Health Systems Transformation Efforts Within ASTHO
One of public health’s great strengths over the past decade has been its ability to adjust to America‘s changing healthcare landscape. Most state public health agencies are at the forefront of population health assessments and health reform efforts that necessitate multi-sector partnerships and cross-governmental agency collaboration. ASTHO’s work in health systems transformation promotes cross-cutting collaboration and integration in a variety of areas to improve the efficiency and effectiveness of public health programs. ASTHO’s work supports the Triple Aim of improving the patient experience of care, improving the health of populations, and reducing the per capita cost of healthcare.
In the last 75 years, ASTHO has achieved several successes in health systems transformation to help state and territorial health departments advance their collaborative efforts.
Primary Care-Public Health Integration
ASTHO’s Integration Forum addresses the intersection of primary care and public health across various public health issues such as chronic disease, infectious disease, workforce, and maternal and child health. The Integration Forum is a partnership of more than 50 organizations and 100 individual partners that work together to improve population health through collaboration.
A key project in this initiative focuses on the specific integration of public health and Medicaid. In September 2016, ASTHO, with support from the de Beaumont Foundation and in partnership with the National Association of Medicaid Directors, launched “Maximizing Public Health Partnerships with Medicaid to Improve Populations Health,” a project that promotes collaborative opportunities by providing resources designed to help address barriers and facilitators to successful collaboration, taking into account information from state health departments and Medicaid experts. The project toolkit includes six in-depth case studies of promising collaborations, learning tools for knowledge transformation and information sharing, and an online resource library which provides examples of approaches that Medicaid and public health agencies have leveraged to address mutual health goals.
Improvements in population health occur when barriers to achieving optimal health for individuals are addressed and removed. ASTHO’s health equity team empowers state and territorial health agencies to address health inequalities and advance health equity. Former ASTHO President Edward Ehlinger, commissioner of the Minnesota Department of Health, strengthened this work with his 2016 ASTHO President’s Challenge focused on advancing health equity and optimal health for all. ASTHO encourages states to work towards achieving this overarching goal via the three objectives of the Triple Aim of Health Equity:
- Implement a health in all policies approach with health equity as the goal.
- Expand our understanding of what creates health.
- Strengthen the capacity of communities to create their own healthy future.
Informatics and the Public Health Community Platform
ASTHO supports the role science plays in advancing public health, addressing electronic health data, health data systems, surveillance systems, and the capacity of state and local information infrastructures to measure population health and workforce capacity.
ASTHO’s informatics team is currently leading a community-driven initiative, with support from CDC, to develop the Public Health Community Platform. In 2015, ASTHO launched a conceptual design to leverage advances in cloud technology. State public health, healthcare, and the vendor community worked together in developing bidirectional electronic case reporting data exchanges that, when fully functional, will ensure better health outcomes. ASTHO continues to work with CDC and several other public health and healthcare partners to progress from design to implementation.
State Health Policy
ASTHO is committed to providing its members with the latest information on state legislation impacting public health and state health agencies. ASTHO’s state health policy team develops research, offers technical assistance, and provides opportunities for state health agency legislative liaisons to exchange ideas on public health policies.
Each year, the team publishes a state legislative prospectus and summary, state and territorial election results, as well as maps and charts detailing state laws and policies. Since 2012, ASTHO has developed various resources to provide a snapshot of the status of various laws, regulations, and policies across the United States
Additionally, ASTHO tracks and analyzes state legislation impacting health agencies and public health. In doing so, state health officials are able to remain aware of policy innovations addressing emerging and existing public health issues that may impact their states specifically. The public health community is also informed of legislative updates via a weekly health policy update column in ASTHO’s Public Health Weekly newsletter.
ASTHO is currently following legislation addressing substance misuse and addiction, environmental health, communicable diseases, emergency preparedness and response, public health workforce, health information and data, community health, and disease and injury prevention. Specifically, several states have recently introduced legislation to expand access to naloxone and the scope of prescription drug monitoring programs, create opioid prescription guidelines, and establish a tax or surcharge on opioid prescriptions as a way of addressing the nation’s opioid epidemic. This focus on substance misuse and abuse is critical to current public health work, and will be monitored closely by ASTHO’s state health policy team.