Building Population Health Confidence in the Asia-Pacific And

Total Page:16

File Type:pdf, Size:1020Kb

Building Population Health Confidence in the Asia-Pacific And Hygiene Factor: Building Population Health Confidence in the Asia-Pacific & Beyond We are living in strange times. Not the least due to the raging modern pandemic but beyond, as we seek to rebalance our livelihoods on what matters most. And it is here that we find ourselves facing a great conundrum ahead – just what level of intervention will be required to build confidence into the new reality, once and for all? The focus at the moment is on the cycle of Pacific, we need to take a multi-pronged approach COVID-19 testing, therapies, vaccines. And rightly to tackling the various health, social, and economic so, the level of global collaboration on these topics dimensions of the pandemic. Continued crisis is nothing short of miraculous. According to the management and risk mitigation are certainly KPMG COVID-19 recovery frameworks being the near-term needs of the hour. deployed by national systems across the Asia- Many countries and Currently unclear how territories countries are long this phase will now past their first peak last and the severity and considering next steps of further waves Number of new cases Time Preparation and containment Mitigate peak and lockdown Recovery and relapse New reality 01 02 03 04 05 06 07 08 International Reduced Partial All Event School Full Business travel economic restriction restrictions restrictions closures lockdown as usual restriction activity lifting removed Number of new cases Self-quarantine Pandemic Hospitals and Non-clinical ‘Clean’ and ‘Dirty’ Triaging elective Emergency Workforce agility of returning declared aged care facilities healthcare healthcare sites and non-COVID- departments and team-based travelers begin lockdown of workers move established 19 cases re-open for care Cost-cutting non- COVID-19 to WFH non-COVID-19 Increased enacted to services Proliferation of Mental health cases Sustainability prevalence of preserve cash PCR lab capacity virtual care to supports put in of digital COVID-19 cases Mandatory expansion maintain access place for health Care facilities advancements Lab capacity, PPE screening at all to services workers undertake post- and equipment health facilities PPE and ventilator pandemic Care system supply chains supply chain Emergency Vaccine trials assessments redesign for under pressure Elective initiatives funding made completing primary and procedures underway available to health with approvals; specialty care Refined contact cancelled systems program rollouts tracing measures begin Fiscal pressures implemented 1 Hygiene Factor: Building Population Health Confidence in the Asia-Pacific & Beyond This article, however, focuses on KPMG’s role in In this article we will cover the story of SGClean, raising the standard level of hygiene in countries as a programme born under prior pandemics and another key interventional tool in infectious disease powered through advanced technology capabilities. control. The truth is, our societies were not nearly as The programme’s success does not just reside considerate as they should have been with cleanliness, in Singapore, as it has been expanded into other hence softer response efforts like social distancing markets too such as the Middle East region. And and the use of masks have become a key strategy this is more than a story of health policy – public in the COVID-19 fight. “Cleanliness is the first law and private sectors alike should pay attention to the of health”, as they say. So the new reality would do fostering of innovation, competitive advantages, and well to incorporate a bit of this classical thinking too. economic opportunities therein. First things first: establish the North Star The SGClean concept, as developed by Singapore • Leveraging a cleanliness framework baseline Tourism Board (STB), was actually born during the “north star”, for further refinement tied to local SARS pandemic some two decades ago, the learnings context and dynamics of which have positioned the Asia-Pacific region well • Benchmarking policies and approaches of similar for the pace and precision of response efforts to market archetypes (usually 3-5), taking note of COVID-19. Hence the first step in bringing hygiene relative maturities in COVID-19 response efforts to the forefront of discussions over the past year too has been in the bespoke design, as spearheaded by STB, of a COVID-19 “cleanliness framework”, • Conducting hands-on working sessions with the which includes details about how organisations key stakeholders to gain inputs and buy-in, cross- as well as associated individuals (e.g. employees) Ministry and also private/third sector constituents should embrace, adopt, and implement the specified such as property, transport, hospitality, among standards. Such a framework is particularly critical others for industries such as tourism and retail, in order to • Providing a level of detailed guideline reopen as quickly as possible and to engender a sense considerations, by industry, in terms of hygiene of trust amongst local communities. requirements, assessment protocols, verifications, reporting, and remediation plans In expanding similar concepts across borders, some of the sub-steps have included: Subject to the final rounds of approval, the sealed policy will be created as well as the legal implications therein. 