By Jennifer J. Salopek
A new initiative being launched today will usher in a new era for population health, whose progress historically has been stymied by multiple stakeholders who don’t communicate, using a variety of unvalidated models. This initiative, A Practical Playbook: Public Health and Primary Care Together, centers on an interactive tool that navigates users through the stages of integrated population health improvement. The initiative was developed by the de Beaumont Foundation, Duke Community and Family Medicine, and the Centers for Disease Control and Prevention.
“This effort is innovative in that we are trying to find a way to reinvent health care, moving it out of a sick care system and into something that really starts in the community,” says Brian Castrucci, chief program and strategy director at the de Beaumont Foundation. “We want to leverage the 300-year-old infrastructure of public health to support the fabulous work that primary care providers are already doing.
“Much of the excellent care that people receive from clinicians is lost when they return to a community that is antagonistic to health. Public health is positioned to maximize the impact of care by ensuring the health of our communities.”
Integration and partnership between local, state, and regional primary care groups and public health officials are central to the Practical Playbook approach. The tools and resources available on the site guide users through six stages of integrated population health improvement.
The partner organizations chose the playbook metaphor because improving collaboration between public health and primary care requires a thoughtful game plan. Like a sports playbook, the Practical Playbook defines the role of each team member as well as actions for different situations.
“It’s very exciting to see the interest in population health,” says Denise Koo, MD, senior advisor for health systems at the Centers for Disease Control and Prevention. “For too long, we have been working in our own silos. The Playbook is designed to work with both primary care and public health. We want to move from a health care system to a health system.”
The interactive, web-based tool provides helpful resources such as case studies, lessons learned, and guidance from industry experts. There’s clear value for academic medicine, says Lloyd Michener, MD, professor and chair of Duke Community and Family Medicine.
“We have been talking about these issues within the academic medical community for a long time. What’s new about this approach is real, practical advice rather than many models. We’ve never had that before.”
Joanne Conroy, MD, chief health care officer at the Association of American Medical Colleges, serves as a member of the National Advisory Committee for the initiative. “Academic medicine is where the conversation needs to start to integrate population health across the continuum,” she says. “The Practical Playbook is a great tool for medical students and residents, as well as nurses and other allied health professionals. Its design is quite deceptive: Although very user friendly, it is not simplistic. The information is quite detailed but easily actionable. And I think the multilayered online format is really innovative.”
“Learners and teachers are intensely excited about the Playbook,” says Michener. “We often talk about population health at a high level. This is the first time we’ve had concrete examples and steps forward that we can not only use, but teach.”
Population health is a fast-growing undergraduate major, notes Koo. “Students are really interested in making a difference, and we can use the Playbook to build an education for health at all levels,” she says.
There has been intense interest from organizations in getting this information into the hands of learners, says Michener. Next steps for the initiative include a hard-copy volume for students that is to be published by Oxford Press in November.
The Playbook is not prescriptive, however, Koo emphasizes. “There is no single, unified path. Approaches will vary by jurisdiction, by its resources and strengths, the disease areas and conditions in the community. You may use different plays in different areas.”
The time of the physician as individual problem solver is gone, Castrucci notes. “We have moved from a time when disease was caused by viruses and bacteria, to a time when it is caused by social and environmental factors. It’s not necessarily about what’s presenting in front of that physician, but rather the patient’s housing, or the fact that he doesn’t have access to fresh fruits and vegetables, or that she has nowhere to be physically active. The only way we can overcome that challenge is by working together.”
The key message of the initiative? “Help is here,” says Michener. “Folks have been feeling really pressed about how to do this. This information is practical, efficient, and effective.
“You don’t have to go it alone.”