Data and collaboration at the local level are at the heart of a $7.5 million challenge for communities to devise novel but scaleable ways of boosting population health and reducing health disparities in low-income neighborhoods.

 

Launched Wednesday, the BUILD Health Challenge – for "bold, upstream, integrated, local and data-driven" – is offering $3.5 million in grant money, consisting of five one-year $75,000 planning grants and nine two-year, $250,000 implementation awards. The sponsors, led by the Advisory Board Co., the de Beaumont Foundation, the Kresge Foundation and the Robert Wood Johnson Foundation, also will make $4 million in low-interest loans available for community revitalization. 

 

In addition, the founding partners will offer support resources to the winners, and a health system in each winning community must pledge to match the grants on a 1:1 basis.

 

[See also: No interoperability? Goodbye big data.]

 

"The aim of the BUILD Health Challenge really is … increasing the number and the efficiency, the effectiveness of the types of partnerships that we know it will take to improve health," Abbey Cofsky, a senior program officer with the Robert Wood Johnson Foundation, said during a conference call to introduce the program. "That means bringing together hospitals, community leaders and public-health leaders to collaborate in efforts that are going to move the needle on health and ultimately really change the dynamic around cost."

 

Indeed, each grant will be awarded to an equal partnership between a hospital or health system, a local public-health department and a not-for-profit, community-based organization. The involvement of community groups will help ensure that care providers pay attention to social and economic causes of chronic disease and other population-health challenges, according to Dennis Weaver, MD, executive vice president and CMO of Advisory. 

 

"Most health systems are comfortable with the clinical determinants of healthcare, but often aren't as much of the social and economic determinants of healthcare, which are so critically important to population health," Weaver said. Such factors might include food deserts, poverty, education and culture, all of which have a bearing on health status.

 

The impact of even the most effective care is "diminished" by neighborhoods lacking fresh produce, pharmacies and safe options for exercising, said Brian Castrucci, chief program and strategy officer at the Bethesda, Md.-based de Beaumont Foundation, which is focused on improving public health in the U.S.

 

"The simple truth is that our traditional model of healthcare delivery doesn't really work anymore," Castrucci said.

 

The hospital-centric model was developed to treat acute, curable diseases such as polio and typhoid fever, caused by specific bugs, bacteria or viruses. Today, chronic illness is a larger problem, exacerbated by lifestyle choices, unhealthy work and home environments and socioeconomic factors. "Jonas Salk is not going to save us from diabetes," Castrucci quipped.

 

Castrucci said that 95 percent of U.S. healthcare spending is on direct medical care: "We need to reorient our approach to achieving health to a focus on impacting the upstream or social determinants of health," he said. 

 

"By working at a community level, public-health systems can help address the ways to prevent disease before they occur, creating healthy, supportive environments for those who may already be sick," he added. "We want to see transformation that values prevention over treatment."

 

This is where data comes in.

 

Former U.S. Chief Technology Officer Aneesh Chopra, who now is co-founder and executive vice president of Hunch Analytics, Arlington, Va., played up open data resources available from federal, state and local governments, which he said are creating unprecedented opportunities for innovation. "The model here is largely about better public-private cooperation and collaboration," Chopra said.

 

He noted that iTriage, founded by two emergency physicians, makes use of open data to help people find Federally Qualified Health Centers and other care options. Open data also has helped identify areas in need of fresh, healthy foods. "Food deserts have been a challenge in communities all over country, so the U.S. Department of Agriculture opened up a database of where the food deserts are," Chopra said.

 

"We are in a world that is flush with data. We think that there are real opportunities to rethink and to apply innovative uses of data and information sharing that can help us better identify needs and opportunities," said Cofsky. Data also can help measure outcomes.

 

Additionally, Castrucci talked of a data divide. "All of this data that's in hospitals really doesn't get shared well with public health," he said, so there simply isn't good data to address chronic disease in communities. "We want to have the public health departments and the communities to address the real cost of disease." 

 

He would like to see physicians, community-based organizations and health departments agree on common goals. "When you have these things aligned, then you can move upstream," Castrucci said.

 

The coalition will begin conversations with potential applicants next month. Initial applications are due Jan. 16, and awards will be announced June 9.