Domains 3 & 4 for Chronic Disease Prevention and Control

Purpose & Agenda| Domains 3 & 4 Review the 4 Domains, provide information and context about Domains 3 & 4 for use in your programs!

• Introduction & Big Picture • Domain 3

o Definition and Example Strategies o The Public Health Impact o State Highlight

• Domain 4 o Definition and Example Strategies o Public Health Impact o State Highlight

• Summary • Q&A Panel

This work was conducted at the Centers for Disease Control and Prevention.

The findings and conclusions are those of the author and do not necessarily represent

the official position of the Centers for Disease Control and Prevention.

DOMAINS & STRATEGIES FOR CHRONIC DISEASE PREVENTION AND CONTROL An Introduction

A Look at the 4 Domains for Chronic Disease Prevention and Control

HEALTH SYSTEMS CHANGE Definition & Examples

Health Systems Change

Improve the delivery and use of clinical and other preventive services that are designed to prevent disease or detect it early, reduce risk factors, and manage complications.

Improve the performance and reach of health systems in order to improve health.

Health Systems: All actors, institutions and resources that undertake health actions.

HEALTH SYSTEM COMPONENTS Health financing

Information systems

Leadership, management,

governance

Medical products / technology Effective service

delivery

A well-performing workforce

World Health Organization

Strategy: Increase implementation of quality improvement processes in health systems.

Interventions: 1. Increase EHR adoption and use of HIT to improve

performance.

2. Increase the institutionalization and monitoring of aggregated/standardized quality measures at the provider and systems level.

HEALTH SYSTEM CHANGE EXAMPLE

Information Systems

Effective service delivery

Strategy: Promote widespread use of evidence- based interventions to increase preventive health screenings such as colorectal cancer screening.

Interventions: 1. Patient & provider reminder systems 2. Provider assessment and feedback 3. Structural changes (e.g., clinic hours) 4. Small media

HEALTH SYSTEM CHANGE EXAMPLE

A well-performing workforce

Effective service delivery

Information systems

HEALTH SYSTEMS CHANGE The Role of Public Health

What have you seen as the role of public health in improving health systems?

QUESTION

Public Health Skills Strengths to be Leveraged

Training and Education

Strategic Communication

Data Collection and

Management

Innovation / Developing the Evidence Base

Evaluation

Partnership Development &

Partner Engagement

Focus on Health Equity

High Impact Work= High Priority Work 1. A Seat at the Table 2. Partnering with Medicare/Medicaid 3. Leveraging Health Information Technology 4. Evidence-based Quality Improvement

Interventions 5. Community Health Needs Assessment 6. Million Hearts TM, Let’s Move

How can you ensure that the population is impacted by improving health systems?

QUESTION

HEALTH SYSTEMS CHANGE State Example

COMMUNITY CLINICAL LINKS Definition & Examples

Link community and clinical services to ensure that people with or at high risk of chronic diseases have access to the resources they need

to prevent or manage these diseases

Community Clinical Links

Improve the way health systems and community based health activities are connected

How are clinics & community linked? (examples)

Community outreach

Informed health care workforce

Information technology

Referrals

Strategy: Increase availability of and access to evidence-based resources for people with arthritis through self-management education and physical activity program by embedding programs within systems of care.

Interventions: 1. Promote clinical services 2. Increase awareness of self-management programs

to health care workforce 3. Increase referrals to easy to community programs

and to clinical settings

COMMUNITY CLINICAL LINKS EXAMPLE

Community outreach

Informed health care workforce

Referrals

Strategy: Increase use of lifestyle intervention programs in community settings for the primary prevention of type 2 diabetes.

Interventions: 1. Increase referrals to CDC recognized lifestyle change

programs through provider education 2. Increase reimbursement of CDC recognized lifestyle

change program

Community outreach

Informed health care workforce

Referrals

COMMUNITY CLINICAL LINKS EXAMPLE

The Role of Public Health COMMUNITY CLINICAL LINKS

What have you seen as the role of public health in connecting health care and communities /

community programs ?

QUESTION

A seat at the table Leveraging health information technology

Data Collection and

Management ●●●

Analyze Medicaid data / insurance claims to

determine screening rates and invite ppl to screening.

Partnership Development & Partner Engagement

●●● Obtain the National DPP as a covered benefit for public employees and Medicaid recipients.

Public Health Skills Aligned for High Impact Work

Providing services in the community

Community Health Needs Assessment

WISEWOMAN

Public Health Skills Aligned for High Impact Work

Actions for High Impact Determine the stakeholders

• Identify community programs • Identify related health care / system areas • Identify other public health areas that could be

interested

How can the connections be strengthened?

COMMUNITY CLINICAL LINKS State Example

Summary New Framework and Content Areas New Opportunities to Improve Health Public Health Skills are Valuable and Aligned New Challenges and Learning

Be open! Learn form each other.

Ask your project officer.

QUESTIONS & ANSWERS