous detection technology that aimed to shorten the time from sample collection to detection to less than 6 hours, reduce the cost of analysis, and increase the number of detectable biological pathogens. Because of concerns about the cost and effectiveness of the proposed Generation 3 system (Gen-3), DHS cancelled its acquisition plans for the next-generation surveillance system. In response to the cancellation announcement, Congress asked the Government Accountability Office (GAO) to conduct a review of the program and the proposed system enhancements that would have been incorporated in BioWatch Gen-3. However, Mike Walter, BioWatch Program manager, Office of Health Affairs, DHS, said that DHS did not agree with all of GAO's characterizations of the BioWatch program efforts described in this review. In response to this, DHS requested that the National Academies of Sciences, Engineering, and Medicine conduct a workshop to further explore the findings of the 2015 GAO report and discuss the impact these findings may have with regard to the future development of the technical capabilities of the BioWatch program. Workshop participants also discussed existing and possible collaborations between BioWatch, public health laboratories, and other stakeholders that could contribute to the enhancement of biosurveillance capabilities at the federal, state, and local levels. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 An Overview of BioWatch Strategic Priorities 3 Recommendations from the Government Accountability Office Report and the Department of Homeland Security Response 4 BioWatch Collaborative Planning 5 Future Opportunities for State and Local Collaboration 6 Reflections on the Workshop References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers and Moderators

Approximately five percent of Medicare beneficiaries (2.2 million Americans) are living with serious illness, as are many other non-Medicare eligible individuals. This number is expected to grow rapidly as the population ages and the prevalence of progressive illness increases. In many communities, particularly urban and rural underserved communities, primary care clinicians are the main workforce caring for people with serious illness, which underscores the need to integrate high quality serious illness care into primary care delivery. To better understand the challenges and opportunities for integrating serious illness care into primary care settings, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Quality Care for People with Serious Illness hosted a virtual workshop on June 10 and 17, 2021. The workshop, titled Integrating Serious Illness Care into Primary Care Delivery, explored the shared principles of primary and serious illness care, the interdisciplinary teams that power both disciplines, the policy issues that can act as barriers to or incentives for integration, and best practices for integrating primary care and serious illness care. This Proceedings of a Workshop summarizes the presentations and discussions that occurred during the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

Consumer genomics, encompassing both direct-to-consumer applications (i.e., genetic testing that is accessed by a consumer directly from a commercial company apart from a health care provider) and consumer-driven genetic testing (i.e., genetic testing ordered by a health care provider in response to an informed patient request), has evolved considerably over the past decade, moving from more personal utility-focused applications outside of traditional health care to interfacing with clinical care in nontraditional ways. As consumer genomics has increasingly intersected with clinical applications, discussions have arisen around the need to demonstrate clinical and analytical validity and clinical utility due to the potential for misinterpretation by consumers. Clinical readiness and interest for this information have presented educational and training challenges for providers. At the same time, consumer genomics has emerged as a potentially innovative mechanism for thinking about health literacy and engaging participants in their health and health care. To explore the current landscape of consumer genomics and the implications for how genetic test information is used or may be used in research and clinical care, the Roundtable on Genomics and Precision Health of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on October 29, 2019, in Washington, DC. Discussions included such topics as the diversity of participant populations, the impact of consumer genomics on health literacy and engagement, knowledge gaps related to the use of consumer genomics in clinical care, and regulatory and health policy issues such as data privacy and security. A broad array of stakeholders took part in the workshop, including genomics and consumer genomics experts, epidemiologists, health disparities researchers, clinicians, users of consumer genomics research applications, representatives from patient advocacy groups, payers, bioethicists, regulators, and policy makers. This publication summarizes the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction and Workshop Overview 2 Understanding Consumer Genomics Use 3 Exploring the Role of Diversity and Health Disparities in Consumer Genomics 4 Integration Within Scientific and Medical Communities 5 Regulatory and Health Policy Issues 6 How Can Consumer Genomics Be Better Integrated to Improve Health? References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Statement of Task Appendix D: Registered Attendees

