Rebuilding Place in the Urban Space

"A community’s physical form, rather than its land uses, is its most intrinsic and enduring characteristic." [Katz, EPA] This blog focuses on place and placemaking and all that makes it work--historic preservation, urban design, transportation, asset-based community development, arts & cultural development, commercial district revitalization, tourism & destination development, and quality of life advocacy--along with doses of civic engagement and good governance watchdogging.

Friday, April 27, 2018

Ordinary versus Extraordinary Planning around the rebuilding of the United Medical Center in Southeast Washington DC | Part One: Rearticulating the system of health and wellness care East of the River

-- "Part Two: Creating a graduate health and biotechnology research initiative on the St. Elizabeths campus"
-- "Part three: the potential for donations around an expanded program"

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A few weeks ago, it was reported ("New DC public hospital will be half as large," Washington Post") that DC intends to rebuild the troubled United Medical Center hospital at a new location in Congress Heights, adjacent to the Metrorail station and as part of the very eastern end of the St. Elizabeths East Campus, which the city has been working on redeveloping for going on ten years.

I was saddened by what I read because it appears that the city has a pretty circumscribed view of the opportunity.

Given the high rates of chronic diseases and other problems prevalent within low income communities, it is unconscionable to not aim to leverage the creation of a new hospital as a way to redevelop the system of community care in that part of the city. From the article:
City Administrator Rashad M. Young said in an interview that plans for a new public hospital are framed around the goal of minimizing the city’s involvement. Although the District will probably own the buildings and equipment used at the new facility, it will hand off most other functions to a private health-care and equipment used at the new facility, Young said.

“The sort of principle here that we’re focused on is D.C. being out of the hospital business,” Young said. “That’s the approach here.”

He said city officials hope to announce a private-sector partner in the next few months, but he declined to He said city officials hope to announce a private-sector partner in the next few months, but he declined to name any companies under consideration.
For one, it's a bad idea to develop a program without already having your "private sector" partner in place, especially on a project as big and as complicated as a hospital, not just to build, but to operate.

Planning for innovation as a part of public projects capital planning.  Looking at the proposal, it made me realize that what I call "Transformational Projects Action Planning" ("(Big Hairy) Projects Action Plan(s) as an element of Comprehensive/Master Plans" and "Why can't the "Bilbao Effect" be reproduced? | Bilbao as an example of Transformational Projects Action Planning") has two dimensions.

One is at the scale of a conurbation, city, or county and that means coming up with a bunch of projects, like what Liverpool or Bilbao or Edmonton has done ("Downtown Edmonton cultural facilities development as an example of "Transformational Projects Action Planning"), or what I've proposed for Silver Spring:

- Part 1: Setting the stage
- Part 2: Program items 1- 9
- Part 3: Program items 10-18
- Part 4: Conclusion.

But the other scale is that of the individual project. With the latter, there the idea is if you're spending many millions of dollars, shouldn't you think hard about how to be innovative and leverage the maximum return from the investment.

I've written about that a lot in terms of libraries ("Neighborhood libraries as nodes in a neighborhood and city-wide network of cultural assets") but this should be the case for virtually any "public-facing" public investment, be it transit, schools, a hospital, libraries, public space, etc.

We should aim to wring out all the possible benefits, sure at the least cost, but we shouldn't put cost and speed in front of reaping the greatest possible social and community return on investment.

To my way of thinking, the program to rebuild UMC fails to look at how it can be transformative and innovative at the scale of the hospital, the community and the city.

Just because it will be new doesn't mean that it will be an example of a transformational project.

These are open questions that aren't being asked, in terms of how to best leverage the creation of a new hospital as a way:

(1) to re-articulate health and wellness care in that area of the city -- an issue made all the more poignant by how UMC has shut down its obstetrics program ("Nursery and delivery rooms at D.C.'s public hospital," Washington Post"), even in the face of high maternal death rates ("D.C.'s maternal mortality rate is at crisis proportions," editorial, Washington Post)

(2) to drive economic development for Southeast DC neighborhoods and the St. Elizabeths Campus

(3) to broaden the city's economy by developing sectors that are not dependent on the federal government.

This piece looks at health and wellness care delivery and the second part addresses "Creating a graduate health education and biotechnology initiative on the St. Elizabeths campus" as an community health and economic development measure.  The third part is brief, and discusses the opportunity to garner large donations for facilities in return for naming rights.

Health districts as community revitalization tools.  There is a lot of talk in the trade about hospitals as redevelopment anchors.  That case has been made for the Prince George's Hospital being built near the Largo Metrorail Station ("Prince George's hospital site starts and stops with Metro" Greater Greater Washington).

But that's not been my experience.

Typically hospitals are behemoths that are internally focused, so it becomes very difficult to harness their activities in ways that strengthen surrounding neighborhoods, except maybe if the hospital has a program that provides mortgage support programs to employees who choose to live in nearby neighborhoods.

For example, when doing some commercial district analysis work in some neighborhoods in Pittsburgh, in Northside, Lawrenceville, and Bloomfield--they have hospitals but the hospitals don't have much revitalization impact--not even for lunch time.  Most people don't get a lunch break long enough to be able to leave the hospital campus.

My lesson was that for direct revitalization benefit, direct connections need to be made.

Although the hospitals in Northside and Bloomfield did contribute financially and otherwise to community improvement in significant ways, the impact ends up being more indirect.

Similarly, most urban hospitals don't seem to anchor successful revitalization efforts outside their campuses. Sometimes that's because of their non-central location, but typically centrally located hospitals don't do much better on this dimension. 

Although in Philadelphia, the Frankford Hospital and the University of Pennsylvania Medical Center help to fund business improvement district initiatives in their communities.

My lesson is that if hospitals are to anchor general revitalization initiatives, the hospital has to be focused externally, rather than internally, and work in specific ways to interconnect with the community.

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Rearticulating health and wellness care programming East of the River. I've written about some best practice programs along these lines in the past, and these are the kinds of programs that ought to be referenced in developing such a program in association with the rebuilding of United Medical Center.

The problem is, like coming "late to the party" on Walter Reed which is discussed in a bit more detail in the second article, I don't think there is any place in DC's "planning" for UMC to bring up these issues and re-orient the development program.  Although the Washington Informer argues that the city isn't moving fast enough as it is ("Is ‘Sense of Urgency’ Behind Plans for SE Hospital?").

Best practice concepts to consider

A system of community clinicsDC already has a bevy of community clinics.  But they are independent, not a system.  A strength of these clinics, called "medical homes," is their independence, but the potential positive impact from knitting these clinics into a network and providing systematic care to people with greater needs is considerable.

... moving more toward how the Bucks County Health Improvement Partnership works, as an integrated system.

Denver public hospital and clinic system ("Denver Health Becomes Profitable After Using Toyota as a Template: Lean manufacturing has made Denver Health a model for public health care," Governing Magazine). There they have integrated the public hospital with community clinics in the manner that I think we should move towards. From the article:
For Denver Health, the key to eliminating waste turned out to be integration, or restructuring operations at its different facilities to create one mega-system of patient care. The organization treats 170,000 patients annually, more than one-third of the city’s population. Forty percent of the city’s children seek treatment there. Roughly 70 percent of the patients are ethnic minorities, and many of them don’t speak English. Most are poor, and 42 percent of them are uninsured. In addition to a large primary hospital and emergency room,  
Denver Health comprises eight community health centers, each equipped with its own pharmacy, and another 13 school-based health centers. Denver Health also runs the city’s 911 emergency medical services system, a non-emergency medical hotline, the Rocky Mountain Poison and Drug Center, and the Rocky Mountain Regional Trauma Center.

But as far as Denver Health is concerned, all those disparate elements are the same. Every one of those institutions shares the same information system, and every patient who enters the system is assigned a number. So whether someone checks into the emergency room or an outpatient specialty clinic, physicians can access all the relevant data that Denver Health has ever accumulated. It’s been a major shift in the way the system operates, says Thomas Mackenzie, who, as chief quality officer of Denver Health, is charged with implementing and maintaining the lean principles. “It’s not thinking about things in different silos for different components,” Mackenzie says, “but thinking about how you can provide the best care for patients across the whole continuum of care.”
Lesson: using the Denver model, DC could integrate community and school health clinics and UMC into one health network.

St. Anthony Hospital in Chicago is doing something similar to Denver, but focused solely on, Lawndale, the impoverished neighborhood where they are based.  From "Chicago safety-net hospitals face uncertain future amid changes to health care system: Area has 20 safety-net hospitals, which are a stop-gap medical system for the poor" in the Chicago Tribune:
When now-CEO Guy Medaglia arrived as a consultant in 2007, the 151-bed hospital was losing millions of dollars annually. Medaglia was tasked by its then owner, Ascension Health, with closing or selling it.

Instead, he emboldened the hospital's board to break away from the chain in 2009 and become independent.  Despite that commercial insurance covers fewer than 1 percent of its patients, St. Anthony has posted operating income nearly every year since.

St. Anthony embarked on its turnaround after assessing the needs of its community and tailoring its services to match. It now functions as a de facto community hub, teaching language classes and hosting courses for people studying to take high-school equivalency tests. It also added health services like dialysis and occupational health and expanded its infusion, pediatric and maternal centers.

"If you're doing what the community needs, you become very valuable to them," Medaglia said. "And to continue to serve them, you really have to think out of the box. You have to think: What can we do that's different, that can service this community at a lower cost and higher quality?"

St. Anthony is pushing forward with plans to build a 1 million-square-foot commercial development at 31st Street and Kedzie Avenue anchored by a 100-bed replacement hospital.

The $430 million Focal Point development is slated to be built on 11 acres acquired from the city for $1 by a nonprofit affiliated with St. Anthony. The complex is set to include two schools, retail stores, a child-care center, an indoor recreation facility and an athletic field.
Lesson: add community serving facilities beyond the medical functions to make the hospital a community hub.

This concept is not unlike the integrated programming model provided by the Ripley Centers of Houston's Neighborhood Centers Inc., which is one of the case studies in the  The Metropolitan Revolution book I reviewed a few years ago.

Church Health, Memphis.  Rather than from a hospital setting like what St. Anthony intends in Chicago, Church Health, an organization founded by churches, provides care to the uninsured in a clinic setting, although they have a comparable and expansive mission.

Services include medical, dental ("Church Health dentists improve patients' smiles, life prospects," Memphis Commercial Appeal), eye, family care and pediatrics, behavioral health, physical therapy, and pharmacy. 

Last year it moved into a consolidated facility of 150,000 s.f.  ("Just what Church Health will do with all its Midtown buildings," MCA; "Church Health Center rebrands in preparation for Crosstown Concourse move," Memphis Business Journal; "Holistic Healthcare for Medically Uninsured: The Church Health Center of Memphis," Ethnicity & Disease Journal).

Wellness programs, also delivered off-site to local churches, include a 25,000 s.f. YMCA facility ("New Church Health Center YMCA opens in Crosstown," MCA) adjacent to the consolidated clinics at Crosstown Concourse Center in Downtown Memphis, which is the adaptive reuse of a former Sears Department Store and catalog distribution center, and a food and nutrition program ("Church Health's Memphis Teaching Kitchen Promotes Healthy Bodies and Communities," Parade Magazine).

Mississippi public health service model for impoverished communities, modeled after a program in Iran ("What Can Mississippi's Health Care System Learn From Iran" New York Times).  From the article:
“When the Iranian system was developed in the 1980s, there were no doctors in rural Iran,” Miller says. “And this is similar to the problem in the delta today.” ...

The Iranians built “health houses” to minister to 1,500 people who lived within at most an hour’s walking distance. Each house is a 1,000-square-foot hut equipped with examination rooms and sleeping quarters and staffed by community health workers — one man and one or more women who have been given basic training in preventive health care. They advise on nutrition and family planning, take blood pressure, keep track of who needs prenatal care, provide immunization and monitor environmental conditions like water quality. ...

People who become very sick, or require surgical procedures, are referred up through a single, multitiered system: from health house to rural health center to district hospital. The integrated nature of the system is what makes it unique. Today, 17,000 health houses serve 23 million rural Iranians. Health disparities between rural and urban Iranians have narrowed; the Iranians have reduced rural infant mortality by 75 percent and lowered the birthrate. Iran’s reforms won praise from the World Health Organization, which has long advocated preventive, primary care.
In seven rural and impoverished counties, Mississippi has developed a similar kind of integrated system. This program is rural focused, on patients living in disparate places, often many miles from large health care facilities.  It's comparable to marrying community clinics to hospital networks, with a focus on providing home care for chronic conditions.  And providing funding for the program, in a state that typically underfunds social and health programs.

-- HealthConnect, Mississippi State University
-- Delta Health Alliance

Lesson: provide an integrated system of health care, with a focus on prevention and chronic conditions, delivered to under-served populations. Providing care is likely to reduce overall costs, since many of these people don't enter the health system until health problems become much more serious.

CareMore, a for profit health provider focusing on providing care to Medicare and Medicaid patients.  According to the Commonwealth Fund case study, "How CareMore Saves Through Investment in Prevention and Early Intervention," the firm:
operates on the premise that a third or more of health care spending on frail and chronically ill patients can be eliminated by restructuring the way their care is delivered.

CareMore has built its business around identifying high-risk patients who have a high likelihood of developing problems as they age, and surrounding them with coordinated services. CareMore’s effort to improve care for frail or chronically ill patients—especially the sickest 15 percent of its membership that accounts for some 75 percent of spending—is part of its strategy to spend more preventing and slowing the progression of disease than treating it. ...

As a result, CareMore says the company spends about twice as much as traditional Medicare keeping sick patients from getting sicker, but only half of what the program spends on the sickest patients.
As part of their total care program and to assure adherence, they pay for medications without requiring co-pays ("4 things CareMore is doing to improve the Medicare patient experience and why consumerization isn’t one of them," MedCity News) and transportation to appointments, provide fitness programs and gyms within their care centers, and have redesigned the clinics to be more engaging ("Are Friends the Secret to Good Health," Wall Street Journal).

Lesson: commit to filling the gaps in care, access, mobility, etc., that often exist for patients, so that adherence to required medical treatment is maintained and wellness maximized.

HealthOnBroadway: El Rio Community Health Center and Tucson Medical Center.  HealthOn Tucson is a joint program of the community health program and the city's major medical hospital ("New downtown Tucson health clinic offers a different patient experience," Arizona Daily Star).

Not unlike "urgent care clinics" and clinic operations in pharmacies like Walgreen's and CVS, their first venture is the creation of a community wellness and "emergency care center" on Broadway Avenue in Downtown Tucson.  The facility is open six days/week, most nights til 9 pm, and is highly visible. According to the article, these are innovations implemented in the center:

-- high quality and modern design (Photos: BWS Architects)
-- self check-in
-- "Dialogue rooms" where people can talk to health care providers without being in an exam room
-- on site classes, including a conference room that doubles as an exercise room
-- health coaches
-- online appointment booking, including the use of virtual applications functioning like telemedicine
-- hours beyond office hours.

But the facility is more than just a place to drop in for a flu shot, as they have a broader focus on working with the patient over time such as with health coaches, offering free wellness programming, etc.

Lesson: develop facilities and programs that respond to the reality of the patients the hospital intends to service and their service expectations.

Teaching Kitchen, River Market, Little Rock, Arkansas
Teaching Kitchen, River Market, Little Rock, Arkansas.  Photo by Daman Hoffman.

Latino Health Access, Orange County, California.   Focused on providing health care to the Latino community, which has traditionally been underserved, the organization focuses on education, prevention and participation, training a cadre--many thousands over the years--of paraprofessionals and volunteers working in and already part of the community, to deliver health education, focused on chronic diseases, such as diabetes.

The organization was featured in a four-part HBO documentary “The Weight of the Nation,” on addressing obesity.

The organization sponsors an annual health walk, has built a park and community center in an impoverished neighborhood that lacked such facilities ("Residents Bring First-Ever Park to California’s 92701 Zip Code," Salud America!), and the organizations main clinic has a community room with space for exercise classes, fitness equipment, and space, a "Youth Room," for adolescents.

LHA has published a workbook, Recruiting the Heart, Training the Brain: The Work of Latino Health Access, discussing what they do, how they built the organization, and their care model.

Dietitians in supermarkets.  It used to be unique, but now many supermarket chains--notably Hy-Vee, Martin's, and Shoprite--have dietitians on staff and they offer programs and counseling so that people can make better food choices ("Dietitians Pay Off for Supermarkets," New York Times; "Where to find a dietitian: your supermarket, Journal News).  Hy-Vee programs include a ten-week program on diabetes care management, weight management for adults, and weight management for children

In the DC area, supermarket chains like Giant and Safeway are offering classes and programming, even if every store doesn't have a full-time dietitian.

I have long thought that Eastern Market, DC's public market, if it had a demonstration kitchen, could work with WIC, senior nutrition, and other food assistance and training programs in a similar way.

Eskenazi Health Indianapolis: Food programs. Eskenazi Health is a county hospital in Marion County/Indianapolis. When the organization decided to build a new hospital they took the opportunity to rethink their food-related health programs.

From the Indianapolis Business Journal article, "Eskenazi Health getting national recognition for healthy, fresh food":
Food is huge at Eskenazi, the oldest and largest public health care system in Indiana. The system—best known for its Level 1 trauma center, burn unit and community health centers—serves mostly poor and underinsured patients, many of whom have poor eating habits and chronic diseases, from diabetes to heart disease. ... But when the hospital moved its operations in 2013 into a brand-new, $754 million complex, leaders decided it was time to rethink food operations.

The first move: Leave the deep fryers behind. Today, all food is cooked on stoves or in huge rows of ovens. Other moves: Drop soda from the menus, offer free fruit-flavored water in retail areas, provide a variety of vegetarian options, and create a huge salad bar, with one low price for the salad, no matter how high it is stacked, rather than charging by weight.

Another big decision was to build a 5,000-square-foot farm on the rooftop, where employees and patients can plant and harvest a huge array of produce, including tomatoes, fennel, arugula, spinach, broccoli, squash and blackberries. Last year, the farm harvested nearly two tons of produce.

“When we had the opportunity to move to this new location,” Harris said, “we decided we were going to put everything we knew about promoting health into the campus, starting with the building: natural light, green space, art, music and fresh air.” She added: “Obviously, food has to be core. We have no message if what we’re serving is not the most nutritious food we can provide.” ...

In recent months, Eskenazi has rolled out a wide array of new programs. It hired an overnight kitchen shift to prepare more foods from scratch. It opened a small fresh-food grocery to help patients and guests who live in food deserts. It started a “Fresh Veggie Friday” to highlight produce grown on its 5,000-square-foot rooftop Sky Garden. 
Lesson: Use food and nutrition programs as a way to redefine the hospital.  Create a rooftop garden program and open it up to the public.  Develop a grocery store or public market type program as part of the facility. The hospital's food service program could be used to seed a food service/culinary education program. Etc.

Also see "Growing Places Indy will operate the Sky Farm on the roof of the new Eskenazi Health Hospital," Green Roofs.

More thinking about food/supermarkets as an opportunity to integrate with a health center. Besides farmers markets, which many hospitals do, and the innovation of the grocery store on the part of Eskenazi Health in Indianapolis, I've mentioned a bunch of times the concept of using a public market as a way to expand food access options.

In "Building a local economy vs. "economic development" in planning: Wizards practice facility," I outlined how the public investment in that facility could be used to anchor food service business development. But actually it would make much more sense out of a community hospital.  I am using some of that text and expanding it here.

1. Supporting the development of social entrepreneurship ventures should be considered as an element of the development program for the new hospital.

