Health care in the U.S. has long been anchored in clinical data and outcomes. But there’s now widespread recognition that better health for more people requires a different approach that accounts for social, economic, and environmental factors….commonly referred to as social determinants of health.
In order to better address those factors, UPMC Health Plan established its UPMC Center for Social Impact in Pittsburgh one year ago. Social Impact partners across the UPMC integrated delivery and finance system, as well as with community organizations throughout Pennsylvania to increase access to housing, jobs, and other needs that don’t signal a person is sick — but can’t maintain good health without them.
Experts there also are conducting research about how to bring these approaches to more people — not just in Pennsylvania, but beyond.
But how do you help people when they’re not inclined to ask for assistance? Community paramedics and health workers are trained to work with the most vulnerable patients to find medical, housing, mental health, and social support.
Dan Swayze is considered a pioneer in the emerging role of community paramedicine, and mobile integrated healthcare systems. In Episode 2 of Good Health, Better World, host Ellen Beckjord talks to Dan, vice president of community services for UPMC Health Plan.
Can you talk about the spectrum of community-based services that you’re leading and that you’re working on with others at UPMC Health Plan?
I have 100-plus people now that are very quietly helping people in their kitchen and in their living room, just trying to figure out, “what problems are you having right now?”
It could be health-related, it could be otherwise. And that workforce consists of everybody from community health workers, where we’re taking them and putting them in these new roles that are taking people off of the streets that live in those communities that really represent those communities. We’re giving them a little bit of training in terms of how they can help their neighbors, and really helping them become an integral part of our workforce.
We also have very traditional nurses and social workers who have stood up and said, I can help people. They are really just trying to identify the most vulnerable of us.
And these other services that we seek to partner with, social services and some of those preventive services, come in because the healthcare system is not currently well-designed to deliver those types of services. Do you see these community-based services as something of a bridging function?
The healthcare system is the de facto place where all of these patients, regardless of their need, end up. It is a perfectly designed system for things like housing. It’s just the most expensive system, right?
So we can put you in a hospital bed overnight. We could probably find a much cheaper option if we were to work collaboratively with somebody who has other housing options available.
I can feed you if you want hospital food at a very expensive price. If I am going to offer an alternative to patients that call 911, then I need to figure out which bridge they need to cross. And that is the critical role I think we’re playing.
Dr. Dan Swayze is the vice president of Community Services for the UPMC Health Plan and the director of operations for UPMC Innovative Homecare Solutions. He co-founded and currently oversees the longest-running, sustainable community paramedic program in the United States. He has also written several papers on the subject, is frequently invited to speak at state and national conferences, and has won several awards for his work, including national recognition from the Journal for Emergency Medical Services and Physio-Control as an EMS10: Innovators in EMS recipient. Swayze also has consulted with several municipal organizations, law enforcement agencies, treatment centers and emergency service providers to transform 911 responses to overdoses from a resuscitation-only focus to a recovery-oriented system of care based on his community paramedic intervention model.
I think the community organizations that are out there, the providers that are out there.....see if there isn’t an opportunity to partner with us in a way that is incredibly different from the way that we’ve traditionally interacted with you.
How do we think about scalability when it seems obvious that that true, authentic human connection is so critical to the way forward?
If we’re going to scale our work, we have to realize we cannot do this by ourselves.
We have to find the problem solvers in every community. They’re there. And I think as we get into these community spaces, more often as we develop more of these community relationships, what we’re going to find is that the helpers have always been there.
We as a nation are facing times that we’ve never faced in our generation.
That’s going to require us all to roll up our sleeves, get our hands dirty and approach life in very different ways.
We’re at a new place. We cannot continue to do the things that have made us successful in the past and expect them to help us transition out of this pandemic phase — into whatever the future is going to hold for us.
I think the community organizations that are out there, the providers that are out there, that we’ve had these traditional roles rethink, restart those conversations with us and see if there isn’t an opportunity to partner with us in a way that is incredibly different from the way that we’ve traditionally interacted with you.
And if we haven’t had an interaction, please reach out to us to let us know that there’s an interest in a particular community.
That’s whether you’re in rural Pennsylvania or in the middle of Center City, Philadelphia.
We want to reach out to those organizations and figure out what we can do together to get through this. Because it’s the only way we’re going to succeed.
Listen to the rest of the conversation on the Good World, Better Health podcast.