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• PHRI to Evaluate Crisis Intervention Team (CIT) Impact
• PHRG to assist FSG in developing Strategic Plan for Maine Health Access Foundation
• ITI & PHRG Selected to Provide State of California with NEDSS Solution
• HFM Publishes Dr. Deprez's Article on Strategic Survival for Rural Hospitals
• PHRG Assists the Yale New Haven HS in Planning an ED Syndromic Surveillance System
• PHRG Assists The MA Department of Public Health Develop State Strategic Biomonitoring Plan
• Neuropathic Pain Research Institute Hires PHRI to Design a Landmark Prevalence Study
• PHRI Follows-up Health Needs Assessment with Evaluation of COPD Care
• PHRG Begins Health Assessment in the Kenai Peninsula Borough of Alaska
• PHRG Begins Assessment and Planning Phase for The Maine Health Alert Network
• PHRG Completes Health Plan for Eastern Maine Healthcare
• American Journal of Public Health has Published PHRI Article on Asthma Surveillance
• PHRG Completes Planning Phase for NEDSS in Maine
• PHRG completes a study of Maine's Certificate of Need Program... Report Available [pdf]
• PHRG president and colleague complete a Book Chapter on Rural Mental Health...
• MA DPH's Bureau of Environmental Health Assessment selects PHRG for Logan Airport Health Study
• PHRG to evaluate Portland's Community Free Clinic (PCFC)
• PHRG to complete rural Maine planning study
• Bureau of Health awards consulting services to PHRG to plan for the NEDSS...
• PHRG begins Community Health Needs Assessment for Eastern Maine Healthcare
• PHRG completes community health needs assessment for the Framingham, MA area Report [pdf]
• Surveillance Data by PHRG helps ALA of Maine track Lung diseases and risk...
• PHRG completes Cardiovascular Services Needs/Demand Study for the Maine DHS Report [pdf]
• Presentation - Understanding the Forces Underlying Service Demand...
• Back to News
NAMI Maine, in collaboration with the Androscoggin County Jail, St. Mary's Hospital, Common Ties/100 Pine Street Social Center, and Tri-County Mental Health Services, has been awarded a Maine Health Access Foundation (MEHAF) grant to evaluate the adaptation of an evidence-based police response to community psychiatric crises to the Androscoggin County Jail. NAMI is contracting with Public Health Research Institute (PHRI) to conduct the evaluation. Crisis Intervention Team (CIT) is a pre-booking jail diversion program that has been shown to improve officer recognition of and response to people with mental illness, to reduce arrest rates, to reduce officer and community injuries as well as the use of restraint, to reduce emergency room admissions, and to improve community and officer satisfaction. Using a retrospective study that compares pre- and post-program data, PHRI will study the process of adapting this model to a jail setting and disseminate the results of the adaptation in Maine and across the nation. A research report will be published in a national peer reviewed journal to inform other jails considering implementing CIT in correctional settings.
The Maine Health Access Foundation (MeHAF) is a charitable foundation established in January, 2001. With annual grantmaking of close to $4 million per year, MeHAF supports strategic solutions to Maine’s health care needs, particularly for those who are medically uninsured or underserved. As the largest health-focused grantmaker in the state, MeHAF has a unique opportunity to impact the state of health in Maine.
The key challenge now facing the Foundation is how best to deploy its resources to address the opportunities and continuing gaps presented as a result of Dirigo and to capitalize on the Foundation’s emerging stature and expertise. Foundation Strategy Group (FSG) and its subcontractor, the Public Health Resource Group (PHRG) has been selected to develop a strategic plan with MeHAF. Together they provide the breadth and depth of skills required for this important strategy development project. The diverse skills and experience of the two organizations, which are highly complementary, will ensure that the Foundation receives the highest level of quality and efficiency in both process and deliverables.
