Coming This Fall to an Exam Room Near You: New Questions

Posted: August 24, 2016

New questions in the exam room aimed at better care, for you and the community

by Lia Spiliotes

K Floyd & Ruth exam on van(2) 2013Does your physician, nurse practitioner or other health care professional ask you about stress? Or whether you feel connected to your neighbors and community? How stable your housing is? Or if transportation problems have kept you from work or medical appointments? Questions like these will soon become familiar as health care providers focus more on collecting data on what is known as “the social determinants of health.”

The “Big Data” movement in health care, which collects and analyzes complex sets of data, has led to new medical treatments, therapeutic care, and the beginning of personalized medicine. Now the trend is towards collecting even deeper information about economic, social, and environmental factors  that affect the health not only of individuals, but of entire neighborhoods and cities.

This fall, community health centers across the U.S., including Community Health Programs — will begin using a new standardized questionnaire to collect more of this data. We will ask about a patient’s financial security, social life, and education, employment and stress. Any or all of these issues can  contribute to mental and physical health–for instance, financial stress can mean choosing food over medication. Transportation challenges can make it difficult to get to a medical office or hospital.

Access to health care services is fundamental to healthy communities, but health cannot be sustained through medical interventions alone.  That’s why collecting this new information is so critical. To better understand why specific health issues persist in communities, we need deeper insights to better prevent disease and to promote well-being for all residents.

More than 50 years ago Dr. H. Jack Geiger observed that “the determinants of health are in the social order — not in health care.” The community health center movement was launched on the notion of creating healthier communities, using new approaches to addressing the social factors behind well-being or illness. CHP began with these exact values in the 1970s.

Today, Community Health Programs has partnered with local farmers to bring local produce to the CHP-Great Barrington campus on Thursdays. CHP collaborates with local nonprofit organizations–such as Greenagers and the Berkshire Natural Resources Council–to build and expand walking trails around our property for patients, children, staff and visitors. Our Family Services program collaborates with such organizations Berkshire Baby Box, to promote safe sleeping for newborns. Family Services offers cooking classes for parents.

In addition, community health centers have surpassed other care providers with integration of mental health and primary care services.  Each patient’s care team includes a mental health professional who is accessible if a patient shares concerns about depression or other such issues during a medical visit. This “on-the-spot referral” to a  ensures that patients’ overall care is seamless. And it helps reduce the stigma of seeking mental health services.

Today we have technology that we didn’t have at the start of the health center movement. The new information we gather provides opportunities for innovators and entrepreneurs across the the health care, life sciences, digital and biotechnology industries to become part of the solution for improving community health.

Change can evolve from seemingly unrelated industries– information around housing conditions could inspire better air filter systems to help reduce acquired asthma. Data about financial stress might stimulate the banking community to create new financial products to under-served consumers. Information about transportation issues might lead to collaborations with community volunteer organizations or transit authorities.

By collecting and evaluating non-clinical information, health centers more readilyidentify whether existing community services contribute to, or compromise, health. Big data can help improve patient outcomes, decrease health disparities, lower the total cost of care, and address the big picture of  health care.It’s a huge, incredible challenge but a step in the right direction–so prepare for some new questions in our offices!

Lia Spiliotes is interim CEO of Community Health Programs.





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