ACHE 2015: KentuckyOne CEO describes efforts to serve the underserved

Ruth Brinkley, CEO of KentuckyOne Health, may now run an organization that serves a quarter of Kentucky's 4 million people, but her nursing background and experience growing up in a Georgia town of about 150 people are what truly drive her to try to improve the health of underserved populations.

"I have a heart for healthcare, because I saw so many people in my little rural area die young from things that could have been treated--but because of belief systems and access they wouldn't go to the doctor," Brinkley (pictured right) said in an exclusive interview with FierceHealthcare during the American College of Healthcare Executives' 2015 Congress. "Or they'd go one time and get their medicines and, when their medicines ran out, that was it."

KentuckyOne Health, a component of the nonprofit Catholic Health Initiatives (CHI), runs more than 200 locations in Kentucky and southern Indiana, including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies. It serves the major metropolitan areas of Louisville and Lexington as well as rural Appalachia, which only emphasizes the importance of striving to accommodate diverse populations, according to Brinkley, who spoke about a similar subject in a Wednesday seminar for ACHE attendees.

"As we become an increasingly diverse country, that knowledge of our customers is going to have to be both broader and deeper," Brinkley said. "You certainly can't know everything. However, what we need to do is really start to understand cultural norms of populations and, as we work with individual patients, try to move them to their optimal level of health. That involves knowing the social situations, around those social determinants of health--housing, good food, safe neighborhoods and the like."

Like many other healthcare organizations, KentuckyOne has undertaken a number of initiatives to address the challenge of improving access and health outcomes. "We have not cracked the code, but we are working on it and learning from others as we go," she said.

Here are a few of the efforts KentuckyOne and CHI have taken that Brinkley said have helped to address the needs of underserved populations:

  • CHI's Mission and Ministry Fund plans, develops and implements new initiatives to promote healthy communities. In Louisville, the fund has helped community efforts to combat domestic and dating violence, promote "violence-free zones" to encourage residents to exercise outside and eliminate "food deserts," Brinkley said.
  • The Anywhere Care telehealth program, now about a year old, allows patients to chat with a doctor or nurse practitioner via Web chat or phone for a $35 out-of-pocket fee. "That's been real popular," Brinkley said, particularly in rural areas where primary care access is limited.
  • A longstanding partnership with the YMCA in Lexington, and a partnership with Walgreens in Louisville, help deliver services "in order to achieve the goals of a healthy community," Brinkley said. "We are really trying to go where people are and not necessarily have them always come to us."
  • The University of Louisville Medical Center's successfully cut overuse of the emergency department and unplanned hospital readmissions, helped in part by an initiative to triage ED patients and if necessary, redirect them to urgent care.
  • KentuckyOne's Healthy Lifestyle Centers have been a "big hit" for patients, employees and their families. "I can remember healthcare organizations trying to do this, like, 20 years ago, and it fell flat," Brinkley said.

In spite of these efforts, however, Kentucky still ranks 49 out of 50 states in health outcomes; the state's population particularly struggles with heart disease, stroke, lung cancer, diabetes and obesity, according to Brinkley. Thus, "we try to align ourselves with the goals of the state, because we all want to improve these numbers," she said.

Improving the health of Kentucky's diverse populations isn't just about helping people live longer, either.

"We want to be an economically vibrant state, and you can't get there without good healthcare," she said. "Healthcare is one of those enablers. I believe that if you've got good healthcare, you can access the rest of the American Dream."