Transforming Communities through Proactive, Preventive Health Initiatives

The significance of population health lies in its holistic approach to care. By proactively managing patient health, preventing chronic diseases, and addressing social determinants of health, organizations can reduce hospital readmissions and unnecessary interventions. Penn Medicine is advancing population health by expanding community health programs, using data analytics to target at-risk populations, and addressing health disparities through preventive screenings and chronic disease management.

Lancaster General Health Food Farmacy Program Raises Nutrition Based Population Health Outcomes

• (LGH) developed a community program, Food is Medicine-Food Farmacy, to help address barriers to healthy eating for food-insecure individuals and families, distributing close to 39,000 pounds of healthy food since it began. 60% of patients reported increased confidence in their nutrition skills, 73% reported improved healthy eating habits, and 49% reported decreased food insecurity.
• Information Services implemented the EHR along with dashboard tools, templates for pre/post assessments, and documentation tools for program evaluation, allowing staff to track patient progress and follow-up needs.
  
  

Food is Medicine

A Penn Medicine Lancaster General Health Program

Pharmacy Injectables

• Seamless Patient Care: Patients now benefit from "one-stop shopping" within Penn Medicine, reducing travel needs and improving care continuity.
• EHR Innovation: Information Services created a new practice in the EHR to streamline prior authorizations, patient scheduling, and injection administration for specialty medications, collaborating with pharmacy operations, finance, and patient accounting to optimize processes and ensure medication reimbursement, ultimately improving care continuity.
• Expanded Capacity: Starting with one specialty injection, the clinic now administers multiple medications weekly, with plans to expand further across the Penn Medicine network.

Mobile Mammograms

• Penn Medicine to Offer Mobile Cancer Screenings and Risk Assessments
• Free, Local Cancer Screenings: Information Services helps enable the Mobile Mammogram Program, bringing free breast cancer screenings and other health assessments directly to under-served communities in West Philadelphia and Upper Darby, removing barriers like transportation and insurance. Since 2021, Penn Medicine’s mobile mammography events have detected several cases of breast cancer, demonstrating the impact of early, accessible screening in increasing survival rates.

Lead-Free Families Program – Targets Community Health Initiative at Lancaster General Health

• • Reducing Lead Poisoning: The Lead-Free Families program has helped decrease the number of children with elevated blood lead levels by 50%, improving community health in Lancaster County. Penn Medicine Lancaster General Health is leading the nation’s first fully funded health system initiative to eliminate childhood lead poisoning, making homes safer for local families. Through integrated technology and community outreach, the program efficiently connects families to resources and ensures timely lead screenings and home safety improvements.
• Leveraging Technology Enables Prevention and Support: The IS telecommunications team launched an outreach campaign using multiple communication channels to increase screening rates, while EHR workflows supported referrals and education for the Lead-Free Family program. ETO software integration with the EHR automated the measurement of program effectiveness, enhancing efficiency.