They're sick. They're getting sicker. There are millions of them. They are unaware that they are sick. No one told them they were sick. No one asked them basic questions to find out if they were sick. No one gave them an offer for services or delivered a screening or an evaluation service. They have not yet had a medical episode. They are in the early stages of diseases that can be generally prevented, or at the very least that can be most easily managed.
Who are "they"? They are children and other young family members. Current data and research suggests approximately 20 percent of families in the general population with children 10 to 14 years of age fit these chronic disease criteria. Interestingly, if addressed on a timely basis, the impact of early detection and intervention of chronic disease among children and their families can actually be turned into a powerful business opportunity for hospitals, providers and plans and can reduce future healthcare costs.
These conclusions are easily demonstrated across the spectrum of primary care and outpatient service lines in almost any care environment or location, whether rural, exurban, suburban or urban. Although a disparity among ethnicities is still present and often associated with family histories for some diseases, this is now less pronounced as more children and young families —regardless of socioeconomic status — are overweight or obese, lead sedentary lives, and consume high-glycemic-indexed foods processed and prepared for maximum consumption. Basically, this "new" population has a lot in common — and it crosses all plan verticals from platinum to the Children's Health Insurance Program.
Who is sick?
Unaware but sick children and young families can be found easily, clustered by self-reported symptoms, located geographically and reached with precisely targeted messages. Early identification efforts accomplished via online assessments can enable the delivery of timely and compelling offers for screenings and evaluations. The benefits are measureable and significant. They include building patient awareness of conditions, explaining increasing costs and risks if conditions are not addressed and identifying convenient clinic, hospital and health system resources for screening, evaluation, treatment and management.
Community Health Needs Assessments conducted in various states, cities and small towns reveal very large populations — sometimes exceeding 20 percent of the total population — of young people and their families that are symptomatic, unaware and untreated. In some assessments taken by thousands of respondents semi-annually over a three-year period in different locations, less than 1 percent of children ages 10 to 14 reported taking medications for diabetes or hypertension. Yet, 13 percent to 22 percent of this demographic self-reported symptoms and markers of chronic disease. Most importantly, recent findings in research suggest that medication(s) are not effective in children that actually acquired the disease. Early identification is the best solution.
If established on interactive communications platforms, the exchange of this population health information can generate low-cost, low-risk and frequent visits for providers — supporting physician contract fulfillments, strategic plans, marketing plans, new construction financing, mission fulfillment, compliance, accountable care organization development and many other day-to-day operations among provider staff and affiliates.
Tools and technologies
Young families use and rely on interactive tools for almost every purpose. Those tools that get the most usage have extremely rapid response times for queries or postings. Resistance to sharing personal information is surprisingly low in social networking environments, whether set up for business, for entertainment or for individual, family or community interest-group communications. Healthcare plan and provider marketers report very mixed results on social media usage, and we think the reason for these mixed outcomes may be attributed to misunderstanding the purpose of the plan member or patient in accessing and then using the tools and technology. Prospective patients simply don't scan health information sites or blogs for diabetes or hypertension in children if they are unaware of the warning signs or symptoms or have not experienced an episode.
Achieving extremely high response rates for assessments and communications is accomplished by clearly establishing a unique and engaged purpose for the users — one that is self-serving for the user and "worth" spending time to access, report and deliver information. The conclusions we can "jump" to are established and produced by professionally reviewed and approved interrelation of certain responses and queries. Responses are weighted, associated, scored and counted by type of response and degree of response. For example, anyone self-reporting they are dizzy all or most of the time definitely needs to schedule a visit for screening and evaluation.
Using communities' relationships more effectively
CHNAs are not just for non-profit tax filings. Our experience in completing new and more focused CHNAs has been most successful in locations where broad community business and health improvement interests were served first — and these are most often understood to be school and group settings where the CHNA supports existing education, intervention, health promotion and prevention programs. The infrastructure is in place. The programs already have approval by the stakeholders. The activity of system access, data entry and communications is desired, and participation rates can actually reach 100 percent.
By working "bottom up" in school and health community settings, the purposes of providers, plans and employers are served best — and these purposes are generally embraced by all participants. Many regional health systems and community health improvement organizations often sponsor programs in schools, for example. The relationships are generally well-established.