2. Position the food service within the building as a specific local economic development initiative. This could be done by creating a kind of "pop up" food service operation within the building, with professional oversight and technical assistance, with East of the River entrepreneurs having the first dibs on developing food-related businesses and providing the food services for the building, perhaps anchored by a couple of other existing locally owned food businesses already operating in the city.

3. Create a "community kitchen" out of the kitchen/food service facilities for the building. One way to facilitate this would be to set up the back of the house kitchen as a catering type facility designed for 24/7/365 use by local food service business entrepreneurs. That would maximize the economic return from this element of the facility.

4. Integrate restaurants and retail into the community facing side of the building to strengthen commercial activity and placemaking opportunities in the vicinity of the Congress Heights Metrorail Station. The model would be the plan for St. Anthony Hospital in Chicago.
The ground floor elevation/entrance should be designed and configured to include one or two food/restaurant event spaces that would be open 365 days/year, building positive business activity on both sides of the street. The key would be to do this well, not badly, unlike how this has been attempted thus far at the Washington Convention Center.

This is suggested for two reasons: (1) to broaden the retail and restaurant offer in Congress Heights/Ward 8 and (2) to enable the creation and maintenance of such businesses when normal economic conditions do not otherwise favor the financing and operation of for profit businesses in such locations.

5. Develop a culinary training program. Examples include DC Central Kitchen, the Nurish project of Kera Carpenter ("NURISH Food & Drink Opens Cafe in Historic Downtown Anacostia"), the Community Kitchen Cafe in Pittsburgh ("Munch goes to Community Kitchen's CK 9th Street Café," Pittsburgh Post-Gazette), or the COLORS training, restaurant, and business cooperative operations in New York City and Detroit (they say they're coming to DC).

6. Develop a healthy grocery store/public market.  Good Food Markets, with two stores in DC and one store coming to Seat Pleasant ("Can a nonprofit grocer succeed in a Prince George's city that Safeway left," Washington Post) is one option.

Planning diagram for the new location of the Mariposa Food Cooperative in Philadelphia.

Creating a food cooperative is another, and could bring in the National Cooperative Grocer Association and the National Cooperative Bank as partners.

As discussed in "The lost opportunity of the Takoma Food Co-op as a transformational driver for the Takoma Junction district," Seattle especially has amazing food cooperatives that are part of mixed use developments.

The Mariposa Food Cooperative in Philadelphia serves a middle income community and recently moved and expanded. The Mariposa market offers workshops and community projects, cooking and nutrition classes, has a community meeting space, and a rooftop garden and beekeeping operation.

The creation of public market is a third option.

Community pharmacy + wellness.  An independent pharmacy could be included as part of the retail offer and integrated into the health and wellness program, especially in association with food service and supermarkets.

The Aurora Hospital and Clinic system includes pharmacies in many of its hospitals and clinic sites.  Separately, it works with the Center for Urban Population Health in Milwaukee "to identify what will make people healthier and create partnerships with community health and academic experts to put those ideas into practice."

Aurora has more than 700 clinical research projects underway with 300+ teaching faculty across the system.

Like many supermarket chains, Hy-Vee has pharmacies, but they've worked to develop a kind of integrated system that works similarly to the Iran/Mississippi program discussed above, and they way they've done it could be an interesting model to consider as part of this proposed program.

From the Mass Market Retailer article, "Hy-Vee Positions Itself as a 'Healthful Spark' for Patrons":
Hy-Vee brings to the task an impressive array of health and wellness resources that includes its in-store pharmacies and staffs, a specialty pharmacy operation, in-store health clinics, in-store dietitians, telepharmacies, and nine Hy-Vee Healthy You mobile units that bring health and wellness services to communities throughout the retailer's eight-state region.

Also see:

-- "Hy-Vee aims to engage children in health and wellness with KidsFit site," Shelby Report
-- Begin Healthy Lifestyle and Weight Management Program, Hy-Vee
-- "Hy-Vee covers all the bases in wellness," Drug Store News

Community pharmacy for seniors.  The Shoppers Drug Mart chain in Canada has created the "Wellwise" format to serve senior populations.  They've opened one store and a website, with plans for more stores.  According to the Chain Drug Review article "Wellwise lets seniors take charge":
Aging Canadians, Wilks says, want to keep active, try new things and stay independent for as long as possible — and it’s that spirit that is the foundation of Wellwise.

What makes Wellwise unique is that the store includes full-size vignettes where customers can walk through a model bedroom, bathroom, living room and garage to try out new products to see how they can possibly fit into their daily lives.

Soon the store will feature an innovation space where people can sample new products yet to hit the market, and it will also include a community room for associations and experts to run educational events.

Wilks notes that the Wellwise target audience starts with caregivers. “One in five Canadians are caregivers,” he says, adding that the loved ones and patients those caregivers take care of want to stay active and in their homes, and Wellwise aims to help them do just that. ...

A key aspect of the Wellwise concept, which differentiates it from other SDM stores, is the focus on prevention. “Our other stores are more about home health care and keeping people comfortable,” Wilks says, while Wellwise is more about protection and keeping customers healthy — or, as he puts it, being an “aging powerhouse.”

“In creating Wellwise, we put the focus on wellness, not illness,” says Theresa Firestone, SDM’s senior vice president of health care businesses. “Wellwise offers an enjoyable shopping experience that gives Canadians the tools and advice they need to age powerfully, not just comfortably.” ...

“At Wellwise, people can find everything from travel accessories to mobility products to help them stay in their homes longer,” says Wilks. “No matter what stage of life people are in, Wellwise will be an important resource for Canadians looking to take control of how they age.”
Community dentistry. There is a great need for public health dentistry programs.  According to the article on the Church Health dental program in Memphis:
The 12,000-square-foot facility on the second floor of the concourse features 24 dental chairs ... Hodge, dental director for Church Health, oversees a staff of four full-time dentists and 22 dental hygienists, assistants and residents. Several pro-bono providers also volunteer their services.

The amount that patients pay — generally 25-50 percent of the cost of services — is determined by a sliding scale based on such factors as income and family size. To use the services, residents must either be established Church Health medical patients or participate in the organization's affordable care plan for small businesses and self-employed people.

The dental program is about more than just fixing teeth. By improving smiles and correcting dental health problems, Church Health is boosting patients' confidence, and therefore their job opportunities and personal prospects, Hodge says.
Public health outreach in DC.  In terms of similar kinds of outreach programs comparable to some of the programs discussed above, DC's Department of Health sponsors various mobile health unit based programs and nutrition outreach programs.

In the summer, the DC police department, working with other agencies, sponsors community information fairs in neighborhoods across the city which include the participation of various health-focused organizations and agencies.

And working with DOH, the Department of Parks and Recreation has a program called Fit DC:
Launched in the Spring of 2015 by Mayor Muriel Bowser, FitDC is a comprehensive health and wellness initiative that encourages residents to live a healthier lifestyle by linking them to nutrition and physical fitness resources in their communities. FitDC will offer "Ward Walk" events, various challenges for District residents and official FitDC Coaches, who will offer guidance on making healthy lifestyle choices.
While it doesn't get much publicity these days, clicking on the FitDC tab of the DPR Events page finds that a wide array of programming is offered across the city at recreation centers and other venues.

Like the Denver system of integrated hospital, clinic, and other health facilities, it occurs to me that city public health outreach programs, along with community clinics, and a new United Medical Center could be linked together as an integrated community health system.

Conclusion.  These examples, and I am sure there are many others, these are merely the ones that have caught my attention over the years, demonstrate that there is a way to use the transformational projects action planning lens generally and specifically for United Medical Center in Southeast Washington, as a way to redefine a hospital serving a largely impoverished population by integrating into it community health promotion and economic development initiatives that are programmatically stunning and innovative.

It will be a tragedy if DC does not avail itself of this opportunity, as it goes forward with planning, constructing, and operating a new Southeast DC hospital, either on its own or with other health care partners.

A program along the lines of these examples makes revitalization spillover benefits more possible than the more typical "we're building it and that will lead to trickle down improvement" approach.

Direct and specific is best.  Indirect and trickle down is not.

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170 Comments:

At 10:02 AM, Blogger Richard Layman said...

It occurred to me after writing this, that the various DOH outreach programs could be merged into this effort, and integrated.

2. A piece in yesterday's Post said that 80% of stroke deaths (140K/year) can be warded off through not smoking, changes in diet and exercise, etc.

 
At 7:56 AM, Blogger Richard Layman said...

Public hospital systems in Miami:

http://www.miamiherald.com/news/health-care/article210704664.html

and Memphis

https://www.commercialappeal.com/story/news/government/county/2018/05/09/shelby-county-eyes-massive-redevelopment-med/596319002/

are going through upgrades.

Miami's did a public bond, with the argument they needed to invest in improvements to be competitive with other private and nonprofit hospitals. To become a hospital of choice rather than one of last resort. Aim to draw in more insured patients to help defray the cost of serving the uninsured.

5/11/2018

 
At 12:19 PM, Blogger Richard Layman said...

I forgot to mention this NYT Magazine piece about the disparities in birth-related deaths in the US between blacks and other races. Pretty damning.

https://www.nytimes.com/2018/04/11/magazine/black-mothers-babies-death-maternal-mortality.html

 
At 10:22 AM, Blogger Richard Layman said...

Seinäjoki, Finland: anti-obesity program for children

http://www.spiegel.de/international/tomorrow/nutrition-how-finland-has-solved-the-problem-of-obese-children-a-1088256.html

neuvola -- health centers for young families, services til the child enters school

https://yle.fi/uutiset/osasto/news/despite_reversal_seinajoki_still_believes_in_childhood_anti-obesity_programme/10112854

 
At 3:24 PM, Blogger Richard Layman said...

JLL 2018 US healthcare real estate outlook:

http://www.us.jll.com/united-states/en-us/research/us-healthcare-real-estate-outlook-2018-jll.pdf

 
At 6:31 PM, Blogger Richard Layman said...

Bon Secours Baltimore Health System in West Baltimore has a big neighborhood revitalization effort.

Their programs include the construction and operation of affordable housing. Almost 800 units.

https://bonsecours.com/library/community-involvement/baltimore/bonsecours_communityworks_broch_111412.pdf?la=en

 
At 9:53 AM, Blogger Richard Layman said...

The Salt Lake _County_ Library system (separate from the SL City library system) runs a library "reading room" in the South Main Public Health Clinic, which serves a predominately low income population. A big element of the service is providing free books to children.

https://www.ksl.com/index.php?sid=25176350&nid=1009&title=clinics-reading-room-making-a-big-difference-for-low-income-kids&fm=related_story&s_cid=article-related-3

https://www.urbanlibraries.org/innovations/2013-innovations/health-wellness-safety/byington-reading-room

 
At 9:30 AM, Blogger Richard Layman said...

Hyvee has created a stand alone "HealthMarket" with some specific features for seniors.

https://www.supermarketnews.com/retail-financial/hy-vee-healthmarket-store-makes-debut

"The new format, a stand-alone version of the retailer’s HealthMarket store-within-a-store concept, is geared toward consumers focused on a healthy lifestyle and features more than 11,000 items."

Besides the normal food offer

... "also serves up an array of health-related amenities, led by a full-service pharmacy and a health clinic but also including a hearing aid center (offering free hearing tests) and a sports nutrition area.

Along with Hy-Vee Aisles online grocery shopping and pickup, the Hy-Vee HealthMarket houses a hydration station with nitro coffee, kombucha and Bevi infused waters, and a nearly 3,000-square-foot Orangetheory Fitness center is attached to the store. Also featured is the retailer’s Basin beauty care brand, which specializes in all-natural bath and body products."

 
At 9:33 AM, Blogger Richard Layman said...

Nationwide Children's Hospital in Columbus, Ohio is developing a neighborhood improvement initiative:

https://www.citylab.com/equity/2018/09/when-a-hospital-plays-housing-developer/569800/

 
At 9:35 AM, Blogger Richard Layman said...

Grubb Care First Pharmacy in NW DC (Dupont Circle) offers "Red Carpet Service which provides round trip transportation service to patients for appointments, free HIV and Hp C testing for high risk patients, and free linkage to care services" according to Drug Store News, 8/7/2018, p. 14

 
At 10:08 AM, Blogger Richard Layman said...

Iora Health integrated model discussed in the Harvard Business Review:

https://hbr.org/2018/07/transforming-health-care-from-the-ground-up

 
At 11:22 AM, Blogger Richard Layman said...

As part of medical school programming, Columbia University has opened the "Community Wellness Center" in Upper Manhattan which provides health services, and some free services, and also "trains residents of Harlem and the surrounding area to serve as community health advocates."

http://communitywellness.manhattanville.columbia.edu

But outside of certain screenings, like for blood pressure and cholesterol, they don't provide medical services.

9/29/2018

 
At 9:28 AM, Blogger Richard Layman said...

Mercer University Medical School students do health screenings at farmers market

http://www.wtoc.com/2018/09/29/mercer-university-students-hold-health-screenings-farmers-market/

 
At 7:33 AM, Blogger Richard Layman said...

1. "Southern diet blamed for Black Male health woes"

https://consumer.healthday.com/cardiovascular-health-information-20/high-blood-pressure-health-news-358/southern-diet-blamed-for-black-americans-health-woes-738250.html

2. Millennials prefer urgent care treatment over having a regular relationship with a doctor.

"Spurred By Convenience, Millennials Often Spurn The ‘Family Doctor’ Model"

https://khn.org/news/spurred-by-convenience-millennials-often-spurn-the-family-doctor-model/

10/16/2018

 
At 4:22 PM, Blogger Richard Layman said...

WSJ article, 10/23/2018, "Your Doctor the Meal Planner" lists some interesting best practice:

- ProMedica system in Toledo has the "social determinants of health institute" and they do provide food security support, and have even opened up a small grocer in a food desert, called "Market on the Green."

- Am Hospital Assn. published a report on food security and health.

- Northwell Health in New York State has a food pantry and will give patients a couple days worth of food.

- St. Joseph Mercy Hospital in Washtenaw County, Michigan grows food on its campus (25 acres) and has a farmers market on Wednesdays. Patients can get a "prescription" good for $10 of produce free.

 
At 7:48 AM, Blogger Richard Layman said...

https://retailleader.com/cvs-details-future-health-care

CVS to pilot stores that focus on five chronic health conditions:

diabetes, cardiovascular disease, hypertension, asthma and behavioral health.

Weis Super Markets making November a special push for nutrition education, a lot around diabetes management

https://retailleader.com/weis-markets-innovates-again-wellness


11/7/2018

 
At 7:50 AM, Blogger Richard Layman said...

More on Shoprite, an early leader in having dietitians on staff.

https://retailleader.com/weis-markets-innovates-again-wellness

11/7/2018

 
At 9:43 AM, Blogger Richard Layman said...

Porter Medical Center in VT, "Farmacy Project," free produce to some of their patients.

http://mountaintimes.info/rutlands-farmacy-project/

http://www.addisonindependent.com/201811farmacy-project-about-produce-not-pills

11/8/2018

 
At 7:55 AM, Blogger Richard Layman said...

California significantly more successful in reducing deaths from childbirth:

https://www.washingtonpost.com/national/health-science/a-shocking-number-of-us-women-still-die-from-childbirth-california-is-doing-something-about-that/2018/11/02/11042036-d7af-11e8-a10f-b51546b10756_story.html

 
At 7:26 AM, Blogger Richard Layman said...

United Health Care providing free Apple Watch to people meeting certain fitness goals.

https://www.cnbc.com/2018/11/14/unitedhealthcare-gives-free-apple-watches-if-walking-goals-met.html

 
At 12:18 PM, Anonymous Richard Layman said...

This article from the Augusta GA Chronicle on the Children's Hospital there discusses the many innovations introduced by the hospital, such as 24-hour visitation, which has now been adopted by many health care institutions, such as Holy Cross Hospital in Montgomery County, Maryland.

https://www.augustachronicle.com/news/20181208/childrens-hospital-celebrates-20-years

But the hospital’s most important “architects” were the patients and families who would use it. The late Pat Sodomka, then associate hospital director, consulted with the Bethesda, Md.-based Institute for Family-Centered Care to find ways to break traditional hospital norms – such as strict visitation hours – that distanced patients and their families from care providers.

The result was the Children’s Advisory Council, a committee of 20 pediatric patients and their families. Children chose the nature- and technology-themed interior decor, selected paint colors and even taste-tested the proposed hospital menu. ...

Sodomka, Moretz and a large list of physicians and administrators successfully lobbied to implement the hospital’s oft-duplicated innovations, such as 24-hour visitation and the large, private rooms equipped with trundle beds and couches enabling parents to sleep at their child’s bedside.

“The concept took a while to develop,” Linder said. “An adult physician may say you need a small room because you’ve got a small baby, when in fact, you’ve got a family, so you need bigger rooms and more space.”

 
At 3:08 PM, Blogger Richard Layman said...

This week's Washington Post Health Section focused on aging. There were two good articles:

- "Hospitals make ERs nicer, safer for the elderly"
- "You're getting older, Is it time to get medical care from a geriatrician?"

Demographically, likely East of the River is likely to have a preponderance of older residents, and providing focused health care services taking aging into account makes sense.

The first article mentions Holy Cross in Silver Spring, which pioneered special senior ER services. That was a factor in us choosing to go there when Suzanne's father was visiting and had a health care crisis...

12/14/2018

 
At 4:01 PM, Blogger Richard Layman said...

Chain Drug Review, 11/19/2018, p. 48 has an article "Rx Services go beyond dispensing" which discusses various ways a pharmacist/drug store can provide added value services, especially wrt management of chronic conditions.

http://digitaledition.chaindrugreview.com/1119018/Default/23/1#&pageSet=23&contentItem=0

 
At 3:50 PM, Blogger Richard Layman said...

CVS HealthHUB concept stores in Houston:

https://www.usatoday.com/story/money/2019/02/13/cvs-concept-store-introduced-space-health-care-services/2845846002/

 
At 12:33 PM, Blogger Richard Layman said...

Leonard Stoler, car dealer in Greater Baltimore, gives $25MM to U Maryland Medical Center for expansion of the cancer center program

https://www.umms.org/umgccc/news/2018/stoler-gift-new-umgccc-building

 
At 5:39 PM, Blogger Richard Layman said...

Boston Globe article about Brigham and Women's Hospital and needs for emergency department given changes in hospital organization and more difficult patients:

https://www.bostonglobe.com/metro/2019/03/02/brigham-expands-emergency-department-amid-changing-demands/DkXc9PrXOtjQI8NzcrMUfI/story.html

From the article:
With a $52 million expansion project that kicks off April 1, the Brigham will become the latest Massachusetts hospital to significantly enlarge and redesign its emergency department amid what leaders describe as unrelenting crowding.
Emergency medicine doctors said they need more space because the patients today require more intensive care, including those with mental illness and drug addiction, or who are suffering the toxic side effects of cancer treatment. These patients need more time, more tests, more attention.

====
Similarly, Washington Hospital Center has had to make similar changes in response to the closure of Providence Hospital and its emergency care facilities:

https://www.bizjournals.com/washington/news/2019/02/05/how-providence-s-service-cuts-have-hit-medstar.html

And there was an interesting article in the Washington Post about the hospital room problem. Most rooms are allocated already to previously scheduled procedures, and they don't keep some rooms available for use on an immediate basis:

https://www.washingtonpost.com/national/health-science/sorry-er-patients-people-with-elective-procedures-get-the-hospital-beds-first/2019/02/22/643d1460-2a25-11e9-984d-9b8fba003e81_story.html

 
At 12:39 PM, Blogger Richard Layman said...

