Durham Health Innovations (DHI), a unique partnership between Duke Medicine and Durham County, is funding 10 teams whose members will work collaboratively to develop ways to reduce death or disability from specific diseases or disorders prevalent in the community. The team projects will focus on improved measurable health status, incorporate multidisciplinary partnerships among representatives from Durham and Duke, and use information technology to facilitate the coordination of care.

Broadly, the projects cover adolescent health, asthma and chronic obstructive pulmonary disease, cancer, cardiovascular disease, diabetes, HIV and sexually transmitted diseases, maternal health, obesity, pain management and substance abuse, and seniors’ health. These issues are not unique to Durham, but local community health officials said that the current methods used to prevent and treat them are inefficient.

The health status of Durham residents is comparable to that of most residents in other parts of the state. However, North Carolina ranks in the bottom 20 percent of all the states in terms of life expectancy and functional status.

DHI brings together community members, health and human services officials, local non-profits, Duke researchers, and Duke Center for Community Research (DCCR) staff in its effort to improve the health of the entire population of Durham County.

Duke conducted technical workshops in August and September 2008 to communicate the goals of DHI, request proposals, and outline the specific resources that Duke will make available to project teams. Twenty-two teams comprised of 413 team members—237 representing Duke and 176 representing 90 community agencies, organizations, and businesses—responded to the call.

Funding comes from an institutional commitment of $1 million from Duke University, support from the Clinical and Translational Science Awards (CTSA), which is funded by the National Institutes of Health (NIH), and in-kind contributions from numerous community organizations. The project teams that were selected will each receive up to $100,000 to be used by the end of 2009. At that point, plans for the projects will be presented and evaluated to determine how to move forward with a new approach to improving health in Durham.

DHI Article, DTMI Summer 2009 Newsletter

Durham Health Innovations Projects

• Adolescent Health Collaborative: Connecting Adolescent-Centered Care in Durham will design a medical home model of care for adolescents to improve physical and mental health services and outcomes for this population.
• Innovative Approaches to Better Detect and Treat Asthma and Chronic Obstructive Pulmonary Disease in Durham will design a model that combines a community healthcare team and chronic disease registry with continuous quality improvement to improve care for patients with asthma and COPD.
• A Partnership for Community Wellness in Durham, North Carolina will develop a model for comprehensive cancer prevention and whole person wellness.
• VIP (Vascular Intervention Project) will design a model of tailored services for cardiovascular disease and chronic kidney disease to identify individual risks and neighborhood resources, foster community involvement, demonstrate applicability to other chronic diseases, and partner with key stakeholders to ensure sustainability.
• Partnership IMPACTS Diabetes Outcomes will develop a plan that redesigns the flow of diabetes care for patients: from home care, to group visits, to primary care support, and finally to specialty care for those with high risk and comorbidities.
• Prevention and Treatment of HIV, STDs, and Hepatitis in Durham County will design a model of integrated strategies for HIV, STD, and hepatitis prevention for the community that will address medical, behavioral, and psychosocial issues faced by persons with these infections and those at risk of becoming infected.
• Expanded Preconception Care: Internatal Care in a Life-Course will design a model to improve the health of mothers before and after pregnancy, for women who have high-risk medical conditions such as hypertension, diabetes, obesity, or who have given birth to a low birth weight infant; and potentially decrease infant mortality by reducing pregnancy complications.
• Achieving Healthy Bodies and Healthy Minds for a Lifetime will design a model to reduce the incidence and prevalence of obesity by encouraging patients to participate in effective community programs; forming partnerships with community organizations to support and develop interventions that fill gaps in needed services; and mobilizing community health advisors and volunteers in community organizing and capacity building efforts.
• Rethinking Pain: Collaborative Approaches to Address the Relationship of Pain, Substance Abuse, and Psychiatric Illness will design a model to improve the approach to chronic pain and substance abuse risk through co-location of substance abuse specialists with primary care providers, systems of care for those at high risk for substance abuse, and education and workforce development.
• Seniors Healthy In Place (‘HIP’ Seniors) will design an innovative coordinated care model for adults aged 60 years and older in Durham County that will engage seniors in health promotion behaviors, reduce the burden of disease, reduce emergency department visits and in-patient hospital services, and improve chronic disease outcomes, including prevention of unintentional injury.

DHI Resources & References

Questions? Please contact Sue Schneider at DukeDurhamTeams@mc.duke.edu