Transcript Fullerton Foundation sponsored Population Health
AAMC/CDC/Fullerton Sponsored Population Health Improvement Leadership
Thursday, June 16, 2015 10:30-11:30am EST
Don Bradley, MD, MHS-CL Associate Consulting Professor Duke Community and Family Medicine Director, The Practical Playbook
Agenda
• Emerging models for chronic care and population health- insights from the IOM Don Bradley • AAMC/Fullerton population health webinars- where we’ve been and where we need to go Don Bradley
• Launched January 2014 • 50 Members • 4 Innovation Collaboratives • 4 annual meetings
Members
American Association of School Administrators American Academy of Pediatrics American College of Sports Medicine American Council on Exercise Alliance for a Healthier Generation American Heart Association Academy of Nutrition and Dietetics American Society for Nutrition Bipartisan Policy Center Blue Cross Blue Shield of North Carolina The California Endowment Canadian Institutes for Health Research ChildObesity 180 Congressional Hunger Center Edelman General Mills, Inc.
Greater Rochester Health Foundation Healthy Weight Commitment Foundation HealthPartners Highmark, Inc.
The JPB Foundation Kaiser Permanente Kellogg Company Kresge Foundation Mars, Inc.
NAACP National Collaborative for Health Equity National League of Cities Nemours Nestle Nutrition Nestle USA Notah Begay III Foundation The Obesity Society Partnership for a Healthier America President’s Council on Fitness, Sports, and Nutrition Robert Wood Johnson Foundation Reebok, International Salud America!
Sesame Workshop STOP Obesity Alliance United Way Worldwide YMCA Shiriki Kumanyika, University of Pennsylvania Sylvia Rowe, SR Strategy, LLC Jim Sallis, University of California, San Diego Russell Pate, University of South Carolina* Bill Purcell, Jones Hawkins & Farmer PLC* Mary Story, Duke University* *Denotes Roundtable Leadership
Innovation Collaboratives
• • • • CEO Innovation Collaborative Physical Activity Innovation Collaborative Early Care and Education Innovation Collaborative
Integrated Clinical and Social Systems for the Prevention and Management of Obesity (ICSSPMO) Innovation Collaborative
ICSSPMO Innovation Collaborative
Integrated Clinical and Social Systems for the Prevention and Management of Obesity
Chairs: Don Bradley (Duke), Loel Solomon (Kaiser Permanente), Bill Dietz (GWU) 50+ Members
Mission: Articulate a framework that integrates clinical and social systems for the prevention and management of obesity; identify, promote, and disseminate effective models and practices. Vision: People engage in a healthcare system integrated within their community, where settings and resources reinforce healthy behaviors and provide needed care. Stakeholders recognize their interdependency and act in a coordinated and collaborative fashion to improve health and achieve health equity.
Chronic Care Model
Community Resources and Policies Self Management Support Health System Health Care Organization Delivery System Design Decision Support Clinical Information Systems
Wagner EH
Informed, Activated Patient Productive Interactions Prepared, Proactive Practice Team
Improved Outcomes 7
Framework for Integrated Clinical and Community Systems of Care Equity Training & Education Care Delivery
• Information Systems • Decision Support • Delivery System Design • Self Management Support • Local Patient Environment • Clinicians
Family & Individual Empowerment and Engagement Integration
Convener, Advocacy, Data Exchange, Financing, Governance/Regulation, Referral Processes, Communication
Community Systems
• Resources • Services • Supportive Environment • Social Norms
Metrics Population Health
Logic Model
Te4Q
Needs, goals, objectives
Logic Model
Educational activities Learners
System, patient outcomes Pt care changes
competencies Te4Q
INPUTS IC members IOM Staff Existing research Other partners / resources Framework development Funding ACTIVITIES Develop framework Share framework with other IOM groups Convene relevant stakeholders and expand ICSSPMO membership (including professional associations) Refine the framework based on stakeholder feedback Identify, evaluate, and disseminate model programs Develop tools for implementation of framework Plan surveillance methods and metrics for health departments, health plans, and payers
INNOVATION COLLABORATIVE LOGIC MODEL
OUTPUTS Publish and refine the framework Disseminate and improve awareness of the framework Compilation of model programs Tool to track and assess the implementation of framework OUTCOMES Short, - I ntermediate -, and Long-term Full or partial adoption of the framework by health departments, health plans, and payers Improved training and education for providers (see box 3) Improved family and individual engagement and empowerment Integrated clinical and community care of obesity Improved care experience and outcomes for patients with obesity Reduced costs to all health and social systems Decreased prevalence of obesity / severe obesity
Where we’ve been;
WHERE DO WE NEED TO GO?