In November 2020, the National Academies of Sciences, Engineering, and Medicine convened a multi-day virtual symposium on imaging the future of undergraduate STEM education. Speakers and participants pondered the future and the past and shared their goals, priorities, and dreams for improving undergraduate STEM education. Expert speakers presented information about today's students and approaches to undergraduate STEM education, as well as the history of transformation in higher education. Thoughtful discussions explored ideas for the future, how student-centered learning experiences could be created, and what issues to consider to facilitate a successful transformation. This publication summarizes the presentation and discussion of the symposium. Table of Contents Front Matter 1 Introduction 2 Goals for the Future: Changing Purposes of Undergraduate STEM Education 3 Transformation in the U.S. Higher Education System 4 Learning from Today's Students 5 Designing for Tomorrow's Students: Creating Equitable Opportunities for Undergraduate STEM Students 6 The Role of Technology 7 Innovations and Strategies for Moving Forward 8 Final Reflections References Appendix A: Statement of Task Appendix B: Symposium Agenda Appendix C: Biographical Sketches of Symposium Speakers and Moderators

The future competitiveness of the United States in an increasingly interconnected global economy depends on the nation fostering a workforce with strong capabilities and skills in science, technology, engineering, and mathematics (STEM). STEM knowledge and skills enable both individual opportunity and national competitiveness, and the nation needs to develop ways of ensuring access to high-quality education and training experiences for all students at all levels and for all workers at all career stages. The National Science Foundation (NSF) holds a primary responsibility for overseeing the federal government's efforts to foster the creation of a STEM-capable workforce. As part of its efforts in this endeavor, NSF's Directorate on Education and Human Resources asked the National Academies of Sciences, Engineering, and Medicine to convene a workshop that would contribute to NSF's preparation of a theoretical and evidence-based STEM Workforce Development R&D Core Framework. Participants discussed research themes, identified gaps and emerging research opportunities, and recommended refinements in the goals of the framework. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 The STEM Workforce Landscape 3 The Student and Recent Graduate Voice 4 Key Challenges Facing U.S. Employers in High-Demand Fields 5 Maintaining Student Interest in STEM 6 Successful Strategies for Aligning Higher Education Programs, Curricula, and Lab Experiences with Workforce Needs 7 Alternative Pathways and Alternative Providers 8 K-12 STEM Education and Workforce Readiness 9 Breakout Discussion Groups 10 Potential Next Steps References Appendixes Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers and Planning Committee Members Appendix C: Anonymous Participant Responses to the Pre-summit Question Appendix D: List of Workshop Registrants

The aging and evolving racial and ethnic composition of the U.S. population has the United States in the midst of a profound demographic shift and health care organizations face many issues as they move to address and adapt to this change. In their drive to adequately serve increasingly diverse communities, health care organizations are searching for approaches that will enable them to provide information and service to all persons, regardless of age, race, cultural background, or language skills, in a manner that facilitates understanding and use of that information to make appropriate health decisions. To better understand how the dynamic forces operating in health care today impact the delivery of services in a way that is health literate, culturally competent, and in an appropriate language for patients and their families, the National Academies of Sciences, Engineering, and Medicine conducted a public workshop on the integration of health literacy, cultural competency, and language access services. Participants discussed skills and competencies needed for effective health communication, including health literacy, cultural competency, and language access services; interventions and strategies for integration; and differing perspectives such as providers and systems, patients and families, communities, and payers. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Health System Transformation to Support Integration 3 Issues and Challenges 4 Addressing the Challenges 5 Break Out Session Reports 6 Reflections on the Day References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers and Moderators

