Chronic obstructive pulmonary disease, COPD, is a leading cause of death in the United States, with more than 150,000 deaths annually. Nationwide millions are affected by the disease, which imposes an enormous burden on individuals with COPD, their caregivers, and the nation’s health care system, especially in rural communities.
The COPD National Action Plan, the first-ever blueprint for a multi-faceted, unified fight against the disease, provides a comprehensive framework for action by those affected by the disease and those who care about reducing its burden. This one-day, in-person meeting will bring together rural health and COPD experts to further the dialogue on how to address the goals and objectives of the COPD National Action Plan from a rural perspective and move toward its implementation by identifying challenges, opportunities, and resources; exploring solutions; sharing best practices; and fostering collaboration. A report will be developed and a webinar will be held later in the summer to summarize key findings from the meeting that can be referenced as organizations move toward implementation of the National Action Plan in rural communities.
James Kiley, Ph.D.
Dr. James Kiley serves as the director of the Division of Lung Diseases (DLD) at the National Heart, Lung, and Blood Institute (NHLBI) at the National Institutes of Health (NIH). Prior to this position, he was the director of the National Center on Sleep Disorders Research at NIH. Dr. Kiley received his education and training at Saint Anselm’s College, Kansas State University, and the University of North Carolina at Chapel Hill. He is a member of a number of professional organizations and has received numerous honors and awards for his outstanding contributions to advancing pulmonary biology in health and disease, sleep research, and public health. His major areas of interest include control of respiration and the pathophysiology of obstructive airways diseases. Dr. Kiley is the author or co-author of over 100 scientific articles.
Paul Moore, D.Ph.
Dr. Moore currently serves as senior health policy advisor to the Federal Office of Rural Health Policy. He has a lifetime of experience related to rural health care from both his family heritage and more than 30 years in community and hospital pharmacy. His experience reaches beyond pharmacy as he has also been the CEO of a county health care authority, consisting of one of the nation’s earliest critical access hospitals, the county EMS, a physician clinic and a home health agency. He is a past president of the National Rural Health Association and currently serves as the executive secretary for the National Advisory Committee for Rural Health and Human Services.
John Linnell is what he describes as an "involved patient.” In addition to being a state captain for the COPD Foundation, he sits on the board of directors for the U.S. COPD Coalition, the COPD Patient-Powered Research Network (PPRN), and EFFORTS (an international peer support group). He is currently co-investigator on a Johns Hopkins clinical study, setting out to demonstrate that peer mentoring and support among COPD patients leads to more positive outcomes. John also serves as a patient reviewer on respiratory health peer review panels for the U.S. Department of Defense, funded through Congressionally Directed Medical Research Programs.
Barbara P. Yawn, M.D., M.Sc., FAAFP
Dr. Barbara P. Yawn is a family physician who spent her first 15 years in practice in a rural community in Minnesota. She moved on to open a research department in a regional health system, the Olmsted Medical Center, and became a senior investigator with the University of Minnesota Rural Health Research Center. Dr. Yawn’s research interests include practice-based screening or identification of chronic respiratory diseases, improving primary care and access to specialty care for COPD and asthma, and using telehealth to improve access to care, such as pulmonary rehabilitation. She has published over 400 peer-reviewed articles and serves as editor-in-chief of Respiratory Medicine Case Reports and Associate Editor of Respiratory Medicine. She recently retired from her research department and became the Chief Science Officer of the COPD Foundation.
Stephanie Cramb, LPN, CTBS*
Stephanie Cramb has worked for Cigna-HealthSpring in various case management roles for the last seven years and has served as a customer centricity ambassador since 2015. Prior to this, her nursing experience has included med-surgery in a local county hospital, drug and alcohol rehabilitation, and organ/tissue donor services. In 2017, Stephanie returned to school to continue working toward her degree as a registered nurse.
