A Health System’s Approach to Healthcare Disparity: Populations, Pipelines and Partners Barry D. Mann, MD Chief Academic Officer, Main Line Health May

A Health System’s Approach to

Healthcare Disparity:

Populations, Pipelines and Partners

Barry D. Mann, MD

Chief Academic Officer, Main Line Health

May 6, 2015

2

Our Geography

MLHNon-MLH

Acute Hospitals

Created July 2012

0 3 61.5 Miles

1930119312 19333

19087

1940619405

19428

1908519035

19010

1907319008

19063

19064

19026

19083

19096

19004

19072

1904119003

19066

Riddle Hospital

Paoli Hospital

Bryn Mawr Hospital

Lankenau Medical Center

Chester County

Montgomery County

* Used for the Community Health Needs Assessment

Delaware County

Philadelphia County

Main Line Health: Our Geography and Service Area

The 67th vs. the 5th: Your zip code is more powerful that your genetic code 4

Geography & Income


Geography & Income


Geography & Income


Geography & Income

Philadelphia - 67th

Montgomery – 2nd

County Health Rankings for Pennsylvania: Health Outcomes*

*Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute

Philadelphia - 67th

Montgomery - 5th

LMC

Bucks – 10th

Delaware - 41st New Jersey

Health Status Source: PHMC Southeastern Pennsylvania Household Health Survey, 2010.

Adults Self-reported Health

Status – Fair Or Poor

LMC serves both relatively healthy and unhealthy populations: Montgomery County ranked 5th and Philadelphia County ranked last at 67th in the State.

A greater percent of persons in the Urban West area report having poorer health as compared to other LMC areas and Southeastern PA (SEPA).

8The 67th vs. the 5th: Your zip code is more powerful that your genetic code

Health Outcomes : 50% Length of Life & 50% Quality of Life

County Health Rankings for Pennsylvania: Health Outcomes*

*Robert Wood Johnson Foundation, University of Wisconsin Population Health Institute

Philadelphia - 67th

Montgomery - 5th

LMC

Bucks – 10th

Delaware - 41st New Jersey

Health Status Source: PHMC Southeastern Pennsylvania Household Health Survey, 2010.

Adults Self-reported Health

Status – Fair Or Poor

LMC serves both relatively healthy and unhealthy populations: Montgomery County ranked 5th and Philadelphia County ranked last at 67th in the State.

A greater percent of persons in the Urban West area report having poorer health as compared to other LMC areas and Southeastern PA (SEPA).

9The 67th vs. the 5th: Your zip code is more powerful that your genetic code

Health Outcomes : 50% Length of Life & 50% Quality of Life

10

Lankenau Medical Center: Addressing the health needs of our most vulnerable populations

• Lankenau Medical Associates

– West Philadelphia

– 28% uninsured.

– median income = $29,107

– college degree - 25.8%

– > ½ difficulty making housing payments

– ¼ reduce size of meal due to cost

– 32% “cost is a major barrier to health care”

11

Lankenau Medical Center: Addressing the health needs of our most vulnerable populations

• Lankenau Medical Associates

– West Philadelphia

– 28% uninsured.

– median income = $29,107

– college degree - 25.8%

– > ½ difficulty making housing payments

– ¼ reduce size of meal due to cost

– 32% “cost is a major barrier to health care”

LMA Patient-Centered Medical Home

Education Level Project Partners

Graduate Medical Education

ResidenciesFellowships

MLH-Graduate Medical Education

Undergraduate Medical Education

Medical Student Health Advocates

Philadelphia College of Osteopathic Medicine

High School Annenberg Science Symposium

16 regional high schools

High School Health Career Academy 4 high schools4 medical schools

High School Health Career Academy AtlantaHouston

Elementary Health Education Center

Lankenau

Elementary Healthy Me Chester/Upland School District

Widener University

Rising High School Students

MLH-WCU Sumer Science Academy

West Chester University

Peri-partum, Early Childhood

Nursing Student Health Advocates

Villanova University

The Impact of Philanthropy on Education and Disparities

Education Level Project Partners

Graduate Medical Education






High School Annenberg Science Symposium


High School Health Career Academy 4 high schools4 medical schools

High School Health Career Academy AtlantaHouston

Elementary Health Education Center

Lankenau

Elementary Healthy Me Chester/Upland School District

Widener University

Rising High School Students







Do we practice with disparities of care?