Early identification strategies as drivers for large-scale CHNAs are something new. Typically, CHNA projects have been conducted by academic and professional research groups within fairly small primary and proxy population samples and control group populations, and they are conducted every three years to assess the value of community benefits. They also develop data on health issues such as access to care, cost of care, quality of care and other information. These CHNAs don't usually ask respondents about symptoms of diseases or actually promote or offer services. This sort of outreach may more often occur at school-based clinics, health fairs and health events. Even in this effort, the needs of a much larger and targeted population of children and young families are not widely assessed, risks are not explained, and services are not delivered.
Marketing departments in healthcare systems are warmly viewed by school community administrators and local organizations as sources for community funding and event sponsorship. However, the healthcare system and its practitioners are also perceived by local interest groups as money-making businesses. Therefore, great care must be taken by the provider, plan or program wishing to conduct a CHNA. In recent months, we have witnessed marketing departments doing it all wrong and — in one instance — inadvertently preventing a CHNA within a willing school community where thousands of children and their families would have been able to express their specific health needs. There is a right way and a wrong way to move the business opportunity forward.
The C-suite rules
To generate new revenues and support business plans, the C-suite must maintain control, and the best way to do so is to assign a well-connected and locally-appreciated person to manage and spearhead the CHNA task. This will not be a full-time job.
A well-regarded and retired physician, an affiliated school nurse or a community health advocate will report directly to the C-suite. Once this key person is in place and the program is established, very little time is required to implement the program on a semi-annual and multi-year basis. This is, in part, attributed to the tools and technology that automates the system and delivers the business opportunities to it.
Site managers will connect the assessment site and a nearby practice. Like the CHNA manager, these individuals can also be part-time, and of course these can be people who are already responsible for outreach or sponsored program management. Their primary function is to make sure all CHNA operations take place on a timely and routine basis.
Conclusions can be created in advance, and all gathered data can support or modify the conclusions. This new way of doing things can precisely link and track the assessment, the scheduling of services, the outcomes and the return on investment.
Children and other young family members are sick. They need screening, evaluation, treatment and management. They are a low-risk, low-cost population to serve. They will schedule frequent visits if reached, engaged and managed. Just ask them.
Clerisys Technologies is a tools and technology company, delivering access to services and systems designed to reduce health risks among young families with children. David E. Anderson can be reached at deanderson@clerisys.com.
Who are "they"? They are children and other young family members. Current data and research suggests approximately 20 percent of families in the general population with children 10 to 14 years of age fit these chronic disease criteria. Interestingly, if addressed on a timely basis, the impact of early detection and intervention of chronic disease among children and their families can actually be turned into a powerful business opportunity for hospitals, providers and plans and can reduce future healthcare costs.
These conclusions are easily demonstrated across the spectrum of primary care and outpatient service lines in almost any care environment or location, whether rural, exurban, suburban or urban. Although a disparity among ethnicities is still present and often associated with family histories for some diseases, this is now less pronounced as more children and young families —regardless of socioeconomic status — are overweight or obese, lead sedentary lives, and consume high-glycemic-indexed foods processed and prepared for maximum consumption. Basically, this "new" population has a lot in common — and it crosses all plan verticals from platinum to the Children's Health Insurance Program.
Who is sick?
Unaware but sick children and young families can be found easily, clustered by self-reported symptoms, located geographically and reached with precisely targeted messages. Early identification efforts accomplished via online assessments can enable the delivery of timely and compelling offers for screenings and evaluations. The benefits are measureable and significant. They include building patient awareness of conditions, explaining increasing costs and risks if conditions are not addressed and identifying convenient clinic, hospital and health system resources for screening, evaluation, treatment and management.
Community Health Needs Assessments conducted in various states, cities and small towns reveal very large populations — sometimes exceeding 20 percent of the total population — of young people and their families that are symptomatic, unaware and untreated. In some assessments taken by thousands of respondents semi-annually over a three-year period in different locations, less than 1 percent of children ages 10 to 14 reported taking medications for diabetes or hypertension. Yet, 13 percent to 22 percent of this demographic self-reported symptoms and markers of chronic disease. Most importantly, recent findings in research suggest that medication(s) are not effective in children that actually acquired the disease. Early identification is the best solution.
If established on interactive communications platforms, the exchange of this population health information can generate low-cost, low-risk and frequent visits for providers — supporting physician contract fulfillments, strategic plans, marketing plans, new construction financing, mission fulfillment, compliance, accountable care organization development and many other day-to-day operations among provider staff and affiliates.