Specifically, PHRG will assist FSG to complete a meta-analysis profiling the health services needs of the Maine population with special attention to the health needs relating to the mission and objectives of MeHAF; aid them in developing a set of grant making options, program strategies, and evaluation metrics that flow from the adopted goals and objectives. Additionally PHRG assist FSG in developing a monitoring plan that MeHAF can use to assess current and future interventions.
Information Technology International (www.itiweb.com), along with Public Health Resource Group have been selected by the State of California's Department of Health Services to provide the state and counties with an integrated disease surveillance system. The system will assist the state and 54 participating counties of California with automated data collection, analysis, management and reporting of communicable and emerging diseases and conditions. The system will also interface with existing information systems, electronic lab reporting, and program area (e.g. by disease) modules at the state and county levels.
PHRG will assist ITI's California deployment through the requirements definition and programmatic configuration of the state and local health environments, designing disease plans and system testing and training. PHRG is an internationally recognized provider of assessment, planning, and population-based health information services in the realms of surveillance, alert notification, and health services delivery.
HFM, the periodical of the Healthcare Financial Management Association [website], has published an article written by PHRG president Ronald Deprez, Ph.D. The article, Physician Specialty Practices: Strategic Survival for Rural Hospitals, appears in the January 2004 edition of the magazine and can be viewed in its entirety here on our site .
The Yale New Haven Health System (YNHHS), as the Center of Excellence for Emergency and Terrorism Preparedness for the southern tier of Connecticut, has hired the Public Health Resource Group (PHRG) to assist them in developing a plan for implementing a hospital emergency department syndromic surveillance system.
PHRG's responsibilities for the project include a variety of tasks. First, PHRG will assist with the development of the specific project objectives and in determining the appropriate tools to measure the effectiveness both qualitatively and quantitatively. Second, PHRG will provide a written review of the literature on the value of syndromic surveillance systems for public and private health systems. Third, PHRG will assess existing (off-the-shelf) syndromic surveillance systems and their ability to function in a pre-sample of Connecticut hospitals.
Biomonitoring is the determination of the concentrations of toxic chemicals or their metabolites in biological specimens, such as blood, serum, urine or saliva to assess the exposure of humans to contaminants in the environment. Biomonitoring is considered an enhancement of common monitoring techniques because it provides a determination of the "internal dose" of environmental contaminants. The Biomonitoring Grant Program was developed by CDC to increase the capacity and capabilities of the state public health laboratories to monitor biological specimens for environmental contaminants or their metabolites. Through this enhanced laboratory capability, environmental health researchers within state health departments can better determine associations between environmental exposures and disease occurrence. The Massachusetts Department of Public Health was one of twenty-five states to receive a planning grant from the CDC to develop a strategic biomonitoring plan.
The MDPH's State Laboratory Institute (SLI) hired the Public Health Resource Group to develop a biomonitoring implementation plan for Massachusetts. The goal of the biomonitoring plan is to provide high quality information that is useful for public health alerting, for public health decision-making and a source of reference data for medical professionals in evaluating patient exposure and in conducting research.
PHRG developed a sampling and implementation plan for obtaining, preparing, transporting and protecting the confidentiality of urine, blood and serum specimens form hospital and reference labs throughout the state. Specific objectives of PHRG's work included:
The result was the development of a comprehensive implementation plan that meets the requirement of CDC; and provides high quality information for alerting as well as testing associations among environmental hazards, exposures and health effects. The plan allows direct reporting of data on hazards exposure across health outcomes; and can interoperate with other state and national public health systems.
The Neuropathic Pain Research Institute (NPRI) is developing scientific information on the prevalence of Chronic Regional Pain Syndrome Types I and II for the adult population in the United States. The prevalence literature on Chronic Regional Pain Syndrome (CRPS) Type I and II, formerly known as Reflex Sympathetic Dystrophy (RSD) and Causlagia, is sparse.
