Thursday, August 13, 2015

Chattanooga Goes Back to School

It is time for Chattanooga to go “Back To School!”  PHIC has decided that it would go back to school as well.  The Coalition has been meeting for some time with Hamilton County Department of Education officials and local health providers about partnering to improve the health of Hamilton County’s children.

Hamilton County is challenged by pediatric asthma.  Asthma is the number one reason children miss school.  These absences are just the tip of the iceberg as many more children are distracted or are sleep deprived at school by the symptoms of their asthma.  42 of Hamilton County 71 schools have more asthmatic children than the state average.  10 schools have twice the state average.

PHIC is working in three ways to improve support for Hamilton Counties most at risk children.  First, we are partnering with existing nursing to better treat asthma and communicate medication needs.  Second, the department is looking into ways to provide care coordination for the moderate to severe asthmatics in county schools.  Care coordination is the individual review of individual child’s medical needs and assist with any gaps in care.  Last, a large community coalition is working to add telemedicine support to school nursing care and build comprehensive medical clinics at central schools in underserved areas.

PHIC looks forward to sharing more of the initial plans as they become finalized.  Each neighborhood that would be served by the proposed clinics will need to assist in the planning of each specific clinic.  The goal is to build the best comprehensive health clinics in the region that serve the neighborhood as precisely as they would like to be served.

It is an exciting time at the possibility that Chattanooga will soon have a tool to remove the barriers to academic success and a fully functional life that poor health now plays. 

Sunday, December 28, 2014

PHIC Committee on School-Based Health Winter Report

The School-Based Health sub-group is composed of individuals from the Hamilton Co. School System (administration and nursing representative), health care providers (Erlanger and HCHD) and the philanthropic community. 

We have met several times throughout Fall 2014 and have prioritized our agenda to include 2 shorter-term goals: 
1) Reducing morbidity/mortality (as measured by school absenteeism, 911 calls and/or ER visits) for Hamilton Co. students with poorly controlled/uncontrolled asthma (possible roll-out Spring 2015);
2) Improving Flu vaccine uptake in Hamilton Co. students, and instituting an influenza data collection system to monitor/predict local epidemiology during flu season. (probable roll-out Fall 2015)

A longer-term goal is the implementation of one or more school-based health centers to provide better access to students with acute and chronic illnesses, ideally integrated with developmentally-appropriate health education.

Steps toward implementation of Goal #1 include:
  • Obtaining funding for a health education program on lung health.
  • Development of asthma-treatment protocols for school nurses (in progress).
  • In-training to school nurses – January 2015
  • Development of asthma data collection system for students in Hamilton county schools.
  • Identification of funding sources for materials and meds for treatment in the schools.
  • Communication to primary care physicians for care coordination and follow-up.
  • Coordination of efforts between PHIC and Dr. Stephen Adams, Medical Director, Hamilton Co. Public Schools

Steps toward implementation of Goal #2 are under discussion.

If you would like to work on School-Based Health, please do not hesitate to contact me at or Kimbilee Jonas at

Thursday, December 18, 2014

President’s Report

This has been a great year for the Pediatric Health Improvement Coalition of the Tennessee Valley (PHIC).  We have completed our Strategic Planning Initiative (SPI), begun the process of building strong community pediatric interest groups, continued work on our comprehensive regional health improvement plan and facilitated partnership with many community organizations to move toward a healthier Tennessee Valley.
In December of 2013, PHIC contracted Blue Cottage Consulting of Ann Arbor, MI to lead the SPI.  This initiative was a catalyst to a rigorous cycle of analysis, discussion and innovative design in regard to the health and well being of our community’s children.
First, an initial study of the Tennessee Valley pediatric market was completed.  This data documented significant deficiencies in local inpatient and subspecialty infrastructure compared to close market competitors.  It also defined discrete community gaps in primary and urgent care that correlated with our poorest and highest health risk zip codes.
In the visioning phase, the project team completed 52 stakeholder interviews with health, business, education, government, non-profit and community leaders.  These conversations clarified the leadership’s vision of current child health and documented the level of commitment to the future. 
The project team also directed four neighborhood listening forums in Dalton, GA; Hixson; Alton Park and East Chattanooga.  These forums defined the participating parents, school nurses and community health advocates’ perception of our primary pediatric issues.  From these sessions, PHIC has continued the development of three community pediatric advocacy groups.  These include the East Chattanooga, Alton Park and Parents of Chronically Ill Children.
From our analysis and community input, PHIC advanced the conversation around improving delivery, access and provider partnership.  PHIC has clearly defined the benefits of greater provider partnership and provider-Children’s Hospital partnership. 
Finally, PHIC has developed a strategic plan for expanded school-based health, provider-school communication and community education standardization.  The initial implementation of this plan around asthma has already begun.
It is exciting to see how much PHIC has matured this year.  The board has transitioned from a planning board to one that is now implementing our first round of projects.  The diversity of gender, race and profession has improved.  We have hired an Executive Assistant, Kimbilee Jonas, to work on day-to-day activity and promote our communication. 

