Fair health care

Health disparities that break along racial lines should concern us all. I found a recent article in The New York Times most troubling. Here's just a sample of what's reported.

A troubling racial divide in breast cancer mortality continues to widen in most major cities around the country, suggesting that advances in diagnosis and treatment continue to bypass African-American women, according to new research.


Read the entire report here. 

Cause for real concern, wouldn't you say? 

At CitySquare we continue to think in terms of "hot spot" interventions in which we know we can play a useful part. Those who support our community clinic will play a huge role in helping us engage even more effectively in the future than we have in the past. 

More later. . .I believe.

Good news on CitySquare pharmacy!

[CitySquare's South Dallas health clinic is a winner! Read on. . .]

CitySquare Leadership Team (and all):

 Our clinic pharmacy had a surprise visit yesterday from the Texas State Board of Pharmacy. The state inspector showed up at about 10a. m.– completely unannounced. These visits are anticipated but it is always nerve-racking when they actually happen.

 For a historical perspective:  we were officially inspected by the State Board of Pharmacy about 6-7 years ago.

 Congratulations are in order – they passed us with flying colors!

 I am so proud and pleased to report that we received 0– repeat zero –actionable items for the future. This is wonderful news.

 WAY TO GO CITYSQUARE CLINIC PHARMACY! 

 Very special thanks to: Crystal Maturino, POR pharmacy assistant, and Oneyda de la O, LVN, for doing everything right–i.e. greeting the inspector, checking his credentials, contacting our Pharmacist (Carlos Alvarez) and answering all his questions prior to Carlos arriving and retrieving all requested information during the survey.

 Sincere thanks to both of you. Carlos– thank you so much for ensuring our success with this inspection. Without your counsel and oversight we would not be where we are today. We appreciate you. Carlos told me that it is not unusual for pharmacies to receive 1 or 2 items that require a written action plan. We received no action items. Wow! Outstanding.

 I know you will all echo my sentiments to this great team for all their hard work and dedication in the CitySquare pharmacy! Congratulations to clinic team!

CitySquare health clinic listed among the best in Dallas!

[Great news for CitySquare!  Our Community Health Services clinic received recognition in the very significant award described below!  Bottom line: we dedicate ourselves to providing our low-income neighbors the very best care possible! As a result, our clinic is listed along with the very best market-rate health clinics in the DFW Metroplex!]

80 Texas Physician Practices Recognized for Improving Care through Health Information Technology

Texas Physician Practice Quality Improvement Award honors physician practices using technology to provide exceptional preventive health care 

FOR IMMEDIATE RELEASE

CONTACT: Emilie Fennell Director, Communications and External Relations 512-334-1649 Emilie.Fennell@tmf.org 1-800-725-9216 Katie Gaide Public Relations Specialist TMF Health Quality Institute 512-334-1709 kgaide@txqio.sdps.org Austin, TX – April 22, 2013 – TMF®

Health Quality Institute, Texas Medical Association and Texas Osteopathic Medical Association announced today that 80 physician practices statewide received the first Texas Physician Practice Quality Improvement Award for effectively using health information technology to improve care for patients through reliable delivery of preventive health services.

The three organizations collaborated to develop the award in 2012 to recognize high performing practices committed to improving clinical measures including cholesterol screening, tobacco cessation counseling and cancer screenings, among others. Using health information technology to drive high-quality preventive services has been designated a priority for U.S. health care by the Centers for Medicare and Medicaid Services (CMS).

Click here to read the entire report and to see the list of award winners!

More good news from CitySquare Community Health Services!

Recently, I received the message below from Leigh Allen, our practice administrator at CitySquare's Community Health Services.  The good news continues to pour in on the quality of the services we offer our neighbors who are also our patients.  We strive to create a user-friendly medical home for everyone who comes through our doors.  It turns out that the "family atmosphere" we offer is an important part of the healing work we do.  Enjoy!

Leadership:

I wanted to share this wonderful email announcement of the TMF Physician Quality ImprovementAwards.  

All the providers in . . . the CitySquare clinic were recognized!  

We were able to achieve this award because of the hard work that previously went in to obtaining our Level 3 Patient Centered Medical Homes recognition.  

I am proud of [our] CitySquare team.  They deserve to be recognized and we will celebrate at the clinic level with a lunch or “dessert” day. 

Carpe Diem!

Leigh Allen, Practice Administrator

CitySquare – Community Health Services

CitySquare clinic scores big!

