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ick Links Bangor Beacon Organization M.Michelle Hood, FACHE
EMHS, President and CEO
Bangor Beacon Community
Statewide Advisory Committee
Chair
Erik Steele, DO
EMHS, Vice President and Chief Medical Officer
Bangor Beacon Community Principal Investigator
Leadership Catherine Bruno, FACHE Bangor Beacon Community Executive Sponsor EMHS, Chief Information Officer Lead
Dale Hamilton Executive Director, Community Health and Counseling Services Alternate
Clincial Transformation
Jim Raczek, MD
EMMC, Chief Medical Officer Lead
Robert Allen, MD
Penobscot Community Health Center, Executive Medical Director
Alternate Evaluation Barbara Sorondo, MD EMMC, Director Clinical Research Center Lead
Frank Bragg, MD
EMMC, Family Practice Provider
Alternate Meaningful Use Dev Culver HealthInfoNet, Executive Director Lead
Bob Kohl
Maine Primary Care Association HIT Project Director
Alternate
Sustainability
Mike Donahue, MBA
EMMC, Vice President, Physician Practices
Lead
Donald Krause, MD
St. Joseph Healthcare
Internal Medicine
Alternate
Bangor Beacon Staff
Mac Hilton Program Director Debra Carpenter-Zeman Project Manager
Andrea Littlefield
Senior Communications and Outreach Specialist
Lanie Abbott
Senior Communications and Outreach Specialist
Julie Adams
Administrative Assistant |
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Stay up to date with the Bangor Beacon Community! |
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Donald Krause, MD, at
St Joseph Internal Medicine is blogging
How Beacon has Improved Patient Care
Participating in the Bangor Beacon Community grant has stimulated a number of changes in our practice at St. Joseph Internal Medicine. Jessica Audet, RN, has been added to the practice as a care manager.
It is her responsibility to review the care of those patients who have severe chronic illnesses that frequently result in admissions to the hospital. The goals of her review is to facilitate improved care, adherence to quality goals, improve patient understanding of their care and compliance with it, and therefore to improve patient satisfaction.
Although we've just started this program, there have already been significant changes in our practice. The education provided to patients regarding their illness has improved. Patients better understand the need for their medications and the life style changes required to maintain good health. Patient participation in their healthcare has also improved as well. Jessica can now cite a number of specific examples of patients who previously have had frequent visits to the emergency room, or frequent admissions to the hospital, who now are better able to manage their illness at home, thus reducing visits to the hospital. These patients no longer feel helpless, and are taking pride in their accomplishments and improving health.
Our providers are now able to review their adherence to quality indicators that reflect the care they provide to chronically ill patients. Openly sharing data with the other practices participating in the Bangor Beacon Community has resulted in improving the system of care and making it more responsive to individual patient needs.
Perhaps more importantly, Beacon has resulted in changing the focus of care from the individual practice to the community as a whole. With better communication between the various healthcare agencies (home health, behavioral health, pharmacies, and community resources) all focused on the care of the individual patient, the health of the community as a whole can be improved. We are currently developing the tools to accomplish this.
St. Joseph Internal Medicine is proud to be an active participant in this program, and challenged to facilitate its success. |
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Join us in a conversation. Comment on Dr. Krause's blog.
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St. Joseph Hospital is the latest Maine hospital to join HealthInfoNet (HIN) in an effort to further enhance the quality of patient care. Current statistics show that 75 percent of patients accessed during startup weeks were already in the system providing a broader picture to providers of care received at other facilities.
Connecting St Joseph Hospital's electronic medical record system to Maine's statewide health information exchange is helping to securely share important patient health information like drug allergies, prescriptions, diagnoses, and lab and test results with other healthcare providers across the state. The goal is for healthcare facilities in the state to be connected through HIN.
St. Joseph Hospital is hosting a press conference on July 18 to announce its connection with HealthInfoNet.
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Greetings!
Summer vacation is officially underway, and many of us are working hard while also enjoying some wonderful weather and all that Maine has to offer this time of year. Meanwhile, our care managers are beginning their six month checkups with their patients and continuing enrollment for new patients. We are now caring for nearly a thousand of our region's sickest community members.
As word spreads across the country about our collaboration, our providers are being asked to present on how we created this culture in a competitive marketplace. This truly is an exciting time for our Bangor Beacon Community as we lead the way in working together to improve quality healthcare.
