By Michelle Medina, Client Executive, Health and Human Services
Being a Native New Yorker and braving a rigorous weekly commute into the melting pot metropolis that never sleeps, I figured, for sure I am up to the task of joining the IBM Health Corps philanthropic project for Duke Health. This entailed leaving my family (including two teens) and work life behind for 21 consecutive days and living, eating and working around the clock with six people I would meet for the first time in Durham, North Carolina. At that point, our only common thread was that we worked for IBM and each of us had a keen desire to contribute our talents toward having an impact on the health outcomes for Durham County. The mission, to immerse ourselves completely with our sponsor, Duke Health and key community stakeholders in order to emerge with a recommended framework that would enable Duke Health and the community at large to harness their most valued assets: People, Resources and Information to improve health outcomes for the community of Durham. The expectations were high, as the goals to decrease healthcare disparities and promote health equity across the community were a vision shared by all. This was not just about getting it right in Durham, it was about establishing a model that could be replicated across the country.
That expression of “being in the boat together” was never more pronounced as it was on the day we all arrived to Durham, Saturday, January 28th, as we sat around in a circle and began to share why we were there and what we each hoped to accomplish. It was through those daily team interactions; morning coffee, team brainstorming, endless analysis and synthesis, honesty, rawness, rubbing eyes tiredness, occasional fits, break through ideas and nightly check ins, that I came to realize, being selected for this project, was by no means an accident. I came to see we formed a tapestry of skills, experiences and talents in areas such as healthcare IT, social services, clinical, design, architecture, software engineering, cloud, emerging technologies, marketing and client relations. We were diverse in culture; Hispanic, Asian, American, Irish, British, 50% men, 50% woman ranging from millennials to those who braved the Y2K era! Honestly, it was a beautiful thing and it set the stage for 3 intense weeks of hard work on our part and massive commitment from Duke Health and the community at large.
Our first team lunch with the Duke Center for Community and Population Health Improvement
There is something about Mondays; kick offs, the start of a new diet, a new workweek, list of things to get accomplished and so on that set the stage. The IBM Health Corps project kicked off on Monday, January 30th in the center of Durham; it was truly all the buzz. We were greeted with warm hello’s, real southern hugs, a line up of carafes brimming with coffee and tea, pastries, happy people with name tags, Duke Coordinators tending to every last detail in a large, open airy forum with great lighting, high ceilings and brick walls. You knew you were in a building that had rich history and pride. It was great energy with over 80 people set up in tables of 10 with a giant white board surrounding nearly half the room. There was chatter as to whether the Mayor would be in attendance or not. First it was on, then it was off, staff were scurrying, the coordinators were unsure and then shortly after the first presenter began, Mayor Bell quietly slipped into the back signaling to all, this was a pivotal moment for Durham.
Our key sponsors, Chancellor Washington and Dr. Ebony Boulware addressed the audience. Dr. Boulware did a great job through visual aid and discussion to set the stage for how academic health systems, such as Duke Health, are evolving to a more population health oriented model. She characterized this transition as the 3rd curve which considers a much wider health improvement approach that places a better lens on the biomedical, contextual and behavioral factors across populations and enhanced collaboration across a wider set of partners within the community.
Each member of the IBM Health Corps team took the podium and introduced themselves and you could literally hear a pin drop as all eyes and ears were upon us. Participants from all parts of Duke Health and the community talked enthusiastically about what was working and what could be improved as many were shaking hands and introducing themselves to each other for the very first time. Many business cards were exchanged and people were excited to learn about each other’s work. We learned of their mission to strengthen the well being of individuals and families through prevention and education. They re-affirmed the value of partnering across their ecosystem to create greater access to health and wellness services.
