Vna Home & Hospice

Programs: Providing clinically excellent, compassionate home health and hospice care to individuals and familiesplease see the excerpt in schedule o from the emhs annual report to the community for details of community benefit projects at emhs members:coming together is a beginning; keeping together is progress; working together is success. The man who spoke these words understood the value of teamwork. He embraced technology in a way that nobody else had before him. His vision, passion, and innovation revolutionized the world. He made it possible for families to feel more connected despite living long distances apart. In many ways, emhs shares the same goals championed 100 years ago by industrialist and automaker, henry ford. Like ford, we know that we are succeeding by working together. Our new integrated, system wide electronic health record (ehr) will allow all our hospitals, primary care practices, and other members within the emhs family to share information seamlessly. Using this system, we can collaborate more effectively and improve patient care. By mass-producing the automobile, ford helped rural americans feel connected. We are connecting people through technology, too. People who live in rural communities can talk one-on-one through a computer screen with doctors who may be several states away, thanks to our investments in telemedicine. Patients have access to specialists that would have been out of reach without this technology. Ford was an innovator. We too are embracing innovation in the way we deliver care. Our partnership with dana-farber cancer institute affords opportunities for cancer patients to access clinical trials closer to home at our lafayette family cancer center in brewer. We are using paramedics to make routine house calls in our rural communities to perform wellness checks. This service is helping patients avoid trips to the hospital or doctors office while getting compassionate care in the comfort of their own homes. Of course, all of these initiatives require dedicated people who are committed to teamwork. Its the very reason why we take extraordinary measures to recruit and retain our employees. We have added a new nurse residency program, which is already showing signs of success in addressing a critical statewide nursing shortage and providing our nurses the tools they need to thrive. By working together, we can continue to do great things. To borrow another line from henry ford, if everyone is moving forward together, then success takes care of itself. In the pages that follow are numerous testaments to the innovative spirit underscoring many successes this past year throughout our system. While the hard work will continue, we are pleased to share with you the progress we are making towards achieving our vision to be a nationally recognized model of excellence in healthcare. M. Michelle hood, facheemhs president and ceobarry mccrumemhs board chair

connecting world class careterry white longs for the day that she can return to the sandy shores of myrtle beach to feel the warm carolina sunshine on her face and the ocean waves splashing upon her feet. She has plans to go back to visit family and wont let cancer slow her down. My journey is not over just because i have this disease, terry said. It doesnt mean life doesnt go on. I definitely have a lot of life to live. Terry was diagnosed with breast cancer a decade ago. I was 38 when i found a lump in my breast in the shower one morning and immediately called my primary care physician. Unfortunately, the cancer became metastatic, meaning it spread to other parts of her body. I went from being a survivor to a lifer because i live with cancer every day, and ill live with it every day until the end, she said. Terry has gone through several treatments of radiation and chemotherapy over the years. During a recent visit to emmc cancer care at the lafayette family cancer center in brewer, she was comfortably dressed in jeans and a maroon blouse, and wore a hat on her head. Because the cancer spread to the bone marrow in her leg, she wore a knee brace to alleviate pain. Whats remarkable about terry is how she projects a positive attitude. A powerful storm that day was toppling trees and knocking down power lines outsideit wasnt enough to stop her from making the 30-minute ride to the treatment center from her home in pittsfield or to diminish her optimism. Research today has given us treatments that are light years ahead of what we used to have, she said. Terry is hopeful because she is taking part in a clinical trial thanks to a collaborative partnership between dana-farber cancer institute in boston and emmc cancer care. She is taking an experimental drug under the coordinated care of her medical team in brewer and the dana-farber specialists in boston. The treatment i come for is administered by a syringe. I dont have to sit there for four hours waiting for this to be over and waiting for the side effects, she said. Eric winer, md, is chief clinical strategy officer at dana-farber and director of the breast oncology center. He and other members of the dana-farber team visited emmc cancer care last fall for a tour. Dana-farber only partners with cancer centers that already deliver excellent care, dr. Winer said. The goal of the collaborative for dana-farber is to extend its reach and bring clinical trials to people living in rural areas. When people participate in clinical trials, the hope is that they will do better than they might with standard care, but no matter what, they are contributing to the future of cancer care, he said. The staff at emmc cancer care also benefits by being in the collaborative. They have more educational opportunities and access to medical specialists at dana-farber for rapid consultation on complex cases. Dana-farber clinical care is provided in boston and this collaborative brings their expertise to the heart of maine, explained thomas openshaw, md, medical director, oncology research at emmc cancer care. The staff at emmc and dana-farber have a firm resolve to help not only current patients, but also future patients to live better lives. Our whole goal is to try to cure whatever patients can be cured, and thats a large proportion of patients, and for the others to give them the best and the longest life that they can have, dr. Winer said. That seems to be working for terry white, whos already making travel plans to myrtle beach. It gives you a reason to go through what youre going through. Weve got to learn from it for the future, she said, adding, i want to be healthy for my family, i want to participate in life with my family and my friends, and continue to enjoy life. Connecting with technologycharles a. Dean memorial hospital (ca dean) in greenville sits along the scenic shores of moosehead lake, one of maines most treasured natural resources. Its a peaceful, idyllic spot that draws tourists from far and away who are eager to get away from the hustle and bustle of their daily grind. But beneath the hum of motorboats cruising along moosehead lake in the summer, or the snowmobiles skirting across its icy surface in winter; beneath the laughter of kids splashing in the water on a hot august day or pulling a trophy trout through the ice on a frigid february morning, there is a rural health problem that those visitors do not see. To be fair, it affects communities throughout maine but has been more problematic in those towns and hamlets tucked far away from urban centers. There is very little rural mental health period, explains joseph babbitt, md, an emergency room physician and hospitalist at ca dean. Historically people in rural communities have had to travel hours to access psychiatric services. If they showed up at any rural hospital emergency room with a mental health crisis, they had to wait hours for an evaluation. Youve got an emotionally unstable patient who is in a very disruptive emergency waiting room environment, waiting 18 hours to have a mental health professional come assess them. That doesnt help anyone, dr. Babbitt said. But technology is bridging the gap and allowing those who live in rural communities to have the same access to psychiatric services as their urban counterparts. Telemedicine is a medium that connects a patient with a practitioner via a screen, explained gavin ducker, md, chief medical officer at inland hospital in waterville. Inland hospital and ca dean use telemedicine to provide psychiatric services to patients through acadia hospital, which offers telepsychiatry services to 15 rural emergency departments and 12 rural primary care practices across the state. Ca dean uses telemedicine for behavioral health in its emergency department. Inland does, too, but also offers the service through its primary care practices. Our goal has been to deliver the care on site, in a place theyre familiar with, comfortable with, and would feel more relaxed, and hopefully in a more timely manner. Telemedicine has allowed us to do just that, dr. Ducker said. In addition to providing patients with access to services closer to home, the technology is also a valuable recruitment tool to attract mental health providers. Theres a combination in my department of folks practicing on site in these practices and telemedicine from afar, jesse higgins, pmh-np, rn, the director of integrated behavioral health at acadia hospital explained. Recruiting has been a challenge in maine. Its a rural state. There are parts of the state that have struggled to get providers to move. Now we can recruit and explain to providers that they can stay in their home and work as fulltime staff at acadia hospital.

