San Diego : Interventions stories

We've created a patient activation campaign that we plan to be the centerpiece of our effort, that will be the centerpiece of our advertising in the media, in the shopping paul, ones buses and what night. i would like to show a bu of them here with you. first, a grandfather and grandson.

Teaching him how to serve, very San Diego appropriate pendant and the saying reads "his first perfect wave, be there. "we also plan to focus very closely upon minorities and undeserved and here you see an African American fathers dancing with his father at her wedding. the saying reads "it's her time to shine, be there.

We intend to get more intention in our messaging as we go along. here you see a picture of a daughter sitting next to her father whose picture is ghosted out, indicate that he's deceased. the bring reads, the ring i mess most is our heart to hearts. there's a little saying on the father that says every five hours someone in San Diego dies of stroke. the last example here shows the son playing chess with his father who is ghosted out. and the saying reads "dad, you never let me win. now i would do anything to have you beat me just one more time. "and the saying on the bottom, "heart disease kills over 100californians each year. "we hope that these kinds of messages will incentive people to take care of themselves so that they can be there for loved ones. so, to summarize, we have initiated a call to action to eliminate cardiovascular disease from San Diego, although we aim for heart attack and stroke-free zone, a more realistic but still audicious goal would be to reduce heart attacks and stroke by 50% in five years. thus far, the entire medical community has been organized. we've been fortunate to receive philanthropic support. activation campaign is fully developed and we have a strong integration with San Diego county health programs. we hope that what we're doing in San Diego and the program that we are creating will be one that can be translated to other communities throughout the country and, in fact, throughout the world.

Thank you very much for giving me the opportunity to bring you up to date on what we've been doing to eradicate heart disease in San Diego.

Now back to Janet. I want to thank all our speakers and encourage those of you who have questions to go to the microphone at either end and ask your question. and tony, i spent more than a couple of decades in northern California. you spent time there, too. i just have a tip for you guys in southern California.
That surf board lesson, it actually works better in the ocean than the beach. so, anyone have a question?i do -- while you're thinking of yours, you know, it strikes me that you all, each in your own way, touched on this concept of behavior change, the the need for behavior change. individual level, system level. where i'm going here is to ask your thoughts for the group about the incentives, either the carrots or sticks that you've seen in your work so far or your building into your work. how do we shake behavior through incentives. question  just, two incentives we're looking at with physicians, one of them is having the feedback. the second is whether reimbursement actually makes a difference or physicians are motivated not to i'm profit their quality of care the patients, financial incentive doesn't make a difference. we have a study going on now.

We don't have the results yet. looking at the early data it looks like we will need both. there may be additional benefit with financial incentives around quality improvement. quickly name four things. one, reporting and feedback, so we think this is critical for clinicians also informing patients. two, patient incentives, so we're moving away from a fee for service model. three, and i was remiss not to hit on this more during the talk. make a lining the public health and the medical care enterprises come from a background of collaborative improvement model, thinking about community and population health. i think the more cms, cdc and others can bring that public health and clinical care together as dr.  friedens alluded to is critically important. i think the last, which i -- is, i think, basically aligning with professionalism. i think we have a lot of ability to work with professionals,whether it be public health professionals or clinical professionals and utilizing that intrinsic motivation for improvement.