1 Hygiene Factor: Building Population Health Confidence in the Asia-Pacific & Beyond Singapore Hong Kong United States Switzerland Portugal Turkey Health Advice on Prevention SGClean Quality Clean & Safe Clean & Safe Safe Tourism Initiative of COVID-19 for Safe Stay Logo Mark Label Seal Certification Hotel Industry (Interim) January 2020 Period March 2020 (Updated April May 2020 May 2020 April 2020 May 2020 Introduced 2020) Singapore Tourism Board, Centre Ministry of National for Health American Hotel Culture and Switzerland Turismo de Lead Authority Environment Protection & Lodging Tourism for Tourism Portugal Agency, (Department Association the Republic Enterprise of Health) of Turkey Singapore Sector Lead Public Public Private Public Public Public Approach Voluntary Voluntary Voluntary Voluntary Voluntary Voluntary Fees will include Free No indication fixed cost of Cost to N/a Free (For first of cost of Free inspection, Business (No certification) (No inspection) certification) inspection stickers, documentation Targeted 15 16 1 6 9 3 Sectors For duration of pandemic No indication of No indication of Validity 30 June 2021 Indefinite 30 April 2021 (Government to validity period validity period define at later date) With the framework in hand, deploy leading edge technology Perhaps one of our greatest learnings across the past protocols, using data visualisation and dashboarding two pandemics is about how to harness the power of techniques to proactively identify those hygiene the latest technologies in order to bring cleanliness standard issues that require intervention. programmes to a new level. With the framework ready, the second workstream in the SGClean Built upon an Azure cloud, it has undergone programme entails the design and implementation of continuous iterations since deployment during the a platform for the tracking and monitoring of the roll- first pandemic and through the COVID-19 period. out to the targeted organisations and individuals. CAST now encompasses interfaces for the web- based front end and verification layer, as well as the The core technology is known as CAST, powered by blockchain processing engine and technology-agnostic our Unify platform through the KPMG Digital Village. integration points. The platform is also now even CAST is the enabler behind the execution of SGClean being considered for dynamic risk profiling in order to for self-reporting and compliance automation serve the population mobility needs. 2 Hygiene Factor: Building Population Health Confidence in the Asia-Pacific & Beyond Web-based Processing Verifier Dynamic COVID-19 Recommended 1 user interface 2 Engine 3 Interface risk profile levels actions • Users’ dynamic risk • KPMG Unify’s engine • Officials and security profile calculated based determines risk scoring enforcement can verify Green on updated health based on collected data a person’s status • Person is healthy, has • Continue to move declaration and visited points through a simple premises not been at any high risk freely QR scan locations of COVID-19 • Can return home case. with low risk Can enter premises. UNIFY • PLATFORM Malls Processing Engine Yellow • Person has been at high • 7 days home stay risk locations or has • Keep monitoring Public been in contact with • Conduct health Transport a COVID-19 case. check at nearest • Can be refused to enter clinic/ hospital if Landmark premises. symptoms occur s Red Technology Agnostic • Person is a confirmed • 14 days home stay 4 COVID-19 case. • Badge color returns • KPMG Unify can potentially be integrated with other applications to capture • Cannot enter premises. to green once location/GPS data recovered successfully Attempting to deploy a technology-driven cleanliness programme across borders, could result in it being a victim of its own fate during a pandemic. We must initiate such programmes b preparing the local working environment for secure and efficient team collaboration under remote structures. From there, some of the sub- steps for the technology workstream include: • Defining the detailed functional requirements as aligned to local market needs, including through wide-reaching survey questions and taking into account language considerations • Arranging the cloud subscriptions to support
Recommended publications
  • Disparities in Health and Health Care: Five Key Questions and Answers
    March 2020 | Issue Brief Disparities in Health and Health Care: Five Key Questions and Answers Samantha Artiga, Kendal Orgera, and Olivia Pham Executive Summary 1. What are health and health care disparities? Health and health care disparities refer to differences in health and health care between groups that are closely linked with social, economic, and/or environmental disadvantage. Disparities occur across many dimensions, including race/ethnicity, socioeconomic status, age, location, gender, disability status, and sexual orientation. 2. Why do health and health care disparities matter? Disparities in health and health care not only affect the groups facing disparities, but also limit overall gains in quality of care and health for the broader population and result in unnecessary costs. Addressing health disparities is increasingly important as the population becomes more diverse. It is projected that people of color will account for over half (52%) of the population in 2050. 3. What is the current status of disparities? Although the Affordable Care Act (ACA) lead to large coverage gains, some groups remain at higher risk of being uninsured, lacking access to care, and experiencing worse health outcomes. For example, as of 2018, Hispanics are two and a half times more likely to be uninsured than Whites (19.0% vs. 7.5%) and individuals with incomes below poverty are four times as likely to lack coverage as those with incomes at 400% of the federal poverty level or above (17.3% vs. 4.3%). 4. What are key initiatives to address disparities? The ACA’s coverage expansions and funding for community health centers increased access to coverage and care for many groups facing disparities, and other provisions explicitly focused on reducing disparities.
