5 thoughts on community health from Rush CIO Dr. Shafiq Rab

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In an effort to address the health of its surrounding community, Chicago-based Rush University Medical Center tied social services tools into its IT systems.

"We have made a mission at our institution to work to improve community health," Rush CIO Dr. Shafiq Rab said of the program, which he discussed during a semi-keynote presentation Sept. 21 at the Becker's Hospital Review 3rd Annual Health IT + Revenue Cycle Conference in Chicago. His presentation centered on how Rush uses data to improve the health outcomes of Chicago residents.

For the program, Rush tapped several IT vendors. For example, it integrated its software with NowPow, a Chicago-based software company that provides underserved residents with referrals to community resources, so "discrete data can flow from one place to the other," according to Dr. Rab. Through the connected software, clinicians can write patients "prescriptions" for lodging, food and clothing.

In one month, the software helped Rush refer 70 patients to community resources — none of whom returned to the hospital for emergency care. "We're not trying to do this by ourselves," Dr. Rab explained. "There's a whole collaborative and we have asked 122 companies to join us. We're not leading it. IT just made it possible for things to happen."

Here are five key thoughts Dr. Rab shared during his keynote speech.

On the struggle for hospitals to survive in healthcare

"Whatever we do is controlled by [a few] 'gods.' No. 1 is Medicare. That god decides how to pay and how to penalize. I have no idea who makes the math at Medicare, but somehow they think things cost 30 cents," he said. "There are other gods, known as the commercial payer gods. They also try to decrease the [reimbursement] rate every year. … The world we live in has made it very hard [for healthcare providers]."

On the significance of social determinants of health

"[At Rush,] we talked about four things: health and healthcare, neighborhood and physical environment, education and economic vitality," he said. "About 50 or 60 years ago, or even a hundred years ago in the United States, we had lots of infectious diseases, water-borne diseases. They didn't go away by themselves. The reason they went away is because we in our country [made] a social change. We brought pure water and sanitation. We don't have typhoid here. We don't have cholera here. ... If we really want to change healthcare, we have to look at healthcare in total."

On why providing medical services isn't enough

"We're talking about taking care of the citizens, not the subscribers. All [the residents] of Chicagoland are our customers," Dr. Rab said, adding Chicago comprises a diverse population, including advantaged and disadvantaged communities. "When we give [a prescription] to somebody, when we give knowledge to somebody, but the person doesn't have a place to sleep, what good is that medication? The person doesn't have food, so what good is that medication? The person doesn't have lodging, so what good is that? It's not good enough."

On supporting the surrounding community

"We're trying to make [our work] a collaborative effort," he said. "What we are trying to do is create a platform where we can combine forces and go forward. But not only in health, but in safety and hiring local, giving people the ability to have economic freedom. Without economic freedom, communities will not prosper. … [Rush is] also are taking students from the community. We, in IT, took 22 students, who I taught for about seven months. … All of them are going to college now."

On collaborating with IT vendors

"I have never treated a single person as a 'vendor.' Absolutely not," he said. "In healthcare, we always forget the fourth partner: the patient, the payer, the provider and the community that makes it happen, otherwise known as the vendor. They are part of us. At Rush, when we decide, we decide as friends, we decide as part of us, so we all are all fighting for the same common cause: We want the healthcare outcome to be better." 

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