Hope you're making wonderful memories,
Lanie Abbott
Senior Communications and Outreach Specialist |
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Relationships are Everything
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It is noon on a Tuesday and Jessica Audet, RN, care manager at St. Joseph Internal Medicine, has already seen three patients and spoken with ten more by phone. "I am doing all the things nurses love to do. I am spending time helping people learn to better care for themselves." Currently, Jessica is working with more than 100 patients, with a goal of enrolling 300 patients who suffer from one of four chronic conditions: asthma, diabetes, COPD, and congestive heart failure. "All my patients have a different level of acuteness so I'm able to see so many of them and still be able to provide the personal touch and care each of them requires." Jessica knows the secret to any care manager's success is the relationships they develop with their patients. "Nobody wants to have to re-tell their story each time they go to the doctor's office. By listening and hearing what their needs are, you can make even so-called non-compliant patients really see improvements."
Prior to hiring Jessica (St. Joseph Healthcare's only care manager), a small internal committee decided that out of their 13 providers, five of them would use a care manager. Staff then culled through their patients and found those who fit the Bangor Beacon Community criteria. "We didn't discriminate.We asked one basic question: Would this patient benefit from care management?" explains Miki MacDonald, nurse practitioner. A list was quickly created of qualified patients. "Some providers sent letters to patients and asked them to contact us if they were interested in participating. The response wasn't great, with only about 12 patients getting back to us," shares Miki. They learned quickly that a provider's endorsement made all the difference. Patients were very interested in working with a care manager if their healthcare provider recommended it. "We were very fanatical about who we hired as our care manager. We needed someone who loves patient contact, someone who would encourage others to care for themselves no matter what." They all agreed Jessica was the perfect fit.
They attribute that to Jessica's background as a home health nurse for eight years. "When you are a home health nurse you only have a few visits with patients. You have to quickly get them involved in managing their own care - that way they can seek help long before a health issue becomes urgent or life threatening," shares Jessica. By the time she started, patients were practically sitting at her desk waiting to sign up. "My medical assistant or I talk face to face or by phone with patients about how the Bangor Beacon Community program is a free program and they really can't lose by giving it a try," shares Miki. Often times the patients are in the office and get a warm hand off from their provider right to Jessica. "I have been a physician for 38 years and I have never seen this kind of transformation happen so quickly and with such provider support. Patients are getting more complete care and providers are getting to spend more time with their patients," smiles Donald Krause, MD, St Joseph Healthcare.
Feedback from patients has been overwhelmingly positive about their experience with Jessica; in fact, so much so that all 13 providers are now on board and referring patients to her. "Jessica goes the extra mile. She listens and gets to know you. She's kept me out of the hospital once already and I just started working with her two months ago," shares one of her patients, Larry Guy.
Larry's diabetes diagnosis is what opened the door for him to work with Jessica. He will be the first one to tell you he is a "frequent flier" at St. Joseph Hospital. Larry has respiratory and circulatory conditions that also require medical attention. "I have seen a lot of healthcare providers during the last 15 years and, to be honest, I wasn't expecting a lot from Jessica. But I was wrong. I have never had an advocate like her."
Jessica treats Larry like she does all of her patients: with compassion and an open mind. "What I'm really doing is collaborating with them - I am not here to hold their hand. I won't tell them what to do - I help them identify ways they can make changes," explains Jessica. By identifying one or two changes that they can make in their daily routine, they will notice change, and that is where success starts and where Jessica helps her patients focus. Dr. Krause can't say enough about Jessica and the changes she's making at both the practice and patient levels. "She is competent, positive, and looks to the providers to see how she can best work with their patients to make their lives better. She is an asset and has transformed the way we give care." |
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Maine Health Access Foundation (MeHAF) Wants to Hear What We're Up To |
Nearly ten years ago MeHAF opened its doors in Augusta, they became a force in promoting access to quality healthcare, especially for the uninsured and underserved. Since 2002, they have become the state's largest private health foundation, awarding nearly $40 million in grants to nonprofit organizations across Maine. They are also highly engaged in public policy.
While attending a Partnership for Patients event in Washington, DC, Wendy Wolf, MD, president and CEO of MeHAF heard that the Bangor Beacon Community was ONC's best grantee, "You are famous and making ripples, so I wanted to know more." Upon Dr. Wolf's return to Maine, she immediately asked for a few hours to meet with staff from the Bangor Beacon Community.
MeHAF's support of HealthInfoNet was integral in getting the statewide health information exchange started and they wanted to hear how it was helping Bangor Beacon primary care practices and hospitals. Also, she was curious about how competing providers are working together to improve the quality of care provided to patients in our community. Dr. Wolf commented, "I'm very interested in how we can work together to share what you are doing and learning throughout our state."
