Practical Playbook Merges Public Health/Primary Care Using Health IT

Brett Coughlin | March 6, 2014

Marrying public health and primary care coordination to improve population health using Health IT sounds like a no-brainer. It sounds easy, right? Maybe not, but a new initiative is bringing these three elements together in a bid to improve health, healthcare and control costs.

Doctors from Duke University, the Centers for Disease Control and Prevention and the de Beaumont Foundation put their heads – and their resources – together to build and launch the Practical Playbook.

“Health IT is essential to aggregate the vast amounts of information – data – so it can be used in a timely fashion to make health care decisions. Otherwise, you are just filling in the blanks,” says Jim Sprague, chair of the de Beaumont Foundation, the philanthropy behind the Practical Playbook. Sprague tells HealthIT Buzz: “What is this? It is local, state and regional primary care groups and public health pros who have partnered up to improve population health.”

The Practical Playbook is an online repository External Links Disclaimer of tools, resources and case studies that explain what happens when primary care, public health and Health IT work in concert, Julie Wood, MD of the American Academy of Family Physicians, explained.

Health IT is “the perfect bridge” to help create an information feedback loop between public health practitioners and primary care doctors in their communities, says the CDC’s Denise Koo MD, who serves on the steering committee for the Practical Playbook. It will help zero in on what we are doing right, Koo said.

The tool is summed up External Links Disclaimer by the concept of a playbook, Sprague explains. “Your football team is over there, and I see what you’re doing, and I adjust my tactics. You see what I’m doing and you adjust. This is about bringing all the public health work to bear in the clinical world,” he said.

The first step of the playbook is this: Do you know the public health officer in your community? Does she know the primary care providers? The next step is where is the common ground between these groups and how are they communicating with each other, or are they?

One scenario

Right now there’s a community where there are four pediatric providers, each is seeing four uncontrolled pediatric asthmatics. Nobody can see that 16-person cluster, but what if we could? And that’s where the playbook comes in.

“Right now, that data lives in each of those three pediatricians EHRs. The playbook helps to bridge that gap,” says Brian Castrucci, chief program and strategy officer at the de Beaumont Foundation.

Public health people ID the cluster, and try and understand it. They work with the primary care providers and find out that the asthma patients all ride on the same bus – a bus that has a faulty (and dangerous) exhaust system. None of these things are obvious to the clinician, but together, they can target the problem.

“The data are the key to this whole thing. If we don’t start using real-time data to identify and target real-time problems, we will not succeed,” said Castrucci, who spent 10 years in public health with the Philadelphia, Texas and Georgia health departments prior to coming to de Beaumont.

Asked about the limitations of health information exchange, Koo said that EHRs have great potential, and the Practical Playbook lays out some of the tips about how to get started and to help set specific targets for implementation and use of the systems.

“There are third parties that can help support the information exchange. We have several success stories External Links Disclaimer about how the data exchange was really key,” she said.

The clinicians who put together the Practical Playbook say it can be a tool to help further a social movement to spur a change in how we provide healthcare in this country.

“This is about moving into an accountable care system, improving PCMH … where the community participates. And this is the visionary part of the playbook,” said Jose Montero, MD, of the New Hampshire Public Health Services. “We are going to use the playbook to advance the integration of health care,” he added.

Note: The Practical Playbook was created with the help of the Institute of Medicine and sprung from a 2012 report: Primary Care and Public Health: Exploring Integration to Improve Population Health External Links Disclaimer.