Primary Care and Public Health— The Intersection

1. Primary Care and Public Health—The Intersection Denise Koo, MD, MPH Director Scientific Education and Professional Development Program Office, CDC PHTC Annual Meeting, August 29, 2012 Office of Surveillance, Epidemiology, and Laboratory Services Scientific Education and Professional Development Program Office

2. The Intersection: A System for Health • A true health system (not just health care system) • System focused on improving and maintaining health • Public health and health care systems integrated together • Seamless system that leverages resources in community

4. Key Principles of this Health System (1) • Defines and measures impact on health of community • Recognizes that communities are different and efforts must be community-driven • Driven by community health needs and priorities for action • Leverages resources in the community • Involves health department and community partners • Involves coalitions of non-traditional partners (e.g., business, education)

5. Key Principles of this Health System (2) • Leverages data and technology for population health • Values critical thinking, accountability • Identifies best practices • Researches how to improve health • Implements changes based on results • Considers influences on health as a systems issue • Documents value of this integrated approach both for health care and public health

6. Key Principles of this Health System (3)--Workforce Development • Interprofessional focus that builds teams who can work together • Boundary spanners who can reach outside of “health” disciplines • Systems thinkers • Critical thinking skills, analytic capacity (judgment) • Technology-savvy • Focus on health and approach reinforced and modeled at all stages of education (including faculty development) • Positive deviants

7. CDC Public Health Workforce Development Initiative • Challenges to public health workforce • Funding, staffing declines • Workforce emphasis on health care, not health and public health • Goal: Determine priority activities and strategy for CDC • Discuss changes in public health and impact on public health workforce • Engaged partners through series of meetings • Attended partner meetings for further input • Culmination late Fall 2012

8. Public Health Workforce Development Initiative • Ongoing transformation — a “new” public health • Community-focused as well as state-based • Dealing with voluminous information from multiple sources • Engaging more stakeholders • Navigating new territory given impact of health reform • Developing stronger links to healthcare and healthcare delivery • More monitoring and measuring • Core functions of “new” public health • Convening and collaborating • Improved monitoring of community health status through community engagement; defining shared indicators • Leveraging policy change • Clear communications (including use of social networks)

9. “New” Public Health Workforce Needs • Collaborative leadership • Systems thinkers/broader definition of public health • Community Engagement • Broaden partnerships • Multiple generational workforce • Non-traditional public health workforce • Public health workforce who can link the public health and health care worlds • Informatics skills and use of technology

10. CDC Workforce Strategy-Individual Approaches • Leveraged Prevention and Public Health Fund (PPHF) funds to increase available training (esp. e-learning) and to support more fellows in the field • Fellows in epidemiology, laboratory, informatics, management • Evolve fellowships consistent with new public health • Integrate new content and experiences, especially informatics • Develop “training-in-place” programs for public health workforce

11. CDC Workforce Strategy--Systems Approaches • Defined competencies for applied epidemiologists • Collaboration with CSTE: www.cdc.gov/appliedepicompetencies • Competencies for multiple tiers of practitioner • Sample position descriptions, self-assessments • Mapped to curricula in SPHs • Defined competencies for the public health informatician • Collaboration with Univ of WA and many other partners: www.cdc.gov/informaticscompetencies • Coming this year: sample position descriptions • Collaborate with Department of Labor (DOL) to designate PHIFP as a DOL Registered Apprenticeship • Lays the foundation for a standard occupational code for the profession of Public Health Informatician

12. CDC Workforce Strategy--Systems Approaches • Complete 101 curricula in core public health sciences • Epidemiology, surveillance, informatics, prevention effectiveness, laboratory science, basic public health • Classroom-based and e-learning • Develop train-the trainer programs for 101s • Job aids for the new public health • Public health workforce enumeration • Collaboration with HRSA, academic and practice partners • Support accreditation and workforce development with CDC funding announcements • Work toward integrated LMS • Continue to support integration of applied public health in education system

13. Academic Partnerships • Redesigned CDC’s cooperative agreements • Framework: improving health outcomes • Strengthen academic-practice linkages • Population health in health professions education • Interprofessional education and training • Hands-on experience for students with communities • Expanded fellowship model: assignments at CDC or in the field • Eligible organizations: ASPH, APTR, AAMC, and AACN

14. Challenges to PHTCs • Coming together • Leverage position in academia to bridge public health and health care • Help public health workforce learn the language of health care system • Leverage the convergence of public health and health care • Link activities to education • Learning needs to occur within a context • Overarching curricular change: mission needs to be improved health • Engage learners, faculty in improving health

15. . Thank you! Office of Surveillance, Epidemiology, and Laboratory Services Scientific Education and Professional Development Program Office