By Robert L. Moore, MD, MPH, MBA, Chief Medical Officer
“Out of clutter, find simplicity. From discord, find harmony.
In the middle of difficulty lies opportunity.”– Albert Einstein
As we emerge from the constraints of the COVID pandemic, we are spending important and deserved energy on restoring our systems and staffing. At the same time, we are trying our best to respond to a flood of new regulations, programs, and provider types.
Given all these activities and external stresses, we have been less engaged with community partners and advocacy efforts. This impacts our effectiveness in addressing challenges in our communities. Lack of engagement also leads to less robust feedback in the policy development process, which impacts the effectiveness of these policies as they roll out.
There are many levels of collaboration in which clinical leaders can and should participate. Last month’s newsletter focused on county medical societies. Next month will cover statewide trade organizations.
This newsletter focuses on local community collaboratives.
Local Community Collaboratives:
In one form or another, each of our counties has one or more health collaborative stakeholder groups. Examples include:
• Hope Rising, Lake County
• Health Action 2.0, Sonoma County
• Shasta Health Assessment and Redesign Collaborative (SHARC)
• Live Healthy Napa County
• Vida Del Norte
Health care provider stakeholders meet together to either keep each other up to date on their major initiatives (helpful for preventing surprises and to look for opportunities to work together) or to actively work across organizations on a common problem (like prescription opioid overuse or adverse childhood events). Major stakeholders may include hospitals, larger medical groups, FQHCs, the county medical society, and the county health department. Sometimes additional community-based providers or even consumers are also included. As a community-based health plan, Partnership HealthPlan of California (PHC) tries to participate in all coalitions of which we are aware.
In many collaboratives, all or most of the stakeholders are non-clinicians. These can achieve the first goal above of giving updates and preventing surprises. In a few communities, clinician leaders representing the different health care providers meet monthly or quarterly. This would typically include the CMO of health centers, the county health officer, an officer of the county medical society, and clinical executive leaders for local hospitals. These can be in parallel to the non-clinician collaboratives. Clinician-level sharing is at a different level than non-clinicians, so having these separate cross-provider meetings can bring additional ideas and group interventions on community health problems.
Many county health departments have a requirement for a community stakeholder process to contribute to their county public health priorities. Often these stakeholder meetings are run by consultants, include some sort of survey (which clinical leaders should try to contribute to), and a series of community meetings. While this process is very time consuming, participating in community prioritization exercises can have some impact on county funding priorities, so it is important to hear the voice of community clinician leaders in that process.
What local community collaboratives exist in your county? Is there someone on that collaborative that represents the primary care providers like yours?
If you are unsure what groups are active in your county or want to strategize on boosting effectiveness of current groups, reach out to your regional PHC staff: your Regional Medical Director, Regional Manager, county Provider Relations Representative, or regional QI staff. None of our work is really siloed; we all need to build relationships to tackle the most challenging issues in our communities.