2016 16th population health colloquium: summary of proceedings
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Transcript of 2016 16th population health colloquium: summary of proceedings
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The 2016 SixTeenTh PoPulaTion healTh Colloquium: Summary of ProceedingSRachel S. Permuth, PhD, mSPh, Senior Director of Research, hospitals, north america & Principal epidemiologist
Jennifer m. Petrelli, Sm, mPh, nutritional epidemiologist
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PoPulation
HealtH in tHe
affordable
Care aCt
institute for
HealtHCare
imProvements
triPle aim
expanded ins
urance Coverage
improved Qua
lity of Care
enhanced Pre
vention and Hea
lth Promotion
Community an
d Population-ba
sed activities
improving Pop
ulation Health
improving the
experience of C
are
reducing the
Per Capita Heal
thcare Cost
SodexowashonoredtobeaSilverGrantorandpresenteratthe2016 sixteenth Population Health Colloquium,theleadingforumoninnovationsinpopulationhealth.TheColloquium,hostedbytheJeffersonCollegeofPopulationHealth,broughthundredstogethertolearnandengageinpersonand
onlinefromMarch7-9inPhiladelphia,Pennsylvania.TheColloquiumprovidedinformationandupdates
onhealthpolicy,healthcaretrends,andpracticeandinnovation.Realworldexamplesofpopulation
healthmanagement(PHM)initiativesthatareimprovingcareandoutcomeswerealsofeatured.
ThecontentpresentedattheColloquiumprovidedavarietyofperspectivesonthecurrentand
futurestateofpopulationhealth.KeynotespeakersincludedDavidB.Nash,MD,MBA,FACP,Dean
oftheJeffersonCollegeofPopulationHealthatThomasJeffersonUniversityandChairofthe
PopulationHealthColloquium;andJulieGerberding,MD,MPH,ExecutiveVicePresident,Strategic
Communications,GlobalPublicPolicy,andPopulationHealth,Merck;FormerDirectorU.S.Centersfor
DiseaseControlandPrevention(CDC).
Conferencehighlightsincludedsessionsonengagingstakeholdersinpopulationhealth,viewing
populationhealthasaservice,effectivelyusingtechnologyanddataanalytics,engagingand
empoweringcommunities,andinnovativepopulationhealthprograms.Theoverarchingthemethat
emergedfromtheColloquiumisthatalthoughthefocusintodayshealthcareenvironmentisalready
onimprovingpopulationhealthandachievingbetteroutcomesforpatients,integrateddeliverysystems
andlargemedicalgroupsarehavingdifficultyadaptingtotheincreasingemphasisonPHM.Inorderto
pursuetheInstituteforHealthcareImprovementsTripleAimandgoalssetforthintheAffordableCare
Actof2013(seeFigure1),collaborativeintegratedcareisessential.
Centraltomanysessionsoftheconferencewasthefollowingquestion:
Given the (ambitious) goal of population health, how can we create feasible solutions to deliver better care and improve outcomes while simultaneously curbing costs?
Figure 1. Population Health in the aCa and the iHis triple aim
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Loners Worriers
Self-Centrics Attention- Seekers
FEAR OF THE INSTITUTION
DEFLECT FEAR
INN
ER F
OC
US R
EAC
H O
UT
TACKLE FEAR
Vitality
Recognition
Conviviality
Security
Listen to me Bond with me Singularize my stay
Respect my loneliness
Follow my plan Regain my balance
FromtheinformationpresentedattheColloquium,wehaveidentifiedfourkeyareasthatwillhave
importantramificationsashealthcareorganizationsseektoimplementpopulationhealthstrategies:
1. understanding and alleviating Patient fear is Key to Patient experience
2. the Case for a new Population Health Protection agenda as a means to drive down Healthcare Costs
3. using data and technology to improve Healthcare for older adults
4. engage Consumers in Wellness-based Population Health and thrive financially
understanding and alleviating Patient fear is Key to Patient experience
Inhealthcare,medicaladvancesalonecannotguaranteebetterpatientoutcomes.Helpingpatients
healorovercomeillnessinvolvesmorethanjusttreatmentthroughmedicalproceduresandproducts;
patientsmentalwell-beingandpeace-of-mindcanbejustasimportant.Dr.RachelS.Permuth,Senior
DirectorofResearch,Hospitals,NorthAmerica&PrincipalEpidemiologist,andLisaHerms,Research
Manager,HealthcareofSodexo,presentedonthephenomenonofpatientfear.Thediscussionaround
thistopicgarneredgreatinterestfromtheaudienceandstartedalivelyquestionandanswersession,
withvariousaudiencememberssharingtheirownexperiencesandperspectivesonpatientfear.