Motley fool article printed in USA Today about how a visit to emergency can zap your finances:

https://www.usatoday.com/story/money/2019/03/04/emergency-fund-how-single-hospital-visit-can-ruin-your-finances/39084571/

 
At 4:09 PM, Blogger Richard Layman said...

Bronson Methodist Hospital in Downtown Kalamazoo has an outpatient pharmacy and they've combined it with their gift shop which they've made over into a fresh food "convenience" store.

While open to the public, it's likely that most of the customers are staff. However, the downtown area doesn't have a grocery, so it may be able to serve some of those needs.

They don't sell prepared foods because of the on-site cafeteria, but I could see it being successful with "meal kits" targeting time-pressed staff.

https://www.mlive.com/news/kalamazoo/2019/01/micro-grocery-store-opens-inside-bronson-hospital-in-downtown-kalamazoo.html

 
At 7:19 PM, Blogger Richard Layman said...

The ProMedica health system in Toledo (1) created the Ebeid Institute for Population Health as a way to serve underserved communities and (2) on the ground floor of the building created a 65000 s.f. "Market on the Green" nonprofit supermarket. A hospital nutritionist does programming, cooking glasses and store tours.

The workforce development program of Ebeid is integrated with the staffing program for the supermarket.

(3) there is a Financial Opportunity Center program too, GED classes, etc.

https://www.toledoblade.com/Food/2017/09/25/Delicious-lessons-Cooking-Matters-classes-teach-adults-to-make-healthier-meals.html

https://www.toledoblade.com/Featured-Editorial-Home/2016/12/06/Toledo-Blade-editorial-The-good-health-store.html

https://www.newswise.com/articles/ohio-based-promedica-celebrates-one-year-anniversary-for-its-grocery-market-and-announces-plans-to-expand

https://www.supermarketnews.com/retail-financial/ohio-hospital-opens-grocery-store

3/20/2019

 
At 7:31 PM, Blogger Richard Layman said...

Basics Market in Portland is "chef-driven store" Classes on knife skills, nutritionist, classes. Discovery classroom.

8 meals featured throughout the store at "meal stations."

https://www.winsightgrocerybusiness.com/retailers/peek-inside-portlands-basics-market#page=0

https://portlandtribune.com/pt/11-features/406294-304473-new-market-brings-the-basics-and-more

https://www.supermarketnews.com/prepared-foods/basics-market-goes-beyond-simply-selling-food

3/20/2019

 
At 2:07 PM, Blogger Richard Layman said...

cancer prevention and education outreach to communities of color

https://www.crainsnewyork.com/gotham-gigs/cancer-survivor-does-outreach-communities-color

3/21/2019

 
At 3:19 PM, Blogger Richard Layman said...

Conway Center, So Others Might Eat, 4430 Benning Road NE

patient navigator, addiction treatment, Unity Health Care clinics, on site pharmacy, classrooms for Center for Employment (medical assistants, building trades including HVAC).

affordable housing units, 152 single adult units, 30 apartments for family. Includes case management. After school program for children.

https://www.washingtonpost.com/local/a-new-building-on-benning-road-ne-offers-new-hope-for-the-homeless/2018/12/31/d7a88a66-0d0a-11e9-84fc-d58c33d6c8c7_story.html

 
At 3:25 PM, Blogger Richard Layman said...

Bethany Women's Day Center, N Street Village

John Kelly Washington Post article, 12/26/2018

 
At 5:16 PM, Blogger Richard Layman said...

3rd Street Youth Center and Clinic, Bayview Hunters Point neighborhood, San Francisco

Interesting ladder of programming to develop youth self-knowledge about health issues.

Also a year program involving various institutions introducing youth to health careers

 
At 7:10 AM, Anonymous Richard L Layman said...

Leeds only major UK city to see a drop in child obesity:

https://www.theguardian.com/world/2019/may/01/leeds-becomes-first-uk-city-to-lower-its-childhood-obesity-rate

It's attributed to the HENRY program:

https://www.henry.org.uk/ourpeople

Health, Exercise, Nutrition for the Really Young

 
At 11:50 AM, Anonymous Richard Layman said...

HBR article on the social determinants of health:

https://hbr.org/2019/05/an-effective-way-to-tackle-the-social-causes-of-poor-health

 
At 6:49 AM, Anonymous Richard L Layman said...

https://www.theguardian.com/society/2019/jun/04/sure-start-saved-nhs-millions

Sure Start children’s centres delivered major health benefits for youngsters in the most deprived areas, reducing the number of people taken to hospital and delivering millions of pounds in savings to the NHS, a study has found.

The Institute for Fiscal Studies research found that where Sure Start offered high levels of service in poor neighbourhoods in England, visits to hospital to treat injuries fell among all children of primary school age, and by a third of all 11-year-olds.

The study questioned the current cuts to children’s centre budgets – reduced by two-thirds nationally between 2011 and 2017 – and urged the government to acknowledge Sure Start’s “big positive effect on children’s health” in future public spending plans.

It also highlighted its effect in reducing health inequalities. “Since the benefits are biggest in the poorest neighbourhoods, access to Sure Start can help close around half the gap in hospitalisations between rich and poor areas,” said Gabriella Conti, a UCL academic and the study’s co-author.

 
At 2:24 PM, Blogger Richard Layman said...

Dallas Parkland Memorial Hospital, creating a linked computer network between the hospital and various social and health organizations.

From the article:

Parkland Center for Clinical Innovation, a health IT research and development think tank created by Dallas-based Parkland Health & Hospital System, in 2015 launched a local health information exchange, called the Dallas Information Exchange Portal. The Dallas IEP connects Parkland Health & Hospital System to social services organizations across the area — such as food pantries and homeless shelters — to help physicians and case managers streamline care coordination.

To date, the Dallas IEP has exchanged information related to a quarter million patient encounters.

"Up to 50 percent of clinical outcomes are driven by social, economic or environmental factors, and not necessarily related to the direct care the individual received," says PCCI President and CEO Steve Miff, PhD. "That has basically set the stage and created the need for this solution to connect communities, and through that, to drive personalized medicine."


https://www.beckershospitalreview.com/population-health/how-a-texas-innovation-hub-is-eliminating-socioeconomic-health-disparities.html

6/11/2019

 
At 6:48 PM, Anonymous Richard Layman said...

Mental Health Center of Denver family clinic with farm and greenhouse.

The overall redevelopment of a shopping center site includes senior housing, affordable housing, and a family health clinic. The Mental Health clinic will include a community space, community gym facility, teaching kitchen, and dental clinic also.

http://renewdenver.org/projects/northeast-park-hill-dahlia-square/

https://www.denverpost.com/2015/12/14/community-input-shaped-new-mental-health-clinic-in-denvers-park-hill/

 
At 2:57 PM, Anonymous Richard Layman said...

Washington City Paper, 7/26/2019, "No Hope for the Cure" about the rise and closure of the DC Cancer Consortium, which was notable for its provision of support services East of the River.

Without the program, limited services are provided. But the program's founders never planned to keep the organization operational once the initial source of funding -- tobacco lawsuit settlement funds -- ran out.

 
At 9:51 AM, Blogger Richard Layman said...

University of Maryland Baltimore community center in West Baltimore will open in the summer:

https://www.bizjournals.com/baltimore/news/2019/10/25/umb-breaks-ground-on-community-center-in-west.html

 
At 6:13 PM, Blogger Richard Layman said...

"Poor diabetes care can be deadly", Jane Brody, NYT 11/26/2019

 
At 9:24 PM, Blogger Richard Layman said...

https://www.nytimes.com/2019/10/10/business/healthcare-anchor-network.html

Economic impact of health care spending on local businesses and hiring local.

 
At 9:12 AM, Blogger Richard Layman said...

https://www.statesman.com/news/20200103/giving-city-st-davidrsquos-ceo-leaves-legacy-of-innovation

St. David's Foundation. Owns 41% of the St. David's Healthcare system in Austin. Uses its share of revenue to fund health care and other programs, from dental outreach to parks improvement.

Says 20% of health care outcomes to do with access to care; the other 80% dependent on family structure, where you live, access to food, parks, etc.

1/3/20

 
At 10:26 AM, Blogger Richard Layman said...

CVS Health Hub concept

https://drugstorenews.com/cvs-health-debuts-first-healthhub-locations-atlanta

During a ribbon-cutting event at the company's HealthHUB location at 687 Johnson Ferry Rd. in Marietta, Ga. the community celebrated the new, innovative store format that features a broader range of health care services to help patients better manage chronic conditions, more products and services focused on overall health and wellness, and personalized care.

1/16/20

 
At 5:18 PM, Blogger Richard Layman said...

"Heart Disease Roars Back, Even in Healthy Places," WSJ, 1/15/2020

 
At 1:04 PM, Blogger Richard Layman said...

speaking of net assessment, hospitals being built going forward should have upgraded emergency and epidemic response capabilities.

https://www.newsweek.com/this-chicago-hospital-was-built-after-9-11-epidemic-like-coronavirus-mind-1493229

3/23/2020

 
At 4:01 PM, Blogger Richard Layman said...

architecture/design and infection control:

https://www.bostonglobe.com/2020/04/06/opinion/role-architecture-fighting-pandemic

 
At 10:48 PM, Blogger Richard Layman said...

higher rate of death from the coronavirus in black and Hispanic communities.

https://www.bostonglobe.com/2020/04/10/nation/with-coronavirus-racism-is-underlying-condition

Detroit, Louisiana, NYC, etc.

 
At 3:35 PM, Blogger Richard Layman said...

St. Agnes Hospital of Baltimore, formerly owned by Bon Secours, but sold to LifeBridge as part of a post consolidation Bon Secours merger, is being downgraded to less than a hospital.

But in 2015, they were pursuing a nearby project to redevelop an old school site as a combo retail and recreation space, similar to what St. Anthony Hospital is trying to do in Chicago.

https://www.bizjournals.com/baltimore/news/2015/05/05/royal-farms-y-of-central-maryland-join-saint-agnes.html

 
At 8:30 AM, Blogger Richard Layman said...

DC health equity report, 2018:

https://dchealth.dc.gov/publication/health-equity-report-district-columbia-2018

 
At 1:37 PM, Blogger Richard Layman said...

post birth period as "the fourth trimester"

https://www.bostonglobe.com/2020/05/06/magazine/fourth-trimester-plight-new-mothers-during-pandemic/

 
At 9:45 AM, Blogger Richard Layman said...

Important article about the Commonwealth Care Alliance in Mass., tasked with providing care to the extremely impoverished (40,000 people on both Medicare and Medicaid). Their use of big data/analytics to deal with the potential of coronavirus, chronic disease management.

https://siliconangle.com/2020/05/23/big-data-safety-net-catching-high-risk-patients-pandemics-rampage/


----
CCA is an insurer and primary health care provider that serves nearly 40,000 of the highest-risk patients in the state: people who receive both Medicaid and Medicare benefits or elderly residents with limited healthcare coverage. Most are either elderly or disabled and all are low-income. More than 60% of CCA members have disabilities and two-thirds of members under age 65 experience severe mental illness. That puts them at the highest risk of dying from COVID-19.

 
At 9:46 AM, Blogger Richard Layman said...

From the article:

The clinician platform CCA built provides a holistic view of each member that includes medical conditions, behavioral conditions and social needs. “It’s a comprehensive view around a single individual at a point in time plus how things have changed over time,” Kudesia said.

Data elements include outreaches, phone call records, telehealth and details of palliative care, which is specialized care for people living with serious illnesses. “We’ve been able to knit the timelines to tell the full tory of a person who’s vulnerable, what we’ve done for them and what services they receive,” Kudesia said.

Clinicians now have tailored visualizations that consolidate clinical data with localized COVID-19 information and highlight the most urgent cases that need attention, such as members in high-infection areas or those needed special services.

Predictive analytics enable the organization to spot potential problem areas before they develop. For example, patients requiring oxygen can only keep small amounts of the liquid form in their homes because of the danger of fire. They rely on frequent deliveries to keep them alive. With risks to supply chains growing, “We were able to reach out proactively to the companies that deliver oxygen, ask about their ability to continue to deliver and request that they leave additional supplies,” Kudesia said. “We have those members in our sights, and they are not going to slip.”

 
At 9:07 AM, Blogger Richard Layman said...

WSJ, "Rethinking the Hospital for the Next Pandemic"

https://www.wsj.com/articles/rethinking-the-hospital-for-the-next-pandemic-11591652504

6/8/2020

Other WSJ articles in the same section:

"Wanted: Doctors to Treat Addiction" -- many doctors lack the certification to use drugs as part of addiction treatment

"The High Cost We Pay for Crowded ERs" -- reports on research that crowded conditions in ERs leads to worse outcomes and more death.

"A Multipronged Strategy for Obesity" looks at addressing obesity more directly and with a wider range of treatments.

 
At 1:55 PM, Blogger Richard Layman said...

More on the revival of Jackson Health System, the public hospital in Miami-Dade.

https://www.miamiherald.com/news/health-care/article74816342.html

Making it a hospital of choice. Management and labor cost improvements.


Public bond to support hospital system.

https://www.miamiherald.com/news/local/community/miami-dade/article1967074.html

 
At 6:10 PM, Blogger Richard Layman said...

"Mortality rate for Black babies is cut dramatically when they’re delivered by Black doctors, researchers say"

https://www.washingtonpost.com/health/black-baby-death-rate-cut-by-black-doctors/2021/01/08/e9f0f850-238a-11eb-952e-0c475972cfc0_story.html

 
At 10:11 PM, Blogger Richard Layman said...

Michael Jordan donates $10 million to open new medical clinics in his North Carolina hometown

https://www.cnn.com/2021/02/15/us/michael-jordan-clinics-donation-trnd/index.html

In 2017, Jordan committed $7 million to Novant Health to open two clinics in Charlotte. The donation came with a pledge to provide resources to communities with little or no health care.

The first Novant Health Michael Jordan Family Medical Clinic opened in October 2019. Last year, it served as a Covid-19 screening and testing site, providing more than 13,000 tests.

Last October, the six-time NBA champion again partnered with Novant Health to open a second medical clinic in Charlotte, North Carolina.
To date, Novant Health said the two Charlotte clinics have brought primary care, behavioral health and social support services to the area's most vulnerable communities, seeing more than 4,500 patients and administering almost 1,000 Covid-19 vaccines.

Novant Health said Jordan's latest donation will help "bring this same integrated care model to more rural and rural-adjacent communities in his hometown."

 
At 2:47 PM, Blogger Richard Layman said...

WRT "chronic conditions"

BYU study: Patients live longer with social and emotional interventions, not just medical care

https://www.deseret.com/2021/5/28/22449445/byu-plos-medicine-study-says-patients-live-longer-psychosocial-interventions-not-just-medical-care

2. Sisters in Birth clinic in Jackson Mississippi, focused on assisting women of color in pregnancy, as black mothers die nearly 3x more often than whites of pregnancy related causes.

https://www.jacksonfreepress.com/news/2021/jul/09/sisters-birth-standing-expecting-mothers/

 
At 1:26 PM, Blogger Richard Layman said...

Yahoo! Voices: Alcohol Abuse Is on the Rise, but Doctors Too Often Fail to Treat It.
https://www.yahoo.com/news/alcohol-abuse-rise-doctors-too-182915495.html

 
At 3:27 PM, Blogger Richard Layman said...

https://www.usatoday.com/story/news/health/2021/07/27/us-news-best-hospital-ranking-includes-first-health-equity-analysis/8090005002/

"US hospitals struggle to reduce health disparities: Minority patients underrepresented in 4 of 5 hospitals"

2.

"Bread for the City expands health-care options in Southeast with new medical clinic"

https://www.washingtonpost.com/local/dc-politics/bread-city-medical-clinic-anacostia/2021/10/04/bcfa71de-22bf-11ec-9309-b743b79abc59_story.html

 
At 10:16 AM, Blogger Richard Layman said...

wrt actual design of the hospital and its campus, Inga Saffron of the Philadelphia Inquirer makes the point that because hospital planning is in large part focused on accommodating cars in parking, etc., that providing high quality people spaces within a hospital complex is stinted.

"Penn’s new hospital belatedly recognizes pedestrian space is a public health issue"

https://www.inquirer.com/real-estate/inga-saffron/penn-medicine-new-hospital-traffic-pedestrians-20211108.html

 
At 10:24 AM, Blogger Richard Layman said...

In 2008 Saffron wrote that the then newest hospital building was constructed for "the suburbs" not the city.

https://www.inquirer.com/philly/gallery/20081017_Changing_Skyline__Penn_got_a_trophy__not_a_triumph__in_hospital_design.html

 
At 3:18 PM, Blogger Richard Layman said...

In Pittsburgh, the Allegheny Health Network has created a health clinic designed to serve people who had been jailed (mental health issues etc.), as a way to keep them out of jail.

"Rare medical clinic aims to keep repeat offenders out of jail"

https://www.post-gazette.com/local/city/2021/11/28/former-county-inmates-healthcare-Allegheny-Health-Network-s-RivER-Clinic-addiction-mental-health-Allegheny-County-Jail/stories/202111230087

The facility is “meeting peoples’ basic needs in ways that we were not previously able to,” said Laura Williams, Allegheny County Jail’s chief deputy warden of healthcare. “And we’ve seen individuals continue care and not come back into incarceration.”

Launched in June, jail administrators say the program is starting to address one of the major causes of people getting arrested over and over: medical issues — mostly addiction and mental health.

Since its opening, the clinic has reached out to 160 former inmates through September after they were identified by the jail as needing healthcare because of addiction, chronic illnesses, or they were met on the street outside the facility as they were released.

Of those 160 inmates, the clinic staff was able to convince 85 to show up to reserve their doctor’s appointments at the facility located on Federal Street on the North Side. Since so many former inmates don’t have cell phones or stable homes and in some cases, are homeless, experts say they’re encouraged by the clinic’s ability to pull in more than half the inmates they’ve contacted in just a few months.

 
At 10:06 AM, Blogger Richard Layman said...

Eight clinics serving seniors open in past two months in St. Louis area.

https://www.stltoday.com/lifestyles/health-med-fit/health/eight-clinics-serving-seniors-open-in-past-two-months-in-st-louis-area/article_97b366a2-31a3-574b-9a67-74bcfc7e3429.html

The new clinics are focused on those enrolled in Medicare Advantage — managed care plans that operate based on value rather than volume.

They are not your typical doctor offices.

The clinical staff provides transportation, same-day appointments and on-site prescriptions. They offer meetings with dieticians and social workers. They coordinate care with specialists.

Community rooms host activities such as bingo, yoga or a nutrition class. Doctor visits take much longer. Patients receive an array of health screenings to catch problems early. ...

“We’re not just doctors taking care of their medical issues,” Wilson said. “That’s why they’re ‘members.’ We want them to come in, interact with us, come into the activity center, use us for whatever they need. Sometimes, they may not be sick. They just need to come in and talk, and we can do that.”

The model is based on the idea that seniors can avoid higher medical costs down the road if they receive coordinated care and a thorough assessment of their chronic conditions and social needs.

 
At 10:06 AM, Blogger Richard Layman said...

https://www.washingtonpost.com/local/bread-for-the-city-dentistry/2021/11/29/95720f26-5133-11ec-8769-2f4ecdf7a2ad_story.html

"Bread for the City’s new Southeast D.C. dental clinic puts smiles on a lot of faces"

 
At 10:10 AM, Blogger Richard Layman said...

https://www.khou.com/article/news/health/university-of-houston-school-of-medicine-clinic-healthcare/285-ec07512c-054d-4bbd-a91e-d074d7a55695

Monthly subscription for low-cost healthcare is now available through University of Houston clinic

No insurance? No doctor? No problem. For $60 a month, the University of Houston College of Medicine Direct Primary Care Clinic is open to you.