14

Project



Annenberg Science Symposium

Health Career Academy



Healthy Me

Health Education Center


Healthcare Disparities Colloquium

15

Private practice

LMCClinic


16

Hematology-Oncology

Gastroenterology:

Medicine

Private practice

LMCClinic


Cardiology

17

Hematology-Oncology

Gastroenterology:

Medicine

Private practice

Diagnosis to Treatment

Surveillance Colonoscopy

Surveillance Mammography

LMCClinic


Cardiology AICD Referral

18

Hematology-OncologyDiagnosis to Treatment

CardiologyAICD Referral

Gastroenterology:Surveillance Colonoscopy

MedicineSurveillance Mammography

RaceEthnicityGenderAgeSexual Orientation


19

Hematology-OncologyDiagnosis to Treatment

CardiologyAICD Referral

Gastroenterology:Surveillance Colonoscopy

MedicineSurveillance Mammography

RaceEthnicityGenderAgeSexual Orientation


+ Socioeconomic Status

Strategy:

Can we assist our patients of lower socio-economic status

by resolving non-medical barriers to care?

20

Project



Annenberg Science Symposium




Healthy Me

Health Education Center



21

Lankenau


ProgramAddressing Non- Medical

Barriers to Care

PARTNER

Philadelphia College of Osteopathic Medicine(PCOM)

http://www.google.com/url?url=http://agsinfo.com/work/philadelphia-college-of-osteopathic-medicine/&rct=j&frm=1&q=&esrc=s&sa=U&ei=FMtUVL3sLpfasATXvYGwBw&ved=0CDQQ9QEwDw&sig2=vLNQgn4TKRfzo5PrBf297Q&usg=AFQjCNGuhoWis_LwbqqYILdt1w_2ssNPIQ

Food assistanceCommodities ChildcareUtilitiesAdult education

Health insurancePublic benefitsHousingJob trainingSmoking cessation

non-medical barriers to care

24

•Patients:

–325

•Encounters

–550

*Many patients have multiple needs for follow-up

Outcomes?

Philanthropy Education Level Project Partners

Annenberg Graduate Medical Education



Pennsylvania Dept of Health




Merck High School Annenberg Science Symposium


Aetna High School Health Career Academy 4 high schools4 medical schools

Aetna High School Health Career Academy AtlantaHouston

Deaver Elementary Health Education Center

Lankenau

Elsevier Elementary Healthy Me Chester/Upland School District

Widener University

Elsevier/Pharma Rising High School Students



PROPOSED: Women’s Board





Outreach:

Annenberg High SchoolScience Symposium

Outreach:

Annenberg High SchoolScience Symposium

Symposium Elements

• Research a Topic

• Link with Hospital Liaison

• Presentation

– Didactic

– Creative Arts

– Ethical

Principles

Collaboration (as opposed to individual achievement)

29

P B

LL

LP LB

PLR

•16 high schools

•11 years

•2,500 students

Annenberg Science Symposium at Main Line Health














Lankenau


Widener University






















Lankenau


Widener University









LL

Health Career AcademyHealth Career AcademyHealth Career Academy

O

http://www.google.com/url?url=http://en.wikipedia.org/wiki/Temple_University&rct=j&frm=1&q=&esrc=s&sa=U&ei=h5vDVL75JZCUsQTL8IGwDQ&ved=0CCQQ9QEwBw&sig2=lEAW7IQMi0INlGIyYp0a3g&usg=AFQjCNGKps7E94GrwMWkvJNSt2spiU73yg

•10th grade

•Emergency Room Theme

– Emergency Room Scenarios

– Risky Behaviors


LL



http://www.google.com/url?url=http://drexel.edu/identity/drexel/logotypes/drexel-medicine/&rct=j&frm=1&q=&esrc=s&sa=U&ei=z5vDVLTjL6easQTE0oKwDQ&ved=0CCAQ9QEwBQ&sig2=u6Ch2dDQkhzjH1oxutpZww&usg=AFQjCNEjarz5Q3mlAAoRKlmsjXjHUaM0Zw

http://www.google.com/url?url=http://www.anatomy.org/content/regional-meeting&rct=j&frm=1&q=&esrc=s&sa=U&ei=GJzDVMaGC87GsQTLn4H4BA&ved=0CDAQ9QEwDQ&sig2=_zcYAQ_xH-ciNBbqjca6PA&usg=AFQjCNH-V4rbMBLi-hx2son-afMJ8ki6hA

http://www.google.com/url?url=http://medical-schools.findthebest.com/l/55/Jefferson-Medical-College-Thomas-Jefferson-University&rct=j&frm=1&q=&esrc=s&sa=U&ei=UJvDVO6LC8XasATen4LIBA&ved=0CBYQ9QEwAA&sig2=CF3Wa6mzLl7bVcH7XMd1mg&usg=AFQjCNF_aOr83F8N52y9lRQENLihglqX5Q


