Primary care and public health integration: Key elements of successful integration

Background: In July 2012, the Association of State and Territorial Health Officials (ASTHO), and the Institute of Medicine (IOM) brought together key federal, state, and local primary care and public health leaders to create a strategic map for primary care and public health integration. The resulting map provides a strategic direction and specific objectives to help achieve the map's central challenge to implement integrated efforts that improve population health and lower health costs. The Primary Care and Public Health Integration Strategic Map outlines “Identify and Create Demonstrated Successes” as one of its five strategic priorities. Methodology: Stories of successful primary care and public heath integration were solicited via an online form on ASTHO's website, and outreach from members of the multi-organizational Successes Track of Work Committee and partnering organizations. The solicitation utilized a data collection template including both qualitative and quantitative questions. The data was reviewed and analyzed and key themes were expanded upon when more details were necessary. Findings: Findings show that most integration efforts started at a state of cooperation, and moved to a state of collaboration on the integration continuum. Communities and states working towards integrated primary care and public health face common challenges of competing priorities, lack of multi-directional data sharing infrastructure, and sustainability. Findings support the IOM Report's assertion that successful integration requires several core principles, including: a common goal of improving population health, community involvement, strong leadership, sustainability, and collaborative use of data. Conclusion: Primary Care and Public Health have historically been a part of different systems, but alignment of efforts through a shared vision, community involvement, strong leadership, and cooperative use of data have resulted in cost savings and improved population health outcomes.