Linking Health Systems and Food Systems to Better Serve Communities

A recent All In: Data for Community Health webinar featured multi-sector collaborations in Houston and Dallas, led by partnerships between health systems and local food banks. Together these efforts are demonstrating how addressing food security can have benefits for the healthcare sector and the community as a whole. By forming community partnerships and data systems linking social service providers, food banks, hospitals/health systems, and other sectors, these projects are fostering environments that improve food access and ultimately lead to better health outcomes and lower costs.

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Innovative Approaches to Improve Precision in Public Health

A recent All In: Data for Community Health webinar featured two projects led by public health departments in Chicago and Baltimore. These health departments, in collaboration with researchers and community partners, are using methods like predictive analytics and hotspotting to target resources more efficiently and working to create a culture of innovation by using data-driven approaches to examine community health trends at the local level.

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All In’s Top Resources from 2017

2017 was a big year for All In: Data for Community Health. We held our first national meeting in Denver, bringing together 250+ stakeholders to discuss strategies for improving population health through multi-sector data sharing. Two new partners joined All In, helping to expand the learning collaborative to include 60+ projects across the country. Together, we hosted several webinars, a regional meeting on health and housing, and developed new resources to document and share lessons from early innovators.

Thanks to everyone who was willing to go “All In” with us this year! We’ve summarized some of our top resources from 2017 that can help inform your work as you move forward.

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Finding the Sweet Spot for Using Big Data and Analytics for Public Health

Increasingly, the public health sector is tapping into the same big data and analytics frameworks used by commercial and clinical organizations and applying them to address a multitude of community health challenges. A recent All In project showcase webinar shared two examples of collaborations led by researchers and public health departments that are at the forefront of the movement to leverage big data to drive community health improvement.

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Optimizing Workflows to Share Data Across Sectors: Promising Approaches to Improve Care Coordination

This blog was originally published on the On Center blog of the National Rural Health Resource Center

To provide coordinated care that meets patients’ needs, many networks and communities are developing information systems to share data across clinical and social service settings. In order for these systems to be effective in connecting patients to the right services at the right time, care teams need access to relevant individual-level data that is seamlessly incorporated into their work process.

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In the Absence of a Road Map, Data Sharing Collaborations Can Start by Asking Questions

By Alison Rein, Senior Director for Evidence Generation and Translation at AcademyHealth

The movement to build health into the fabric of our communities is taking hold and stimulating the formation of many local collaborations focused on understanding and addressing the social, environmental and other factors that drive individual and population health. As they navigate these new relationships and work toward building a shared data infrastructure to support ongoing improvement and impact assessment, these local collaboratives must overcome a number of hurdles—some technical and legal—but many more related to process and culture change. Fortunately for those in the early stages, many early population health improvement pioneers have made progress and have useful insights and lessons to share.

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Data is Alive!

What 68 Post-It Notes tell us about the challenges of sharing data

By Peter Eckart, Co-Director, Data Across Sectors for Health (DASH) at the Illinois Public Health Institute

Representatives from 19 community collaborations funded by the BUILD Health Challenge came together in September to meet each other, share experiences and begin to form the learning collaboration that will sustain their work as they embark on efforts to transform health locally over the next two years.

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Using Electronic Health Record Data to Improve Community Health

By Bree Allen, MPH, Shine Fellow, Office of Health Information Technology, Minnesota Department of Health

Minnesota’s local health departments and hospitals have a common need to develop actionable, outcomes-oriented, and collaborative community health assessments. Many Minnesota hospitals, being newer to this reporting requirement, have reached out to their local health departments for support in developing these assessments and integrating social determinants of health.

Data housed within hospitals’ and health systems’ electronic health record (EHR) systems have the potential to provide timely and complete data for subpopulations, geographic areas, and health conditions that are typically underrepresented in traditional assessment methods. For example, a rural Minnesota local public health department worked with a local provider to use EHR data to validate regional survey data related to smoking rates by zip code to assist public health in targeting outreach to a specific community. Another Minnesota collaborative is piloting the use of EHR data to enhance public health surveillance around the root causes of obesity, identifying and mapping individuals with high health needs.

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Building Care Coordination Data Systems to Better Meet Patients’ Needs

Integrating data from sectors such as medical, behavioral, and social services enables care teams to proactively identify and address the needs of patients—improving outcomes for individuals while having positive community-wide health and cost implications.

The latest webinar in the All In project showcase series featured presentations from projects in two communities developing technology solutions to improve care coordination for special needs populations. In case you missed it, below is a recap of their projects and key takeaways.

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Measuring What Matters for Community Health Improvement

A Virtual Conversation Across Two National Networks

By Clare Tanner, PhD, Michigan Public Health Institute; Soma Stout, MD, MS, Institute for Healthcare Improvement; and Peter Eckart, MA, Illinois Public Health Institute

Multi-sector approaches are an exciting and growing element of addressing health equity and community health improvement. It is somewhat ironic, then, that many federal agencies and private philanthropic organizations continue to perpetuate funding and service silos, even within their efforts to lift up multi-sector approaches. Within this dynamic environment, leaders of major national innovation networks are building new coalitions to magnify the impact and accelerate the progress of local collaboratives to measure and understand community health improvement.

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