Three finalists for the Robert Wood Johnson
Foundation Home and Community Based Care and Social Determinants of Health
Innovation Challenges competed live at the Health 2.0 Conference on Monday,
September 16th! They demoed their technology in front of a captivated audience
of health care professionals, investors, provider organizations, and members of
the media. Catalyst is proud to announce the first, second and third place
Home and Community Based Care Innovation Challenge Winners
Nearly a decade has passed since Healthy People 2020positioned social determinants of health (SDoH) at the forefront of healthcare reform. As defined by the report, SDoH are the “conditions in the environment in which people are born, live, learn, work, play, worship, and age, that affect a wide range of health, functioning, and quality of life outcomes.” Examples of social determinants include:
Resources to meet daily needs (e.g., safe housing and local food markets)
Educational, economic, and job opportunities
Community-based resources in support of community living and opportunities for recreational and leisure-time activities
The ability to influence
social determinants largely falls outside of the health care system’s reach.
Therefore, a key to address opportunities for health involves collaboration between
health care and different industries such as education, housing, and
transportation. Both the public and private sectors have made significant
efforts to bridge the gap between physical, mental, and social care by
experimenting with non-traditional partnerships.
The Center for Disease Control and Prevention (CDC) has spearheaded multiple programs with government agencies and community partners to achieve the goals outlined in Healthy People 2020. One of the most notable successes is the Childhood Lead Poisoning Prevention Program, an initiative by the CDC with the Department of Housing & Urban Development and the U.S. Environmental Protection Agency. Through housing rehabilitation, enforcement of housing and health codes, and partnerships with healthcare experts, the program helped Healthy People 2020 exceed their target of reducing blood lead level in children.
Other programs such as the “National Program to Eliminate Diabetes Related Disparities in Vulnerable Populations,” leveraged community partners and resources to increase food security, health literacy, and physical spaces for active living. In one of their projects, the program partnered with community health workers (promotoras) who spoke Spanish to engage with Hispanic/Latino communities where participation to Diabetes Self-Management Education (DSME) was low. The community health workers provided linguistically and culturally-sensitive materials that effectively increased participation in DSME among the targeted population. The outcomes from such initiatives have inspired more health and community organizations to work together to reduce health disparities.
Jessica DaMassa asks me all about health & technology, in just 2 minutes, featuring venture rounds for Kyruus, Parsley Health, Livongo buying RetroFit, the RWJF AI challenge from Catalyst @ Health 2.0 and a ridiculously long explanation of where the @boltyboy twitter name came from…–Matthew Holt
I am thrilled that Health 2.0 is today announcing a new program aimed at improving diversity in the field of health technology. This will run all year (and hopefully beyond) and will start at the Health 2.0 10th Annual Fall Conference on Sept 25-8, where we will host a group drawn from populations that are underrepresented in the health technology field. There’ll also be a dedicated session on the topic on Sept 26 at 12.15pm that has been generously supported by the Robert Wood Johnson Foundation. Matthew Holt
The Problem: There is a lack of diversity among health technology innovators and a shortage of technologies that meet the needs of minority audiences. Technology is a powerful tool that can help improve health outcomes and alleviate problems within our current health system. As our society grows increasingly diverse and gaps in health among different populations increase, there is an urgency to develop solutions for underserved communities and diversify the population of innovators who are creating these solutions.
The Conference Support Program: The Diversity in Health Technology Conference Support Program, supported by the Robert Wood Johnson Foundation, encourages individuals interested in diversifying the health technology field and who are interested in, or currently engaged with, health technology, to attend Health 2.0’s 10th Annual Fall Conference (Sept 25-8). Individuals from populations that are underrepresented in the health technology field are particular encouraged to apply. The conference support will include complimentary access to the annual conference. Conference support recipients will be required to attend the “Diversity in Health Technology” workshop. The workshop will serve as the formal kickoff to a year-long campaign focused on engaging more diverse voices in health technology. Conference support recipients must also attend and participate in two webinars hosted by Health 2.0 to further review the diversity in technology issue, submit a post-conference summary to Health 2.0 of the individual’s conference experience that Health 2.0 may use for a white paper on the diversity issue and a summary about specific activities the individual plans to do over the next year to address diversity in technology.