June 2014
• • • • Population Health definition, and overview of disease burden and health inequities in U.S.
Call for integration Milestones and CLER as related to population health Brief overview of educational materials available • • • PHIT curriculum iCollaborative Practical Playbook
July 2014
• Teaching Methods and Materials – – – – Population Health Competency Map Practical Playbook iCollaborative Population Health Collection Duke Family Medicine PHIT curriculum
August 2014
• • • Milestones and population health Population health content across specialties Generic population health milestones • • • • “Pre-packaged” Curricula The AAMC’s 6-Module Curriculum The Duke GME Population Health Innovation Modules Modified Duke Family Medicine Population Health Improvement Teamwork Curriculum • Curricula based on identifying recommended materials to match generic milestones and primary care milestones(in process)
September 2014
• • Practical Playbook Use Cases • To engage learners (and specifically residents) engaged in population health projects.
Katrina Hedberg—Oregon’s Health System Transformation • • • Health System Transformation Public Health and Health Care integration Addressing triple aim of: improved care; lowered costs; improved health requires transforming health care system AND community in which people live • Medical care providers play a critical role in providing direct patient care, and supporting policy/ environmental/ systems changes
October 2014
– Janet Townsend—The Commonwealth Medical College • A community based, patient centered, inter-professional and evidence-based model of medical education – Jonathan Fischer—Community Care of North Carolina • A national model for population health management • Professionals work together to provide cooperative, coordinated care through the Medical Home model
November 2014
– Population Health Curriculum at Dartmouth • Primary goal is transformative learning - resident chooses focus • Patient/family-centered care, community responsive
practice
• • Current model – begin with patient – Phase 1 Patient -> population -> community – Phase 2 • • Use reflection to reinforce learning points Educating peers and team through presentations – Jefferson College Population Health Curriculum • Community Benefit Curriculum—incorporates community wellness training • Population health focus throughout curriculum
December 2014
– Population Health Curriculum at the University of Wisconsin • Prevention Innovations in Medical Education (PRIME) program offers medical students classes in order to “shape a new generation of health professionals who will value primary care and incorporate health promotion and disease prevention into their practice.” – Population Health “Small Bytes” • Efficient, interactive learning modules which promote learning before entering the classroom setting, and better discussion within the classroom • Helps instructors receive more feedback for course
January 2015
– The Practical Playbook and Population Health – NACHHO—Identifying Your Public Health Partner – Orange County Health Department—Connecting with Your Local Public Health
February 2015
– Population Health in the Carolinas Medical Center Family Medicine Residency Program • • Community-based curriculum PGY-3—month of Population Health – Safe Communities: A Model for Population Health & Injury Prevention • Applied, translational, and practical interventions which are never done in isolation, but always in partnership
March 2015
– Population Health Improvement: Public Health and Health Care Integration through SIM • Transformation strategy for multiple provider types and for multiple health care services • • Leadership in efficiency and effectiveness Accelerate the use HIT • • Approach consumers holistically Prepare and begin to implement value based payment
April 2015
– Population Health in the Duke Primary Care Leadership Track (PCLT) • Four-year parallel track for medical students who apply simultaneously to Duke School of Medicine and to the PCLT (Eight students admitted each year) • Population Health training objectives to develop skills in: team work, public health, community engagement, critical thinking – PowerUP—Marna Canterbury • Works within the community to promote preventative health care • Multiple partners throughout the community that help advance their initiative
Potential opportunities
•
Broader audiences?
– Public Health – Sub-specialties – Other health professions – Inter-professional education – – – Community workers and leaders Payers Health system administrative leadership – State Innovation Model (SIM) grant stakeholders • • •
Integrator/connector role?
– Positioning for primary care – Community links
Complementary competencies?
– Strategic planning for health – Project planning and management – Grant writing/business case development
Other?
Access to 2014-15 Webinars:
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NEW LINK: Recordings of past webinars are available at: http://cfm.mc.duke.edu/resources
Thanks!!
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