The Past, Present, & Future of Population Health Research: A National Perspective
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1 The Past, Present, & Future of Population Health Research: A National Perspective LUCY A. SAVITZ, PH.D., MBA AVP, DELIVERY SYSTEM SCIENCE INTERMOUNTAIN HEALTHCARE RESEARCH PROFESSOR, EPIDEMIOLOGY UNIVERSITY OF UTAH ADJUNCT ASSOCIATE PROFESSOR, HPM UNIVERSITY OF NORTH CAROLINA
2 Population Health Defined Kindig & Stoddart defined it as the health outcomes of a group of individuals, including the distribution of such outcomes within the group inclusive of: Health outcomes (shared but accountability difficult) Patterns of health determinants Policies and interventions that link these two 2
3 Changing Paradigm in Considering Health & Wellness The time has finally come for populationbased health principles, philosophy, and methods to be applied in medical education and practice. Ibrahim, Savitz, Carey, Wagner 2001 Ibrahim et al. Population-Based Health Principles in Medical and Public Health Practice, J. Public Health Management Practice, 7(3):75-81, 2001.
4 What does our community want?
5 Life expectancy at birth rises for black men and Hispanics, falls for white women This is the first time in over 20 years that a decline in life expectancy at birth has been observed for any group in the United States, the CDC report notes.
6 Fundamental Operating Presumption Health = Health Care
7 Medicalization of Health
8 Altering Our Perspective $ Hot Risk Population Health Well
9
10 Population Health View Health Health Care
11 Progress in Patient Centric Care
12 Revitalizing/Rethinking the Primary Healthcare System 1 HOUR VS 8,765
13 It takes a lot of really hard work to make Parkinson look this good! My pills for one day. The first column is my early morning dose, the second is for late morning, the third is afternoon, the fourth is early evening and the last column is for late evening.
14 Integrating Primary Care with Other Health & Community Services
15 Moving from Volume to Value We need to think broadly about where to find leverage for achieving a healthier society. We can learn from countries that have created government ministries that marry health and social services. We need to consider not just how much we are spending but how we allocate those resources we are spending. Incentivize collaboration between health care, public health, and social service sectors.
16 Health Care Spending in the U.S.
17 Resolving Tension between Population Health & Individual Health Care Optimizing population health requires determining frequency, cause, and consequences of common medical conditions in a population and devising strategies for dealing with them over the life span. Social factors are stronger determinants of the health of a population s health than health care. Collaboration between public health system, the medical care system, and community resources is key. HC Sox, JAMA, 2013
18 Payment & Population Health Context Three Elements: 1. Commit to collaborate with geographic responsibility 2. Invest in creative and innovative approaches 3. Participate in coordinated efforts to modify causes of disease. Example: Coordinated Care Organizations (CCOs) in Oregon
19 Oregon CCO Examples Bud Clark Commons: integrated housing and health/wellness services using a harm reduction model C-TRAIN: affordable housing + health care, recovery services, and employment assistance Documented cost/utilization reductions (>50%) with reduced mortality & morbidity.
20 7 Drivers for Population Health 1. Align financial models 2. Provide effective health promotion, prevention, and self-management to improve the health and wellness. 3. Measure and monitor what matters. 4. Reduce/eliminate unnecessary care. 5. Meet the majority of health needs with high quality primary care + community-based services. 6. Ensure high quality hospital care transition services. 7. Improving innovation, productivity, and efficiency in the delivery of health services.
21 Develop a system-wide strategy with a harmonized set of patient reported measures (PRMs) Life Course E P I S O D I C Approved 12/22/16
22 Patient Reported Measures Across the lifespan Quality of life Availability of social support Episodic TBD by Clinical Area
23 Social Determinants: Area Deprivation Index (ADI)
24 Example Type 1 Research to Be Done How can we effectively extend the primary care workforce & workflows to meet the needs of the community? Can we successfully employ shared decision making to support collaborative treatment planning & informed choice? What business model optimizes local/regional collaborative health resources planning across health care, social services, and public health? In measuring what matters, how can we advance our understanding of PRMs?
25
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