How Can We Better Connect Community Health Improvement Efforts in Durham?

IBM Health Corps team shares ideas on how to better connect and coordinate Durham’s efforts to make our community healthier

February 24, 2017

Marissa Mortiboy scanned the whiteboard covered with sticky-notes of different colors and considered carefully where to add hers. Walking slowly in front of the long board, she scanned the notes clustered under questions about health care in Durham such as “How do I get access to care?” “How do we get researchers and experts involved?” “What’s working?”

Jostling among two dozen representatives from the Durham County Department of Public Health, Partnership for a Healthy Durham, Duke, and other organizations serving the health needs of the local community, she placed her note on the board near a similar concept and continued to scan answers from others.

 “. . . It became clear that there is a large concerted effort to improve healthcare across the community. . . Clearly, Durham’s challenges are not caused by lack of effort.”

-- Jason Gilder, PhD, a member of the IBM Health Corps team from Cleveland, Ohio.

The flood of ideas was part of a design thinking workshop held by a seven-member IBM Health Corps team during their three-week visit to Duke in January and February.

“It was a fun and effective way to brainstorm because everyone had input,” said Mortiboy, coordinator for the Partnership for a Healthy Durham. “It reaffirmed that we share common concerns and allowed us to see where we have overlapping goals and resources.”

Those common concerns and goals were at the heart of the final report that the IBM Health Corps Team brought back to community leaders on Feb. 17, suggesting a possible structure for human and technological resources that could increase coordination among the many organizations striving to improve the health of Durham.

 

Three Intense Weeks

The seven members of the IBM Health Corps team arrived in Durham on January 30 from New York, France, Ireland, California, and Ohio to set in motion a process funded by IBM’s new Health Corps award. This program brings together small teams of IBMers who dedicate three weeks to provide pro bono consulting expertise to a community in an effort to address disparities in health. Duke Health was one of five institutions selected for the inaugural year of IBM Health Corps, and the only institution selected in the U.S.A. In total, the program provides over $2.5 million worth of public health-related benefits to the chosen communities.

During their three weeks in Durham, the team interviewed 32 local organizations and leaders in the community, made site visits to large organizations such as the Lincoln Community Health Center and small non-profits such as the Diaper Bank of North Carolina, attended three meetings with committees from the Partnership for a Healthy Durham, and hosted several roundtable and design thinking workshops.

The team came away with a heartfelt appreciation for the level of commitment to improving health in Durham.

“There are large disparities in wealth and health outcomes in Durham County,” says Jason Gilder, PhD, a member of the IBM Health Corps team whose regular job is senior director of analytics and informatics at IBM Watson Health in Cleveland. “However, it became clear that there is a large concerted effort to improve healthcare across the community. . . Clearly, Durham’s challenges are not caused by lack of effort.”

 

Harnessing Technology

To better harness that effort, the team recommended a combination of technology and human power.

They noted that during the three-week visit they found that many organizations working to improve health in Durham were unaware of the efforts of other groups. “For a short time, we acted as human glue in the community, introducing and matching people,” said Caroline Lu, whose regular job is with IBM Watson Commerce in New York.

The team demonstrated how to leverage technology to improve information sharing among organizations, linking clinical care providers and organizations tackling other issues that affect health, such as housing, access to healthy food, mental health, and medication adherence. Such a technology platform could provide a centralized, searchable database of services offered. It could also create a feedback loop for organizations to let each other know whether patients referred to one service had followed through with the referral.

Ideally, the platform could also link to other available non-health data such as public transportation maps, census data, and locations of grocery stores and fast food restaurants – all items that can influence population health. By tying together information from various organizations, Durham leaders would be better able to see where to focus attention, and to track whether programs are actually improving health. The team recommended using the platform to create community care plans, the macro analogy of an individual care plan. Users of the platform would be able to see areas of need, areas of strength, who is doing what, and who is missing from the conversations. Ultimately, this information could be used to increase the impact of individual organizations and improve community health.

Lastly, the IBM Health Corps team noted that any such technology requires a clear governance body. This body could decide issues such as what data can and should be shared and who should have access to the data, who chooses what organizations to include in the system, how to educate people in the community about the technology and services, and how to ensure audits and other structures to ensure that the system works as planned.

“It is crucial to continually maintain, expand, and refine improvement efforts so that the community remains engaged in the process and to ensure that the momentum of driving improved health outcomes is not lost,” said Gilder.

 

NEXT STEPS

Community members received the presentation eagerly, and participated in another round of discussions over lunch to think of next steps, including the possibility of quickly creating a coordinating committee to gather resources, choose what systems to build or buy, and keep the momentum moving.

The IBM Health Corps team stressed their belief that Durham could move quickly because of the strength of the community’s commitment to minimize health disparities. “Our recommendations are just a continuation of all the work already taking place,” said Eoin Carroll, a lead software architect in IBM Watson Health in Ireland.

Judging by the applause and smiles at the end of the meeting, the community is ready to take the baton and run.

“Fresh eyes help us see how far we’ve come,” said Michelle Lyn, chief of the Division of Community Medicine within Duke’s Department of Community and Family Medicine. “They have convinced me that closing the gaps in healthcare in Durham is doable.”

Ebony Boulware, MD, director of the Duke Center for Community and Population Health Improvement, agreed.

“I am blown away by what this effort has produced,” she said. “It is truly visionary.”