A public health expert returns to the institution that saved her life
Interview BY Martha Thomas Portrait BY Mary C. Gardella
Elizabeth Edsall Kromm is vice president of population health and advancement for Howard County General Hospital, leading community health activities and setting the strategic direction for development and community engagement. Before joining the hospital in 2015, she served as the policy director for Howard County government and a senior program officer for the Pew Charitable Trusts. She has a doctorate from the Johns Hopkins Bloomberg School of Public Health, a master’s in international health policy from the London School of Economics, and did her undergraduate work at the University of Pennsylvania. The Daily Record named Kromm a 2017 Leading Woman, an award that recognizes women age 40 or younger for their community involvement and commitment to inspiring change.
Q What does your job at Howard County General Hospital entail?
I came here to lead a new initiative. There’s a recognition in the industry that even if we provide the best in terms of clinical care inside the hospital, we’d be remiss if we didn’t focus on things outside the hospital, such as behavior, social issues, and making sure people have food, transportation and affordable housing.
Q Does your status as a nonprofit mean extra responsibility for the community?
We have certain requirements for our tax status. We’ve done a variety of programs in the community, such as screenings and supporting other organizations in the health space. This is a new era to be a better partner.
Q So promoting wellness is good for the hospital overall?
Regardless of how many people come in our doors, we have to treat everyone, all within a defined budget. Say you come to the emergency room 10 times a year. We should look at what is going on in your life. Do you need help getting to doctors’ appointments? Are you getting older and feeling isolated? Can we connect you to a faith community or a social network—all of these things are important to slowing down the progression of other issues.
Q What do you think is on the horizon for health care?
We follow everything that happens at the federal and state levels, but at the end of the day we’re the sole community hospital in Howard County, and we’re prepared to take care of anyone who comes through our doors. We’re constantly thinking about how to help those who don’t have chronic conditions, to help those on the lower end of the health continuum. Since the Affordable Care Act (ACA) was passed, people have become more accustomed to a wellness approach. If the ACA is compromised, the hospital will continue this approach, even if the government doesn’t subsidize it.
Q When you worked with Howard County government, you worked on issues like healthy meals with the Roving Radish. Is the hospital involved with that sort of program?
The Roving Radish I consider a child. I’m so proud of that. It’s a way to bring local food to the community. We delivered two meal kits a week, with the recipes. In designing it, we had full market rate and the subsidized rate with a goal that at least 50 percent of the kits sold be to those who have subsidies—either WIC benefits or food stamps (SNAP). This past year they’re using more locally sourced foods, they added vegetarian options and I think they even did turkeys and sides for Thanksgiving. It’s not enough to say, ‘Join a CSA, here are a bunch of root vegetables, have at it.’ This says, ‘Yeah, we know it’s hard. We understand that you are working and time limited. We want to make it easy for you to be healthy. The hospital serves as a pick-up location for Roving Radish.
Q Does being part of Johns Hopkins Medicine affect the small community hospital vibe?
Being part of something the scale of Johns Hopkins has an advantage when it comes to resources and buying power— compared to what we could do on our own as a 260-some bed hospital. We can collaborate with Hopkins on quality care, but we are definitely the experts when it comes to our community. We get the best of both worlds in that way: As a resident of Howard County you get a top-quality community hospital, but if you are in need of care that a community hospital can’t offer, we are connected to a place where you can get it.
Q How has the trend toward integrative care affected the hospital’s approach?
We are happy to be a really strong partner with the Maryland University of Integrated Health (MUIH). We actually have yoga therapies through MUIH on some of our inpatient units. We’ve recently launched a program with integrative energy therapy. We have a qualified therapeutic touch practitioner (QTTP) who talks with people to see if they would like integrative energy therapy for pain treatment. We are very interested in expanding our integrative health offerings. We know the benefits and we also know that this is something the community is interested in.
Q What got you into the health field?
I’m a childhood cancer survivor. I was treated at Hopkins many years ago. As a result, I felt a commitment to be in the health space. At first I thought I would become a doctor, then I discovered all the things you can do from a community perspective— where your patient is the population not just one individual at a time.
Q What kind of cancer did you have?
It was Wilm’s tumor, a form of children’s kidney cancer. This was 1981, when I was 3. My primary care provider found it, and we rushed to Hopkins. It was stage 4 so it had already spread outside the kidney. I went through three surgeries as well as chemo and radiation. I was very lucky that I was diagnosed at a time when the treatment protocols were refined. Five years earlier the survival rate was not as good.
Q That must have been terrifying for your parents.
I didn’t know till many years later that mine was not the normal childhood experience. Even on days that I wasn’t receiving treatment they would bring me up to the Child Life Department at Hopkins so I could be with other kids I knew from clinic, and sort of have, you know, a regular time, doing things like making macaroni necklaces. Even if you are getting chemo, you still need to be a kid being a kid.
Q I’m sure not all of those children survived.
This was between the ages of 3 and 7, so I knew people who did well and didn’t come back to clinic, and I also knew kids who didn’t do so well and didn’t come back to clinic.
Q So you keep coming back to Hopkins?
In college, I was able to work at the School of Public Health on some initiatives, and that introduced me to the public health world. I went back and got my Ph.D. in public health and health policy there. One of my daughters was born at Howard County General Hospital. She was a 27-week preemie and she lived here for three months. So even before I worked here, I got to see that we have this hospital in Howard County that can do amazing things to take care of super tiny babies.