COMMUNITY ENGAGEMENT REPORT 2014 Working for wellness in our communities COMMUNITY ENGAGEMENT REPORT 2014 PAGE 1
Giving back by giving care IN THE COURSE OF OUR NEARLY 70 YEARS as a health system, Group Health has sought to improve the health of every person we touch. We ve done this by offering coverage options to individuals and families, employer groups, and Medicare recipients. And by providing outstanding care to patients at Group Health Medical Centers and beyond. But there s more to our organization than just providing care to those who enroll in our plans or choose to see our doctors. We also constantly seek to improve the health of the community at large, especially through research, education, and by providing care for those people who, for whatever reason, may not have access to quality care. GROUP HEALTH FOUNDATION We do this by giving of our time, talent, and resources through Group Health Cooperative, Group Health Foundation, and Group Health Research Institute to benefit the underserved in areas where we live and work. Through our investment in programs and research, we extend helping hands and hearts into the community, improving the health of members and neighbors alike. GROUP HEALTH COOPERATIVE GROUP HEALTH RESEARCH INSTITUTE Our work for the commmunity is strenthened by the unique ways we work together. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 2
GROUP HEALTH COOPERATIVE HEALTH NEEDS ASSESSMENT Three gateways to better health: Access, prevention, and improved lifestyles WE UNDERTOOK A COMMUNITY HEALTH NEEDS ASSESSMENT in 2013 to determine how we could make the biggest difference in the health of individuals in our communities now and in the years to come. Three strategies rose to the top: 1 Promotion of physical activity, improved fitness, and healthy eating 2 Access to care for underserved populations 3 Diabetes and cardiovascular disease prevention and management With these strategies in place, we set out in 2014 to implement programs that would powerfully affect these areas. Here are some of the highlights. 1 ACTIVE LIVING AND HEALTHY EATING Encouraging a cycle of better health Not long ago, Francisco Juarez, a high-school senior in Shoreline, spent most of his free time playing video games. Today, you re likely to find him cycling around his neighborhood thanks to the Major Taylor Project (MTP). MTP is a joint effort between Group Health and the Cascade Bicycle Club that ensures middle- and high-school students in underserved areas can learn to ride and care for their own bike. Through MTP, students from 10 schools in four local school districts learn to use bicycles to help expand their world view and realize they have the ability to change themselves and their communities. In 2014, 45 Major Taylor cyclists took part in the Group Health Seattle to Portland (STP) bicycle classic, a 206-mile ride! COMMUNITY ENGAGEMENT REPORT 2014 PAGE 3
MTP showed me how to enjoy the outdoors on a bike. My favorite part is to discover things around my community, like when we went to Angle Lake Park, says Francisco. I never noticed it when driving by. I went there with the bike club once, and I now take my little sister there. As the Major Taylor Project motto states: It s not just about a bike. It s about where the bike can take you. One place the MTP took a number of students was on the 206-mile Group Health Seattle to Portland Bicycle Classic (STP). Last year was Group Health s 11th year as the STP s title sponsor. Called one of the best cycling events in the nation by Bicycle magazine, the two-day ride from the Emerald City to the Rose City drew 10,000 registered cyclists. Included in the event were more than 100 riders from Group Health, as well a number of staff members who provided medical coverage along the route and at the finish line. Closer to home, Group Health is also encouraging bicycling as a supporting sponsor of Pronto Bike Share, Seattle s new cycle sharing system. Riders are able to check out any one of 500 bikes located at 50 stations throughout Seattle. Helmets are available, too. Group Health is sponsoring 15 docking stations in the Capitol Hill and South Lake Union neighborhoods. On hand to help launch Pronto Cycle Share were (l-r) Diana Birkett Rakow, executive vice president Marketing, Public Affairs, and Foundation, Brad Tilden, chairman & CEO of Alaska Air Group, and Ed Murray, mayor of Seattle. In its first five months of operation, Pronto Bike Share made possible more than 38,500 two-wheel trips around town. Investing in Pronto is a great way to promote fitness, says Diana Birkett Rakow, executive vice president, Marketing & Public Affairs, and president, Group Health Foundation. She joined Seattle Mayor Ed Murray and others to kick off the program with an inaugural ride from downtown Seattle to Pioneer Square. I m thrilled with the way we re able to make it easier for more people to pedal their way to better