Giving primary care a public health playbook

Whether linking up with public health outfits is a golden opportunity to bolster the health of your practice’s patient population or a prohibitively daunting task most likely comes to down to expertise and resources, IT and otherwise.

To help guide medical groups and public health units, the Centers for Disease Control and Prevention, along with the de Beaumont Foundation and Duke University compiled what they christened the Practical Playbook.

Calling it an online repository of case studies, resources and tools, Julie Wood, MD of the American Academy of Family Physicians, explained to Health IT Buzz blog that the Practical Playbook outlines “what happens when primary care, public health and health IT work in concert.”

The technology creates “an information feedback loop between public health practitioners and primary care doctors in their communities,” the CDC’s Denise Koo, MD, said in the post. 

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Brett Coughlin, a health information specialist at the Office of the National Coordinator for Health IT, shared an example scenario wherein disparate providers are treating, say, four asthmatic patients, yielding a “16-person cluster” that nobody can see into, analyze, glean insights from. That is a gap the playbook’s creators hope it can help close.

“Public health people identify the cluster, and try and understand it,” Coughlin wrote in a blog post about the playbook. “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 first step, according to the playbook, is to get to know the public health officer in your region as well as other primary care providers and, from there, find common ground between these groups and means of effective communication.

To enable that manner of communication the playbook sketches five stages of integration: organize, prioritize, implement, monitor/evaluate, and then share what you’ve learned.

Underlying this fusion of primary care and public health to the betterment of patient populations, of course, is the practice of health information exchange. The Practical Playbook offers tips for beginning and setting implementation goals and, what’s more, the authors are thinking big, hoping it can “further a social movement to spur a change” in how care is delivered in the U.S.

“This is about moving into an accountable care system, improving [patient-centered medical homes] … where the community participates. And this is the visionary part of the playbook,” said Jose Montero, MD, of the New Hampshire Public Health Services said in the article. “We are going to use the playbook to advance the integration of healthcare.”

A noble vision for federal agencies and large hospital systems, indeed. For small and mid-size medical groups the real opportunity lies in learning how to work with public health professionals and incorporating that feedback into your practice to better treat patients with modern and perhaps otherwise unaffordable population management techniques. 

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