Here's what community-driven healthcare looks like: Thoughts from Geisinger President and CEO Dr. David Feinberg

Plenty of innovation is coming out of the area code 17821 — a food pharmacy to better tackle hunger as a health problem, advancements in precision medicine and an innovative refund program where dissatisfied patients can get up to $2,000 back. Here's the interesting thing: 17821 isn't in Silicon Valley. It's the zip code for Danville, Pa., the seat of a 18,000-person county.

In Danville is Geisinger, a 100-plus-year-old system led by David Feinberg, MD, president and CEO. During the keynote address he delivered at Becker's Hospital Review's 6th Annual CEO and CFO Roundtable Nov. 14, Dr. Feinberg discussed how Geisinger has pioneered patient care innovations in often overlooked locations.

The 12-hospital system serves a number of rural populations in Pennsylvania and New Jersey, covering approximately 50 counties. In many of these areas, Geisinger is increasingly making connections to how the local environment and industries impact patients' health. "The death rate is higher in some zip codes here than in some underdeveloped countries," Dr. Feinberg said.

Healthcare quality, according to Dr. Feinberg, needs to move beyond the conditions that only make up 10-15 percent of care, such as patient access and convenience. "We need to address the other 80 percent — patients' genome, their zip codes, housing, transportation, opiates, medical literacy."

In response to this idea, Geisinger examines how patients' surroundings impact their health and then explores the medically actionable conditions it can change, such as how diabetes affects low-income patients in particular zip codes.

For example, to fight diabetes patients' food insecurities in these zip codes, Geisinger launched its Fresh Food Pharmacy in 2016, just one of several innovations the system has adopted to improve patients' health outside of medical offices.

The pharmacy partners with the Central Pennsylvania Food Bank in Harrisburg to provide low-income, diabetic patients in Shamokin, Pa., with bags full of fresh produce, lean proteins and healthier sugars. "Our philosophy is to make sure that every time a patient comes in, they have fresh fruits and veggies each week," Dr. Feinberg said.  

The effort has seen tremendous success. "We've seen an amazing transition for diabetes patients, and it's been — this is hard to say — 100 percent successful," Dr. Feinberg said. "Every single patient has had a decrease in blood sugar, hemoglobin A1C levels and medication use."

Yet another patient-centered innovation is Geisinger's effort to understand genomes. In 2014, the system collaborated with the Regeneron Genetics Center to create a biobank and DNA sequencing study, which examines DNA that contains disease-related information and provides results to participants at risk for specific diseases. 

"Providers need to look toward patients' environments and genetic backgrounds, which are as important as everything else we talk about when we talk about hospitals and physicians," Dr. Feinberg added. Geisinger is extending its reach with genome mapping through its 2015 affiliation with AtlantiCare. The system's headquarters — Atlantic City, N.J. — is more racially and ethnically diverse than central Pennsylvania. 

However, perhaps the most significant innovation for Dr. Feinberg, who has long prioritized patient satisfaction, is Geisinger's ProvenExperience. The system piloted the initiative, which provides refunds to patients if they are unhappy with their care experience. Since the program launched in fall 2015, Geisinger has given over $1 million back to patients.

Dr. Feinberg discussed the idea driving the program, emphasizing that patients should be able to feel "dignified" in their experience when they are dissatisfied with the care received. Patients are too often voiceless in the healthcare system. "Imagine you're in Starbucks and they made your drink wrong. The barista sips the coffee and says, 'No we made it the right way, so you have to drink it.' That's what we do in healthcare." 

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