Leading with Love: Ellen Beckjord

Ellen:  On the phone he says to the reporter, “Do you know what the most important thing in the world to me is right now?” And the reporter says no, and Mister Rogers says, “Talking to you.”  You know like what if we put connection at the heart of everything we did?

Mike: From CTSI, this is the Products of Pittsburgh. A show about the people in Pittsburgh – innovators, scientists, community leaders – and the remarkable stories behind how they came to be and the work they’ve produced.   I’m Mike Flock.  On the show today, we meet with Dr. Ellen Beckjord, Associate Vice President of Population Health and Clinical Affairs at the UPMC Health Plan    

Mike: Ellen returned home to Pittsburgh in 2007 after years of training as a clinical psychologist and behavioral scientist.  She quickly established herself as an innovator at the intersection of digital and population health.  Now, as a leader at the UPMC Health Plan, Ellen is using her expertise and compassion to support the health of millions.  It all began in the South Hills of Pittsburgh where Ellen grew up in the house that her grandparents built and her mother still lives in today.  Her father was an architect and her mother, a high school English teacher. Ellen as well as her younger brother though decided to study psychology

Mike.  So both of you going in psychology were there any early influences that both encourage you to kind of go that trajectory?

Ellen: That’s an interesting question, one that my mom wonders about a lot.  So we took very different paths in psychology. Psychology is a field that has lots of different trajectories within it. So my brother is trained as a clinician and did a lot of work in adult psychopathology assessments a little bit in forensic psychology, which was very different than the path that I took which was very squarely focused in clinical health psychology.  I don't know that he and I have ever talked about why we both pursued psychology and I don't have a great answer except to say that I think our parents and my mom especially really put a lot of value on insight and thinking carefully about things so that may have had some influence but it also could be coincidence.

Mike: Growing up were there any particular jobs or careers that you envisioned?

Ellen: I think the first thing I really felt passionate about wanting to do was epidemiology. I didn't know that word at the time and I was really influenced by a film called And the Band Played On, which is an old film about the beginning of the HIV and AIDS epidemic.  It's a great film and I was really moved by that film and at that time wanted to pursue a career in biochemistry. I never wanted to be a physician, but I was really interested in illness and disease and in doing something in that arena to combat illness and disease.  So I spent time in high school, I was a student at something called the Pennsylvania Governor's School for the Sciences the summer after my junior year of high school which is an intensive program in math and science at Carnegie Mellon University.  After that I had the opportunity to work in a biology lab at Carnegie Mellon University during my senior year of high school in the summers after my freshman and sophomore years of college.  Working in a lab environment was not particularly well suited to my interests or my temperament and I became more interested in the human experience of disease and so that was about my junior year of college I changed my major to psychology and then since then have been focused on disease, illness, wellness but all kind of within the human experience

Mike:  I read that while you were in college you were also part of an international dance ensemble.

Ellen: That’s true. 

Mike: Tell me about that.                         

Ellen:  How did you find that? Well, I love to dance and I always have. It's probably one of my one of my favorite things to do and I took a ballroom dance class in college for a gym credit and the teacher of the dance class had ran what was called the Penn State International Dance Ensemble and encouraged me to audition for it. So my Junior and Senior year I danced with the Penn State International Dance Ensemble.  It was just a really incredible experience so it's learning traditional and folk dances from all around the world.  I had a chance to learn dances from many many different countries and perform those dances and had some of the best experiences of my time in college with the dance ensemble

Mike: Ellen graduated in 1999 from Penn State with a degree in psychology and then decided to pursue a PhD at the University of Vermont where she worked with cancer survivors and their families delivering evidence-based behavioral medicine interventions.   At the end of her graduate work, Ellen completed an internship at Vanderbilt University; however, she wanted to get additional training in epidemiology - the study of the distribution and determinants of health-related states and events in defined populations, where the patient is the community.  So in 2004 she started a postdoctoral fellowship at the National Cancer Institute in Bethesda, Maryland.  It was a three year fellowship that also included a Master’s in Public Health focused on epidemiology and biostatistics.  Ellen became quite the expert in analyzing large datasets and eventually decided to bring her clinical and quantitative skills back to Pittsburgh.  First, as a behavioral scientist working at the RAND Corporation. 

Mike:  What was some of the focus of the work you did at RAND?

