KENT BISHOP M.D. ProMedica Chief Experience Officer President - - PowerPoint PPT Presentation

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KENT BISHOP M.D. ProMedica Chief Experience Officer President Women’s Service Line

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WHEN A VISION TAKES SHAPE….

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Modern Facilities Clinical Service Lines Quality/ Safety Mental Health Clinical Research Satisfaction

Cost Efficiencies & Transparency

Information Technology

Healthcare Medical & Professional Education

Innovation College/ University Programs Education Housing

Economic Development

School Nursing Job Training

Financial Opportunity Centers

Personal Security Infant Mortality Hunger

Summer Feeding Ebeid Institute SDOH Screening Staff Support Pharmacy Food Reclamation The Root Cause Coalition LISC/ Key Bank Green & Healthy Homes Lead Abatement EPIC Social Determinants Screening Downtown Generations Monroe Lenawee Health & Wellness

CLINICAL EXCELLENCE

SOCIAL DETERMINANTS

ANCHOR INSTITUTIONS

OVERALL HEALTH DISPARITY

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10 20 30 40 50 60 Fair to poor health status Smoking (male) Obseity (female) Hypertension (male) Diabetes

Lucas County Overall Health Disparity

Black White

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GOAL HEALTHY PEOPLE 2020 – 6.0 ALL RACES

ALL RACES WHITE BLACK HISPANIC 2013 7.4 6 13.8 8.8 2014 6.8 5.3 14.3 6.2 2015 7.2 5.5 15.1 6 2016* 7.4 15 2 4 6 8 10 12 14 16 RATES PER 1000 BIRTHS

OHIO INFANT MORTALITY RATES

*2016 rates are not projected and therefore not yet official

PHYSICIAN & PROVIDER BIAS Nationally 46% of providers admit to some racial bias It is found to lead to less time spent with the patient More importantly, it is felt to portend less involvement of the patient and their family in the decision making process

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INFANT MORTALITY SCREENINGS

8 Non-Referred , 14259 Referred, 2992 Community Referrals, 690

Since implementation (April, 2015), 17,941 patients have been screened:

• OB, ERs and urgent cares
• And/or referred to the HUB

from the community. 3682 (21%) of screened patients resulted in HUB referrals Screenings have since been expanded to include pediatrics and family medicine

INFANT MORTALITY SCREENINGS

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12 41 57 73 118 103 126 153 142 95 128 91 141 124 164 99 143 120 146 174 152 137 206 195 272 229 223 50 100 150 200 250 300 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Referrals By Month

2015 2016 2017

This can not be approached as a company project To be effective there must be commitment and a community collaboration There is not a single

• rganization that can

comprehensively effect the social determinants of health by themselves

INFANT MORTALITY SCREENINGS

The average age of referred patients is not what you might have guessed.... it is 26 years old

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0% 10% 32% 46% 8% 0% 4%

Age of referred patients

11-14 15-19 20-24 25-34 35-44 45+ Unknown

INFANT MORTALITY SCREENINGS

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38% 39% 4% 5% 14%

Race

Black White Hispanic Other Unknown

Referrals by patient demographics Does your workforce and community resources align with the diversity in your community? How will you create a culture

• f inclusion among your

diverse community needs?

INFANT MORTALITY SCREENINGS

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[VALUE] (4%) [VALUE] (5%) [VALUE] (5%) [VALUE] (13%) [VALUE] (20%) [VALUE] (20%) [VALUE] (20%) [VALUE] (21%) [VALUE] (24%) [VALUE] (24%) [VALUE] (36%) [VALUE] (47%) 200 400 600 800 1000 1200 1400 1600 1800 2000 Medication Assist Domestic Violence Insurance Substance Use Child Care Other Transportation Tobacco Baby Items Housing Mental Health Food

n=3682

What your neighbors need might surprise you too….

• 47% are food insecure
• 36% require mental

health resources

• 24% are struggling with

safe and secure housing

• 24% need basic baby

supplies

COMMITMENT TO IMPROVING INFANT MORTALITY

The need

• Ohio’s infant death per live births was

7.33 in 2014--well above the national rate of 5.93

• Ohio infant mortality for African

American babies was 14.3 in 2014

• To address the issue, Pathways HUB

was initiated and has shown great results

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Improvement

• African American women enrolled in

Pathways had a lower rate of 9.5% in Lucas County

• Pathways referrals, community

education, and physician awareness has driven the improvement

• Community health workers integral to

care team

COMMITMENT TO IMPROVING INFANT MORTALITY

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50% 25% 38% 39% 39% 23% 21% 22% 21% 20% 20% 18% 20% 19% 18% 18% 16% 16% 15% 16% 15% 15% 14% 14% 15% 15% 50% 25% 38% 28% 32% 21% 18% 18% 14% 12% 12% 12% 14% 13% 13% 13% 13% 13% 13% 14% 13% 13% 14% 14% 14% 13% 0% 10% 20% 30% 40% 50% 60% May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 16-Oct 16-Nov 16-Dec 17-Jan 17-Feb 17-Mar 17-Apr 17-May 17-Jun Total

Cummulative Preterm and LBW

% PT Cumulative % LBW Cumulative

LUCAS COUNTY INFANT MORTALITY RATES

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5 10 15 20 25 2013 2014 2015 2016

LUCAS COUNTY RACIAL DISPARITIES

White Black

*2016 rates are not projected and therefore not yet official

Interesting data emerging? 2016 black infant mortality rates by payer Medicaid - 12.8 Private Insurance - 14.2

COMMITMENT TO IMPROVING INFANT MORTALITY

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[VALUE] (88%) [VALUE] (89%) [VALUE] (89%) [VALUE] (12%) [VALUE] (11%) [VALUE] (11%) 50 100 150 200 250 300 350 Black n=193 White n=114 All Races n=338

Race Outcomes Enrolled More Than 90 Days

HBW LBW

INFANT MORTALITY SCREENINGS

Screenings Community Partners Links to Resources Self Empowerment

• Individuals enter this phase with varied

degrees of readiness, often

• ptimistically skeptical
• Referrals are made in

a dignified manner

• Outcomes are improved with

sustainability considerations

Individuals Partners

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A TRULY INTEGRATED HEALTH SYSTEM FOCUSING ON THE SOCIAL DETERMINANTS OF HEALTH IS COMMITTED TO PARTNERING WITH ALL SOCIAL AGENCIES AND RESOURCES IN A GIVEN COMMUNITY The test of leadership is not to put greatness into humanity, but to elicit it, for the greatness is already there ~James Buchanan

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KENT BISHOP M.D. ProMedica Chief Experience Officer President Women’s Service Line