Patient-Centered Approaches to Improving Population Health


by Susan van der Sommen, MHA, CMPE, FACHE

Crowd of multidisciplinary people-for webAn increasingly prevalent term in our health-related vocabulary is “population health.”  Every journal or health-related article uses the term as if it is widely understood. So what is it, really? How will we measure it and, more importantly, improve it?

The oft-quoted article by Kindig and Stoddart (2003), “What is Population Health?”  defines population health as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”  Whereas others have also sought to define the term, in my readings and research, I have yet to come across a more comprehensive—yet startlingly straightforward—explanation.  In his paper, Population Health in the Affordable Care Act Era, Michael Stoto, PhD, notes that despite differing definitions, the term “population health” is seen by many as an opportunity to connect healthcare delivery systems with community-based organizations, public health departments, and other entities to reach community members that may not access the traditional healthcare system effectively and/or receive the care they need.

Leaders at the Duke Cancer Institute  in Durham, North Carolina, have adopted a new approach to research and patient-centered care; that is, collaborating with local community members and groups to improve education, outreach, and access for their most disparate – and often underserved – populations. Their patient-centered approach, designed to assess and respond to community needs, increase participation in clinical trials (particularly for minority populations), and mitigate care gaps, is being implemented as part of a five-step strategic plan. At the core of the plan is the development of a Community Advisory Council, inclusive of community partners and patients, and the broad dissemination of findings in their robust community needs assessment. Resulting from these two initiatives was a prioritization of program and research activities with further development of programs and partnerships focused on the highest priorities defined by the council’s work. Of course, measurement and evaluation is at the core of all population health initiatives – and is the fifth component of Duke Cancer Institute’s strategic plan. Learn more.

The Duke Cancer Institute is seeking to meet the health needs of their population in a manner that is pertinent to all cancer centers and healthcare organizations. Defining a population’s needs through community partnerships and patient involvement is the key to being able to measure and ultimately improve health outcomes.

In a more widespread population health initiative,  ACCC has recently launched its Optimal Care Coordination Model for Lung Cancer Patients on Medicaid project with support from the Bristol-Myers Squibb Foundation. Research shows that minority and socio-economically disadvantaged individuals have higher incidence of cancer, are diagnosed at a later stage, and have a higher mortality rate. To address this unmet need, ACCC is currently partnering with five ACCC-member programs located in different geographic regions throughout the U.S. These programs are serving as Development Sites, helping ACCC document the current state of care coordination for Medicaid patients with lung cancer. This will help inform draft principles for development of a model for a more comprehensive, evidence-based approach to care coordination, access, and health equity for Medicaid patients with lung cancer. Read more about this exciting initiative in the September/October issue of Oncology Issues.

Make plans to attend the 2016 National Oncology Conference  in St. Louis, Missouri from October 19-21 to learn best practices from your colleagues at cancer programs across the country.

Susan  van der Sommen, is Executive Director, DSRIP, Bassett Healthcare Network, and Chair of the ACCC Editorial Committee.

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