Tag Archives: Health

Running to the Ball: the Shiny Object of Social Determinants of Health

Social Determinants of Health (SDoH) are all the rage, we see it discussed by hospitals, physicians, IT companies, health plans, academia, community non-profits, government, and the list goes on and on.  It’s amazing how rapidly addressing SDoH has sprung up as “the solution”, and it may in fact be.  But before we get too excited we need to consider that approaches to solve SDoH need to be operationalized and who does what, how the approaches are overseen, and accountability will make or break the outcomes.

The current behavior of the majority of sectors reminds me of a kid’s soccer game.  If Soccer Kidsyou’ve ever watched one you’ve no doubt seen a mass of children tightly arranged around the ball, each one trying to kick it, while 98% of the field is wide open.

Effective teams spread out, each one playing their role, in their assigned space while being held accountable.

If we’re not careful, our current efforts to address the Social Determinants of Health in each of our communities will experience the same thing, a promising approach will be replaced by the next healthcare shiny object; not because the concept was wrong, but because the execution was flawed.

So how should these efforts be organized, who should be in charge and who should be Walking Dogaccountable for what?  Here’s an interesting photo to ponder as an example, it’s used quite often in presentations about obesity, behavior change and in just a few instances, Social Determinants of Health.

Audience –  “Ha ha, that’s the lazy American, just look at them driving and walking the dog, they are the source of our obesity problem. We need behavior change. They need to get out of that car and walk.”

And in response to the clamor, in rushes our current healthcare system “get out of our way, we have come to solve the obesity problem, we are going to do it by addressing the new-fangled shiny object, Social Determinants of Health.”

And the overall system say’s “fine, let’s hold the hospitals and doctors accountable for the obesity problem by establishing quality measures and value-based reimbursement and penalize them when their patients are overweight, or our health measures don’t improve.”

And run towards the problem we all go.

But, perhaps the healthcare system shouldn’t run in so fast or forcefully to the ball, perhaps the healthcare system shouldn’t be the one to kick it at all.

A better response might be “Wait are you/we sure?  Can we really fix this? I don’t see any sidewalks? Is the neighborhood safe?” Or the myriad of other issues associated with Social Determinants of Health.

As Bones, Doctor McCoy might say, “ Dammit Jim, I’m a Doctor, not a sidewalk builder, Bonesengineer, grocer, community non-profit, housing authority or police officer.”

And if it’s not the healthcare system that can solve these problems, perhaps, someone else should lead these effort’s, resulting in the healthcare system focusing on their unique and needed areas of expertise.  Playing their role on the field as a team member.

To solve the SDoH, the most critical role the healthcare system should be addressing is the oft forgotten Triple Aim concept of “lowering the costs of healthcare”.   It’s estimated that 30% or maybe more of healthcare is waste, unnecessary, fraud etc.,  that’s a meager trillion dollars that we could and need to free up to provide funds to the groups building the sidewalks, opening grocery stores, creating safe neighborhoods, improving education and the rest of the issues we know so well.  Addressing the SDoH should not require new funds, the money is there already, it just needs to be released.

And when it comes to focus and accountability, I’m not just picking on the healthcare system. Those in government, non-profits, IT etc., need to play a role, by working in their unique space, on the field.  And in that role, they too need to be held accountable.  Just as the healthcare system has waste that needs to be freed up or eliminated, many community organizations and government players have been working for years in their communities yet the statistics on health status are no better or getting worse.  What benefit has the community gotten from those services? And in the  IT world many companies have promised interoperability, increased efficiency, improved outcomes, yet we still haven’t seen it. Unfortunately, the list of poorly executed systems crosses all players.

It’s time to organize a broad-based coalition, not led by the healthcare system, but led by the community with the healthcare system at the table (and not the biggest vote either), each sector bringing their expertise, playing their position and being held accountable.  If we all run to kick the ball, try to be the coach, go after that shiny object called Social Determinants of Health, we’ll end up right where we are; just older, having squandered another goal scoring opportunity.

 

 

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Interview with Brenda Schmidt CEO of Solera Health: Creating a Broader Network of Community Providers

At the recent HiMSS 2016 conference in Las Vegas I had the pleasure of interviewing Brenda Schmidt of Solera Health, an Integrated Health Network. Solera connects a nationwide network of community organizations and digital solutions for chronic  disease prevention programs (including the CDC National Diabetes Prevention Program) with technology that manages service referrals, reimbursement and payment, aggregates data and reporting simplifying enrollment and supporting increased consumer engagement and choice.

