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Healthy Chicago: Driving Innovation in Health at the Colorado Health Symposium 2013
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Healthy Chicago: Driving Innovation in Health at the Colorado Health Symposium 2013


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Commissioner Choucair presents Healthy Chicago at the Colorado Health Symposium - Start Your Engines: Driving Innovation in Health. …

Commissioner Choucair presents Healthy Chicago at the Colorado Health Symposium - Start Your Engines: Driving Innovation in Health.

The words "levers" and "drivers" are frequently used these days to describe strategies to achieve change in health and healthcare. Often in approaching solutions to complex problems, the hardest step is choosing which lever to pull first.

Presenters share the levers they focused on to drive innovation and change. From disruptive technologies enabling better results in the healthcare delivery system, to policy and practice shifts aimed at achieving individual and community wellbeing– they provide an inspiring and thought-provoking glimpse of what our health future could look like.

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  • Healthy vending, austin farmers market/link urban ag
  • First and foremost Chicago Health Atlas is a collaboration. It came to life through the work of informatics researchers at several institutions in Chicago who asked the question: How much overlap is there in patient care? Or, in other words, to what extent are individual patients seen at more than one institution or network for their health care. The researchers were convened under the umbrella of the Chicago Regional Extension Center . This is the agency that works to promote the use of electronic health records / and provide technical assistance / in our city. The Chicago Community Trust has several projects related to expanding access to the Internet across all areas of the city. It also provides great leadership and technical skill in our local open data movement. My institution, the Chicago Department of Public Health, has been able to provide a public health perspective on potential uses of the data, and give input on approaches to analyzing the data and disseminating results.
  • Thanks to the work at Chicago Community Trust, the collaborative has a website that's up and running at This serves as the public face of the project - the place where can make data about public health indicators - as well as community assets - available to the public.
  • Chicago Health Atlas is a big database, too. It has de-identified electronic health record data for about one million Chicagoans, with in-patient and out-patient visits spanning from 2006 through 2011, and individual patient records matched across institutions. Much more detail is on the way about all this.
  • One last highlight from Healthy Chicago is the strategy to Increase the availability of public health data through the City ’s website. To that end, we now make use of the City ’s Open Data Portal to push out frequent updates of indicator data related to births, deaths, infectious diseases, environmental health, hospital discharges, and public health assets. The way it works, we don ’t provide any data directly to the Chicago Health Atlas website; the developers subscribe to our feed on the Data Portal, and can update their views with new data as it becomes available.
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    • 1. Bechara Choucair, MD Commissioner Chicago Department of Public Health @ChiPublicHealth #HealthyChicago Policy, Systems, Environmental Change & Technology in Chicago August 8, 2013 Chicago Department of Public Health Commissioner Bechara Choucair, M.D. City of Chicago Mayor Rahm Emanuel
    • 2. PRESENTATION OUTLINE 1. What Influences Public Health? Policy, Systems & Environmental Change (PSE) 2. Healthy Chicago Public Health Agenda 3. PSE Successes: Tobacco, Maternal and Child Health, Obesity, and Adolescent Health 4. Advancing Healthy Chicago Through Technology
    • 3. FACTORS INFLUENCING HEALTH McGinnis et al. The Case for More Policy Attention to Health Promotion. Health Affairs, Vol. 21 (2)
    • 4. Socioeconomic Factors Changing the Context to make individuals’ default decisions healthy Long-lasting Protective Interventions Clinical Interventions Counseling & Education Examples Poverty, education, housing, inequality Immunizations, brief intervention, cessation treatment, colonoscopy Fluoridation, trans fat, smoke-free laws, tobacco tax Rx for high blood pressure, high cholesterol, diabetes Eat healthy, be physically active Smallest Impact Largest Impact HEALTH IMPACT PYRAMID
    • 5. POLICY, SYSTEMS & ENVIRONMENTAL CHANGE (PSE) •Makes default decisions healthy •Big impact & sustainable •Relatively little time and resources needed •Engages diverse stakeholders
    • 6. POLICY, SYSTEMS & ENVIRONMENTAL CHANGE (PSE) Policy- Written statement of organizational position, decision or course of action, including ordinances, resolutions, mandates, guidelines, & rules Systems- Changes in organizational procedures (personnel, resource allocation, & programs) Environment- Physical, observable changes in the built, economic, and/or social environment
    • 7. PROGRAMS/EVENTS • Short term • Generally has beginning and end of intervention • Distinct target audience • Reliant on funding or other support for replication • Doesn‘t impact environment • Lessons learned can inform policy CHANGE IN POLICY, SYSTEMS, ENVIRONMENT • Institutionalized • Equitable reach • Sustained beyond individual champion or specific funding • Ongoing without start and stop times • May still need programmatic elements to achieve desired impact WHAT IS THE DIFFERENCE?