Ellen: So that was in 2007, not that long after 9/11 and RAND was doing a lot of work and RAND have a lot of funding from the government and then lots of other places.  I worked in the health unit within Rand and RAND and has multiple units but I was anchored in the health unit.  I did a lot of work on risk communication and emergency preparedness from a behavioral science standpoint. I did a lot of work on military mental health and was able to begin overtime to build a portfolio of work in cancer survivorship through the Livestrong Foundation initially the Lance Armstrong Foundation but I worked with them through their transition to becoming the Livestrong Foundation and loved working at RAND. It's an incredible environment full of very bright people doing very interesting work, but after about the third year I was there and I’d been able again to kind of build up a portfolio of work and cancer survivorship I realized that I really wanted to focus on cancer survivorship and that I wanted to work in a clinical environment. I missed clinical work, I hadn't seen patients as a psychotherapist at that point for about 3 or 4 years, I guess more like 5 years actually, wanted to get back into a clinical environment, really wanted to focus full-time on cancer and at around that same time and opportunity opened up at the University of Pittsburgh, a faculty position in the Department of Psychiatry but working at the Cancer Center in the biobehavioral oncology group and so made the decision in 2010 to leave RAND and to join the faculty at Pitt and to work at the Cancer Center where I started to write grants and try to generate funding and building a body of work focused on digital health and use of digital tools for cancer prevention and control and also saw patients one or two days a week and during that time became a licensed clinical psychologist which I hadn't previously done before. I used hypnosis a lot in my clinical practice to help people quit smoking, which was a modality that I've been fortunate to be trained in graduate school and there are a lot of different ways you can talk about what this is.  The way I've always thought about hypnosis has you were with someone you try to get their consciousness into a state that is so kind of relaxed that they're very susceptible to suggestion that you might give to them during that state, suggestions like smoking you know is not something that they want to do any more that quitting smoking might be easier than they think that you know about all kinds of different things and evidence-based scripts around how to help people quit smoking using hypnosis and the general idea is that because I can't be there with that person all the time reminding them of their commitment to quit smoking that the experience of hypnosis will let these suggestions rise to their level of conscious awareness throughout the day at any point in time and then it occurred to me around that same time that another way to do that was through a mobile device.  Your phone based on the way you use it and the different sensors embedded in a smartphone actually knows quite a lot about your behavioral patterns and I wasn't the only person thinking about that.  I'm always surprised frankly at how long it took the field to sort of recognize that mobile devices could be used to provide real-time intervention because for a long time before people started writing about that really kind of like in 2009 or 2010 behavioral scientists had been using mobile devices to get real-time assessment but for reasons that still kind of just baffle me no one had said oh why don't we go ahead and also use this device to provide real-time intervention. So instead of like hanging my hat only on hypnosis I thought you know what if we could use a mobile device to give people intervention in real time when they need it because behavior change is really a real time game.  I can have willpower, commitment, accountability. I can say I am not going to engage in this behavior anymore, but there are so many contextual factors kind of internal to my emotions and cognitions and external in the environment that threaten that commitment and those threats occur in real time, they are to some extent predictable. So it's the area that was really ripe for innovation and I thought that technology can facilitate a new way of delivering intervention that might be better suited to kind of the mechanisms of health behavior change and so I wrote a grant to the NIH called the new innovator award and it was a 10-page grant proposal that wasn't like a typical grant proposal was really a proposal about you and your idea. So I threw my hat in the ring and I made it to the first round of cuts so was finalist in still a relatively big pool but ultimately it wasn't funded and so I took that proposal and I turned it into a proposal to the clinical research Scholars KL2 to program at the University of Pittsburgh and that was funded and so then I had some money and some protective time to pursue this idea and over the course of that build a prototype and tested a prototype of a context-aware mobile application for smoking cessation that we called QuitNinja.

Mike: Cigarette smoking rates in the United States have steadily decreased over the past couple decades, however, there has been a recent rise in the use of e-cigarettes or vaping, specifically among teens, which makes digital tools like QuitNinja an important resource to help combat addiction. In 2012, Ellen was selected as one of the few Clinical Research KL2 Scholars, which is a highly competitive training award and multidisciplinary career development program offered by the Institute for Clinical Research Education.   Two years later, she won the inaugural Pitt Innovation Challenge or PInCh award which brought even more visibility to her translational research and innovative work.  Not long after winning the PInCh award, Ellen was recruited by the UPMC Health Plan for a new position focusing on the intersection of population health and digital health.  She wasn’t looking to make a career change, although always open to having a conversation and ultimately saw an opportunity to have an impact at a large scale.   

