Public health initiative

Friday, May 01, 2015 12:20 PM

Focusing a lens on public health

by Tamaan Osbourne-Roberts, MD, CMS President

As many of you know, as your president, I recommended and the board approved that CMS should support a long-term public health initiative as part of its core work. While this idea was enthusiastically embraced by the entire board, two board members who have dedicated their careers to public health – Mark Johnson, MD, and Christine Nevin-Woods, MD – voluntarily took on leadership of this initiative, which led to a grand meeting of more than 20 of the state’s top public health officials at the CMS office in March.

The attendees included myself; CMS President-elect Mike Volz, MD; Colorado’s Chief Medical Officer Larry Wolk, MD, and several other leaders from his Colorado Department of Public Health and Environment; multiple representatives from local public health agencies around the state; and leaders from the University of Colorado School of Medicine and the Colorado School of Public Health.

Before the meeting, CMS asked our invited guests to consider which public health initiatives deserve primary focus over the next decade of those proposed by the CMS Board of Directors. Marijuana and immunization rates were ranked highest, and the collection and use of public health data, health equity, diabetes and obesity were also deemed priorities.

However, after lengthy discussion about the topics, those in attendance agreed that they did not want to focus on a singular public health issue, or even multiple issues. They are particularly interested in public health having a more ubiquitous role at CMS, influencing the many policy decisions made at a higher level. They want more formalized engagement for public health within the CMS structure and created a proposal they feel will create partnerships, flexibility, and relationships at multiple levels.

Their recommendations are to:

1. Create a section on the CMS Board of Directors that represents public health, and
2. Create a standing committee as part of the section structure.

While my own interest in this initiative derives largely from my own career experiences, beginning at a federally qualified health center as a Colorado Health Service Corps member, and continuing now at a rural critical access hospital, it has long been my belief that most CMS members are deeply interested in public health, viewing it as a foundational discipline within the wider realm of health care policy. However, it has also been my experience that, for multiple reasons, many physicians working outside of public health often view health care policy primarily through the lenses of cost and quality, and may not necessarily know how to incorporate public health into their other advocacy.

Fortunately, public health has a long history of focusing on communities and CMS has a long history of focusing on physicians and their patients. A long-term commitment between CMS and public health leaders can help connect clinical physician practices and public health agencies to keep our patients and communities healthy. CMS helps provide the framework and coordination so desperately needed to be effective in this arena. And we’re aided by such efforts as the State Innovation Model, which will fund care coordination efforts for behavioral health and primary care in Colorado; project ECHO, which uses videoconferencing for patient visits and physician training, and is an effort that the state is currently considering; and initiatives present within the Affordable Care Act.

If approved by the board, the members of the new public health section will identify what public health initiatives to work on, work to recruit public health members to CMS, and work to create strong partnerships with other public health advocacy groups.

I welcome hearing from members on our efforts to advance CMS’s public health presence. Don’t hesitate to email me at president@cms.org.