in fact, understanding and alleviating fear is central to improving the Patient experience.Ashumans,wehavecoreneeds,andfearoccurswhenoneoftheseneedsisnotbeingmet.However,fear
inthehospitalsettingisamplifiedandmuchmorecomplex.Toppatientfearsincludeinfectionand
germs,incompetence,anddeath.Thisfeartypicallyrevolvesaroundtwoaspects:alossofcontroland
depersonalization.
Thoughtheunderlyingemotionmaybeuniversal,however,everypatientexperiencesfeardifferently
(seeFigure2).Itisthereforevitalforhealthcareorganizationstolooktowardenhancingpatient
experienceinthehospitalsettingthroughinitiativestargetedatthesedifferentmanifestationsoffear.
Staffawareness,patientinvolvement,andsocialsupportareessentialforovercomingpatientfearand
arekeyareasforimprovement.
Figure 2. sodexos Personixtm visualization of different manifestations of Patient fear
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the Case for a new Population Health Protection agenda as a means to drive down Healthcare Costs
Dr.JulieGerberding,EVP,Merck&Co.,Inc.andFormerDirector,U.S.CentersforDiseaseControl
andPrevention(CDC),outlinedherthoughtsonthepopulationhealthlandscape.Shefocusedonthe
followingkeyissues:
Potential causes of the health disadvantage experienced in america relative to other high-income countries.
opportunities and limits of the affordable Care act in closing the health gap.
motivating private sector leadership actions that will help improve population health in worksites and communities, and inform local, state and national policies.
TheU.S.hasrelativelyunfavorablehealthoutcomescomparedtootherhigh-incomecountries,despite
ourvastexpenditureonhealthcare.TheOrganizationforEconomicCooperationandDevelopment
rankedtheU.S.NationalHealthPerformanceamong34countries,andtheU.S.ranked26thinlife
expectancy,31stininfantmortality,28thinlowbirthweight,and25thinmaternalmortality.
WhydoestheU.S.experiencethishealthdisadvantage?Thereareavarietyofissuesthatare
hypothesizedtocontributetotheproblem.Oneissueisthatourhealthcaresystemisinefficientand
encouragesunnecessary,redundant,andexpensivecare.Therearealsopublichealthsystemissues.
Forexample,ourpublichealthsystemisnotadequatelylinkedtothehealthcaredeliverysystemand
notadequatelyresourcedtoaccomplishitsmission.In2014,only3%ofthenationshealthdollarswent
towardspublichealth.OtherfactorscontributingtothehealthdisadvantageareshowninFigure3.
Figure 3. determinants of the u.s. Health disadvantage
Healthcare & Public Health System
Issues
sHorter life
exPeCtanCy & Poorer HealtH status
Policies & Culture
Economic & Psychosocial
Factors
Physical & Social
Environment
Individual Health
Behaviors
u.s.
HealtH
disa
dvan
taGe
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Dr.Gerberdingemphasizedthatthe most powerful opportunity for stopping the growth in the cost of healthcare in the united states is to create more health in the population.ShefurtherdiscussedtheideathathealthimprovementisnotonlybroughtaboutinthedoctorsofficeortheACO.Healthy
behaviorsarefosteredinourhomes,schools,worksitesandcommunities.Theproblemisthatweare
notinvestinginprogramsandservicesthatimprovehealthandwell-beingfromabroaderperspective.
Creatingaholistichealthsystemthatpromotesbetterhealthandgreaterhealthequalityisimperative.
AccordingtoDr.Gerberding,privatesectorleaders,especiallythoseinthehealthsector,haveaunique
opportunityandresponsibilitytocatalyzeprogresstowardbetterpopulationhealth.Shecalledupon
privatesectorleaderstosetthetoneatthetop,byprovidingsmokingcessationbenefitsforemployees,
nudgingemployeestochoosehealthierfoodchoicesandengageinphysicalactivityandincentivizing
wellnessinthedesignofbenefitsprograms.
