POPULATION HEALTH DIVISION Transforming Public Health in San Francisco

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1 POPULATION HEALTH DIVISION Transforming Public Health in San Francisco Update on the San Francisco Program Collaboration and Service Integration (PCSI) Initiative Israel Nieves-Rivera Director of Public Health Accreditation, Equity, and Quality Improvement Population Health Division San Francisco Department of Public Health July 11, 2013 HIV Prevention Planning Council

2 NATIONAL CENTER FOR HIV/AIDS, VIRAL HEPATITIS, STD, AND TB PREVENTION (NCHHSTP) Goal 1: Prevention Through Health Care Goal 2: Program Collaboration and Service Integration Goal 3: Health Equity Goal 4: Global Health and Health Systems Strengthening Goal 5: Partnerships Goal 6: Workforce Development and Capacity Building

3 ADDRESSING SYNDEMICS THROUGH PROGRAM COLLABORATION AND SERVICE INTEGRATION CDC-PA-PS Syndemics: When used as a noun, a syndemic is defined as two or more afflictions (diseases), interacting synergistically, contributing to increase transmission and/or worsen outcomes of either or all diseases in a population Purpose of award: The purpose of this grant is to plan, scale-up, and support the implementation of a syndemic approach to the prevention of HIV/AIDS, viral hepatitis, STDs and TB System Level Intervention: The goal of the grant is to develop system level changes that can be sustained over time

4 ACCOMPLISHMENTS IN YEAR 1 AND 2: We identified clinical settings for appropriate integrated services: Health department Community Oriented Primary Care Clinics, Jail Health Services, and Municipal STD Clinic The Health Officer made final recommendation that PCSI project should aim to achieve a fully integrated data system for all communicable diseases in San Francisco The health department identified populations in clinical and community settings for appropriate integrated services Completed clinical guidelines for integrated HIV/AIDS, viral hepatitis, STD, and TB prevention services Completed an estimate of the prevalence of hepatitis C among MSM

5 ACCOMPLISHMENTS IN YEAR 1 AND 2: We developed the framework for Just Ask SF, an on-line tool to assist local residents and providers on preventative screening and vaccination recommendations based on the local clinical guidelines Utilizing the CDC Data Security and Confidentiality Guidelines, we developed an Integrated Security and Confidentiality Guideline for the health jurisdiction PCSI Staff worked with CDC Informatics Staff to develop a report titled An Informatics Analysis of Enhanced Integration and Collaboration ; the report outlines Sectionspecific needs and how they can be maintained in a integrated data system Building on the work from our Expanded HIV Testing Project, we supported the development of the framework for gathering data from the Electronic Medical Record on preventive services provided in the health department primary care clinics

6 ACCOMPLISHMENTS IN YEAR 3: PCSI Staff work with CDC Informatics Staff to develop a report titled A market Analysis for Public Health Integrated Systems ; the report outlines options for an integrated system for public health services Utilizing the CDC report and intensive review of each of the options on the market place, the jurisdiction selected the Maven system from Consilience software We integrated our staff that conduct assessment, surveillance, informatics, and data management to support division, health department, and citywide efforts We integrated our disease prevention and control services We integrated specialists in community engagement, planning, and mobilization to focus on the spectrum of prevention We created division-wide infrastructure to support professional development, quality improvement, grant development, operations and fiscal efficiencies, and public health accreditation

7 ONGOING ACTIVITIES: We are finalizing a scope of work and bringing together division-wide teams to support integrated services in the community: Mapping common populations for integrated services Aligning data requirements to develop one common data gathering tool Develop a comprehensive training plan to meet the technical/certification requirements to provide integrated services Identifying the best testing technology to support these efforts Streamlining the purchasing and dissemination of supplies Developing policies regarding the provision of providing test results Aligning our efforts regarding the data collection and reporting of positive test results Aligning our public health follow-up activities and medical follow-up protocols

8 ONGOING ACTIVITIES: Finalizing and launching the Just Ask web tool Supporting the development and implementation of the integrated data system Developing a framework for integrated services in clinical settings Providing Technical Assistance (TA) on clinical guidelines and best practices for integrated services Developing a Quality Improvement plan to evaluate our efforts Developing improvement of lab and billing systems for preventive services at the Public Health Lab and Public Health Clinics

9 QUESTIONS?