Population Health in Indiana

IHA’s Population Health Task Force is finding out what is killing us and how to prevent it.

For Steven Long, president and CEO of Hancock Health in Greenfield, tackling the multifaceted challenges presented by population health starts with asking the right questions.

“Life expectancy in the early 1900s was 47,” Long notes. “By the end of the century, it had risen 50 percent. How did our parents and grandparents do this? They asked themselves: ‘What is killing us?’ The answer was typhoid, measles and diarrhea, so they implemented sanitation programs, developed vaccines and promoted food safety.”

Today, many Americans are dying from preventable chronic diseases that require a second population health revolution. “We can treat chronic disease,” Long continues, “but the real answer is attacking the root causes of chronic disease and preventing it from happening in the first place. That’s where health care can make the greatest difference right now.”

As the chair of IHA’s Population Health Task Force, Long has found that numerous Hoosier health care organizations are interested in attacking the root causes of population health challenges. Launched in December 2016, the task force comprises 28 hospitals and health providers, ranging from smaller rural organizations to larger urban systems. Though their delivery systems are diverse, they serve populations facing the same challenges: obesity, substance abuse and mental illness, among others.

The task force’s goal is to convene these institutions three times in 2017 to promote population health activities, share information and collaborate toward a healthier Indiana.

If the first meeting was any indication, Hoosiers everywhere have a healthier future to look forward to.

CHURCHES, CHIMEMAPS AND PARAMEDICS: THREE UNLIKELY TOOLS OF THE POPULATION HEALTH TRADE

During the task force’s December 2016 kickoff meeting, two member organizations presented population health initiatives that are currently producing positive results in their communities.

In order to combat mental illness and substance abuse in Hancock County, Long and his colleagues at Hancock Health have implemented a Congressional Network program, which brings together members of the medical and faith communities to increase awareness of—and access to—treatment, and to bolster the community-wide referral process for these services.

Here’s how it works: a “Navigator” from Hancock trains members of a congregation to become “Liaisons” in their church community. Liaisons are the hospital’s eyes and ears on the ground, following up with patients after they’ve been discharged, helping refer patients to additional support and communicating their concerns with the Navigator.

The Navigator, in turn, informs Liaisons when a member is admitted and discharged from the hospital and helps build the Liaison network across congregations. Navigators and Liaisons also work together to promote and coordinate wellness activities within the faith community.

“When you look at the ability to reach people en masse in Central Indiana, congregations are a great place to start,” Long notes. “We’re trying to find ways to change our environments for our community members where they live so that the healthier choice is the easier choice to make.”

ST. VINCENT CARMEL COLLABORATES WITH CARMEL FIRE DEPARTMENT TO ASSIST FREQUENT ER PATIENTS

How do you help people who make repeated visits to the hospital emergency department for non-emergent cases? In 2015, the Carmel Fire Department (CFD) asked St. Vincent Carmel to help expand the CFD’s Community Paramedicine Program, which utilizes firefighters and paramedics to help care for frequent emergency room visitors.

Starting in 2016, St. Vincent Carmel collaborated with the CFD to concentrate on 48 patients who had made numerous emergency room visits. During the discharge process at St. Vincent Camel, a firefighter or paramedic assists the patient and ensures that the patient returns home safely. Shortly thereafter, a paramedic returns to the patient’s home to make sure the patient is okay. During the visit, the paramedic also conducts Social Needs and Safety Assessment screens in an effort to determine what additional resources the patients might require. “We’ve found that the Community Paramedicine Program has been particularly successful with patients who don’t necessarily require in-home care, but who benefit greatly from being checked on once in a while,” says Rebecca Adkins, system director of population health for St. Vincent.

The results of the first six months of the Community Paramedicine program were staggering. In the three months leading up to their enrollment in the program, the 48 patients had required 23 ER transports and 47 ER visits. In the three months following an intervention by a Community Paramedicine professional, ER transports among this population fell to 13 and ER visits fell to 21. Most importantly, the paramedics were able to connect seven of the patients with a primary care provider.

Long and Adkins expressed admiration for each other’s programs—and found the kickoff Task Force meeting a valuable introduction to novel methods of tackling population health problems. “There’s always value in coming together to learn from others,” says Adkins. “We’re all sharing patients and making those connections between patients and first responders really benefits the communities we serve.”

2017 AND BEYOND

The first order of business for the Population Health Task Force in 2017 will be to develop a survey for all Indiana health care providers that will touch on a range of topics, including what population health programs are already in place, where needs exist and how Hoosier hospitals can make the most of each other’s resources to better serve their communities.

Steve Long invites all Indiana hospitals and health systems interested in serving their communities to join IHA’s Population Task Force. “Right now is not the time to take a step back from population health,” Long advises. “It’s time to jump in. Those who jump in right now are going to be more successful in the future.”