On October 29, AcademyHealth and America's Essential Hospitals co-hosted an Innovations Summit in Washington, D.C. to highlight how social networks improve population health. The blog below, by AcademyHealth Research Assistant Danielle Robbio, offers a snapshot of the event.
Social networks span beyond the chime of a tweet or “like” of a photo. Our connectedness to those in our community, our friends, family and colleagues—our real-world connections—determine our behaviors and ultimately, our health. The 2014 Innovations Summit began with a presentation by Dr. Nicholas Christakis on his social network research that illustrates the behavioral phenomenon of “social contagion.” Studies show that who you target for an intervention in a network is critical to the success or adoption of the intervention; knowing who to target for systemic change will greatly improve the uptake of the desired change. This work is of particular interest to the health services research and policy community as we look to design interventions that impact a variety of communities in order to improve population health
The illustration social networks' importance in the wake of a health systems remodel provides much needed insight for those involved in improving population health. However, it also forces us to self-reflect and ask not only who are we targeting for change, but what kind of change are we trying to make.
In addition to the presentation by Dr. Christakis, panelists representing different health systems across the country presented their unique approaches to care and the innovations their organizations are fostering. Although each system is geographically and demographically different, every panelist demonstrated that their purposeful investment in each individual in their social network (via time and non-financial methods) made the difference in health outcomes. For example, in Arizona the Refugee Women’s Health Clinic incorporates cultural competencies into their service delivery. Midwives are trained as cultural health navigators—building trust and appropriately administering care. The ability to connect with the community has allowed the Center to make real changes in the health of the social network they serve.
Over lunch, participants debated key questions related to social networks and health:
- How do you define population health?
- What are some challenges to practicing population health?
- How can social networks support population health activities?
- What roles can researchers, policymakers, and/or communities do to promote the field of population health?
- What unique roles do essential hospitals have in providing population health programs and services? How does this role differ from hospitals that don’t have a commitment to serve the underserved?
- What would you propose as measures or metrics for measuring the success of population health programs?
These questions promoted lively discussion among participants. Specifically, challenges and opportunities were identified.
Challenges to improving population health:
- Leadership—defining who is responsible for assuring care can be difficult, especially when population health is not uniformly defined.
- Infrastructure—Data quality and access issues have proven to be roadblocks to improving population health. Harnessing data sources and utilizing them appropriately has the potential to improve research and delivery of services. Additionally, programmatic and physical infrastructure can be problematic for the delivery of services that are relevant to population health e.g. EHR adoption and use; clinic location (urban vs. rural).
- Sustainability—in order to continue improving population health, we must think beyond grant funding and develop models of sustainability.
Opportunities for action:
- Trust—understanding our social networks and their priorities is the most important strategy.
- Contact—deliberately and mindfully designing interventions and strategies to target key members of our social networks will vastly improve our success.
- Partnership—collaboration with other sectors (i.e., housing; transportation) will allow us to align clinical care and social services. By leveraging other resources and engaging various stakeholders, we can holistically improve population health.
As we move forward with health systems change, we heard clearly that the networks with whom we are working are critical to our strategy and to our success. We also know that the strategy must be inclusive and purposeful. In the words of panelist Gilbert Salinas, “We no longer ask patients what’s the matter with you, but rather what matters to you.”
Let us bear this in mind as we move forward with improving population health.