Shealsoencouragedprivatesectorleaderstofosteralliancesincommunityhealthnetworksby
engagingwithpublichealthleaders,committingleadershipandresourcestosupportingpriority
communityeffortsandputtinghealthonthebusinessagenda.
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using data and technology to improve Healthcare for older adults
Dr.JaewonRyu,MD,SegmentVicePresidentandPresidentofIntegratedCareDelivery,Humana,Inc.,
spokeaboutseniorsbeingthefocusofpopulationhealthforHumana.Heemphasizedthatcreatingthe
rightenvironmentmakesitpossibletoexpectimprovedhealthforolderadults.
Humanaisworkingtoaddressmultiplefactorstiedtothehealthofolderadults,including:
Casting a broader net from the traditional scope of the healthcare system to encompass non-traditional areas that impact health.Thisincludesaccesstonutritiousfood,chroniccarecoordination,real-timemonitoringofolderadultsandtheuseoftechnology(smartphones/tablets).
moving from traditional to integrated healthcare. Inthetraditionalhealthcaremodelpatientsoftenexperiencedis-integrated,episodicandconflictedcare.Intheintegratedhealthcare-model,careis
patient-focused,primarycare-centricandproactive.
Preparing care providers for the new era of population health.Physiciansneedassistanceintransitioningfromthevolume-basedtovalue-basedmodelofcare.Therearesignificantgapsinthe
transitiontowardvalue-basedcare,andmanyorganizationsarenotreadytomeetthechallenge.
using data, analytics and technology to bring about results.Theuseofanalyticsallowsforactionableinsightsthatdrivevalue.Telehealthisalsogainingprominence,includingremote
monitoringasawaytoextendcaremanagementand/ortelemedicine/eVisits.Forexample,Dr.Ryu
notedthattele-dermatologyimprovespatientaccesstocareandreduceswaittimesfrom21daysfor
anappointmentto42minutesforapatienttoreceiveacareplan.
Dataandtechnologyarepowerfultoolsintheintegratedhealthcaremodel.Theycanbring
interventionstoalargernumberofpeopleandimproveaccesstocare.High-costandhigh-risk
individualscanbetargetedandresourcescanbeappropriatelydeployedtogetpatientsthecare
theyneed,whentheyneedit.Itiscriticalthatcareprovidersreceiveassistanceinadaptingtonew
innovationsandotherdemandsoftodaysintegrated,value-basedsystemofcare.
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engage Consumers in Wellness-based Population Health and thrive financially
Dr.DavidJ.Peter,ChiefMedicalOfficerandLauraKukral,DirectorofStrategyoftheClevelandClinic
AkronGeneralMedicalCenter,Akron,Ohio,discussedhowAkronGeneralahighlyrenownedand
influentialOhiohospitalviewspopulationhealth.Dr.PeteremphasizedthatPopulation health is a mode you take your organization into. it is a philosophy.
KeycommunityhealthprioritiesforAkronGeneralincludechronicdiseases,mentalhealth,accesstocare,
substanceabuse,smokingcessation,elderlycaresupportandobesity.Theseareconcernsthatarefamiliar
tohealthprofessionalsinvolvedinCommunityHealthNeedsAssessmentsinhospitalsacrosstheU.S.
AkronGeneralhasmadewellness-basedpopulationhealthcentraltoitsmissionfor20years.Theyhave
institutedthreehealthandwellnesscenters,whichincludegyms.Infact,35%ofgymmembersbecome
first-timeusersoftheClevelandClinicAkronGeneralHealthSystemafterjoining.Throughthesecenters,
Akronisabletotakeitscareastepfurtheranddeliverhigh-valuecareacrossthebroadercontinuum.
akron General medical Centers emphasis on the community is part of its success, and has moved it from the red into the black.
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ThekeycomponentsofAkronGeneralsapproachincludecommunityhealthimprovementand
repositioningitsbrandarounditswellnessmessage.Throughafocusoninnovationinseveralkeyareas
(seeFigure4),Akronhasbeenabletoachieveitspopulationhealthgoalswhilealsothrivingfinancially.
