Jennifer Schmidt

Saving Lives Upstream: The Population Health Payoff

Here in the Patient Experience Lab at BIF, there is a favorite parable, and you may have even heard it before — the one that goes:

One day a villager was fishing in a local river. All of a sudden, he noticed a baby floating in the water. He quickly jumped in to save the baby, only to notice another baby floating towards him. Without hesitation, he saved the second baby and cried for help. Villagers came rushing over and all jumped in the river to start rescuing the babies that kept floating towards them. As everyone was busy rescuing the babies, two villagers started to run along the shore upstream. “Where are you going?” the villagers yelled!

Their reply: “We’re going upstream to stop whoever is putting the babies in the water.”

Upstream thinking has long been a staple for those in the prevention and public health worlds. Think fluoridated water or physical education. But healthcare delivery has mainly stayed a point-in-time service, where services are delivered only when needed. This mindset is often due to the fact that the business model of healthcare is one that still relies on direct fee-for-service, where physicians are paid based on the amount of services provided rather than for a particular outcome. This is changing.

“Looking towards moving healthcare upstream means looking to innovative new approaches to how we provide care throughout a community.”

As organizations increase their focus on value-based and population health management models that reward providers for keeping patients and populations healthy, traditional players in healthcare are feeling accountable for the health of their patients, even outside of the clinical setting. A new focus on patient and community activation and engagement is breaking down the traditional barriers of clinical care.

However, this new population health model is not without its own barriers to adoption and implementation.

When helping industry leaders move forward towards these next practices, BIF first guides them to proactively identify their own internal capability gaps, such as: Is the organization ready? Is there buy-in from leadership and stakeholder groups? How are we delivering and capturing value to our patients? From there, we lead organizations through a human-centered design approach that realigns their business model toward innovative new solutions that originate from key end users and stakeholders.

Looking towards moving healthcare upstream means looking to innovative new approaches to how we provide care throughout a community. Healthcare institutions have started to engage non-medical and community partners such as schools, religious organizations, and housing agencies to address communal problems that have a significant downstream effect on the health of the community. By removing the silos within which these players have typically operated, partnerships are able to form that work to empower patients and families to engage in their own healthcare.

BIF has seen how these partnerships between community-based organizations, and healthcare institutions will become the drivers for new and innovative care delivery networks and systems, and have been eagerly exploring ways to engage and support these new partners willing to share resources and risk. Not only will this new model of community-based health help to move care upstream and identify causal factors that affect health, but it will accelerate positive change and encourage activities that foster coordination and collaboration across the industry. It is our belief here at BIF that partnership is at its most successful when simple collaboration transforms into a system of shared resources and shared risk.

With increased partnership, we begin to see a bidirectional relationship develop in an ecosystem that has largely relied on the one-way provision of service. Patients feel more engaged and activated in their own care when they feel supported by their community and understood by their provider; and outcomes improve when all sectors of a community have a vested interest. Healthcare delivery is moving outside the walls of a primary care office and into the community. For us to ensure that the patient feels supported on their path to health and wellness, these touch points of care must become the role and responsibility of sectors across the community.

Fostering a successful interdependent relationship will require self-motivated leaders who are willing to be the catalysts of transformation in an industry that has relied on incremental change. The innovative junkies across the healthcare industry (myself included) may look towards the knee-jerk reaction of jumping into the virtual care space as a means of patient interaction; however, when we consider, develop, and test new models that incorporate new partnerships and integrate an understanding of how community factors impact population health, we can create a coordinated effort that will improve the health of all.

As leaders in the industry continue towards a model of care that is community-based and focused on the shared value, accountability, and risk, we at BIF look towards how those leaders ensure that community activation, engagement, and expertise are key components, so upstream thinking keeps those babies out of the river!

What are you doing to keep babies out of the river? We’d love to learn! please email us at [email protected]

Rethinking health and health care through education, innovation and design at #theBIF; Associate at @BIFpxl; @jschmidt19

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