Matthew H. Richards, MD, chief of resource management for Northwest Permanente and regional physician lead for Care Without Delay at Kaiser Permanente Sunnyside Medical Center in Oregon, delved into the social determinants of health and Kaiser Permanente’s Thrive Local initiative on a recent edition of “What They’re Watching” on the State of Reform website.
In the interview, Dr. Richards, a hospital medicine physician, discusses the regional work he leads for the in-patient care of hospitalized patients. This includes improving the social determinants of health such as housing, food, and transportation, in addition to providing high-quality medical care.
Thrive Local is a cornerstone of these efforts, and the Kaiser Permanente Northwest Region is the first location to pilot this program. In partnership with Unite Us – a national organization that provides community-based groups with a technology platform to connect patients through referrals – Kaiser Permanente’s Thrive Local aims to connect health and social service providers to offer an unprecedented level of integrated care.
“If you identify those needs on a screening questionnaire or in your conversation with a patient, you then make a referral through this platform that Unite Us has that includes community-based organizations all around,” Dr. Richards says in the video.
Tracking these referrals and other data through Thrive Local can help to better address patient and community needs, according to Dr. Richards.
“Ultimately what we’re hoping to see is that people’s health improves. And when their health improves because you’re addressing both their medical and their nonmedical, then they’re not going to have to be in the hospital as often and they’ll be able to spend more nights in their own home.”
For the full video, visit the State of Reform website.