Physicians tout personalized health care model

Approach helps businesses save money, they say at Vancouver forum

By Libby Clark, Columbian Web Editor

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A new model of personalized health care could help local businesses save money on employee health plans, according to a presentation by a panel of physicians at a Community Choices health forum in Vancouver on Tuesday.

PeaceHealth and Southwest Washington Medical Center, Kaiser Permanente, Legacy Health Systems and Providence Medical Group are all experimenting with a “patient-centered” model in which all of a patient’s needs are met in one place, also known as their “medical home.” The model is essentially high-functioning primary care, focused on prevention and easy access to doctors or other health care providers via same-day appointments and secure email, for example.

Better use of electronic records and disease-management software also help clinics track individuals’ health histories and local trends.

This differs from standard practice, in which doctors from different specialties rarely share notes about patients with complex medical needs, and no single physician is in charge of coordinating care.

This medical home approach provides lower-cost and higher-quality health care, said Dr. David Ruiz, director of family medicine at PeaceHealth and Southwest Washington Medical Center. PeaceHealth began a pilot project using the new model in 2003 and saw patients’ emergency room use drop by 40 percent in one year at that clinic, Ruiz said.

Patients end up having more contact with their “medical home,” but fewer costly procedures over the long run. Cost savings also come from a team-based approach, in which nurses and medical assistants perform routine exams and basic procedures and doctors take on more complicated and specialized tasks, said Dr. Melinda Muller, vice president of primary care with Legacy Health Systems.

In most cases, savings are then passed along to the patient and his or her health insurer, in the form of a smaller bill.

“It will be a better investment of health care dollars, and in the private sector that money comes from businesses,” said Dr. Joe Siemienczuk, chief executive of Providence Medical Group in Portland. “It can also provide a healthy work force that’s more productive, mitigating time loss.”

Siemienczuk, Muller and Ruiz joined Dr. Albert Luh, medical director of Kaiser Permanente Kelso-Longview Clinic, on the panel of experts at Tuesday’s forum, which addressed why patient-centered medical homes are important in Clark County.

The approach takes a wide view of a patient’s whole health when factoring in care, including mental health and personal circumstances. And clinics become better about educating patients about their conditions, getting them in for check-ups and making sure they have the resources needed to get proper care.

“The benefits of the medical home will really impact our community, said Sharon Pesut, executive director of Community Choices and organizer of the forum.

Many insurance providers haven’t yet signed on to the concept, however, Pesut said, and so much of the cost of testing this new model is borne by health care providers — a potential obstacle to widespread adoption and change.

The model is also already in use by “safety net” organizations that serve low-income and uninsured populations, said Carrie Vanzant, clinic manager at Sea Mar Community Health Center in Vancouver. Adoption by larger health care providers won’t solve the broader community issue of access to care, she said. Many of these larger health care groups have stopped accepting referrals from her clinic, she said, due to the cost of caring for uninsured patients.

“We as a community have got to figure out how to take care of our most vulnerable, and most expensive, community members,” Vanzant said.