What if I asked you to talk data—about lots and lots of health data? By that I mean data about you and your community that you and others could use to improve your health.
What if I asked you to sit for hours with others from your community to talk about using the giga-bytes of data from your devices and other sources like electronic health records to help improve health—your health and the health of your community?
Would you play? Would you do that?
Or would you blanch, shake your head incredulous, yawn with boredom and possibly run in the opposite direction?
Well, your colleagues in five cities, Philadelphia, Phoenix, Des Moines, San Francisco and Charleston, SC, played that very game with the Robert Wood Johnson Foundation and members of our Data for Health advisory committee along with the National Coordinator for Health Information Technology and members of her staff.
Boy, did they play.
Last fall in our initiative, Data for Health, the Foundation asked people in those places to spend an entire day talking with us about their hopes, aspirations, worries and concerns with using digital data to improve health.
Honestly, we weren’t at all certain people would play this particular game. We understood—in fact some people told us—that this discussion could seem turgid, distant, maybe even a boring academic hypothetical discussion.
That was not the case.
Turns out it was very easy to draw people into this conversation. People attended and engaged passionately and vigorously. It was a powerful thing to behold.
These people were very interested in using data to improve both their individual as well as their community’s health. Continue reading…
We’ve all experienced the crushing agony of a heartbreak, or the deep foundational stress of worrying about how you’ll pay all your bills, or the isolating and bleak reality of a mum or dad or loved one whose health is failing in a way you can’t figure out how to stop – or fix. Life is hard. Now – how hard is all relative … but for most of us, our days are consumed on some level with a pretty significant level of worry. Did you overextend when you bought that house? Is so-and-so gunning for your job? Is it wrong that you secretly and deeply resent your partner because you’re sick of them “never doing anything”?
And how about the real worries – will you have food, electricity, heat, clothing, safety…the worries that consume more people than any of us would care to imagine (The Shriver Report has 1 out of 3 women living ‘on the brink’ – in other words, right smack dab in this reality). For fun – let’s try an exercise marriage counselors use for marriages that are in trouble…they have each of you sit down and write on a piece of paper what matters to you, and what you think matters to your partner. Then they compare the two. And what do you think stands out in stark testament to the current state of the relationship? Pretty much zero overlap. You don’t understand what matters to me, and I don’t understand what matters to you.
Let’s extend that analogy to the healthcare space…picture a typical day for many of us in the health communication space, for example. How are we spending our days? Dreaming up new and more imaginative ways to lecture about the importance of getting a colon cancer screening, or eating well, or taking your blood pressure medication, or getting in for your annual Medicare wellness visit, or or or…
And a question for those of us working on this stuff. If you turned all that passion and intensity you bring with you to work, and to the task of telling others how to live in a way that complies with HEDIS this or STAR that or [insert any other traditional health quality metric here]…if you turned that lens on yourself – how are you doing? Do you eat the way you should? How’s your weight? Do you sleep the recommended 7 to 8 hours of sleep a night? How are you on your preventive screenings – are you up to date? Did you exercise at all in the last week?
Let’s see a show of hands. Who among us, doctor, nurse, patient, family member, wants to give or get health care inspired by a factory—Cheesecake or any other?
I didn’t think so.
True confession: I have never actually eaten at a Cheesecake Factory (hereinafter referred to as the Factory). My wife, Mary, and I did enter one once. We were returning from a summer driving vacation. Dinnertime arrived, and we found ourselves at a mall walking into a busy Factory.
It seemed popular. The wait was long—really long. We got our light-up-wait-for-your-table device. We perused the menu. There was a lot there. Portions seemed gigantic. We looked at each other and, almost without speaking, walked back to the hostess, returned our waiting device and left.
You got me—I cannot say 100 percent that I wouldn’t love Factory food. We were so close that one time!