"The clinic is the medical school’s first in a planned network of DPC clinics aimed at increasing access to care for those without health insurance.

Houston has the highest rate of uninsured residents in the nation, according to a press release from UH.

Startup costs for the pilot clinic were funded by a $1 million gift from The Cullen Trust for Health Care.

 
At 11:45 AM, Blogger Richard Layman said...

The rising homicide rate in D.C. is nothing compared with what fentanyl is doing

https://www.washingtonpost.com/dc-md-va/2022/02/07/opioid-fentanyl-addiction-narcan-racism-health-equity-gun-violence-dc/

 
At 2:51 PM, Blogger Richard Layman said...

"The Philadelphia Inquirer: Penn receives record $125 million to offer free tuition to nurse practitioners to work in underserved communities."

https://www.inquirer.com/news/penn-nursing-gift-leonard-lauder--20220214.html

2. Jackson County Michigan has a "community integrated paramedicine" program where EMS personnel are utilized as a way to provide "continuity of care" between hospital release and home, with the aim of increasing care compliance and reducing readmissions.

http://ippsr.msu.edu/sites/default/files/SOSS/CIP%20Pres%20Leg%20Edu%202.8.21.pdf

3. Regions Hospital, Minnesota, community paramedicine program.

https://www.regionsems.com/cp

 
At 9:45 PM, Blogger Richard Layman said...

https://www.post-gazette.com/news/2022/03/11/black-infant-mortality-ahn-elissa-edmunds-hunt/stories/202203130012

"Allegheny Health Network launches new effort to tackle Black infant mortality" (Pittsburgh)

In Pittsburgh, Black infants are more than four times as likely than white babies to die before they reach their first birthday.

This grim gap is the reason for a new initiative launched by Allegheny Health Network called First Steps and Beyond. The program aims to monitor the health and well-being of African American parents and their babies through the first year of life by expanding prenatal, perinatal, birthing and fatherhood services to residents. In doing so, it hopes to slash infant mortality of Black babies by at least 28% over the next five years.

 
At 2:46 PM, Blogger Richard Layman said...

Interesting article about a multi site medical practice system integrating services with urgent care. Separate from the two major hospitals in the Boise Idaho region.

Primary Health CEO David Peterman, champion of accessible health care, retires.
https://www.ktvb.com/article/news/local/idaho-press/primary-health-ceo-david-peterman-champion-of-accessible-health-care-retires/277-600726b8-2f96-4634-a4ea-4003068bf7fd

 
At 1:52 PM, Blogger Richard Layman said...

https://www.star-telegram.com/news/local/crossroads-lab/article262256272.html

6/12/2022

Program to manage chronic conditions for the uninsured. 10$ per month, mostly checkup, almost free medicines, etc.

 
At 12:53 PM, Blogger Richard Layman said...

We must reimagine how to address D.C.’s persistent health inequities

https://www.washingtonpost.com/opinions/2022/06/17/we-must-reimagine-how-address-dcs-persistent-health-inequities/

 
At 6:59 PM, Blogger Richard Layman said...

https://www.post-gazette.com/news/health/2022/06/26/upmc-annual-nicu-reunion-premature-babies-nurses-doctors-pittsburgh-zoo-magee-womens-childrens-hospital/stories/202206260187

"Hundreds of UPMC hospital NICU patients, caregivers reunite at Pittsburgh Zoo"

On Sunday at the Pittsburgh Zoo & PPG Aquarium, Ms. Moats and more than 350 former Magee and UPMC Children’s Hospital of Pittsburgh patients and their families were reunited with the UPMC nurses, doctors and clinical staff who cared for them.

The 19th Annual NICU Reunion was hosted by Magee-Womens Research Institute & Foundation to celebrate children who were born prematurely. Families enjoyed live music, dancing, crafts and more.

Dr. Ayesha Alriyami, who has been working at Magee for two years, said that on average, 10% of newborns need to be in the NICU and often stay for days or even months.

 
At 10:27 PM, Blogger Richard Layman said...

https://www.post-gazette.com/business/healthcare-business/2022/06/14/new-upmc-presbyterian-hospital-oakland-pittsburgh-opening-construction-groundbreaking-2026-leslie-davis-ceo-beds-surgery/stories/202206140032

"As UPMC breaks ground on new Presbyterian Hospital, the strategy isn’t about new beds"

Interesting discussion about the reorganization of hospital services. Still a big hospital. Hospitals in the DC area are being constructed with fewer than 300 beds.

 
At 4:53 PM, Blogger Richard Layman said...

New book, 2022.

Under the Sun: The Hidden Toll of Racism on American Lives and on the Health of Our Nation

Linda Villarosa

https://www.penguinrandomhouse.com/books/604283/under-the-skin-by-linda-villarosa/

 
At 9:55 PM, Blogger Richard Layman said...

D.C. is a world-class city without world-class health care

https://www.washingtonpost.com/opinions/2022/08/12/dc-is-world-class-city-without-world-class-health-care/

 
At 10:27 AM, Blogger Richard Layman said...

USA Today has a six part series on obesity.

https://www.usatoday.com/web-stories/obesity-rate-in-america/

 
At 9:01 PM, Blogger Richard Layman said...

Boston Hospital Teaching Kitchen

https://www.bmc.org/nourishing-our-community/teaching-kitchen

Currently via zoom

https://www.bmc.org/nourishing-our-community/teaching-kitchen/about-us

https://www.boston.com/news/local-news/2018/04/01/at-boston-medical-center-cooking-classes-aim-to-restore-health-after-addiction/



Teaching Kitchen Collaborative for hospitals and public health

https://teachingkitchens.org/

Teaching Kitchens Research Conference

https://cdn1.sph.harvard.edu/wp-content/uploads/sites/65/2021/06/TKRC2020_FinalReport.pdf

 
At 10:22 PM, Blogger Richard Layman said...

CBS Boston: Robert Kraft donates $50 million to Massachusetts General Hospital for community health equity.

https://www.cbsnews.com/boston/news/robert-kraft-massachusetts-general-hospital-50-million-dollar-donation-mgh/

10/12/2022

The money will support community health and health equity and "address healthcare disparities caused by race, ethnicity, geography, and economic status," according to a statement from MGH.

Kraft helped establish the Kraft Center for Community Health at the hospital back in 2011.

This new donation will continue to help the center and allow MGH to expand its blood donation facility. The money will also create a "permanent Robert K. Kraft Endowed Chair in Diversity, Equity and Inclusion."

"By creating an endowed position focused on addressing clinical health care disparities, Robert Kraft and the Kraft family are creating important pathways for patients living with sickle cell disease to receive comprehensive medical care which has not traditionally been available to them," MGH senior vice president Dr. Joseph Betancourt said in a statement.

====
Seems like the focus might be on sickle cell anemia.

 
At 10:29 PM, Blogger Richard Layman said...

MetroHealth’s new $759 million Glick Center opens Nov. 5, signaling a new era of healthcare.

https://www.cleveland.com/healthfit/2022/10/metrohealths-new-759-million-glick-center-opens-nov-5-signaling-a-new-era-of-healthcare.htm

10/15/2022

{Akram] Boutros — who is among the longest-serving CEO of any major corporation, hospital or institution in Cleveland — leaves MetroHealth at the end of the year after nearly 10 years at the helm. He exits MetroHealth after overseeing the successful completion of a major portion of its multi-year, multi-building Transformation project, meant to uplift the community surrounding MetroHealth and address the social determinants of health. ...

In August, the hospital system opened its affordable housing project Vía Sana in Cleveland’s Clark-Fulton neighborhood. Vía Sana – meaning “healthy way” in Spanish -- is the first $15 million investment in MetroHealth’s $60 million mixed-use development aimed at improving both the physical and economic health of the community adjacent to its main campus.

Construction of the new $140 million outpatient care facility and administrative building, called the Apex Project, began last year. delivers on MetroHealth’s promise to turn its main campus into a “hospital in a park” and to create a more welcoming neighborhood. The Apex Project includes renovation of the hospital’s Rammelkamp Center for Education and Research and a 700-car parking garage for patients and visitors. ...

Focus on underserved is critical

Glick’s opening comes as MetroHealth prepares to step into the gap created by the loss of inpatient services this year at St. Vincent Charity Medical Center near downtown, and at University Hospitals’ Bedford and Richmond locations.

Like MetroHealth, St. Vincent is a safety net hospital. But while St. Vincent eliminated patient beds, MetroHealth is the midst of a building boom.

While hospital systems nationally and locally are reducing inpatient beds in favor of outpatient care, MetroHealth is bucking the trend. Glick will increase its bed total, from 365 in the old towers to 380 in Glick. ...

With the addition of Glick, the healthcare system is well positioned to serve the Cleveland area as its population grows older, Lane said.

That’s because MetroHealth anticipates a 20% increase in patients being treated at Glick within three years, Boutros said. Northern Ohio’s aging population will put an increased burden on hospitals. Patients are sicker and spend more days in the hospital.

 
At 4:33 PM, Blogger Richard Layman said...

Athletic fields etc. are being installed as part of a new health campus in Greater Pittsburgh.

"Allegheny Health Network serves notice to its rivals with Coraopolis athletic, outpatient center"

https://www.post-gazette.com/business/healthcare-business/2022/11/04/allegheny-health-network-highmark-upmc-robert-morris-university-competition-higher-costs/stories/202211040090


At the ribbon cutting Wednesday, hospital officials and others pointed to the community benefits of the AHN Montour Health + Sports Medicine Center, which has three soccer and multipurpose fields, including one for year-round use. Seven other outdoor fields are under construction.

“This facility is going to be second to none and it will provide terrific benefits to our organizations, the Coraopolis community and athletes from all around the region,” Tuffy Shallenberger, project developer and Pittsburgh Riverhounds owner, said in a prepared statement.

Highmark Health’s Allegheny Health Network and the Pittsburgh Riverhounds Soccer Club are partners in the project, where AHN’s orthopedic and sports medicine doctors will treat athletes at a 20,000-square-foot facility that will also offer primary and pediatric medical care, lab services and diagnostic imaging.

In addition to medical care, the complex will serve as a practice site for the Pittsburgh Riverhounds and home for the Riverhounds Development Academy, which annually trains more than 5,000 athletes ranging from 4 to 18 years old.

 
At 1:41 PM, Blogger Richard Layman said...

I guess the positioning is really building a healthcare system versus a hospital, which DC could do because it is small and controls the ACA element of "health insurance" for the city.

https://www.wsj.com/articles/cvs-announces-deal-to-acquire-home-healthcare-company-signify-11662411855

"CVS Agrees to Buy Home-Healthcare Company Signify for $8 Billion"

9/5/2022

The drugstore giant’s deal to acquire home-healthcare company Signify Health Inc., announced Monday, will add 10,000 contracted doctors and clinicians and give CVS a hand in coordinating medical care for millions of Americans.

CVS for years has worked to transform itself from a pharmacy chain to an integrated provider of medical services, with the biggest step being its 2018 acquisition of insurer Aetna. Initially, CVS envisioned a model centered on pharmacists, in-store clinics and a giant insurance business.

But Karen Lynch, who took over as CVS CEO last year, determined that the company needs doctors on its payroll to fulfill those ambitions. She also set out to expand CVS’s presence in home healthcare, demand for which has been rising as the U.S. population has aged.

“The house call is having what I’d characterize as a renaissance,” she said in an interview. “This deal enhances the connection to consumers in the home.”

Signify’s model is based on an analytics-and-technology platform, used by doctors who go into homes equipped with connected iPads, that allows the clinicians to assess patient needs and connect them with follow-up services.

 
At 9:33 PM, Blogger Richard Layman said...

Re public health and covid

https://us.macmillan.com/books/9781250796639/theviralunderclass

The Viral Underclass: The Human Toll When Inequality and Disease Collide

Having spent a ground-breaking career studying the racialization, policing, and criminalization of HIV, Dr. Thrasher has come to understand a deeper truth at the heart of our society: that there are vast inequalities in who is able to survive viruses and that the ways in which viruses spread, kill, and take their toll are much more dependent on social structures than they are on biology alone.

Told through the heart-rending stories of friends, activists, and teachers navigating the novel coronavirus, HIV, and other viruses, Dr. Thrasher brings the reader with him as he delves into the viral underclass and lays bare its inner workings. In the tradition of Isabel Wilkerson’s Caste and Michelle Alexander’s The New Jim Crow, The Viral Underclass helps us understand the world more deeply by showing the fraught relationship between privilege and survival.

 
At 9:55 PM, Blogger Richard Layman said...

Not unlike Latino Health Access in Santa Ana, California.

"To Sway the Unvaccinated, Latino Teens Deputized as Health Educators"
Kaiser Health News

https://www.usnews.com/news/health-news/articles/2023-01-24/latino-teens-deputized-as-health-educators-to-sway-the-unvaccinated

Alma earned her reputation as a trusted source of information through her internship as a junior community health worker. She was among 35 Fresno County students recently trained to discuss how COVID vaccines help prevent serious illness, hospitalization and death, and to encourage relatives, peers and community members to stay up to date on their shots, including boosters.

When Alma’s internship drew to a close in October, she and seven teammates assessed their work in a capstone project. The students took pride in being able to share facts about COVID vaccines. Separately, Alma persuaded her family to get vaccinated. She said her relatives, who primarily had received COVID information from Spanish-language news, didn’t believe the risks until a close family friend died. ...

Community health groups in California and across the country are training teens, many of them Hispanic or Latino, and deputizing them to serve as health educators at school, on social media and in communities where COVID vaccine fears persist. According to a 2021 survey commissioned by Voto Latino and conducted by Change Research, 51% of unvaccinated Latinos said they didn’t trust the safety of the vaccines. The number jumped to 67% for those whose primary language at home is Spanish. The most common reasons for declining the shot included not trusting that the vaccine will be effective and not trusting the vaccine manufacturers. ...

Some training programs use peer-to-peer models on campuses, while others teach teens to fan out into their communities. FACES for the Future Coalition, a public youth corps based in Oakland, is leveraging programs in California, New Mexico, Colorado and Michigan to turn students into COVID vaccine educators. And the Health Information Project in Florida, which trains high school juniors and seniors to teach freshmen about physical and emotional health, integrates COVID vaccine safety into its curriculum.

In Fresno, the junior community health worker program, called Promotoritos, adopted the promotora model. Promotoras are non-licensed health workers in Latino communities tasked with guiding people to medical resources and promoting better lifestyle choices. Studies show that promotoras are trusted members of the community, making them uniquely positioned to provide vaccine education and outreach.

The teens participating in Promotoritos are mainly Latino, immigrants without legal status, refugee students or children of immigrants. They undergo 20 hours of training, including social media campaign strategies. For that, they earn school credit and were paid $15 an hour last year.

“Nobody ever thinks about these kids as interns,” said Celedon. “So we wanted to create an opportunity for them because we know these are the students who stand to benefit the most from a paid internship.”

 
At 8:48 PM, Blogger Richard Layman said...

Oak Street Health, value based care model.

https://www.oakstreethealth.com/osh-value-based-care-751584

 
At 11:14 PM, Blogger Richard Layman said...

"Philadelphia to pilot a guaranteed income program to reduce rates of infant mortality"

https://www.inquirer.com/news/philadelphia/philadelphia-joy-bank-universal-basic-income-infant-mortality-20230320.html

Hoping to reduce racial disparities in infant mortality, Philadelphia hopes to pilot a monthly guaranteed income for 250 expectant mothers in Cobbs Creek, Strawberry Mansion, and Nicetown-Tioga — neighborhoods with the highest rates of low birth weight. But those at the helm say they need additional funding to get across the finish line. The program will be called the Philly Joy Bank.

The Philadelphia Department of Public Health aims to begin the program in early 2024, having already secured more than $3 million in contributions from the William Penn Foundation and Spring Point Partners. The Philly Joy Bank will offer $1,000 monthly cash payments for a total of 18 months, including a year postpartum.

 
At 5:17 PM, Blogger Richard Layman said...

"In Pittsburgh, now you can wash, rinse, spin and sign up for health insurance"

https://www.post-gazette.com/business/healthcare-business/2023/03/29/upmc-health-plan-medicaid-insurance-fabric-health-laundromat-wifi/stories/202303280106

UPMC Health Plan is joining a Philadelphia startup to bring Wi-Fi access and information about health insurance and social services to five Pittsburgh area laundromats. Fabric Health, which was formed in 2021, will staff laundromats in Edgewood, Mount Washington, Shadyside, South Park and West Mifflin, where waiting for a dryer will become opportunities to apply online for food stamps, enroll in a health insurance plan and learn about health services.

“UPMC for You wants to make accessing social supports and health care coverage for those in need as convenient and easy as possible — even if it means reaching out to one individual at a time,” John Lovelace, president of UPMC’s health insurance plan for low-income and disabled people, said in a prepared statement.

Some 32 million Americans use a laundromat each week, which UPMC and Fabric Health see as an opportunity to reach low-income people who are passing time scrolling through email on their smartphones. UPMC’s Insurance Services Division provides health coverage and related services to 4.5 million members and UPMC for You is among UPMC’s plans.

Fabric Health co-founder Allister Chang said he got the idea for the company while working in a literacy program for public libraries. Laundromats turned out to be excellent places to reach people who wanted to polish their reading and writing skills, he said.

 
At 4:48 PM, Blogger Richard Layman said...

UPMC Announces New Innovative Hospital Model in Lock Haven to Best Serve Community Needs

https://www.upmc.com/media/news/012023-lock-haven-oed

Downgrading a rural hospital to acute care emergency services, no beds.

UPMC in North Central Pa. will work with the Pennsylvania Department of Health (PADOH) to convert services at UPMC Lock Haven to an outpatient emergency department, the first of its kind in the commonwealth under the new guidance provided for Innovative Hospital Models.

“The Innovative Hospital Models released last year by the PADOH gave us a unique opportunity to explore and support the most effective and efficient delivery of emergency care in this rural area where inpatient hospital admissions have been very low for a long time. Local and national trends also show an exponential increase in patient preference for outpatient services,” said Patti Jackson-Gehris, president of UPMC in North Central Pa. “We are pleased to announce this plan and we are confident that this is the best model of care to meet the needs of this community.”

https://www.health.pa.gov/topics/facilities/hospitals/Pages/Innovative-Hospital-Models.aspx

Below are brief descriptions of each model. Details on the eligibility criteria can be found in the guidance document for the model, with supplemental information available in the FAQ and matrix.

Micro-hospital

A micro-hospital refers to an acute care hospital that offers emergency services and maintains facilities for at least ten inpatient beds with a narrow scope of inpatient acute care services, such as no surgical services. Formerly known as the "innovative hospital model," this model has proven to be a viable alternative to many facilities and will continue to be an option for providers seeking to offer acute care services in a smaller footprint.

Tele-emergency Department or "tele-ED"

Tele-ED refers to the operation of a tele-ED staffed by Advanced Practice Providers (APP) 24 hours per day/7 days per week (24/7) with a physician available at all times through telecommunications but not physically present in the emergency department. The Department is making available a structured exception request for eligible low-volume rural hospitals to operate a tele-ED.

Outpatient Emergency Department or "OED"

An OED refers to an outpatient location of a hospital that offers only emergency services without inpatient beds on-site and is not located on the grounds of a main licensed hospital. Hospitals will be able to operate an OED in rural areas in accordance with the guidance.​

 
At 4:50 PM, Blogger Richard Layman said...

Nonprofit hospitals are being challenged because of high salaries for executive officers, and relatively low levels of charitable care.

One hospital in Southeastern Pennsylvania was denied a property tax exemption on that basis.