health. Giving exercise a good run Group Health did more than provide pedal power in 2014. We helped nearly 1,000 runners prepare for the 7.5-mile Lilac Bloomsday Run in Spokane, working with Providence Health Care to sponsor six training clinics leading up to the race. It s something we ve done for 30 years. Runners and walkers also benefited from our sponsorship of the Nordstrom Beat the Bridge to Beat Diabetes fundraiser. Proceeds from the event which included an 8K run and wheelchair race, 4-mile walk, 1-mile fun run, and Diaper Derby for toddlers go to the Juvenile Diabetes Research Foundation, the leading global organization funding type 1 diabetes research. Group Health s 85 entrants, including six teams, generated nearly $15,000 in pledges, in addition to our event sponsorship donation. Overall, more than 4,000 participants crossed the finish line and helped raise more than $1.7 million for juvenile diabetes research. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 4
Our family participates every year because we re very hopeful one year we can say our son used to have type 1 diabetes, says Group Health clinic coordinator and participant Lisa Alexander. My son goes through more in a day than most 7- year-olds, and the least I can do is raise money for his team every year by heading out to Husky Stadium rain or shine to walk or run in his honor. It s hard to put into words how full my heart becomes. As part of YMCA s Healthy Kids Day, Group Health volunteers distributed more than 1,000 bike helmets. Just for kids Research shows that kids are prone to gain more weight and fall behind in studies in the summer. The YMCA s Healthy Kids Day is designed to counter that trend. In 2014, as part of this national initiative, we contributed more than 1,000 bike helmets, 200 water bottles, and 600 firstaid pouches to 11 YMCA locations across the region, from Seattle to Olympia, Puyallup to Spokane. Nearly 20 Group Health volunteers helped to fit helmets to heads. All in all, the event benefited 4,000 attendees. Group Health also contributed to an effort to provide meals to underserved kids year-round. Most food programs for kids are tied to the school calendar, which means that when the school year ends, so does the program. Group Health worked with Within Reach to connect kids with free meals in the summer. We produced rack cards for distribution in our medical centers with information showing families where and when lunches were being served near our clinic locations. The effort is working. In the past three years, Within Reach has helped increase the number of summer meals served to kids in Washington state by nearly 270,000. 2 ACCESS TO CARE Giving care in our communities For four days in October 2014, more than 75 health, human service, and civic organizations from across Washington state joined together to produce the Seattle/King County Clinic, a giant health clinic in Key Arena at Seattle Center. This volunteer-driven event provided a full range of free dental, vision, and medical care to 3,400 of our neighbors across the region who are underserved and vulnerable. Group Health provided more than $100,000 of services for the event, including pregnancy tests, lab services for throat cultures and blood work, and more. Group Health Foundation This clinic represents the serious dedication of a caring community to address health care issues at the local level, and to make a difference for the most vulnerable among us. Christine Lindquist MPH, executive director, Washington Healthcare Access Alliance Clinic photos by Auston James COMMUNITY ENGAGEMENT REPORT 2014 PAGE 5
donors provided funding for flu vaccines. An evaluation by the Group Health Research Institute found that the event delivered over $2.3 million in services to 3,400 patients. Group Health employees were among the more than 1,450 volunteers donating 25,000-plus hours. More than 70 Group Health staff including doctors, nurses, and lab technicians volunteered to help. Most are planning to do so again in 2015. A Group Health lab assistant was moved by the experience. A patient came in for lab work and, after looking over his history, I saw that his last doctor s visit was 20 years ago, she recalls. I asked him about it and he said he did not have insurance or money to afford care. The money he had he used for his kids to have their check-ups. That brought tears to my eyes. Another patient shared his gratitude for eye care and new glasses, describing how it enabled him to see well enough to be able to fill out a job application. Helping youth get care YouthCare operates the James W. Ray Orion Center in downtown Seattle, a place where homeless youth can plug back into life. The center serves thousands of people every year, from children as young as 12 to young adults twice that age. Most of the drop-ins don t have health insurance or a family doctor. Through our Family Medicine Residency Program, Group