In 2004, the Institute of Medicine released Health Literacy: A Prescription to End Confusion, a report on the then-underappreciated challenge of enabling patients to comprehend their condition and treatment, to make the best decisions for their care, and to take the right medications at the right time in the intended dose. That report documented the problems, origins, and consequences of the fact that tens of millions of U.S. adults are unable to read complex texts, including many health-related materials, and it proposed possible solutions to those problems. To commemorate the anniversary of the release of the 2004 health literacy report, the Institute of Medicine's Roundtable on Health Literacy convened a 1-day public workshop to assess the progress made in the field of health literacy over the past decade, the current state of the field, and the future of health literacy at the local, national, and international levels. Health Literacy: Past, Present, and Future summarizes the presentation and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Health Literacy at the U.S. Department of Health and Human Services: Progress and Possibilities 3 Health Literacy and Medications 4 Use and Delivery of Health Care 5 Education 6 Looking to the Future 7 Where Do We Go from Here? References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers

The United States faces an alarmingly high rate of maternal morbidity and mortality, distinguishing it from other high-income countries that have achieved decreases in these rates in recent years. U.S. maternal morbidity and mortality rates are disproportionate across racial, ethnic, socioeconomic, and geographic groups. Statistics on maternal health outcomes reveal that there are challenges to protecting both the lives and future health of birthing people and their children. Recognizing the urgency of this growing problem, the National Academies Board on Population Health and Public Health Practice convened a 2-day virtual workshop, Advancing Maternal Health Equity and Reducing Maternal Mortality. The workshop examined the current state of maternal health in the United States and explored the factors needed to help communities and health care systems become more effective in reducing maternal morbidity and mortality and improving health outcomes through the fourth trimester. This publication summarizes the presentations and discussions of the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers, Moderators, and Planning Committee Members

Despite spending far more on medical care than any other nation and despite having seen a century of unparalleled improvement in population health and longevity, the United States has fallen behind many of its global counterparts and competitors in such health outcomes as overall life expectancy and rates of preventable diseases and injuries. A fundamental but often overlooked driver of the imbalance between spending and outcomes is the nation\'s inadequate investment in non-clinical strategies that promote health and prevent disease and injury population-wide, strategies that fall under the rubric of "population health." Given that it is unlikely that government funding for governmental public health agencies, whether at the local, state, or federal levels, will see significant and sustained increases, there is interest in finding creative sources of funding for initiatives to improve population health, both through the work of public health agencies and through the contributions of other sectors, including nonhealth entities. Financing Population Health Improvement is the summary of a workshop convened by the Institute of Medicine Roundtable on Population Health Improvement in February 2014 to explore the range of resources that might be available to provide a secure funding stream for non-clinical actions to enhance health. Presenters and participants discussed the range of potential resources (e.g., financial, human, and community) explored topics related to financial resources. This report discusses return on investment, the value of investing in population-based interventions, and possible sources of funding to improve population health. Table of Contents Front Matter 1 Introduction and Overview 2 Paying for Population Health Improvement: An Overview 3 Health Care System Investments in Population Health Improvement 4 Community Development and Population Health 5 Pay-for-Success Financing and Population Health 6 Implications of New and Emerging Sources of Population Health Funding Appendix A--References Appendix B--Workshop Agenda Appendix C--Biographical Sketches of Workshop Speakers and Moderators

The field of health literacy has evolved from early efforts that focused on individuals to its current recognition that health literacy is a multidimensional team and system function. Health literacy includes system demands and complexities as well as individual skills and abilities. While communicating in a health-literate manner is truly important for everyone, it can be especially important for those with mental or behavioral health issues and for the systems and teams that interact with them and treat these individuals. The purpose of the workshop, which was held on July 11, 2018, in Washington, DC, was to explore issues associated with effective communication with individuals with mental or behavioral health issues and to identify ways in which health literacy approaches can facilitate communication. In particular, the workshop aimed to gain a better understanding of how behavioral health and mental health concerns can adversely affect communications between providers and patients and their families. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 The Personal Experience 3 Setting the Stage 4 Exploring Innovative Approaches 5 Where Do We Go from Here? 6 Reflections of the Day Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Moderators, Speakers, and Panelists

