As the cost of health care rises, experts say it’s increasingly important to save physician time for the things that doctors are uniquely qualified to do. In North Philadelphia, one hospital system is turning to “community health workers” to bridge the gap.
Hospital executives are betting that training lay people to knock down health-care barriers could lower costs for the entire community, said Dr. Paula Stillman, Temple University Health System’s vice president for health care services.
Temple, the safety net hospital for about 750,000 people in North Philadelphia, designed a four-week training program to teach residents to work with patients as community health workers. Stillman says the focus is on high-cost patients and people who use health resource inappropriately.
“So we are looking at patients who are in and out of the emergency departments, in and out of the hospital and miss appointments with their primary care physicians,” Stillman said.
Community health workers call patients to remind them to take their medications and make house calls to bridge gaps in care. That frees nurses and doctors to focus on more complicated work.
Stillman says Temple’s corps of community health workers — on average — were unemployed for more than a year before joining the training program.
“One of the side benefits of this program is economic development for North Philadelphia,” she said.
After training, the community health workers got help with job placement, and earn $13 an hour plus benefits.
Stillman says it’s crucial to recruit motivated trainees.
“We offered jobs to some people, and they said they didn’t want to disrupt their welfare benefits,” she said. “So we need to be very careful about that in the future because we spent our time and effort training them.”
Temple’s second community health worker training session begins in April.
Looking beyond individual care
Stillman spoke at this week’s Population Health and Care Coordination Colloquium in Philadelphia.
Each year, Dr. David Nash, dean of the Jefferson School of Population Health, gathers experts to discuss ways to look beyond individual patient care and manage the health of an entire population.
Terry Hisey, vice chairman and U.S. Life Sciences leader for Deloitte in Philadelphia, spoke about some of the “practical” ways health systems are using aggregated patient data to change physician behavior.
One cancer-treatment center discovered that its specialists were treating the same kind of cancer in myriad ways, Hisey said.
“But when they really looked at the data, they found that they had three that emerged that were most effective,” Hisey said. “At an institutional level, they changed their protocols, and said, ‘We’re going to go with these three, and if you as a physician go with anything else than these three — and aren’t getting good outcomes — it’s something that we’ll want to talk about. We’ll want to know why you chose a path that went counter to what the evidence suggested we should.'”