Innovations in Safety Net Primary Care - Specialty Care Collaboration

 

by Neda Ratanawongsa, MD

When my 4-year old asked me why I was staying at work last Tuesday evening, I told him, “To learn about how doctors can work together to take care of people.” 

I’m a primary care provider at the General Medicine Clinic at SFGH. Although I wish I could provide my patients with all of their care within my clinic’s walls, I rely on colleagues in medical and surgical specialties to help care for my patients’ concerns around diabetes, heart disease, arthritis, broken bones, and eyes.  When my patients and I need that help, I want the same quick access to specialists’ advice that my in-laws receive in their health networks. However, safety net health systems often experience long wait times for visits because there is such a high need for specialty clinics with limited appointment slots.  The referral system can also be confusing to patients because of communication barriers; over half of my patients speak a language other than English as their first language and have limited health literacy.  

Last week’s Primary Care – Specialty Care Leadership Retreat showcased the fabulous work of the Center for Innovation in Access and Quality www.ciaqsf.org. Since 2007, CIAQ has promoted the creation and implementation of innovative approaches to improving quality care at San Francisco General Hospital (SFGH) and other safety net systems.  With the creation of the San Francisco Health Network, CIAQ’s work offers an exciting foundation and momentum for ensuring high quality primary and specialty care for patients.

You can read more about the CIAQ projects below:

•  eReferral, a web-based referral and consultation program developed by UCSF and SFGH for SanFrancisco’s safety net system

•  The Specialty Care Initiative, a coalition of key safety net stakeholders working to improve primary care – specialty care communication and coordination, clinic efficiencies, and registry development in specialty clinics

• This article  highlights an innovation to improve the quality of communication between specialists and primary care clinicians through consultation notes.

• Telehealth programs which allow specialists within San Francisco's safety net to provide live video and store and forward telehealth consultation services through innovative collaborations with community services and primary care. 

• The  Innovations Hub for the Safety Net  will be a platform for testing, implementing, evaluating,  and spreading innovations.

Inspired by their work to write my first blog post, I just wanted to give kudos to my impressive friend and colleague Dr. Alice Chen, a primary care provider in our General Medicine Clinic and Director of CIAQ.  She is a role model for me and for everyone who believes that all patients have a right to outstanding health care delivered with compassion and respect. Her diverse and committed team also deserve commendation, including Kathryn Horner, Kiren Leeds, and Tekeshe Mekonnen, and specialty physicians Drs. Lukejohn Day, Lisa Murphy, Marika Russell, Justin Sewell, George Su, and Delphine Tuot. 

The leadership of the SF Health Network left last week’s retreat inspired and committed to investing in future innovations for our community’s health.  And when I returned to my son and he asked what I learned, I told him, “I learned that people who work together and work hard can make a big difference.”