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Thursday, October 26, 3:30 p.m.-5:00 p.m.
Moderator
Trent Haywood, M.D., J.D.
Deputy Chief Officer, Centers for Medicare and Medicaid Services
Presentations
HEALTHIERUS VETERANS INITIATIVE
Linda S. Kinsinger, M.D., M.P.H.; Kenneth R. Jones, Ph.D.; Leila C.
Kahwati, M.D., M.P.H.
Veterans Health Administration, Durham, NC
Veterans and their families make up one-quarter of the U.S. population (70 million). The Department of Veterans Affairs (VA) in collaboration with the U.S. Department of Health and Human Services (HHS) has recently launched an exciting initiative called HealthierUS Veterans. This initiative encourages veterans, their families, and their communities to adopt healthy lifestyles, to eat nutritious foods and limit calories, and to increase physical activity everyday to decrease risks for obesity and diabetes.
This session will present the components of the HealthierUS Veterans initiative, which include (1) local and national promotional events; (2) partnerships between VA Medical Centers, Steps to a HealthierUS communities, and other community organizations; (3) VA's weight management program for veterans called MOVE!; (4) the Fit for Life volunteer corps of ambassadors for health and wellness; (5) Prescriptions for Health—tools for VA and non-VA healthcare providers to promote physical activity using pedometers and/or wheelchair odometers; and (6) fitness challenges such as the President's Challenge. Together, VA and HHS have worked to identify effective and existing strategies, tools, and materials with which to implement this initiative.
Since inception in early 2006, HealthierUS Veterans has held several local and national publicity events, collaborated with several Steps programs, and distributed several thousand Prescriptions for Health and other patient materials. Further development of initiative components and an evaluation plan continues.
The HealthierUS Veterans initiative is one effort that can contribute to obesity and diabetes prevention in the United States. The Veterans Health Administration recognizes the importance of directing efforts beyond the clinical exam room to address these important public health problems.
PROMOTING EVIDENCE-BASED CLINICAL PREVENTIVE SERVICES THROUGH PARTNERSHIPS AND TARGETED RESOURCE MATERIALS
Claire A. Kendrick, M.S.Ed., CHES; Janice Genevro, Ph.D.; Therese
Miller, Dr.P.H.; Tricia Trinite, MSPH, APRN
Agency for Healthcare Research and Quality, Rockville, MD
Research has clearly demonstrated that providing high-quality, evidence-based care is integral to helping people lead healthier lives. The Agency for Healthcare Research and Quality (AHRQ) uses the recommendations of the U.S. Preventive Services Task Force and translational evidence from practice-based research networks to promote the provision of appropriate clinical preventive services. Two critical elements of this work are the development of partnerships with Federal and non-Federal organizations, and the creation of resource materials, including clinical decision support tools.
AHRQ works with many healthcare sectors to promote the provision of clinical preventive services. These include primary care clinicians, businesses and employers, healthcare purchasers, and consumers. Ensuring the provision of effective preventive health care also depends on building linkages between community programs and clinical practices.
This presentation will highlight partnerships and targeted resource materials designed to promote healthier practices. Examples of resource materials include the following:
Partnerships that reach underserved and priority populations will be highlighted. Examples of partnerships include the following:
THE VERMONT BLUEPRINT FOR HEALTH: AN INTEGRATED APPROACH TO CHRONIC DISEASE PREVENTION AND CARE
Ellen B. Thompson, M.S.1;
Sharon Moffatt, M.S.N., R.N.1; Paul Jarris, M.D., M.B.A.2; Eileen Girling,
M.P.H., R.N.1 1Vermont Department of Health, Burlington, VT;
2Association of State and
Territorial Health Officials, Washington, DC
The Vermont Blueprint for Health is an initiative to reduce the burden of chronic disease through an integrated approach to prevention and care. The Blueprint merges the resources and skills of health care and public health to address the problem at the state and local levels. Built on the chronic care model and the social-ecologic model of health, the Blueprint incorporates public policy, health systems change, and quality improvement in physician practices; facilitates the development of self-management skills; and within communities, promotes changes to the built environment and services that encourage and support healthy behaviors.
Grants were awarded to two communities last year for project implementation; four more have been funded this year. Grants are used primarily to cover the costs of coordination and a portion of implementation expenses. Community partners include healthcare providers, hospital staff, health department directors and staff, municipal officials, civic leaders, businesses, and consumers.
State-level support for communities includes training, development, and distribution of evidence-based/promising practices, deployment of a chronic disease health information system to participating practices, and other infrastructure support.
The initiative was begun with diabetes as the first condition addressed. Hypertension and hypercholesterolemia will be added this year, with additional conditions added annually.
The evaluation plan includes short-term process measures related to implementation and deployment, mid-term measures of behavior and practice change, and long-term measures of improved health outcomes and cost moderation.
CLINTON FAMILY HEALTH CENTER
James B. Sutton, RPA-C
Clinton Family Health Center/ViaHealth, Rochester, NY
Faced with the dilemma of rising emergency room use and growing health disparities in the northeast sector of Rochester, New York, Rochester General Hospital asked Clinton Family Health Center (CFHC) to pilot new ways to provide health care. In 2003, CFHC undertook an ambitious and aggressive approach to completely redesign its delivery system with prevention in mind.
CFHC instituted the following changes in a 2-year period: team formation, open access scheduling, embedding of the chronic care model and disease prevention into daily practice, and the initiation of group medical visits.
Patients were tracked to provide evidence-based data for the spread of these ideas to practices locally as well as throughout the country. Patients receiving care in the new system were tracked for 2 years prior to the program and 2 years after its inception.
Open access scheduling increased the likelihood that the target group came to the right place for medical care (i.e., not the emergency room). Before the project, only 50 percent of scheduled patients showed up for their appointments. With open access scheduling, the show rate is 95 percent. There has been a 24 percent decline in all emergency room visits, and an astonishing 30 percent decrease in the number of CFHC patients going to the emergency room for non-urgent care. The number of diabetics reaching their goals on their hemoglobin A1C and LDL cholesterol has nearly doubled, and the average hemoglobin A1C of diabetic patients has dropped from 8.5 to 7.4 since the program started.
For questions or more information, please contact summit@hhs.gov.
Office of Disease Prevention and Health Promotion
U.S. Department of Health and Human Services
