Shore Re­gional Health of­fers update on ser­vices

Record Observer - - News - By MIKE DAVIS mdavis@kibay­

CENTREVILLE — Dur­ing the Tues­day, June 14, Queen Anne’s County Com­mis­sion meet­ing, Univer­sity of Mary­land Shore Re­gional Health Se­nior Vice Pres­i­dent Patti Wil­lis gave a quar­terly update about some of the health care sys­tem’s ser vices and its plans.

Wil­lis spoke about the “dar­ling of the EMS world,” the Mo­bile In­te­grated Com­mu­nity Health (MICH) pro­gram and how it has con­tin­ued to be a suc­cess.

The MICH pro­gram is a ser­vice free to Queen Anne’s County res­i­dents 18 or older who have been iden­ti­fied as high risk pa­tients who overuse 911 ser­vices and vis­its to the emer­gency room. Rather than re­ceiv­ing treat­ment at a fa­cil­ity, a nurse prac­ti­tioner and a para­medic visit a client’s res­i­dence to re­ceive ser­vices. The pro­gram re­ceived the 2014 Pres­i­dent’s Healthy Coun­ties Best Prac­tices Award from the Mary­land As­so­ci­a­tion of Coun­ties as well as re­ceived the Star of Life Award for Out­stand­ing EMS Pro­gram by the Mary­land In­sti­tute for Emer­gency Medicine this past year.

Wil­lis said one of the pi­lot stud­ies at the Queen Anne’s emer­gency cen­ter was the emer­gency ser­vices trans­port of pri­or­ity two pa­tients, which are peo­ple with mod­er­ate to se­ri­ous in­juries or ill­ness that are not im­me­di­ately life threat­en­ing. In Fis­cal 2011 when the Queenstown fa­cil­ity fully opened, Wil­lis said it saw about 180 pri­or­ity two pa­tients in its emer­gency cen­ter, “and those were largely walk-ins be­cause EMS was trans­port­ing right by there and go­ing to area hospi­tals.”

Through­out the sub­se­quent years the num­ber of pri­or­ity two pa­tients rose into the low 200s, but since the pi­lot of the mo­bile in­te­grated health care project over the past year the num­ber has grown close to 400 pa­tients at the Queenstown emer­gency cen­ter.

“That’s prob­a­bly about 200 more times that your units are stay­ing in the county be­cause in­stead of by­pass­ing the emer­gency cen­ter and go­ing straight to an in­pa­tient fa­cil­ity, they are able to stop there with a pri­or­ity two pa­tient and in more than 85 per­cent of those cases, those pa­tients are able to be treated, sta­bi­lized ... and re­leased and not need a sub­se­quent hos­pi­tal ad­mis­sion,” Wil­lis said.

The in­for­ma­tion gath­ered in the past year of the pi­lot has been sent to the Mary­land In­sti­tute for Emer­gency Med­i­cal Ser­vices Sys­tems (MIEMSS) for re­view where it will de­cide the pro­gram’s fu­ture. Wil­lis said one out­come could be it be­com­ing “stand­ing pro­to­col” for a free stand­ing emer­gency cen­ter but will need to see what the in­sti­tute de­ter­mines.

“We be­lieve it’s a suc­cess in that it has kept the units in the county, it has en­abled them nearly twice as many times to be able to stay here and not trans­port di­rectly to a hos­pi­tal when a pa­tient could have been treated and re­leased,” she said. “So, we be­lieve that that is suc­cess­ful.”

The MICH pro­gram re­cently re­ceived a $400,000 grant from health in­surer CareFirst BlueCross BlueShield.

For those who have stayed en­rolled in the pro­gram for the past year, Wil­lis said, there has been be­tween 116 and 136 “avoid­able uses of the ER or trans­ports by 911 that could have been avoided.”

Though Com­mis­sioner Steve Wil­son was ap­pre­cia­tive and com­pli­men­tar y of the Univer­sity of Mary­land Shore Re­gional Health sys­tem and its co­op­er­a­tion with the county, he said slow-ups in the emer­gency room can still be im­proved upon at both Anne Arun­del Med­i­cal Cen­ter and the Chestertown hos­pi­tal. De­spite the MICH pro­gram sav­ing 100 res­i­dents from be­ing in a care fa­cil­ity, Wil­son said 1,200 peo­ple were trans­ported over to AAMC and once at the hos­pi­tal they are sub­ject to wait hours be­fore re­ceiv­ing ser­vices.