The primary challenges have become very clear.  These are severe disparity in pediatric healthcare and outcomes, obesity, asthma, peri-natal health, infant mortality, school readiness and behavioral health.  The leadership has moved from a conversation focused on what doesn’t exist in the Tennessee Valley.  The new conversation is the narrative of leveraging our current resources to address these real challenges in an impactful and sustained way.

I was surprised this year by the many pediatric efforts already present in our community.  It is encouraging to see individuals; often non-health licensed respected community members, performing essential pediatric health services.  It was also discouraging how many of these individuals and larger programs were siloed, non-cooperative, overlapping and competing for resources.  To this end, PHIC is helping to build partnerships for better function and document impact data to help sustain ongoing work.
It has been a joy to see the PHIC vision come to exist in reality.  There is a growing community in the Tennessee Valley committed to improving the health and well being of all children.  There is now increased discussion and new partnership between many community partners: the Bethlehem Center, Le Paz, Chattanooga State, UTC, Siskin, the Hamilton County Department of Education, the Hamilton County Department of Health, Children’s at Erlanger, the Children’s Discovery Museum, Le Bonheur Children’s Hospital, Cincinnati Children’s Hospital, the Tennessee Chapter of the American Academy of Pediatrics and the Pediatric Healthcare Improvement Initiative for Tennessee.
PHIC is excited for the New Year and beyond.  Specifically, we project that the next three years will have some discrete outcomes.  First, the Ambulatory component of the Erlanger System’s Capital Building Program will receive input on components that meet health gaps in our community.  Second, the pediatric community health will have a robust input from the Hispanic, Black and Families of Children With Special Healthcare Needs communities.  Next, our region will have a better tool for identifying community health resources that are culturally relevant and available for more families.  Lastly, Asthma will have a significantly decreased impact on Chattanooga children.  This will be evident in increase school attendance, academic improvement, fewer emergent transports from school to the Emergency Department for Asthma and fewer total Emergency Department visits for Asthma.
PHIC is a community organization.  It is your tool to improve our children’s health and well being.  We could not have had the year we had in 2014 without you involvement and financial support.  Thank you!
I encourage you to partner with us in 2015 on projects in which you find interest.  We appreciate your continued financial support.  This work cannot go forward without the financial resources to impact the barriers to health that exist in our community.  Please consider making PHIC apart of your charitable giving plan.  Online donations can be made through the Pediatric Health Fund of the Community Foundation of Greater Chattanooga at

R. Allen Coffman, Jr., MD, FAAP
The Pediatric Health Improvement Coalition of the TN Valley

Sunday, August 24, 2014

Adult Obesity Continues to Increase

The new County Health Statistics from the University of Wisconsin Population Health Institute are published.  They can be reviewed in detail online.  The web site is very user friendly and interesting to study.

One of the most disappointing stats is the persistent increase in adults with BMI over 30 or obese.  Hamilton County is now at 31% of the population with a BMI of 30 or above.

It is clear that more detail of this data is needed.  The work of the Pediatric Health Improvement Coalition has found that there is a dramatic variation in obesity rates by demographic factors in the Chattanooga Region.  We have also seen that some communities, especially the at-risk communities, have started to fatigue on addressing obesity.  I hope that this continued increase in obesity will propel a coordinated and effective effort to curb the impact of obesity in the Tennessee Valley.

PHIC Vice-President and Children's CEO Speak Out about Cover Kids Program

The changes to CoverKids are among a series of recent cost-saving measures made by TennCare and other insurers over the past two years that have hit children’s hospitals’ bottom lines to an unprecedented degree, said Dr. Alan Kohrt, CEO of T.C. Thompson Children’s Hospital at Erlanger. Kohrt is also chairman of the Children’s Hospital Alliance of Tennessee, which met with state leaders this week.
Children’s at Erlanger for example, has lost more than $3 million from a string of recent cuts.
“We’re seeing increasing cuts to the children’s hospitals that threaten the level of care that we provide,” Kohrt said. “We have not had to cut any services — yet. But we continue to face financial pressure.”

Friday, February 21, 2014

Local Families Have a Voice in Children’s Health

Local Families Have a Voice in Children’s Health
As the Pediatric Healthcare Improvement Coalition Announces
The Tennessee Valley Pediatric Health Week
March 3rd through March 6th

Chattanooga, TN - The Pediatric Healthcare Improvement Coalition for the Tennessee Valley (PHIC-TV) is releasing the announcement of four regional Pediatric Health Forums.  These open meetings will invite the public to comment on personal experience with local health services for children in the Tennessee Valley (Southeast Tennessee, North Alabama, North Georgia and South Western North Carolina).

