Providing the best health care possible for each of its patients is not a process limited to what goes on inside the four walls of Access Health Louisiana’s St. Charles Community Health Center.
Efforts to extend the scope and quality of that patient care have resulted in the launch of Access Health’s Chronic Care Management Program, which focuses on caring for seniors living with two or more chronic conditions like diabetes, arthritis, depression or high blood pressure, and keeping them on a healthy track between visits to the doctor’s office. Patients who have Medicare Part A or B plans qualify for the program.
Through the Chronic Care Management program, a dedicated health care professional works with a patient to create a care plan for them, after assessing overall and specific health goals.
“A health care provider’s goal might be for a patient to lower their A1C levels, their blood sugar count for their diabetes,” said Chatrian Kanger, Population Health Director. “But that might not resonate with a patient … how do I get to that goal? The professional says, ‘OK, where do you want to start?’ Maybe its losing weight, or exercising more, making more of an effort to get outside and take some long walks with your dog. It’s a way to break down a process that might be a bit overwhelming to a patient once they leave the office.”
Kanger said the patient and his or her professional would usually touch base with a 20 minute phone call each month, covering topics like progress, if the patient has continued with medication prescribed and reminders of any upcoming appointments one might have with a specialist. If the patient has any questions, the professional is able to answer them or make inquiries on their behalf.
“They start to build more of a one-on-one relationship and you can see over time how that builds,” Kanger said. “It allows us to provide a little more support outside of the office. Your time in a given appointment can be very limited with doctor and patient right in front of one another.”
She said it allows the center’s care team to connect better with patients in their visits as well, as doctors have insight into the progress their patient has made since the last appointment. Kanger said a goal of having 100 patients enrolled in the program within its first month — it began on March 12 — has already been exceeded and close to doubled. By June 30, the hope is to have 500 patients enrolled by June 30.
Feedback so far has been positive.
“I think they really appreciate that one-on-one personal touch. It’s been well received by patients, and providers as well, because they really like knowing their patients will be followed up with beyond being directly in the (examination) room,” Kanger said.
The Chronic Care Management Program is part of a number of ongoing initiatives by Access Health in St. Charles Parish to improve its level of patient care.
The Access Health Louisiana Pharmacy, which offers free home delivery service, was recently opened at St. Charles Community Health Center along with the launch of its expanded dental department at the site.
A pair of school-based wellness centers have also been established by Access Health, both on-site clinics that each serve two schools: one in Paradis serving J.B. Martin and R.J. Vial Elementary schools and one serving Albert Cammon Middle and St. Rose Elementary schools.
Parents with students attending those schools must fill out consent and enrollment forms to receive healthcare services for the 2018-19 school year. Sports physicals are also offered at any clinic location, including the school-based centers.