Sara Koliner was in a job training session when she got a crash course on the U.S. health system.
Koliner was in Madison working for the medical software firm Epic Systems. Part of her training included discussion about U.S. health care. "I gained an appreciation for the impact created by the people working behind the doctors, nurses and other front-line medical workers," Koliner says. "From hospital administrators to government officials, these people were trying to solve the problems associated with health care, and I knew that this was how I wanted to be involved."
She subsequently pursued that interest as an office manager and coordinator for the Society for the Study of Reproduction, a scientific organization based in Madison, then enrolled at La Follette.
"After working for Epic Systems Corporation and the Society for the Study of Reproduction, I gained a great respect for the process of applying good science and policy to the health-care system in America," says Koliner, who graduated from Arizona State University in 2008. "Here at the La Follette School I am finding my footing in health care policy, especially with regard to women and low-income populations. A degree in public affairs is teaching me how to pursue improvements in the real world, where budgets, politics, and constantly changing social landscapes influence feasibility."
Koliner says she appreciates the blend of technical skills with public affairs theory. "La Follette allows students to build a philosophical understanding of public affairs on top of real analytical skills that can be directly applied in their careers," she says. "After just one year, I feel my abilities are already honed to the level employed in health policy careers."
She applied those skills as a project assistantship in spring 2013 with Project HealthDesign at the University of Wisconsin–Madison School of Nursing. The $10 million initiative sponsored by the Robert Wood Johnson Foundation explored the use of personal health record systems that individuals can use to collect data about their own health to share with doctors.
Koliner assisted with the project's final phase, especially the evaluation of policy applicable to Project HealthDesign findings and their dissemination to relevant policy-related fields. "I wrote blog posts for the website, co-wrote official comments to agencies such as the National Institutes of Health and published an editorial in the journal Computers Informatics Nursing," says Koliner, who had a fellowship for her first year and has a project assistantship for 2013-14 with economist Jason Fletcher, who joined the La Follette School's faculty in 2013.
"The HealthDesign position provided invaluable lessons in the pathways available for influencing policy, as well as an introduction to the state of patient-centered health-care information technology in the United States," she says. "The most rewarding experience, however, was being able to share this information through our blog and journal editorial so people can help shape the direction of health-care policy."
In writing for the blog, Koliner found her health economics course especially relevant. "Although patient-defined health information is helpful, utilizing it carries costs," she says. "The technology to collect and distribute the data, the labor to process the information, and the ramifications about legal responsibility and privacy all have to be calculated when determining the benefits of personal health technology. I used lessons from the health economics course to frame my policy discussions on the Project HealthDesign blog."
As an English literature major at Arizona State, Koliner enjoyed the critical reading and writing entailed in producing the blog entries. She also values how the La Follette School's statistics courses improved her critical reading skills. "With the skills I have gained at La Follette, I can more confidently understand what numbers from a study or a poll can tell me while also being aware of what they don't, and so I make more informed decisions on the data I receive," Koliner says. "Luckily, I know that these skills will be applied to more than just reading the news—an understanding of epidemiology is essential to working within the public health sector. Knowing how to analyze quantitative information gained through health studies, when to trust a finding and when to recognize more research is needed will serve me well throughout my career."
After Koliner graduates, she hopes to work for an agency or organization committed to helping women and/or low-income people with their nutrition and health. "So far I do not have a preference for working with top-level decision-makers or with consumers," she says. "The most important goal is to be able to see clearly how my work is contributing to the world around me."
Koliner gained insight into women's health care this year when she gave birth to her son in May. "While I understood the importance of healthy women and children when I began this graduate program, seeing how the system works from the perspective of the health consumer has proven how influential public policy can be," she says. "Decisions made on vaccinations, delivery, post-natal care, breastfeeding (and many more!) have all improved considerably in the past decade due to changes in public policy. Through my firsthand experience making these decisions, I am even more assured that health policy is what I want to be part of."
"Improving health care for women not only improves the physical health of her children and family, but the emotional and economic health as well," she adds. "I am even more excited for this next year of classes, and the work I'll be able to do once I graduate."