Public Health Research Institute Group (PHRI) is assisting NPRI in this effort by designing a landmark prevalence study of CRPS. PHRI is conducting an extensive literature review and analysis on CRPS, as well as conducting structured interviews with key stakeholders to gain insights on the barriers and solutions to designing the prevalence study of CRPS. Ultimately, NPRI will seek funding for the prevalence study from NIH and other funding institutions.
CRPS is a debilitating disease that is very difficult to diagnose and costly to treat because the natural history and pathophysiology are poorly understood. Estimating the prevalence is particularly challenging because there is no set of validated diagnostic criteria that are consistently applied. Recent external and internal validation studies of the CRPS diagnostic criteria proposed by the International Association for the Study of Pain (1994) have concluded that while the proposed criteria is very sensitive; it lacks specificity. The combination of high sensitivity and low specificity leads to overdiagnosis. The clinician’s task is made even more difficult by the lack of a definitive objective diagnostic test. Instead, the clinicians rely on a loose constellation of signs and symptoms in conjuncture with excluding all other diagnostic possibilities to make the diagnosis for CRPS. This approach severely hampers the timeliness, the accuracy and the consistency of the diagnosis for CRPS. All of these factors make estimating the prevalence of CRPS problematic.
In 2001, Eastern Maine Healthcare (EMH), the parent organization of several healthcare facilities located in the rural northern and eastern counties of Maine, undertook a Community Health Needs Assessment conducted by the Public Health Resource Group (PHRG). That study substantiated the urgent need for specific efforts to address severe chronic health conditions, to reduce the high cost of care and to expand critical access to comprehensive services in rural areas of Maine. In response to those findings, EMH proposed the Rural Maine Health Improvement Demonstration Project.
With the support of the Health Resources and Services Administration Office of Rural Health Policy, EMH launched the Demonstration Project. The first initiative is organized under the aegis of the EMH-sponsored Institute for Medical Improvement (IMI) and is addressing quality improvement in the treatment of the chronic obstructive pulmonary disease (COPD) identified in the community health needs assessment. This project will engage rural primary care providers and their patients to implement evidence-based clinical guidelines for the management of COPD. Implementation in pilot practices in rural Aroostook County is expected to reach a minimum of 50 patients during the first year with expanded implementation in subsequent years. The Public Health Research Institute (PHRI) is the project evaluator and is also providing expert guidance on the design of the implementation.
Carefully selected, implemented and evaluated best practice changes is expected to result in earlier diagnosis, more effective treatment and more efficient use of healthcare resources; ultimately lowering healthcare costs and improving health status for the community.
The Central Kenai Peninsula Hospital, located in Soldotna, Alaska needs a comprehensive demographic and health information on residents as an integral part of its strategic health planning process. Public Health Resource Group (PHRG) was hired to assist them in their planning by conducting a community health needs assessment to more clearly understand the health needs and preferences of Kenai Peninsula Borough residents. PHRG has conducted over 75 health needs assessment throughout the US and overseas.
PHRG will utilize its Community and Institutional Planning Process (CIAP) to identify the health needs and preferences of citizens residing in the Central Kenai Peninsula Hospital Service Area. The findings from the PHRG report will shape the hospital’s strategic planning and future allocation of resources to more effectively and efficiently meet the needs of the Alaskan residents.
PHRG, partnering with the Maine Health Research Institute, recently began the assessment and planning phase for Maine's bio-terrorism response network-known formally as the Maine Health Alert Network (HAN). The HAN is a nationwide, integrated information and communications system spearheaded by the Centers for Disease Control. It serves as a platform for distribution of health alerts, dissemination of prevention guidelines and other information, distance learning, national disease surveillance, and electronic laboratory reporting, as well as for CDC's bioterrorism and related initiatives to strengthen preparedness at the local and state levels.
When complete, the Health Alert Network will:
PHRG's assessment technology, used most recently to develop a plan for the state's electronic disease surveillance system (NEDSS) will be used in HAN assessment and planning. The HAN engagement will utilize this technology to assess training, education, hardware and system needs for the HAN development at hospitals and local public health agencies as well as the state.
