As hospitals and medical facilities look for innovative ways to address the growing national healthcare worker shortage, Parkview Health is moving toward a collaborative care team approach to improve the patient experience and address the most critical health needs for the communities we serve.
“Healthcare is changing,” Joshua Kline, MD, chief medical officer, Parkview Physicians Group, PPG – Family Medicine, said. “To me, it makes sense to turn toward team-based care models as a way to adapt while keeping the patients at the heart of everything we do.”
The value of a team-based approach
In recent years, as Parkview’s health system and physician leaders have looked at the landscape of primary care, some of the challenges are clear. “When I started as a physician 17 years ago, if somebody wanted to see me, they called and we would get them in, one way or another. But today, the data is telling us that we simply aren’t graduating enough new family medicine physicians to keep up with the demand of our population,” Dr. Kline said. “This is why leveraging the expertise of other talented specialized medical professionals and these team-based approaches, where our medical facilities offer additional services to patients who can benefit from them, have become so important.”
Many Parkview patients are already benefiting from this collaborative mindset, as several facilities offer additional services like pharmacy, lab, virtual care options and access to care team members like nurse practitioners (NP) and physician assistants (PA) to improve access to care. Forming an official model of care that brings these services together in a patient-focused approach that fits into the current healthcare climate was an organic next step.
Introducing the Enhanced Primary Care Model
Parkview recently introduced two Enhanced Primary Care sites: PPG – Family Medicine at Liberty Mills and Parkview Physicians Group Clinic at Electric Works.
“The goal of enhanced primary care is to have a team working with our family medicine doctors so we can improve access to services for patients close to home and allow those physicians to serve more patients,” Dr. Kline explained.
What would that look like? “The physician works with one or more advanced practice providers (APP), either an NP or PA, as well as an extended care team. This could be a pharmacist working with some of our patients with certain chronic diseases, like high blood pressure or diabetes. It could be a behavioral health professional who sees patients navigating depression or anxiety. Or perhaps a nurse care coordinator assisting patients with more complicated health issues who might benefit from a little extra help navigating the complexities of the health system or managing their disease through lifestyle modifications. It’s about creating better access to experts in different areas who can help patients meet their health goals and manage their medical concerns.”
The enhanced primary care model ensures that every patient has both a physician and APP on their care team, so they see one of their providers on their care team as well as the appropriate support services at their appointments to help improve continuity and outcomes.
Virtual care is another important piece of the holistic approach. “When the situation lends itself to a virtual visit, that’s certainly a convenient and efficient option for our patients and an important piece of the enhanced primary care model,” Dr. Kline said. “Recognizing that access to care can be challenging, we’re seeing a lot of virtual healthcare pop-up options and services through retailers and tech companies. The issue with a third-party healthcare service is the lack of information sharing and care coordination. Getting services outside of Parkview might be convenient in the moment, but ultimately, it could lead to a crucial disconnect down the road.
“When patients use our virtual offerings, everything lives in their patient record. That visibility allows Parkview providers to see the patient’s health journey and access all of the elements necessary to help them reach their health goals.”
From the Virtual Walk-in Clinic to E-Visits, Parkview’s virtual options provide convenient access to care that’s integrated into the broader health system, contributing to that single story of care for the patient. Virtual services are an extension of your PPG care team, there when you need a digital option with the same level of service and attention you would get from an office visit.
Overall, the enhanced approach allows Parkview to serve a larger population, through a care team they know and trust while ensuring access to needed services. The result is a more cost-effective and holistic experience for all involved.
“The patients who utilize the enhanced primary care model could be healthy and working to maintain their health, or managing a temporary or chronic diagnosis,” Dr. Kline explained. “Either way, they will start with their doctor or APP, who will determine if the patient benefits from working with a pharmacist or behavioral health professional or other care team member. Having these team members in one location supports communication and continuity of care. All of this helps the patient reach their health goals.”
This coordinated approach creates a single story of care for patients, which leads to optimal outcomes.