Health residents spend time working at Orion Center. It s a way for our residents to gain valuable experience and the center s youth to get invaluable care. And a way for Group Health to add value to an existing, safety-net organization. The program provided by the incredible team at Group Health has been a huge success at Orion, notes Ruth Blaw, the center s director. The doctors are respectful and nonjudgmental, and help the homeless youth using our services to have access to high-quality, professional medical advice on a consistent basis. From wound care to STD prevention, these docs have it covered, and the young people we serve really appreciate the opportunity to ask questions and take charge of their own health. Group Health resident, Byron Doepker, MD, meets with youth at Orion Center as part of the weekly Doc Talks series. Group Health augments funding from the Families and Education Levy and provides staff to help support five school health clinics at Aki Kurose and Washington middle schools, Franklin, Nathan Hale high schools, and Interagency Academy, an a network of alternative high schools. We also teamed up with Seattle/King County Department of Public Health to provide behavioral health care at Cleveland, Ingraham, and Rainier Beach high schools. Other ways we provide care Project Access Northwest provides health care for the lowest income, most ethnically diverse populations in King, Kitsap, and Snohomish counties. Nearly 83 percent of patients live at or below 200 percent of the federal poverty level. In King and Snohomish counties, Project Access works with Group Health to provide specialized care to eligible patients who might otherwise be unable to afford it. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 6
Patients are directed to our Bellevue, Capitol Hill, and Everett clinics where available physicians volunteer their services for everything from eye care to gastroenterology to women s health. Even hearing aids are made available to patients through designated donations to the Group Health Foundation. What s more, Group Health is able to follow through with the patient s care for 12 months. Group Health doctors also volunteer their time at The Olympia Free Clinic, which offers acute medical care to the un- or under-insured in Thurston County. We provide primary care services for acute and chronic problems. Group Health also donates free lab services, which helps expedite care for patients, especially those with diabetes, hypertension, and thyroid conditions. Says Group Health doctor Britt Smith, MD, I m involved in this clinic because this is my community. I grew up here, work here, and plan to stay here. I believe in keeping my whole community healthy. 3 HEART DISEASE AND DIABETES While most of our community efforts addressed Active Living and Access to Care, we are also raising awareness in the cardio and diabetes area. To help Group Health and other providers and care teams keep up with the latest findings in diabetes care, we offer an accredited continuing medical education course online. Group Health physician David McCulloch, MD, created the course and uses nine realistic case scenarios to emphasize several practical suggestions for the management of patients with type 2 diabetes. Though available only during the latter part of 2014, more than 25 providers took advantage of the convenient coursework to further their professional education. In another program, we collaborated with Tacoma Metro Parks to offer cooking classes for people with diabetes. Held during Diabetes Awareness Month in November 2014, the classes followed a Thanksgiving theme, with participants joining in to make diabetic-friendly dishes, including roasted turkey, squash soup, cranberry salad, and crustless pie. The classes were so successful that several others are planned for 2015. The cooking with diabetes classes were so successful that more are planned for 2015. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 7
GROUP HEALTH FOUNDATION Better care: Tested by science, funded by philanthropy Parent-advocate Alisson Bonner posts announcements about Immunity Community, a peerto-peer advocacy program to address vaccine hesitancy in grade schools. WITH THE SUPPORT OF OUR GENEROUS DONORS, the Group Health Foundation is able to invest in innovative ways to improve the health of Group Health patients, and address critical and emerging community health needs. PHOTO OF LADY IN BHAM Together with Group Health Research Institute (GHRI), the Foundation proposes potential health care solutions that are tested by science and funded by philanthropy all to benefit people in our communities and across the country. The Foundation s two signature programs promote childhood immunizations and the testing of innovative ideas. Childhood Immunization Initiative Over the course of the Initiative s life, we ve helped vaccinate more than 17,000 students across the state with more