Behavioral health conditions, which include mental health and substance use disorders, affect approximately 20 percent of Americans. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. As many as 80 percent of patients with behavioral health conditions seek treatment in emergency rooms and primary care clinics, and between 60 and 70 percent of them are discharged without receiving behavioral health care services. More than two-thirds of primary care providers report that they are unable to connect patients with behavioral health providers because of a shortage of mental health providers and health insurance barriers. Part of the explanation for the lack of access to care lies in a historical legacy of discrimination and stigma that makes people reluctant to seek help and also led to segregated and inhumane services for those facing mental health and substance use disorders. In an effort to understanding the challenges and opportunities of providing essential components of care for people with mental health and substance use disorders in primary care settings, the National Academies of Sciences, Engineering, and Medicine's Forum on Mental Health and Substance Use Disorders convened three webinars held on June 3, July 29, and August 26, 2020. The webinars addressed efforts to define essential components of care for people with mental health and substance use disorders in the primary care setting for depression, alcohol use disorders, and opioid use disorders; opportunities to build the health care workforce and delivery models that incorporate those essential components of care; and financial incentives and payment structures to support the implementation of those care models, including value-based payment strategies and practice-level incentives. This publication summarizes the presentations and discussion of the webinars. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Statement of Task Appendix B: Virtual Workshop Agenda

To draw attention to health determinants and health inequities among populations that live in urban environments and to explore challenges faced in establishing urban population health, the Forum on Public-Private Partnerships for Global Health and Safety hosted a 1.5-day workshop on the role of health-focused public-private partnerships (PPPs) in the urban context. The workshop, held June 13-14, 2019, in Washington, DC, aimed to illuminate some of the intervention strategies that have been designed to attenuate these urban health issues and highlighted the importance of PPPs and urban-level governance in remediation efforts. By facilitating discussion among participants in both the public and private sectors, as well as among policy makers, the workshop served as a platform to share best practices on how to address health challenges through interventions that target healthier urban populations. This publication highlights the presentations and discussion of the workshop. Table of Contents Front Matter 1 Introduction 2 Cities and Planetary Health: Why Urban Issues Matter 3 Evidence and Challenges for Urban Health Initiatives in International Development 4 Identifying and Addressing Health Inequities in Urban Settings 5 Effect of Food, Agriculture, and Transportation Systems on Urban Population Health 6 How Digital Technology and Artificial Intelligence Can Help Improve Urban Health 7 Political Leadership and Governance of PublicPrivate Partnerships for Urban Health References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Speakers

With U.S. health care costs projected to grow at an average rate of 5.5 percent per year from 2018 to 2027, or 0.8 percentage points faster than the gross domestic product, and reach nearly $6.0 trillion per year by 2027, policy makers and a wide range of stakeholders are searching for plausible actions the nation can take to slow this rise and keep health expenditures from consuming an ever greater portion of U.S. economic output. While health care services are essential to heath, there is growing recognition that social determinants of health are important influences on population health. Supporting this idea are estimates that while health care accounts for some 10 to 20 percent of the determinants of health, socioeconomic factors and factors related to the physical environment are estimated to account for up to 50 percent of the determinants of health. Challenges related to the social determinants of health at the individual level include housing insecurity and poor housing quality, food insecurity, limitations in access to transportation, and lack of social support. These social needs affect access to care and health care utilization as well as health outcomes. Health care systems have begun exploring ways to address non-medical, health-related social needs as a way to reduce health care costs. To explore the potential effect of addressing non-medical health-related social needs on improving population health and reducing health care spending in a value-driven health care delivery system, the National Academies of Science, Engineering, and Medicine held a full-day public workshop titled Investing in Interventions that Address Non-Medical, Health-Related Social Needs on April 26, 2019, in Washington, DC. The objectives of the workshop were to explore effective practices and the supporting evidence base for addressing the non-medical health-related social needs of individuals, such as housing and food insecurities; review assessments of return on investment (ROI) for payers, healthy systems, and communities; and identify gaps and opportunities for research and steps that could help to further the understanding of the ROI on addressing non-medical health-related social needs. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Setting the Stage 3 Housing Interventions 4 Interventions Addressing Food Insecurity 5 Interventions Addressing Multiple Social Needs 6 Return on Investment 7 Research Gaps 8 Reflections on the Day References Appendix A: Statement of Task Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches

