Alumna leads efforts in mental health, aging services
By Mike Friend
In Pennsylvania, people aged 65+ now outnumber children, a trend that accelerated in Western Pennsylvania with the collapse of the steel industry in the late 1980s. With the average age in the Pittsburgh metro area among the oldest in Pennsylvania, the need for high-quality, affordable and compassionate care continues to grow. At UPMC, the person responsible for much of it is Deborah Brodine (MHA, HPM '93, MBA, BUS '93), president of UPMC Western Psychiatric Hospital and UPMC Senior Services.
While working for a large, national consulting firm before graduate school, Brodine felt the need to find a role with a stronger connection between her personal values and the organization's that consulting work didn't meet.
"As corny as it sounds, I aspired to apply my skills to something that was more intrinsically valuable," said Brodine. "That passion to make a meaningful difference has been part of me for a very long time."
One of Brodine's consulting clients was a health insurance company, which sparked her interest in health care, but she says it was the School of Public Health that taught her about the consumer-driven side of health and wellness.
"Pitt Public Health was the program through which I learned the application of these concepts of health care," she said. "It is the channel that refined my perspective and gave me the ability to direct or lead efforts that improve health outcomes and population-based care."
In more than three decades of roles with continuous growth at UPMC, Brodine says that as the scope of her duties has changed, she's also seen a change in how aging is addressed.
"Early in my career, I was focused on rehabilitation with a capital 'R,'" she says of growing new physical and occupational therapy programs in collaboration with the School of Health and Rehabilitation Sciences. She was also involved with occupational medicine and disability issues, partnering with the Department of Physical Medicine and Rehabilitation, School of Medicine, and worked on the acquisition and integration of the Rehabilitation Institute, which was formerly in Squirrel Hill.
As she moved into aging services, Brodine says her work began to focus on caring for people more longitudinally in settings outside the hospital—coming naturally once again to rely upon her public health background.
"Aging services are really about the 360 other days a year that people aren't in the hospital," she says. "All of those community-based activities, whether it's home health or hospice, pharmacy services, or any level of long-term care, are super important to he overall health of seniors."
Key advances came with the development of the UPMC Palliative and Supportive Institute and of the joint Pitt-UPMC Aging Institute, resources that have become significant not only to Pittsburgh, but to aging services throughout the region.
The greatest current challenge is finding and retaining enough people to provide services to an aging population that needs increasing care over time, she says, noting a similar staffing challenge facing the behavioral health sector.
"You're talking about people who provide very personal services and activities of daily living that older adults may not be able to do for themselves anymore," she says, adding that the best behavioral health service providers are similarly compassionate and nonjudgmental.
"Caregivers are underappreciated by society, and that is reflected in policy and economic models currently in place," says Brodine. "It's one of the biggest barriers to aging and behavioral health services—and a public health approach of understanding economic modeling and applying it to policy decisions is the greatest gift—if you can achieve it."
Brodine has led several initiatives to improve care for older people, including Golden Care, which aimed to raise the floor of primary care for older people, and UPMC Health Plan partnerships to enhance communication and outcomes while reducing the cost of care. >>See Giving
She's also worked closely with the U.S. Centers for Medicare and Medicaid Services to reduce avoidable hospitalizations from nursing homes by advancing telehealth services, providing primary care on site, improving team communication, adding palliative care and improving medication management for patients in long-term care.
During the pandemic, these efforts pivoted to providing infection control and safety measures and education in crowded care settings to reduce infection rates and deaths.
Brodine's most recent career transition, into mental health, means she sits in a unique position, focusing on different but not totally dissimilar populations.
"From a public health perspective, both aging and behavioral health deal with underserved populations and have fragmented financing that is often misunderstood by the public, and even by some health care professionals in some in public health," she says, adding that both require active, ongoing preventative care and face stringent regulatory requirements that complicate care access and affordability.
"We need to be cognizant of the economics that drive care and outcomes, and we need policy collaboration when we implement care models, particularly care models that work," adds Brodine. "How do we get public policymakers to hear what works, welcome and embrace those care models?"
This is the root of public health.
"Let's remove barriers to care and demonstrate the economic value of providing services to people in the community that enhance their quality of life," she says. "Let's fund those services on an ongoing basis rather than isolating the people and waiting for them to deteriorate."