(bright music)
-: Welcome and thank you for joining us.
I'm Stacey Barrett, a Research Scientist in the Division
of Healthcare Quality Evaluation at the Joint Commission.
I'm here today with Andrea Gibson
chief Strategy Officer at Cook County Health.
It's a pleasure to be with you today, Andrea.
-: It's nice to be here, Stacey.
-: Today we'll be discussing approaches
to prioritizing, planning
and taking action to address healthcare disparities.
Can you describe some
of Cook County Health's priorities related
to healthcare equity, Andrea?
-: Sure, we are not new to health equity as an organization.
It's been a cornerstone
of our organization for its over 180 year history.
We've always focused
on being available to provide healthcare regardless
of the ability to pay, and particularly
before the Affordable Care Act that was critical
for those who didn't have insurance.
Insurance access is less of an issue now.
It's making sure individuals have access to services
and also services that are multifaceted
so that aren't just clinical services.
In some cases, there's a need
for addressing things that are ancillary
to traditional healthcare.
So some of the things we've done to
provide greater access include building centers in
in the community and providing some
of the ancillary services that I mentioned.
So, for example, providing food
for those who might be food insecure
providing housing subsidies, providing transportation.
All of these things are things that have an impact
on receiving healthcare and living a healthy life.
And so that we've been able to focus
on those things to support our health equity goals.
-: Thanks, Andrea.
What would you say has been most helpful
in helping you scope your work
and set priorities for these goals?
-: I would say what's been most helpful is
the strong commitment of the organization to help our
our patient population
in traditional ways and non-traditional ways.
So I mentioned some of the things that aren't
traditional healthcare that's been critical
in helping our patients, you know
viewing them as a whole person
and supporting them in a lot of different ways.
-: What factors would you say influence the prioritization
of the initiatives that you spearhead to
address health related social needs at Cook County Health?
-: We've recently, I would say
since the Affordable Care Act focused a little more
on data driven work to support these concepts, including
you know, you'll talk, I think
to others who have worked more directly in housing
but that's one of the big areas that we focused on.
We did some research on the connection
between healthcare and having access to stable housing
and there's a strong connection there
which makes intuitive sense.
But it was really important
for us to review that data specific to our populations
both our patients and our insurance plan, county care
the members that are part
of that plan and what their needs are.
-: Thanks, could you share a bit
about the internal collaborations and partnerships
at Cook County Health that have really helped to shape
and drive your work around healthcare equity?
-: Sure, yeah.
Two examples come immediately to mind.
One, we've been providing the healthcare
to the asylum seekers who have been bused
up to Illinois from Texas.
And that required us to, you know
establish space, providers, different clinical workflow
and totally different support requirements
for that population.
So our whole organization really had to come together
and both, you know, we are a complex organization.
We're a provider, we're a public health organization
and we have an insurance plan.
And all of those participants really helped put
in place the, you know
providing healthcare to the asylum seekers.
The other example that comes to mind is when we set up
our mass vaccination sites, this was, you know
as soon as I think the vaccines were available
we started to put together mass vaccination sites
and for the community, not just our patients.
And that was an example of terrific collaboration.
You know, we are a part
of county government and it served us very well
in this instance because we had access
to the Department of Emergency Management Services.
We had a lot of different kinds
of support that helped us establish those sites.
-: That's great.
Could you share some successes
of some of your prioritized healthcare equity initiatives
at Cook County Health?
-: Sure, well, I mentioned the asylum seekers.
We've provided healthcare to
over 4,000 asylum seekers in a very short window.
We've administered over a million doses
of the Covid 19 vaccine.
We've distributed over a hundred thousand pounds
of food to our patients.
We've led some local campaigns
like we call them hyper-local campaigns
for the vaccine to reach hard to reach populations.
And, you know, I mentioned the mass vaccine sites.
We opened up, you know,
we now have the ability to flex those up and down as needed
depending on what's going on with the pandemic.
We've also provided housing units to both of our
our patients and our county care members.
You know, our public health department has done a lot
of work remediating lead hazards in homes, which has a
a big impact on health, especially for kids.
And we've, you know, launched a lot
of programs at our community health centers to
like care coordination programs that think
beyond the traditional healthcare delivery process.
-: So what efforts have you taken to make sure that all
of this work becomes actionable at Cook County Health?
-: I would say that there's a lot of the work
in health equity space that is in place hardwired
but frankly, the pandemic amplified the need
for even more work in this space.
One thing that we did was we applied
for federal stimulus dollars
and we identified enhancing a lot
of these programs around food insecurity
housing insecurity, behavioral health.
That has been a big area identified
especially during the pandemic
that we need a bigger presence in that space.
And there's just such a big need for that.
We've also done some things like update our coding
which is important because it reflects
in the electronic medical record if any
of our patients are facing some of these social risk factors
like food insecurity, housing insecurity, things like that.
So that is another step towards hardwiring information
and we're hopeful that the federal government
at some point will reimburse us for those coding
for some of those expenses related to that enhanced effort.
But, so we're ready.
We've established the computer system to
to capture that in our health assessments and in our coding.
-: So you mentioned the Covid 19 pandemic.
Can you elaborate
on any other challenges that you've encountered
at Cook County Health
throughout this process of planning and prioritizing
and taking action to address healthcare equity?
-: Sure, I mean, I would say most
most recently what's on my mind is the pandemic.
And we just had a bandwidth issue.
Never was it more important to reach vulnerable populations
because of the impact of the pandemic.
But, you know, we were trying to do so many things at once.
So, and, you know, I think it's well known that hiring and
across the country and healthcare is a challenge right now.
So we've really had to think of
we had to think outside of the box to deliver some
of the care that we saw that was needed and kind
of stretch ourselves in different ways during the pandemic.
-: And Andrea
what strategies have you implemented to help address some
of these challenges and barriers that have come your way?
-: Well, I think setting up
the mass vaccine sites was a big learning experience.
And when the asylum seeker healthcare came about
we kind of understood what it took and who to
gather together to make something of that magnitude happen.
And, you know, I think
we set some pretty audacious goals
and tried to pull together the right people.
These were situations that we couldn't ha, you know
an individual team couldn't handle alone
and we had to pull in different partners and stakeholders.
-: Great, what advice would you give
to other organizations who might not be as far along
in their healthcare equity journey
as Cook County Health is maybe just beginning to plan
and prioritize their work?
What would you tell them?
-: Well, I would first of all tell them
I think the pandemic made it clear
that health equity should be everyone's priority.
The pandemic hit vulnerable patients much harder
than other patients, and that has a community health impact.
And so it's
in everyone's interest that everyone's health improve
and everyone has access to health.
The real advice though, that I would have for
for any organization is set bold goals for yourself.
I remember when the CEO said
let's try to give a million doses of the Covid 19 vaccine.
All of us, you know, we
didn't know how we would possibly hit that mark.
And we did it.
We really, we did it, and it shows the importance
of setting a goal that feels a little uncomfortable
but can really push people to think
beyond their normal boundaries.
-: Thank you so much, Andrea.
And thank you for taking the time to talk with me today
about how Cook County Health has thoughtfully planned
prioritized, and taken action to advance healthcare equity.
Thank you.
-: Thank you.
(energetic music)