Tools and technologies
Young families use and rely on interactive tools for almost every purpose. Those tools that get the most usage have extremely rapid response times for queries or postings. Resistance to sharing personal information is surprisingly low in social networking environments, whether set up for business, for entertainment or for individual, family or community interest-group communications. Healthcare plan and provider marketers report very mixed results on social media usage, and we think the reason for these mixed outcomes may be attributed to misunderstanding the purpose of the plan member or patient in accessing and then using the tools and technology. Prospective patients simply don't scan health information sites or blogs for diabetes or hypertension in children if they are unaware of the warning signs or symptoms or have not experienced an episode.
Achieving extremely high response rates for assessments and communications is accomplished by clearly establishing a unique and engaged purpose for the users — one that is self-serving for the user and "worth" spending time to access, report and deliver information. The conclusions we can "jump" to are established and produced by professionally reviewed and approved interrelation of certain responses and queries. Responses are weighted, associated, scored and counted by type of response and degree of response. For example, anyone self-reporting they are dizzy all or most of the time definitely needs to schedule a visit for screening and evaluation.
Using communities' relationships more effectively
CHNAs are not just for non-profit tax filings. Our experience in completing new and more focused CHNAs has been most successful in locations where broad community business and health improvement interests were served first — and these are most often understood to be school and group settings where the CHNA supports existing education, intervention, health promotion and prevention programs. The infrastructure is in place. The programs already have approval by the stakeholders. The activity of system access, data entry and communications is desired, and participation rates can actually reach 100 percent.
By working "bottom up" in school and health community settings, the purposes of providers, plans and employers are served best — and these purposes are generally embraced by all participants. Many regional health systems and community health improvement organizations often sponsor programs in schools, for example. The relationships are generally well-established.
Early identification strategies as drivers for large-scale CHNAs are something new. Typically, CHNA projects have been conducted by academic and professional research groups within fairly small primary and proxy population samples and control group populations, and they are conducted every three years to assess the value of community benefits. They also develop data on health issues such as access to care, cost of care, quality of care and other information. These CHNAs don't usually ask respondents about symptoms of diseases or actually promote or offer services. This sort of outreach may more often occur at school-based clinics, health fairs and health events. Even in this effort, the needs of a much larger and targeted population of children and young families are not widely assessed, risks are not explained, and services are not delivered.
Marketing departments in healthcare systems are warmly viewed by school community administrators and local organizations as sources for community funding and event sponsorship. However, the healthcare system and its practitioners are also perceived by local interest groups as money-making businesses. Therefore, great care must be taken by the provider, plan or program wishing to conduct a CHNA. In recent months, we have witnessed marketing departments doing it all wrong and — in one instance — inadvertently preventing a CHNA within a willing school community where thousands of children and their families would have been able to express their specific health needs. There is a right way and a wrong way to move the business opportunity forward.
The C-suite rules
To generate new revenues and support business plans, the C-suite must maintain control, and the best way to do so is to assign a well-connected and locally-appreciated person to manage and spearhead the CHNA task. This will not be a full-time job.
A well-regarded and retired physician, an affiliated school nurse or a community health advocate will report directly to the C-suite. Once this key person is in place and the program is established, very little time is required to implement the program on a semi-annual and multi-year basis. This is, in part, attributed to the tools and technology that automates the system and delivers the business opportunities to it.
Site managers will connect the assessment site and a nearby practice. Like the CHNA manager, these individuals can also be part-time, and of course these can be people who are already responsible for outreach or sponsored program management. Their primary function is to make sure all CHNA operations take place on a timely and routine basis.
Conclusions can be created in advance, and all gathered data can support or modify the conclusions. This new way of doing things can precisely link and track the assessment, the scheduling of services, the outcomes and the return on investment.
Children and other young family members are sick. They need screening, evaluation, treatment and management. They are a low-risk, low-cost population to serve. They will schedule frequent visits if reached, engaged and managed. Just ask them.
Clerisys Technologies is a tools and technology company, delivering access to services and systems designed to reduce health risks among young families with children. David E. Anderson can be reached at deanderson@clerisys.com.
More Articles on Population Health Management:
Inadequate Demographic Data Collection Could Hamper Population Health Efforts
A Roadmap for Population Health Management: 6 Stages in a New Era of Healthcare
10 Ways for Hospitals and Health Systems to Increase Profitability in 2012