Shore Regional Health offers update on services
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.