Jason Burke, managing director & chief strategist for the SAS Center for Health Analytics & Insights, recently toured Carolina Advanced Health (CAH), a collaborative venture between UNC Health Care and Blue Cross and Blue Shield of North Carolina. The practice brings together a comprehensive and coordinated team of primary care physicians and other health care providers, including professionals trained in internal medicine, family medicine, behavioral health, nutrition, medication management, laboratory services and care management. Burke’s blog post focuses on how the combination of the team and technology at CAH make it an innovative model for care. You can read his post here.

The Agency for Healthcare Research and Quality (AHRQ) recently released its 2011 State Snapshots, which provide state-level performance overviews on treating cancer, diabetes, maternal and child disorders, heart disease and other diagnoses. According to the data, North Carolina performs well in areas like preventative care and acute care. Quality of hospital care also remains on track with national averages. In clinical areas, our state has improved respiratory disease and cancer care since baseline year data was collected. You can view North Carolina’s full state snapshot here.

I am proud of North Carolina’s performance in these categories and I commend the work of our state’s providers. However, there is still much to be done to improve the quality of and access to care across our state. For instance, we lag behind other states in diabetes and heart disease measures. According to the Centers for Disease Control, nearly 30 percent of North Carolinians were considered obese in 2010 – making them more susceptible to diabetes and heart disease. As the needs of our state increase, the care we provide must change to meet the growing demand for services.

At UNC Health Care, we are working with other organizations and providers across the state to meet the growing demand for services and care. By improving access to quality public health services, training the next generation of physicians and conducting research, we hope to mitigate the challenges our state continues to face. The AHRQ snapshots provide a helpful benchmark for improvement as we move forward.

One critical tenet of UNC Health Care’s mission is ensuring that patients have access to excellent and affordable care. The Supreme Court’s action today will continue to help make that possible, as the almost one in five North Carolinians who do not have health care insurance will now have coverage. Evidence clearly shows that those who do not have insurance are less healthy than those who do. I am hopeful this decision will lead to a healthier and more productive North Carolina.

Health care providers across the nation, including UNC Health Care, have been reacting to the realities in health care through industry consolidation, partnerships among hospitals, physicians and other health professionals and an increased emphasis on shared responsibility for improving health outcomes and reducing costs.

I recently was interviewed by the People’s Pharmacy about the state of health care in our country. We discussed American medical myths and ways health care access and delivery could potentially be improved. You can listen to the interview here.

On Sunday afternoon, North Carolina’s starting point guard, Kendall Marshall, suffered a fractured wrist during the Tar Heels’ 87-73 win over Creighton. The Tar Heels advanced to the Sweet 16 and will play Ohio University on Friday, but even after a successful surgery on Monday, it is questionable whether Marshall will play. An anonymous student started a Twitter account on Monday to support Marshall, called @PassFir5t, and asked fans to write a “5″ on their right wrists, and send photos in support of Marshall and his recovery. So from my wrist to yours, Kendall, here’s to a speedy recovery and good luck to the Tar Heels this weekend.

Our flight from Kigali, Rwanda to Brussels was uneventful and pleasant.

In addition to our week in Africa, we added on two days in Europe.

We rented a car in Brussels and drove over to Normandy.

I’ve long wanted to tour the D-Day sites, and it was everything I had thought it would be, and more.

We had an all day tour with a very experienced guide, and Will and I learned a lot about this important chapter in American and world history.

The D-Day landing, on June 6, 1944, is something I’ve read a lot about and seen in several movies.

Recently I read a new book, D-Day, by Antony Beevor — I heartily recommend it.

And we had planned to see Saving Private Ryan again, but didn’t get that done — but we will soon.

Will and I saw Arromanches, where some of the key events occurred, and then Omaha Beach — the most celebrated of the landing spots.

The beach is very broad — and it was incredible to stand there and imagine running up onto the shore, and trying to find cover from the shots raining down.

We then went to the American Cemetery — an awesome and impressive spot — with rows and rows of crosses.

Finally went went to Pointe du Hoc, where the American Rangers scaled the cliffs — an act of heroism that is almost beyond belief.

I strongly recommend that you do such a tour if you possibly can. We are changed because of this experience.

Then we drove back to Brussels and flew home — arriving safe and sound.

Will and I are already talking about the 2012 trip — lots of discussion and planning to come.

Stay tuned for more!

Our final two days here in Rwanda have been very worthwhile and enjoyable.

Yesterday we spent time in doors — it rained VERY hard most of the afternoon.

It was actually pleasant to sit and read and listen to the rain.

Last evening we had dinner with Bishop Nathan Gasatura and his wife Florence in their home.

[check out the pictures at www.flickr.com/photos/billroper]

Will and I had enjoyed their hospitality when we were here in 2010.

This time we were able to meet all four of their children — David (24), Daniel (22), Darius (20), and Deborah (17).

They are each bright and engaging.

Also with us at dinner were Dr. Patrick Kyamanywa, whom I met last year, and with whom I visited in June in Durham, NC.

He is dean of the School of Medicine at the National University of Rwanda — and he and I have hit it off quickly and well.