A young woman in our small New Jersey town recently opened a new restaurant here. We tried it the other night. She and her business partner tended us and all the other patrons with such attention and care. We waited some, true, but she seated us near the bar while we waited—brought over pieces of cheese (no light-up device) for us to enjoy. The menu was ample and varied—not enormous. It’s also true that two items on the menu—including my first choice—were no longer available that evening. The chef however crafted the dishes that we did select with flare and pride. Dinner was a delicious, wonderful, relaxing experience—made better because of the human touch.
It’s probably not fair to contrast my one near-Factory dining experience with this other. Big chain restaurants have clearly figured out a way to provide a consistent meal for millions of satisfied customers. But the Factory way is not for everyone. People, I think, crave customized, attention-to-detail service experiences—in their dining choices. And—I’ll go out on a limb—in their health care too.
“Not everything that counts can be counted, and not everything that can be counted counts.”
This aphorism has been deliciously, but, alas, incorrectly attributed to Albert Einstein (the saying actually has mixed origins, but credit properly might be given to sociologist William Bruce Cameron, writing in 1963).
But, whatever its provenance, the saying is particularly appropriate in describing the woeful lack of attention paid to the long-standing problem of diagnosis errors in the provision of health care services.
Last week academic researchers from Baylor and the University of Texas published important research estimating that one in 20 adults in the U.S., or roughly 12 million people every year, receive an error of diagnosis—a wrong, missed or delayed diagnosis—in ambulatory care.
This likely represents a conservative estimate of the incidence of such errors in ambulatory care and does not attempt to include inpatient hospital care or care provided in nursing homes and post-acute care facilities, such as rehab hospitals.
The news media correctly decided that this peer-reviewed finding deserved prominent attention—it was a lead story on “NBC Nightly News” and other national news programs.
It seems that attaching a large number to the prevalence of such errors provided the needed news hook to give the problem the attention it has long deserved. Surveys reveal that the public is worried as much about a misdiagnosis or missed diagnosis as any other quality and safety issue in health care.
Autopsy studies performed over time find that unacceptably high rates of diagnosis errors persist; similarly, diagnosis errors continue to represent a leading cause of medical malpractice suits.
But even without newsworthy body counts, the problem of diagnosis errors has been known to clinicians for decades, if largely ignored by stakeholders and policy-makers as a major quality and safety problem.
2014 marks the launch of the Affordable Care Act’s (ACA) most important coverage expansion provisions, designed to dramatically reduce the number of uninsured Americans. Between now and the end of 2016, millions of individuals are expected to sign up for subsidized insurance coverage through newly established health care exchanges, or marketplaces.
Other tracking initiatives are closely monitoring the number of individuals that sign up for this coverage as well as those that take advantage of expanding Medicaid coverage in some states.
With ACAView, we will take a different approach. We will focus on the provider perspective; more specifically, how the ACA affects the practice patterns and economics of physicians and other care team members around the country. This is also part of a wider effort, Reform by the Numbers, RWJF’s rich source of timely and unique data about the impact of health reform.
ACAView will monitor the impact of coverage expansion on a monthly basis, mining insights from athenahealth’s cloud-based network of more than 50,000 providers and 50 million patients.
athenahealth is a technology and services provider that delivers physicians the tools and support needed to manage the business and clinical aspects of their medical practices. Our cloud-based, centrally hosted software platform provides us with near real-time visibility into practice patterns of physicians around the country.
Our goal is to inform, exchange ideas, and provide a timely, front-row view of how this landmark legislation affects a robust cross-section of providers across the nation. In subsequent reports, we will examine an evolving set of metrics that address a broad range of topics.
We will also share our analyses on the extent to which our providers represent all providers in the US. For more about our data on practices and patients, as well as our preliminary list of metrics, please read our Methodology report.
No Meaningful Change to Date in New Patient Volumes
Among the many unknown questions surrounding coverage expansion is the number of new patients physicians will accommodate. This is a critical issue because one of the goals of health care reform is to allow individuals to form stable physician relationships, rather than seek care in high-acuity settings or forgo care altogether.
If the ACA is working, we would expect physicians to see a higher percentage of new patients over the course of the year. Over the long term, this number should eventually return to historical levels as these new patients become established.