S1 E22 Catalyzing High-Quality Research to Address Social Needs in Healthcare Settings

Show Notes

Dr. Caroline Fichtenberg, Managing Director at SIREN (Social Interventions Research & Evaluation Network), catalyzes high-quality research that advances efforts to address social needs in healthcare settings. She joins the All In podcast to discuss her work.

S1 E21 Building and Sustaining Effective Networks to Improve Community Health

Show Notes

Dr. Danielle Varda is a scientist turned start-up founder who is the CEO of Visible Network Labs, a social enterprise that provides tools, training, and other services to help communities build their capacity to leverage network science to strengthen supportive connections and improve health outcomes. In her work, she leads multidisciplinary teams in tackling complex social systems issues using technology, research, and translation to practice. In this episode, Dr. Varda discusses how to build effective networks and shares strategies and bright spots to guide communities that are building multi-sector collaborations to improve health.

S1 E20 Collaborating to Improve Care for Medicaid and Uninsured Populations in Staten Island NY

Show Notes

Dr. Joseph Conte is the Executive Director of the Staten Island Performing Provider System (SI PPS), an alliance of clinical and social service providers focused on improving the quality of care and overall health for Staten Island's Medicaid and uninsured populations. SI PPS is one of 25 groups across the state working on the Delivery System Reform Incentive Payment (DSRIP) program, which aims to fundamentally restructure the health care delivery system by reinvesting in Medicaid to reduce avoidable hospital use. Dr. Conte discussed how the collaboration is working to improve care coordination to better address residents' social and medical needs.

S1 E19 Using Privacy-Preserving Technology to Create a Continuum of Support for Families in Tulsa OK

Show Notes

Podcast host Peter Eckart joined Jeff Jaynes, Executive Director at Restore Hope Ministries, and Aaron Bean, Managing Partner at Asemio, in Tulsa, Oklahoma during a site visit for their DASH CIC-START project, which is applying analytics technology to analyze the overlap between individuals who require basic needs assistance (eg. rent, food, utilities, etc.) and those whose children attend early childhood centers. The project utilizes an innovative technology that allows for analysis of personally identifiable information while preserving clients' privacy. The results are informing collaborative efforts to knit together programs and services to create a seamless continuum of support for Tulsa's families.

S1 E18 BUILDing a Movement Going Upstream to Address Health Disparities

Show Notes

Emily Yu, MBA, is Executive Director of the BUILD Health Challenge, an All In partner initiative that supports local collaborations between community-based organizations, health departments, and hospitals/health systems that are working to address important health issues in their communities. She shared examples of innovative multi-sector projects happening across the country and described key learnings, tools, and frameworks for multi-sector, community-driven partnerships working to reduce health disparities caused by system-based or social inequity. To date, BUILD has supported 37 projects in 21 states and Washington, DC.

S1 E17 Coordinating Care for Individuals Experiencing Homelessness in Chicago IL

Show Notes

Padma Thangaraj, MS, PMP, is the Vice President of Information Services & Analytics at All Chicago Making Homelessness History, a nonprofit organization that is working to integrate housing, health, and human services data to coordinate care for Chicago residents that are experiencing housing insecurity or homelessness. As one of the pilot awardees of DASH CIC-START, All Chicago worked to refine their mechanisms for exchanging data between hospitals, health care payers, and the county's Homeless Management Information System (HMIS). She joined the podcast to share her lessons learned and advice for others working to improve improve residential stability and health outcomes through the integration of HMIS and other data.

S1 E16 Bringing Multi-Sector Partners Together to Tackle Obesity in Hunterdon County NJ

Show Notes

This podcast episode features the work of the Hunterdon County Partnership for Health, a multi-sector coalition that includes over 60 community agencies that share a common interest in improving health in Hunterdon County, NJ. Kim Blanda is a Project Director at Hunterdon Healthcare, Dr. Rose Puelle is a Senior Director of Population Health at Hunterdon Healthcare, and Karen DeMarco is the Director of the Hunterdon County Department of Health. Together, they are working on a project funded by New Jersey Health Initiatives (NJHI) focused on healthier weight as a mechanism for improving community health. The Partnership is addressing obesity-related social determinants of health related to access and transportation, mental health and healthy behaviors.

