The June 17 shooting at a Trenton, N.J., Arts All Night event that injured 22 people, 17 of them by gunfire, was a tragic reminder of the challenges the city faces and of the importance of multi-sector efforts to solve societal and public health problems.
The shooting “speaks to the importance of multisector partnerships,” said Greg Paulson, executive director of the Trenton Health Team. “Our mayor views gun violence as a public health issue.”
Still impacted by the initial shock of the shooting, Paulson was speaking during a June 19 webinar co-hosted by All In: Data for Community Health and the Illinois Public Health 3.0 Workforce Development Forum. The title was “Effectively Stewarding Multi-Sector Partners for Health System Transformation.” Paulson explained that the Trenton Health Team was formed in 2006 to meet an urgent need in response to a hospital closure, and it became a nonprofit organization in 2010. The collaborative is a partnership among Capital Health, St. Francis Medical Center, Henry J. Austin Health Center, and the Department of Health and Human Services of the City of Trenton. It started out focusing on high utilizers of the health system, particularly emergency departments, but then it expanded to focus on a shared vision of the future in terms of health and well-being.
“Looking out one year, five years and generationally, we asked our stakeholders how we would envision the community if we are wildly successful,” he said. They started bringing more stakeholders to the table, with representation from social services, housing, health — growing to 60 agencies and 160 individuals. “For us, it was important to focus on a shared vison so that everyone sees value in partnership, because they are better able to achieve their own institutional objectives,” he said. “That is the secret sauce. We are able to bring competitive stakeholders together on grant opportunities involving health.”
In another example of its work in 2017 Trenton Health Team launched the Capital City Diabetes Collaborative to improve health outcomes of Trenton residents with diabetes, increase patient engagement and self-management of their disease and improve the availability of healthy foods for Trenton residents.
The partners in the collaborative are working to identify the best, evidence-based approaches for screening and treatment that will be adopted city-wide. “In addition, community-based tactics will be used to help close gaps in health care and mobilize cross-sector collaboration to address barriers to effective diabetes management,” according to a description on the website. “The project will introduce risk stratification to enable patients with the highest level of need to be identified and enrolled in care management, use a care coordination model for complex diabetes patients, and will partner with non-health sector organizations to increase access to healthy foods, safe places for physical activity, and offer peer support and mentoring, both in-person and through a multi-media technology platform called InquisiHealth.”
The use of analytics and data has been key to the organization’s efforts, Paulson said. In 2014 the Trenton Health Team launched the Trenton Health Information Exchange (HIE), which provides health practitioners access to integrated and holistic patient records in real-time to support treatment decisions and strategies. According to the Trenton Health Team website, more than 600 clinical users can access millions of records for more than 250,000 patients. The reporting functions of the HIE are being continuously enhanced to include analytics at both the macro (population) and micro (individual, disease category, age group, or other subset) levels.
The HIE is adding other relevant data sources such as environmental data, vacant properties and abandoned housing. “We are building a unified source of truth,” Paulson said. In terms of seeking to understand gun violence, Paulson said the use of data and grounding the effort in what is effective and measuring change helps keep the conversation focused rather than getting pulled into political conversations.
Jane Erickson, the project director for ReThink Health, a national learning community of multisector partnerships looking to transform how health is produced, joined Paulson during the webinar. She noted that while some organizations have legislative authority to lead these efforts, such as Oregon’s coordinated care organizations, many are built through sweat equity. Many take the lead by “being a champion of a vision and a recognized and trusted source of information,” she said. “Leading or being involve in formal community health needs assessment needs or fulfilling data-sharing functions can be a springboard to broader decision making, she added.
From ReThink’s study of multi-sector partnerships, she said they are most powerful when they are anchored really broadly rather than solving a specific problem or disease focus. “Often, groups that start with a narrower focus find it harder to expand down the road,” Erickson said. She said ReThink recommends working on a shared vision for regional change. “First, name the North Star,” she said. “Then develop the value proposition.”