"It's time to hold nonprofit hospitals in NC accountable"

https://www.citizen-times.com/story/opinion/2023/04/02/opinion-its-time-to-hold-nonprofit-hospitals-in-nc-accountable/70005151007/

"A Pa. hospital’s revoked property tax exemption is a ‘warning shot’ to other nonprofits, expert"

https://www.northcentralpa.com/features
/spotlight_pa/a-pa-hospital-s-revoked-property-tax-exemption-is-a-warning-shot-to-other-nonprofits/article_4939a326-c1ad-11ed-a406-0b9d40d07b6a.html

 
At 6:15 PM, Blogger Richard Layman said...

Black men face many more health hurdles. An expert discusses why.

https://www.washingtonpost.com/wellness/2023/04/15/black-men-health-problems-disparities/

 
At 12:30 PM, Blogger Richard Layman said...

Facing high death rates, Black expectant parents seek out Black doulas

https://www.washingtonpost.com/dc-md-va/2023/05/14/black-doulas-maternal-mortality-rate/

 
At 11:01 PM, Blogger Richard Layman said...

Roxbury-based Nuestra Comunidad Development Corporation and
East Boston Neighborhood Health Center have leveraged social capital to facilitate
community engagement by providing healthy cooking classes, facilitating field trips, hosting
resident meetings, and creating an entirely new Community Resource and Wellness Center
for residents to connect, respectively. The result has been self-sufficiency for residents and neighborhood revitalization.

https://www.ebnhc.org/en/services/crwc.html

Health and well-being are more than what's in a medical chart. EBNHC's Community Resource & Wellness Center connects community members with essential wellness resources. Our team of experienced Care Navigators can help with many issues that impact well-being:

Food access resources
Housing supports
Immigration services
Financial assistance
Legal assistance
Supports for seniors
Educational services
Child care options
Parenting programs
Domestic violence support
Disability resources

 
At 9:00 PM, Blogger Richard Layman said...

Nonprofit gives back to moms in need with community baby shower (in North Charleston, SC)

https://www.live5news.com/2023/06/13/nonprofit-gives-back-moms-need-with-community-baby-shower/

 
At 3:00 PM, Blogger Richard Layman said...

https://www.ocregister.com/2023/06/17/caloptima-health-wants-to-create-a-facility-to-better-serve-ocs-unhoused-aging-population

CalOptima Health wants to create a facility to better serve OC’s unhoused, aging population
Proposed $49 million facility will bring recuperative care and elder care services under one roof


CalOptima Health, the provider of publicly funded health coverage in Orange County, is investing about $49 million to create the Community Living Center of Tustin, with the purpose of addressing challenges faced by the one of the county’s most vulnerable populations, those experiencing homelessness and aging.

From 2017 to 2021, the number of people 55 and older who accessed homeless-related services in Orange County increased by about 89%, according to the state’s Homeless Data Integration System. They are part of a growing “silver tsunami” of older adults who are falling into homelessness for the first time after the age of 50. ...

Overall, the recuperative care center will take care of 119 unhoused older adults working toward a permanent housing placement. The PACE center is expected to serve up to 500 individuals from both the surrounding community and the recuperative care center.

Each semi-private room will have its own bathroom and shower. The building will be divided into five “pods,” roughly 25 beds in each, that will be staffed with its own social worker and nurse, as well as a guest safety associate stationed 24 hours a day. Each pod will also have its own living room and space for socializing.

The facility will include an indoor gym, store, beauty salon and cyber café. PACE services include routine physicals, outpatient surgical and mental services, rehabilitation therapy and transportation services. The recuperative care program will provide additional services such as medication management, three meals a day, support in accessing benefits and interim housing until permanent housing is secured.

“The shelter system is not built for this population, it’s built for economy of scale. It’s built to serve as many folks as possible. It’s meant to serve a younger, more physically agile group of individuals,” Bruno-Nelson said, adding that this facility will be designed to serve the older residents in ways traditional shelters are not.

 
At 9:50 PM, Blogger Richard Layman said...

Do Philly-area hospitals give enough charity care? There’s no simple answer.
IRS does not quantify its requirements — which include more than charity care — for hospitals to be tax-exempt. That makes it hard to assess whether not-for-profit hospitals are doing enough.

https://www.inquirer.com/health/charity-care-philadelphia-area-hospitals-tax-exemptions-20230620.html

 
At 9:40 AM, Blogger Richard Layman said...

Oak Street Health acquired by CVS. CVS will open 50 senior clinics in association with stores, as Health hubs.

https://www.supermarketnews.com/nonfood-pharmacy/cvs-build-more-50-senior-clinics-2024

8/7/23

 
At 4:44 PM, Blogger Richard Layman said...

Indiana (Pennsylvania) Regional Medical Center and Indiana University of Pennsylvania have organized the PENNSYLVANIA MOUNTAINS RURAL HEALTH CONFERENCE. This year is the second.

IUP aims to create an osteopathic medical school aimed at serving rural populations.

https://www.alumni.iup.edu/s/894/bp21/project.aspx

DC could organize an annual urban health conference.

 
At 1:00 PM, Blogger Richard Layman said...

https://thehill.com/opinion/healthcare/4324044-how-three-black-women-took-on-breast-cancer-in-our-failed-healthcare-system/

 
At 10:09 PM, Blogger Richard Layman said...

Speaking of the opportunity to push improvements in African-Americans forward, a new hospital with a focus on public health could have done something like what Penn Medical is doing.

https://www.inquirer.com/health/penn-medicine-biobank-dna-research-20231129.html

More than 260,000 Penn Medicine patients have agreed to share their DNA for research, and the discoveries are just getting started

And would you like to contribute a blood and DNA sample for a massive research project?

That last question is now part of the electronic check-in process for patients at Penn Medicine clinics and hospitals, and it already is yielding promising clues in the study of disease.

More than 260,000 people have signed up to participate in the project, called Penn Medicine BioBank, agreeing to have their samples stored in secure freezers set to negative 80 degrees Celsius. By cross-referencing participants’ DNA with their electronic health records, researchers have discovered genetic variants related to heart disease, hearing loss, diabetes, glaucoma, and muscular dystrophy, among other conditions.

The project began more than a decade ago and has doubled in size since the invitation to participate was incorporated into the electronic check-in process in 2020, making Penn’s one of the largest of a dozen similar efforts in the United States.

Rather than collect DNA from patients with a specific condition, the idea is to obtain samples from a wide cross-section of humanity, enabling researchers to tease out the genetic causes for a range of diseases, said geneticist Marylyn Ritchie, co-director of Penn’s program.

... Unlike most other biobanks here and abroad, Penn’s repository boasts a high percentage of samples from people of color. Nearly one-third are of non-European ancestry, including 17% who identify as African American — a group often underrepresented in clinical trials and other research.

The inclusion is crucial, as the rates of disease and the effectiveness of treatments can vary greatly in people of different racial and ethnic ancestry, Ritchie said.

“That is a huge strength,” she said. “The participants that are enrolling reflect our patient population in terms of biogeographic diversity.”

A case in point is a 2019 study of a type of heart disease, which relied on patient samples from the Penn BioBank and a similar effort at the Geisinger health system in Danville, Pa.

Researchers found a genetic variant in white patients that was associated with a higher risk of dilated cardiomyopathy, a condition in which the heart’s main pumping chamber becomes enlarged and weak. But in people of African ancestry, the same genetic variant was not connected to a higher risk of that disease, said Penn cardiologist Dan Rader, one of the authors.

 
At 10:18 PM, Blogger Richard Layman said...

https://www.inquirer.com/health/abramson-senior-care-managent-sold-home-care-hospice-nursing-homes-20230705.html

Abramson Senior Care is reinventing itself again after selling its nursing home and other businesses

Then called the Home for Aged and Infirm Israelites, the operation eventually owned two nursing homes. By the early 2000s, what is now known as Abramson Senior Care had expanded ambitiously into community-based home care, hospice, and private-duty nurses.

An aging population will need all those services and more. But after selling its highly regarded but money-losing Horsham nursing home in October 2020, the organization is reinventing itself for the third time in 157 years to continue serving the elderly.

Abramson is trying to build a model designed to help poor and lower-income seniors living at home navigate health care and other services that help them remain independent.

The service combines care managers and nurse practitioners to help seniors and their families assess the safety of living at home, understand their options, create care plans, and access resources.

... "It’s OK as a nonprofit to lose a little bit of money, if you’re also fundraising and serving your mission, but we were losing more than we were comfortable with,” said Robin Brandies, who became Abramson’s executive director in April.

The organization’s new focus is bolstered by a $30 million endowment, which it hopes to preserve by drastically scaling back its former scope.

... In 2020, Abramson had about $70 million in revenue, but the Abramson Center for Jewish Life, its Horsham nursing home, was losing $4 million a year, its former CEO said at the time.

For a time, the organization filled the hole with surpluses from other businesses. Then it sold what had long been its marquee facility.

Abramson employed 750 people when it owned two nursing homes, plus the home care and hospice businesses. Moving forward, it expects to have 8 to 10 employees, Brandies said.

 
At 10:24 PM, Blogger Richard Layman said...

Foundations created by nonprofits when hospitals and other health care facilities are sold to for profits.
====
From the Philadelphia Inquirer:

Ralston’s transition from a nonprofit that provides services to a grant-making foundation doesn’t happen often in the nonprofit world, and when it does, it usually involves the sale of a nonprofit hospital to a for-profit company. In those cases, net proceeds from the sale typically go into a foundation that supports health programs in the same area serviced by the hospital.

Local examples are the Foundation for Delaware County from the 2016 sale of Crozer-Keystone Health System, the Phoenixville Community Health Foundation from the 1997 sale of Phoenixville Hospital, and the Foundation for Health Equity from the 2005 sale of Chestnut Hill Hospital.

The shift at Ralston is in line with good governance, said John MacIntosh, managing partner at SeaChange Capital Partners, a New York nonprofit that provides grants, loans, analysis, and advice to other nonprofits. The duty of nonprofit boards, he said, is “to the mission of the organization, not to the particular form in which that mission is delivered.”

 
At 10:31 PM, Blogger Richard Layman said...

Washington Post series on the problems of chronic conditions

https://www.washingtonpost.com/health/interactive/2023/american-life-expectancy-dropping/?itid=lk_interstitial_manual_16

AN EPIDEMIC OF CHRONIC ILLNESS IS KILLING US TOO SOON

A year-long Washington Post examination reveals that this erosion in life spans is deeper and broader than widely recognized, afflicting a far-reaching swath of the United States.

While opioids and gun violence have rightly seized the public’s attention, stealing hundreds of thousands of lives, chronic diseases are the greatest threat, killing far more people between 35 and 64 every year, The Post’s analysis of mortality data found.

Heart disease and cancer remained, even at the height of the pandemic, the leading causes of death for people 35 to 64. And many other conditions — private tragedies that unfold in tens of millions of U.S. households — have become more common, including diabetes and liver disease. These chronic ailments are the primary reason American life expectancy has been poor compared with other nations.

Sickness and death are scarring entire communities in much of the country. The geographical footprint of early death is vast: In a quarter of the nation’s counties, mostly in the South and Midwest, working-age people are dying at a higher rate than 40 years ago, The Post found. The trail of death is so prevalent that a person could go from Virginia to Louisiana, and then up to Kansas, by traveling entirely within counties where death rates are higher than they were when Jimmy Carter was president.

... This phenomenon is exacerbated by the country’s economic, political and racial divides. America is increasingly a country of haves and have-nots, measured not just by bank accounts and property values but also by vital signs and grave markers. Dying prematurely, The Post found, has become the most telling measure of the nation’s growing inequality.

The mortality crisis did not flare overnight. It has developed over decades, with early deaths an extreme manifestation of an underlying deterioration of health and a failure of the health system to respond. Covid highlighted this for all the world to see: It killed far more people per capita in the United States than in any other wealthy nation.

Chronic conditions thrive in a sink-or-swim culture, with the U.S. government spending far less than peer countries on preventive medicine and social welfare generally. Breakthroughs in technology, medicine and nutrition that should be boosting average life spans have instead been overwhelmed by poverty, racism, distrust of the medical system, fracturing of social networks and unhealthy diets built around highly processed food, researchers told The Post.

America’s medical system is unsurpassed when it comes to treating the most desperately sick people, said William Cooke, a doctor who tends to patients in the town of Austin, Ind. “But growing healthy people to begin with, we’re the worst in the world,” he said. “If we came in last in the next Olympics, imagine what we would do.”

--- continued

 
At 10:51 PM, Blogger Richard Layman said...

What emerges is a dismaying picture of a complicated, often bewildering health system that is overmatched by the nation’s burden of disease:

Chronic illnesses, which often sicken people in middle age after the protective vitality of youth has ebbed, erase more than twice as many years of life among people younger than 65 as all the overdoses, homicides, suicides and car accidents combined, The Post found.

The best barometer of rising inequality in America is no longer income. It is life itself. Wealth inequality in America is growing, but The Post found that the death gap — the difference in life expectancy between affluent and impoverished communities — has been widening many times faster. In the early 1980s, people in the poorest communities were 9 percent more likely to die each year, but the gap grew to 49 percent in the past decade and widened to 61 percent when covid struck.

Life spans in the richest communities in America have kept inching upward, but lag far behind comparable areas in Canada, France and Japan, and the gap is widening. The same divergence is seen at the bottom of the socioeconomic ladder: People living in the poorest areas of America have far lower life expectancy than people in the poorest areas of the countries reviewed.

Forty years ago, small towns and rural regions were healthier for adults in the prime of life. The reverse is now true. Urban death rates have declined sharply, while rates outside the country’s largest metro areas flattened and then rose. Just before the pandemic, adults 35 to 64 in the most rural areas were 45 percent more likely to die each year than people in the largest urban centers.

“The big-ticket items are cardiovascular diseases and cancers,” said Arline T. Geronimus, a University of Michigan professor who studies population health equity. “But people always instead go to homicide, opioid addiction, HIV.”

... Tobacco looms large in this sad story. One of the signal successes of public health in the past half-century has been the drop in smoking rates and associated declines in lung cancer. But roughly 1 in 7 middle-aged Americans still smokes, according to the CDC. Kentucky has a deep cultural and economic connection to tobacco. The state’s smoking rates are the second-highest in the nation, trailing only West Virginia. Holloway began smoking at 12, Desirae said. And for a long time, restaurants still had a smoking section right next to the nonsmoking section.

... Partly, that is a reflection of how the United States approaches health. This is a country where “we think health and medicine are the same thing,” said Elena Marks, former health and environmental policy director for the city of Houston. The nation built a “health industrial complex,” she said, that costs trillions of dollars yet underachieves.

“We have undying faith in big new technology and a drug for everything, access to as many MRIs as our hearts desire,” said Marks, a senior health policy fellow at Rice University’s Baker Institute for Public Policy. “Eighty-plus percent of health outcomes are determined by nonmedical factors. And yet, we’re on this train, and we’re going to keep going.”

--- continued

 
At 10:59 PM, Blogger Richard Layman said...

... The pandemic amplified a racial gap in life expectancy that had been narrowing in recent decades. In 2021, life expectancy for Native Americans was 65 years; for Black Americans, 71; for White Americans, 76; for Hispanic Americans, 78; and for Asian Americans 84.

For more than a decade, academic researchers have disgorged stacks of reports on eroding life expectancy. A seminal 2013 report from the National Research Council, “Shorter Lives, Poorer Health,” lamented America’s decline among peer nations. “It’s that feeling of the bus heading for the cliff and nobody seems to care,” said Steven H. Woolf, a Virginia Commonwealth University professor and co-editor of the 2013 report.

In 2015, Princeton University economists Anne Case and Angus Deaton garnered national headlines with a study on rising death rates among White Americans in midlife, which they linked to the marginalization of people without a college degree and to “deaths of despair.”

... Obesity is one reason progress against heart disease, after accelerating between 1980 and 2000, has slowed, experts say. Obesity is poised to overtake tobacco as the No. 1 preventable cause of cancer, according to Otis Brawley, an oncologist and epidemiologist at Johns Hopkins University.

Medical science could help turn things around. Diabetes patients are benefiting from new drugs, called GLP-1 agonists — sold under the brand names Ozempic and Wegovy — that provide improved blood-sugar control and can lead to a sharp reduction in weight. But insurance companies, slow to see obesity as a disease, often decline to pay for the drugs for people who do not have diabetes.

... nstead, experts studying the mortality crisis say any plan to restore American vigor will have to look not merely at the specific things that kill people, but at the causes of the causes of illness and death, including social factors. Poor life expectancy, in this view, is the predictable result of the society we have created and tolerated: one riddled with lethal elements, such as inadequate insurance, minimal preventive care, bad diets and a weak economic safety net.

“There is a great deal of harm in the way that we somehow stigmatize social determinants, like that’s code for poor, people of color or something,” said Nunez-Smith, associate dean for health equity research at Yale. And while that risk is not shared evenly, she said, “everyone is at a risk of not having these basic needs met.”

 
At 11:07 PM, Blogger Richard Layman said...

The geography of life and death in America has changed in recent generations, with decaying life expectancy in much of rural America.

... Across the heartland, countless communities are barely hanging on. This has long been a story described in economic terms — hollowed-out factories, bankruptcies, boarded-up downtown storefronts. But the economic challenges of these places go hand-in-hand with physical pain, suffering and the struggle to stay alive.

When economies go bad, health erodes, and people die early.

“The people in our country who are dying are the poor and the marginalized communities,” said Imburgia, the cardiologist. “It’s a money thing.”

 
At 1:40 PM, Blogger Richard Layman said...

Ascension Sacred Heart Pensacola (Fla.). Ascension Sacred Heart Pensacola employs innovative techniques to tackle healthcare insecurity for mothers and infants. The Women's Care Center team addresses the main obstacles for mothers who need prenatal and post-pregnancy care, which includes lack of transportation, insurance, financial resources and child care. They employ rideshare services to help patients attend their appointments, provide pack-n-plays for safe sleep, and are launching an iron-rich food and education bag program. Research conducted by the University of Florida obstetrics and gynecology residency program has shown a significant decrease in the number of missed clinic appointments.

Becker's Hospital Review
12/6/2023

 
At 1:40 PM, Blogger Richard Layman said...

Children’s Hospital New Orleans. The Children's Hospital New Orleans works to address gaps in the existing care infrastructure with its ThriveKids Student Wellness program, an innovative program that addresses the emotional and physical wellbeing of New Orlean's youth. The program is providing medical and mental healthcare to more than 100,000 students across 180 school campuses. The hospital is an epicenter of innovation and quality care, overcoming the national shortage of child psychiatrists and employing a population health approach to health.

Becker's Hospital Review
12/6/2023

 
At 1:46 PM, Blogger Richard Layman said...

Boston Medical Center Health System. Focused on health equity, Boston Medical Center Health System’s transformative programs are reimagining the patient experience. ... Beyond traditional healthcare, its first-in-the-nation Clean Power Prescription pilot program allows providers to prescribe a reduced utility bill by leveraging renewable energy generated by BMCHS solar panels, which supports 80 patient households and lowers utility bills by $50 each month for a year. The StreetCred initiative provides comprehensive free tax prep services offered during pediatric wellness appointments to increase economic mobility for families with infants below the federal poverty level while concurrently supporting health equity. Additionally, it turned a rooftop into a thriving farm yielding tens of thousands of pounds of crops annually, which nourishes the patient population and contributes to urban green space and broader energy reduction efforts. The health system is steadfast on eliminating disparities and creating pathways for holistic treatment of each patient.

Becker's Hospital Review
12/6/2023

 
At 1:47 PM, Blogger Richard Layman said...