    [Show full text]
  • Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk
    UNLV Theses, Dissertations, Professional Papers, and Capstones 8-1-2020 Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk Alexus Miranda Follow this and additional works at: https://digitalscholarship.unlv.edu/thesesdissertations Part of the Geriatrics Commons, Public Health Commons, and the Virus Diseases Commons Repository Citation Miranda, Alexus, "Sexually Transmitted Infections and the 65 and Older Population: Knowledge and Perceived Risk" (2020). UNLV Theses, Dissertations, Professional Papers, and Capstones. 4012. http://dx.doi.org/10.34917/22110077 This Thesis is protected by copyright and/or related rights. It has been brought to you by Digital Scholarship@UNLV with permission from the rights-holder(s). You are free to use this Thesis in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s) directly, unless additional rights are indicated by a Creative Commons license in the record and/ or on the work itself. This Thesis has been accepted for inclusion in UNLV Theses, Dissertations, Professional Papers, and Capstones by an authorized administrator of Digital Scholarship@UNLV. For more information, please contact [email protected]. SEXUALLY TRANSMITTED INFECTIONS AND THE 65 AND OLDER POPULATION: KNOWLEDGE AND PERCEIVED RISK By Alexus Maurine Miranda Bachelor of Science – Biological Sciences Chapman University 2014 A thesis submitted in partial fulfillment of the
    [Show full text]
  • Recommendations for Maternal Health and Infant Health Quality Improvement in Medicaid and the Children's Health Insurance Prog
    Anchor Recommendations for Maternal Health and Infant Health Quality Improvement in Medicaid and the Children’s Health Insurance Program December 18, 2020 JudyAnn Bigby, Jodi Anthony, Ruth Hsu, Chrissy Fiorentini, and Margo Rosenbach Submitted to: Division of Quality & Health Outcomes Center for Medicaid and CHIP Services Centers for Medicare & Medicaid Services 7500 Security Blvd. Baltimore, MD 21244 Contracting Officer Representative: Deirdra Stockmann, Ph.D. Contract Number: HHSM-500-2014-00034I/75FCMC18F0002 Submitted by: Mathematica 955 Massachusetts Avenue Suite 801 Cambridge, MA 02139 Telephone: (617) 491-7900 Facsimile: (617) 491-8044 Project Director: Margo L. Rosenbach, Ph.D. Contents Introduction ................................................................................................................................................. 1 Poor outcomes and disparities call for urgent actions to improve maternal and infant health ............. 1 The role for Medicaid and CHIP to improve maternal and infant health .............................................. 2 Opportunities to Improve Maternal and Infant Health .................................................................................. 4 Maternal health ................................................................................................................................... 4 Infant health ........................................................................................................................................ 5 Recommendations .....................................................................................................................................
