People live within a matrix of family, friends, jobs, homes, neighborhoods, geographical areas and psychological and cultural environments, all of which can influence health. For decades, the American medical system has elevated measurable, physical aspects of a person over those harder to measure, unseen aspects of the mind – behavioral and mental health.
Today, it has become increasingly clear there is a need to treat the whole person. Multiple reports indicate the providers who choose to coordinate and collaborate on consumer care see better outcomes.
The Wyandotte County Public Health Department has been among the most innovative in the country, integrating care internally between programs that formally operated in silos. For example, Wyandotte now combines its women’s preventative health clinic, family planning and sexually transmitted disease divisions into a Clinical Services unit, serving all women’s health needs.
"We do a little of everything," says Program Head Terrie Garrison. Clinical Services offers annual woman well exams, pap smears, breast exams, contraceptive counseling and prescriptions, prenatal visits, sexually transmitted disease prevention and treatment and immunizations, among other services.
"Since we integrated, we found we can not only take care of our consumer’s issues, but get them on track for preventative care," Garrison explains.
As of yet, Wyandotte has not been able to capture any hard ROI on this shift, but Garrison says consumers and clinicians report satisfaction. From a clinical flow perspective, it saves time for all involved. In the past, consumers would have to make two separate appointments to get checked for a STD and discuss pregnancy options. Now, they can do both all on the same day.
"Healthcare is a collaboration. Working with your provider partners is vital for everything running smoothly for the consumer."
"This is treating the whole person," says Garrison.
Recently, Wyandotte County took the goal of integration to the next level when it selected Netsmart’s CareConnect™ connectivity solution to share secure, HIPAA-compliant data with other providers outside its four walls. CareConnect is Netsmart’s integration engine that optimizes the advances in interoperability standards and provides organizations with the ability to connect to lab vendors, state immunization registries, local or regional health information exchanges, and other external providers for point-to-point referral capabilities.
Through direct messaging and secure transfer of Continuity of Care Documents (CCDs), Wyandotte hopes to be able to offer more seamless transitions of care from its Clinical Services unit to labor and delivery wards, primary care providers and the area Federally Qualified Health Center. The solution also supports secure messaging where providers can have secure electronic discussions about consumers before a transfer. This helps the next provider be more prepared for the consumer’s visit.
"This is a new paradigm," says Maria Salas, Wyandotte County division head.
While the solution is new to Wyandotte and they are still working out some of the ins and outs with other providers who might not be as up to speed on the technology, Salas says there are already some real wins. For example, the FQHC will often transfer consumers to Wyandotte County to receive an intrauterine device (IUD), which serves as a more permanent form of contraception that the FQHC does not provide. However, the FQHC can offer pre-implantation counseling as well as schedule the appointment at the local health department for the consumer. Using CareConnect, the consumer’s record from what has been done at the FQHC can be shared with Wyandotte County’s Clinical Services unit.
Soon, they hope to have similar protocols in place with providers that offer sonograms and other primary care providers that monitor hypertension, diabetes or other medical ailments. Salas says ROI in the form of hard numbers is not being captured yet, but she anticipates cost savings from redundant laboratory tests and other screenings (suicide, depression, domestic violence), which are already done in the local health department and could be sent to the next provider.
"Technology is here and it’s great," says Salas, encouraging other local health departments to explore new solutions that could improve care. "Healthcare is a collaboration. Working with your provider partners is vital for everything running smoothly for the consumer."