By Michele Gillis

The future of healthcare is here.

A Connected Care Center opened in February at the Wheeling Clinic to help close the gaps in health care for its patients.

“Closing gaps in care allows for early diagnosis,” said Heidi Porter,” vice president of quality and regulatory affairs at the Wheeling Hospital. “If someone would have any type of chronic condition or any condition that can be diagnosed early, that will lead to obviously better outcomes for the patient and lower costs for the healthcare system in general.

Porter said that the whole crux of the center is to create a safer environment for patients to have early diagnosis, early intervention, higher quality of life and lower healthcare costs.

Routine screenings and preventative services can go a long way in helping patients live longer and healthier lives.

“Our initial prompt was to make sure that patients understood their course of care and that there was a place patients could go where we could spend a little more time than the provider can spend with them talking with them about the specifics of their diagnosis, plan of care and especially looking at any gaps of care,” said Porter.

The center has seen over 300 patients since February and has closed over 350 gaps in care.

“We are just one clinic with seven doctors,” said Porter. “If you multiply that times the potential across this entire system it will be amazing what we will be able to do from a life-saving standpoint, a disease management standpoint and a quality and cost standpoint.”

Dr. Daniel Jones, medical director of the Physical Practice Division, Wheeling Hospital is one of the physicians who helped set up the Connected Care Center. “We want to take a moment and instead of just treating a name on a chart, we want to treat the whole patient,” said Jones. “We want to include everything from not only vitals, blood pressure and maybe laboratory results but let’s look at the bigger picture. Let’s look at the patient for who they are as a person.”

In doing so, he said, they may discover some challenges to obtaining healthcare such as transportation, food insecurity or other barriers.

“Its role is to enhance the care of the primary care physician and help them help the patient,” said Jones. “A lot of times, providers are very busy and they have to prioritize, so we are meant to be an additional arrow in their quiver, so to speak, and help those patients continue to achieve high-level quality care that enhances what goes on in the provider’s office as well.”

Tami Magruder, director of population health and quality nurse with the Connected Care Center said that in addition to the visit to the center, they have disease-specific information on many chronic conditions and community resources available to patients.

“Many times patients will stop back by after their primary care appointment and we can hook them up with community resources or diabetic information since we have a large diabetic population in our area,” said Magruder. “We want to be a place where patients can come in to find resources or ask questions.”

In the initial stage, they are focusing on patients over 65 that have certain preventative testing requirements such as breast cancer screenings, colonoscopy screenings, annual well visits, bone density scans and health equity needs.

“The goal is to help the physician close the care gaps because the staff doesn’t always have the time to address everything that needs to be addressed, look for the resources, call all the optometry offices to get reports or track down old colonoscopies,” Kelley Hicks, a registered nurse with the Connected Care Center. “There is a lot of behind-the-scenes work that happens after the patient leaves our office.”

Preventative procedures allow the patients to have evidence-based care and help the doctors catch any diseases early on.

When patients come to see their primary doctor, they are first directed to the Connected Care Center to be interviewed so the staff can

determine their social determinants of health, which are non-medical factors that may go beyond the hospital that affect health outcomes.

Porter said if a patient doesn’t have access to transportation, food, housing, rent payments or a primary care physician, the center will help coordinate to make sure the patient has everything they need to close that gap in care and to close that social determinants of health need.

Kelley Hicks, a registered nurse at the Wheeling Clinic is part of the patient’s first contact when visiting the Connected Care Center.

“We look at the provider’s schedule in the morning and select the patients who will be seen in the center that day based on if they are there for an annual check-up or wellness visit,” said Hicks. “Once they come in, they come our way and we spend about 5-10 minutes with them addressing their open care gap needs

or any other needs that they may have. It is a pretty quick visit because we don’t want to hold them up from their visit with their provider.”

If they find a gap in care, they can offer testing in the center such as Cologuard, FIT Test, diabetic eye screening and diabetic labs.

“The visit is to address the care gap and if they need any resources, we get them the help they need,” said Hicks. “We send them upstairs and we can message the physicians with any concern we have or anything pertinent we feel they should know prior to their visit with the patient.”

The Connected Care Center is located in a space within the Wheeling Clinic. Wheeling Clinic is part of Wheeling Hospital which under the WVU Healthcare System. The West Virginia University Health System, commonly branded as WVU Medicine is a nonprofit health enterprise affiliated with West Virginia University.

This month, they will be expanding the center into Reynolds Memorial Hospital in one of their outpatient clinics. “Our goal is to work on this blueprint or model for the Community Care Center and use for a model for the state and the nation,” said Porter.

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