Children’s Nebraska (Omaha)... Another recent accomplishment is the mobile application AdaptCare, which bridges the knowledge and training gap between the hospital and first responders by providing personalized care plans – an app that has delivered a 27% reduction in hospital admissions, a 50% decrease in overall hospital length of stay and a 55% financial cost reduction across organization services.

Becker's Hospital Review
12/6/2023

 
At 1:50 PM, Blogger Richard Layman said...

CommonSpirit Health (Chicago). CommonSpirit Health's open innovation philosophy encourages the combination of externally developed resources with internal competencies to deliver meaningful patient care improvements. The system addresses community needs through the Connected Community Network, which connects multiple stakeholders to meet the needs of patients. To date, the program has provided over 22,000 people with housing, food, transportation and more in partnership with over 900 community organizations. The system has also launched a virtual behavioral health support program and improved consumer access to care by pairing teams with founders from innovative companies in order to provide patients with market-leading technology.

Becker's Hospital Review
12/6/2023

 
At 1:54 PM, Blogger Richard Layman said...

Inova (Falls Church, Va.). ... It also launched the Inova Cares Clinic for Families, which provides primary care for families who are un- or underinsured.

Becker's Hospital Review
12/6/2023

 
At 1:58 PM, Blogger Richard Layman said...

Memorial Hermann Health System (Houston). Memorial Hermann demonstrates a strong commitment to innovation. The Clinical Innovation & Research Institute brings together the health system, McGovern Medical School, private practice clinics and the community to bring meaningful benefits to patients, such as leading new treatment options and enhanced clinical practice.

Becker's Hospital Review
12/6/2023

 
At 2:01 PM, Blogger Richard Layman said...

Mercy (St. Louis). Mercy is committed to delivering a transformative healthcare experience, launching several health initiatives to improve patient care. Every few years, the system conducts a community needs assessment to understand how to increase access to care. They use the assessment to understand how to increase access to services. Through the assessment, the system provides $550 million in community benefits annually. Since its founding 200 years ago, Mercy has put a strong emphasis on health equity. As part of the emphasis, the system uses de-identified data from decades of advanced EHRs to achieve a more complete view of patient needs. The approach helps to reduce any patient inequities. The system is also committed to diversity, equity and inclusion initiatives, attracting workers and senior leaders of different backgrounds. The system also has mentorship and development opportunities for women and employees of color.

Becker's Hospital Review
12/6/2023

 
At 10:18 PM, Blogger Richard Layman said...

We Were Here: Black Infant Loss in D.C.

https://washingtoncitypaper.com/article/645311/we-were-here-black-infant-loss-in-d-c/
12/14/2023

Between 2014 and 2020, more than 330 Black infants died in D.C. before their first birthdays. Recent perinatal reports show this problem isn’t going away anytime soon. Washington City Paper is taking a closer look at why this crisis hits the Black community in D.C. so hard, how it affects families and clinicians, and who is working to prevent infant loss. This series is being produced as a project for the USC Annenberg Center for Health Journalism’s 2023 National Fellowship.

 
At 4:33 PM, Blogger Richard Layman said...

About the UK but of course fully relevant.

https://www.theguardian.com/commentisfree/2023/dec/16/the-observer-view-on-the-nations-poor-health

The Observer view on the nation’s poor health

Britain cannot fix its growth problem without reducing the number of people who have left the labour market altogether because of ill health. This is also key to tackling not just health inequalities – the gap in life expectancy for the most and least affluent has increased in recent years – but also to reducing the UK’s gaping economic inequalities between the regions; the more deprived an area, the higher rate of working-age ill health it is likely to have. The growing numbers of younger people with long-term health conditions, including mental health concerns, who have many years of their working lives left, suggests that if this issue goes unaddressed, the problem will get worse.

 
At 9:28 PM, Blogger Richard Layman said...

Didn't really talk discuss the necessity for a lot of addiction treatment capacity.

Colorado’s quiet killer: Alcohol ends more lives than overdoses, but there’s been no intervention

Four-part series examines why state isn’t sounding the alarm after drinking deaths spiked during pandemic

https://www.denverpost.com/2024/01/04/colorados-quiet-killer-alcohol-deaths-colorado-addiction-intervention/

Colorado consistently has one of the worst rates of drinking-related death in the country, but alcohol hasn’t gotten nearly the attention devoted to other drugs. In this four-part series, The Denver Post investigated why so many Coloradans are dying from drinking, and what the state could do in an effort to reduce the number of people lost.

By the most conservative measures, alcohol kills nearly as many Coloradans as drug overdoses. When counting deaths from chronic conditions caused and worsened by alcohol, drinking’s toll far exceeds that of illicit drugs.

Deaths from drinking shot up since 2018, but during that time, Colorado didn’t take steps designed to change that trajectory, like raising alcohol taxes. The only major changes in liquor laws during that time expanded where residents could buy alcohol.

Part 1: Colorado alcohol deaths surged 60% in 4 years, but there’s been no public outcry or push to save lives

Coloradans die from the effects of alcohol at one of the highest rates in the country, but, in comparison to fentanyl, the state’s reaction has been a shrug. Legislators haven’t seriously considered measures to discourage drinking, and voters expanded access to alcohol in grocery stores.


Part 2: Colorado has some of the lowest alcohol taxes and highest drinking deaths. That’s no coincidence, experts say.

Experts say raising state alcohol taxes also would make more money available for programs aimed at preventing unhealthy drinking and to enforce the state’s liquor laws. Currently, the department charged with regulating Colorado’s alcohol outlets can’t afford to fill all its open positions.

Part 3: Beer and wine became more widely available in Colorado even as drinking deaths rose

Five years ago, a workgroup tasked with finding ways to reduce Colorado’s rate of drinking-related deaths issued a simple recommendation: cut back on when and where people can buy alcohol. Since then, however, the state has only expanded access to alcohol.

Part 4: Alcohol addiction treatment is available in Colorado, but people struggle to get the help they need

Despite the availability of addiction programs, people who are concerned about their own drinking or a loved one’s don’t always know where to turn. Treatment options may not meet patients’ preferences, aren’t easily accessible in certain parts of the state, or don’t necessarily accept all forms of insurance, including Medicare and Medicaid.

RELATED ARTICLES
How do I cut back on drinking? 10 tips for a successful Dry January

Am I drinking too much? Here are two ways to find out

 
At 11:26 PM, Blogger Richard Layman said...

https://www.denverpost.com/2024/01/04/colorado-alcohol-deaths-drinking-fentanyl-addiction/

Colorado alcohol deaths surged 60% in 4 years, but there’s been no public outcry or push to save lives

When fentanyl deaths spiked, the state responded. When alcohol deaths did the same, Colorado was silent.

Deaths from alcohol in Colorado shot up more than 60% between 2018 and 2021, falling slightly in 2022 — as did fatal overdoses. But alcohol fatalities are still 50% above pre-COVID levels, and experts fear Coloradans’ heavier drinking since 2020 will continue to exact a deadly cost in the years to come.

Alcohol killed 1,547 people statewide in 2022 — fewer than the 1,799 who died of overdoses — but that narrowly defined figure only includes certain types of organ damage and complications of withdrawal. Factor in deaths from long-term complications of drinking, and estimates put alcohol’s annual toll in this state at roughly twice that number.

[NOTE: 387 murders, 754 traffic fatalities, in Colorado, 2022]



 
At 11:28 PM, Blogger Richard Layman said...

When marijuana is legalized, societal statistics go to pot

https://www.washingtonexaminer.com/opinion/editorials/when-marijuana-is-legalized-societal-statistics-go-to-pot

1/5/2024

The more studies that are done on the growing of marijuana, the more it is becoming clear legalization of the drug is becoming a major public health crisis. Controls on marijuana should be not eased but strengthened.

In a December report in the New England Journal of Medicine, Dr. David A. Gorelick and others show that cannabis-related mental health problems are rising rapidly nationwide in conjunction with increasing legalization of the drug. Gorelick reported that almost 20% of those aged 12 and older used marijuana in 2021, with 16 million suffering from “cannabis use disorder,” which is the inability to stop taking the drug even as it causes health and social problems. And almost half of those addicts suffer other mental health illnesses such as anxiety, major depression, post-traumatic stress disorder, hallucinatory delirium, suicidality, or schizophrenia.

https://www.nejm.org/doi/full/10.1056/NEJMra2212152

Cannabis-Related Disorders and Toxic Effects

 
At 10:53 AM, Blogger Richard Layman said...

https://www.nbcnews.com/health/diabetes/diagnosed-type-2-diabetes-may-different-form-disease-rcna132571

 
At 5:27 PM, Blogger Richard Layman said...

Overbrook Environmental Education Center, Philadelphia

Farmacy proposal

6150 Lancaster Avenue will be the future home of a "Farmacy" or wellness center for the community. Overbrook Environmental Education Center plans to provide a center where the "Prescription 4 Better Health" (P4BH) program can be fulfilled on a daily basis. The center will focus on the four key areas of the P4BH:

1. food literacy, 2. food access, 3. movement, and 4. overall wellness.

Potential features for this site include a farmer's market, clinical services, a demonstration kitchen and more!

Visit farmacyphilly.org for more information!

 
At 1:10 PM, Blogger Richard Layman said...

https://progressivegrocer.com/how-culturally-relevant-food-marketing-promotes-health

 
At 1:20 PM, Blogger Richard Layman said...

Interesting because this is being done in association with a project involving the Cleveland Clinic.

https://progressivegrocer.com/meijer-debut-smaller-format-banner-cleveland

 
At 4:32 PM, Blogger Richard Layman said...

Bozeman non-profit works to serve and uplift individuals across Gallatin Valley

https://nbcmontana.com/news/local/bozeman-non-profit-works-to-serve-and-uplift-individuals-across-gallatin-valley

1/12/2024

Greater Impact started as a small organization actively aiding people in recovery coaching, addressing car issues, and resolving housing challenges.

Now witnessing the growth of people across the Gallatin Valley, the non-profit is attempting to increase additional services and programs.

... Some of the programs offered include neighbors first housing, neighborhood auto, recovery coaching, sober housing, ignite learning, and wilderness skate program.

The goal for the non-profit is to have people feeling empowered and learning self-sufficient skills to help better themselves for their own good.

https://www.greaterimpact.us/

 
At 11:51 PM, Blogger Richard Layman said...

Mobile Grocery Store, Virtua Health

https://www.virtua.org/about/eat-well/mobile-grocery-store

In fall 2020, Virtua Health announced the latest component of its food access initiatives: the Eat Well Mobile Grocery Store. This year-round store-on-wheels is the newest addition to Virtua’s portfolio of programs that position food as a form of medicine.

The 40-foot mobile store offers fresh, healthy, and culturally relevant foods at below-market prices to residents of Camden and Burlington counties – particularly in food-desert communities that experience higher rates of obesity, diabetes, and other diet-related diseases.

Virtua offers other mobile services to address the health needs of South Jersey residents. In addition to its sister program, the Eat Well Mobile Farmers Market, Virtua operates a Pediatric Mobile Services Program for children in underserved communities and mobile mammography for women who are underinsured or without health insurance.

The Eat Well Mobile Grocery Store is “fueled” by the generous support of philanthropic donors. For more information on how to support Virtua’s philanthropic initiatives, visit GiveToVirtua.org.

 
At 2:24 AM, Blogger Richard Layman said...

https://www.post-gazette.com/opinion/editorials/2023/12/15/allegheny-county-wic-mobile-clinic-transit-van/stories/202312150022

County mobile WIC clinic will help families access essential services

 
At 1:19 PM, Blogger Richard Layman said...

https://www.beckershospitalreview.com/workforce/michael-dowling-on-northwells-new-high-school-theres-only-a-workforce-shortage-of-the-future-if-you-dont-do-anything-today.html

1/19/2024

In New York, Northwell Health gives millions of dollars each year to area schools and students. Now the system is partnering with New York City Public Schools and Bloomberg Philanthropies to build a new high school in Queens devoted to healthcare education, marking a big step forward in the direction the health system has worked toward for years.

... In 2022, Northwell signed on as an anchor employer in partnership with New York City Public Schools to combine classroom and work-based learning in partnership with four high schools in Queens and Manhattan. Additionally, the system invests $5 million in its Northwell Community Scholars Program, in which students in seven economically disadvantaged, underrepresented school districts receive mentorship, college preparation, career guidance, shadowing and internship opportunities and financial support to pursue associate's degrees or certificates at area community colleges.

Others initiatives include Northwell's student ambassador program, in which students receive training to communicate with peers about topics directly impacting youth health; numerous medical school pipeline programs, of which 100% of participants have gone to college or a professional healthcare program; and a 10-week management internship for college juniors to gain exposure to healthcare administration and leadership.

 
At 1:21 PM, Blogger Richard Layman said...

It turns out that a friend has a rare blood disorder. He lives in DC and there is a self help group, but it is based in Northern Virginia, does all of its programs there, and isn't focused on transit accessibility.

There is a role for hospitals/public health to organize and support such groups within their communities.

 
At 12:42 PM, Blogger Richard Layman said...

https://www.cbsnews.com/minnesota/news/10000-in-donated-warm-clothing-delivered-to-hennepin-healthcare-for-patients-in-need/

 
At 6:14 PM, Blogger Richard Layman said...

This article about how Mercy Hospital in South Side Chicago was threatened with closure, discusses the purchaser, Insight Health of Flint, which does a lot of interesting stuff.

https://www.bloomberg.com/news/features/2021-10-01/mercy-hospital-gets-second-chance-to-provide-health-care-to-chicago-s-poor

The Left-for-Dead Hospital That Got a Second Chance for $1
Mercy Hospital, a 168-year-old anchor on Chicago’s South Side serving the poor and uninsured, was about to succumb to the brutal economics of American health care. Then an unlikely savior appeared.

====
In 2008 he launched Insight, a neurosurgery center that began with a staff of four. He put a bid on a 16,000-square-foot building, which he hoped might become a clinic site, but his offer was rejected. Shortly after that, he stumbled across a less conventional space: a 600,000-square-foot former General Motors manufacturing plant. The empty complex was an eyesore in a town littered with abandoned factories. He paid less than $200,000 for it.

“It was a massive building, and it changed the entire vision of what we were to do,” Shah said.

He rented suites to commercial clients—a lawyer, a doctor, a trucking company, a food pantry. Then he worked out a deal with Diplomat Pharmacy, a Michigan company that had recently gone national and was on its way to becoming the country’s largest independent provider of specialty prescription drugs—the types of infrequently prescribed medications that retail pharmacies don’t often stock.

The city marketed the complex as a medical Silicon Valley that could help revive Flint, and Shah was celebrated as a revitalizing force. He hired orthopedic surgeons, more neurosurgeons, and several nurses. He opened an 18-bed rehabilitation center to treat victims of catastrophic brain and spinal injuries. He added an imaging center, specialists in pain and addiction management, and chiropractors, and he converted a gymnasium into a wellness center. Soon, Insight employed more than 300 people and was performing more than 1,000 surgeries each year.

Shah wasn’t just a surgeon anymore; he was a Jack Welch-quoting entrepreneur who began thinking of Insight as a business incubator.

... When the Trinity team traveled to Flint, Shah gave them a tour of the campus and an overview of his operations. He and Bawahab were ready to answer all sorts of questions about their medical operations. But the Trinity executives kept asking about a project that had little direct connection with health care: a youth community center in a once-abandoned school building. Shah bought the building in 2015 for $1.

The center, called the Sylvester Broome Empowerment Village, offers free training and programs for children in sports, music, visual arts, journalism, health, science, and the performing arts. Originally, Insight funded all of those programs. But Shah’s gift for finding external funding partners—charitable foundations, endowments, and private businesses—has allowed it to explode in size and ambition. The NFL, for example, is building a sports complex connected to the building. Michael Jackson’s daughter, Paris, helped fund the music studio inside the center. At the height of Flint’s water crisis, Will Smith’s son Jaden helped turn the building into a site for distributing clean water.

... Trinity’s keen interest in the project surprised Bawahab, until he began to sense what was behind it. On the South Side of Chicago, those Trinity executives were cast as villains with no concern for the well-being of a community they didn’t belong to. If the next owners of Mercy were to have any chance of success, they’d need the local people on their side.

 
At 6:36 AM, Blogger Richard Layman said...

Food as Medicine 1/26/2024

https://progressivegrocer.com/sifter-joins-foodmed-certified-founding-member

https://progressivegrocer.com/food-medicine-trend-retail

https://progressivegrocer.com/dispatchhealth-home-providers-can-now-easily-prescribe-food-thanks-instacart

 
At 12:27 AM, Blogger Richard Layman said...

https://www.bostonglobe.com/2024/01/25/business/cvs-health-care-medical-retail/

CVS wants to serve nearly all your medical needs. Retail woes could derail that plan.

CVS’s plan could work like this: A woman with diabetes picks up medication from a CVS pharmacy. After learning the patient also suffers from joint pain, the pharmacist tells her that her Aetna health plan covers an in-home medical evaluation. A nurse from Signify Health visits her and discovers complications with arthritis. The patient then schedules an appointment with a doctor at Oak Street Health, who then coordinates care with the CVS pharmacist and a rheumatologist.

“It’s the retail-ization of medicine,” Anthes said.

Indeed, CVS executives say its large network of stores serves as a critical linchpin to this strategy because of the frequent interactions between pharmacists and patients. The company wants to turn many stores into destinations for health care services, where doctors, nurses, and pharmacists can collaborate on care, and possibly improve medical outcomes for patients.

“Our retail stores are the cornerstone of our brand and of our consumer engagement,” chief pharmacy officer Prem Shah told analysts during Investor Day.

 
At 12:12 AM, Blogger Richard Layman said...

Project Mend seeks medical equipment from San Antonio community to continue helping those in need

https://www.expressnews.com/news/local/article/Project-Mend-seeks-medical-equipment-from-San-15268748.php

5/14/20

MEND stands for “medical equipment network for those with disabilities.” In 1992, Murlin Johnson founded the organization that serves people of all ages who are without much-needed items due to denied medical insurance coverage or because they simply can’t afford the equipment.

... Valdez said all of the issues are tied up to securing funding to get small transit vans to put in rotation of scheduled donations and deliveries.

http://www.projectmend.org

 
At 1:49 PM, Blogger Richard Layman said...

Relevant only in that a medical center expands with a building providing various outpatient and other services in another community.

https://www.chicagobusiness.com/health-care/rush-university-system-health-plans-lakeview-medical-office

Rush plans new $27 million medical office in Lakeview

1/9/2024

Rush University System for Health is planning to build a $26.6 million medical office in Lakeview, where it will offer primary and specialty care and outpatient services.
Details of the center, which would be housed in a building at 2928 N. Ashland Ave., were disclosed in a recent application Rush filed with the Illinois Health Facilities & Services Review Board. If the board approves the project, the nearly 24,000-square-foot center would open in summer 2026, Rush spokesman Tobin Klinger said in a statement.

... Rush currently has two practices in the area — one in Lakeview and another in Lincoln Park — but demand is growing in the neighborhoods, Rush says in its application. At the Lincoln Park location, Rush recorded more than 10,000 patient visits in fiscal 2023, up almost 9% compared the year before.
“Clearly the (Rush University Medical Group) physician practices in the immediate community are rapidly growing, and with that growth comes a need for additional capacity and ability to provide specialty services that are proposed at the Rush Lake (Medical Office Building),” the application reads.
The new Lakeview center would include 29 exam rooms, two procedure rooms and a laboratory, according to the application. It would also house private physician offices across specialties like primary care, obstetrics/gynecology and dermatology, and include an imaging room, with magnetic resonance imaging, computed tomography scans, ultrasound, echo and general X-ray capabilities.

