The IHI Triple Aim: Changing Care and Communities

​This story first appeared in IHI's 2013 Progress Report.

 

A simple question from an Allegiance Health board member in 1999 upended the way this hospital and health system in Jackson, Michigan, cares for patients. At the time, Allegiance, which owned the local health maintenance organization (HMO), was facing an employer outcry after a proposed 40 percent premium increase. In the ensuing discussions, one board member asked, “Why does the HMO want to maintain this community’s poor health? We should become a health improvement organization, not a health maintenance organization.”

 
Allegiance Health’s focus on health improvement led to the creation of the Jackson Community Medical Record.
More than 50% of residents are now accounted for in this leading-edge medical records database.

Over the next decade, this one moment was the guiding light that led Allegiance to do just that. In 2000, the organization created “It’s Your Life,” an employer-based health management program designed to improve both the experience of care and the health of the community by using health coaches to encourage employees to take control of their own preventive care. Then in 2006, Allegiance partnered with the Jackson Physicians Alliance to create the Jackson Community Medical Record, a county-wide database at the leading edge of medical record use.

 

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Photos: Jackson, Michigan; Ray King, MD, Allegiance Health Senior Vice President and CMO

 

 

“Now, instead of each physician’s office maintaining individual patient records in isolation, more than half of the population is in the community medical record,” says Ray King, MD, Allegiance Health Senior Vice President and CMO.

 

In 2009, IHI invited Allegiance to participate in the Triple Aim initiative — which focuses on simultaneously enhancing patients’ experience of care, improving overall population health, and reducing costs — as a prototyping partner.

 

Defining Moment
One board member asked, “Why does the HMO want to maintain this community’s poor health? We should become a health improvement organization, not a health maintenance organization.”
“It was a big advantage to put our work within that framework and look at it through that lens,” says Amy Schultz, MD, MPH, Director of Prevention and Community Health at Allegiance and Medical Director of the Jackson County Health Department. “It was also exciting to find other people doing this work in other places around the country, so we could come together and share ideas.”

 

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