*I wish to disclose that I am here on behalf of Cigna-HealthSpring and my perspectives therefore represent those of the company unless otherwise stated.
Eugenia Wyatt, LMSW, CCM*
Eugenia Wyatt has worked in chronic disease case management at Cigna-HealthSpring for more than six years. She received her master’s degree in social work from Western Kentucky University. She is currently pursuing a master’s degree in health care administration with a focus on community education. She has served as customer centricity ambassador for her organization, and has served and presented on multiple panels regarding care coordination/ health education in the community. Eugenia currently resides in Nashville, TN.
*I wish to disclose that I am here on behalf of Cigna-HealthSpring and my perspectives therefore represent those of the company unless otherwise stated.
Dan Doyle, M.D.
Dr. Dan Doyle has been a practicing family physician in Fayette County, WV, since 1978. He helped found the New River Health Association, a federally qualified community health center, in 1978 and has practiced there ever since. Dr. Doyle graduated from the University of Notre Dame in 1968, Harvard Medical School in 1974, and completed a family medicine residency at the University of Massachusetts, Worcester, in 1977. His teaching and research have focused on medical education for community health, evidence-based practice, communication skills, and pulmonary rehabilitation.
Claibe Yarbrough, M.D.
Dr. Claibe Yarbrough is the national program director for Pulmonary, Critical Care, and Sleep Medicine. He is chief of pulmonary/critical care at the Veterans Health Administration (VHA) North Texas Health Care System in Dallas, TX, and professor of medicine at the University of Texas Southwestern Medical Center. Dr. Yarbrough is chair of the Operations Critical Care Committee and Pulmonary Field Advisory Committee, member of the Surgical Advisory Board for Critical Care, and co-chair of the ICU Clinical Information System (CIS) and Anesthesia Record Keeper (ARK) Advisory Board. He developed an early warning dashboard for real-time prospective rapid response alerts that is available to more than 35 VA hospitals contracting with one of the major ICU-CIS vendors.
Akshay Sood, M.D., MPH
Dr. Akshay Sood, an occupational and environmental pulmonologist, is a tenured professor and the Miners’ Colfax Medical Center endowed chair at the University of New Mexico’s School of Medicine. Dr. Sood received his postdoctoral fellowship in pulmonary, critical care, and occupational and environmental medicine at Yale University. He became a member of the American Thoracic Society Environmental, Occupation, and Population Health Assembly as a fellow in 1996. Additionally, he served the Society’s New Mexico Chapter as a member of its board of directors (2007-2010), president (2009), and president-elect (2006-2008).
David N. Weissman, M.D.
Dr. David N. Weissman has directed the Respiratory Health Division (RHD) of the National Institute for Occupational Safety and Health (NIOSH) since 2005. RHD is dedicated to preventing work-related respiratory disease and optimizing workers’ respiratory health. To achieve this goal, it conducts research, performs respiratory disease-focused health hazard evaluations, carries out a national program of occupational respiratory disease health and hazard surveillance, and operates the Coal Workers’ Health Surveillance Program and the NIOSH Spirometry Course Certification Program. Dr. Weissman’s own research has been in the areas of respiratory immunology and occupational respiratory disease. He is board certified in internal medicine, allergy and immunology, and pulmonary diseases.
Janet B. Croft, Ph.D.
Janet B. Croft is a senior epidemiologist and branch chief of two branches at the Centers for Disease Control and Prevention (CDC). In the past 26 years at CDC, Dr. Croft’s career has focused on identifying surveillance gaps in the epidemiologic assessment of many chronic disease conditions, including COPD, and developing new surveillance systems or improving existing ones to fill those gaps. She is committed to improving the epidemiologic and surveillance capacity of state health departments. Her collaborations with the NHLBI leveraged support to allow state health departments to collect the first-ever state-specific COPD surveillance data in the Behavioral Risk Factor Surveillance System (BRFSS) beginning in 2011. Current collaboration resulted in additional NIH support to states to identify the prevalence of persons with undiagnosed COPD symptoms. Dr. Croft also helped to develop the 500 Cities Project, which provides census tract-level data on COPD and other chronic diseases and their risk factors. Her work is reflected in over 325 scientific publications. Her career efforts have impacted a broad spectrum of chronic diseases and risk factors across the lifespan.