... The new center would add to Rush’s growing footprint in the Chicago area. Rush, which currently has more than 30 outpatient centers in the area, is also planning to open a $70 million, 60,000-square-foot multispecialty care outpatient center at the corner of North and Harlem avenues next year.

... Outpatient centers are typically cheaper to operate than hospitals and serve as patient touch points for basic care in several areas. And when patients need more advanced — and expensive — care, health care organizations usually work to funnel them to their major hospitals.

 
At 2:06 PM, Blogger Richard Layman said...

'We heal better in our homes': Intermountain hospital-at-home program surpasses 1K patients

https://www.beckershospitalreview.com/innovation/we-heal-better-in-our-homes-intermountain-hospital-at-home-program-surpasses-1k-patients.html

1/3/24

The service is provided through Castell — a digital and population health subsidiary of Intermountain — and aims to provide patients with the right level of care in the right place at a lower cost, the health system said in a Dec. 19 news release.

"Since beginning, the hospital-level care at home program has saved Intermountain over 3,000 bed days from participating hospitals and can cost patients up to 30% less than traditional hospital stays, depending on the care needed," Castell Director of Home Services Anna McMillan said.

In-person caregiver visits are provided by Intermountain Homecare, with remote monitoring and virtual visits provided by telehealth providers located at the Intermountain virtual hospital in Murray, Utah.

"Our comprehensive in-home services provide the technology to monitor vital signs remotely, and offer daily in-home nurse visits, daily telehealth rounding by a medical provider and access to 24-hour on-call nurses and physicians," Nathan Starr, DO, internal medicine physician and medical director of home services for Castell and Intermountain's telehospitalist program, said.

The program is available to Intermountain patients who meet specific clinical and nonclinical criteria and come in through an emergency department visit or have been admitted to the hospital and qualify for early transfer home.

It supports an individual's social determinants of health and covers diverse ethnic backgrounds, diversity of age and various financial backgrounds, including people who are unhoused.

 
At 2:17 PM, Blogger Richard Layman said...

The most pressing question to start the year

https://www.beckershospitalreview.com/hospital-management-administration/michael-dowling-the-most-pressing-question-to-start-the-year.html

1/2/24

The new year is always an ideal time for healthcare leaders to reflect on the state of our industry and their own organizations, as well as the challenges and opportunities ahead. As the CEO of a large health system, I always like to reflect on one basic question at the end of each year: Are we staying true to our mission?

Certainly, maintaining an organization's financial health must always be a priority but we should also never lose sight of our core purpose. In a business like ours that has confronted and endured a global pandemic and immense financial struggles over the past several years, I recognize it's increasingly difficult to maintain our focus on mission while trying to find ways to pay for rising labor and supply costs, infrastructure improvements needed to remain competitive and other pressures on our day-to-day operations.

After all, the investments we need to make to promote community wellness, mental health, environmental sustainability and health equity receive little or no reimbursement, negatively impacting our financial bottom lines. During an era of unprecedented expansion of Medicaid and Medicare, we get less and less relief from commercial insurers, whose denial and delay tactics for reimbursing medical claims continue to erode the stability of many health systems and hospitals, especially those caring for low-income communities.

=== continued

 
At 2:17 PM, Blogger Richard Layman said...

=== continued

The list of other worthy investments goes on and on: charity care to uninsured or underinsured patients who can't pay their medical bills, funding for emergency services that play such a critical role during public health emergencies, nutritional services for families struggling to put food on the table, programs that combat human trafficking and support women's health, the LGBTQIA+ community and global health initiatives that aid Ukraine, the Middle East and other countries torn apart by war, famine and natural disasters.

We must also recognize the key role of healthcare providers as educators. School-based mental health programs are saving lives by identifying children exhibiting suicidal behaviors, anger management issues and other troublesome behaviors. School outreach efforts have the added benefit of helping health systems and hospitals address their own labor shortages by introducing young people to career paths that will help shape the future healthcare workforce.

Without a doubt, the "to-do" list of community health initiatives that support our mission is daunting. We can't do it all alone, but as the largest employers in cities and towns across America, health systems and hospitals can serve as a catalyst to get all sectors of our society — government, businesses, schools, law enforcement, churches, social service groups and other community-based organizations — to recognize that "health" goes far beyond the delivery of medical care.

The health of individuals, families and communities hinges on the prevalence of good-paying jobs, decent and affordable housing, quality education, access to healthy foods, medical care, transportation, clean air and water, low prevalence of crime and illicit drugs, and numerous other variables that typically depend on the zip codes where we live. Those so-called social determinants of health are the driving factors that enable communities and the people who live there to either prosper or struggle, resulting in disparities that are the underlying cause of why so many cities and towns across the country fall into economic decay and become havens for crime and hotbeds for gun violence, which shamefully is now the leading cause of death for children and adolescents.

To revive these underserved communities, many of which are in our own backyards, we have to look at all of the socioeconomic issues they struggle with through the prism of health and use the collective resources of all stakeholders to bring about positive change.

Health is how we work together to build a sense of community. Having a healthy community also requires everyone doing what they can to tone down the political rhetoric and social media-fueled anger that is polarizing our society. Health is bringing back a sense of civility and respect in our public discourse, and promoting the values of honesty, decency and integrity.

As healthcare providers and respected business leaders, we should all make a New Year's resolution to stay true to our mission and do what we can within our communities to bring oxygen to hope, optimism and a healthier future.

 
At 2:19 PM, Blogger Richard Layman said...

https://www.beckershospitalreview.com/hospital-management-administration/the-tsunami-of-change-in-patient-expectations.html

The 'tsunami' of change in patient expectations

12/29/23

"From the time I began training decades ago to today, that change has been like a tsunami. It is unstoppable," said David Lubarsky, MD, vice chancellor of human health sciences and CEO of UC Davis Health in Sacramento, Calif., during an interview with the "Becker's Healthcare Podcast." "It is an expectation of customer service number one, immediacy. People want what they want, and they want it where they want it and how they want it."

People have become comfortable with ordering custom food delivery and having it delivered in minutes, or goods delivered within hours. They have the same expectation of healthcare, Dr. Lubarsky says, and they are rejecting the paternalistic healthcare of the past where they visit the physician's office and the physician tells them exactly what to do.

"What they want is a valued and trusted partner who knows them, who will create a joint and shared decision-making opportunity for how aggressive they want to be in treating their diseases, balancing the side effects and the risks of treatment versus the ongoing disease, understanding how it's going to impact their joy of living and to make a good decision for them," Dr. Lubarsky said.

Patients also want a global view of their health. Dr. Lubarsky noted two-thirds of patients want the data they're collecting from the Apple Watch and Fitbit to be included in their medical records, and many hospitals don't collect that information. Physicians may not know as much about the day-to-day health of their patients as the patients do when they're monitoring their devices.

There is also an opportunity to improve access to care. Healthcare is an infinite need, Dr. Lubarsky said, and as people age their need increases.

"What we really must do is create an information technology transfer capability so that patients can self-investigate, self-diagnose and self-triage, and even occasionally, self-treat themselves before they even progress to a virtual visit, let alone a brick and mortar visit," he said. "We need to change the idea that I'm going to call the doctor and go to the office. We will never meet that demand. There will never be enough providers."

For underserved populations that don't have access to mobile devices or high speed internet, digital health navigators within the community can serve as an intermediary or coach to connect with community members and make sure they connect with healthcare providers. The digital health navigators can work with them on gaining proficiency with computers and iPhones and iPads.

 
At 11:08 PM, Blogger Richard Layman said...

support group for people with vision loss, University of Utah Health, Moran Eye Center

https://www.flickr.com/photos/rllayman/53501626234

1/31/2024

 
At 11:22 PM, Blogger Richard Layman said...

https://www.supermarketnews.com/nonfood-pharmacy/hy-vee-adds-patient-employer-clinic-suite-health-offering

Hy-Vee adds patient, employer clinic to suite of health offerings

1/31/24

Hy-Vee, Inc. has become a joint owner of medical clinic company Exemplar Care as the retailer continues to expand its primary care offerings.

Under the agreement, Exemplar Care medical clinics will be renamed to Hy-Vee Health Exemplar Care, offering direct primary care and 24/7 urgent care (where available). Locations are currently open in West Des Moines, Ankeny and soon Bondurant, Iowa. These clinics will be managed by Hy-Vee’s Chief Medical Officer Dr. Daniel Fick and Exemplar Care’s leadership team, including founder Dr. Jon Van Der Veer.

Through Hy-Vee Health Exemplar Care, employer groups can provide their employees access to unlimited primary and urgent care through memberships for a fixed monthly fee or layer the membership with a major medical health plan. Health care memberships are also available to individuals and families outside of an employer-funded plan.

Hy-Vee currently operates more than 275 retail pharmacies across eight Midwestern states, as well as Amber Specialty Pharmacy, an award-winning, national specialty pharmacy provider. In 2020, Hy-Vee formed its own pharmacy benefit manager Vivid Clear Rx to combat rising drug prices by bringing more transparency to the industry.

Hy-Vee has also entered the medical space in recent years, launching a low-cost telehealth and online pharmacy provider called RedBox Rx that specializes in mental health, men’s health, women’s health and more. Most recently, Hy-Vee opened Hy-Vee Health Infusion Care medical practices in West Des Moines, Iowa, and Chicago to provide affordable infusion therapy to patients with chronic conditions.

The retailer has invested heavily in the wellness industry, employing a team of registered dietitians who offer nutritional services virtually and in person. Hy-Vee’s dietitians and pharmacists also work together to offer Food as Medicine-supported services to help individuals manage health conditions through dietary changes.

===
Meanwhile CVS is closing all its Minute Clinics in LA.

 
At 11:55 PM, Blogger Richard Layman said...

https://www.beckershospitalreview.com/hospital-management-administration/meet-the-24-year-old-running-a-colorado-hospital.html

2/1/24

In terms of organizational strategy, Mr. Hettler said Sedgwick County Health Center has focused on reducing reliance on travel staff and improving its financial picture, among other priorities.

He said the hospital is also focused on establishing new partnerships with larger health systems to attract specialists and create equitable access for those who live in the surrounding rural areas.

"Our commitment goes beyond just your organization," he said. "You're looking out for the wellness of the entire county and the areas we serve because the reality is these are agricultural communities. The health centers are the cornerstone of the foundation of the entire economy. Everybody either knows or is related to someone who works here at the health center. So, our success is so much more than just any other business surviving. It's for the whole survival of the county."

 
At 8:33 PM, Blogger Richard Layman said...

https://www.washingtonpost.com/dc-md-va/2024/02/01/dc-cash-payments-mothers-pilot-program/

D.C. sent $10,800 to dozens of new moms. Here’s how it changed their lives

In 2022, the D.C. government announced a pilot program that offered 132 new and expecting low-income mothers $10,800 over the course of a year — no strings attached — intended to assess how unconditional cash payments could improve their families’ outcomes and economic mobility.

Facilitated by the nonprofit Martha’s Table, the $1.5 million Strong Families, Strong Futures pilot was limited to families in Wards 5, 7 and 8, which contain some of the District’s poorest neighborhoods. The city’s program was based on similar successful cash-transfer pilots that have now been modeled in at least 100 U.S. jurisdictions and drew 1,553 applications in just three weeks, requiring a lottery system to winnow down the final group.

All 132 mothers had to choose whether they wanted 12 monthly payments of $900 or the entire amount immediately in a lump sum, a unique feature of D.C.’s pilot. About 75 percent chose the lump sum — which was better for those also receiving government benefits, for whom monthly payments from the pilot were more likely to be flagged as additional income, potentially affecting their eligibility, said David Lloyd, the deputy chief of programs at Martha’s Table.

... Did it work? Program coordinators at Martha’s Table say that over the pilot’s duration, the moms reported spending the majority of their funds on needs such as housing, food and transportation. Comparing responses from the middle of the program’s first year to the closing months, participants increasingly said they were using the money to build up cash savings for the future, illustrating a behavioral shift toward financial security — a core goal of the pilot.

 
At 12:19 AM, Blogger Richard Layman said...

https://www.wfaa.com/article/news/health/st-vincent-de-paul-offers-free-pharmacy-access-health-resources/287-bb434b31-45ca-481d-a3e8-de829d05ee61

St. Vincent de Paul offers a free pharmacy to provide better access to health resources

St. Vincent de Paul's free pharmacy hits its highest number yet, having filled and shipped more than 100,000 free prescriptions in 2023 with the help of a new robot

https://svdpdallas.org/pharmacy/

https://www.wfaa.com/article/news/local/free-pharmacy-helps-uninsured-patients-texas/287-07dfe49e-fb02-433e-b6f7-4fdd466f8560

Free pharmacy helps uninsured patients in Texas

Since St. Vincent de Paul Pharmacy opened its doors in 2018, it's been busy and growing. It's the first charitable pharmacy in Texas and continues to provide free medications for uninsured and low-income residents.

In five years, more than 200,000 prescriptions have been filled at this Dallas pharmacy. That's equivalent to $55 million worth of medications. They have served more than 5,500 patients.

The initial goal was to provide services for nine counties in North Texas. They now serve patients across the state.

 
At 6:42 AM, Blogger Richard Layman said...

Fort Worth leaders break ground on 'life-changing' medical complex in Las Vegas Trail neighborhood

https://www.wfaa.com/article/news/local/tarrant-county/fort-worth-life-changing-medical-complex-las-vegas-trail-neighborhood/287-7ed188f3-6f0e-4327-adc9-7a5be16ba45f

11/14/23

The two-story, 40,000 square-foot facility should open in 2025. The complex will host primary care offices, a food bank with a demonstration kitchen, a job training center and a police substation.

... JPS Health Network and Cook Children's will each operate from the facility, a first-of-its-kind partnership between the public and private hospitals. The agreement allows doctors to pass along pediatric patients to primary care physicians without forcing them to a new clinic.

 
At 2:19 PM, Blogger Richard Layman said...

https://www.chicagobusiness.com/crains-forum-physician-retention/harris-poll-shows-need-more-medical-providers

Harris Poll: Wide divide in health care providers explains a lot about sickness and health in Chicago

1/29/24

There is a 10-year gap in average life expectancy between Black and white Chicagoans. Residents on the city’s South and West sides have higher cancer mortality rates than North Side residents. The city’s South Side had no trauma center for 30 years. These stark realities illuminate a serious issue — Chicago residents lack equal access to affordable, quality health care.

Cook County residents’ access to health care can often be predicted based on their address, race and socioeconomic status. Chicago’s poorer, and more diverse, South and West Side communities disproportionately suffer from a lack of quality health care when compared to the city’s more affluent, and whiter, North Side neighborhoods.

According to a recent Harris Poll survey, 41% of white Cook County residents, but only 23% of residents of color, consider their health care access to be “very good” or “excellent.” Similarly, one-third (36%) of white Cook County residents, but only 20% of residents of color, consider their health care quality to be “very good” or “excellent.” Little wonder: For the 30 years before the University of Chicago opened a Level 1 adult trauma center in 2018, patients had to be transported to a North Side trauma center, delaying potentially life-saving care.

Compounding the access problem, Chicago’s communities of color suffer from higher rates of many chronic conditions, including obesity, diabetes and HIV. Nationally, racial minorities are 1.5 to 2 times more likely to develop most major chronic diseases, according to the Biomedical Research Institute. We’re no exception: Chicago’s communities of color have diabetes rates three times higher than among the city’s white residents.

 
At 11:34 PM, Blogger Richard Layman said...

Behind Hannaford’s Mission to Improve the Well-Being of Older Adults
Grocer partnering with Maine Council on Aging on new initiative

https://progressivegrocer.com/behind-hannafords-mission-improve-well-being-older-adults

12/12/23

Hannaford Supermarkets is taking steps to help older adults in New England and New York gain a path toward better health through its new Connection, Health and Equity Through Food program. The initiative, which has been kicked off through a $1.3 million donation to the Maine Council on Aging (MCOA), aims to enhance access to food and social connection.

The new program sits under the banner of Hannaford’s “Eat Well, Be Well – A Path to Better Health” initiative and will fund organizations and projects that support the needs of diverse older adults, including the BIPOC community, LGBTQ+ individuals, adults with disabilities, immigrants and military veterans, as well as those living in rural areas with limited access to transportation. The program will allow MCOA to evaluate opportunities to distribute micro-grants to organizations, programs and projects serving older people throughout New England and New York.

 
At 11:37 PM, Blogger Richard Layman said...

Meijer Launches Personalized Nutrition Coaching Service
Program available in Michigan to start, with plans to expand across Midwest

https://progressivegrocer.com/meijer-launches-personalized-nutrition-coaching-service

1/11/24

Meijer has launched a new virtual personalized nutrition coaching service to help individuals achieve their health-and-wellness goals. The coaching service will only be offered in Michigan to start, with future plans to expand across the retailer’s Midwest footprint.

Led by Meijer registered dietitians, this new offering provides personalized nutrition guidance for individuals at any stage of their health journey. Those wanting to learn more can schedule a complimentary 15-minute exploration session with a Meijer registered dietitian or get started right away with the full service by scheduling a 45-minute initial session for $89. Customers can then schedule as many follow-up appointments as needed, at $49 per session. All appointments can be made via the Nutrition by Meijer webpage.

The virtual coaching service is confidential and focused on helping individuals achieve and maintain optimal health through proper nutrition and dietary choices. Based on the individual’s needs, the program may include:

Assessment, Monitoring and Evaluation: Conducting thorough assessments of an individual’s current dietary habits, lifestyle, medical history and nutritional needs, and making necessary adjustments based on feedback and changes in health status.
Education: Providing education on nutrition principles, food choices, portion control and the importance of a balanced diet.
Meal Planning: Creating personalized and balanced meal plans based on the individual’s specific health goals, dietary preferences and any existing medical conditions.
Nutritional Coaching: Offering guidance and support to individuals with specific health concerns, such as diabetes, chronic inflammation, cardiovascular issues and gastrointestinal challenges.
Food Allergy and Intolerance Management: Assisting individuals with identifying and managing food allergies or intolerances and helping them plan meals accordingly.
Weight Management: Assisting clients in achieving and maintaining a healthy weight through appropriate diet and lifestyle changes.
Behavioral Change Support: Helping clients adopt and sustain positive changes in their dietary habits by addressing psychological and behavioral aspects of eating.

 
At 7:44 PM, Blogger Richard Layman said...

https://www.beckershospitalreview.com/health-equity/christianacare-finds-superior-outcomes-in-black-patients.html

ChristianaCare finds superior outcomes in Black patients

2/23/24

With Story Health, the system launched a digital platform that offers a health coach who helps with medication adherence, coordinates lab work and aids patients with transportation and prescription assistance.

Here are the collaboration's results:

Six times improvement on target doses of beta blockers (76%)

Seven times improvement on target doses of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and angiotensin receptor neprilysin inhibitors (54%)

Two times improvement on target doses of mineralocorticoid receptor antagonists (57%)

Increase in sodium-glucose cotransporter 2 inhibitor adherence, rising from a 32% baseline to 74%

Decrease in average absolute systolic and diastolic blood pressure levels after 120 days

 
At 9:27 PM, Blogger Richard Layman said...

BHR, 2/19/24

Neil M. Meltzer. President and CEO of LifeBridge Health (Baltimore): LifeBridge Health is building a legacy of reimagining what a community health system can be. Our Center for Hope is a national leader in comprehensive and integrated programs to advance hope, healing and resilience for those impacted by trauma, abuse and violence. Some may question why a health system is involved in community violence intervention, gun violence prevention, child abuse, etc. With cancer or heart attack, we understand the benefits of preventing these illnesses rather than having to treat them. The same can be said in taking a public health approach to violence; we aim to save physical, emotional and ongoing trauma to individuals and communities. Over the last year, we have seen how this integrated approach to violence (along with many partners in our communities) has helped to move the needle and lower the number of gunshot wounds and traumas we are seeing across our city.

