Nurse practitioners are transforming care to be more thorough, direct and personal. Curious about their patients as well as their illnesses, NPs’ person-centered care supports overburdened medical teams to expand access and provide efficient, direct care, improving outcomes.
Through one-on-one dialogue and a consistent presence in the community, NPs trained in holistic care help individuals monitor and even prevent chronic disease. Cost-effective interventions address the unique barriers that commonly face high-risk populations, not only at the South Side Chicago health center where I practice, but spanning rural clinics and health care centers of excellence as well.
Emerging best practices and technology tools have expanded the reach of community health care and its impact, engaging patients in their own care plans. How we use technology to expand and simplify access to health care demonstrates the curiosity and connection with patients that truly drives meaningful change.
1. Lowering practical barriers to prevention. Cost-effective interventions fit into patients’ lives. Diabetes testing provides one example: While three tests are available – A1C, fasting glucose and oral glucose tolerance – insurance companies typically authorize the faster A1C test only after practitioners conduct the other two tests. For community health center patients doing heavy manual labor or long shifts, fasting or spending hours at a test site isn’t practical. Friend Health invested in A1C testing equipment and supplies. The gold-standard test takes 10 minutes. By getting tested immediately, with or without insurance coverage, patients can get back to work or their families, removing a major barrier to care.
A practical barrier for many patients is simply getting through the door. Some cannot make repeat trips or work irregular, long hours. To address this, community health centers stay open late during the week, early on weekends and across multiple locations. Being open longer and in multiple locations makes it easier for patients to commit to care. Service-oriented thinking like this avoids many of the usual roadblocks that undermine success.
2. Using technology to empower self-care. Technology is most effective when used thoughtfully and with the patient’s reality in mind. Friend Health’s Dr. Geetha Govindarajan is an expert on hypertension, a condition that requires twice-daily blood pressure testing. To simplify the process, Govindarajan’s patients use self-monitoring devices paired with mobile health apps, which transmit readings to the medical team. The mhealth apps give clinicians a deeper knowledge of how patients live with high blood pressure and empowers patients to be active participants in their own health.
Telehealth is valuable, but our practice is intentional about using it where it adds the most benefit. Illnesses like the flu or pink eye rate a video visit, but our practice tries to see patients for most conditions in person. Nothing replaces face-to-face interaction. This balanced perspective ensures we are leveraging technology without losing an opportunity to make a personal connection with our patients.
3. AI in preventative care: The man with a lump in his neck. In the right hands, advanced technology can be a powerful tool to enhance judgment and accelerate outcomes. When a patient sought medical attention for a lump on the side of his neck, I asked AI to run a differential diagnosis, analyzing his patient history and exam. While AI processed the case, I thought about potential causes and treatments. Together – patient, NP, AI – we crafted a plan. The patient saw a specialist and had a biopsy. Later, the patient shared that the ear, nose and throat doctor told him to thank me for doing a good job — including using AI. I felt odd involving the technology at first, but a doctor of nursing practice assured me, “Don’t hesitate. You got the patient into diagnosis and treatment faster, exactly what he needed.”
The bigger picture: A model for community health
Community health centers are nonprofit organizations that give treatment regardless of ability to pay. Other practitioners can use their strategies to unlock and fulfill the true needs of their communities. Public health efforts revolve around healthy eating, exercise and quitting tobacco. These programs have significantly lowered the risks of heart disease and stroke. However, success rates drop 10%–15% in at-risk populations, undermined by factors like food insecurity, unstable housing, transportation barriers and stress.
Ultimately, successful outcomes hinge on a commitment to using whatever means at hand to help patients overcome these deep-seated challenges. One-on-one dialogue and a consistent presence in the community can guide individuals to make lifestyle changes that prevent chronic disease. Community health centers face new financial pressures in reversing the social risks in their communities – including the threat of 2 million patients losing Medicaid coverage due to budget cuts, and the potential 2 million newly uninsured patients – but their cost-effective interventions can be extended across the health ecosystem, lowering barriers to better health for all.
Opinions expressed by SmartBrief contributors are their own.
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