Using Bridging Strategies to Improve Health

Transcription

1 Using Bridging Strategies to Improve Health To hear the audio portion of this webinar: ; Access code: # Webinar for Small Health Care Provider Quality Improvement and Delta States grantees Presented on behalf of the Federal Office of Rural Health Policy April 21, 2015

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4 Click to edit Master text styles Second level Third level Fourth level» Fifth level Chris Parker MBBS, MPH Georgia Health Policy Center 4

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8 From: A Population Health Framework for Setting National and State Health Goals JAMA. 2008;299(17): doi: /jama Click to edit Master text styles Second level Third level Fourth level» Fifth level The right side conceptualizes broad population health outcomes. The left side represents the determinants of population health outcomes. The quadrants in the outcomes component are arbitrarily sized equally, as are both the disparity domains within outcomes and the determinant categories. QOL indicates quality of life. Date 8 of download: 4/20/2015 Copyright 2015 American Medical Association. All rights reserved.

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11 Public Health Click to edit Master text styles Social Environment Second level Third level Policymakers Supports for healthy behaviors and return to wellness Fourth level Community and clinical preventive linkages» Fifth level Access to coordinated, Physical quality care Environment Collection and exchange of Public data and information Physical Environment Payors Other clinical and nonclinical providers 11 Policy Environment Hospitals/ Health Systems

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14 In your opinion, which of the following pictures best represents the type of bridge that will be necessary to link health and healthcare in your area? Click to edit Master text styles A Second level Third level Fourth level» Fifth level B C D 14

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16 Bridging Strategies to Improve Health: Community Centered Health Homes Demonstration Project Eric T Baumgartner, MD, MPH TA Provider Rural Health Technical Assistance Program Georgia Health Policy Center

17 Let s Hear from You Now that you have heard a little bit about bridging strategies, how many public health/health care integration activities does your organization do at present? o A lot o Fair amount o A little o None at all o I m still not sufficiently clear on what bridging means

18 Representative Attributes of High Performing Clinics - Engaged Leadership - Patient Centered Medical Home Recognition - Meaningful Use of EMR - Empanelment - Clinical Decision Support - Transitions of Care - Patient Registries - Team-Based Care - Health Information Exchange - Eligibility Screening & Enrollment - Pharmacy Assistance - UDS Data Use Optimization - Operational Efficiency - Financial Management - Chronic Disease Management - Medication Reconciliation - Performance Improvement & Measurement - Mental & Behavioral Health Integration - Environmental & Occupational Health Integration 18

19 Poll #1 How inclined or currently active are you in engaging in public/community health activities beyond services integration? o Very much o Somewhat o Slightly o Not at all o I m still not sufficiently clear on what public/community health activities means

20 You can do more than bail out these medical disasters after they have occurred go upstream from medical care to forge instruments of social change that will prevent such disasters from occurring in the first place. Jack Geiger, MD Photo Credit: Daniel Bernstein

21 Elements of Community Health EQUITABLE OPPORTUNITY PLACE Racial justice Jobs & local ownership Education What s sold & how it s promoted Look, feel & safety Parks & open space Getting around Housing Air, water, soil Arts & culture PEOPLE HEALTH CARE SERVICES Preventative services Access Treatment quality, disease management, in-patient services, & alternative medicine Cultural competence Emergency response Social networks & trust Participation & willingness to act for the common good Norms/Costumbres

22 Community-Centered Health Homes Patient-Centered Health Homes Medical Homes

23 Community Prevention Influence Medicine Population Medicine Population Health PCMH, ACO CCHH, ACC

24 Health Care and Health Equity Convergence Unprecedented merging of interests from the health care financing and delivery sectors with those engaged in creating the conditions for health equity and resilient communities. Primary care is at the foundation for both domains.

25 Existing Clinician Skills PATIENT INTAKE DIAGNOSIS TREATMENT Transferable to Community Prevention INQUIRY Capture and identify population level health trends ANALYSIS Analyze and prioritize relevant community conditions ACTION Engage in advocacy and translate clinic priorities into action

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27 Inquiry: Housing Questionnaire

28 Clinical Quality Initiative vs CCHH Clinical Quality Focus is on patients Clinic sets priorities Clinic decides strategies Clinic directs inquiry, analytics and action Action more limited to services only Partners generally clinical and social services chosen by clinic Clinic quality initiatives can be directly aligned with/ adjunctive to community agenda CCHH Focus on residents Community sets priorities Community decides strategies Clinic supports community throughout inquiry, analytics and action Action emphasizes community systems, policy and environmental change Community vets partners assuring responsible inquiry, analytics and action (policy and environmental change). Partners are civic engagement organizations or support them Clinic role in CCHH can be directly aligned with/ adjunctive to clinic quality initiatives

29 LPHI CCHH Demonstration Project An initiative of the Primary Care Capacity Project of the Gulf Region Health Outreach Program of the Deepwater Horizon Medical Benefits Class Action Settlement with BP. In partnership with the Prevention Institute Four FQHC s along central Gulf Coast 2 years Funding and TA Evaluation

30 LPHI CCHH Demonstration Project The PCCP CCHH Demonstration Project aims to advance health equity and community resiliency by enhancing the capacity of selected health center sites to take the next step beyond the patient centered medical home model and serve as trusted, effective, partners in community prevention.

31 Catalysts for Change An ecological system approach can more effectively address a chronic public health problem... health centers can function as catalysts of community and economic development. -Liou and Hirota on the Revive Chinatown! campaign, as described in From Pedestrian Safety to Environmental Justice: The Evolution of a Chinatown Community Campaign Spring 2005

32 Representative Attributes of High Performing Clinics - Engaged Leadership - Patient Centered Medical Home Recognition - Meaningful Use of EMR - Empanelment - Clinical Decision Support - Transitions of Care - Patient Registries - Team-Based Care - Health Information Exchange - Eligibility Screening & Enrollment - Pharmacy Assistance - UDS Data Use Optimization - Operational Efficiency - Financial Management - Chronic Disease Management - Medication Reconciliation - Performance Improvement & Measurement - Mental & Behavioral Health Integration - Environmental & Occupational Health Integration - Community Centered Health Home 32

33 Let s Discuss How are health agencies in your own communities moving beyond clinical care to engage around prevention and population health? What conversations are happening and who is involved? What bridges are being built (financial, data, care coordination, communication, etc.)

34 Questions? Slides available at under the Resources Tab - Training Within a day you will receive a very brief evaluation survey

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