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National Public Health Improvement Initiative (NPHII)

2011 National Public Health Improvement Initiative (NPHII)
Grantee Meeting

Atlanta, Georgia
March 30 – April 1, 2011

Public Health Transformation

Speakers: Edward L. Hunter, MA, Director, CDC-Washington; Karen Remley, MD, MBA, FAAP, Principal Public Health Advisor to the Governor, Secretary of Health and Human Resources, the Virginia General Assembly and the Board of Health

Description: Mr. Ed Hunter and Dr. Karen Remley briefly addressed the context in which our work takes place, from the federal and state perspective respectively. This context includes broad health systems transformations; implementation of (and continued controversy surrounding) the Affordable Care Act at the national and state levels; fiscal constraints; and an evolving policy environment. They focused on opportunities and challenges these factors present to public health agencies and our work in performance improvement.

Key Themes and Highlights:

  • Discussion around the fiscal context in Washington, DC
  • Health systems are being transformed, both by the Affordable Care Act and from other pre-existing trends
  • Insurance reform have important implications for public health agencies – including how they interact with the clinical care system
  • Health IT investments provide significant opportunities for population-level prevention, as well as for improving clinical care
  • Technology, discovery and drug development are driving the future
  • Innovative performance improvement is necessary in times of budget cuts
  • We are in the middle of a significant pendulum swing in role of government in public health, as well as other sectors
  • Amid change, there are opportunities for public health agencies to reposition themselves
  • Significant issues about what services to focus on as resources are constrained and more individuals obtain insurance for clinical prevention
  • The public is revisiting the role of government in social policy, and have concerns about overreaching in selected areas
  • It is critical to continually update our situational awareness – within States, across States, and across levels of government. Change is rapid, and opportunities emerge and disappear quickly.
  • We need to constantly question whether we are doing the right thing, and expect the uncertain.

Questions and Answers:

Q: How can agencies coordinate more regarding child health issues?

A: Chronic disease grant consolidation is one example of moving toward more integrated approaches in public health. States should request flexibility in how and for what purpose funds can be used.

Q: How do we get infrastructure in place for technology if we don’t have the resources for it?

A: You need to develop a value proposition that justifies the need and demonstrates the benefit, and seek to leverage the resources of others as they implement Health IT systems, for example.

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