What’s new in health care

As technology and processes evolve, New Hampshire’s health care providers are keeping pace. Thanks to improvements that range from increasing access to creating efficiencies to utilizing the latest advances, Granite Staters have access to facilities, services and innovative thinkers that are adapting to the modern market.

We reached out to some of the region’s top health care experts to discover what’s new across New Hampshire’s health care landscape.

Our panel:  

• Dr. Joseph Pepe, president and CEO of Catholic Medical Center
• Lisabritt Solsky, executive director at Well Sense Health Plan — a not-for-profit managed care organization (MCO)
• Caren Eliezer, Doctor of Osteopathic Medicine at Derry Medical Center
• Greg Baxter, MD, chief medical officer of Elliot Health Systems

Elliot Health Systems

Q. In what ways has Elliot Health Systems streamlined care or created efficiencies? 

Baxter: Elliot was an early adopter of a single electronic medical record allowing our patients to be seen anywhere within our health system and enjoy the fact that their entire medical history, labs, medications are all available in one record. This has allowed our doctors the ability to see the information they need about a patient, consult one another and work collaboratively to support patient treatment and positive outcomes. Elliot has also been the first to bring urgent care services to the market where anyone could be seen for an accident, illness or injury. We are proud to have a proven model of care in our urgent care centers, placing emergency medicine doctors there so that when the patient arrives with a potential
life-threatening illness, we have the skill and expertise to stabilize and transfer the patient to an elevated level of care at Elliot Hospital. 

Q. What new additions/programs has Elliot Health Systems added or created? 

Baxter: First and foremost, we have added 12 primary care providers and a new facility in Bedford that will house urgent care, imaging including CT scan, lab, pharmacy, primary care and more. Also, we are thrilled to have just added a plastic surgeon to our medical staff to support the needs of our breast surgeons and for elective care that patients want and seek out, often outside the state. We have also introduced a lung cancer screening program, and have our new thoracic surgeon on-site to eradicate the tumors when found. We have the Mako robot to allow our orthopaedic surgeons to do extremely precise total knee and hip (or partial) replacement surgery. For asthma sufferers, we are the only hospital doing bronchial thermoplasty which is a procedure proven to reduce asthma attacks for up to five years post procedure. We are also embarking on the building of a comprehensive cancer center that will have everything located in one center of excellence.

Q. In what ways is SolutionHealth innovating health care?  

Baxter: SolutionHealth is the regional health care system being created to allow Elliot and Southern New Hampshire Health to find the best ways to expand access to care, access to specialty services and create value for patients by reducing the cost of care. There are many ways we hope to innovate, but we are starting with the electronic medical records and bringing Southern New Hampshire Health up onto the EPIC platform Elliot has had for many years, so that there will be a single patient record no matter where patients see a doctor in the SolutionHealth network. There are so many wonderful things we hope to do, but we are just getting started.

Q. What are some recent changes that patients may notice, and how would they benefit from those changes? 

Baxter: Throughout Elliot Health System, we have taken a great deal of pride in updating the physical spaces where we meet, greet and care for patients. We want the patient experience to be exceptional and part of that is having a free valet park your car so you can get to an appointment. We are providing environmental enhancements to make our patients and visitors comfortable, and our centers reflect the high quality care that you will get when you enter our doors. We are working to be transparent and by that I mean, communicate as much and as often as possible to help people understand their care. We have set patient experience as a top priority because we want to be your first choice to receive care.   

Q. What innovations has Elliot Health Care implemented to address the opioid crisis? 

Baxter: Elliot has been extremely busy on this front and we are proud to say that when Serenity Place went into receivership, Elliot stepped up and took over as the provider for the drug court. Our financial commitment and our actions have allowed social workers and case managers to continue to work with the drug court participants and we have been able to support a program that has proven itself nationally, to be a means to success for individuals suffering from addiction. One of the participants who recently entered our facility for treatment said, “Thank you Elliot. I finally feel there is hope and you have treated me like a person.” We also have physicians actively managing patients with substance use disorders via the Medication-Assisted Treatment (MAT) program.

