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College announces chronic care degree program

First in nation

College announces chronic care degree program

A Philadelphia university will soon become the nation’s first to offer a chronic care management degree program and a doctorate in population health.

The Jefferson School of Health Policy and Population Health (JSHPPH) will open its doors in 2009 with three master’s degree programs in public health, health policy, and healthcare quality and safety, as well as certificate programs in health policy and healthcare quality and safety. The quality and safety program will only be the second such program in the nation, following the program at Northwestern University School of Medicine.

In 2010, the school will add master’s and certificate programs in chronic care management and a doctorate in population health/health policy. Private sector certificates in chronic care management are available, but this is a first for a university, says David B. Nash, MD, chair of Jefferson Medical College’s department of health policy in Philadelphia. Jefferson decided to take on the topic because of the need for education about population health and healthcare’s consumer movement, Nash says.

Although many have promoted the need for chronic care management, Nash says there is limited training in DM practices and interventions, adding that it’s no longer possible to achieve clinical excellence, to educate medical health professionals, and to serve the community without making health policy and population health a central focus.

Nash says the chronic care management program will help graduates assume leadership roles in managed healthcare, DM organizations, integrated healthcare delivery systems, community-based service or advocacy organizations, public service, and ambulatory settings.

The program will prepare graduates to:

  • Develop, implement, and evaluate coordinated, system-based strategies to effectively prevent and manage complex health conditions of patients
  • Promote patient engagement through shared decision-making

The school’s instructional format will be a blend of online and traditional approaches that officials say they believe will suit the student population.

The degree programs will emphasize fieldwork, experimental learning, and interprofessional collaboration.

The courses will focus on disease prevention, protection against environmental hazards, healthy behavior promotion, and system changes to support healthy lifestyles.

Course content will cover topics such as the medical home, electronic medical records, the rise in consumerism, chronic care management, workplace wellness, case management, and prevention.

Why is a school needed?

Chronic disease accounts for 75% of all healthcare spending and affects an estimated 133 million people in the United States, close to half of the population, according to Jefferson.

And that doesn’t count nonmedical costs, such as presenteeism and absenteeism. According to Jefferson, chronic disease accounted for 80% of healthcare spending in Pennsylvania in 2007. In addition, four out of every five hospitalizations, 76% of physician visits, and 91% of all filled prescriptions are due to chronic disease, it states.

Nash says healthcare is in a crisis, and chronic ill-ness is an epidemic. Healthcare leaders need information on quality and safety improvement and the challenges related to access, coordination, disparities, and cost. They must also address affordability, accessibility, efficiency, productivity, quality, and safety. The aging of the U.S. population, coupled with a shortage of trained professionals with specialized expertise, creates a need for population health, he says.

During an earlier strategic planning process, Thomas Jefferson University identified population health and health policy as one of five key strategic priorities. Nash says the university created a task force that researched the topic and ultimately presented a plan to the Jefferson board July 28.

Nash says the new program doesn’t need expensive equipment and laboratory space like other medical schools, so the new school is actually a low-cost, low-risk, high-visibility opportunity. “Those are the kinds of things leaders like,” he says.

Jefferson will link the new school closely with Jefferson’s Disease Management journal, which will now be called Population Health Management, and the annual colloquium, which will be renamed the Population Health Colloquium. “I think it’s a reflection of our new thinking about the new school and where the field is going,” Nash says.

The change to population health is part of a larger movement within the industry. DM companies have transitioned from caring solely for the chronically ill to the larger population. The Disease Management Association of America changed its name to DMAA: The Care Continuum Alliance because of the change in focus from disease management to population health.

Excitement about new school

Thomas Wilson, PhD, DrPH, epidemiologist of Trajectory Healthcare, LLC, and founder and board chair of the nonprofit Population Heath Impact Institute (PHII) in Loveland, OH, supports the new school and the college adopting the term population health. Academic institutions usually use the phrase public health for these kinds of programs, but many associate the word public with only government-based programs, Wilson says.

“I think, as we all know, a population health strategy—where decisions must be based on evidence—can be done by a public agency or can be done by private agencies,” says Wilson, who has a doctorate of public health from UCLA and who founded the PHII four years ago.

Wilson says he hopes the new school focuses on an expansion of epidemiology, the science on which public health is based. “I think science should be the basis of the whole program: the bride, not the maid of honor,” he says about the school’s focus, adding that population health strategy is a continuous quality improvement process and isn’t definitive, like physics.

“Everybody wants the final answer. We learned a long time ago in epidemiology that, for the most part, the answer you get from science is better than the answer you get from pulling something out of the air. But levels of certainty exist in science, and most of it is not definitive. Thus, most rational debates around population will be informed by social values, ethics, and economics, too,” Wilson says.

Although the phrase population health is more popular now than when Wilson founded PHII, he says there is still education needed. Some people think population health means health programs for the entire population, but it also involves targeting specific subpopulations, he says.