Eric Stockton, B.A.
Eric Stockton is the health program manager for the Appalachian Regional Commission (ARC), a federal-state partnership that works for sustainable community and economic development in Appalachia. ARC’s health programs include documentation of the region’s health disparities and their economic impacts, strategic grantmaking for government agencies and non-profit organizations, and the deployment of multi-sector public health partnerships that support Appalachia’s economic growth and stability. Eric’s activities include management of a large grant portfolio, implementation of long-term regional interventions in diabetes, substance abuse, and cancer, and engagement with the Appalachian Health Policy Advisory Council. Eric received a B.A. in English from the University of North Carolina at Chapel Hill in 1987. His background includes extensive work in leadership and capacity building for small communities, environmental infrastructure, and partnership initiatives in public health. He has been with ARC since 1996 and lives with his family in Washington, D.C.
Cara James, Ph.D.
Dr. Cara James is the director of the Centers for Medicare and Medicaid Services (CMS) Office of Minority Health (OMH) and co-chair of the CMS Rural Health Council. She is a nationally recognized expert and thought leader in health disparities, health equity, and improving health outcomes for vulnerable populations. As the director of the CMS OMH, Dr. James leads CMS’ efforts to meet the unique needs of minority and underserved populations. Under her leadership, CMS OMH developed the first CMS Equity Plan to Improve Quality in Medicare, created and launched an ongoing initiative to help individuals understand their coverage and connect to care, and strengthened the quality and increased the collection and reporting of demographic data. Dr. James is a member of the National Academy of Medicine (NAM) Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and has served on several NAM committees. Dr. James received both her Ph.D. in health policy and her A.B. in psychology from Harvard University.
Alana Knudson, Ph.D.
Dr. Alana Knudson serves as a program area director in the Public Health Department at the National Opinion Research Center (NORC) at the University of Chicago and is the co-director of the NORC Walsh Center for Rural Health Analysis. Dr. Knudson has more than 20 years of experience implementing public health programs, leading health policy research projects, and evaluating programs. Dr. Knudson has state and national public health experience having worked at the North Dakota Department of Health and for the Association of State and Territorial Health Officials; she also served as associate director for research at the Center for Rural Health at the University of North Dakota.
Rowena Dolor, M.D., M.H.S
Rowena Dolor is an associate professor of medicine with tenure in the Division of General of Internal Medicine at Duke University Medical Center. The focus of her research pertains to primary care clinical and outcomes research. Since 1996, she has been director of the Duke Primary Research Consortium (PCRC), a network of primary care practices in the Duke University Health System. Dr. Dolor has contributed to the development and methodology of Practice-Based Research Networks (PBRNs). She has served as a co-investigator on three online resources to help researchers conduct multi-center research in the primary care practice-based setting. In the fall of 2014, Dr. Dolor joined Vanderbilt part-time as a Consultant/Adjunct Associate Professor of Medicine within the Division of General Internal Medicine. Her role is to assist in the formation of the Meharry-Vanderbilt Clinical Research Network. Additionally, she is a co-investigator on the Mid-South Clinical Data Research Network (CDRN), a PCORnet-awardee, to build the partnership with the community practices for comparative effectiveness studies that will utilize the electronic health records/information system infrastructure of the CDRN.
Jean Rommes, Ph.D.