    [Show full text]
  • Key Messages
    KEY MESSAGES he coronavirus disease (COVID-19) pandemic has caused significant loss of lives, disrupted livelihoods and undermined well-being throughout the world. The COVID-19 crises have underscored how unprepared most health T systems were and the negative impact this can have towards achieving the Sustainable Development Goal (SDGs). These is an urgency to invest in health systems, services and workforce. The 2030 Agenda is a powerful accountability mechanism for the world. It is now more critical than ever to take stock of the lessons learned and progress made in improving population health, and more importantly, to identify and address the gaps that persist where progress is not on track. World Health Statistics 2020 sheds light on the progress towards relevant SDGs and their implications in the midst of the current COVID-19 emergency. The report highlights the need to track population health and its determinants in a comprehensive and continuous manner. This report’s key messages are presented below. 1. The world population is not only living longer but living healthier Life expectancy and healthy life expectancy (HALE) have both increased by over 8% globally between 2000 and 2016, and remain profoundly influenced by income. Despite the largest gains in both indicators being due primarily to the progress made in reducing child mortality and fighting infectious diseases, low-income and lower-middle-income countries continue to suffer from the poorest overall health outcomes, lagging far behind the global average. To effectively sustain the progress in ensuring longer and healthier lives, timely and effective health policies and interventions are needed to minimize the potential direct and indirect impact of COVID-19 on life expectancy, due to excess mortality, and on HALE for populations of different ages, especially among older adults.
    [Show full text]
  • Environmental Gradients and Health Inequalities in the Americas
    Sustainable Development and Health Equity Technical Report Series 1 Environmental Gradients and Health Inequalities in the Americas Access to Water and Sanitation as Determinants of Health This report shows that, while the Region of the Americas as a whole was on track to meet the targets of MDG 7 in water and sanitation, large, pervasive, and growing inequalities between and within countries remain hidden behind the regional averages. Tackling these environmentally determined health inequities should be the highest priority in the post-2015 development agenda: inequality is a growing threat to both global health governance and sustainability. The first step is to document, measure, and monitor these inequalities. This report could serve as a benchmark for assessing the impact of actions taken toward health equity under new and existing policies and comparing the results over time. Sustainable Development and Health Equity Technical Report Series 1 Environmental Gradients and Health Inequalities in the Americas Access to Water and Sanitation as Determinants of Health Special Program on Sustainable Development and Health Equity Washington, D.C. 2016 PAHO HQ Library Cataloguing-in-Publication Data **************************************************************************************** Pan American Health Organization Environmental Gradients and Health Inequalities in the Americas. Access to Water and Sanitation as Determinants of Health. Washington, DC : PAHO, 2016. 1. Social Determinants of Health. 2. Environmental Health. 3. Water Value. 4. Water Supply. 5. Sanitation. 6. Health Inequalities. 7. Equity in Access. 8. Gradient. 9. Americas. I. Title. ISBN: 978-92-75-11913-6 (NLM Classification: WA 30.5) © Pan American Health Organization, 2016. All rights reserved. The Pan American Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full.
    [Show full text]
  • Planning for Population Health Improvement ……………..…………………...5
    Maryland Population Health Improvement Plan: Planning for Population Health Maryland Department of Health and Mental Hygiene Office of Population Health Improvement Improvement 12.31.2016 December 31st, 2016 1 Table of Contents Executive Summary ………………………………………………………………….…………….. 3 Introduction to Planning for Population Health Improvement ……………..…………………...5 Maryland Population Health System Transformation………………………………..………......7 The Maryland All-Payer Model Background Planning for Population Health Improvement within the Maryland Context Existing Population Health Infrastructure Importance of Population Health Improvement Planning Data Broadening the Concept of Prevention ……………………………………………………………15 Population Health Management and Population Health Improvement 3 Buckets of Prevention Stakeholder Engagement …………………………………………………………………………..19 Planning for Population Health Improvement: Prioritization Framework and Process……… 21 Planning for Population Health Improvement: Net Savings and Return on Investment (ROI) Concepts ………………………………………………………………………………………......... 24 Future Design Work for Planning for Population Health Improvement..................................... 26 Planning for Sustaining Population Health Improvement Next Steps Vision for Implementation ………………………………………………………………………… 32 Appendices………………………………………………………………………………………… 33 Bibliography ……………………………………………………………………………………….. 73 2 Glossary of Terms ACO: Accountable Care Organizations CDFI Fund: Community Development Financial Institutions Fund CHNA: Community Health Needs Assessment