S1 E15 The National Inventory of Data Sharing Collaborations for Health

Show Notes

A special message from Podcast Host Peter Eckart: All In released a new survey that will inform a national analysis of community partnerships that are systematically sharing data across sectors to improve health. Your contribution will help highlight opportunities to advance a common agenda that can support and expand this crucial work!

S1 E14 Analyzing Health and Human Services Data to Maximize the Impact of Public Funds in Chicago IL

Show Notes

This episode features two guests from the University of Chicago -- Dr. Julia Koschinsky, the Executive Director for the Center for Spatial Data Science, and Dr. Nicole Marwell, an Associate Professor in the School of Social Service Administration. They are leading a project, funded by the Public Health National Center for Innovations (PHNCI), which is analyzing data on geographic access to health and human services to help government officials address gaps and maximize the impact of existing resources. The project will offer a replicable framework and tool for analyzing and improving distributions of public funds for health and human services.

S1 E13 Empowering Communities to Discover and Use their Assets to Create Change

Show Notes

Asset-Based Community Development (ABCD) is a large and growing movement that considers local assets as the primary building blocks of community development, social capital, and health and well-being. Ron Dwyer-Voss, MA, the Owner of Pacific Community Solutions, who also happens to be a long-time friend of podcast host Peter Eckart, joined the show to discuss how ABCD draws on existing strengths of local residents, associations, and institutions to build stronger, healthier, and more sustainable communities. He shared strategies, tools, and examples of how ABCD can be used to engage community residents and support them in understanding and applying their power to improve their neighborhoods.

S1 E12 Adding New Partners Sectors and Data to a Care Coordination System in Humboldt County CA

Show Notes

This episode features Martin Love, CEO and Jessica Osborne-Stafsnes, Program Manager at the North Coast Health Improvement and Information Network (NCHIIN) - a non-profit health information exchange in Humboldt County, CA. NHIIN focuses on exchanging information across multiple sectors - including social care, medical care, behavioral health, criminal justice, education and more - to support care coordination and improve health. As an awardee of DASH CIC-START, NCHIIN worked with partners to add new organizations, sectors, and data streams to ACT.md, their care coordination and alerts notification system. They provided insights about engaging partners to incorporate the system into their workflows to provide more holistic care for patients, especially those with complex health and social needs.

S1 E11 Advancing Health Equity in Data Collection Analysis and Reporting

Show Notes

Applying a health equity frame during every phase of the data process can help communities understand and address the root causes of persistent health disparities. Marijata Daniel-Echols, PhD, Director of the Center for Health Equity Practice at the Michigan Public Health Institute (MPHI), and James Bell, MSW, Director of Policy & Engagement at MPHI, joined the podcast to explain the ways in which the development of research questions, data collection and analysis methods, and reporting strategies can either promote or thwart health equity. They also shared strategies and examples of how communities can capture and lift up diverse perspectives through a combination of data and storytelling.

S1 E10 Coordinating Health and Social Services in San Diego CA

Show Notes

Karis Grounds, Vice President of Health and Community Impact at 2-1-1 San Diego, joined the podcast to discuss how she is supporting the strategic development of San Diego's community information exchange (CIE), a technology platform that is enabling data sharing and collaboration between health and social service providers to deliver person-centered care and improve health equity. Grounds shared strategies for aligning multi-sector partners around a shared language and an integrated technology platform to deliver enhanced care coordination. She also discussed how 2-1-1 San Diego is spreading its impact by sharing practical tools to help other communities make progress towards implementing a community information exchange.

S1 E09 How Can Neighborhood-Level Data Improve Health and Equity

Show Notes

Leah Hendey, MPP, Senior Research Associate at the Urban Institute, joined the podcast to reflect on her experiences co-directing the National Neighborhood Indicators Partnership (NNIP), a nationwide effort to advance the use of neighborhood-level data to drive local decision-making. NNIP is led by the Urban Institute and a network of 32 partners representing local data intermediaries across the country. Hendey discussed the role local data intermediaries play in their communities, explained how neighborhood-level data can be used to understand and address issues of health equity, and shared examples of communities that have successfully used neighborhood information systems in innovative ways to solve pressing public health challenges.

