A New Opportunity For Diabetic Patients Comes To Washington County!

by Justin Duncan, W.C.A.D.

Through an innovative collaborative effort between Great Mines Health Center (GMHC) and Washington County Ambulance District (WCAD), diabetic patients can now receive routine care in their home.
This project started when COVID hit and we noticed that patients were not going to the doctor or the emergency room. WCAD began doing “home visits” of patients identified by local clinics, doctors’ offices, public health and the ambulance district who we were worried about. We found some very sick folks and were able to help them get the care they needed, safely. We thought there was some real opportunity here and started looking for grant funding to prove the concept worked.
GMHC secured grant funding on a diabetic project that we thought would fit this model. After some conversations with folks in Jefferson City about taking this specific grant and adjusting it a bit, it was declared “an innovative and exciting idea” by leaders at Missouri Health Net (Missouri Medicaid) and the Missouri Primary Care Association. And here we are, taking the clinic to the patient instead of taking the patient to the clinic.
So, what are we doing? Well, it is simple. WCAD is sending a Mobile Integrated Healthcare Clinician (MIH-C) to make house calls. The MIH-C is completing an advanced assessment, taking vital signs, completing an EKG, drawing blood and doing point of care testing (A1C) for our diabetic patients, right in their living room. Then, a telehealth visit takes place with a provider at Great Mines Health Center. The MIH-C is an advanced practice paramedic with education in critical care and primary care for a “well rounded” education package. The MIH-C is able to report findings to the provider at GMHC and take “add on” orders based upon specific findings.
The goal of our program is simple; improve the quality of life of our uncontrolled diabetic patients. Our vision to accomplish this goal is through collaboration and innovation of two not so common partners in healthcare. It has been identified that GMHC has over 700 active diabetic patients between July 2019 – Present day with 200 diabetic patients living within Washington County. Out of the 200, 87 are considered uncontrolled and high risk with a A1C greater than 9 whom routinely miss appointments for A1C checks and follow-up with their providers and who carry MO Healthnet insurance. Given the level of non-compliance, we have decided to think outside the box and take the appointment to the patient. Our goal is to reduce the level of non-compliance, get these patients feeling better and improve their quality of life. GMHC and WCAD will partner to not only assist the patients with immediate need for treatment but to continue care with education on proper diabetic care, increase patient provider relationships, reduce emergency needs, and reduce spread of COVID while safeguarding these patients in their home.
We are being proactive by taking clinic care to the patient instead of waiting until the patient becomes critical and needs treatment in a hospital. The goal of our project is to improve the quality of life of our patients. The times are changing, COVID-19 has been a huge game changer in our business. People are nervous and they do not want to leave their homes, but their medical conditions still exist. Diabetes did not just go away. We had patients who were identified as non-compliant. In the COVID-19 world, that number has increased, as expected. We feel that it is our obligation as healthcare leaders to “think outside the box” and help our patients in this ever-changing world.

The goal is to show that this model of care works and that it should be a model statewide. There are other opportunities and ideas that we are working on to expand the program, to include cardiac patients and others, so that we can simply “do what is right” and help people in our community receive the care that they deserve. Many people can’t make it to their clinic appointment, or they don’t feel safe in doing so. Therefore, we will take the clinic to the patient.
Interested in participating in this program? Please contact Great Mines Health Center to speak with a Community Health Worker at 573-438-9355 or Tori Theiss directly at 573-438-8328.