Ellen:  One of the things that I often tell people if they ask me for career advice generally is that you need to understand what your own personal needs are as they relate to how close or far away you're willing to be from a target population that you're trying to serve.  That's kind of predicated on the idea that you're in a career of service.  Not everybody is and that's okay, but I know for me that my career is about being of service to some target population and for me that target population is people who are struggling with or trying to prevent illness. I worked at the National Cancer Institute where I was extremely far away from that target population. I was working with national survey data that had a replicate weight data and so it would be like 6,000 real people but then a bunch of replicates of those people not even real people just statistical replicates of them to arrive at nationally-representative statistics and estimates. So far away from actual people, but working at that level of affords you levers of intervention that are kind of like policy-level levers that are hugely you know impactful.  I worked at the Cancer Institute where I was in a room with my target population you know one on one for 50 minutes at a time working as a psychotherapist.  I was really very close to my target population and that's incredibly fulfilling in lots of ways, but difficult to achieve scale.  So the thing that really appealed to me about working here in the insurance services division is that for me it's like exactly the right balance.  I am working to help support the health and well-being of millions of members of the health plan. I have spoken on the phone with or directly interacted with those members at times. I have worked on initiatives that affect huge percentages of the population.  So for me I need a little bit of both and this was a really good setting to achieve that balance and was just also very interested in getting exposed to a new environment, working more in the context of the business of healthcare delivery and health insurance. I wanted to learn more about that, I think I'm still learning about that it's incredibly complex.  Donna Keyser was here your my colleague who I love working with a RAND and I knew I'd get to work with Donna again and have met and continue to work with some of the best collaborators and colleagues of my career here at the health plan.

Mike: So being able to see the impact that you're having but also at a scale to have a wider impact or broader impact?

Ellen: Yes, and even I would say the opportunity to have impact at scale which is does not come easily but to even have the opportunity to pursue it is enough for me to be really very happy in what I'm doing.

Mike: What is pinksocks? I've seen on social media a lot of things related to this.  What is it, what is it about?

Ellen: Pinksocks life. Inc is a nonprofit organization that is a global community about a hundred thousand people all around the world who wear actual pink socks or if your a person like me who often has high heels on and it's not quite ready to delve into a rocking socks and high heels, there are pink socks pins there are medallions there are stickers and I have a lot of my things kind of tagged with the pink socks sticker. The organization is simply a nonprofit that is focused on promoting awareness of enacting value of connection, kindness, and empathy. But for me what has been so appealing about it and I guess why I feel so committed to the organization is that it’s an incredible example of how the connectivity that exists today can be used to create opportunity for authentic connection. We're really swimming in connectivity today, but I would argue that we actually have a lot of scarcity when it comes to connection and we can use that connectivity to promote authentic connection and the pink socks community does that over and over and over again. So modern Life Is so fast-paced and there are so many ways I think that we haven't really kind of caught up in our socio-cultural evolution to the ways that technology has changed life whether it be the information were exposed to or the means by which we have to communicate with one another and to me pinksocks is really about returning to some core first principles of kindness and connection and the socks are a visual cue that kind of make you stop and remember that kindness and connection are important, that help you remember that maybe you should pick up the phone and hear a person's voice instead of shooting them a text, maybe you should wait for a little bit longer in line so that you can talk to someone standing with you and hear the story that they want to tell you that we're kind of all in this together and if we're willing to rely on each other the world could be a very different place in many ways than it is right now.  A lot of this I think it's also kind of happily part of the national dialogue right now because of the new Mister Rogers movie.  If you haven't seen that the film, not the documentary which is amazing, but the film that Tom Hanks is in portraying Mister Rogers a moment in that movie that reminds me very much of some of the core principles of the pink socks movement is when Mister Rogers is speaking to the reporter who's going to write a story about him and on the phone he says to the reporter, “Do you know what the most important thing in the world to me is right now?” And the reporter says no, and Mister Rogers says, “Talking to you.”  You know like what if we put connection at the heart of everything we did? Right now what if I sort of really tried to settle into the idea that the most important thing in the world to me right now is talking to you Mike?  Listening to the questions that you're asking me and sharing my answers and being grateful to share this space in this time with you.  It seems almost so obvious but unfortunately it isn't and so I have a bunch of my stuff has pink socks stickers on and I wear my socks I wear my pins as a practice to remember that to prioritize that to acknowledge that it is a practice it doesn't happen naturally in day-to-day life but it doesn't have to be that way it can be something that we all do every day.

Mike: The nonprofit pinksocks life was in founded in 2015 by healthcare executive and entrepreneur Nick Adkins.   Rather than handing out a business card, a pair of distinctive, mustache adorned pink socks is gifted as a way to help foster human connection.  The result?  A growing global community of pink socks wearing people focused on empathy, caring, and love. 
Mike: Does your daughter have similar interests as yourself in terms of where she's at in her education?

