Contributed by Jeffrey Marr, ’18
This summer I had the opportunity to work as an intern with Hudson Headwaters Health Network through the Upstate Institute’s Field School. Hudson Headwaters is a large non-profit health network in the Adirondack region that covers an area of around 5,000 square miles and serves a population of around 80,000 people. Hudson Headwaters provides comprehensive and coordinated healthcare services to this population including primary care, urgent care and specialty services. In doing so, it seeks to provide each person with access to quality preventative care to ensure that they, and the population as a whole, are as healthy as possible. Hudson Headwaters serves a rural area that is at risk of being under-served by the healthcare system. While Hudson Headwaters serves a heterogeneous patient population, many of its patients are low-income and are at risk of falling through the cracks. To combat this, Hudson Headwaters provides millions of dollars worth of uncompensated care and pharmacy discounts every year.
Healthcare is constantly changing. Regulations are updated; new laws are enacted; new treatments are developed; new technologies are invented. While working at Hudson Headwaters this summer I have seen the inner workings of a system continuously in motion and the constant innovation that is necessary to move the healthcare system in the right direction. This focus on innovation and rapid adaptation to changes allows Hudson Headwaters to continually improve the experience of care, expand access to that care and to do so at the lowest possible per capita cost. To this end, Hudson Headwaters has worked to pioneer the most recent developments in healthcare delivery and reimbursement strategy such as Patient-centered Medical Home and Value-Based Payment Models, which both attempt to encourage the healthcare system to increase positive evidence-based outcomes throughout the patient population through changes in financial incentives and increased coordination of care. Within this framework, Hudson Headwaters has worked to integrate new approaches that enhance the network’s ability to improve outcomes.
My work this summer has been part of this larger effort to stay on the cutting edge of rural healthcare. While I have had the opportunity to observe and tangentially work on a variety of new developments, my focus this summer has been on two projects dealing with new treatments and technologies that have the potential to improve care.
The first project was to analyze the rollout of a handheld ultrasound device. Hudson Headwaters physicians have been piloting the device in collaboration with the device’s manufacturer. This technology is new to primary care and the aim of this pilot project is to assess how useful the device is in certain clinical scenarios and to determine where it adds value by possibly increasing patient satisfaction and convenience, reducing ER utilization, cutting readmission rates or eliminating the need for advanced imaging. I compiled and analyzed data to develop an assessment of the frequency and area of the device’s use as well as an estimation of its added value. Using this analysis in conjunction with the comments of the physicians involved in the pilot, I drafted a report to the manufacturer and helped to write proposals to secure funding to expand the network’s handheld ultrasound program going forward. The device has the possibility to expand a primary care physician’s capability in an office visit and its widespread implementation could help increase the ability of primary care physicians across the network to provide excellent care.
The second project was to help develop a strategy to treat Hepatitis C (HepC) in primary care. HepC is a disease that affects around 1% of the population and last year killed more people than any other infectious disease. Approximately half the people who have HepC are undiagnosed and of the people who are diagnosed, an even smaller number have been treated. HepC has also become more easily treatable in recent years with the invention of new but expensive drugs. With these facts in mind, I helped to begin to create a system to identify patients through the electronic medical record, refine the patient list to those who are good candidates for treatment in primary care, acquire prior authorization to treat from insurers and work with specialists to provide the necessary level of care. As this program expands in the coming years, it will hopefully lead to improved patient population health by expanding the local healthcare system’s ability to treat HepC.
It has been incredibly exciting to work on these projects and to learn about healthcare from those who dedicate themselves to finding new ways to improve people’s lives and the larger healthcare system.