Population health management is on the mind of every health system CEO. The Advisory Board Co. recently addressed this subject, reporting on three success factors: information-powered clinical decision-making; primary care-led clinical workforce; and patient engagement and community integration. While the health care field has made strides in the first two, we are considerably behind in the key components of patient engagement and community integration outlined by the Advisory Board:

• Map services to population need.
• Overcome nonclinical barriers to maximize health outcomes.
• Integrate the patient’s values into the care plan.
• Use community stakeholders to connect patients with high-value resources.

In Detroit, we have developed an innovative initiative using patient and community engagement to address a serious health problem. With Detroit’s infant mortality rate at nearly 15 per 1,000 live births — among the highest in the nation — the Detroit Regional Infant Mortality Reduction Task Force has initiated a comprehensive system of care to reach at-risk women in their neighborhoods.

The task force is a partnership with Henry Ford and three competing health systems within the Detroit region. An important element in the program is the Women-Inspired Neighborhood (WIN) Network. The WIN Network: Detroit connects women to resources that address their immediate needs so they can focus on their health and that of their families. The network employs community health workers trained in maternal-child health and based in three Detroit neighborhoods to assist women between the ages of 18 and 34. Through personal approaches, such as home visits, mentoring, group meetings and social media tools, the network offers women support and connection to local resources.

After the first year, there were no preventable infant deaths among project participants. The success of the pilot gives us confidence that we are connecting patients with the resources most valuable for their overall well-being, and this may be a template for addressing other populations.

Leveraging our own diverse workforce can be an important factor in providing a more individualized approach to population health. At Henry Ford, we have become more intentional about using the diverse expertise of our staff, and developed employee resource groups, or ERGs, that assist us with providing more culturally sensitive, personalized care. ERGs have been developed around ethnic, racial, generational and sexual orientation. Examples include a Generation Y group that helps us to understand better ways to engage younger customers; a group of African-American physicians focusing on the needs of the African-American community; and PRIDE, our advocacy group for LGBT employees.

We have a Hispanic ERG that opened a clinic specifically for Spanish-speaking individuals, and a Middle Eastern group that helps us to increase sensitivity in how we market to and care for the Middle Eastern community.

For population health management to be successful, we must not think of people as populations but as individuals who require care plans that consider the patient’s life circumstances. At the same time, we must proactively address socioeconomic factors that could derail a care plan, and partner with trusted community-based stakeholders.

Nancy M. Schlichting is CEO of Henry Ford Health System. She is the recipient of the 2014 TRUST Award from the Health Research & Educational Trust. Visit www.hret.org/trust.

 


 

News from the AHA

See You at the Summit

“Health Care and Hospitals in Transformation — Early Results from the Front Lines” is the theme of the 22nd annual Health Forum and AHA Leadership Summit in San Diego July 20–22. Speakers include former defense secretary Robert Gates, author Malcolm Gladwell and NFL quarterback Peyton Manning on “Lessons from the Line of Scrimmage.” Visit www.healthforum-edu.com/summit.

Preparing for the next wave of population health

“The Second Curve of Population Health” builds on prior American Hospital Association reports that outline a road map for hospitals and care systems to use as they transition to the second curve of population health. Though the extent to which hospitals and care systems engage in population health may vary, a significant shift toward population health initiatives is anticipated in the next three to five years. The tactics described in this guide provide a framework for initiatives that hospitals and care systems could pursue to develop an institutional infrastructure that supports population health. Visit www.hpoe.org.

Facilities managers to meet

The annual ASHE Conference & Technical Exhibition will bring together health care facilities managers Aug. 3–6 in Chicago. Key tracks include compliance strategies, management development and business acumen, patient-focused strategies, and delivering value to the executive level. Visit www.ashe.org.

How hospitals can implement sustainability strategies

The “Environmental Sustainability in Hospitals: The Value of Efficiency” guide explains why hospital leaders should explore sustainability strategies for their organizations. Hospitals in Pursuit of Excellence and the American Society for Healthcare Engineering highlight best practices, such as water conservation, reducing energy usage and proper waste disposal techniques, that ultimately reduce cost for the hospital. Visit www.hpoe.org.