What follows is a direct, cut and paste email message that I received recently from Frances Martinez, Operations Manager for CitySquare's Community Health Services. 

Our clinic, located in South Dallas-Fair Park just off the intersection of Malcolm X and Grand Avenue, scored big in the latest Health Texas Provider Network (the Baylor Health Care System's physicians group) audit of our Adult Preventative Services. 

The translation is very simple, and most encouraging:  our clinic ranked second among all the HTPN clinics in the system!  This includes the clinic that I call my medical home out in the North Dallas suburbs! 

Great work, CitySquare health care team!  Great work! 

Our patients receive the best care possible, and evidently the best care available! 

 

____________________________________

 

Everyone,

Please see below, we are #2 in HTPN for the July-September Adult Preventative Services (APS) audit!!  Congratulations everyone!  It is definitely a team effort from scheduling WWEs, to requesting the tests, to putting in the orders, to scheduling the tests.  Please take a moment and give each other a high five!

 

Rank Practice Name

POA

1 Signature Medicine

N 278

95.41%
 

2 City Square Community Health Services

N 643

92.87%

Frances Martinez

Operations Manager

CitySquare-Community Health Services

2835 Grand Ave.

Dallas, TX 75215

214-421-1783

francema@baylorhealth.edu

Costumbres Peligrosas

Kathy Bennett, our social work director at Community Health Services here at CtiySquare sent me the following information about a novella (soap opera) that our team produced with the help of our AmeriCorps team and an ExxonMobil intern.  I think you'll find this creative piece most encouraging.  We'll let you know when the finished product is set to air--complete with sub-titles!

We are using our ExxonMobil intern to direct this educational film in Spanish in the form of a Spanish novella (Soap opera.) We think this format is more interesting and appealing to the people we serve.


The completed video will have subtitles in English. I am happy with the response of our clinic family in all the help the patients and staff have given for this to be a success.  Almost everyone in the video is a patient and everyone associated with it except for the interns are volunteers. We have a long list for the credits of people to thank. I would love to hear what you think of the trailer. Of course we are all hoping the video is as good as the trailer.

CitySquare Community Health Services receives highest rating as "medical home"!

Great news for CitySquare's Community Health Services!  The National Committee for Quality Assurance, a private, 501(c)(3) not-for-profit organization dedicated to improving health care quality recently released the results of the following practices as receiving the organization's highest quality ranking:

Baylor Family Medicine at Legacy
Family Medical Center at Terrell
Baylor Occupational and Family Health Center at TI
City Square
City Square- Pediatrics

Since 1997, our Community Health Services department has partnered with the Baylor Health Care System and Health Texas Provider Network to bring extremely high quality medical services to inner city Dallas.  The following letter tells the wonderful story:

Congratulations!

We have not only completed the application process for NCQA Patient Centered Medical Home recognition for all of our adult, geriatric, residency and pediatric practices, but have now received the results. All practices received the highest possible level of recognition. Level 3 is the highest level for Electronic Health Record (EHR) practices and the highest for paper practices is Level 2. Out of a possible 100 points, our EHR clinics scored in the mid-90s on average. This means that we now have 60 practices, 271 physicians, and 59 non-physician providers (APRNs and PAs) in recognized medical homes. This is the second highest total of any system in the nation.

During this implementation and application process we have seen engagement in new discussions around topics like pre-visit planning, ambulatory care coordination, patient/family activation and patient access. More practices have extended hours than ever before. Heart failure readmissions have dropped significantly. Diabetes scores have improved. Guidelines have been standardized across our practices including many specialty practices. Insurers are coming to us asking for PCMH contracts that allow for new funded resources and opportunities for shared savings.

The journey started many years ago with the Quality committee's work on quality standards and measurement of preventive services and diabetes metrics. It continued with the work of the Service Excellence committee, the Ambulatory EHR committee, Patient Safety committee, Disease Management and EHR Content Committee, and then the PCMH Task Force. The medical home applications included work from all of these committees.

Join me in thanking the chairwomen/chairmen and members of these committees for their hard work as well Sarah Gahm and David Winter for their leadership. Of course we should especially thank Pat Link, the PCMH Director, and her team of consultants, writers and contributors: Endia Kendrick, Michell Martin, Niki Shah, Patrice McConnell, Ashley Wood, Vivian Plumlee, Joe Brumbelow, Nancy Trinh, Kelly Risinger, Beulah Casey, Cynthia Granade and Tim Houtchens. We also need to thank our physician auditor team who gave personal time to audit over 2,300 patient records, Drs. Hickl, Astbury, Aponte, Molen, Massey, Stroud, Thompson, Bassel, Berry, Caudill, Garcia, De Leon, Holbrook, McMillin and Sharp.