S1 E08 Partnering with Residents to Improve Asthma through Housing in Greensboro NC

Show Notes

Josie Williams, Project Coordinator at the Greensboro Housing Coalition, joined the podcast to discuss a BUILD-funded project called Collaborative Cottage Grove that is fostering resident-led efforts to improve poor housing conditions that are leading to asthma-related emergency department visits in the Cottage Grove neighborhood of Greensboro, NC. Motivated by a desire to improve conditions in neighborhoods similar to the one she grew up in, and guided by resident voices, Williams is working with multi-sector partners to map asthma hospital visits and housing condition data to identify areas in need of support. The collaborative is also in the process of developing an electronic referral system to link families with asthma education and housing assessments.

S1 E07 Capturing the Community Voices Behind the Data in Denver CO

Show Notes

Podcast host Peter Eckart joined Jodi Hardin, Co-Executive Director of Civic Canopy, during a site visit for their DASH CIC-START project, which is using a Results Based Accountability methodology to harness community member and partner perspectives and move from talk to action around measures, indicators and data-informed decision-making. They are part of a multi-sector collaboration called East5ide Unified that aims to ensure all children and families in East Denver are valued, healthy, and thriving. As part of their CIC-START project, East5ide Unified is developing a framework to document shared results and measures of success they aspire to achieve and identifying the routines and structures needed to utilize the data to meet their goals.

S1 E06 An Equitable Approach to Community Heath Planning in Garrett County MD

Show Notes

Podcast host Peter Eckart met up with Shelley Argabrite, health planner for Garrett County Health Department, while they were both at the Communities Joined in Action conference in Atlanta, GA. Shelley explained how the health department has developed a digital data platform that has transformed the way they engage hard-to-reach rural residents in community health planning, making the process more equitable and using multi-sector data to drive decision-making. She also shared how, with funding from the Public Health National Center for Innovations (PHNCI), Garret County Health Department is working to make the digital tool available to other communities across the U.S.

S1 E05 Public Health Innovation What Is It and How Can It Be Achieved

Show Notes

Jessica Solomon Fisher, is the Chief Innovations Officer at the Public Health National Center for Innovations (PHNCI), the newest partner to join the All In network. Fisher joined the podcast to explain how PHNCI is working to make innovation a useful tool for public health departments rather than a buzzword. She shared examples of innovative initiatives happening in communities across the country and gave advice for overcoming the many challenges to driving meaningful change. PHNCI continues to work to foster a multi-sector learning community to help identify and test new and innovative practices to improve public health capacity.

S1 E04 Connecting Hospitals and Food Pantries in Dallas TX

Show Notes

Stephanie Fenniri, senior community partnerships manager at the Parkland Center for Innovation (PCCI) and Dr. Yolande Pengetnze, medical director at PCCI and a board-certified pediatrician, joined the podcast to discuss a DASH-funded project that is connecting hospitals and food banks in Dallas, Texas to improve the nutrition of patients who experience food insecurity and have been diagnosed with chronic diseases like hypertension and diabetes. They are developing a network of health care and community-based organizations in the Dallas region that are sharing information through the Dallas Information Exchange Portal.

S1 E03 Integrating Data to Ensure All Children Thrive in Cincinnati OH

Show Notes

Dr. Andy Beck is a pediatrician at the Cincinnati Children's Hospital Medical Center, where he conducts research focusing on population-level health disparities and forms partnerships with community organizations to reduce risks related to poverty. He sees patients as a primary care and hospitalist pediatrician. Dr. Beck joined the podcast to discuss a project that is addressing disparities in hospital bed days for kids with asthma and respiratory issues in Cincinnati's Avondale neighborhood. The project, which was partially funded by the Community Health Peer Learning Program (CHP), a founding All In partner, integrates inpatient hospitalization records and geographic information systems to better understand and address underlying social determinants of health.