Developing a Sustainable Model for Medicaid Enrollment at the HOPES Free Clinic.

When Virginia expanded Medicaid, many citizens still faced barriers to enrolling in Medicaid. In response, a student-led Medicaid Enrollment Team was created at the HOPES free clinic to provide comprehensive enrollment assistance. In reviewing this program, this paper outlines steps taken that may be used by future enrollment efforts.

How to Prepare Interprofessional Teams in Two Weeks: An Innovative Education Program Nested in Telehealth.

PROBLEM: Preparing health professional students for interprofessional collaborative practice, especially at a distance where provider shortages prevail remains difficult. APPROACH: A two-week interprofessional education (IPE) immersion experience preparing students from 11 disciplines and four universities was implemented. Week-one, using online technology, students develop/present an interprofessional careplan for a complex patient. Students then meet face-to-face to conduct group interviews with two standardized patient dyads. Week-two, students develop a website for use of the patient dyads. Websites are presented to faculty and fellow students via an online virtual meeting space. OUTCOMES: To date, 594 students have participated demonstrating capacity to: 1.effectively engage in interprofessional care, 2. utilize Telehealth to impact care and break down barriers of isolation, and 3. implement skills to advance healthcare. CONCLUSION: IPE combined with Telehealth technology provides future providers with knowledge and skills for interprofessional care regardless of geographic barriers. Next Step: Integrate more technology using mobile devices and enhance the evaluation process.

MODELING CHRONIC DISEASE PATIENT FLOWS DIVERTED FROM EMERGENCY DEPARTMENTS TO PATIENT-CENTERED MEDICAL HOMES.

Chronic Disease is defined as a long lasting health condition, which can develop and/or worsen over an extended time, but which can also be controlled. The monetary and budgetary toll due to its persistent nature has become unsustainable and requires pressing actions to limit their incidence and burden. This paper demonstrates the utility of the System Dynamics approach to simulate the behavior of key factors involved in the implementation of chronic disease management. We model the patient flow diversion from emergency departments (ED) to patient-centered medical homes (PCMH), with emphasis on the visit rates, as well as the effect of insurance coverage, in an effort to assure continuity of quality care for Asthma patients at lower costs. The model is used as an evaluative method to identify conditions of a maintained health status through adequate policy planning, in terms of resources and capacity. This approach gives decision makers the ability to track the level of implementation of the intervention and generate knowledge about dynamics between population demands and the intervention effectiveness. The functionality of the model is demonstrated through the consideration of hypothetical scenarios executed using sensitivity analysis.

A comprehensive model for optimizing empathy in person-centered care.

OBJECTIVE: This study examined perspectives regarding the use of empathy within medicine and developed a model to demonstrate the components of empathy in a medical setting. METHODS: Grounded theory guided the methodology and final theory formation. Participants included 21 medical professionals representing multiple specialty areas and employed in a teaching hospital, private practice, or clinical setting in Eastern Virginia. Processes for transcription analysis and coding preserved participant perspectives and contributed to a final model. RESULTS: Participant interviews revealed a seven-tier model that displays the facilitative conditions and potential barriers that may impact the full expression of empathy within the medical setting. Interviews also delineated between levels of empathy and described the benefits of providing empathic care, all of which are included in the final model. CONCLUSION: This new model of empathy describes a complex and dynamic process and conceptualizes ideal conditions for empathic treatment. The model presents concepts that may be useful in medical education, and creates new directions for empathy research. PRACTICE IMPLICATIONS: Physicians can assess themselves along each level of the model and can use it to identify barriers as well as ensure optimal conditions for empathic treatment. This new conceptualization of empathy also has implications for medical training and directions for future research.