QUALITY: Can a Community With Zero Heart Attacks Become a Reality?

It’s no surprise that citizens of a town heavily influenced by its German roots joke that its major food groups are “beer, brats and butter with a little cheese thrown in for good measure.” But at first glance, this characteristic makes it surprising that New Ulm, Minnesota, has been chosen by Allina Hospitals and Clinics for one part of its $100 million initiative to promote community health and clinical research, according to a piece in the Star Tribune by Josephine Marcotty. “The Heart of New Ulm” seeks to find out if it is possible to completely eliminate heart attacks in a community. (Yes, completely eliminate heart attacks.) So why is New Ulm, with all its brats and butter, the perfect place for this innovative experiment?

Because the community is essentially a miniature integrated health care system. More than 90 percent of New Ulm’s 15,000 citizens are patients of the local hospital or clinic, both owned and operated by Allina. And Allina utilizes electronic medical records for all of its patients, following the mantra, “One patient. One record.” Such high levels of participation and the widespread use of interoperable electronic records make New Ulm a promising testing ground to study and analyze population health.

Allina is hopeful that the integrated system will allow them to identify and address risk factors beyond high cholesterol and smoking. "It's working on the things that cause illness upstream rather than waiting for something to go wrong and fixing it later," commented Donald Berwick, head of the Institute for Healthcare Improvement in Cambridge, MA.

But it takes more than treatment and medications to eliminate heart attacks; the project will also engage in important efforts to raise education and awareness about prevention and disease management. Ultimately, such programs require the community to make some big decisions about lifestyle, like whether to stop selling soda in schools, build new parks, or add regulations on cigarettes. Just how Allina will branch out from the clinics to encourage change in the community has not been released yet, but this is a great chance for all of us to see what an integrated system of health care providers, and a dedication to improving the health of the community, can achieve.