Healthcare 360: Striving To Help Communities Thrive

Podcast: A Discussion on the Challenges in Community Health Systems

On this week’s episode of Healthcare 360, Dr. Rob Fields sits down with Nancy Kasen, Vice President of Community Benefits and Community Relations at Beth Israel Lahey Health, Kelly O’Neil, MSN, RN, ACM, Executive Director of Network Care Management for the Beth Israel Lahey Performance Network, and Dan Curley, Program Manager of the Beth Israel Lahey Health Medicaid Accountable Care Organizations, to discuss community health systems and the challenges they encounter.

Earning Community Trust

Discussing the way health systems engage with their communities, Dr. Fields presents the challenge of struggling with community mistrust and varying degrees of openness – both of which are historically understandable concerns. When he poses the question of how his colleagues work with community stakeholders to build trust and effectively provide healthcare to the population, Kasen is the first to speak.

“Mistrust is sort of part of the tapestry and the landscape in which we have historically worked for a very long time,” she starts, “But what we’ve been doing as we come together as a system and what I’ve been doing with my team is we’re trying to build both our team’s capacity as well as the community’s capacity.”

She discusses her time at Beth Israel Deaconess Medical Center and how the hospital received a $30 million determination of need for their inpatient building. To build trust with the community, she talks about project transparency, saying, “I was very committed to making sure and setting up that process to be transparent and to be as community-driven and community-led as possible.”

Addressing Community Needs

Over the course of the conversation, Dr. Fields asks the group about whether they think patients expect to be asked about – and provided resources for – any needs they may be struggling with, such as food or housing insecurity.

O’Neil responds that the public typically doesn’t expect to be asked those types of questions within a healthcare setting and acknowledges that discussing such personal struggles can be difficult for both patients and providers. She notes that providers use an evidence-based acceptable tool called PRAPARE in order to ask patients those questions as sensitively as possible. However, she says, “I do think it takes relationship building in some scale – getting to know the individual and build(ing) that trust to be able to get fruitful answers, truthful answers, or the confidence that, ‘if I tell you this’ that you’re going to be able to do something with that.”

“As far as the challenges, a lot of it is, definitely with this patient population, is the engagement,” says Curley. He explains that while we have an amazing group of community health workers, community navigators and practice staff, no patient is the same and some have different needs than others when it comes to navigating the system. What we need to figure out is how to engage with them in ways that provide realistic solutions to their needs – many of which are multifaceted.

Every other week, we’ll chat with a leading expert in healthcare to learn about the many challenges and opportunities facing the industry. Listen to the full conversation with Kasen, O’Neil, and Curley, and check in regularly for new episodes of Healthcare 360.