New IOM Report Highlights SF HIP Efforts

April 26, 2012

In March, 2012, the Institute of Medicine (IOM) released a report, Primary Care and Public Health: Exploring Integration to Improve Population Health, that includes a case study of the San Francisco Health Improvement Partnerships (SF HIP), a public health and primary care integration in San Francisco. The report was compiled by the IOM's Board on Population Health and Public Health Practice.

“This report highlights the need for public health departments and primary care clinicians to work together more closely,” said Kevin Grumbach, MD, co-director of the Community Engagement and Health Policy (CE&HP) program of UCSF’s Clinical and Translational Science Institute (CTSI). CE&HP serves as the administrative core of SF HIP, and is supporting the effort through planning and implementation phases.

We need to move out of our traditional silos and bring people together across disciplines and sectors...
Kevin Grumbach, MD

For example, public health campaigns to encourage people to consume less sweetened beverages or not smoke work best when these messages are reinforced by doctors and nurses caring for individual patients, Grumbach says. The report also pointed out that the research assets of Academic Health Centers have a valuable role to play in the integration of public health and primary care by helping to ensure that these efforts are guided by scientific evidence and are systematically evaluated.

“We need to move out of our traditional silos and bring people together across disciplines and sectors if we are to make greater progress in improving the health of our communities and eliminating disparities,” Grumbach said. “I am proud of how SF HIP has brought together such diverse partners—from UCSF, community-based organizations and the SF Department of Public Health to the SF Unified School District and private medical groups—to harness our collective assets and tackle the most pressing public health problems in San Francisco.”

Below is an excerpt from the report, which focuses on SF HIP's efforts to address three distinct issues: 1) high users of multiple services, 2) Hepatitis B, and 3) physical activity and nutrition.

The Healthy San Francisco program has served as an exemplar of a local health department promoting access to health care built on a primary care model; the initiative focuses largely on patient care services rather than on intervention in more upstream determinants of health and illness. The department of public health also is engaged with other stakeholders in broader efforts to integrate primary care and public health to improve population health. One such effort is the San Francisco Health Improvement Partnerships initiative. This initiative originated in 2010 in discussions between leaders in the department of public health and representatives from the National Institutes of Health (NIH)-funded Clinical and Translational Science Institute at the University of California, San Francisco, about how to build more productive collaborations to apply university research assets to solving local public health problems. Diverse constituents in addition to the public health department and the University of California, San Francisco, now participate in the Health Improvement Partnerships, including the San Francisco Hospital Council, the mayor’s office, community-based organizations, community clinics, private medical groups and independent physician associations, and the school district. Representatives of many of these constituents serve on a coordinating council, and the Clinical and Translational Science Institute provides staffing and research support to the council and work groups and pilot funding for the work groups. Initial projects of the Health Improvement Partnerships are focused on three issues that emerged as priorities from a systematic review of San Francisco health needs assessments.

Access the full IOM report here (SF HIP is featured on pages 2-17 to 2-19).

The Institute of Medicine is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. 

CTSI is a member of the National Institutes of Health-funded Clinical and Translational Science Awards (CSTA) network focusing on accelerating research to improve health. The Institute provides services, training, and funding for researchers at every stage, and promotes online collaboration and networking through UCSF Profiles.