than 34,000 immunizations. A new campaign is raising awareness about the need for 11- to 13-yearold girls and boys to complete the full series of vaccinations to prevent cancers caused by the human papillomavirus (HPV). In Washington, only 44 percent of pre-teen girls and 25 percent of pre-teen boys complete the series. To help with this effort, over $660,000 in donations to the Foundation were targeted to support the Immunization Initiative. Hallways to health When it comes to good health, wellness, and nutrition, you re never too young or old to learn. In partnership with Kaiser Permanente, a Group Health health educator worked with a nurse practitioner and a mental health specialist at the Washington Middle School school-based health center in an effort to achieve three goals: obesity prevention and treatment, social and emotional health, and school staff wellness. Though limited to one school, thanks to health coaching, relationship groups, and wellness programs, the results were quite promising. In the obesity prevention program, 17 of 18 students lost or maintained their weight. Regarding social and emotional health, more than 600 students signed the pledge to follow the Kind2All anti-bullying, pro-respect program. And 83 of school staff percent adhered to their health action plan versus an industry average of 25 percent. Photo by Timothy Aguero Photography COMMUNITY ENGAGEMENT REPORT 2014 PAGE 8
GROUP HEALTH RESEARCH INSTITUTE Researching innovative care for the world IN THE 30-PLUS YEARS SINCE BEING ESTABLISHED, Group Health Research Institute has had one goal: Conduct practical research for better health. Our research findings help people everywhere not just Group Health members lead happier, healthier lives. For example, our phone- and web-based quit-smoking effort led to Quit For Life, the nation s leading tobacco cessation program, helping millions of people quit tobacco. In conjunction with researchers at the University of Washington, we showed that wearing bike helmets reduces hospital admissions for head injuries, inspiring cyclists to see helmets not as an accessory but as a necessity. And our chronic care model set a standard of care that s now been disseminated worldwide. In 2014, we ve continued to expand our influence and impact with new grants and ongoing studies. Key projects include: Research on vaccine hesitancy. Research on shared decision making between physicians and patients. Evaluation of the Choosing Wisely initiative to reduce low-value care, which doesn t improve health and may be harmful. Research on improving the safety of prescribing opioids for patients with chronic pain. A big part of our funding comes from the National Institutes of Health, other federal agencies, and private organizations such as the Robert Wood Johnson Foundation. Our researchers also work closely with Group Health clinicians to test innovative ideas via projects funded by the Group Health Foundation. All told, in 2014 we received 252 new grants and contracts, and published 452 papers in peerreviewed journals. Healthy Findings, the Group Health Research Institute s blog at grouphealthresearch.org, highlights the Institute s studies and their impact on our community and the world. 2014 GHRI HIGHLIGHTS Shared decision making One of the pillars of care at Group Health is shared decision making, where physicians and patients collaborate on a course of treatment for the patient s health condition. For some conditions where there is not one best course of treatment, Group Health provides decision COMMUNITY ENGAGEMENT REPORT 2014 PAGE 9
aids to patients. From booklets to videos, these resource tools explain treatment options, including surgery. Since 2009, Group Health has distributed about 50,000 such aids to patients, more than any other single organization in the nation. To date, GHRI has found that video-based aids and booklets for knee and hip injuries have led to reduced rates of surgery, reduced costs of care, and improved patient satisfaction. Currently, we are evaluating the shared decision aids for more than a dozen diseases and conditions, including prostate and certain heart conditions, women s health, breast cancer, and back and maternity care. Choosing Wisely: High-value, low-cost care In 2012, in an effort to reduce the unnecessary tests and redundant care that patients receive, Consumer Reports and the American Board of Internal Medicine Foundation launched Choosing Wisely. The initiative s goals are to help providers and patients choose care that is: Supported by evidence. Not duplicative of other tests or procedures already received. Free from harm. Truly necessary. The work of this team is helping Group Health patients and accelerating the Choosing Wisely work in the broader health care community in Washington state and nationally. Matt Handley, MD, Group Health medical director, Quality Diana Buist, PhD, MPH and Matt Handley, MD, helped