September is National Recovery Month — a time to recognize the more than 11 million Americans who are struggling with opioid addiction. This massive problem has grown exponentially over the years and, unfortunately, seems to be the new norm.
In 2014, Parkview Medical Center realized that it needed to reduce its readmission rate significantly while also fixing a communication gap between home health care agencies and other post-acute facilities. To address these issues, my director and a team of other leaders joined together to pilot a new transition care center that went live in 2016.
In the latest installment of our thought leader podcast series, I chat with Billie Lynn Allard, MS, RN, and Jennifer Fels, RN, MSN, co-founders of Southwestern Vermont Medical Center's transitional care program. Allard and Fels explain how they designed a program that addresses recurring gaps in care caused by social determinants of health in their rural community.
In behavioral health, social determinants is something we look at, but many of us haven’t made it a part of our everyday language. We know social factors have an impact, but because of how broadly defined they are, finding the next steps to take can be difficult.
There are distressing similarities between what the United States faced with HIV/AIDS in the 1980’s and the current opioid epidemic. Most people have a personal story related to the harm that can be associated with opioids. The numbers of opioid deaths and people suffering from substance use disorder has reached staggering numbers.
There is no shortage of social determinants of health (SDOH) that can present roadblocks for patients in Kalispell, Montana. Our vast landscape means that patients may live some 30 miles from their providers. With limited access to public transportation, many patients are left struggling to attend regular primary care appointments. We also live in a zero vacancy area, making it nearly impossible for some of our patients to find affordable housing.
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I was rounding with a colleague in the pediatric area of The Valley Hospital, in Ridgewood, New Jersey, when we entered the room of a young boy with his mother sitting by his bed. As we entered, we explained that we were visiting pediatric patients to see if they were interacting with the newly-installed GetWell Inpatient™ solution, GetWellNetwork’s interactive software that uses a bedside TV to get patients and their families more involved in the care process.
Ample evidence indicates that improved patient engagement is better for doctors and patients. With EHRs and government regulations, the rise of patient portals has been dramatic. A recent AMA study says that 92% of hospitals offer the ability to view medical records through an online portal (compared to 43% in 2013). But availability of an online portal doesn’t mean patients are accessing or getting value from it. How can we help patients move from simply looking up lab results, requesting refills, and checking schedules to more active and meaningful engagement? One technically simple, but remarkably powerful answer is to have clinicians share their visit notes with patients. It’s something we call OpenNotes.