Addressing the greatest needs
As leaders set out to assemble the enhanced model of care, in addition to the inclusion of APPs, pharmacy and behavioral health support services stood out as differentiators for Parkview patients based on data and feedback acquired through, among other avenues, the community health needs assessment, which identified obesity and mental health among the greatest well-being issues in our area.
Mental health
The Centers for Disease Control and Prevention (CDC) report that more than 1 in 5 adults in America are living with a mental illness, making it one of the most common conditions in our country. “The reality is that a good deal of mental healthcare falls to primary care,” Dr. Kline said. “I think there’s a widely held assumption that these patients all see a psychiatric professional, but that’s simply not the case. Conditions like depression and anxiety are often managed by the primary care team and are frequently connected to physical symptoms.
“We see patients end up in the Emergency Room because feelings of anxiousness or panic can present as serious medical events, like a heart attack. Because our mental and physical health are so interconnected, behavioral health has become a huge part of what family medicine doctors do. There is just such a great need for mental healthcare.”
Primary care providers recognize that these conditions can be tied to sensitive life events or daily challenges, which makes it all the more important to have a dedicated team member who can spend that important time going over treatment options. “Having these professionals available to provide their expertise and plan care, in coordination with the patient’s primary care provider and APP, is invaluable,” Dr. Kline said.
Pharmacy
Pharmaceutical services were also paramount to setting patients up for success. The American Hospital Association (AHA) has data showing that 133 million Americans, approximately half the population, have at least one chronic disease. These include heart disease, cancer and diabetes, as well as obesity, which affects more than 42% of adults. With statistics like this, the need for medication education and oversight is critical to patient outcomes.
“One of the biggest challenges we see in primary care is coverage for medications,” Dr. Kline said. “A lot of times we know a patient needs a drug in a class of medications and it doesn’t necessarily matter which particular brand they get as long as it’s covered and reasonably affordable so they can keep taking it. Having a pharmacy resource available to help make this happen is a huge differentiator for patients.”
Medication education is another crucial piece of the puzzle. “If I start a patient on insulin, for example, they need to titrate the dose to reach a goal amount,” Dr. Kline explained. “Typically, as the primary care physician, I would be giving them direction to go up one unit every couple of days until their morning blood sugar is less than 120 and then see them back in three months. And compliance with this approach was fairly low. With the enhanced care model, I can make a referral to the pharmacist and he or she can reach out and check on the patient, let me know how it’s going and provide guidance to help follow the care plan. That team approach leads to much better outcomes.”
This collaborative model also leads to higher patient satisfaction, as detailed instructions, changes to care and new medications can be extremely overwhelming. “This way, they have someone following up and providing extra support,” Dr. Kline said.
The big wins of enhanced primary care
When we step back and look at the impact of a collaborative approach to care, we see the downstream effects of broader access, more specialized care and support services, which is, ultimately, stronger outcomes for our patients and a seamless experience.
“We always have our patients in mind,” Dr. Kline said. “This care model brings care closer to home, so patients don’t have to go to multiple locations or seek out services. It supports better communication between care team members and the patient and a single source of truth in the patient’s care journey.”
A more coordinated approach with convenient access to behavioral health, pharmacy, APP and primary care providers, with integrated virtual care options when you need them, is a strong step forward for the populations Parkview serves at Electric Works and the PPG Liberty Mills locations. “Our goal is to learn from the enhanced primary care model and then apply what we learn in other locations,” Dr. Kline said. “We know we’re facing a growing demand that call for creative solutions. This enhanced care model is about serving patients to the best of our abilities while making their health journey easier to navigate. At the end of the day, it comes down to improved access and communication.”
Patients at Parkview Physicians Group Clinic at Electric Works and PPG – Family Medicine at Liberty Mills can experience the enhanced primary care model now, while patients seeing Parkview providers at other locations can expect to see these concepts applied in the future. If you need help scheduling an appointment or establishing care with a Parkview provider, our Access Center can help. Call any time, at 877-PPG-TODAY or 877-774-8632 for assistance.