 

 

 

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Can a Biometric Device Change My Behavior?

For the past few months, I’ve wanted to get back into shape and lose some weight; concurrently I’ve also been interested in playing with some of the newer biometric devices. Having previous experience with an early FitBit device and a number of health and exercise tracking apps like mapmyrun and Noom; I decided to start this adventure by purchasing a FitBit Flex as the first one to test and see what impact it would have on me.

The Fitbit Flex was easy to set up, track on the website and set up on the iPhone.  As a competitive person, I instantly decided that I had to beat whatever I had done the day before and as is sometimes the case when one gets older; during the second week, got a bit of pain in my hip and hamstring from over-exercise. At that point I also read an article discussing exercise at various ages and decided to save my joints for playing soccer and moved off the treadmill and onto the elliptical. This appeared to help.

Its pretty clear that a 10,000 step daily goal is fairly achievable but Continue reading

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“Cheat Death” Slogan doesn’t last long..

Well the slogan “Cheat Death” developed by the marketing firm Immortology for the CaroMont Health/Gastonia health-care system hospital that I commented on this past weekend didn’t last long, just shy of one week.  The community and media had a quite a lot to say about it, resulting in the hospital announcing they were pulling the tagline and that “Immortology will work with CaroMont to choose another tag line that is clear, motivational and works for the community. No timetable has been set for that to happen.”

Read about it here

And there is apparently more to this story.  Turns out the firm Immortology was co-founded by the son of one of the members of the CaroMont Health Board of Trustees and the daughter of the Board Chairman began working at Immortology this past week.

CaroMont spokeswoman Dallas Paddon stated:

“… our professional relationship with Immortology posed no conflict of interest,” she said in an email. “They and other firms were interviewed prior to making a hiring decision. We chose to work with this company based solely on their proven track record in successfully transforming and reviving companies’ brands.”

While it is only the appearance of a potential conflict, I think executives at the hospital might have had a little voice in the back of their heads telling them that this might look good to their overseers.

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“Cheat Death” as Your Healthy Living Slogan, Come On!

First let me apologize for the error in the blog post I wrote below as pointed out by an individual, CaroMont is not owned by Carolinas Healthcare System and so I have revised the blog. I apology again for the error.

 

I couldn’t help but comment on this news story from the Shelby Star in Cleveland County, North Carolina. The hospital announced a new name and slogan for one of their hospitals.  The name, CaroMont Regional Medical Center, not bad, although the community is slightly upset, but the slogan “Cheat Death”???

Why you might ask? Well the slogan change was for the right reason; the hospital wants to improve the health of the region, which is very poor; but give me a break,  “Cheat Death” as your slogan!  Lets discuss a few reasons why this is a just an unbelievably poor choice of a name for a good idea.

First of all its a just a bummer, using the word “death”, while powerful is a negative word. It also  has not been shown to be a motivator in adherence studies of people who know if they don’t take their medications they are going to die. They don’t follow through just like the rest of us. But more importantly “Cheat”?  Yes people cheat on tests, cheat on their taxes, cheat at cards, and on and on; but cheating means you are doing something wrong, you’re taking shortcuts!

According to the article, CEO Randall Kelley in response to some concern over the name said “people can realize that the tagline represents exactly what patients  want doctors to help them do – live  longer”

Creating a healthier community, improving ones behaviors and thereby delaying death is not cheating! It’s doing the right thing, it’s not a shortcut to get around doing the right thing, it is in fact putting in the time to exercise, to study more so you understand your health condition, to take your meds on time and fill prescriptions; to visit your doctor when needed; it’s the exact opposite of cheating.  There are no shortcuts to a longer healthier life and you sure can’t “cheat” your way to it, nor do you cheat it, for in the end, death is an absolute, it’s still there.

I know the hospital is placing a major emphasis on healthier communities and employer wellness which is a great concept for a hospital system, but in the area of behavior change, population health management and wellness, there is more learning to do, which may come with a few hard knocks as I don’t think they’ll be able to cheat their way to it.

What are your thoughts?

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