the use of a population health measurement conceptual model to develop a partnership model for a
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The Use of a Population HealthMeasurement Conceptual Model toDevelop a Partnership Model for a
Regional Population HealthObservatory
Tracy Halbert, Director, Population Health Surveillance & Community Data Management
David Strong, Deputy Medical Officer of Health
Justine Fitzpatrick, Assistant Director, London Health Observatory
Rizwan Shahid, Senior Research Analyst
Sean McIntyre, Health Services Planning Consultant
Micheline Nimmock, Director, Primary Care
Population Health
Three years ago a Population Health Measurement Strategy was initiated within the Calgary Health Region resulting in the development of a conceptual model with three basic steps
_To Estimate_
_To Determine_
Primary and Secondary Sources of Health Condition Data
Health State Incidence/Prevalenceo Cause Specific Mortalityo Cause Specific Morbidityo Mortality/Morbidity Combined
Mortality/Morbidity Burdeno Attributable and
Avoidable Mortalityo Attributable and
Avoidable Morbidity o Attributable and
Avoidable Costso Inequities (Distributive
Justice)
Conceptual Model
1. Establish the leading burden of disease for age cohorts and defined geographic boundaries
Conceptual Model
_To Estimate_
_To Determine_
Conceptual Model
Review of Epidemiologic
Research
_Conduct_
Relative Risks of Health State
Determinants
Attributable Risk Fraction
2. Establish from the literature the leading modifiable risk factors contributing significantly to the onset and progression of the leading burden of disease
_To Determine_
Conceptual Model
3. Measure the prevalence / incidence of the identified modifiable risk factors
Primary and Secondary Sources of Risk Factor Prevalence Data
· CHRPS· CCHS
Prevalence of Distal and Proximal Risk Determinants
in the CHR
Conceptual Model
Regional Priority Settingo Health Condition Targetso Risk Determinant
Reduction Targetso Research Agenda
System PerformanceMeasurement
To Provide DirectIon
To Provide Direction
Primary Care/Chronic Disease Initiatives
Acute Care Serviceso Based on Evidenceo Monitored via Performance Indicatorso Enhanced by QIo Maintained by QAo Supported by EHR and EDWCommunity and Continuing Care Serviceso Based on Evidenceo Monitored via Performance Indicatorso Enhanced by QIo Maintained by QAo Supported by EHR and EDW
Health Promotion/Wellness Initiativeso Based on Evidenceo Monitored through Evaluationo Enhanced by QIo Maintained by QA
Integrated with
Conceptual Model
Distal Risk Determinants
o Povertyo Educationo Unemployment...
Proximal Risk Determinantso Obesityo Activityo Tobacco...
Diseases and Injuries Impairments Disability Death
Health promotion/wellness initiatives integrated with primary care/chronic disease initiatives modify the prevalence and the progression of morbidity and mortality
Conceptual Model
Prevalence
Progression
PHO
Population health surveillance is concerned with the interaction of modifiable determinants of health both within and outside of the health domain
Need to develop an infrastructure to facilitate access to data owned by health as well as cross sectoral partners was identified
PHO
The social, health and educational sector organizations providing services in Calgary and surrounding areas are proposing to establish through a partnership a Public Health Observatory (PHO)
PHO
City of Calgary
Calgary Board of Education
Calgary Separate School Division
United Way of Calgary and Area
Calgary and Area Child and Family Services Authority
Calgary Health Region
PHO
Better data Better decisions Better outcomes
“For the first time, some of the largest public sector organizations in the Calgary area will pool their data. Together, we can create a bigger, broader picture of complex issues to create effective and targeted solutions”
PHO: Purpose
The PHO exists so that organizations can make informed decisions related to problem solving and planning based on comprehensive data shared by social, health and educational sectors that will help the public achieve optimal health and wellness outcomes
PHO: Vision
The effectiveness of service delivery systems will be enhanced by using the highest quality information from partnering organizations for decisions in health, education and social sectors
PHO: Mission
The PHO houses, maintains, links, monitors and analyzes existing datasets about health, income, education, employment and social circumstances, and builds capacity to enable stakeholders to understand and use the data
Social Factors
Education Employment
Income
Health
Data Haven
PHO: Governance Model
• An incorporated non-profit, wholly owned subsidiary of the Calgary Health Region
• Calgary Health Region business infrastructure will be used to support operations
• A Board of Directors will operate within the constructs of the Carver Policy Governance Model for Non profit Organizations
PHO
A Data Haven that contains linked but anonymized health, education and social data
PHO
PHO: Products & Services
• Service oriented
• Secondary analysis of existing data sets
• No new data collection
• No research for which the primary intent is to make information generalizable
• Linkages to academic researchers
PHO: Products & Services
PHO: Products & Services
PHO: Products & Services
PHO: Products & Services
PHO: Products & Services
PHO: Products & Services
Profiles:
Reports of core sets or baskets of indicators, useful for monitoring health status, health inequities and health system performance for subpopulations that may be defined by geography, ethnicity or provider group
PHO: Products & Services
Synthesis reports: analyzed, integrated and synthesized
information to create short and long synthesis reports that focus on the whole system
PHO: Products & Services
Impact Assessments:
qualitative and quantitative assessment of the impact of planned programs and policies
PHO: Products & Services
Capacity Building:
helping providers in health, education and social sectors to use information and knowledge to make decisions that will benefit the population they serve
PHO: Products & Services
Enquiry Service:
Response in a timely fashion to ad hoc questions from service providers and the public
PHO: Products & Services
Three-Year business cycle updated annually
• Products & Services Advisory Committee
• Partner organization recommendations
• Expert Advisory Committee
PHO Future
Pending partner acceptance:
• Soft launch fall 2008
• Development of one-year work plan– Data sharing agreements– Data Haven infrastructure– Privacy protection policies and processes– Communication and consultation policies and processes– Secondment agreements
• Formal partnership agreements completed by March 2009
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