PARTNERS

Lankenau / PCOM Overbrook High

SchoolWest Catholic

Temple Univ. School Of Medicine Lincoln High School

Jefferson Medical College Chester High School

Drexel Univ. School of Medicine M. L. King High

School

PARTNERS

Lankenau / PCOM Overbrook High

SchoolWest Catholic

Temple Univ. School Of Medicine Lincoln High School

Jefferson Medical College Chester High School

Drexel Univ. School of Medicine M. L. King High

School

http://www.google.com/url?url=http://goodlogo.com/download/aetna_logo_vector_3768&rct=j&frm=1&q=&esrc=s&sa=U&ei=WAVXVNL5FKzdsATXyIHABA&ved=0CB4Q9QEwBA&usg=AFQjCNHZxkVxxqptZ-LSu3wfpaRjVLGZlg

• 11th grade Public Health-Related Modules

– Nutrition/Obesity/Diabetes

– Hypertension/Heart Disease

– HIV/STIs

– Cancer Screening

– Trauma and Violence Prevention


• 12th grade


Community Health Needs Assessment

Health Fair for Community

40

41

Outcomes?

Health Career AcademyHealth Career Academy


42



MLK Graduation Rate 54%

43



MLK Graduation Rate 54%

100 %

44

Outcomes: Impact on the Medical Students

Atlanta


46

Atlanta

Houston

Cultural Adaptation of the Health Career Academy for Hispanic Youth and Partnership Development in Houston, TX















Lankenau


Widener University









Lankenau’s Health Education Center:putting children on the correct path

49

50

• Over 20 years of serving children and families

Last year:

• 7,000 visitors

• 175 classes

• General health

• Nutrition

• Fitness,

• Substance abuse

• Safety

• Bullying

Health Education Center regional resource promoting health and wellness

51

• Over 20 years of serving children and families

Health Education Center regional resource promoting health and wellness

• 509 schools

• 220,00 visitors

52

Delema G. Deaver Wellness Garden














Lankenau

Elsevier ElementaryHealthy Me

Chester/Upland School District

Widener University









Widener University

Stetser Elementary

https://www.google.com/url?url=https://www.facebook.com/pages/Stetser-Elementary-School/240979983846?sk=likes&rct=j&frm=1&q=&esrc=s&sa=U&ei=FCBVVP2MDISggwSynYSgCQ&ved=0CB4Q9QEwBA&sig2=W63h54kSh7ooKYDrx8iq3g&usg=AFQjCNFOMurC1qynjUzxy_zDufqKabDNCA

55

Healthy Me, Chester

http://4.bp.blogspot.com/-uImgRjI08uQ/UtdH7FV576I/AAAAAAAAHaY/eXkTS2EAmWY/s1600/DSCN0584.JPG

http://3.bp.blogspot.com/-Vl1PdSEicWc/UtdGncM--2I/AAAAAAAAHaI/EU2cwgGt0nc/s1600/DSCN0591.JPG

http://1.bp.blogspot.com/-xGkxDd32DZM/UtdIsmvTqcI/AAAAAAAAHao/SNSnbveLP7A/s1600/DSCN0590.JPG

http://1.bp.blogspot.com/-ouPsCnN_KfE/UtdJO_xcC0I/AAAAAAAAHaw/L8mTjnlee5w/s1600/DSCN0589.JPG

http://2.bp.blogspot.com/-gj3MlMkJxpQ/UtdGD3Ku-JI/AAAAAAAAHaA/wWuNdLE_cOw/s1600/DSCN0583.JPG














Lankenau



Widener University









PARTNER


Special thanks to

http://www.google.com/url?url=http://www.gopixpic.com/1200/lankenau-medical-center-10am-1pmget-the-program-support-/http:%7C%7Cwww*thejawn*com%7Cjawn-photos%7Csoutheast-health-center-philadelphia-1345059354*jpg/&rct=j&frm=1&q=&esrc=s&sa=U&ei=VOnEVMayHdbbsATRyYLYDA&ved=0CBYQ9QEwAA&sig2=j4n5jyiFCDIrRS__04DQSw&usg=AFQjCNHXcBPBRlZht7Qud0hMbafDETtyBA

Coming Soon…

59














Lankenau



Widener University









Main Line Health + Villanova Nursing

Nursing Health Advocates Visiting Low-Income Mothers

to Improve Child Development

61

http://abcnewsradioonline.com/health-news/2010/11/1/nurse-visits-to-low-income-mothers-improve-child-development.html

http://www.google.com/url?url=http://nurseweb.villanova.edu/Enewsletters/VillanovaNursing/CON_enews_August%202012.htm&rct=j&frm=1&q=&esrc=s&sa=U&ei=781UVPSOOuLasATS_oKYCA&ved=0CBwQ9QEwAw&sig2=pBlIknlQhEBbqJly_ShvKg&usg=AFQjCNG-VAr_HQvdyPZ5EpZJ2tnA_JlU1w














Lankenau



Widener University









Thank you!

Documents

A Health System’s Approach to Healthcare Disparity: Populations, Pipelines and Partners Barry D. Mann, MD Chief Academic Officer, Main Line Health May