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