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Community-Wide Population Health Management in New Orleans

May 28, 2013
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Patient-centered medical care in the New Orleans metro area

How can public-private partnerships drive better health and quality of life? One example of such an initiative is the Louisiana Public Health Institute (LPHI), which has collaborated with physicians and hospitals to create a community-wide care-coordination system for New Orleans. (The initiative was a second-place co-winner in HCI’s Innovator Awards program, and was featured in the February issue of the magazine.)

The effort garnered federal support through its creation of the Crescent City Beacon Community (CCBC), and also attracted the participation of community physicians, notably from the Tulane Community Health Centers (TCHC), a group of federally qualified health centers that is the core physician organization collaborating with LPHI and CCBC. Leaders of the initiative were on hand at the HCI Executive Summit earlier this month to give their perspectives on the challenges and the lessons learned from their experiences.

Anjum Khurshid, M.D., Ph.D., MPAff, and director of the Health Systems Division and Crescent City Beacon Community, Louisiana Public Health Institute, said the initiative is a unique collaboration that brings together population health management and public health. Noting that traditionally these topics have been separate, he said, “more and more in this country, we need to think about these as a comprehensive approach.”

Khurshid outlined three concepts to reach sustained improvements in population health: systemic improvements, consisting of data, technology, processes and people; improvement of the social determinants of health that impact outcomes; and linking what happens in healthcare to the economy as a whole; population health outcomes should be a priority for the entire community, including employers, which have a stake in helping to maintain the health of the local population. He also pointed out the New Orleans has long-standing barriers to better population health, including a high poverty rate and natural and man-made disasters.

Eboni Price-Haywood, M.D., M.P.H., director of the Brinton Family Health & Healing Center and co-director and co-executive director and chief medical officer of the Tulane Community Health Centers, said that following the destruction of Hurricane Katrina in 2005, health information policy in the state were redesigned around collaboration to improve the quality of care around the vulnerable population.

That work was underway for five years when the CCBC received Beacon Community status in 2010, providing a framework to create a governance model. Price-Haywood said physicians took a leading role in the steering committee that established priorities for the Beacon Community project. Tasks included understanding the software architecture with regard to the clinical workflow; doing a deep dive into how the system would work; and understanding how clinical analytics information would be presented to providers in an understandable way.

A priority was to strengthen the continuity of care as patients move from one provider to another, Khurshid said, adding that a community-wide health information exchange has answered some of the care coordination needs.

Khurshid said that a focus of the CCBC is control of chronic diseases through a care coordination system that includes health systems and social services. To be sustainable, the effort has to pull in as many partners as possible, from both the public and private sectors, he said. He is optimistic that a sustainable care coordination model for the New Orleans area is both achievable and necessary for the health of its most vulnerable population.