The way hospitals and physicians provide health care is shifting, and the Cotton O’Neil North primary care clinic is working to bring innovative practices to the Stormont Vail Health system.
“This is set up and designed as a patient-centered medical home model,” said Melissa Herrman, a family medicine physician practicing at the clinic, 4505 N.W. Fielding Road. “The idea is to be in people’s neighborhoods and where they live, where they work, for easy access and to be part of their community.”
It’s also, she said, focused on providing wrap-around services to help people more successfully control their own health.
What that means is that the clinic has a mental health provider, a social worker, a Medicare wellness nurse and a care coordinator — services not typically found in primary care practices.
Randy Peterson, Stormont president and CEO, said the experiment at the north clinic will ultimately affect Stormont’s system.
“You can’t go to a physician and expect them to cover the gamut,” he said. “You have to use ancillary staff to cover. We’re doing team care up there, versus physician care, and obviously the physician is the leader of the team but it takes an army and a team of people to really do holistic medicine and to do preventive medicine. The focus has to be on what’s really valuable to the patient, not what’s valuable to us.”
Herrman is seeing the impact and already can’t imagine practicing any other way. The team’s social worker, for instance, deals with socioeconomic needs of patients.
“Transportation is a big one,” Herrman said. “If you don’t have a ride to see your orthopedist, then your knee or whatever is bothering you isn’t going to get fixed. Medication assistance is another big one. Medications are very expensive. She can help with insurance needs or if someone doesn’t have insurance, then she can help them connect with those services.”
The care coordinator is a registered nurse who follows up with patients between appointments, especially checking on patients with multiple chronic conditions or problems with compliance with treatments, Herrman said.
“She does a lot of education with disease process, diabetes and COPD (chronic obstructive pulmonary disease), and helps them and encourage them to learn about smoking cessation and things like that,” she said. “It’s really valuable in trying to help compliance, understanding of their underlying disease processes, what they can do to help themselves. The goal is to hopefully avoid and stay on top of ER admissions and in-patient admission by having that education.”
Five physicians and six advanced practice providers currently work at the practice.
A year and a half into the patient-centered model, the system is still a work in progress. The mental health therapist is already booking out several weeks, so they’re working together to determine how best to utilize her time, Herrman said.
It’s different medicine than physicians are taught in medical school to practice, she said.
“You’re trained through medical school and residency to be very autonomous and kind of do things on your own, and take care of everything,” Herrman said. “This is more of a team approach. But I think we’re giving better care. It’s relying on some of your other staff members to do their jobs, but they can do their jobs. That frees up our time to concentrate on what our primary focus and training has been on. I wasn’t trained on social work and how to help somebody get their medicine if they can’t afford it.”
It was tough getting used to the idea she had people to help her. But now that she has adjusted, she appreciates the additional input.
“I know if my patient’s not taking their medicine because (another provider) told me, or if they couldn’t get it filled,” she said. “I can prescribe them all the medicine in the world to control their diabetes, but if they can’t afford it, and they’re only taking one of the three, I’m not going to get anywhere no matter how much more medicine I throw at them. Now we have the resources to help them get their meds and be successful.”
Patient-centered models are being instituted across the country, and Herrmann is pleased to see Stormont taking the plunge as well. It’s The health system is tracking data to see how it’s working and how it can improve care.
Although it’s difficult to understand how they’re impacting ER visits and in-patient admissions, they do see that their patients are getting more preventative health measures taken care of, such as mammograms and colonoscopies. Pneumonia vaccine rates also are up.