Catholic Medical Center

Q. Please tell us about the newly opened Vein and Vascular Center at CMC. 

Pepe: CMC’s Vein & Vascular Specialists is a first-of-its-kind practice for our area. It offers diagnosis and treatment for a host of vein and arterial conditions, from addressing simple cosmetic issues through managing complex vascular diseases. It’s convenient, located in the newly renovated medical building at 160 South River Road in Bedford, but it also offers advanced technology. Nowhere else gives patients access to cosmetic treatments and board-certified, accomplished vascular surgeons in one place. We’re providing the same level of compassion and care that people expect from CMC, outside of the hospital in a pampering setting.  We’re very excited about the value this gives to our patients.

Q. What’s the newest addition to CMC’s Intensive Care Unit?

Pepe: We’ve just begun construction on a new, 10-bed addition to our 20-bed Intensive Care Unit. It’s one part of a major hospital renovation that kicked off last fall in which we are making the best use of the space we have to provide the right care at the right time. The unit provides new technology to help move and mobilize patients. The rooms are larger to accommodate more technology and make them more comfortable for family members — they also have private bathrooms. We’ve also laid out the rooms in a way that allows nurses to more closely monitor patients. When all is said and done, the new ICU beds will make CMC the largest community hospital intensive care unit in the state.  

Q. How has CMC’s new Observation Unit modernized patient care?

Pepe: Sometimes, patients don’t necessarily need to be admitted to the hospital, but they should be monitored for a while. An observation unit, or Clinical Decision Unit, provides ongoing, short-term treatment and assessment before a decision is made about whether to admit or release the patient. It’s particularly helpful in providing the right kind of care for patients who come in to the Emergency Department with symptoms like chest pain, asthma or a kidney stone. They may not be able to go home, but they don’t necessarily need to be admitted to an inpatient unit. At the same time, they certainly don’t want to be in the ED indefinitely. The Clinical Decision Unit is the right place to assess their condition and make decisions about their care in a comfortable setting.

Q. How will CMC patients benefit from the newly planned facility at the Tuscan Village in Salem?

Pepe: CMC is talking with Massachusetts General Hospital, Massachusetts Eye & Ear Infirmary, Spaulding Rehabilitation Hospital and others about developing a multi-specialty medical facility at Tuscan Village. At this point, we’ve only signed a letter of intent, so the exact services that would be offered at the site are still being discussed. CMC envisions providing the care of our nationally-recognized New England Heart & Vascular Institute. Obviously, the partners involved bring a range of expertise across many specialties which people in the Salem area would otherwise have to travel to Manchester or Boston to receive. Salem is halfway between those cities, yet it lacks a comprehensive facility offering medical specialties. A project like this would be tremendously convenient to the people working, living and visiting in both Tuscan Village and the Salem area.

Q. How has CMC streamlined and/or updated its IT and health information systems?

Pepe: Customers — even health care customers — expect to do more and more of their business digitally and we’re working to provide those options to our patients. We’re in the process of going to a single-platform electronic medical record (EMR) system, which will make it easier for all of our practices and departments to share important information with each other and with other facilities. This creates a seamless transition of care. As part of this conversion, we’ve recently re-launched our patient portal, giving patients access to more information and tools than ever before. A highly-interactive patient portal, connected to a comprehensive EMR, lets patients be more connected to their providers and share in decision- making about their care.

Derry Medical Center

Q. What are some of the new services you’ve made available to patients?

Eliezer: I am very pleased to be part of the new dedicated Functional Medicine team, which includes Ted Brooks, MD, and Julie Brooks, PA-C.  In addition to being a DO (Doctor of Osteopathic medicine) with over 10 years as a primary care internist, I am also certified by the Institute of Functional Medicine. 

The Functional Medicine model is an individualized, patient-centered approach that uses nutrition, diet, exercise and other lifestyle interventions to both prevent and treat chronic disease. We empower patients to understand the root cause of their illness, and rely upon and support their engagement and readiness to make lifestyle changes. We partner closely with a patient’s primary care provider, but our approach to disease is different, so we are often able to help patients rid themselves of what is causing their problem by looking at it with a different lens.  We view Functional Medicine as an enhancement to regular primary care, particularly for those patients with chronic diseases such as pre-diabetes, Type 2 diabetes, irritable bowel syndrome, GERD, thyroid disorders, Celiac disease for support, Fibromyalgia, chronic fatigue and more.

