Health systems must put patients first

Robert C. Garrett and Patrick Young

For decades, the American healthcare system has focused primarily on healing patients and connecting with people in illness or crisis.

Fortunately, there is a new approach. Increasingly, American medicine is looking beyond the radar of traditional health care to tackle some of the biggest barriers to good health: issues such as lack of housing, food insecurity, transportation. and drug addiction.

Instead of just discussing a patient’s diabetes during a checkup, many doctors ask about their diet and see if they need help with their groceries. The patient is connected to a pantry and there is a follow-up to make sure the fresh produce arrives. If a patient cannot get to a specialist due to transportation issues, a ride is organized. The idea is to look beyond the medical record and consider all the factors that have an impact on a patient’s health, which are called the social determinants of health. This new approach achieves two goals: Americans will be healthier and have a better quality of life, and the nation will spend much less to provide quality health care.

The need for a new strategy is urgent: life expectancy in the United States continues to decline. Even though we spend about $ 12,000 per person per year on health care – twice as much as most other countries – our results are much worse. America has the highest unnecessary hospitalization rate of any country in the world. We also have the highest rates of obesity and chronic disease.

Here’s what we’re doing to change course. Hackensack Meridian Health, which has 17 hospitals and 500 patient care centers across the state, launched HMH Healthy Connections, an innovative strategy that relies on new technology, by hiring community health workers – non-medical staff with close links with their neighbors – and an investment in better coordination of care. With 1.2 million visits per year to our network, we believe this new network-wide approach is a win for everyone. Here are some examples:

  • We have partnered with NOW POW, a digital platform that integrates five key issues – food, safety, housing stability, mental health, substance use – into a patient’s electronic medical record so that providers can assess these aspects of a patient’s life – just like they monitor cancer. and cholesterol tests. Operating throughout the network, the program then connects a social service agency with the patient to provide the necessary support. A primary partner is the Community Food Bank of New Jersey.
  • The Neighbors in Health program in partnership with Horizon Blue Cross Blue Shield of New Jersey, which has invested $ 25 million in the statewide program, relies on community health workers to help patients identified as at risk of health problems. Our network has hired a dozen community health workers – non-medical staff with close ties to their neighbors – in Monmouth and Ocean counties who help patients cope with a variety of issues. Additional employees will be hired as the program progresses.
  • We cannot change medicine without changing the way we train future doctors. Social determinants of health are a major focus of the Hackensack Meridian School of Medicine program. Students are matched with residents of underserved communities including Hackensack, Clifton, Nutley, Passaic and many other North Jersey communities. They meet with people regularly and discuss many issues: housing issues, nutrition counseling, programs for children with special needs, training in technology so people can communicate with doctors through telehealth – especially helpful during the pandemic.

Our approach is already changing the narrative. Our medical students helped a woman from Hackensack who has diabetes lose weight as her doctor ordered. The students provided nutritional counseling and the woman lost 15 pounds and needed less medication. His motivation to be healthier exploded.

In another case, our future doctors reached out to a housing advocacy group to help a man who uses a wheelchair find a more affordable and accessible apartment, a problem a doctor would never have time to solve, but a larger support system could do that.

We are already rolling out these successes in our network of eight counties. Imagine scaling the whole state. And the whole nation.

We are deeply committed to the transformation of healthcare. This strategy really puts patients – and people – at the heart of healthcare. Not only will we improve lives, but we’ll improve outcomes and make healthcare more affordable in New Jersey.

Robert C. Garrett, FACHE, is CEO of Hackensack Meridian Health.

Patrick Young is President of Population Health for Hackensack Meridian Health.

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