The journey of course never ends. We are already implementing the new PCMH criteria into our practices. Many of these are meaningful use criteria. We are also preparing to apply for NCQA recognition for our new practices under these new guidelines as well as preparing to support BQA non-HTPN practices.

We are blessed to have a group of physicians, nurse practitioners, physician assistants, administrators and staff who strive to provide safe, effective, efficient, equitable, timely and patient centered care. It makes our work more enjoyable and meaningful.

Thank You All,

Cliff Fullerton, M.D., M.Sc.
VP Chronic Disease Baylor Health Care System
Chief Quality Officer HTPN

What a privilege to be working in tandem with our partners at Baylor and Health Texas!  CitySquare continues to help provide the highest quality care possible to low income neighbors in the inner city of East and South Dallas. 

Way to go, CitySquare team!

The City Square "Opportunity Center"--a dream coming soon. . .



CitySquare clinic impact

Recently, I received a report on the impact of the work of our Community Health Services team on the health outcomes of our patients.  The analysis compared hospital utilization and costs of CitySquare patients to those of similarly uninsured patients from the Baylor University Medical Center (BUMC) service area.

Here’s what we found:

a. CitySquare patients were half as likely to be admitted to BUMC as their non-CitySquare counterparts.

b. When admitted, the average length of stay for our patients was 4.6 days, compared to 5.6 days for the non-CitySquare, uninsured patients.

c. When admitted, the average cost of an inpatient stay for a CitySquare patient was $6,500, compared to $9,100 for non-CitySquare, uninsured patients.

d. Unfortunately, this study revealed that CitySquare patients were just as likely to visit the ED as their non-CDM counterparts. Among other responses, this finding should motivate us to make medical contact information more readily available to our patients for those after hours times when care is needed. 

Clearly, the partnership we enjoy with the Baylor Health Care System and Health Texas Provider Network is paying off for and in our community.

Community medicine. . .really!

Here at CitySquare we've been working off of a "community care," community-based model in our Community Health Services department for a long time.

Listen to the following NPR report describing new approaches to medical education and community health improvement.  When in doubt, go to the community!

New Medical School Model: Adopt A Family to Treat

Diabetes and depression--hand-in-hand?

Type-2 diabetes continues to ravage low-income, inner city communities.  Many factors contribute to the escalating health challenge, including diet, obesity and the lack of safe places for exercise.  Now comes a study indicating that diabetes and depression may be feeding each other. 

As I read the report below from the "Health Day" section of Bloomberg News, I recalled a conversation I had with an elderly woman from South Dallas years ago. 

"Brother Larry," she said, "around here we carry our grief in buckets."  Her way of describing the many sources and forces behind her own depression.  The work we do creating hope and friendship as a vital part of our daily response to diabetes is right on target. 

Diabetes, Depression Can Be Two-Way Street


By Ellin Holohan
HealthDay Reporter

MONDAY, Nov. 22 (HealthDay News) -- Diabetes and depression are conditions that can fuel each other, a new study shows.

The research, conducted at Harvard University, found that study subjects who were depressed had a much higher risk of developing diabetes, and those with diabetes had a significantly higher risk of depression, compared to healthy study participants.

"This study indicates that these two conditions can influence each other and thus become a vicious cycle," said study co-author Dr. Frank Hu, a professor of nutrition and epidemiology at the Harvard School of Public Health in Boston. "Thus, primary prevention of diabetes is important for prevention of depression, and vice versa."

To read the entire report click here.

Local NPR station--KERA 90.1--reports on CDM health clinic and Project Access

Yesterday, KERA 90.1 FM, our NPR station here in Dallas ran a great report on the dilemma facing uninsured people when illness strikes. 

The work being done by Central Dallas Ministries was featured prominently in Bill Zeeble's compelling report.  Both our Community Health Services clinic and our involvement in Project Access Dallas were included in the report. 

To listen to the story click here. 

After you check it out, do me a favor and pass it along! 

Health Care Crisis

The health care "debate" rages on, fueled at times by hysterical fears and plenty of outright falsehood.

What seems lost to many is the growing need among millions of Americans for basic health care.

Take a look at the video. It first aired on "60 Minutes" in 2008 before the Presidential election.



Sustainability and scale are the key challenges facing "free clinics" like the ones featured in the report. We need to find a way to care for one another, and that means everyone.

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