PHRG has completed a comprehensive strategic healthcare services planning study for Eastern Maine Healthcare (EMH). EMH is a system of providers serving more than half of the geographic area of Maine with Eastern Maine Medical Center, a 426-bed tertiary care hospital located in Bangor, as its flagship facility. In addition, EMH includes six other acute care hospitals, long-term care facilities, home care providers, physician practice groups, and emergency transportation organizations. Norman Ledwin, chief executive officer for EMH, commissioned the landmark study, partly because of the scarcity of data and information available from other sources. "If you don't understand the epidemiology of the region," said Ledwin, "how can you develop services that meet your clients' needs?"
"In working with EMH and its affiliates," says PHRG President, Ron Deprez, "our goal was to turn data from numerous sources into information so that EMH could better plan for service delivery." Among major findings of the study, which included nine of Maine's thirteen counties, were:
· Mental health problems are particularly high in northern, eastern and central Maine
· Cardiovascular disease is high in the region with more associated deaths than average per capita
· Cancer risks from smoking and obesity were elevated across most of the area
A lengthy set of recommendations were part of the final planning report and covered such timely areas as:
· Approaches to strengthen subspecialty physician care access in rural areas
· Standardizing hospital and doctor operating procedures in the region
· Expanding insurance coverage to uninsured children and adults through public-private initiatives
· Collaborative efforts to increase primary prevention services
· Development of a behavioral health system to divert patients away from inpatient care and towards outpatient and
home-based services
For a copy of the EMH Health Planning Report, click here [adobe acrobat reader required].
Regional reports also available: Aroostook, Bangor, Central, Hancock, Knox Waldo, Penquis, and Washington.
"Statewide Asthma Surveillance: The Development of a Prototype System" is the title of an article recently published in the American Journal of Public Health. The authors are Ronald D. Deprez, Ph.D., MPH, Nancy L. Asdigian, Ph.D., and L. Christine Oliver, M.D., M.S. from PHRG's research affiliate, Public Health Research Institute, along with Norman Anderson, M.S.P.H., Edgar Caldwell, M.D., and Lee Ann Baggott, M.D. of the American Lung Association of Maine.
Research for the article was supported by a grant from the American Lung Association of Maine to the Public Health Research Institute. In brief the authors report that several databases were found to be useful for estimating the burden of asthma in study communities in Maine, targeting areas for asthma intervention, and identifying high-risk groups. More information is available by contacting PHRG-PHRI.
PHRG recently completed a comprehensive plan for implementing the National Electronic Disease Surveillance System (NEDSS) in Maine. PHRG wrote the plan under contract to the Maine Bureau of Health. NEDSS is an IT approach to monitoring infectious disease patterns in a systematic, consistent manner and is in part funded by the US Centers for Disease Control.
PHRG completes a study of Maine's Certificate of Need Program including revised proposed legislation
For a copy of the Executive Summary of the full report, click here [adobe acrobat reader required].
The book entitled Rural Behavioral Health Care--an Interdisciplinary Guide (APA 2003) and edited by B. Hudnall Stamm features a chapter by Dr. Deprez and Mr. Gale entitled "A Public Health Approach to the Challenges of Rural Mental Health Services Integration". Using the tools of public health, the authors present a strategy for rural communities to develop and integrate their mental health delivery systems. These tools include the development of surveillance efforts to collect data on the epidemiology of mental illness among resident populations, an inventory of existing services, the mobilization of community partnerships to identify and address mental health issues, and the use of community-level data to maximize existing resources and develop services to address gaps in the system. In doing so, rural communities will strengthen the foundation of their existing mental health infrastructures and provide a base to support the development of longer-term, system-level changes.
