Meet Marty

NEW INITIATIVES ARE PERSONALIZING POPULATION HEALTH

Ascension continues to accelerate our transformation as an integrated health ministry that delivers improved health outcomes for the individuals and communities we are privileged to serve, with special attention to persons who are poor and vulnerable. As part of the Ascension Strategic Plan, we are evolving our care model to one that takes a population segment-based approach — focused on quality, experience, value and affordability. “Our goal is to improve our patients’ health status and experience through a variety of meaningful programs, services and activities that emphasize the importance of quality and integrated care across the continuum,” said Mark Whalen, Senior Vice President, Population Health and Service Line Operations, Ascension. “By further defining and personalizing Ascension’s population health capabilities, we aim to raise awareness about our vision for population health, its role in Ascension’s

transformation and ultimately how we will continue to enhance care for all the populations we serve.” To help share our care model approach with associates, Ascension’s Mark Whalen Population Health team partnered with Marketing and Communications to create and launch a video that introduces viewers to an animated Ascension “patient” named Marty. Viewers are taken through Marty’s complicated health journey — captured through the personal lens of Marty and his family, including his caregiver and daughter, Alexis. In the video, Marty struggles to stay healthy, frequently visits the Emergency Department and feels his care is disconnected when he sees his providers. Meanwhile, Alexis struggles to manage her dad’s health as she works away from home and also takes care of her son.

However, we can improve Marty’s health outcomes through a population health approach. This begins by delivering care anchored in quality, exceeding patient expectations and coming together across the care continuum to coordinate care.

“Marty reflects many of our patients here at Ascension who are struggling to navigate their care due to multiple chronic conditions

SHARE YOUR MARTY MOMENT

We want to hear your stories on how you or others have engaged in population health to provide personalized care to our patients like Marty. For example, did a referral for local transportation help a patient attend their appointments? Or did you help a caregiver take steps to care for a loved one?

Visit the Good Day Ascension Intranet’s Meet Marty page (gdaintranet.ascension.org/home/meet-marty) to share your story.

and barriers related to social determinants of health,” said Aaron Shoemaker, MD, Chief Medical Officer, AmbulaAaron Shoemaker, MD tory Services and Population Health,

Clinical & Network Services,

Ascension. “Through the video, we hope to not only share our approach to how we care for the populations we serve but also inspire our associates to take part in shaping a positive care journey for patients and their families.” Ascension’s population health approach is rooted in incorporating shared decision-making and coordinated communication between patients and clinicians to build trust.

This trust can ultimately contribute to better adherence to treatment recommendations and more appropriate healthcare utilization. Strong patient engagement is a core pillar of meaningful healthcare. This approach also aims to reduce costs by leveraging technology such as electronic health records and expanding access through optimizing health promotion and disease prevention.

A new initiative called Neighborhood Resource is one of the many ways Ascension is identifying gaps to help improve the health of each patient and deliver personalized care. Neighborhood Resource is a free and easy-to-use online platform that connects those in need to social services and resources right in their own community. Through a simple ZIP code search, patients can find free or reduced-cost services in their community, including food, housing, transportation, job training, legal help and more.

The Neighborhood Resource program is already in use in a few markets, with great success. One nurse care manager noted: “I recently used Neighborhood Resource to connect my patient Mary with transportation and food resources after receiving a referral from her primary care physician. My patient is now receiving benefits for food assistance and is able to get transportation to and from her doctor appointments without having to rely on her one friend all the time.”

“Engaging in personalized care begins by listening to the patient, asking action-oriented questions and working collaboratively across care teams to deliver patient-centered care plans based on what matters to the patient,” said Rebecca Adkins, Vice President, Population Health Operations, Clinical & Network Services, Ascension. “Every patient should have the opportunity to reach their full health potential just like Marty. By identifying gaps in care and reducing disparities, we can improve the health of our communities.”

Rebecca Adkins

Learn more by visiting healthcare. ascension.org/neighborhood-resource.

JOIN MARTY’S JOURNEY TO BETTER HEALTH Scan the QR code below to watch the video introducing Marty and see how you can engage in population health.