Firearm injuries and death are a serious public health concern in the United States. Firearm-related injuries account for tens of thousands of premature deaths of adults and children each year and significantly increase the burden of injury and disability. Firearm injuries are also costly to the health system, accounting for nearly $3 billion in emergency department and inpatient care each year. The National Academies of Sciences, Engineering, and Medicine convened a workshop to examine the roles that health systems can play in addressing the epidemic of firearm violence in the United States. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction 2 Why Do Health Systems Have a Role? 3 The Toll on Individuals and Communities 4 Identifying Individuals at Higher Risk for Firearm Violence 5 Developing Health System Interventions 6 Key Issues from the Workshop's First Day 7 Programs and Research 8 Developing Networks and Sharing Information 9 Developing a Culture of Health Care Providers as Interveners 10 Closing Remarks References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches

On July 30-31, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop titled Continuous Manufacturing for the Modernization of Pharmaceutical Production. This workshop discussed the business and regulatory concerns associated with adopting continuous manufacturing techniques to produce biologics such as enzymes, monoclonal antibodies, and vaccines. The participants also discussed specific challenges for integration across the manufacturing system, including upstream and downstream processes, analytical techniques, and drug product development. The workshop addressed these challenges broadly across the biologics domain but focused particularly on drug categories of greatest FDA and industrial interest such as monoclonal antibodies and vaccines. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Workshop Agenda Appendix B: Biographies of Planning Committee Members, Speakers, and National Academies of Sciences, Engineering, and Medicine Staff Appendix C: Running Themes Across Workshop Sessions

In an increasingly interconnected world, perhaps it should come as no surprise that international collaboration in science and technology research is growing at a remarkable rate. As science and technology capabilities grow around the world, U.S.-based organizations are finding that international collaborations and partnerships provide unique opportunities to enhance research and training. International research agreements can serve many purposes, but data are always involved in these collaborations. The kinds of data in play within international research agreements varies widely and may range from financial and consumer data, to Earth and space data, to population behavior and health data, to specific project-generated data?this is just a narrow set of examples of research data but illustrates the breadth of possibilities. The uses of these data are various and require accounting for the effects of data access, use, and sharing on many different parties. Cultural, legal, policy, and technical concerns are also important determinants of what can be done in the realms of maintaining privacy, confidentiality, and security, and ethics is a lens through which the issues of data, data sharing, and research agreements can be viewed as well. A workshop held on March 14-16, 2018, in Washington, DC explored the changing opportunities and risks of data management and use across disciplinary domains. The third workshop in a series, participants gathered to examine advisory principles for consideration when developing international research agreements, in the pursuit of highlighting promising practices for sustaining and enabling international research collaborations at the highest ethical level possible. The intent of the workshop was to explore, through an ethical lens, the changing opportunities and risks associated with data management and use across disciplinary domains?all within the context of international research agreements. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Privacy, Security, and Confidentiality of Data Sharing and Storage 3 Emerging Technologies and the Social Landscape 4 Reports from the Breakout Sessions 5 Final Thoughts and Next Steps References Appendix A: Workshop Agenda Appendix B: Statement of Task Appendix C: Guiding Questions for the Breakout Sessions Appendix D: Speaker and Moderator Biographies

