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Not long ago I sat around a dinner table with brilliant individuals from all different work sectors coming together to discuss opportunities to improve the healthcare system and the health of our communities.
Much of our discussion focused on the patient-centered medical home (PCMH) and government intervention(s) to improve upon this concept. We shared lots of interesting perspectives, best practices, lessons learned, impacts and lack of impacts of efforts in this area, and in some cases, disagreements as to where we go from here.
The patient-centered medical home concept has always fascinated me (having run an organization that in 2010 was referred to by the leading driver of the PCMH model in Maine as the standard for PCMH in 2020 because we were so far ahead of the curve). Although I agree with the intention of the PCMH, I do have significant concerns with the execution, cost and impact (financial and clinical outcome return on investment) and the fact that the PCMH itself is becoming the end goal rather than the improved health of our communities (with PCMH serving as a tool).
Believe it or not, however, the PCMH was not the most interesting aspect of the discussion. Curiously what I found most intriguing that night was a detail shared quickly by a brilliant individual and then left behind as focus returned to the PCMH.
The detail: "Cardiovascular Disease Control Through Barbershops: Design of a Nationwide Outreach Program," a study published in the Journal of the National Medical Association.
With many African-American men having uncontrolled high blood pressure (which can lead to premature disability and death) and also not going to the doctor's office for preventive care, clinicians identified new venues to meet these men where they are (in this case barbershops) for effective monitoring of blood pressure and encouragement to get treatment.
Barbershops had been used in the past for community outreach but systematic assessment had historically been lacking.
The innovation led to increased treatment rates and improved blood pressure control in African-American males with hypertension, (which would translate into significant cost savings as well).
It clearly was a tremendous innovation with significant impact that meets people where they are. Researchers absolutely should study this innovation further and continue to adapt and leverage it to better the health of our communities.
And what else can we learn from this care innovation?
According to the Centers for Disease Control and Prevention, "[B]arber shops often draw large, loyal followings and serve as a trusted venue for open discussions with influential peers on numerous topics, including health."
Yes, the keys to optimizing the encounters within this innovation include trust, open discussions and influential peers. Trust, open discussions and influential peers also are critical to optimizing encounters within the healthcare system.
As healthcare leaders it is our responsibility to embrace and create systems to exploit these same optimizers of impact: trust, open discussions, influential peers if we truly want to optimize care. Let's continue the wonderful community outreach innovations and at the same time let's bring the lessons learned from these innovations into the healthcare system--maybe even into the patient-centered medical home.
Thomas H. Dahlborg, M.S.M., is chief financial officer and vice president of strategy for the National Initiative for Children's Healthcare Quality (NICHQ), where he focuses on improving child health and well-being.
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