Mayor Fenty Announces RAND Report Recommendations

Second Phase of Historical Health Study Provides Guidance for Investment of Tobacco Settlement Funds

Today, Mayor Adrian M. Fenty and Department of Health Director, Dr. Pierre Vigilance, released the second phase of the RAND Corporation report, “Assessing Health and Health Care in the District of Columbia.”  This second report offers guidelines and recommendations as the city prepares for one of the most significant capital investments in the District’s health care infrastructure.  More than $135 million in tobacco settlement funds will be used to improve the health and well being of District residents.

“I thank the RAND Corporation for its in depth research and recommendations,” said Mayor Fenty.  “In the coming months, the city will be reviewing these findings with internal experts as well as stakeholders in the community to develop an overall plan for investing these funds through grants and other partnerships.”

Phase one of the report provided a detailed analysis of the health status and health care delivery system in the District and included information on the distribution of disease, accessibility of services, utilization and capacity within the system, and the timeliness and quality of care.  

Since the release of the first phase in January, the study added focus groups with community residents, hospitals, health centers, other providers and key stakeholders.  RAND also collected and analyzed emergency department and EMS data to shape their recommendations on all segments of the health care delivery system.

“Our goal is to use targeted, cost-effective investments that address not only existing health risks and gaps in care, but address the underlying root causes of disparities and poor health,” said Dr. Pierre Vigilance.  

A summary of their recommendations are outlined below:
Expansion of Primary and Urgent Care
•    One of the central recommendations is to expand primary care capacity through the creation of new ambulatory care centers in the most underserved segments of DC.  Both new and existing facilities should be supported in achieving more patient-friendly environments that promote higher quality of care, patient privacy and efficiency in care delivery.
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Page 2 - RAND Recommendations

•    Also mentioned was the need for urgent and after hours care capacity to alleviate some of the demand on Emergency Departments.  
•    The report recommends that in combination, the District allocate roughly $90 million for these primary and urgent care capital investments.

Investment in Health IT Connectivity
•    The report recommends building on the District’s existing investments in Electronic Medical Records (EMR) in primary care clinics, as well as in Regional Health Information Organizations (RHIO).  
•    In addition, the report highlights the need to engage private medical providers, including specialists and hospitals, to adopt a system of Electronic Medical Records and participate in the RHIO to create a more comprehensive system of connectivity across the spectrum of care.
•    The report suggests a $24 million investment in these information technology upgrades.

Improved Emergency Medical Care
•    The report recommends improved coordination between FEMS and area hospitals to reduce Emergency Department diversion and patient ambulance drop times.
•    The report also recommends the development of an “Emergency Department dashboard” – a real-time database of bed availability and diversion status at all area hospital Emergency Departments – to ensure that patients are transported to the care center that is best suited to meet their needs.

Non-Capital Investments and Policies
•    The report also indicates the need for non-capital investments and complimentary policies to support a more response health care system.  These include:
o    Strengthening the primary and specialty care networks that provide care for Medicaid, the Alliance, and the underserved through incentives and other partnerships.
o    Improve the coordination of care between hospitals, primary care physicians, specialists, and other providers.
o    Expanding health education and patient navigation programs that support residents in meeting their health care needs.
o    Engaging and empowering District residents to take a more active role in their health care decision making and planning.

Focus on Future Data Collection and Long-Range Planning
•    The report describes the need for ongoing data collection and analysis; this is particularly necessary to address the gaps in data on children’s health status, mental illness, substance abuse, and oral health, which may reveal future areas of need for additional capital investment.


About the RAND Corporation:
The RAND Corporation is a non-profit institution that helps improve policy and decision making through research and analysis.