    [Show full text]
  • Fundamentals of Population Health
    Whose Health Is It, Anyway? Fundamentals of Population Health ACP Illinois: Internal Medicine 2016 November 18, 2016 Dave Steward, M.D., M.P.H., M.A.C.P. Vice Chair for Diversity, Inclusion, and Community Engagement Department of Internal Medicine Southern Illinois University School of Medicine [email protected] Nothing to disclose Objectives 1. How does Population Health fit in the whole scheme of health care? 2. What does “Population Health” really mean? 3. How does Population Health work in practice? Objectives 1. How does Population Health fit in the whole scheme of health care? 2. What does “Population Health” really mean? 3. How does Population Health work in practice? The Triple Aim Care, Health, and Cost Berwick, Nolan and Whittington, The Triple Aim: Care, Health, and Cost. Health Affairs 27, no. 3 (2008):759-769 Improving the Health of Populations Improving the Individual Experience of Care Reducing the Per Capita Costs of Care for Populations The Triple Aim Care, Health, and Cost Berwick, Nolan and Whittington, The Triple Aim: Care, Health, and Cost. Health Affairs 27, no. 3 (2008):759-769 Specifying a population of concern Examples: all diabetics in Massachusetts all people in Maryland living at <300% of the poverty level all citizens of a county all of Dr. X’s patients Health Care System Initiatives Related to Population Health • Community Health Needs Assessments – All not-for-profit hospitals, every three years • Accountable Care Organizations (ACO’s) • MACRA, MIPS, APMs • Center for Medicare and Medicaid Innovation – Example: Accountable Health Communities • Health system screens patients and refers to social services Objectives 1.
    [Show full text]
  • Population Health Epidemiologist I
    Population Health Epidemiologist I GENERAL STATEMENT OF DUTIES Performs basic epidemiologic and statistical analyses, and health planning for Tri-County Health Department (TCHD). Applies epidemiological and statistical methods, and geographic information systems (GIS) to understand the distribution and determinants of disease in populations to inform and guide decision-making and prioritization surrounding TCHD’s efforts to improve population health. This includes providing current research, data management, and statistical analyses for evidence-based decision-making, conducting community health assessments, and using data for program planning. Works independently and may assume project management and lead technical responsibilities as directed by supervisor. REPORTING RELATIONSHIPS Supervision Received: Supervision is provided by the Informatics, Epidemiology and Health Planning Manager Supervision Exercised: No formal supervisory responsibility. ESSENTIAL DUTIES Any one position may not include all of the duties listed, nor do the listed examples include all tasks, which may be found in positions of this class. The Tri-County Health Department retains the right to modify or change the duties or essential and additional functions of the job at any time. Develops and applies epidemiological approaches to understand and describe the distribution and determinants of disease in populations and identify trends. Uses analysis to inform and guide decision-making and prioritization surrounding TCHD’s efforts to improve population health. Utilizes mathematical and statistical methods using SAS or other statistical software to perform data analysis. Performs descriptive and inferential statistics to support data-driven decision making for population-based program planning. Uses Geographic Information Systems (GIS) to map health, demographic and programmatic data to help inform the work of TCHD programs.
    [Show full text]
  • Health for Every Mother
    HEALTH for Every Mother A Maternal Health Resource and Planning Guide for States SPRING 2015 2030 M STREET, NW | SUITE 350 | WASHINGTON, DC 20036 PHONE: (202) 775-0436 | FAX: (202) 775-0061 ABOUT AMCHP The Association of Maternal & Child Health Programs (AMCHP) is a national resource, partner, and advocate for state public health leaders and others working to improve the health of women, children, youth, and families, including those with special health care needs. AMCHP supports state maternal and child health (MCH) programs and provides national leadership on issues affecting women and children. We work with partners at the national, state, and local levels to expand medical homes, provide and promote family-centered, community-based, coordinated care for children with special health care needs and facilitate the development of community- based systems of services for children and their families. 2 Table of Contents A Message to Our Members ........................................................................................................ 4 An Invitation to Our Partners ..................................................................................................... 5 Where is the M in MCH? ............................................................................................................... 6 What’s Inside ............................................................................................................................... 8 How to Use the Maternal Health Resource and Planning Guide .............................................