Dr. Jean Rommes is a COPD patient and advocate with intimate knowledge and experience with the challenges for the care and treatment of patients. She is a former smoker who quit in 1992 and was diagnosed with severe COPD in 2000. She “saw the light” in 2003, and through an aggressive exercise and diet program, lost over 100 pounds and vastly improved her health. She is a great advocate for exercise and pulmonary rehabilitation, and attends many conferences and meetings as a patient advocate. Dr. Rommes is a member of the COPD Foundation’s Patient Powered Research Network Board and Medical and Scientific Advisory Committee; is the Primary Patient Investigator for the RELIANCE study; a member of the EFFORTS board and the Lung Force Expo planning committee for the American Lung Association (ALA) in Iowa and Nebraska; and serves on the board of ALA of Iowa. Dr.
Rommes attended Michigan State University and Syracuse University. She is a Doctor of Philosophy in higher education administration, has a M.S. in student personnel administration, and B.A. in English.
David Mannino, M.D., FCCP*
Dr. David Mannino joined GlaxoSmithKline (GSK) in August 2017 as a medical expert focused on COPD. He joined the CDC’s Air Pollution and Respiratory Health Branch in 1991 until his retirement from the U.S. Public Health Service in 2004. While at CDC, he helped to develop the National Asthma Program and led efforts on the surveillance reports that described the
U.S. burden of Asthma (1998) and COPD (2002). After his retirement from CDC in 2004, Dr. Mannino joined the faculty at the University of Kentucky and also helped to launch the COPD Foundation, where he served as a board member from 2004 through 2015, chairman of the Medical and Scientific Advisory Committee from 2010 through 2015, and Chief Scientific Officer from 2015 to 2017. Dr. Mannino has over 300 publications and serves as an associate editor or editorial board member for six respiratory journals. He was also a coauthor of the
U.S. Surgeon General’s Report on Tobacco in 2008 and 2014. Dr. Mannino received his M.D. from Jefferson Medical College (now Sidney Kimmel College of Medicine) in 1981.
*Dr. Mannino is an employee of GSK, but his opinions do not necessarily represent those of his employer.
Graham T. Atkins, MBChB
Dr. Graham T. Atkins graduated from medical school in Edinburgh, Scotland. He completed his medical residency in Edinburgh and is a member of the Royal College of Physicians. After moving to the U.S., he undertook further training in Albany, NY, worked as a primary care physician in the Adirondacks, and then completed a fellowship in pulmonary and critical care medicine at Dartmouth-Hitchcock Medical Center in Lebanon, NH. He is now a faculty member at Dartmouth-Hitchcock and an assistant professor at the Geisel School of Medicine where he teaches respiratory physiology. His chief interest is in improving clinical care for patients with COPD, particularly those patients living in rural areas with impaired access to care. Dr. Atkins recently published an article on the effects of rurality on lung cancer care and has ongoing clinical research in COPD.
Maggie Elehwany, J.D.
Maggie Elehwany joined the National Rural Health Association (NRHA) in 2007. She is the head lobbyist for the association and is responsible for the Government Affairs and Policy department. She has 20 years of federal legislative experience. She previously served as health counsel to Senator Lisa Murkowski, a member of the Senate Health, Education, Labor, and Pensions Committee, and to Senator Frank Murkowski, a member of the Senate Finance Committee, where Maggie worked on comprehensive Medicare and Medicaid legislation.
Maggie also served as counsel to former U.S. Senate Finance Committee Chairman Bob Packwood. From 1999 to 2005, she served as assistant director of congressional affairs for the American Medical Association, where she advocated on patient and physician issues. Maggie earned a J.D. from the University of Oregon and a B.A. from Oregon State University.
Lisa Davis, M.H.A
Lisa Davis is the director of the Pennsylvania Office of Rural Health where she is responsible for the overall direction and leadership of the state office of rural health, including ensuring that the office meets its mission of being a source of networking, coordination, and technical assistance to organizations focused on rural health care delivery; developing and sustaining linkages with state and national partners; and seeking ways to expand the office’s role in enhancing the health status of rural Pennsylvanians. On the national, state, and university levels, Lisa serves on a wide range of boards of directors, advisory committees, and task forces focused on rural health policy, rural health research, economic development, outreach and education, and vulnerable populations and specific health issues. Lisa is the recipient of several awards pertaining to her efforts in rural health. She holds a graduate degree in health administration from Penn State University.