On the first Wednesday, it was then time for design thinking and suddenly a sea of people stood up and were ushered to the white boards with multi-colored post notes and guided through a design thinking workshop. It was like a massive jam, so well orchestrated as we moved in teams looking at what each team had to say and being guided through a process that helped us to harness these brilliant inputs. Everyone loved being heard, seeing what others were saying, sharing their bold ideas and watching a collaborative human centered process unfold before their eyes. Little did I know, that session would spark a desire from the community to adopt design thinking as their new mode of operating. Early observations were oriented around the need for greater trust, communication, collaboration and engagement across the community and with Duke Health. There was a desire for smarter use of tools and technologies, access to critical information and data on a more timely basis and ability to know of and access resources and programs to aide clients or collaborate more effectively on mutual areas of interest. It became clear early on that in Durham, there was no lack of hard work, commitment or talent from those with missions around the health and well being of individuals and the community. Yet, even so, there was something standing in the way of full or perhaps faster realization of progress in health outcomes in a more system-wide way. Something would need to be different. Something would need to change or be activated in order to have that broader, more visible and measurable impact on population health improvement that is beckoned by the 3rd curve.
At our design thinking workshop
So, what is the problem when Durham County has so much going for it? Duke University Hospital is ranked nationally in 13 adult specialties. There is also a plethora of community based organizations, programs, health services, call centers, faith based organization, volunteers and mission driven staff all looking to fulfill every possible health need in the highest quality way. The Partnership for a Healthy Durham is a shining example of collaboration at its best, which has leveraged the 2014 Durham County Health Assessment and resulting 6 priorities organized into 6 active committees on Access to Healthcare, Education, HIV/STIs, Mental Health / Substance Use, Obesity and Chronic Illness and Poverty. Over time, it became clear and with our good understanding for what was working and where the challenges still existed, I grew excited about what was possible largely because of great work already underway in Durham, but also because we had an engaged community, committed sponsor and motivated IBM Health Corps team.
I’ll admit, while 3 weeks goes by in a flash, you still miss your family and there were days I longed for the hug from my child and just when I thought homesickness would overtake me, someone in the community offered a warm smile, a big hug, a cup of coffee and recommendations on where to eat or what to do. I marveled at how cars would randomly stop at a place that was not a typical cross walk, just to let us cross the street. That’s certainly a stark comparison as to what you might experience in the Big Apple! Everyone made us feel welcomed, not only the project sponsors and key community stakeholders, but everyone; from the building security guard, parking attendants, pedestrians, shop owners, neighbors, Uber car service and many more. While the project goal felt large and the time frame compressed, with long days spilling into evenings and weekends, the IBM team comradery and community at large, made it doable.
I still look back and say I can’t believe how much we accomplished in such a short time; 32 interviews, 60 person round table, 25 person Design Thinking workshop, 3 Partnership For a Healthy Durham committee meetings and a 7 person co-creation workshop, not to mention our own team meetings and breakouts among ourselves! It was a fascinating process to take part in, that resulted in a representation of what our sponsor and key community stakeholders told us they needed. The mantra, “If It’s With Us, About Us then It’s For Us”, was our guiding principle in our design efforts. The result was a recommended framework that would activate the strengths of a coordinated and connected community through the implementation and adoption of a new platform. The platform takes advantage of the robust tools and systems that exist today which house clinical, claims, social determinants, public and other data sources in a manner that is secure, aggregated and governed. Fundamentally the platform provides a shared resource catalogue, communications channel and set of tools that together, empowers Duke Health and Durham community stakeholders to take the right set of actions aimed at improving health outcomes.
The day of the final presentation was as energetic as day one. I’ll admit, you can’t help but wonder, will they like our recommendation? Will they believe in it? Will they adopt it? Now, looking back two weeks post project, and reflecting on that last day, the enthusiasm, the commitments, the feedback and subsequent press releases, I can honestly say, together, IBM, Duke Health and all members within the community, made this happen. Certainly moving the needle on health outcomes or reducing health inequity will not happen by the flick of a switch, but it will happen because it’s already happening. We reaffirmed they can do this, we provided the critical success factors to build on their momentum, we assembled a rational and doable analytics framework and more than that, we activated a community! What a great day, a great moment and a mark in IBM and Durham history. I am proud to say, I was an integral part of with an esteemed IBM team. I look forward to staying connected to the project and continuing to offer my support.