The first week of March will be the Tennessee Valley Pediatric Health Week.  PHIC-TV will have four public listening forums in Alton Park, East Side, Dalton and Hixson.  These will be meetings driven by the attendees.  The focus will be perceived barriers to good health, areas of local health success and elements we must have to meet the needs for our future.

The Alton Park Forum will be at the Bethlehem Center on Monday, March 3rd at 7PM.  The Dalton, Georgia forum will be at the Mack Gaston Community Center on Tuesday, March 4th at 7PM.  The East Side and East Lake forum will be held at East Side Elementary School on Thursday, March 6th at 4PM.  And, the Hixson forum will be held at DuPont Elementary School on Thursday, March 6th at 7PM.  Everyone is welcome to attend any of the forums.  Forums will not be limited to the immediate neighborhood community.

The purpose of the forums is to reach out to all families, especially those who utilize a significant amount of pediatric health resources.  We want to listen to the individual triumph, success, challenges, barriers and dreams for the future as families look to our local pediatric delivery of care.  We also want to hear the community’s view of barriers to good public health in general.

The Pediatric Health Improvement Coalition of the Tennessee Valley (PHIC-TV) is an organization that is working to improve the health of all children in our region.  This organization is dedicated to breaking down barriers to our children to effective and innovative healthcare.  Please support the ongoing work of PHIC-TV by getting more information at or following on Twitter @PHIC_TV.

R. Allen Coffman, Jr., MD, FAAP
President, Pediatric Healthcare Improvement Coalition or the TN Valley
Pediatrician, Highland Pediatrics

Pediatric Healthcare Improvement Coalition – Tennessee Valley
P.O. Box 96
Signal Mountain, TN  37377



Sunday, December 15, 2013

Shocking Rates of Pediatric Asthma in the Tennessee Valley are the Number One Cause of School Absence

Asthma is a chronic medical condition that affects the lungs.  Patients can experience frequent cough, shortness of breath, and chest pain or tightness on a regular basis.  Occasionally a patient with asthma will suffer an “asthma attack.”   During an attack the airways in the lungs become inflamed, make excess mucous, and become constricted.  An asthma attack causes significant trouble breathing and can lead to an emergency room visit, a hospital stay, or even death.  Infections, allergies, and irritants, such as cigarette smoke and pollution, can lead to an asthma attack.  Attacks can easily be prevented with regular doctor visits and effective and inexpensive medications.

7.1 million American children suffer from asthma, which is about 8% of all children, making it one of the most common chronic medical conditions of childhood.  Here in the Chattanooga area, however, 12.5% of our children have asthma, over 50% higher than the national average.  In fact, Chattanooga is the fifth worst city in the country for asthma according to the Asthma and Allergy Foundation of America.  WedMD places Chattanooga second.  These poor rankings are due to low air quality and high cigarette smoke exposure.  Such a staggeringly high rate of asthma in a city conducive to asthma attacks brings the scope of this local problem into focus when considering the following nationwide facts:
·        Asthma is the number one reason children miss school
·        Asthma is third most common reason for a child to spend the night in the hospital
·        Asthma costs our nation 56 billion dollars annually
·        157 children died from asthma in 2009
The most frustrating aspect of these alarming statistics lies in the relative ease in which asthma is treated and attacks are prevented.  Regular doctor visits and readily available medications virtually eliminate symptoms and prevent attacks.  In fact, a recent medical study showed that even 8% of elite athletes from the last five Olympics suffered from asthma.  These athletes have doctors, take their medicine regularly and are able to compete at the highest level of their sport.  Yet, in Chattanooga, one in five children does not have a primary care doctor.  7% of Hamilton County’s children have no insurance at all.  20% of babies in Chattanooga grow up breathing second hand cigarette smoke.  This area has childhood obesity rates 25% higher than national averages.  These factors all play a detrimental role in the lives of Chattanooga’s asthmatic children.

The Pediatric Healthcare Improvement Coalition—Tennessee Valley (PHIC—TV) is a community health partnership striving to decrease the negative impact of asthma on all Tennessee Valley children.  PHIC-TV is currently implementing a strategic initiative to define the asthma challenges for children and organize the means to address themPlease invest in the ongoing work of PHIC-TV and get more information at

Matthew Good, MD, FAAP
Chief of Staff, Children’s Hospital at Erlanger

Pediatric Healthcare Improvement Coalition – Tennessee Valley
P.O. Box 96
Signal Mountain, TN  37377