Hunting for the Heart of a Changing Community

by Jack Murtha and Ryan Black
APRIL 12, 2018
This is the cover story from our April 2018 issue. Our bimonthly print magazines are available for free at this link.

IT WAS A DREADFUL MONTH in what was shaping up to be an even worse school year. Upon its arrival, February 2014 began pummeling the people of Douglas County, Colorado, leaving a special bruise on its 68,000-student school system. Four teenagers killed themselves in the first 11 days of the month. All but one were enrolled in the district. Their suicides rendered their parents heartbroken, their peers confused, and local officials struggling to comprehend the scope of the problem at hand.

“It is our understanding that there is no link other than geographic proximity between these 4 tragic deaths,” the district’s superintendent wrote in a letter to parents. “However, as a community, we need to be aware that anytime there are multiple deaths in a short time period, there is an increased risk for imitation.” Months earlier, a family buried an eighth-grade girl who reportedly had joined a suicide pact with several friends. In 2009, a popular high school boy took his own life. A year before, 3 teens killed themselves in the span of 24 hours. Tragic as each individual event was, together they contributed to rising suicide rates, both in the county and Colorado at large, which had stirred legislators and community leaders to search for solutions.

Not long before, Centura Health opened a 50-bed, $128 million hospital in the county seat, Castle Rock. The faith-based health system was rapidly expanding, and it saw in the community an entity going through a similar transition. Seated halfway between Denver and Colorado Springs, Castle Rock had swollen from roughly 8600 to 56,000 residents since 1990, reflecting a countywide blossoming. The new, upper-middle-class, highly-educated population needed somewhere to go when they got sick.

So when 5 teenage girls tried to commit suicide during that dark period, they ended up in Castle Rock Adventist Health. “We lost a couple,” says James Corbett, JD, Centura’s senior vice president and chief mission officer, “and I can tell you that changes the community and changes the way you work in that community.”

Health Tech’s Mirror on the Wall

They might seem worlds apart, but public health issues, such as suicide, and demographic trends, like population growth, present healthcare organizations with challenges and opportunities that share common blood. Each phenomenon generates diverse data, and each data point melds to form a clearer picture of what, exactly, is going on in a community. If a health system so desires, it may corral disparate pieces of information to more effectively anticipate and meet the needs of the fluctuating populace it serves, according to experts interviewed by Healthcare Analytics News™.

What makes this sort of population health campaign possible are new tools—electronic medical records, big data, artificial intelligence (AI)—and creative information gathering. Such efforts can yield insights that optimize care and increase value. They hold the power to enable health systems to navigate, say, gentrification or urban decline and societal crises, from suicide to diabetes to opioid abuse.

In Camden, New Jersey, healthcare visionaries have used data and analytics to hot-spot public health on a block-by-block basis, permitting them to tackle housing issues associated with excessive emergency department readmissions. In Maine, a health system examined population data to identify locations for behavioral health clinics to combat the opioid crisis, a notable feat for a state where wilderness reigns. In Mississippi, the difference between a few percentile points has helped healthcare draft targeted interventions for diabetes.

The timing for population health is right. Over the past decade, major metro areas have been swelling, especially places such as New York, San Francisco, Nashville, Austin, and Denver. Conversely, low-income individuals who once occupied city neighborhoods are migrating to suburbs and the countryside, says Steven Pedigo, MS, MA, who heads an urban lab at New York University and directs the advisory firm Creative Class Group. Millennials, empty nesters, the working poor—they’re all on the move, and they’re moving all over.

But healthcare is only beginning to take a high-tech approach to analyze communities, experts say. The cutting-edge practice, after all, stands to topple long-held approaches and business motivations, causing some hesitance, they say. Novelty makes existing examples and lessons all the more valuable. “If healthcare has a burden or a role to play in meeting unmet needs, then big data has to be part of the solution,” says Michael Topchik, MA, national leader for the Chartis Center for Rural Health, a firm that uses data to develop and improve health networks outside the urban core and suburban rings.  

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