Figure 4. akron General medical Centers Key areas of focus for Population Health improvement
AquotefromAkronGeneralsCEO,Dr.TimStover,aptlysumsuptheunderlyingfoundationofAkrons
presentation.HestatedthatWe want to put smart minds around us who can help discover what clinical prevention should really look like; and can define medical fitness best practices for the next 20 years.NotonlyhasthisbeenasuccessfulprincipleforAkron,butitcanalsoserveasaguidelineforotherhealthcareorganizationsastheyseekinitiativestoachievethesamegoalofpopulationhealth.
outreaCH
researCH Collaboratives
innovative delivery
Consumer enGaGement
Partnerships to improve health of low SES groups
Mobile unit offering services (e.g., physicals, health screenings, womens health exams, educational classes)
Kent State University
Cleveland Clinic Wellness Institute
Health & Wellness Center
LifeStyles
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Conclusion
The2016PopulationHealthColloquiumfocusedonseveralareaspertainingtothefutureofpopulation
healthintheeraofvalue-basedcare.AccordingtoDr.DavidB.Nash,theDeanoftheJefferson
CollegeofPopulationHealth,thedefinitionofpopulationhealthisstillnebulous.Yet,populationhealth
managementisattheforefrontofthehealthcareagenda,andthegoalofPHMisclear:todeliverhigher
qualitycareandachieveimprovedhealthoutcomesforpopulations.
Hospitalsandotherprovidersarenowincreasinglypaidbasedonthequalityandeffectivenessof
theircare,ratherthanthesheervolumeoftestsandotherprocedurestheyperform.Therefore,itis
necessarytonotonlyaddressacutemedicalneeds,butalsotheemotionalandsocialwell-beingof
patientsandthekeysocialdeterminantsofhealthofacommunity.Morespecifically,providerswillhave
toaddressfactorsthatnegativelyimpactthePatient Experience,suchaspatientfear,andimproveinvolvementwithcommunityentitiesinordertosucceed.
Toaccomplishtheambitiousaimsofthepopulationhealthagenda,collaborativeintegratedcareis
required.ThemostpowerfulopportunityforstoppingthegrowthofhealthcarecostsintheU.S.is
tofosterimprovedhealthinthepopulation.Theprivatesectorshouldstrivetofindsharedvaluein
populationhealthopportunitiessuchasdiabetespreventionandpopulationvaccinecoveragewithin
thecommunity.Dataanalyticsandtechnologycanalsobringmeaningfulinterventionsandimprove
accesstocare.Butphysiciansandhealthsystemsneedassistanceinmeetingthechallengesposedby
thenewpopulationhealthfocus.
Insum,theColloquiumallowedforfrankdiscussionsaboutthecurrentstateofpopulationhealth
andthechallengesposedbytheAffordableCareAct.However,speakersandaudiencemembers
acknowledgedthatmanyquestionsremainunanswered.ForumslikethePopulationHealthColloquium
arecriticalforexchangingideasandfocusingonviablesolutionstoaccomplishournationspopulation
healthobjectives.
additional resources
TolearnmoreaboutthePopulationHealthColloquium,populationhealthandSodexoscontributionsto
populationhealthinitiatives,thefollowingresourcesmaybeofinterest:
Population Health Colloquium website: www.populationhealthcolloquium.com
sodexo White Papers:
SodexosPopulationHealthManagement:Approach&KeyRoleofRegisteredDietitianNutritionistshttp://viewer.zmags.com/publication/cd16a7af#/cd16a7af/1
UnderstandingandManagingPatientFearintheHospitalSettinghttp://viewer.zmags.com/publication/0351c0e8#/0351c0e8/1
NewChallengesFacingtheHospitalC-Suite http://viewer.zmags.com/publication/1e16c929#/1e16c929/1
CommunitiesforHealthLaunchEventSummaryofProceedingshttp://viewer.zmags.com/publication/dc43c72e#/dc43c72e/1
GoingBeyondtheFourWalls:PopulationHealthManagement(PHM)PartnershipStrategiesMUSC&Sodexohttp://viewer.zmags.com/publication/c8359abd#/c8359abd/1
AmbulatoryNetworks:ThePowerofTechnologyhttp://viewer.zmags.com/publication/082d4227#/082d4227/2
additional white papers can be found on sodexos thought leadership library: bit.ly/sodexothoughtleadership
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