Innovation Expands Access

KentuckyOne develops two new possibilities for providing primary care to Kentuckians

Access to primary care is the key to creating a healthier Kentucky, but it remains limited at certain times and in some Commonwealth locations. KentuckyOne is hard at work piloting new ways to help ensure that all Kentuckians have that access when they need it. With 200 locations, KentuckyOne is the largest health system in KY, yet its leaders know that innovation is required to effectively meet the needs of the population. Access to primary care physicians, particularly in rural areas, has long been a problem in Kentucky, but KentuckyOne Anywhere Care, which allows virtual care delivery by phone or video web chat, and the KentuckyOne Health Community-Based Health Delivery Model (telehealth) are making a difference.

In response to the ACA and the ever-changing health care market, KentuckyOne Health is doubling down on its original commitment. Travis Burgett, director of Strategy for KentuckyOne Health, says, “We need to go back to our roots and focus on keeping the community healthy.” In order to do that, he continues, “We need a broad primary care strategy, and we are going to need to have access points in many locations.” Currently, the strategy is focused on these two innovative initiatives, both of which solve access problems in rural areas, provide convenience for the consumer, and are cost-effective for the provider. In addition to rural access issues, Anywhere Care is intended to fill the access gaps for all Kentuckians, including on nights and weekends or when getting in to a more traditional provider is just not possible.

Primary Care – Anytime, Anywhere

Through Anywhere Care, Kentuckians can consult with a board-certified family practice provider without leaving home, 24 hours a day. A toll-free phone call or online request guarantees a return call or video chat within 30 minutes. Anywhere Care providers may prescribe medications, if appropriate, recommend an over-the-counter medication, or provide home care options. A follow-up report to the patient’s KentuckyOne provider is included. If needed, the KentuckyOne Anywhere Care provider will refer patients for a follow-up clinic visit or to an emergency department.

KentuckyOne is one of the first providers in the nation to try such a service. It was beta tested with their own employees last fall to great reviews, and now the service is available to any patient in Kentucky who would like to take advantage of it. Ron Waldridge, MD, a KentuckyOne Health family physician, says, “Anywhere Care is a logical extension of the care that we provide, and it complements in-person services.” Currently, all calls are answered by remote physicians who are employed by a national firm called Carena Inc., but KentuckyOne will be using their own physicians in the future. Carena was a logical choice: having pioneered this field, they have infrastructure in place and expertise in the new modality.

Doctorless Clinics in Rural Communities

The lack of physicians in many of Kentucky’s rural areas is being remedied with the use of so-called “telemedicine.” In the KentuckyOne Health Community-Based Health Delivery Model, primary care clinics are staffed by nurse practitioners, nurses, and office coordinators, who utilize telemedicine technology to collaborate with remote physicians and specialists. The care providers at the clinic help insure a patient’s needs are clearly addressed by a remote physician. This way, patients get the attention and reassurance they need from trained professionals, who in turn are getting the guidance they need from licensed primary care physicians.

The first telehealth clinic was established in Powell County in 2011. The second, Saint Joseph Telehealth Primary Care Clinic – Campton, opened in August 2012 in Wolfe County. Several grants have helped establish these two clinics: a Social Innovation Fund (SIF) grant from the federal government and a Foundation for a Healthy Kentucky grant.

Refinement of the model continues as care-providers on the ground – and KentuckyOne leadership – learn more. The Campton clinic has integrated physical and behavioral health services in one location and offers all patients access to specialty consultations. A third grant, from Catholic Health Initiatives Mission and Ministry, allows Registered Nurse Transition Coaches to provide home visits for patients discharged from the facilities. These nurses also work with the Primary Care Clinic ARNPs in identifying patients at high risk for hospital readmissions and emergency department use.

Ruth W. Brinkley, chief executive officer of KentuckyOne Health, sums up the mission that is driving these innovations: “Increasing access to health care and strengthening the primary care system in the Commonwealth is an important step in our work to create a healthier Kentucky.” Such new access points will surely be joined by others, as KentuckyOne continues to innovate.

KENTUCKYONE HEALTH’S ANYWHERE CARE AND COMMUNITY-BASED HEALTH DELIVERY MODEL SOLVE ACCESS PROBLEMS IN RURAL AREAS, PROVIDE CONVENIENCE FOR THE CONSUMER, AND ARE COST-EFFECTIVE FOR THE PROVIDER.