Recap Midwest Forum on Hospitals Health Systems and Population Health - Chicago 2017

I had the pleasure of attending the Midwest Forum on Hospitals Health Systems and Population Health in Chicago last week and the content was amazing! #MWHospitalForum. 3 word synopsis: Collaboration, Community, and Accountability.

I am used to traveling to Chicago after thanksgiving since I had to work the booth at #RSNA for many years (not fun). This time, however, I was thankful to be staying at the hotel where the conference was held. As some of you know commuting to McCormick place can be extremely tiring and cold.

I was blown away by the caliber, passion and content at #MWHospitalForum conference. It was organized by Illinois Public Health Institute. Check out the schedule and speakers here.

I had the extreme honor of listening and meeting Dr. Mona Hanna-Attisha (@MonaHannaA). Dr. Mona is a true hero to the Population Health community for having the strength to call-out the issues during Flint Michigan water crisis (#FlintWaterCrisis).

She is full of passion for the community she serves and most definitely deserves all of our admiration and respect. Simply an amazing person; I thanked her for staying in Michigan and continue to make her community better. Check out her TedTalk.

[Parents asks me] is my kid gonna be ok? They were told the water was fine #FlintWaterCrisis

[my] Life took a turn of taking one hand at a time towards taking thousands of little hands #pophealth

My key take-aways from the conference:

1. Community Hospitals and Healthcare networks must partner with food trucks and food growers. The the medicine for malnutrition is still and will always be "good healthy food".
2. Housing Partnerships are essential social determinants of health - 1 in 5 ACA eligible member is under housed.
3. We can't solve problems by using the same kind of thinking we used when we created them. - Albert Einstein 
4. Focus on the community and social determinants and away from utilization management. Implement pay for success.
5. Use the community pathways hub models. --> to address social determinants. Don't reinvent the wheel.
6. Show me the money - Funding for partners. Government + Providers + Investors (social impact bonds). Pay for the outcomes you want and pay for success. Check out CDFIs.
7. Traditional care coordination that simply calls and send snail mail may not work for community linkages. - instead, community health worker as a relationship steward that identifies evidence-based interventions. Social service pathways (transportation medical home, healthy pregnancy, etc). Implement process outcomes measures to get paid. Leverage money from manage care plans to the hub to fund the foundation but then get a higher payment with a positive outcome. Is the intervention a change agent? Quantify and qualify success
8. Jan Ruma - Northwest Ohio Pathways (HUB). 5 medicare advantage payers contracts. Ohio medicaid. Community health workers. Creating a workforce who has never been seen before and managed by people that have never managed them before... new models = new ways of managing and thinking.
9. Data for social determinants - Open data portal for state of IL. Heat maps. Zip codes transportations, housing, led poisoning, etc. Check out https://allindata.org/
10. Program success is about ROI and showing improvement of your communities. Solve the systemic problem that has more implication on adult absenteeism and school drop out, etc. Create Programs, Policy, and Partnerships - a 3Ps prong approach to make change. https://buildhealthyplaces.org/
11. Go where the people are... "Aaron Perry is the founder of the nonprofit Rebalanced-Life Wellness Association, which works to improve the health of African-American men in Dane County. He started a health center in the backroom of JP Hair Design Barbershop to help teach the barbershop customers, who are mostly African-American men, about topics like obesity and heart disease."
12. What are the CPT/HCPCS billing codes for behavioral health? check out --> https://www.bh.medicaid.ohio.gov/manuals new code
13. Careful on how we build partnerships - hospital may think of themselves as the sun and community as surrounding planets. While community sees hospital as an ancillary service.
14. Start with a pilot - find a good partner, look at resources and the evidence of what works. Iterative development. Everyone in healthcare is using the same plan, you need the right people to execute that plan. Look for capital and opportunities to fund the transformation. Improving community health by strengthening community investment.
15. Funding (sunk cost) vs Financing (expectation of returns, eg mortgage). Social impact bond (expectation to get it back - high degree of of return. Profitable things attract capital. Community investment as a heroic quest (making money flow uphill).
16. It is easier to build strong children than to repair broken men.
17. My question to Dr. Mona: In the technology sector, It was reported in the news that you used Epic to find this problem with lead in the water. What is your point of view around data liquidity (pun intended). The ability to free the data so that we can have more Dr. Monas in the community?
18. Pediatric public health initiative. Clinic is on a second floor of a farmers market. #Flintkidscook. In the birthplace of car, there are huge barriers on transportations.
19. Collaboration is key! CAPriCORN: Chicago Area Patient-Centered Outcomes Research Network
20. #CDC is funding a registry for proactive crisis management. We worry about ACEs and toxic stresses [in pediatrics]. Just the trauma of these can lead to chronic diseases.

*** [there were many more points made during the conference, but as you can imagine it got overwhelming] *** please reach out if you'd like me to go into more details.

I also had the honor to be selected to present one of the concurrent educational sessions. The format was 3 separate stories weaved together under one theme. My topic was:

... tips and tricks on creating a robust high-performing multi-collaborative teams to support population health and value based care programs including: how business questions are changing to target population and longitudinal view for patients; the role of disparate IT systems to support VBC, the skills and functions needed to support VBC, and how to build a data-driven organization using analytics.

Unfortunately, I had to miss the concurrent session my dear friends from Dayton Children's (Lisa Henderson and Jessica Saunders) were giving at the same time of my presentation. As you may know (especially if I have ever talked to you), Dayton Children's is doing a tremendous job reaching into the community and addressing social determinants. These ladies are on an amazing data journey and I am honored to be part of the journey with them.

Working with public health departments and child-serving organizations, Dayton Children’s Hospital transformed its community health needs assessment (CHNA) into actionable programs and services driving improved health care outcomes. The resulting children’s health agenda launched Dayton Asthma Alliance and a Clinically Integrated Network that engages pediatric care providers to track and improve pediatric quality outcome measures.

And finally, kudos to Rebeca Gordenstein and her team for a flawless, organized and extremely well-thought out conference. Thank you Illinois Public Health Institute for including me in your program.

Salud!

Gabe Orthous

PS: Guess who made most influential on twitter those two days ;-) Follow me @orthous or check out #MWHospitalForum