Staten Island Performing Provider System

Joseph Conte, PhD

Joseph Conte is the Executive Director of the Staten Island Performing Provider System (SI PPS).  SI PPS is the preeminent population health organization on Staten Island focusing on health equity, addressing disparities and health-related social needs.

At Northwell Health, formerly the NS-LIJ Health System, he served for over 15 years in various executive capacities, including Senior Vice President for Quality. He completed his doctoral dissertation at the Seton Hall University School of Health and Medical Sciences.

Innovation in any healthcare space requires transformational thinking, not just “evidence-based,” but “evidence-making” initiatives that will truly impact the population health crises of today. Technology deployed on the ground is essential to re-introduce the patient-facing and personal care that previously was the hallmark of the US healthcare system when physicians practiced in small groups in their communities and saw generations of family members. The Staten Island Performing Provider System (SI PPS) is dedicated to bringing back empathy, value and positive experiences to patients and healthcare workers.

Source and evaluate scalable innovations

It is the only awardee in New York of a Medicaid Innovation Collaborative grant (MIC) which aims to advance health equity and improve beneficiary outcomes by partnering with state Medicaid agencies, managed care plans and community members to align on a health equity goal. The focus is on innovation, care delivery models, and tech-based solutions that can address the last-mile problem in social determinants of health.

In this initiative, the SI PPS is deploying tech-enabled solutions to house the homeless and bring resources to those in need. This is an example of our use of technology to enable community health workers (CHW) to engage homeless and at-risk community members in Staten Island, a borough of NYC with a population of 500,000.

Below I will explain the unique and independent tech solutions braided into a powerful tool to help those most in need in our community.

“As a mobile solution, the platform can link back to our extensive database of health care utilization and connect individuals to primary care to manage their chronic disease,”

The CHWs from several partner agencies use a mobile screening and referral platform to meet people where they are. This may be in homeless shelters, public spaces, or health settings to assess their immediate needs, screen them with the CMS ACH tool, and then refer them to community-based organizations (CBOs) to meet those needs. As a mobile solution, the platform can link to our extensive database and connect individuals to primary care to manage their chronic disease. Another facet of the innovation is a digital wallet that individuals are offered to support their path to independence. By meeting milestones mutually agreed upon with the CHW, they work with increasing financial support, including a stable housing solution that aligns with public benefits. While in its early stages, the innovation is a hit, with numerous clients benefiting from the tech-powered program.

Automating Detection and Diagnosis

Another innovation that has proven extremely beneficial to the community is our work in substance use disorder (SUD). The innovation utilizes an AI-based algorithm to scour the extensive population health database to identify individuals most at risk of overdose. Once those individuals have been identified, our community partners reach out to engage using Certified Peer Recovery Advocates (CRPA). Then, using the same mobile platform described above in the MIC innovation, a recovery plan is developed and engagement in treatment is started. This peer-led but clinical professional-managed program also utilizes a contingency management digital wallet that encourages individuals to reach milestones, like obtaining reversal medication and fentanyl test strips, meeting their counselor, peer check-ins and primary care visits. After the first year of the program, there was an 80% reduction in overdose deaths and overall overdose for the 650 individuals participating. Using technology, embedded into an innovative solution, is the critical ingredient here alongside a willing and dedicated workforce.

Improving the national healthcare mindset

In closing, one thing is certain, with a five trillion-dollar health system that produces the lowest life expectancy in the world, US healthcare needs a makeover. The overemphasis on tertiary and even quaternary care has led to an extreme shortage of family physicians, mental health professionals and care in the community. The federal government has signaled that value, not volume is the path that the future will hold for the nation’s largest purchaser of healthcare services.  By relying on innovation, technology-enabled partners in healthcare and community-based organizations, we can turn around the abysmal results in population health and be proud of the best healthcare system in the world.