New Studies Test Novel Systems for Integrating Medical, Public Health and Social Services

LEXINGTON, Ky. (March 21, 2016)  To support its new Systems for Action: Systems and Services Research to Build a Culture of Health Research Program, the Robert Wood Johnson Foundation announced $3 million of research funding to support three new Collaborating Research Centers at Arizona State University, Indiana University-Purdue University Indianapolis and the University of Chicago.

These awards are managed by the Systems for Action National Coordinating Center, housed at the University of Kentucky College of Public Health. Systems for Action seeks to identify system-level strategies for enhancing the reach, quality, efficiency and equity of support services that promote health and well-being on a population-wide basis. Providing expertise in diverse health and social science disciplines, the centers will conduct studies that test novel ways of integrating the multiple financing and delivery systems that support a Culture of Health in U.S. communities.

Each center will receive up to $1 million in funding over two years to lead research initiatives that test innovative ways of integrating medical, public health, social, and community services. Collectively these studies aim to solve vexing problems of fragmentation, duplication, and variation that currently exist in the delivery and financing of services that address social determinants of health and well-being. New research conducted by the centers will identify how services in sectors such as housing, transportation, food and nutrition, criminal justice, and arts and culture can be better coordinated with medical and public health services so as to achieve larger and more equitable impacts on health and well-being. All three centers will work closely with the National Coordinating Center on collaborative research designed to expand scientific knowledge about ways of improving population health through multi-sector alignment and integration.

“The health of a community is shaped by a constellation of services and supports delivered outside the traditional health and medical sectors. These new studies will help us learn better ways of deploying these resources so as to achieve a larger collective impact,” Glen Mays, director of the Systems for Action National Coordinating Center, said.

The three centers and their investigators are:

Arizona State University

Financing and Service Delivery Integration for Mental Illness and Substance Abuse

Principal Investigators: William J. Riley, Ph.D., and Michael Shafer, Ph.D.

Arizona State University’s School for the Science of Health Care Delivery and School of Criminology and Criminal Justice will integrate rich data sources from Arizona’s medical, mental health, and criminal justice systems in order to explore opportunities for better coordinating services for persons with mental illness and/or substance abuse disorders. Using interactive system dynamics modeling and network analysis methods, this study will identify how people and dollars move between and within the state’s medical, mental health, and criminal justice systems. Interactive simulation models informed by stakeholder input will then explore how changes to funding streams and service delivery models can produce improved health and social outcomes.

Indiana University-Purdue University Indianapolis

Improving Population and Clinical Health with Integrated Services and Decision Support

Principal Investigators: Paul K. Halverson, Dr.P.H, and Joshua R. Vest, Ph.D.

Researchers from IUPUI and the Eskenazi Health System will use retrospective studies and a prospective randomized controlled trial to test the effectiveness of several strategies for integrating the delivery of medical, public health, and social services for low-income populations receiving care through Indianapolis’ network of federally qualified health centers. The integration strategies to be studied include the use of population health nurses who conduct home and community visits, the use of interdisciplinary case conferences involving medical and public health professionals, and a novel electronic decision support tool that combines clinical, social, and public health data to better characterize the social and physical environments in which patients live. This research will provide important insights into the value of integrated approaches to health delivery and how public health organizations can contribute to efforts of the health care and social and community services systems.

University of Chicago

The Comprehensive Care, Community, and Culture Program

Principal Investigators: David Meltzer M.D., Ph.D., and Harold Pollack, Ph.D.

The University of Chicago’s Urban Labs will use a randomized controlled trial to test the feasibility and effectiveness of a comprehensive community care model for low-income, urban-dwelling seniors at high risk of hospital admission. The model combines (1) “comprehensivist” physicians who provide both inpatient and outpatient care for their patients, (2) community health workers who connect seniors to needed social and community services such as transportation and food assistance; and (3) a community arts and culture program designed to strengthen social support and community engagement. This study will examine the individual and combined effects of these strategies on important health and economic outcomes for vulnerable seniors.

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