Doctors in Michigan don’t just write prescriptions – Michigan Advance with a new health justice project


When a patient is referred to the Greater Flint Health Coalition, a doctor or other health professional has determined that there is more than just physical health at risk to the person’s health.

They may not have regular access to transportation to get to their doctor’s appointments or there may not be enough food on their table. Maybe the apartment is a problem or they haven’t found a job.

“In traditional health systems, we go to the doctor when we are sick; If we have a chronic condition, we get treatment for it, ”said Kirk Smith, president and CEO of the Greater Flint Health Coalition, a nonprofit that works to improve the health of Genesee County’s residents. “But for me, when we talk about health care, we have to talk about education, employment, quality of housing and food that people have access to – all of these are health issues too.”

It is this concept – that health care is much more than treating an immediate physical problem – that is fueling a new “health justice project” on which the Greater Flint Health Coalition and a host of other organizations across the state are collaborating.

Started with $ 9 million from the U.S. Centers for Medicare and Medicaid Services (CMS) and $ 1 million from Michigan Medicine, the project initially aims to provide health care in five Michigan counties – Washtenaw, Genesee, Jackson, Kent and Livingston – through another holistic approach to health. This approach means doctors and other health professionals can better identify and collect a patient’s socio-economic challenges – such as lack of food or lack of housing – and instantly connect them to social support services that address those issues.

Ultimately, the project leaders hope to expand the project to all 83 counties in the state.

Terrisca Des Jardins, executive director of the Center for Health and Research Transformation (CHRT), a not-for-profit center for health research and policy at the University of Michigan, said the goal of the project is to transform the way society works has historically separated medical care from social assistance to improve the health of residents across the country.

For example, she said that someone struggling with food insecurity may face a variety of social challenges that affect their health. This new health justice project will lay the foundation for this person to share information about their social challenges with their GP or other health care providers.

Rather than having a doctor write this person a prescription for an immediate medical problem, they know the community-based organizations their patients can go to for assistance with these social challenges. These organizations, like the Greater Flint Health Coalition, will then be able to work with individuals on a variety of issues, from securing jobs to preventing evictions.

“When I was in my early 20s, one of my first projects while I was working in the state of New Mexico looked at the benefits of Medicaid,” said Des Jardins. “We traveled around the state holding focus groups with community members to get input on Medicaid services. In a small rural New Mexico community, people didn’t want to talk about health benefits; they wanted to talk about running water and electricity. It was a profound experience for me. Since then I want to focus on a holistic approach [to health]. “

As part of the new Health Equal Opportunity project, CHRT officials will educate healthcare professionals about health equity and how to incorporate it into their work, said Dr. Michael Englebe, professor of surgery at the University of Michigan. Englesbe is the portfolio director of the Collaborative Quality Improvement (CQI) initiative, which is a collective of approximately 20 groups across the state that aim to improve healthcare delivery by hospitals and doctors by sharing data on patient risk factors and analyze health care outcomes.

Under the direction of Michigan Medicine and funded by Blue Cross Blue Shield of Michigan, the CQIs such as the CHRT play an important role in the new project. Other key players in the project include the Michigan Data Collaborative, a data collection, aggregation, and reporting organization at the University of Michigan, and the Michigan Health Information Network, a not-for-profit organization that provides patient health information to medical providers.

“We don’t have a lot of information on social issues like food insecurity, poverty – all those things that have massive implications for people’s health and health care,” Englsebe said, referring to doctors across the country. “With this [health equity project], we are building an infrastructure so that doctors have data on their patients to understand their social determinants of health. When they see patients facing social care challenges, we will put in place an infrastructure so doctors know where to send their patients. “

Englesbe indicated that the Health Equity Project will ensure that patient records contain information about social determinants of health. This way, when a healthcare provider pulls up a patient record, they can see previous challenges, such as:

“I am a liver transplant surgeon and the answer to better health care is not to do more liver transplants, but to make sure we don’t have to do liver transplants at all,” said Englebe, emphasizing the importance of medical professionals as part of their job addressing socio-economic issues .

“Let’s talk about all of these basic health problems that the health system is not designed for,” continued Englesbe.

Smith, of the Greater Flint Health Coalition, stated that connecting disenfranchised patients – such as those who have faced systemic racism in health care – are far more likely to trust the health system when it provides both medical and social support.

He noted that he had already seen this through the explosion of patients offered by the Genesee Community Health Access Program (CHAP). CHAP is administered by the Greater Flint Health Coalition; Since 2015, it has been working in a similar way to the Health Equal Opportunities Project by connecting with hospitals, doctors and health insurers to provide a range of social support to patients.

“When we started in 2015, our goal was to provide for a total of 800 people per year; we now serve 1,500 people a month, ”said Smith.

With the Health Justice Project, Smith expects that number to continue to grow.

“This is really very important work,” he said. “It’s one of the most important things we can do. When it comes to the health impact of an individual or the community, so much doesn’t happen in the doctor’s office. We need to be able to address food, transportation or shelter and the resource gaps. “

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