 
At 9:28 PM, Blogger Richard Layman said...

BHR, 2/19/24

Mike Young. President and CEO of Temple University Health System (Philadelphia): Our Temple Center for Population Health implemented a comprehensive approach to screening and responding to social determinants of health that advances health equity, partners with our communities, and improves the quality and delivery of our care. Patients are screened for social determinants such as inadequate healthcare access, financial instability, poor housing conditions, domestic violence, and food insecurity so that the most effective care strategies can be delivered to address them. Community Health Workers connect patients to resources and support. Community organizations, payers, and philanthropic groups develop effective responses. The program demonstrated significant reductions in ED visits and hospitalization rates for diabetes, asthma/COPD, and heart failure.

 
At 9:29 PM, Blogger Richard Layman said...

BHR, 2/19/24

Elizabeth Wako, MD, MBA. President and CEO of Swedish Health Services (Seattle): We have a lot to be proud of in this area. We're committed to innovation as a cornerstone of our clinical excellence as well as our community work. One really bright highlight in this area is The Justice Unity Support Trust (JUST) Birth Network. JUST Birth was established at Providence Swedish to ensure that every birthing parent receives care from someone who understands their unique needs and experiences.

We believe this model of care is essential to reducing the significant disparities in pregnancy and birth outcomes among Black and Native parents, which are well-documented here in our Puget Sound region and nationally. JUST Birth was envisioned with our community health partners as a resource by the community for the community. The network includes dedicated cultural navigators, childbirth educators, and birth and postpartum doulas who provide patients and their families with expert care and guidance throughout their pregnancy and postpartum journey.

We know we are making a difference; analysis of initial data showed a reduced number of C-sections and an increased number of unmedicated births among Black parents who had the support of a Black doula during childbirth. In fact, JUST Birth is making such a difference that Biden Administration officials and a team responsible for innovation in Medicare and Medicaid services met this summer with JUST Birth leaders to learn more about the program and the broader application of its principles. I'd say that's moving the needle in a big way and in the way we're most committed to here at Providence Swedish.

 
At 9:30 PM, Blogger Richard Layman said...

BHR, 2/19/24

Peter Pronovost, MD, PhD, FCCM. Chief Quality and Clinical Transformation Officer; Veale Distinguished Chair in Leadership and Clinical Transformation of University Hospitals Cleveland: Like all health systems, we at University Hospitals are always looking for innovative ways to provide high-value care to our patients, while ensuring hospital access for our sickest patients and managing costs. In many cases, this is easier said than done – but not always. A needle-moving innovation we unveiled this year does both things: our new Healthy at Home program. Tailored for patients with conditions like COPD, pneumonia and cellulitis, it allows us to deploy a variety of services and be flexible in meeting patients' needs.

The model usually begins with a paramedic visit and includes home health, a tele-physician or nurse visit as needed, and can sometimes include infusion of medications. We now have an average census of about 80 patients a day. That means 80 people who might otherwise be in the hospital are not only being compassionately cared for in their homes, but are now receiving high-quality care at a lower cost. Our hospitals are normally full, as many are, but now we're freeing up beds to enhance access for cancer patients and high-risk surgery patients who need timely inpatient care. This innovation is a testament to what's possible when thoughtful strategy and purposeful collaboration among different groups of caregivers unite for a singular purpose: keeping people healthy at home.

 
At 9:33 PM, Blogger Richard Layman said...

BHR, 2/19/24

Peter Pronovost, MD, PhD, FCCM. Chief Quality and Clinical Transformation Officer; Veale Distinguished Chair in Leadership and Clinical Transformation of University Hospitals Cleveland: Like all health systems, we at University Hospitals are always looking for innovative ways to provide high-value care to our patients, while ensuring hospital access for our sickest patients and managing costs. In many cases, this is easier said than done – but not always. A needle-moving innovation we unveiled this year does both things: our new Healthy at Home program. Tailored for patients with conditions like COPD, pneumonia and cellulitis, it allows us to deploy a variety of services and be flexible in meeting patients' needs.

The model usually begins with a paramedic visit and includes home health, a tele-physician or nurse visit as needed, and can sometimes include infusion of medications. We now have an average census of about 80 patients a day. That means 80 people who might otherwise be in the hospital are not only being compassionately cared for in their homes, but are now receiving high-quality care at a lower cost. Our hospitals are normally full, as many are, but now we're freeing up beds to enhance access for cancer patients and high-risk surgery patients who need timely inpatient care. This innovation is a testament to what's possible when thoughtful strategy and purposeful collaboration among different groups of caregivers unite for a singular purpose: keeping people healthy at home.

 
At 9:35 PM, Blogger Richard Layman said...

BHR, 2/19/24

Joanna Perdomo, MD. Physician of Pediatric Care Center at Nicklaus Children's Health System (Miami): This year, we are rolling out a systemwide social drivers of health screening and referral system, in which we ask questions about food, nutrition, housing, utilities, transportation, and overall resource needs. We have already piloted this initiative in five clinical areas and found that 40% of patients have screened positive for a need in at least one domain, and 30% have screened positive for food insecurity. We believe that the ability to identify needs and most importantly connect families with necessary resources is hugely impactful on patients' and families' overall health and wellbeing.

 
At 9:38 PM, Blogger Richard Layman said...

BHR, 2/19/24

Robert J. Corona, DO, MBA, FACP. CEO of Upstate University and Community Hospitals (Syracuse, N.Y.): The most needle moving innovation has been the opening of our "Connect Care" service. It is a clinic that sees lower acuity cases and thus it is effective at helping to decant the volume in our emergency room.

Results:

1. It has significantly reduced the number of patients who left without being seen in all 3 of our hospital emergency rooms.

2. It has lowered the average time to complete an ER patient visit as patients can be triaged to the Connect care clinic

3. It has helped reduce the average boarding time in the emergency room.

 
At 9:41 PM, Blogger Richard Layman said...

BHR, 2/19/24

Amy Tucker, MD. Chief Medical Officer of Upstate University Hospital (Syracuse, N.Y.): Upstate University Hospital in Syracuse, N.Y., has successfully introduced a convenience care clinic known as the Connect Care Clinic, which has had a significantly positive impact on both patient care access and hospital throughput. Connect Care serves as a cornerstone for a variety of ambulatory initiatives, such as providing timely follow up care for patients after inpatient or emergency department discharges, implementing streamlined clinical pathways for low-acuity medical conditions, and providing onsite walk-in care. Hence, Connect Care functions as a secure bridge to primary and ambulatory care for patients from various segments of the care continuum — ED, inpatient, and outpatient. The streamlined pathway for the evaluation of patients presenting to the ED with low risk chest pain has reduced admissions for this diagnosis more than 50%.

The Connect Care Clinic also houses the Upstate Cares Program, catering to the urgent medical needs of our employees and improving the Upstate employee experience. Finally, Connect Care provides convenient access for a variety of outpatient bedside procedures, such as paracentesis, thoracentesis, lumbar puncture, punch biopsies, and PICC line placements, providing patients with access to care without the need for an emergency room or observation encounter. As part of our commitment to community service, we are expanding the clinic's walk-in clinic hours, aiming to better serve our local community.

 
At 9:42 PM, Blogger Richard Layman said...

BHR, 2/19/24

Nwando Anyaoku, MD. Division Chief Health Equity Officer of Providence (Renton, Wash.): I am incredibly proud of the Providence Health Equity Fellowship program, an initiative we recently launched that empowers caregivers to design specific equity programs to meet unique needs of their patient populations. Last year, our inaugural cohort of 19 caregivers dedicated 25% of their time to the program, receiving didactic training on health equity, process improvement and leadership development. Today, each has launched their respective initiative, and we are thrilled about the results we are seeing in this short time. From advancing language access and health literacy for patients with limited English proficiency to expanding data collection to improve care needs for our LGBTQIA+ populations, we are moving the needle on shortening health equity gaps that have plagued our communities for decades. I am excited to see how far we will go in 2024.

 
At 12:14 AM, Blogger Richard Layman said...

https://progressivegrocer.com/health-care-leaders-back-foodsmart-expand-foodscripts-solution

Health Care Leaders Back Foodsmart to Expand Foodscripts Solution

1/31/24

Foodscripts aims to simplify the process by which doctors refer patients to dietitians and prescribe quality food, just as they would medication, offering a cost-effective way to tackle chronic diseases. With more than 80% of American adults facing such chronic health conditions as diabetes, hypertension, hyperlipidemia and obesity, such a solution is more crucial than ever.

Primary care providers of all sizes can use Foodscripts to help patients improve their food and nutrition security. Foodscripts mimic a pharmacy prescription: Patients get a referral to Foodsmart dietitians and subsidized meals tailored to their specific medical conditions.

Thanks to Foodsmart’s partnerships with health plans, patients usually receive the Foodscripts, access to telenutrition visits, medically tailored food subsidies and the Foodsmart platform, all at $0 out-of-pocket costs. Further, according to the company, its comprehensive approach has enabled 42% of program members experiencing food insecurity become food-secure within six months, with many better able to manage their health conditions.

Outside of dietitian visits, members use the Foodsmart App to stay on track with their healthy-living program, receiving daily support from the food marketplace. Within the marketplace, members can find thousands of healthy recipes, compare prices on groceries, and even have food delivered to their homes through Foodsmart’s integration with Instacart, Grubhub and Walmart. The company also works with numerous local minority and women-owned businesses, as well as food-centric nonprofits such Dion’s Chicago Dream and Eridor Food Service, to name a few. Foodsmart supports more than 2 million members across the United States through partnerships with some of the largest health plans and employers.

 
At 12:04 AM, Blogger Richard Layman said...

At new South Side birth center, Pritzker touts state spending on Maternal health

mhttps://www.chicagobusiness.com/politics/new-south-side-birth-center-pritzker-touts-state-spending-maternal-health

2/26/24


Trump warns of big losses from asset sales during property slump
February 26, 2024 05:40 PM
State and community leaders on Feb. 26 celebrated the planned opening of a new freestanding birth center on Chicago’s South Side while emphasizing proposed maternal health spending increases in Gov. J.B. Pritzker’s budget.

The nonprofit Chicago South Side Birth Center will mark the city’s second active midwife-led birth center, but the first for the South Side. Advocates say the Black-led center offers safe birthing alternatives in a medically underserved area of the city.

Pritzker also continued to promote his proposed budget, highlighting the Illinois Birth Equity Initiative — a multi-pronged proposal aimed at promoting infant health while reducing the number of maternal and infant deaths.

He proposed allocating $5 million to a home visiting program for new parents and over $4 million to IDPH to create a statewide maternal health plan and distribute grants to community-based reproductive health care providers.

Pritzker highlighted other measures from his budget aimed at new parents, including a $1 million pilot diaper distribution program, operated through the Department of Human Services, and $12 million to create a tax credit aimed at low-income families with children younger than age three.

 
At 10:02 AM, Blogger Richard Layman said...

The developers include Henry Ford, MSU and the Detroit Pistons owner Tom Gores, who will develop the commercial corridor, according to the report. The Gilbert Family Foundation plans to develop a stroke and neurofibromatosis research center on the campus.

The developers project their benefits agreement to total $604 million, including:

A $310 million uncompensated care fund for under-insured residents within a 3-mile radius.
$90 million for the research center.
$10 million for a 1,500-space parking garage.
$55 million on infrastructure improvements.
$30 million on rehabbing five acres of greenspace around the hospital.
Over the next 35 years, developers are expected to receive $231.7 million in tax revenue reimbursement, $117 million of which will stem from property tax, according to The Detroit News.

Anchored by Henry Ford's academic healthcare campus, the "Future of Health" project will include a major expansion of Henry Ford Hospital and a medical research facility for Henry Ford Health + Michigan State University Health Sciences, as part of their 30-year partnership.

Residential, affordable housing, commercial and retail components are also included in the project, which builds on the partnership between Henry Ford and Mr. Gores.

 
At 9:49 AM, Blogger Richard Layman said...

https://www.beckershospitalreview.com/hospital-management-administration/ochsners-lofty-goal-to-redesign-care.html

Ochsner's 'lofty goal' to redesign care

2/29/24

The organizations that do a great job with patient access will be successful over the course of time. And so we're really focused on patient access and the ambulatory setting, in our group practice, in our clinics. That comes in a lot of different ways, but first and foremost is care model redesign and scaling new technologies. Our goal around patient access long term is to be able to care for every patient within two weeks of that patient inquiry or referral, and we're not there yet. That's going to require growth of use of alternative delivery models like e-consults and e- visits, telehealth. Again, redesigning the care so our physicians and caregivers can meet patient needs in a very different way than they're able to do today. That's a lofty goal. We've got to go department by department to redesign the care if we're going to achieve that goal. So that doesn't get done in a year. That's a long-term goal. But we're really focused on that care model redesign, especially in the ambulatory and clinic environment. That's a big body of work in 2024.

 
At 10:16 AM, Blogger Richard Layman said...

More Chicagoans are dying from heart attacks outside of hospitals and at a younger age, especially among Black men, a University of Illinois Chicago and Illinois Heart Rescue study finds.

 
At 9:44 AM, Blogger Richard Layman said...

https://www.bostonglobe.com/2024/03/11/business/steward-health-care-crisis-state-help

https://www.bostonglobe.com/2024/03/11/business/steward-health-care-crisis-state-help/

Steward Health Care’s Massachusetts hospitals are on the brink of financial disaster. But in many important ways, Steward’s troubles are just a symptom of a larger crisis engulfing the entire industry.
While Steward’s for-profit ownership structure put its hospitals at a disadvantage, many health care executives say the state’s entire network of hospitals is approaching a capacity shortage not seen since the early days of the COVID-19 pandemic.
Industry leaders are calling for urgent action from the Healey administration and the Legislature to help stem the crisis. Even just simplifying the state regulatory bureaucracy and approvals for bringing uninsured patients into the MassHealth system would help, executives say.

“It’s not just more patients, it’s more patients in the wrong places,” said Brian Patel, chief medical officer at Sturdy Memorial Hospital in Attleboro. “We’ve got to work together to figure out how to get them in the right place.”
Rob Fields, chief clinical officer at the Beth Israel Lahey Health system, said the industry’s capacity crisis has been years in the making. But the pandemic, he said, accelerated the dynamics and left the hospitals with less time to adapt, although it did spur more telehealth services. Fields would like to see state officials urge private insurers to follow the state’s lead, through its MassHealth policies, to provide adequate reimbursements for telehealth and hospital-at-home.

On one day recently, the hospital had 130 more patients than it did at the height of the pandemic. Dickson is even looking at buying a post-acute care facility, such as a skilled nursing facility — even if it loses money — to take the strain off the hospitals.
“We are in every inch of real estate we can be in, managing surges,” Dickson said.

Dickson, for example, wants to see someone at the state level handling what he calls “care traffic control” — someone who has real-time information about hospital capacity across the state to coordinate transfers, with some kind of connection happening on a daily basis.

Another big reason for the backups at the hospitals is insurance authorization for post-acute care. Hospitals don’t typically discharge patients to a nursing or rehab facility until they know their care will be covered by insurance.

 
At 6:12 PM, Blogger Richard Layman said...

Harris County Public Health introduces Latino Chronic Disease Cohort pilot program

https://www.houstonpublicmedia.org/articles/news/health-science/2023/09/19/462915/harris-county-public-health-introduces-latino-chronic-disease-cohort-pilot-program

Harris County Public Health (HCPH) has introduced a new pilot program to help the local Latino community battle chronic diseases.

The Latino Chronic Disease Cohort is part of a larger health initiative, Accessing Coordinated Care and Empowering Self-Sufficiency (ACCESS) Harris County. The initiative helps underserved communities that HCPH has identified as having critical needs.

The cohort will also focus on teaching residents how to manage chronic diseases.

"Have you reduced certain factors relative, like, is your blood pressure at this number and now it's reduced to that number? Is your diabetes under control? Are you managing it well? Have you lost X amount of weight or whatever it is," Robinson said.

According to a report from HCPH, cancer and heart disease are the leading causes of death for the Latino community in Harris County. Harris County Commissioner Lesley Briones said that the Latino community also has higher rates of obesity and diabetes than other ethnic and racial groups.

"Latinos, we are almost half of this county... and, it is staggering, but nearly half of our Latino community here in Harris County do not have health insurance," Briones said. "So we want to make sure that these uninsured and underinsured individuals have this access to the care that they need.

 
At 6:14 PM, Blogger Richard Layman said...

Lavetta Finds Healing Through Support Groups

https://www.washingtonpost.com/creativegroup/elevance-health/lavetta-finds-healing-through-support-groups

3/16/24

 
At 10:00 PM, Blogger Richard Layman said...

Lavetta Finds Healing Through Support Groups

https://www.washingtonpost.com/creativegroup/elevance-health/lavetta-finds-healing-through-support-groups

3/16/24

 
At 4:04 AM, Blogger Richard Layman said...

Residents offered free health checks in libraries

https://www.bbc.com/news/articles/cn0e5w1g2qjo

3/17/24

Residents are being offered the chance to check their blood pressure in libraries and community centres in Wolverhampton.

City of Wolverhampton Council said health monitors had been installed so people could also measure their height, weight, body mass index (BMI) and heart rate.

No appointments are required and the checks are free and confidential, the authority said.

Results are printed on a slip of paper for users

 
At 10:24 PM, Blogger Richard Layman said...

https://www.ideastream.org/health/2024-03-21/metrohealth-tri-c-initiative-aims-to-reduce-disparities-by-educating-local-health-care-workers

MetroHealth, Tri-C initiative aims to reduce disparities by educating local health care workers

The MetroHealth System and Cuyahoga Community College leaders announced a new initiative March 20 to educate all 8,700 of MetroHealth's caregivers about the various obstacles to good health and other challenges faced by marginalized communities, including LGBTQ+, Hispanic and Black populations.

Leaders from the two institutions said providing this education through these new Health Equity Centers of Excellence is meant to improve treatment of these groups and address long-standing disparities in care and public health.

Charles Modlin, MetroHealth's chief health equity officer, said the program differs from other efforts to address health care inequity beyond engaging primary care doctors. The program aims to engage all medical staff, with a particular focus on hospital staff that work within medical specialties, such as oncology and cardiology. He said a more focused approach is necessary because specialists in these and other fields deal with the diseases that disproportionately harm marginalized groups, resulting in higher mortality rates and lower life expectancies.

 
At 12:20 AM, Blogger Richard Layman said...

Taiwan postpartum hotels.

These days, Taiwan tends to leave the postpartum month to professionals. New mothers can stay in one of approximately two hundred and eighty specialized hotels, where they will receive food, round-the-clock child care, doctor visits, and miscellaneous perks such as yoga classes and milk pumping. According to Gary Lee, the founder of MamiGuide, a Web site that books postpartum-hotel stays, they cost an average of two hundred and twenty U.S. dollars per night. For Americans, this can seem like an unbelievable deal. But here, where the average salary is slightly more than twenty-two thousand U.S. dollars, a monthlong stay can consume between twenty to thirty per cent of one’s annual income. Still, according to Lee, sixty-five per cent of postpartum parents check into one of these hotels, even if that means saving up for years. “It’s like buying a diamond ring,” Lee told me over the phone. Similar accommodations are available in China and South Korea.

 
At 11:04 AM, Blogger Richard Layman said...

https://www.bu.edu/articles/2024/impact-of-hospital-design-on-patient-recovery/

How the Design of Hospitals Impacts Patient Treatment and Recovery

3/14/24

 

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