The Massachusetts Department of Public Health's Bureau of Environmental Health Assessment (BEHA) has commissioned PHRG to assist them in a study of the potential health effects from potential environmental exposure at Boston's Logan International Airport. The project is designed to determine relationships between environmental exposure to particulates from Logan and health outcomes, including respiratory, cardiovascular, and auditory endpoints. The study, conducted with PHRG's survey research partner, Critical Insights, includes completing a telephone survey of two thousand seven hundred residents living within a five mile radius of the airport. Planning and survey design began in January 2002. PHRG welcomes the occasion to work with the Massachusetts BEHA to ensure optimal health planning for communities surrounding Logan International Airport.
The City of Portland, Maine's Public Health Division has contracted with PHRG through the UNE/Spurwink Center for Research to design and develop an on-going outcome evaluation beginning in December 2001. The PCFC, started in 1993 as a collaboration between the Portland Public Health Division, Mercy Hospital, and various volunteer clinicians, provides comprehensive primary care services to local area low income, uninsured, and homeless persons. The primary goal of the project is to determine the quality of care provided by the clinic. Compliance with a set of preventive service delivery indicators, based on accepted standards, for delivering recommended health screening and counseling services will be used in the evaluation. PHRG will conduct the study under the design of its research partner, the UNE/Spurwink Center for research.
Aroostook County Health Link, a consortium of hospitals, home health care and long-term care providers in Maine’s northernmost county, has engaged PHRG to conduct a heath needs and health services assessment. The project, to be completed by March, 2002, will focus on how member organizations can realign services to better meet the needs of area populations.
PHRG has been selected by the State of Maine to provide a complete assessment of current information technology systems and resources with the Bureau and to assist in developing a comprehensive plan for implementation of the National Electronic Disease Surveillance System (NEDSS) in Maine.
The assessment will identify the most important health care services issues in the community using scientifically valid data, comparative information, and input from local residents, providers and leaders. The assessment will take a special focus on substance abuse, and its treatment in the Bangor area and throughout the region. In addition the assessment will also focus on EMH's market for a select number of service lines by their respective service areas. The latter analysis will include market preference information from consumers as well as quantitative indicators. The end result of this project will be tangible, outcomes-based health services recommendations that improve the health of communities served by EMH and complements the financial well being of EMH.
For a copy of the Executive Summary of the full report, click here [adobe acrobat reader required].
In 1998 PHRG worked with the American Lung Association of Maine to develop a prototype lung health surveillance system. This was the first comprehensive surveillance system in the nation. As a offshoot of that project PHRG is assisting ALA of Maine in presenting asthma and other lung health indicators on the Web. The information is being used to help plan and evaluate tobacco prevention and asthma programs.
To obtain the ALA of Maine’s indicator reports, click here.
The Maine Department of Human Services awarded PHRG a contract to study the state's need for cardiology services. PHRG evaluated the demand/need for eight new diagnostic catheter labs, and one angioplasty and open-heart surgery program in Maine. For a copy of the Executive Summary of this study click here [adobe acrobat reader required].
To read the editorial by Ron Deprez and William Stason published in the Portland Press Herald, please click here.
Authors: Ronald D. Deprez, Ph.D., MPH, PHRG/Public Health Research Institute Amy S. MacNulty, MBA, The Bristol Group, Inc.
Presented at The Drivers of Healthcare Facility Planning, The Harvard University Graduate School of Design, January and March 2001, Boston, Massachusetts
Effective healthcare planning must be based on accurate and applicable health status and service demand information. The focus of this seminar will be on how to use population-based healthcare information to improve the health of client populations and growth of market share. This program will cover the methods needed to effectively use population health information in healthcare planning. A comprehensive and systematic process for assessing health status, healthcare needs, and service utilization will be introduced. Both quantitative and qualitative evaluation tools will be covered. Methods will be integrated in conceptual models and demonstrated through case studies. Discussion will also include practical approaches for applying population health data towards service-line restructuring, and identifying and benefiting from community opportunities.
