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

KENT BISHOP M.D. ProMedica Chief Experience Officer President Women’s Service Line 1

WHEN A VISION TAKES SHAPE … . 2

3

SDOH Ebeid The Root Screening Institute Cause Coalition Clinical Staff Pharmacy Summer Support Feeding Cost Satisfaction Service Efficiencies & Quality/ Lines Transparency Safety Social Food Determinants EPIC Mental Reclamation Screening Health Hunger Information Infant Technology Mortality Health & Generations Wellness CLINICAL Modern Personal Downtown SOCIAL Facilities Security EXCELLENCE Lenawee DETERMINANTS Monroe Healthcare Financial Medical & Opportunity Professional Centers Education ANCHOR INSTITUTIONS Clinical Job Training Research School Innovation Nursing College/ University Housing Economic Programs Education Development Green & Lead LISC/ Healthy 4 Abatement Key Bank Homes

OVERALL HEALTH DISPARITY Lucas County Overall Health Disparity Diabetes Hypertension (male) Black Obseity (female) White Smoking (male) Fair to poor health status 0 10 20 30 40 50 60 5

GOAL HEALTHY PEOPLE 2020 – 6.0 ALL RACES OHIO INFANT MORTALITY RATES 16 14 12 RATES PER 1000 BIRTHS 10 8 6 4 2 0 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 *2016 rates are not projected and therefore not yet official 6

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 7

INFANT MORTALITY SCREENINGS Community Referrals, Since implementation (April, 690 2015), 17,941 patients have been screened: • OB, ERs and urgent cares Referred, 2992 • And/or referred to the HUB from the community. 3682 (21%) of screened patients Non-Referred , 14259 resulted in HUB referrals Screenings have since been expanded to include pediatrics and family medicine 8

INFANT MORTALITY SCREENINGS Referrals By Month This can not be approached 300 272 as a company project 250 229 223 206 To be effective there must be 195 200 commitment and a 174 164 152 community collaboration 146 143 141 137 150 128 124 153 120 142 99 There is not a single 95 126 91 118 100 103 organization that can comprehensively effect the 73 50 57 social determinants of health 41 12 by themselves 0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2015 2016 2017 9

INFANT MORTALITY SCREENINGS Age of referred patients 0% 0% 4% 10% The average age of 8% referred patients is not what you might have 32% guessed.... 46% it is 26 years old 11-14 15-19 20-24 25-34 35-44 45+ Unknown 10

INFANT MORTALITY SCREENINGS Race Referrals by patient Black White Hispanic Other Unknown demographics 14% Does your workforce and community resources align 5% with the diversity in your 38% 4% community? How will you create a culture of inclusion among your diverse community needs? 39% 11

INFANT MORTALITY SCREENINGS n=3682 Food [VALUE] (47%) What your neighbors need Mental Health [VALUE] (36%) might surprise you too … . Housing [VALUE] (24%) Baby Items [VALUE] (24%) • 47% are food insecure Tobacco [VALUE] (21%) • 36% require mental Transportation [VALUE] (20%) health resources Other [VALUE] (20%) • 24% are struggling with Child Care [VALUE] (20%) safe and secure housing Substance Use [VALUE] (13%) • 24% need basic baby Insurance [VALUE] (5%) supplies Domestic Violence [VALUE] (5%) Medication Assist [VALUE] (4%) 0 200 400 600 800 1000 1200 1400 1600 1800 2000 12

COMMITMENT TO IMPROVING INFANT MORTALITY The need Improvement • Ohio’s infant death per live births was • African American women enrolled in 7.33 in 2014--well above the national Pathways had a lower rate of 9.5% in rate of 5.93 Lucas County • Ohio infant mortality for African • Pathways referrals, community American babies was 14.3 in 2014 education, and physician awareness • To address the issue, Pathways HUB has driven the improvement was initiated and has shown great • Community health workers integral to results care team 13

COMMITMENT TO IMPROVING INFANT MORTALITY Cummulative Preterm and LBW 60% 50% 50% 50% 39% 39% 38% 40% 38% 30% 32% 25% 23% 22% 28% 21% 21% 20% 20% 20% 25% 19% 18% 18% 18% 20% 16% 16% 16% 15% 21% 15% 15% 15% 15% 14% 14% 18% 18% 14% 14% 14% 14% 14% 14% 13% 13% 13% 10% 13% 13% 13% 13% 13% 13% 12% 12% 12% 0% 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 % PT Cumulative % LBW Cumulative 14

LUCAS COUNTY INFANT MORTALITY RATES LUCAS COUNTY RACIAL DISPARITIES 25 Interesting data 20 emerging? 2016 black infant 15 mortality rates by payer 10 Medicaid - 12.8 Private Insurance - 14.2 5 0 2013 2014 2015 2016 White Black *2016 rates are not projected and therefore not yet official 15

COMMITMENT TO IMPROVING INFANT MORTALITY Race Outcomes Enrolled More Than 90 Days 350 [VALUE] (89%) 300 250 200 [VALUE] (88%) 150 [VALUE] (89%) 100 [VALUE] [VALUE] (11%) 50 [VALUE] (12%) (11%) 0 Black White All Races n=193 n=114 n=338 HBW LBW 16

INFANT MORTALITY SCREENINGS Community Links to Screenings Self Empowerment Partners Resources Individuals Partners • Outcomes are improved with sustainability considerations • Referrals are made in a dignified manner • Individuals enter this phase with varied degrees of readiness, often optimistically skeptical

The test of leadership is not to put greatness into humanity, but to elicit it, for the greatness is already there ~James Buchanan 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 18

KENT BISHOP M.D. ProMedica Chief Experience Officer President Women’s Service Line 19