michael workman, pmh-np, is one of those providers who works for acadia but lives in indiana. He is a psychiatric mental health nurse practitioner who sees patients in maine via telemedicine. He works from a laptop in his home office. Its actually no different than you sitting across the table from me in my office. Were just using the technology available to help people living in areas where we dont have as many psychiatric providers, workman explained. He says initially he thought the technology would make it harder to do his job and make a personal connection with a patientto pat them on the shoulder reassuringly as theyre leaving his office or to shake their hand as they arrive. He says sometimes hell shake their hand through the screen, which he demonstrated. It lends some humor to the visit and makes a connection with the patient, he said, adding that even some reluctant patients came around quickly. I had one gentleman who came into the office and said im not doing this and by the end of the session, i had a hard time getting him out of the room because he was so comfortable talking to me. Mike is eminently qualified and is great with patients, dr. Ducker noted, adding that he is pleased with the telemedicine services and the benefit it has offered to patients. And even though mike is several hundred miles away, hes a full-time employee at acadia. He attends staff meetings, has supervision, and help is just a phone call or computer screen away. They really are a part of our team at acadia and inland, whether they live in indiana, arizona, or anywhere. The result of this technology is that people living in rural maine, who choose to live far from the noise or chaos of a larger community, can still have access to quality care and enjoy their beautiful corner of the world that tourists only see on short visits. Connecting your care teamcolbey bowen noticed that norma craft was clenching her hands and seemed a little uneasy at one point when he was explaining her medical care. So, he decided to stop talking and give his patient some time to process what he was saying. Colbey is a medical student on a home health visit as part of a program of beacon health called interprofessional practice and education. That program teams up medical students, pharmacy students, and social work students to go on home visits to provide care for patients who have recently returned from the hospital or may be at high risk to end up in a hospital. I think one of the greatest things it does is it exposes us to different viewpoints from other professions because in medicine we all speak a slightly different language, colbey said. And, it also brings the patient into a more confident, more comfortable setting which really helps us to bring them in as a part of a team experience. Pharmacy student, manpreet badwal, went with colbey on this visit with norma. She let norma show her all her prescriptions and carefully categorized and explained what each one was. This is helping me to be a better pharmacist because it helps me practice the skills we learn in the classroom and use them in the real world, said manpreet. Felix hernandez, md, is a retired cardiothoracic surgeon who runs the interprofessional practice program. He helped debrief colbey and manpreet after their home visit. Hes a staunch supporter of this approach to patient care. When you combine many of these skill sets and many of these knowledge sets in the same room with the patient, you get what i call a synergy where the sum of the parts is bigger than just adding them up, he said. Dr. Hernandez gives colbey high marks for reading his patients nonverbal communication, and he says manpreet did a great job preparing, asking good questions, and seeking feedback. When you are with a team thats firing on all cylinders, learn that, know that, see what that feels like. So, next time when youre with another team not functioning on all cylinders, you recognize it and you can troubleshoot it, said dr. Hernandez. Megan foss, lmsw-cc, is a member of the beacon health community care team that goes out on home visits and provides the same services that these students are learning through the interprofessional practice and education program. Ultimately, this means better doctors, better pharmacists, better nurses, better social workers, better healthcare, she said. Laurie chadbourne, rn, a community care team nurse, echoes those sentiments. You can meet the patients where they are living. Sometimes, they cant get out of their homes; so, i think its a very good benefit. We can make sure they have the resources they need, so they dont get readmitted after they leave the hospital, she said. This way of delivering care to patients is a different approach than even some medical professionals were trained to provide. James jarvis, md, faafp, interim senior vice president and chief medical officer at eastern maine medical center, says the old way of doing things no longer makes sense. Doctors were always trained by doctors, nurses by nurses, pharmacists by pharmacists, and social workers by social workers, but in practice, we work better as a team, he said, adding that the changes that are happening are for the better.