    • 8. HEALTHY CHICAGO PUBLIC HEALTH AGENDA • Released in August 2011 • Identifies priorities for action for next 5 years • Identifies health status targets for 2020 • Shifts us from one-time programmatic interventions to sustainable system, policy and environmental changes
    • 9. Increasing Population Impact Increasing Individual Effort Needed Smoke-free Campuses SHIFT TO PSE CHANGE: TOBACCO PREVENTION EFFORTS
    • 10. TOBACCO USE
    • 11. TOBACCO USE SMOKE-FREE CAMPUSES  3 Colleges / Universities  5 Hospitals  6 Behavioral health organizations  8 Public housing developments
    • 12. TOBACCO USE Joint Enforcement
    • 13. PSE CHANGE TO SUPPORT HEALTHY MOTHERS & BABIES 15 hospitals working towards Baby-Friendly Designation
    • 14. PSE CHANGE IN OBESITY PREVENTION Chicago Streets for Cycling Plan 2020
    • 15.  Over 200 miles of on-street bikeways, including almost 35 miles of barrier and buffer protected bike lanes.  3000 bikes to share at 300 stations OBESITY PREVENTION
    • 16. Dearborn Street - Before Dearborn Street - After OBESITY PREVENTION
    • 17. Bike Sharing in Chicago 3,000 bikes 300 stations by the end of summer 2013 OBESITY PREVENTION
    • 18. Health Goals  Increase the number of pedestrian trips for enjoyment, school, work, and daily errands  Increase the mode share of pedestrian trips for enjoyment, school, work, and daily errands OBESITY PREVENTION
    • 19.  13 licensed carts operating  30 vendors trained  30 carts planned for 2013 OBESITY PREVENTION
    • 21. A Recipe for Healthy Places •Released in January 2013 •Includes six community- based planning strategies to support healthy eating OBESITY PREVENTION
    • 22. A Recipe for Healthy Places: Strategies 1. BUILD HEALTHIER NEIGHBORHOODS: Focus planning and programs in communities with an elevated risk for obesity-related diseases 2. GROW FOOD: Create systems of productive landscapes 3. EXPAND HEALTHY FOOD ENTERPRISES: Support businesses and social enterprises that produce and distribute healthy food 4. STRENGTHEN THE FOOD SAFETY NET: Ensure that residents can eat well regardless of income 5. SERVE HEALTHY FOOD AND BEVERAGES: Change the culture of eating at work meetings, festivals, sports gatherings, community activities and places of worship 6. IMPROVE EATING HABITS: Help people discover appealing, nutritious foods Check out the food plan - OBESITY PREVENTION
    • 23. PSE CHANGE TO PROMOTE ADOLESCENT HEALTH The Office of Student Health & Wellness: A Collaboration between the Chicago Department of Public Health and Chicago Public Schools
    • 24. ADOLESCENT HEALTH  CPS hires chief health officer  Dually reports to CDPH  CDPH creates Adolescent and School Health Office
    • 25. ADOLESCENT HEALTH  Revised Wellness Policy  Competitive Foods Policy  Expanded STI Screening  $26M New grants • CTG – Healthy CPS • Teen Dating Matters • Teen Pregnancy • Farm to School • Wellness Champions
    • 26. BUILDING ON POLICY SUCCESSES Mayor Emanuel Takes Action to Protect Chicago’s Kids from Menthol Cigarettes
    • 28. Advancing Healthy Chicago Through Technology Data Portal – Flu App Chicago Health Atlas FoodBorneChi
    • 29. Chicago Health Atlas is a . . . collaboration • Informatics researchers from multiple healthcare institutions • Chicago Regional Extension Center (CHITREC) • Chicago Community Trust • Chicago Department of Public Health
    • 30. Chicago Health Atlas is a . . . website
    • 31. Chicago Health Atlas is a . . . database • De-identified electronic health record data for ~1 million Chicagoans • In-patient and out-patient visits spanning 2006-2011 • Individual patient records matched across institutions
    • 32. Developing Procedures and Best Practices • Public health indicators from City Data Portal can be viewed for temporal and neighborhood trends • Incorporating CDC guidelines for classification of map categories • How to make metadata easily accessible to users • How to deal with aggregated geographies and time periods
    • 33. Health Information Exchange Neighborhood Pages
    • 34. Health Information Exchange City Level Comparisons
    • 35. Open Data Portal Infrastructure Increase the availability of public health data through the City of Chicago website.
    • 36. Open Data Portal • Brief (recent) history of open data in Chicago • Focus on public health indicator data preparation • Navigation of the Data Portal and apps
    • 37. Open Data in Chicago • May 2011 Mayoral Transition Plan • First 100 days Data Portal expansion • December 2012 Open Data Executive Order
    • 38. Public Health Context • Most frequent requests are for statistics by neighborhood • Neighborhood summaries published once every 3-4 years by paper/PDF • Many data objects generated in response to requests
    • 39. Number of customized data objects released to individuals or institutions (rather than to public), cumulative, 2011 – May 2013
    • 40. Discussion • Open data initiatives prompted revisions in epidemiologic practices • Use of Data Portal temporally associated with decrease in releases of customized data objects • Epidemiologic concepts are being discussed and implemented in the broader community
    • 41. A Guiding Principle • What are the data or statistics you’re using to make decisions? • Trust the user . . . but also document and highlight limitations and imperfections
    • 42. Flu App
    • 43. FoodBorne Chicago  Web Application Based on Machine Learning  Mathematical algorithm  App “taught” to ID Food Poison Tweets  App “learns” relevant Tweets  Collects Chicago Food Poisoning Tweets  Human Classifier Determines Responses
    • 44. • Actionable – Submissions are Investigated • Sentinel for Outbreaks • Inspection Status: • Residents See Results Online • Open 311 • Data Portal • 50 Inspections Since Released • Future: Emergency Response, Flu FoodBorne Chicago
    • 46. FoodBorne Chicago @foodbornechi
    • 47. @ChiPublicHealth 312.747.9884