Mike Witte, M.D.
Dr. Mike Witte is currently chief medical officer at the California Primary Care Association (CPCA). He is a family physician and pediatrician and founder and previous medical director of the rural Coastal Health Alliance, a full-service, three-site federally qualified health center, in rural West Marin County in Northern California. Dr. Witte received his medical degree from the Medical College of Wisconsin and did his residency in pediatrics at Children’s Hospital Oakland. He is board certified in both family practice and pediatrics. He is a graduate fellow and alumnus of the California Health Care Foundation’s Leadership Fellowship. He has been an instructor in the School of Nursing, California State University, Sonoma, since 1996. Dr.
Witte served as a board member at CPCA from 2009-2015, until he joined the staff as chief medical officer in 2015.
Antonello (Tony) Punturieri, M.D., Ph.D.
Dr. Tony Punturieri is a program officer in the Division of Lung Diseases (DLD) at the NHLBI at NIH. In this capacity, Dr. Punturieri administers a varied portfolio of grants and contracts in the area of COPD and environment. Specifically, he participates in the development and administration of programs that aim to understand COPD disease mechanisms, COPD prevention, and the testing and evaluation of COPD therapies. Dr. Punturieri attended medical school in Ferrara, Italy, and obtained a Ph.D. in immunology at “La Sapienza” University in Rome, Italy. He joined NHLBI in 2006.
If you missed the meeting or would like to revisit the discussions, you may watch the full recording.
To learn more about COPD and rural health, we suggest reviewing the following resources and materials:
• Urban-Rural Country and State Differences in Chronic Obstructive Pulmonary Disease — United States, 2015.Janet B. Croft, PhD; Anne G. Wheaton, PhD; Yong Liu, MD, et al. MMWR Morb Mortal Wkly Rep 2018;67:205-211.
• Health Disparities in Appalachia PDA, Inc., Cecil G. Sheps Center for Health Services Research, and the Appalachian Regional Commission
• Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease. Matheson MC, Benke G, Raven J, Sim MR, Kromhout H, Vermeulen R, Johns DP, Walters EH, Abramson MJ. Thorax. 2005 Aug;60(8):645-51. PMID:16061705
• Occupational exposure to pesticides are associated with fixed airflow obstruction in middle-age. Alif SM, Dharmage SC, Benke G, Dennekamp M, Burgess JA, Perret JL, Lodge CJ, Morrison S, Johns DP, Giles GG, Gurrin LC, Thomas PS, Hopper JL, Wood-Baker R, Thompson BR, Feather IH, Vermeulen R, Kromhout H, Walters EH, Abramson MJ, Matheson MC. Thorax. 2017 Nov;72(11):990-997. doi: 10.1136/thoraxjnl-2016-209665. Epub 2017 Jul 7. PMID:28687678
• Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults. Doney BC, Henneberger PK, Humann MJ, Liang X, Kelly KM, Cox-Ganser JM. MMWR Surveill Summ. 2017 Nov 3;66(21):1-5. doi: 10.15585/mmwr.ss6621a1. PMID:29095802
• Leading Causes of Death in Nonmetropolitan and Metropolitan Areas — United States, 1999-2014. Moy E, Garcia MC, Bastian B, et al. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas — United States, 1999-2014. MMWR Surveill Summ 2017;66(No. SS‐1):1‐8. DOI: http://dx.doi.org/10.15585/mmwr.ss6601a1
COPD National Action Plan Overview and Charge to the Group
COPD in Rural America
Antonello Punturieri, M.D., Ph.D., Program Officer, Division of Lung Diseases, National Heart, Lung, and Blood Institute