Q. What’s something that is unique about Derry Medical Center?

Eliezer: Derry Medical Center is the oldest and largest independent primary care practice in New Hampshire, founded in 1964, and is governed by a board of our own physician partners. We have more than 40 providers in five locations that allow same-day access for appointments. Since we are neither owned nor affiliated with any one hospital, our patients can use any hospital system in NH, MA, VT or Maine.

Q. How do patients benefit from the way Derry Medical Center approaches health care?

Eliezer: Derry Medical is unique in its multi-dimensional approach to primary care that includes onsite access to diabetes management, sleep medicine, sports medicine, pain management, behavioral health and Functional Medicine. We are as inclusive in our model of care as we are in our approach to health care access. Appointments can be requested online from our website, or by phones that are answered live from 7:30 a.m. to 7:30 p.m. Our offices are open until 8 p.m. most weeknights and until 3 p.m. on Saturday in the Derry office. With call-ahead urgent care exclusive to Derry Medical patients, it is very rare for our patients to have to go to an outside urgent care. All offices are always accepting new patients.

Well Sense Health Plan

Q. Who is Well Sense Health Plan for and how can people take advantage of its services?  

Solsky: Well Sense is one of only two managed care organizations serving New Hampshire’s Medicaid population. We are a not-for- profit, mission-driven organization owned by Boston Medical Center, New England’s largest safety-net hospital. We have been covering members in New Hampshire since 2013, but our parent company has over two decades of experience in publicly funded managed care.

Q. In what ways is Well Sense Health Plan innovative?  

Solsky: New Hampshire took a huge step forward in 2013 in starting the managed care program. New Hampshire Medicaid has evolved from a fee-for-service program that rewarded volume and offered little care coordination. Well Sense incentivizes providers to achieve higher quality metric scores and to improve the experience of care for members. We offer outreach and care managers to support members to get and stay healthy no matter what their baseline burden of disease may be. Care management helps members better manage their health by preventing conditions from worsening due to neglect, a common phenomenon that drives cost throughout the health care continuum. We have also been working for several months on an opioid strategy that we will launch very soon. The goals of the strategy are modest but not insignificant, decrease incidence of overdose among our membership, decrease incidence of babies born with neonatal abstinence syndrome and increase the number of members with opioid use disorder who access treatment services. We believe carefully crafted interventions and partnerships with local community organizations can help save lives.

Q. How is Well Sense Health Plan’s Care Management program different from other, similar plans?  

Solsky: Our care management programs are designed around the unique needs of low income people and informed by the barriers they experience in engaging in care. Whether the barrier is transportation or stigma, homelessness or illiteracy, we connect members with services and supports that enable them to turn chaos into stability. In the Medicaid space it’s simply not enough to send a postcard to a diabetic reminding them to get their annual eye exam, for example. We must use multiple forms of outreach, motivational-  and trauma-informed interviewing, incentives and education to support members to be their healthiest selves.

Q. What are some of the extras that members receive to help families get and stay healthy?  

Solsky: By far the most popular member extra offered is the infant/toddler car seats. We also offer bicycle helmets for kids under 12, fitness club reimbursement, Weight Watchers reimbursement, personal care kits and dental kits. We also offer a case of diapers as an incentive for new moms to receive their postpartum checkup. Looking ahead, we will be taking a fresh look at incentives for 2019 to make sure we are responsive to member needs and addressing trends in utilization.  

Q. How does the medical transport offering work and who can benefit from it?  

Solsky: Transportation is a huge barrier to receiving timely care, especially in rural parts of the state. We use a vendor that coordinates rides for members. Any Well Sense member can benefit from the program. A member who drives themselves to a covered service appointment can be reimbursed for gasoline. Members who don’t have a car or access to a car benefit from taxi and livery services that bring them to their appointment and return them home afterwards. Members need only call our vendor with at least two days advance notice to coordinate a ride. Thousands of rides are coordinated every month to everything from a prenatal appointment, to specialists or substance use treatment. There are companies providing these rides, some owned by new Americans, that do all or nearly all of their business transporting Medicaid enrollees to appointments, and in this way, we are addressing a barrier to getting the care one needs while also providing meaningful stimulation to the local economy.