ALBANY – While Phoebe Putney Memorial Hospital was in the national media spotlight focusing on the impact of COVID-19 on health care systems in southwest Georgia, other health care providers were facing similar challenges in the shadows.
One of these health care networks was Albany Area Primary Health Care (AAPHC). As one of the largest medical groups in the region, AAPHC was facing similar service delivery challenges for the more than 45,500 patients it currently serves.
Albany Area Primary Health Care operates 26 clinics in 14 counties providing services that include internal medicine, family medicine, pediatrics, obstetrics and gynecology, podiatry, general dentistry, vision care, behavioral health and pharmacy services. The agency also has school-based health centers for students, their families and faculty members at a number of schools.
Nationally Community Health Centers are caring for 29 million uninsured or underinsured patients. Serving these patients means that, in most instances, adequate funding is a continual challenge.
In a strange twist of a fate, as COVID-19 impacted the nation’s economy, forcing businesses to close, adding dramatically to the unemployed and uninsured population, it was also responsible for the closure of 1,900 CHCs when they were most needed.
“When we realized the impact (the pandemic’s) arrival would have on us, we focused on two things,” Shelley Spires, chief executive officer of AAPHC, said. “One was to make sure that we could still provide care to our patients. It was very important to us to keep them out of the emergency room. The second thing was to keep a 100% level of staffing even though we had to close some facilities.”
AAHPC’s Chief Medical Officer, Dr. John Edward Vance Jr., highlighted the importance of having the ability to continue seeing their patients.
“We knew they were the most vulnerable patients, not only to the virus but from their own chronic health conditions,” Vance said. “We didn’t want them to end up in the hospital, so we elected to never close our doors and to continue seeing patients in our clinics.”
The only closures for AAPHC included temporarily closing of its dental clinics, following the recommendations of the American Dental Association, and all but four SBHCs.
“Our providers were concerned that while seeing our patients we ensured we were protected, and our patients were protected,” Vance said. “It was important that we had enough personal protection equipment. We were fortunate to have a more than adequate supply of some of these items and were able to find what we needed.”
Even with the level of care AAPHC provided, many of its most vulnerable patients were afraid of going to clinics due to the fear of contracting the virus. In order to interact with these patients, an alternative method of service delivery was needed.
“We creatively, which we seem to do a lot of these days, came together,” Spires said. “Our director of nursing, Betsy Powell, had an idea.”
Powell’s idea rapidly evolved into an at-home care program.
Nurses take the necessary medical instruments needed to monitor patients’ health issues. These “home kits” might include thermometers, blood pressure cups, pulsometers or other monitoring equipment. They instruct patients in how to not only use these instruments but to ensure that they not only have the devices but the skills necessary for a web-enabled telemedicine appointment.
Combining the at-home care program with AAPHC’s telemedicine efforts was a critical component of its effort to continue addressing the health care needs of the agency’s patients. To date, more than 300 patients have been able to provide their health care providers with the necessary stats for effective clinical judgements relating to their medical conditions.
“Although this was an incredible way to connect with my patients, I thought it would be an impersonal interaction … actually, it feels more personal,” Vance said. “It’s like you are receiving a call from a friend, not a business call. I get to see patients interacting in their home. You see what their home environment looks like in the background. You see kids running around. I’ve had patients smoke in front of me, they feel so relaxed.”
The program was not only well-received by AAPHC providers and patients, it was impressive enough that the Dobbs Foundation provided AAPHC a $50,000 grant in recognition of the program’s contribution to health care services in the region. The success of AAPHC’s telemedicine programs will more than likely ensure that these efforts are expended as broadband services expand into the rural areas it serves.
“We are looking at ways to purchase inexpensive, smart devices and iPads and things of that nature for our patients that need in-home care,” Vance said. “We were able to actually maintain patient access and ‘provide quality health care for everyone,’ which is the motto of AAPHC. We were still able to do that. We were very proud to be able to do that. I told my staff several times: ‘We didn’t run from it. We ran toward it and we battled this thing.’”