Innovations in Community Health: Part 1

In finding your authentic health career, it is important that you expose yourself to as many facets of the health field as you possibly can. One way to do this is to find and follow health care trends and topics. A current trend in health care that you should know about involves innovations in community health centers. In this first of a two-part blog on the topic, I will explain what community health centers are, some of the current challenges and issues they’re facing, and how innovation as a process and in technology can help overcome them.

So what are community health centers? Community health centers are non-profit organizations that provide essential primary and preventive health services to predominantly low-income populations in medically underserved communities, regardless of their insurance status or ability to pay. Services available can range from basic doctor's visits, immunizations, health screenings, and laboratory services to radiology, pharmacy, dental, and mental health services. Community health centers are part of the larger healthcare safety net that also includes public hospitals and health departments. Some examples of these safety net organizations are places like San Francisco General Hospital or Venice Family Clinic.

In today’s rapidly changing health care environment, community health centers and public hospitals are under pressure to adopt new approaches to control costs while increasing access and providing high quality care to a growing patient population. According to the Bureau of Primary Health Care, since the passage of the Affordable Care Act, health centers have increased the total number of patients served on an annual basis by nearly 5 million people, increasing the number of patients served from 19.5 million in 2010 to an estimated 24 million in 2014. The expansion of coverage to low-income and underserved populations is also pushing these safety net organizations to innovate by creating competition to be the provider of choice for patients who previously had few options for care. With a long history of bringing comprehensive care in the communities where patients live and in the languages that they speak, safety net clinics and hospitals continue to struggle with tight budgets, swelling patient demand, and high rates of chronic disease. These challenging conditions constrain their efforts to innovate—to take risks, develop partnerships, and invest in new care models to meet the needs of the most vulnerable populations.

What do I mean by innovation and how is this applied in health care? At the Center for Care Innovations (CCI), we refer to innovation as implementing new ideas (processes, services, or products) that create value or capture value in a new way. Large health systems including Kaiser Permanente, Cleveland Clinic, and Mayo Clinic have built innovation centers within their organizations allowing the ability to generate, incubate, and test new ideas and technologies that meet the needs of the patient populations they serve. These innovation centers use a process called design thinking as an approach to problem-solving that begins and ends with the needs of the user (the people they are designing for). It is a process that combines creative and analytical approaches and requires collaboration and experimentation that is centered on a deep understanding of the behaviors, motivations, and perspectives of the user to uncover rich insights (that cannot be captured in a traditional survey or focus group) that lead to creative and meaningful solutions. More on design thinking in part two of this blog.

In an effort to adapt and apply this model in the healthcare safety net, CCI has developed a portfolio of programs to strengthen the capacity of safety net clinics and hospitals and accelerate the adoption and spread of innovative practices, technologies, and partnerships. CCI provides support through grant funding, coaching, curating resources and tools and convening a learning network.

Through CCI’s Safety Net Innovation Challenge program, the Los Angeles County Department of Health Services used creative approaches to learn about patients' experiences and design care from their (the patient’s) point of view, applying the design thinking approach to problem solving. They used a mobile app called dscout to enable providers and care managers to share observations and experiences by submitting real-time feedback via photographs and text. This research led to new insights about patients’ experience being discharged from the emergency department (ED) or hospital that is analogous to “lost travelers,” often confused by their diagnoses and unsure of next steps. This new perspective prompted the creation of a “patients’ concierge travel agency,” an automated email notification to medical home care managers when their patients visit the ED or inpatient setting, so they can follow up and offer help in managing whatever issues led them there. In a pilot, this effort resulted in a 6% absolute and 25% relative risk reduction for repeat ED visits.

This is only one example of innovation in community health. In part two of this blog, I’ll share my personal experience getting into the field, dive deeper into design thinking as one approach to drive innovation, and provide some resources for those interested in skill-building and professional opportunities in this space.

About the Author:

Roza Do is Program Manager at the Center for Care Innovations (CCI) where she is responsible for designing and managing programs focused on building capacity for innovation in safety net clinics and hospitals to develop, test, and adopt new strategies and approaches to transform care for vulnerable populations. Prior to joining CCI, Roza’s work in community health spans from improving quality of care to promoting healthy environments through the Pacific Business Group on Health, Kaiser Permanante Community Benefit, and Oakland and West Contra Costa Unified School Districts. She is a proud alumna of HCC (2005) and UC Berkeley (Class of 2013) holding a dual Masters degree in Public Health and City Planning with concentrations in Health Policy and Management and Housing, Community, and Economic Development. When she’s not fighting for health, you can find her DJing at a local bar or music festivals in the Bay Area and beyond.

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