Over the past several years, large and wealthy hospital systems have been investing in technology and dedicated staff to meet the goals of the Affordable Care Act and better coordinate patient care among different healthcare and social-service providers. But for hospitals that serve largely low-income residents, it can be difficult to pay for the programs to attain this level of coordination .
A training program called the New Jersey Innovation Catalyst Initiative and funded by the Nicholson Foundation, aims to close the gap between wealthier providers and those that serve as a safety net for patients who are uninsured or receive Medicaid.
The initiative will bring experts from the San Francisco-based Center for Care Innovations (CCI) to help New Jersey hospitals, clinics and trade associations improve the healthcare they provide patients by using technology -- often programs that are free or low-cost.
“Safety-net institutions work on much lower margins, so there are not a lot of resources,” said Joan Randell, the foundation’s chief operating officer. “So what we’ve decided to do is to help healthcare institutions in New Jersey to think differently, in order to improve care.”
Veenu Aulakh, CCI’s executive director, said that there’s already a lot of technology that can help healthcare providers improve how they interact with patients, such as mobile applications that let patients and providers share information. But as her organization has held training sessions with 80 California healthcare providers over the past two years, it’s found that many safety-net providers aren’t aware of what’s available.
“They can start thinking about their problems in different ways once we find solutions that work,” Aulakh said. “The more we’ve been exposing folks to cutting- edge technology, there’s a realization that if they don’t play, they’re going to be left behind.”
For example, until recently, providers frequently assumed that mobile technology was of limited use because many low-income residents didn’t have I. cellphones. But as the share of the population with smart phones has soared, mobile apps are increasingly realistic for safety-net providers, Aulakh said.
“There’s a lot you can do with just some simple technologies,” she said. For example, they can be used to remind patients about appointments and medications, or to connect them with other local social-service providers.
The low price of many applications is an advantage in another way. Safety-net hospitals “can take risks, but they can be smaller risks,” Aulakh said.
The training program will begin next week with a three-day session in Newark. ICI will follow up with webinars and web conferences, leading up to an “innovation fair” in February that is intended to launch providers on technology projects.
Randell said the initiative, which will cost $958,000, is intended to lay the groundwork for two “centers of excellence” for innovation -- providers that are committed to building technology and programs that can be emulated around the state.
The idea for the initiative came from feedback that the foundation received from providers 18 months ago. It was further honed by a workshop the Nicholson Foundation held in Hamilton that drew 80 participants.
“(Safety-net providers) know that they need to do better,” Randell said. “We were amazed at the hunger there was, and the receptivity. That’s what made us decide to go forward.”
The initiative will help providers focus on three areas: addressing the social factors that determine patients’ health; improving access to care; and increasing engagement with patients.
The participants include CompleteCare Health Network, a group of federally qualified health centers in Cape May, Cumberland, and Gloucester counties; Henry J. Austin Health Center, an FQHC in Trenton; Hospital Alliance of New Jersey, a trade group of 17 safety-net hospitals; and New Jersey Primary Care Association, a trade group of 20 FQHCs.
Also included are Newark Beth Israel Medical Center; Robert Wood Johnson University Hospital in New Brunswick; St. Joseph’s Regional Medical Center in Paterson; Trinitas Regional Medical Center in Elizabeth; and Visiting Nurse Association Health Group Inc.
“We invited a diverse group, because we know that problems improving care and reducing costs can’t be done by one type of institution alone,” Randell said, adding that another benefit of the initiative is that it will bring together providers who rarely get a chance to talk with healthcare workers from other organizations.
“All of us have inertia,” she said. “ We develop what we think are really good systems and approaches and it’s really hard to change what we do.”
Randell added that this “gives people a way to figure out how to look at things differently … and gives them the tools without huge risks.,” The Nicholson Foundation is focused on improving the health of low-income communities.
Hospital Alliance CEO Suzanne Ianni credits the foundation with “outside-the-box thinking” in aiming to spur innovation among safety-net providers. Her association will be participating, with the ultimate goal of helping patients become healthier so they don’t rely on frequent emergency room visits and hospital stays.
“Safety nets understand firsthand that to truly improve health, we can't just treat presenting medical problems but must often address socioeconomic and psycho-social issues affecting our patients,” she said.