Be­cause many peo­ple don’t have in­sur­ance, Wil­son said, they aren’t go­ing to pri­mary care be­cause it is un­af­ford­able. Another rea­son that forces peo­ple into emer­gency rooms, he said, was the fact that many in­ci­dents hap­pen dur­ing the night or on week­ends.

“So this busi­ness of tr ying to hope we’re go­ing to tele­port pa­tients into pri­mary care isn’t re­ally go­ing to hep I don’t think,” Wil­son said. “So, that means that what has to hap­pen is not slow the vol­ume down but speed the process up.”

In June, Wil­lis said the Shore Re­gional Health board will re­view the ser­vice de­liv­ery plan de­vel­oped by five clinical coun­cils to de­fine how it will pro­vide health care ser­vices in the re­gion, mainly look­ing at how to ap­proach health care in a ru­ral set­ting. In March and April, rep­re­sen­ta­tives from Shore Re­gional Health “went out into the field” and con­ducted com­mu­nity lis­ten­ing ses­sions.

Other than the sup­port re­ceived for main­taing in­pa­tient ser­vices at the Chestertown hos­pi­tal, res­i­dents ex­pressed two main con­cerns, she said: get­ting to health care and ac­cess to spe­cial­ists.

De­spite Queen Anne’s County’s “ro­bust pub­lic tran­sit sys­tem,” Wil­lis said they heard pub­lic trans­porta­tion was dif­fi­cult for peo­ple re­ceiv­ing chemo­ther­apy or ra­di­a­tion treat­ment mul­ti­ple days a week for mul­ti­ple weeks as well as peo­ple get­ting re­ha­bil­i­ta­tion ser­vices. One so­lu­tion be­ing looked at, she said, was the pos­si­bil­ity of an Uber-type in­di­vid­ual trans­port sys­tem for pa­tients.

And fi­nally, Wil­lis touched on the Am­bu­la­tory Surgery Cen­ter at the Shore Med­i­cal Pavil­ion in Queenstown, which has been open on the third floor of the building for more than a year now. Though the num­ber of pa­tients seen has grown slowly but steadily, Wil­lis said ser ving more pa­tients de­pends on grow­ing pri­mary care re­fer­rals to the sur­geons at the cen­ter and in­creas­ing ac­cess to the sur­gi­cal spe­cial­ists.

Wil­lis said the re­la­tion­ship building process be­tween pri­mary care and spe­cial­ists “doesn’t just hap­pen over night be­cause you hang a shin­gle,” so part of the fa­cil­ity’s growth will nat­u­rally take time. But more im­por­tantly, she said, is get­ting the spe­cial­ists to pro­vide more hours. By hav­ing more hours at the cen­ter, the spe­cial­ist can see the pa­tients be­fore sched­ul­ing the surgery, Wil­lis said.

“That re­ally has to do with the abil­ity to re­cruit more physi­cians to the area, more spe­cial­ists, so that they can de­ploy from wherever their cen­tral of­fice hub is and spend more time at the Queenstown fa­cil­ity,” Wil­lis said.

Be­cause many of the spe­cial­ists are reg­u­larly busy, tak­ing time away from their prac­tice for a day to see pa­tients in Queenstown can be tough. Not only are they adding more of­fice hours, they are adding trans­porta­tion time, she said.

“We’ve got to be able to have enough re­cruited physi­cians to han­dle the vol­ume of pa­tients at the cen­tral of­fice so we can free those sur­geons,” Wil­lis said.

Fol­low Mike Davis on Twit­ter: @ mike_k­iby­a­times.


Patti Wil­lis, se­nior vice pres­i­dent of Univer­sity of Mary­land Shore Re­gional Health, gave the board of county com­mis­sion­ers a quar­terly update of the sys­tem’s pro­grams dur­ing the com­mis­sion’s Tues­day, June 14, meet­ing in Centreville.

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