promote evidence-based care. In 2014, Group Health adopted the initiative into its care protocols. GHRI s senior investigator Diana Buist, PhD, MPH, joined Matt Handley, MD, Group Health s medical director, Quality, to help the organization deliver all the evidence-based care that s needed and none of the care that s not. In its first effort, clinicians at Group Health clinics documented clinically important reductions in too-frequent Pap tests for cervical cancer. Collaborating with this team has been great because they are not just about learning, says Dr. Handley. They re committed to making a meaningful difference for our patients and the organization. The work of this team is helping Group Health patients and accelerating the Choosing Wisely work in the broader health care community in Washington state and nationally. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 10
Dr. Buist co-authored a report that sets research and policy priorities to give Americans the care they need no more, no less. Entitled Promoting the Appropriate Use of Health Care Services, the report grew out of a project funded by the Group Health Foundation to improve the value of care. Her conclusions including eliminating tests and treatments with a high level of evidence of causing physical and/or financial harm support the adoption by Group Health of the Choosing Wisely initiative. Opioid safety In 2010, a GHRI study was the first to identify a link between higher daily doses of prescribed opioids (drugs such as Oxycotin and Vicodin) for chronic non-cancer pain and increased risk of overdose, both fatal and nonfatal. Our research drew attention to this nationwide problem from the White House Office of National Drug Control Policy, says GHRI senior investigator Michael Von Korff, ScD. It was a factor in their decision to develop a national action plan for prescription medicine abuse. Michael Von Korff, ScD (l r); Michelle Seelig, MD; Randi Beck, MD; and Ryan Caldiero, MD, were part of the Group Health team that set new guidelines for safer opioid prescribing. Meanwhile, Group Health launched successful 90-minute online training materials for primary care physicians funded with a $67,500 grant from the Group Health Foundation to enhance opioid prescribing safety within its own care system. An early evaluation of the initiative showed how Group Health quickly improved care by providing standardized care plans for nearly all patients with long-term opioid prescriptions. Based on his initial research, Dr. Von Korff received a $1.8 million grant from the Patient- Centered Outcomes Research Institute (PCORI) in 2014 to further evaluate the initiative s impact on controlling the risks of opioid therapy. We look forward to sharing the results of that evaluation when they re published. COMMUNITY ENGAGEMENT REPORT 2014 PAGE 11
2014 GROUP HEALTH SNAPSHOT 2014 Group Health Community Contributions Programs and services highlighted in this report, as well as other efforts, all support Group Health s commitment to enrich people s lives by improving health. In 2014 that amounted to a nearly $94 milion value to the community. Research $49,694,000 Care and coverage for low-income populations $29,246,000 Community health initiatives and services $6,030,000 Health professions education $8,977,200 Total value $93,947,200 $93,947,200 Total value Group Health Foundation Last year, Group Health physicians and staff, and other donors, once again committed generously to the Foundation s mission. Contributed cash and pledges totaled $2,911,524. WHERE DOES THE MONEY COME FROM? Members 35% Medical staff 14% Staff 16% Corporations 21% Other individuals 4% Estates 10% WHERE DOES THE MONEY GO? Immunization 25% Innovation & research 31% Adolescent health 15% Group Health departments/programs 29% GROUP HEALTH FOUNDATION 2014 Board of Directors Scott Armstrong Grace Chien Jim Elliott Debbie Huntington Jane A. Johnson Eric B. Larson, MD, MPH Jeff Lindenbaum, MD Neil McReynolds Marc Mora, MD Tony Richardson Leslie Rugaber Dodie Ruzicki, PhD, RN Jeff Sakuma Barbara Shickich Robin Shuler, CPA Sandeep Sinha Kevin Sullivan Barbara Trehearne, PhD, RN Janet Wainwright Michael Wanderer, MD James Wong Group Health Research Institute In 2014, the Group Health Research Institute continued to receive more than half of its funding from the National Institutes of Health (NIH). We successfully increased or maintained support from other sponsors, including the Patient-Centered Outcomes Research Institute (PCORI) and biomedical partners. In total, revenues for the year were $45.8 million. 2014 REVENUE BY SPONSOR NIH 56% Non-NIH federal sources 14% PCORI, state, industry, and other 11% Foundations 12% Group Health Cooperative 7% 252 Grants submitted 307 Active grants 452 Publications in peer-reviewed journals, with GHRI being the lead author in 94 Group Health Cooperative 15-GHF-1087 2015-09 COMMUNITY ENGAGEMENT REPORT 2014 PAGE 12