His two young children were at dinner last evening.

The house full of people made for a very good and lively time.

Today we checked out of the Anglican Guesthouse, where we have been staying in Butare, and went to see two “factories.”

One is a tinnery near Butare, where we saw them make beautiful pieces with tin.

And we went to Maraba Coffee, also nearby, where we saw them processing and sorting coffee beans.

Then we drove to Kigali, had lunch and then John, our driver, took us by to see his family.

His very modest home was filled with joy by him, his lovely wife Aline and their two young children, Samuel (5) and Elijah (2).

Each of them let Will and me hold him, but Elijah was not at all sure of us for a while.

We are now at Kigali International Airport — about to fly overnight to Brussels.

It has been an amazing week here.

Rwanda is a beautiful country with a heart-rending past, and a bright future.

We met wonderful people and learned a great deal.

Will and I are already planning our 2012 trip — BACK TO RWANDA!

Stay tuned.

Over the weekend I had several very worthwhile experiences.

I got some chores done in Kigali, and then had dinner in the home of new friends, Cal and Mimi Wilson.

Cal is a family medicine doctor and a faculty member at the University of Colorado Denver.

He is UCD Director of the Capacity Building Project in Medical Education in Rwanda, which is a consortium of several US med schools working to strengthen medical education here.

He also directs a family medicine residency program in Rwanda — and we have several mutual friends.

Cal and Mimi have done similar work in Jordan and Ecuador in the past.

After church on Sunday, we drove to Nyanza, about two hours south of Kigali, to visit with Godfrey Kalema and his wife Diane.

We had met last year when we were in Rwanda.

Godfrey is a high school teacher who started a non-profit group in 2003 called the Dufatanye Cooperative.

It provides a place to live and some opportunity for income for extremely poor people who are HIV positive.

Currently seventy seven people live there, most of whom are on anti-retroviral therapy.

Will had spent the past two days there — working at the Cooperative.

After lunch at Godfrey and Diane’s house, we went to Dufatanye.

You can see pictures of our visit at www.flickr.com/photos/billroper.

The members of the coop welcomed us with song and dance — and Will and even I got into it!

Then there was some speechmaking and translating, ending with their giving us gifts they had made, woven grass baskets and other items.

We walked around and saw their gardens — and then their brick and roof tile making activities. Will had worked on this and did cabbage planting too.

He had a great time there — and told the group that he looks forward to coming back next year!

We Americans have so much to be grateful for — and so much to learn from others. I was really moved by my time at Dufatanye.

We are now at Butare — a bit further south. It is the third largest city in Rwanda, and the home of the National University of Rwanda, so think of it as the Chapel Hill of this country.

More to come, stay tuned!

This morning we got to visit Sonrise School in Ruhengeri.

This is the school that Joel attends and Theoneste used to attend.

The two of them took us around the high school, which has about 550 students, mostly boarding.

We learned that Sonrise has one of the top records in Rwanda for students passing the national exam.

That’s a tribute to the dedicated teachers and the rigorous curriculum.

Part of the fun of the day was getting to visit again with Moses, the young Rwandan boy who lives with the Kings.

Moses is about to turn eight, and he is quite interactive — I took several pictures of him (at his request) and he used my camera to take pictures of Will and of me.

He also attends Sonrise — in the primary school.

This afternoon we drove back to Kigali — about two hours.

There are bicycles everywhere in Rwanda — and we saw an ingenious way of climbing a tall hill on a bike — by holding on to a truck.

Will and Theoneste have gone on to Nyanza, where they will spend the next two days.

They will be at the Dufatanye Cooperative, the non-profit organization that provides a place to live and some income for people with HIV/AIDS.

Will worked there last year on our visit — where he learned how to make bricks.

More to come!

Today has been a full and rewarding day.

After a quick trip with our young friend Theoneste for him to see a local dentist, we headed out for Ruhengeri (or Musanze as it is now known officially).

It is about 70 miles, but it took us more than two hours, as there is quite a lot of road repair work underway.

Once we arrived, we went to the new home of Drs. Louise and Caleb King.

They used to live and work at Shyira Hospital, but now are in the city of Ruhengeri.

Louise will be teaching in the local family medicine residency program, and Caleb is devoting himself fully to launching a major hydroelectric project in the region.

He has been working part time on this for several years — the first construction phase has been underway since January, and he took us to see it.

About an hour drive out of Ruhengeri the project will divert a small river — the water will run in a canal they are building for 1.4 kilometers, gradually sloping downhill.

At the end, the water will descend almost straight down about 70 meters, in a 70 centimeter pipe — to turbines, which will generate electricity.

When fully built out, the projects Caleb is working on will be able to produce power equivalent to 20 percent of all the power now being produced in Rwanda by all methods.

His company is called “Peace Power and Light.”

I took several pictures that will show you the work — but I currently do not have enough bandwidth to upload them.

Check later at www.flickr.com/photos/billroper.

We had dinner tonight with Pastor Frank and his wife Peace, at the Kings’ home. They are the parents of Joel Gashagaza, the other young Rwandan student we are working with.

Stay tuned!