Memorial Healthcare System MHS'NET

1
Memorial Healthcare System(MHS.NET)

• Patient, Community Centered
• Health Initiative
• John A. Benz
• S.V.P. Chief Strategic Officer

2
Memorial Healthcare System(South Broward
Hospital District)

• Who Large Public Healthcare System (1,792)
• What Healthcare (Preventive Long-Term)
• When Created 1947, Opened 1953
• Where Broward County, Fla, 680K residents
• How Much 1.4B a year, 10.6K employees
• How Vision / Mission / Pillar Focused

3
Memorial Healthcare Systems Commitment to
Community Health
Community-based Healthcare
Primary Care Services

• JDCH Childrens Mobile Health Center
• MHS Adult Mobile Health Center
• SBHS School Nurse Program
• HACC Teen Pregnancy Program
• Gulfstream Race Track Homeless Clinic
• BOC Homeless Clinic
• Mammography Van
• Disaster Response
• HITS

Hospital-based Healthcare

• Adult, Pediatric OB/GYN services
• Three convenient clinic locations (Hollywood,
  West Hollywood Dania Beach)

Outpatient Services
Inpatient
ED

• Hospitalists
• Specialists
• Intensivists

• Laboratory
• Radiology
• PT-OT
• Home Health

• Pharmacy
• Specialists
• Disease Management
• Behavioral Health
• Social Services
• Transportation

Continuum of Healthcare
4

• Memorial Healthcare System strives to become
  world-class and a national model in each of its
  pillars

5
Quality of Life (Application of Data)

• Determine Gaps
• Determine Location
• Determine Partners
• Determine Programs
• Establish Goals
• Report Outcome
• Trend
• Cultural / Racial
• Economic Level
• Against Goals / Others

6
Quality of Life / Health StudiesOur Favorite
Study / Story

• Policy
• Adoption of Community Benefit Vision
• Acceptance of Responsibility for Health of
  Community
• Acceptance of Social Responsibilities
• Need for Collaborative / Community-Based Partners
• Recognition - Quality of Life / Health linkage
• Application
• Focusing of Community Relations Programs
• Development of Community Benefits Program
• Initiation of Targeted Neighborhood Programs
• Adoption of H.I.T.S. Initiative (Health
  Intervention Targeted Services)
• H.E.R.O.s (Health Employees Reaching Out) Program

7
Community Relations

• Leading Causes of Death
• Leading Causes of Injury
• PRC Community Health Assessment
• Major Chronic Diseases
• Preventive and Screening Opportunities
• Major Partnerships / Collaboratives

8
Community Health Status - Benchmarks
9
Broward CountyLeading Causes of Death by Age2006
10
Leading Broward County Unintentional Injury
Deaths by Age2006
11
Targeted Neighborhood Program /Quality of Life
Studies

• Complimentary Studies
• PRC Neighborhood Study
• Door - to - Door Outreach
• Determination of Needs
• Determination of Priorities
• Facilitating Resources
• Leadership Training
• Establishing Goals
• Trending Results

12
Neighborhood Projects

• Phase I (Organization and Data Collection)
• Data Collection (PRC door-to-door)/Staff Review
• Community Asset Identification
• Steering Committee Formation
• Trust Building (Quick Success Projects)
• Venting
• Phase II (Improvement)
• Strategic Plan Development
• Sub-Committee Action
• Improvement Linkage to Sources, Increased
  Partnerships
• Start of Grant Cycles
• Phase III (Transition)
• Initiate Longer Term Improvements
• Steering Committee Training
• Linkage to Coalition for a Healthy South Broward
  MHS
• Celebration of Success
• Elimination of MHS as Coordinator Transfer to
  Steering Committee

13
Impact of Targeted Neighborhood Program

• Identification / Validation of Quality of Life /
  Health Status of Neighborhood Residents
• Comparative Specific Neighborhood Data
• Identification of Specific Key Issues /
  Priorities
• Impact
• Specific targeted interventions
• Development of trust / communications
• Alignment with Memorial Healthcare System
• Increased access to available resources
• Leadership training / advocacy development

14
Heath Intervention with Targeted Services
15
Background

• Result of hospital data analysis.
• Improved health.
• Targets areas with high numbers of uninsured.
  Medicaid, Memorial Primary Care and Florida
  KidCare.
• Relies heavily on partnerships for impact.
• Two six-month projects completed.

16
Memorial Healthcare SystemInpatient Write-offs
for CY 2005Ranked by Program Line and Zip Code
17
Total Inpatient Non-Contractual Write-offsSouth
Broward Residentswith and without Primary Care
FlagCalendar Year 2005
18
48
19
Health Intervention with Targeted Services (HITS)
(11/20)
20
H.I.T.S. Initiative (Health Intervention
Targeted Services)

• Targeted Door to Door Initiative
• Improve Residents Health
• Increase Access to Health Services
• Maximize Eligibility in Available Programs
• Establishment of a Medical Home for Chronic
  Diseased Patients
• Measurement
• Personalized Contact (100 of Households)
• Increase in Residents with Medical Home
• Increase in Coverage (Medicaid, SCHIP, etc.)
• Immediate Impact on Health (Screenings)

21
H.I.T.S. Program(Health Intervention Targeted
Services)
22
HITS I Results(1,217 households, 2,843
individuals)

• Medical
• 798 Blood pressure screenings
• 798 Cholesterol
• 86 Flu shots
• 44 EKGs
• 62 Mammogram referrals

• Eligibility
• 202 Medicaid
• 330 Memorial Primary Care
• 57.8 of uninsured (1,643) are aligned for
  coverage / medical home

23
HITS II Results 5/1/08-7/31/08

• 64 patients successfully contacted. (Includes 12
  family members)
• 33 additional targeted patients could not be
  reached, 2 refused services and 1 passed away.
• 34 patients have / are being enrolled in Memorial
  Primary Care. One has qualified for Medicaid and
  2 KidCare applications are pending.
• 11 patients have had or been scheduled for their
  first physician appointment.
• 25 have been enrolled in Disease Management.

24
HITS III Results (6/3/08-7/31/08)

• 126 patients targeted for outreach.
• 48 patients were reached by phone. 18 more
  patients reached through home visits and 18
  through referral.
• 18 patients made appointments for home visits and
  17 kept their appointments.
• 11 Medicaid Applcations filed, 5 patients
  approved for Medicaid, 6 pending determination.
• 45 PCC applications filed, 26 patients approved
  for Memorial Primary Care, 19 pending paperwork /
  determination

25
Future

• Additional Neighborhood Projects Continue
  Community Building
• Expansion of HITS Outreach Program -Medical Model
  (adult and children)
• Pursuit of Grant Funding
• Further develop HITS Initiative
• Independent Evaluation