While the federal government may be declaring an end to the COVID-19 public health emergency, there are still significant, longstanding gaps in the public health infrastructure in the U.S. Investing in the resilience of the public health system can help promote health equity, maintain the health and well-being of communities, and ensure better preparedness for future health emergencies. That is where a new coalition is key to improving the public health infrastructure.
Careful coordination across the health care system is essential for supporting a safer future with public health, which is why Kaiser Permanente is working closely with the AMA, AHIP, Alliance of Community Health Plans and the American Hospital Association. This new health care industry coalition will ensure the nation’s health care and public health systems have the tools, knowledge and working relationships needed to respond effectively to future emergencies.
“Unfortunately, few of us in health care had a well-defined playbook nor an opportunity to rehearse for this pandemic. We improvised as best we could, and we saw tremendous courage on both sides,” Greg A. Adams, CEO of Kaiser Foundation Health Plan Inc. and Hospitals, said during an event hosted by Kaiser Permanente.
“We have emerged with some wounds and scars from this shared experience and have learned that we must get better at planning for future health crisis events that we know will happen,” Adams said. Several of the Permanente Medical Groups, which provide care to Kaiser Permanente members, are part of the AMA Health System Program.
Gerald Harmon, MD, immediate past president of the AMA, represented the AMA at the launch event. Dr. Harmon noted the “AMA’s commitment to public health is evident in our long-standing mission which is ‘to promote the art and science of medicine and the betterment of public health.’”
In 2021, the AMA Council on Science and Public Health studied ways to strengthen the nation’s health and public health system infrastructure (PDF). The policies adopted by the House of Delegates as a result of that report will be furthered through the work of this new coalition. Health care organizations have a role to play in raising the visibility of public health to ensure the work they do to advance health is appreciated and valued.
More than a year ago, Kaiser Permanente began reaching out to industry and community partners to start the conversation on how to improve public health and better prepare for the next emergency. And after conducting several rounds of surveys of more than 40 national experts, the health care industry coalition partners determined four focus areas.
The first focus area “is building a durable connectivity between public health and health care through formalized mutual agreements, joint planning and explication of mutual responsibilities, tasks and deliverables,” said David Grossman, MD, MPH, vice president of social health and equity at Kaiser Permanente.
“The connectivity between public health, private sector and health care is of critical importance,” said Richard McCarthy, MD, executive medical director for the Mid-Atlantic Permanente Medical Group, a member of the AMA Health System Program.
For example, Dr. McCarthy said, “we were able to partner with the state of Maryland to vaccinate thousands of Marylanders and pool our resources to provide better services for the community and vaccination.”
“The second is ensuring that emergency preparedness is always on in our health care institutions, so that we know that what, how, where and when to do the right things to lend assistance to our public health and our communities during those emergencies,” Dr. Grossman said.
This means building an infrastructure for collaboration between the health care sector and public health agencies that can be upscaled during an emergency.
“We need better data interoperability standards, especially for data that will help to ensure an equitable response so that everyone in our community is counted and no one is left behind,” Dr. Grossman said.
“At Kaiser Permanente we are constantly comparing outcomes between Zip codes, socioeconomic status and race,” Dr. McCarthy said. “Because of that, we’re able to track results and hone our tactics to make sure that we’re providing culturally competent care and that everyone is getting the best health care possible. We all know that data and research are needed to lead better outcomes.”
“We'd like to see a national infectious disease surveillance program that cuts across all boundaries so that public health can see in real time what we're seeing in our emergency rooms, our hospitals and our clinics,” Dr. McCarthy said.
“Disparities, which were known before the pandemic, became much more transparently available to all of us—in front of our faces—either from a data perspective or from others actually seeing it in the general public,” said Stephen Parodi, MD, associate executive director of The Permanente Medical Group, which is also a member of the AMA Health System Program.
When it comes to collecting data, “health systems are all over the map. But now that most of us are in EHRs, we are able to extract that data,” Dr. Parodi said. “We’ve got to figure out a way to transfer it and certainly that was a challenge during the pandemic.”