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Archive for the ‘Public Health’ Category

Innovative partnerships among hospitals, public  health departments, and community organizations are addressing root causes of local health problems, according to a new report from Advisory Board that outlines best practices from 18 communities that have begun forming effective coalitions under the BUILD Health Challenge.

By 2019, Medicare and Medicaid reforms will affect physician payments based on resource use and total costs of care, prompting hospitals and health systems to focus more strongly than ever on community health as a whole. According to research published in The New England Journal of Medicine, up to 80-90% of health status is attributable to factors other than clinical care. The vast majority of physicians cite socioeconomic conditions such as lower income or education, environmental hazards, and lack of access to healthy food, safe housing, and transportation as leading directly to poorer health outcomes, but only 20% of physicians are confident in their ability to address these problems, according to a study conducted on behalf of the Robert Wood Johnson Foundation.

Hospitals and health systems have struggled to build partnerships that would improve health outcomes and generate significant savings. The new report – Building the Business Case for Community Partnership: Lessons from the BUILD Health Challenge – identifies four critical steps to promote population health management and collaboration across the continuum of care: strongly engage hospital or health system leadership; prioritize initial focus on a subset of initiatives that will be iterated; strengthen partnerships to build on the skillsets, relationships, data, or tools each partner brings; and design seamless screening and referral protocols.

The BUILD initiative, cofounded by Advisory Board to promote partnerships that are Bold, Upstream, Integrated, Local, and Data-Driven, started with grants to 18 communities in 2015. This analysis of the 18 funded communities reinforced the belief that transforming health outcomes requires a carefully coordinated effort to eliminate silos.

The report found that engaging hospital or health system leadership helps garner the executive buy-in and secure the resources needed for success. Since many health care organizations have multiple initiatives occurring at once, the report suggests that hospital and health system leaders recognize that the process is an iterative one and begin by focusing on a few prioritized services.

The research also found that successful initiatives leveraged the unique strengths of community organizations to extend the reach of the health care team. The recommended final step – design seamless screening and referral protocols – helps health care providers ensure timely follow-through, which also improves patient and provider satisfaction.

Data demonstrate the need for such coordinated efforts to address “upstream” health factors. For example, while people are 2.9 times as likely to have poor overall health if they are members of a food-insecure household, evidence shows that programmatic approaches can help.  Research from the Center for Effective Government showed that every $1 spent on Meals on Wheels produced $50 in Medicaid savings. Similarly, offering housing and supportive services to high-cost homeless individuals produces an annual per-person health care savings of $8,000, according to a study in Health Affairs.

BUILD Health Challenge Open for New Grant Applications
The BUILD Health Challenge will fund additional grants for at least 17 more communities in 2017. The Round 1 application period for funding closes on February 21. Interested hospitals and health systems can attend informational webinars on December 12 or 15 or January 31.

 

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I’ve been reading and hearing a lot about Public Health 3.0. If I’m hearing a lot about it, I figure others must be as well. What is it and why is it important? In this blog post I plan to address those questions and provide links to resources that can given you a greater depth of information on the subject.

My understanding of Public Health 3.0, in very simple terms, is that it is a reaction to the recognition that addressing the social determinants of health will require the involvement of an increased number of stakeholders, pooling of resources and multi-sector collaboration, leading to greater innovation in the ways we address these challenges to population health improvement.

The key components of Public Health 3.0 are enhanced public health leadership in the community, broad engagement with partners across multiple sectors, an accreditation process that includes Public Health 3.0 elements, more timely and locally relevant data, new metrics of community health and more flexible public health funding. The HHS Office of the Assistant Secretary for Health is leading the Public Health 3.0 initiative, which will build off ongoing Healthy People 2020 efforts that encourage collaboration across sectors and communities.” (Source: The Nation’s Health, “Social determinants take center stage in call for Public Health 3.0”)

On the Office of Disease Prevention and Health Promotion website (Health.gov), the Office of the Assistant Secretary for Health on Public Health 3.0 has established a blog (Public Health 3.0 in Action) to provide regular updates showcasing examples of Public Health 3.0. The blog take Public Health 3.0 out of the theoretical realm, giving current real world examples of this approach in practice.

Why do we need Public Health 3.0? Why is it important?

Despite public health’s increasing focus on how environments impact health, our ZIP codes remain a more accurate determinant of health than our genetic codes. As a society, we have a collective responsibility to create conditions that allow all members of our communities to make healthy choices. And yet public health initiatives often exist in silos, resulting in missed opportunities to leverage the critical knowledge of communities to improve health at the local level.” (Source: HealthyPeople.gov)

The historic lack of collaboration between public health organizations, healthcare systems, community organization and private enterprise has always puzzled me. Public Health 3.0 seeks to change that prevailing paradigm by calling for cross-sector collaboration and innovative solutions. It’s an exciting initiative that is provoking conversations and action!

For more information on Pubic Health 3.0, here are some resources I recommend:

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Early this week, my colleague, Kate Gillmer, and I were invited by the Centers for Disease Control and Prevention (CDC) to sit in on a webinar where they formally launched their new initiative – Health Impact in 5 Years (HI-5). The HI-5 or “High-Five” initiative highlights a list of non-clinical, community-wide approaches with a proven track record. Each intervention listed is associated with improved health within five years and is reported to be cost-effective or cost-saving over the lifetime of the population or even earlier. Public and private organizations can use this list to quickly assess the scientific evidence for short-term health outcomes and overall cost impacts of community-wide approaches.

