Physician focus group

Friday, January 01, 2016 12:22 PM

9Health Fair seeks input about new directions in balancing public health with individual health

by Jim Goddard, 9Health Fair president/CEO, and Sherri Laubach, MD, chair of the 9Health Fair Medical Advisory Committee

The Colorado Medical Society has endorsed 9Health Fair (9HF) for many years, recognizing its role in giving individuals the tools they need to take responsibility for their own health. So when 9Health Fair needed input from primary care physicians, CMS immediately offered to help.

In 2012 CMS surveyed members to get feedback about how physicians utilize the screening results that are brought by their patients from a 9Health Fair. The feedback received from that survey was encouraging for the nonprofit screening organization, showing the vast majority were supportive of, or had actively utilized, those results. There were also many very helpful comments that spurred further conversation between our two organizations.

In October 2015 CMS gathered a group of primary care doctors and facilitated a conversation to give more specific input about 9HF’s mission and selection of specific screening tests and to gain more insight into the organization’s future direction. CMS President Michael Volz, MD, welcomed the group and CMS CEO Alfred Gilchrist facilitated the discussion.

We gave an overview of the operation of 9Health Fair; the focus group was pleased to learn more about our mission and also how helpful the health fair website is in describing offerings and the model of the fairs. There were also some pleasant surprises that the group reported: 9Health Fair plays an active role in connecting their uninsured participants with enrollment resources (both Medicaid and Connect For Health Colorado) and with a medical home, and all the data collected at 9Health Fair via blood screening is stored with CORHIO and is ready to be downloaded to electronic medical records, upon permission from the patient.

Several questions were posed to the group about the current array of screenings. Overall the focus group participants were supportive of the 9HF concept and several had volunteered in the past. Two participants expressed interest in volunteering to serve on the 9HF Medical Advisory Committee (MAC).

There were differing thoughts within the group about the helpfulness of the results that 9HF participants bring to them and some members of the group expressed their opinion that the screenings need to be more evidence-based and updated to reflect current thinking about population health. They advised 9Health Fair to be mindful of the influence vendors might have on the selection of screenings or tests. They expressed the need for 9Health Fair to help reduce the fragmentation of health care (the connectivity to CORHIO was lauded as a good step in this direction). And the group supported the refocusing of screenings and health education toward those interventions that are known to make the most difference, especially in underserved populations (diabetes, hypertension, metabolic syndrome, stroke, heart disease, obesity, alcohol, smoking, etc.), and to continue to reach out to sections of the population where certain conditions are most prevalent.

Much of the discussion pertained to the selection of screenings, and there were many questions about how they were selected and whether they were aligned with the recommendations of the U.S. Preventive Services Task Force. With this movement, it was recommended that good educational support tools and patient decision-making aids be used to help participant-patients understand the risks/benefits of each screening to prepare them for shared decision-making discussions with their doctor. The group also recommended a number of things for the MAC to consider.

• Support the ongoing opportunity that 9Health Fair offers for medical and allied health profession students.
• Educate participants more about appropriate medications.
• Continue to offer health insurance enrollment resources.
• Promote further the CORHIO connection for providers to access results.
• Create a direct connection to the Medicaid RCCO and ACO programs for results, enrollment and connection to providers.
• Expand screenings that support the aging population.
• Provide leadership to help improve health outcomes.

Additionally the focus group noted that 9HF’s mission of patient responsibility aligns with the greater mission of patient engagement and is commendable. They felt that the MAC should consider using more quality improvement review processes to get at best practices and the best evidence for screening selections, and that a discussion should be initiated to consider adding more aspects of public health to the focus on personal health within the mission of 9Health Fair.

The next meeting of the 9Health Fair Medical Advisory Committee will be in January, just before the implementation of the spring 2016 health fair season. We appreciate the input from our partners at CMS to help us further refine our array of educational and screening options for 9HF participants. The goal of 9Health Fair has always been individual choice, with consultation between providers and patients.

9Health Fair’s leadership will recommend that input from this focus group be used to implement changes to future 9HF seasons. It is a huge advantage to us to engage CMS members to help us continue engaging patients in their own health, and to facilitate conversations with these doctors.

Thanks to the CMS members who gave their valuable input as a part of this focus group.

• Samuel G. Cloud, MD
• David A. Downs, MD
• Shannon E. Jantz, MD
• Mark Mathews, MD
• Debra J. Parsons, MD
• H. Manning Pickett, MD
• Genie Pritchett, MD
• Christopher J. Unrein, DO
• Simi Varanasi, MD
• Michael A. Volz, MD
• Erik Wallace, MD
• Prosper L. Wang, MD

There is no substitute for the experience of practicing physicians when evaluating how to maximize the effectiveness of community health programs.