The Bangor Beacon Community's integration of behavioral health into primary care practices, as well our home care project which will allow home health agencies to treat more patients using telehealth monitors are also of interest. "What you are doing in these areas is really ground breaking. You are light years ahead of anyone in the country in your thinking and approach," adds Dr.Wolf.
MeHAF is committed to helping the Bangor Beacon Community be successful not only for this project but to further the approach to healthcare reform throughout our state.
MeHAF staff members who visited Bangor included Wendy Wolf, MD, Len Bartel, Barbara Leonard, Morgan Floyd, and Becky Boober. They met with Bangor Beacon Community membersBarbara Sorondo, MD, Janet Bayleran, PhD, Sandy Wardwell, NP, Lori Newcomb, RN, David Prescott, PhD, Tom Lynn, LCSW, Eve Preston, Morgan Connelly, Frank Bragg, MD, Lisa Harvey-McPherson,RN, Andrea Littlefield, Lanie Abbott, Mac Hilton, and Cathy Bruno. |
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Bangor Beacon is Providing
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Recruiting patients, auditing data, and publishing findings from the Bangor Beacon Community are perfect opportunities to get three local college students home for the summer. Recently, EMMC's Clinical Research Center found themselves with more work than people, so they hired a few summer interns to help them out. "It's an exciting opportunity and these students will be very valuable to our work. Plus, providing opportunities to tomorrow's healthcare workforce is an honor." shares Barbara Sorondo, MD, director of the Clinical Research Center.
Anna Carmack, a sophomore at Notre Dame University and 2010 graduate of John Bapst High School in Bangor, is thrilled to join the team. "I didn't think I was going to come home this summer, but this opportunity was too good to pass up. I am a Pre-Med student and very interested in public health." Anna will spend her summer recruiting patients for participating in the Bangor Beacon Community program as well as helping to complete data for the non-intervention group. In addition to the obvious draw of the job, the opportunity allows her to spend the summer with her family.
Sam Dow, a recent graduate of Dartmouth College, and a 2006 graduate of Hampden Academy, wanted more medical experience on his resume before applying to medical school next year. "I am very interested in improving healthcare in rural areas. I was part of a similar project in Ecuador." Sam would love an opportunity to move back to Maine someday, to be closer to his family, and seeing opportunities like this in the area helps him feel that is a possibility. Sam is a member of the auditing team, and will be working on data compliance for the already enrolled intervention and non-intervention patients.
Michael Rocque, an Augusta native and University of Maine graduate, is back for his third summer. Currently, he is working towards his PhD in Sociology from Northeastern University. "This position provides me the opportunity to be a part of something that is important both locally and nationally. It also allows me to be involved in and learn about advanced technological designs, which is the future of not only medicine but also research." Michael is a member of the publication team and the Hot Spot feasibility group. |
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Is Your Medical Record Accurate?
Many of us get immunized each flu season, often right at work, but how many of us take the extra step and make sure our immunization record is updated in our electronic medical record (EMR)? One of the goals of the Bangor Beacon Community is to increase the number of people in our community getting immunized as well as making sure that the information is passed along to their primary care provider.
Poppy Thacher Arford is a patient advocate for HealthInfoNet as well as for the Maine Patient Centered Medical Home pilot project. As the daughter of a physician, wife of a cancer survivor, and mother of two teenagers, Poppy has a unique perspective as we move into the age of shared patient information. Poppy recently lost her mom and on numerous occasions over the years had wished her mom's medical information was accessible. "Often times my mom couldn't remember if she'd had a test, or a lab, or an immunization. If she had had an EMR, it would have made things so much easier." Even with this experience Poppy admitted being less than attentive about updating information in her own EMR; however she was shaken out of her complacency, when her husband was diagnosed with colon cancer. "Having an accurate EMR makes it easier to coordinate care, and I see the only way to do this is by having an effective, confidential, and reliable statewide health information exchange. Why wouldn't we want to have all our medical records available?"
Miki MacDonald, nurse practitioner, agrees. As a nurse practitioner at St. Joseph Internal Medicine, Miki sees firsthand the benefit of keeping our medical records up to date for seasonal flu vaccinations. "It helps prevent duplication of services now that vaccines are given in many settings from hospitals, walk-in care clinics, pharmacies, and primary care clinics. The patient's home chart is at their primary care office and that's the best place for this information to be stored, no matter where the vaccine is given. Other healthcare providers look at a patient's primary care provider for all medical information, including vaccinations."
During this upcoming flu season we encourage everyone to not only get immunized but also to take the extra step and be sure your immunizations become part of your medical record. You can do that by letting your primary care office know during your next visit. | |
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The 12 Bangor Beacon Community partners:
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