Ellen: She's 10, but I will say that that my daughter Lou is superior to me in every way and that brings me a great amount of joy and satisfaction. I have a friend from high school who I reconnected with recently and he's met my daughter Lou and he was talking about how when I was young when we were young together.  We went to elementary school together all the way through high school. He said you know you were you were so shy and it took you a really long time. I see you're looking surprised.  Everyone is very surprised because yes there was a time in my life where I didn't talk very much or speak up and apparently I will spend the rest of my time on Earth making up for that.  But I was very very shy really until I would say probably not so much about midway through high school.  I didn't really become a more extroverted person really until my late twenties for her early thirties and he was saying it took you a long time to come out of your shell but Lou is like you are now.  And it's true, I mean my daughter's first word was Hi. I observe her as she becomes older in developmentally sort of expectable ways to be a little bit more self-conscious than she maybe was then when she was younger to be a little bit more socially aware in ways that kind of our seem a little bit inhibiting but she is not shy she is so of the world and interested in the world and resilience and loving and giving and hilarious. I can totally see Lou having an interest in a profession like psychology or a profession like teaching.  I asked her once several years ago what she wanted to be when she grew she said a lifeguard and I haven't asked her since then.
Mike:  If you could select one word to describe yourself what would that one word?
Ellen: I would say loving

Mike: I can see that based on the things you’ve described and obviously the passion to describe the round pink socks and the focus of that movement.

Ellen:  Thank you. 

Mike: Are there any of their particular hobbies in addition to dance these days outside of the work that you do?
Ellen:  I love being exposed to art that's a real need that I have to kind of be in the context of art expo start so try to try to find opportunities to sing and dance and play music as much as possible. My daughter plays guitar so we enjoy doing that together and a colleague of mine here who recently taught me which was a goal I had was like a 2019 was the year I really wanted to nail making pies. So Rosa taught me how to make pies and now I consider myself something of a pie maker. So I've been baking and cooking a lot more recently and I love to ride my bike, I'm a cyclist. I bike commute to work a few days a week and I just really love being on the bike and you know has the added benefit of like being outside which is important to me as well but I do love to ride my bike

Mike: Practice what you preach in terms of health and behaviors. 

Ellen:  I try to. So yes. One of the group's I work with here we have a lot of us are bike commuter as we say you know you got to walk the walk you got a bike the bike and so I do and when I do I think the thing that stands out to me the most is I reflect on how you know I'm not always meeting my physical activity goals. I find it challenging to sometimes in an act these behaviors to do the things that I've committed to do for my health and wellness and then I reflect on how is it is difficult for me who is so well resourced in every way to achieve these goals how difficult it must be for everyone else and so I am very focused on the construct of equity one of the ways that we talked about the mission of the work that my team does here at the health plan is putting healthy choices within equal reach of all people because they are not it is much easier for me to be healthy than it is for most people and so the degree to which we are able to put things in place to move healthy choices closer to people who need equity in their health behavior attempts you know it's something that we take really seriously here in the work that we're doing at the health plan

Ellen:  When you asked me what word I would use to describe myself, I tried to come up with one word that would represent this, but I wasn’t able to come up with one word.  But I will say that I look for opportunities to challenge convention particularly in my professional life perhaps. 

Asking to bring my 6 year old daughter to the picture that would accompany the article in the Innovation Institute magazine.  I don’t feel like my integrity or value proposition or identity as a professional should in anyway be threatened by my identity as a mother.  And I look for opportunities to push back and say absolutely not.  I show up sometimes to professional events when it sort  started ends up being the most convenient way to do so in my cycling gear if I'm coming in to a meeting or and I've cycled to work drive cycle to an after-work event and I have I caught heat for doing that and I thought you know I am refusing to participate in a culture that assumes that I can't be physically active and a complete consummate professional and maybe you don't think my attire is professional I don't think that my attire has anything to do with my professionalism and I also don't think that there's anything wrong with my pushing back against being in a profession that requires me to sit on my behind for about eight hours a day.  Yeah I get out there and I get physically active and I figure out how to fit into my life because it doesn't fit particularly well in the modern life and I prioritize my health and wellness in fact it is what enables me to be the productive and active professional that I am. So I often look for opportunities I mean I have a tagline in the signature of my email that says lead with love you know and maybe some people don't think that love is a construct has any place in professional life I strongly disagree and so I often look for maybe instigator would have been the other word you could say describes me and these are small acts of rebellion they don't they're not even particularly courageous people do much more courageous things than what I've just talked about it and I'm so privileged in almost every way that I haven't had to be particularly rebellious most of what I've accomplished has not been is not required me to overcome challenges that so many other people typically face and perhaps in recognition of that I seek to advocate for ideas or advancements that I think are important for people as we've kind of all seek to navigate the world we live in and do our best to achieve our own goals and support people around us.

Mike:  Ellen Beckjord, PhD MPH – Associate Vice President of Population Health and Clinical Affairs at the UPMC Health Plan.  And by the way, Ellen returned to the PInCh stage in 2019, five years after winning the award.  Not as a contestant though, but instead as a final judge ….. 

That’s our show.  Thank you for listening to the Products of Pittsburgh. Be sure to check out our website at ctsi.pitt.edu/podcast to hear more episodes as well as learn about CTSI programs and services.    I’m Mike Flock along with Zach Ferguson, until next time on the Products of Pittsburgh.