Keeneland Conference: A Conversation with John Lumpkin
NewPublicHealth.org sat down with Dr. John Lumpkin, M.D., M.P.H., Senior Vice President and Director of the RWJF Health Care Practice, to talk about the intersection of public health and health care. Here are some of the questions and answers from that discussion.
NPH: Where do you see the greatest potential for the public health and health care communities to work together?
Dr. Lumpkin: There are some critical areas where public health and health care need to work together. The first is on implementation of the affordable care act, such as primary care extension systems. The systems looks to the public health departments to be the driver for reaching out to individual practices and small groups to better implement primary care and how to do it in a way that yields better quality and better efficiency.
NPH: What research questions most need to be answered now to help health departments perform at a high level and improve the health of their communities?
Dr. Lumpkin: Clearly, the number one research question that state and local health departments have is how they maximize available resources in the faces of budget cuts. More than half have had layoffs and other budget restrictions. So PHSSR, first and foremost, needs to help these agencies figure out how best to use their limited workforce to carry out essential services, and then look further—at what are their priorities if they have limited funds, what are the public health returns on public dollars that are being invested in the public health system.
NPH: How can public health improve on how they showcase the value of their work, particularly when they’re facing budget cuts?
Dr. Lumpkin: In three ways—two are traditional ones, and the third will be a challenge for public health. By having good data, and public health tends to have a lot of good data, and that data has to be converted into information through analysis. Then, make that analysis available and that is what helps create the evidence for what public health is doing.
But what public health has been less good at is in telling the story. Public health has to get better at putting a face upon the issues we deal with. For example, what we did with immunization when I was a state public health director, is that we had very few deaths in any state from lack of immunizations, but we compared the death rates in 1920 with the number of kids we had, we could show that we saved 14,000 lives. Stories have to be based on evidence, but you have to tell a story to get your message across.
NPH: What’s the intersection between public health and health in making electronic health records as valuable as they can be?
Dr. Lumpkin: Chris Gebbie, first HIV czar in the U.S., has said that public health and clinical care both use the same data, they just look at it differently. We have the opportunity with electronic health records, to learn more about what is going on about with such issues as risk factors. Public health has to get better at getting that information back to the clinicians. There is required reporting for infectious diseases, for example, but then the doctor doesn’t hear back. All of it seems to go into a black hole in public health agencies. Public health needs to get better at doing analysis of that information and feeding it back in. That will make doctors more likely to report their data to public health departments, because they would see a utility.