With its emphasis on community-wide approaches, HI-5 complements CDC’s 6|18 Initiative, which focuses on 18 traditional and innovative clinical interventions for six high-burden conditions. Together, HI-5 and 6|18 provide public health, health care, and a diverse array of other sectors with evidence across the continuum of prevention and care.

As you can see in the graphic below, HI-5 is focused on non-clinical, community-wide public health interventions for population health improvement – those interventions that have the greatest potential for impact on health because they reach entire populations of people at once and require less individual effort than clinical interventions.

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HI-5 highlights two types of public health interventions: 1) Those that help to change the context by making the healthy choice easier, and 2) interventions addressing the social determinants of health.

Interventions Changing the Context:

School-Based Programs to Increase Physical Activity
School-Based Violence Prevention
Safe Routes to School
Motorcycle Injury Prevention
Tobacco Control Interventions
Access to Clean Syringes
Pricing Strategies for Alcohol Products
Multi-Component Worksite Obesity Prevention

Interventions Addressing the Social Determinants of Health:

Early Childhood Education
Clean Diesel Bus Fleets
Public Transportation: System Introduction or Expansion
Home Improvement Loans and Grants
Earned Income Tax Credits
Water Fluoridation

For more information on the HI-5 initiative, go to http://www.cdc.gov/HI5.

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Screen Shot 2016-05-20 at 7.55.57 AMAfter a day and a half of the Practical Playbook National Meeting, I am blown away by the activity on Twitter. Heading into the conference, I had no idea what to expect. The people attending this conference are not marketers (the folks I usually interact with on social media). For the most part, these are public health professionals, people who work for community organizations and government agencies, foundation professionals and clinicians employed by health systems. Let me tell you, the digital engagement has been impressive.

Heading into our the final day of #PPBMeeting, there have been 195 individuals Tweeting with the conference hashtag. I believe there are 330+ people attending the National Meeting. These individuals have generated 1,616 Tweets for a total of 2,391,582 potential impressions. See some of the Twitter analytics below, provided by Symplur.

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On Sunday morning I’m heading to Bethesda, Maryland to attend the Practical Playbook National Meeting (#PPBMeeting). It’s a conference dedicated to bringing public health and primary care professionals together, facilitating collaboration, for the purpose of driving improvements in population health. Jennings‘ digital engagement staff is part of the social media team for the conference. We’ll be Tweeting (@pracplaybook, @JenningsHealth, @dandunlop, @physicianfocus) live from all the sessions, sharing content in real time. We’ll also maintain a storify to curate the social media content. I’ll post that link as soon as it is available.

Here’s some background information on the National Meeting:

“The Practical Playbook National Meeting will be a milestone event towards advancing robust collaborations that improve population health. By bringing together key stakeholders from across sectors – representing professional associations, community organizations, government agencies and academic institutions – the National Meeting will help to catalyze a national movement, accelerate collaborations by fostering skill development, and connect like-minded individuals and organizations to facilitate the exchange of ideas to drive population health improvement.” (PPB National Meeting Website)

We’ll be on site Sunday through Tuesday. Please follow along using the conference hashtag: #PPBMeeting. I’m very excited to be a part of this conversation over the next few days. This is exactly where our focus needs to be. I hope you’ll join us. For more information on the Practical Playbook, go to https://www.practicalplaybook.org/.

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Screen Shot 2016-05-02 at 11.47.25 AMJust last week, one of my firm’s clients, The Practical Playbook, launched a LinkedIn Group dedicated to the sharing of resources and facilitation of conversations around population health improvement. The group is titled: “Working Together for Population Health.” For those of you who now work at hospitals and health systems across the country, population health management is in our future, and is a reality today for many of us. Here’s the group description from LinkedIn:

“Public health and primary care are natural, foundational partners for addressing the challenges in today’s health system. Together, along with other partners, we can improve population health. The Practical Playbook will share guidance and lead discussions to advance population health partnerships.”

I invite you to head over to the LinkedIn Group and introduce yourself. We look forward to your input. By joining the discussion group, you will:

  • Find practical, actionable advice to help you identify potential partners and implement projects
  • Ask questions and share resources with a diverse group of colleagues
  • Read the latest thought leadership from collaboration experts
  • Connect with colleagues and gain insight into other sectors

 

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For the last year my firm has worked with the team from A Practical Playbook to build awareness around the understanding that population health improvement needs to be driven by collaboration between primary care and public health. The separation of primary care and public health in the United States has been damaging and self-perpetuating. Given all that we need to achieve within the healthcare arena, we cannot keep working in silos; there is so much to be gained from collaboration. Here’s a link to the Storify of a recent #HCLDR Twitter Chat on the subject that was moderated by Brian Castrucci, one of The Practical Playbook editors.

The big news is that The Practical Playbook – until now primarily an online resource – is now available as book, in paper or electronic form. The Practical Playbook offers professionals in primary care and public health a roadmap to integrating their work with the larger goals of population health.

Comprising case studies, practical recommendations, data resources, and commentaries from national leaders on both sides, The Practical Playbook is the new benchmark for primary care and public health practitioners working to improve population health. The book gives clear guidance to clinicians on how to find and work effectively with community partners, and advice to public health practitioners on how to find the key leaders and work effectively with clinical groups.

To visit Oxford University Press and purchase the book, use this link.

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