    [Show full text]
  • Population Health Advisory Committee's Summary of Strategies
    Population Health Advisory Committee I. Summary of T3: Testing, Tracing and Tracking It is tempting to say we are too far behind to stop the epidemic. While we are behind in our response, we can slow it down. We know from previous outbreaks, including SARS and H1N1, as well as the 1918, 1957, and 1968 influenza pandemics that we can expect to see multiple waves. Our aim now is to minimize the second peak. The proven public health approach to COVID-19 includes three interventions to reduce exposure and new cases. The multiphase plan depends on widespread testing, extensive contact tracing and centralized isolation. Dr. Ashish Jha, director of the Harvard Global Health Institute explains that without testing, we are blindfolded and if we’re going to get testing ramped up, local and state officials and the private sector will have to do it. The "Wakayama model" in Japan adopted strict coronavirus testing policies and managed to curb the pandemic in their community. “It's a lesson in how nimble thinking and concerted action — grounded in fast, well-targeted testing and tracing — can beat back the novel virus and break its chain of transmission.” In South Korea, health officials tested a broader sample of the population, which allowed epidemiologists to better understand the extent of the disease in the community and target the response efforts. While there is community transmission, risk of exposure is not the same for every person in the area. The risk is greatest for persons who have/had prolonged close contact with a COVID-positive person.
    [Show full text]
  • Using Data to Reduce Health Disparities and Improve Health Equity
    Hospitals and health systems are looking at Using Data to Reduce ways to use data to leverage new capabilities to improve health outcomes for patients Health Disparities and and their communities Improve Health Equity MARKETINSIGHTS 2 Executive Summary Using Data to Reduce Health Disparities & Improve Health Equity The COVID-19 outbreak in the U.S. has shown the country what all hospital and health systems leaders have known for years: Serious gaps exist in access, cost and quality for patients based on their race, ethnic- ity, gender and gender identity, age, sexual orientation or other demographic and socio-economic factors. Hospitals and health systems have the opportunity to use data to identify disparities in outcomes which are the result of inequities and societal factors that influence health. ExploreAHA’s Societal Factors that Influ- ence Health: A Framework for Hospitals for insights into how hospitals can address social needs, social determinants and COVID-19 hospitalization by race/ethnicity the systemic causes of health inequities. Data-related resources This graphic shows the rate of laboratory-confirmed Hospitals and health systems can apply the data they have available from the COVID-19-associated hospitalizations in the US from March 1 to drive their strategy to advance health equity. They can also AHA Center for Health to December 28, 2020. A systemic review examining the role use insights culled from data to identify health care dispari- Innovation and IFDHE of race in hospitalization and death due to COVID-19 in the ties, find the root causes and craft targeted interventions to Annals of Internal Medicine (Dec.
    [Show full text]
  • The Future of Public Health: Personalized, Participatory, Predictive, Precise
    Deloitte | A Middle East Point of View - Spring 2021 | Healthcare 34 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare The future of public health: Personalized, participatory, predictive, precise The Covid-19 pandemic has changed the entire concept of public health. As we progress through it and the subsequent global mental health pandemic we are likely to face, a future of public health that is personalized, participatory, predictive, and precise will help us navigate changed public health principles and how we deal with ourselves. 35 Deloitte | A Middle East Point of View - Spring 2021 | Healthcare ublic health has developed from analysis of their health all the way down focusing only on health to their genes and granular behavioral P promotion and lifestyle insights (to be combined with data for paradigms—to avoid many preventable Population Health Management), leading diseases—to a more holistic view beyond to decision-making and tailored traditional/clinical personal health and treatments based on data. Finally, the reactive care to include social, political, digitally-enhanced user experience and economic, environmental, and public health and healthcare journeys for geographic determinants, all while individuals, payers and care providers will improving outcomes and ideally reducing be seamless and interoperable, allowing costs. for greater satisfaction, empowered self- management of care, increased With the advent of globalization, efficiency, and reduced costs. increased interconnectedness, social media, and more readily available Public health becomes personalized education, individuals are steadily and predictive becoming the stewards of their own As populations continue their health. We are living in a culture of health demographic and epidemiological and well-being, in which a well-informed, transitions, and people start suffering more health literate person is the from consequent diseases related to ultimate decision-maker and is at the aging, longevity and increased life center of their own health.
    [Show full text]