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CASE STUDY | ESKENAZI HEALTH
THE BIG-PICTURE TRANSFORMATION OF HEALTH CARE
Dr . Nir Menachemi , chair of the health policy and management department at Indiana University ’ s Richard M . Fairbanks School of Public Health .
There is one clue that speaks volumes about your health prospects but has nothing to do with your medical records .
“ We know now that one of the greatest predictors of health outcomes for almost any patient , undergoing any procedure , or with almost any disease , is one value on a patient ’ s chart ,” says Dr . Nir Menachemi , chair of the health policy and management department at Indiana University ’ s Richard M . Fairbanks School of Public Health . “ And that value isn ’ t medical . It ’ s their ZIP code . You can tell with extreme accuracy how someone is going to fare , after a procedure , by their ZIP code .”
Where a person lives is critical because health is shaped by factors outside the scope of traditional medical interventions and advice .
“ In this country , we tend to medicalize health-care issues ,” Menachemi says . “ If someone is having a health issue , we automatically assume the medical system can fix it . A lot of organizations are now beginning to realize that many health issues are not necessarily problems that can be
addressed through medical care alone . They ’ re bigger issues in the communities where people live .”
Menachemi is participating in a study , funded by the Robert Wood Johnson Foundation , that aims to help medical professionals and institutions make better use of that data . The project , which draws on the resources of The Polis Center , the Regenestrief Institute , and the Richard M . Fairbanks School of Health , is testing a tool that predicts what kind of care might best serve a patient . To do so , it uses an algorithm that incorporates medical records as well as neighborhood-level data from the SAVI Community Information System supplied by Polis .
“ We ’ re taking data about the neighborhood where patients live and seeing if we can predict who ’ s at risk for needing some of these social services ,” Menachemi says . Services include nutritionists , financial and legal advisers , and mental health professionals . “ The medical way of thinking about a problem is , if the patient isn ’ t doing well after a
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