Engaging patients in their healthcare is a challenge. Engaging patients in their healthcare in a rural setting where many people can't access care is an entirely different challenge, and it's one that Valparaiso, Ind.-based HealthLinc is working to solve.
HealthLinc is a federally qualified health center with seven healthcare sites across most of Indiana. The organization serves populations that are typically underinsured or uninsured. However, now that the Affordable Care Act has brought health coverage to more individuals, HealthLinc is redoubling its population health and patient engagement efforts to meet the new and growing healthcare needs of its community.
Melissa Mitchell, CIO and interim COO of HealthLinc, spoke with Becker's Hospital Review about some of these challenges and what the healthcare provider is doing to address them.
Note: Answers have been lighted edited for style and clarity.
Question: As largely providing primary and preventive care services, population health efforts seem to be at the forefront of what you do. Can you discuss HealthLinc's approach to population health?
Melissa Mitchell: We've been able to use tools like The Guideline Advantage [a quality improvement project from The American Cancer Society, American Diabetes Association and American Heart Association providing population health management software from and by Forward Health Group] to open up information into our current population and to find ways to meet the needs they have specifically. We have two people on staff who do nothing but analyze the data of our visits and the outstanding needs of our patients and then reach out to find ways to help them with their healthcare.
The ACA has been great in getting many people insured, but what's happened is that so many of those people who for a very long time did not have any care coverage have now presented to us with conditions which have been significantly worsened. Population health for us is identifying not just individual gaps in care, but also identifying those patients that have multiple comorbidities that are just getting insurance and need to navigate the landscape of healthcare right now.
Q: What are some of the population health challenges you're facing?
MM: There are barriers that patients come up against that are beyond whether or not they have health insurance, or beyond whether they understand what needs to happen next for them to get better. Some of the challenges we face are people not understanding how healthcare works now with the new insurance — there's an education piece of it. Because of our setting — we're somewhat rural — there's a huge barrier with even getting to care, including a shortage of providers that are available.
Q: How are you addressing these challenges?
MM: We are working with Guideline Advantage to come up with identifiable populations we can target for different interventions. For one project we're working on, we have a list of people who have healthcare gaps, and we're working with the local college to get a mapping system so we can download patient [information] and their location. We'll take our mobile unit to them and make sure they can get the care right at their door.
One of the stories I tell is we were able to identify a mother of six children. The laws in Indiana for Medicaid will allow these people to get transportation to and from a doctor's visit. The transportation model will only allow you to take one child with. [The mother] had for two years gone without well checks for any of her children because she could not get to healthcare. When we found out, we brought our mobile unit to her and got all six of her children cared for in that day.
It's being able to identify these people and reach out to them and understand why they aren't seeking services at our locations that allows us to be proactive and take the steps to get the treatment they need.
Q: How do you use IT to boost population health and patient engagement efforts?
MM: The two words you just mentioned can be big pieces of a single puzzle: the patient engagement piece. Beyond getting patients to do anything, you have to engage them [so they ask] "Why does this matter? What difference does it make?" So first we have to tell that story, and we use IT to tell that story. We publish videos and we provide education pieces all through things like our EHR and our…patient portal.
The second part is how can we use IT to assist them in doing something about it at that point? We've always been very forward in getting as connected to the rest of the community as we can. We're currently hooked up to two separate health information exchanges — Indiana has five. Because of the type of population, which is a nomadic bunch, it's helpful to have as much information as possible on these patients. We use the technology so we know who to reach out to, and from there we have a different means of care.
And we continue to move forward and we're investigating a few different solutions, such as getting home-based care integrated into our system as it becomes more available.
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