Genomic medicine is defined as the routine use of genomic information about an individual as part of his or her clinical care as well as the health outcomes and policy implications of that clinical use. It is one approach that has the potential to improve the quality of health care by allowing practitioners to tailor prevention, diagnostic, and treatment strategies to individual patients. In recent years, research breakthroughs, technological advances, and the decreasing cost of DNA sequencing have led to the wider adoption of genomic medicine. However, as with the introduction of new technologies into health care, there are concerns that genetic and genomic testing and services will not reach all segments of the population both now and in the near future, and there remains a gap in knowledge regarding potential health care disparities in genomic medicine and precision health approaches. On June 27, 2018, the National Academies of Sciences, Engineering, and Medicine hosted a public workshop to examine the gaps in knowledge related to access to genomic medicine and to discuss health care disparities and possible approaches to overcoming the disparate use of genomic medicine among populations. Workshop participants discussed research on access to genetics and genomics services in medically underserved areas, model programs of care for diverse patient populations, and current challenges and possible best practices for alleviating health care disparities as they relate to genomics-based approaches. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Overview 2 Exploring the Barriers to Accessing Genomic and Genetic Services 3 The Role of Health Systems in Delivering Equitable Access 4 How Can Providers and Payers Make Genomic Medicine More Accessible? 5 Exploring Innovative Solutions and Models of Success 6 Considering Unmet Needs to Alleviate Disparities in Genomic Medicine References Appendix A: Summary of the Pre-Workshop Twitter Chat Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches Appendix D: Statement of Task Appendix E: Registered Attendees

The Centers for Disease Control and Prevention estimates that approximately 40 million people in the United States suffer from a serious illness that limits their daily activities. These illnesses include heart and lung disease, cancer, diabetes, and Alzheimer's disease and other forms of dementia. However, significant disparities exist across different communities in the quality and access to care for these illnesses. Factors such as race, ethnicity, gender, geography, socioeconomic status, or insurance status exacerbate these complex disparities. It is critical to reevaluate the current models of care delivery across diverse communities and vulnerable populations. On April 4, 2019, The National Academies of Sciences, Engineering, and Medicine convened a workshop to investigate barriers, policy initiatives, and opportunities for improving access to and equity of care for people living with a serious illness. Discussions explored the current climate of health care and opportunities to improve access to care using organizational, community, patient and family, and clinician perspectives. This publication summarizes the discussions and presentations from the workshop. Table of Contents Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda

The field of health literacy has evolved from one focused on individuals to one that recognizes that health literacy is multidimensional. While communicating in a health literate manner is important for everyone, it is particularly important when communicating with those with limited health literacy who also experience more serious medication errors, higher rates of hospitalization and use of the emergency room, poor health outcomes, and increased mortality. Over the past decade, research has shown that health literacy interventions can significantly impact various areas including health care costs, outcomes, and health disparities. To understand the extent to which health literacy has been shown to be effective at contributing to the Quadruple Aim of improving the health of communities, providing better care, providing affordable care, and improving the experience of the health care team, the National Academies of Sciences, Engineering, and Medicine convened a public workshop on building the case for health literacy. This publication summarizes the presentations and discussions from the workshop, and highlights important lessons about the role of health literacy in meeting the Quadruple Aim, case studies of organizations that have adopted health literacy, and discussions among the different stakeholders involved in making the case for health literacy. Table of Contents Front Matter 1 Introduction 2 The Patient Perspective on the Need for Health Literacy 3 Improving Health and the Bottom Line: The Case for Health Literacy 4 Why Health Literacy? 5 Adopting Health Literacy in an Organization 6 Where Do We Go from Here? 7 Reflections on the Day References Appendix A: Workshop Agenda Appendix B: Biographical Sketches of Workshop Moderators, Speakers, and Panelists Appendix C: Improving Health and the Bottom Line: The Case for Health Literacy