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Airmen here will begin seeing a change in the way their family’s medical care is administered as the 86th Medical Operations Squadron implements the Family Health Initiative.
The FHI is an Air Force-wide initiative that takes a patient-oriented approach to family medicine. This approach allows Airmen to see the same provider on a more consistent basis.
“We want to get away from patients seeing different providers for the same issues,” said Lt. Col. Gabriel Zimmerer, 86th MDOS medical director. “The Family Health Initiative will allow providers to really get to know their patients both in and out of the clinic.”
In the past, Airmen could find themselves explaining the same symptoms to a host of different providers. Under the FHI, this scenario should be greatly reduced as Airmen will more consistently be assigned to someone within their primary care management team.
These teams will consist of two primary care practitioners (a physician, a physician’s assistant or nurse practitioner), a nurse and five medical technicians. These teams can provide care for up to 2,500 patients.
“It’s not only good for the patient because they get to see the same provider more regularly, but it’s also good for the primary care management teams as we get to work together more often,” said Capt. Dale Harrell, a family nurse practitioner at the 86th MDOS. “As team members we learn each other’s strengths, which enhances the care of the patient.”
Furthering the commitment to really “knowing their patients,” the 86th MDOS has assigned one of the 12 PCM teams to every unit on base. The team will provide care for every Airman and their family in that unit.
Commanders also benefit by having a single point of contact for questions regarding the medical readiness of Airmen under their command.
In a recent sit down with the 86th Logistics Readiness Squadron commander, Captain Harrell introduced the concept of the initiative and the PCM team that will be responsible for the care of LRS Airmen.
“There’s no amount of frustration that goes into getting a profile form in an e-mail that says such and such person is unavailable for work without an explanation or a prognosis for success,” said Lt. Col. Joel Gartner, 86th LRS commander. “Under the team based approach, it’s good to know that there will be a relationship between the commander and the health care provider so that it’s as simple as picking up a phone, knowing who the provider is and working with them to make the best possible decision for the Airman and the unit.”
Captain Harrell said PCM teams will have the ability to track various things within the squadron — tobacco usage rates, obesity level, vaccination currencies, etc. — and can work with organizations around base, like the HAWC or mental health, to bring a tailored program to the squadron.
With the squadron as their focus, the PCM team will have a better understanding of the types of jobs their patients have, which can help with more accurate diagnoses.
“Since I take care of the fuel systems personnel I’m going to know what their job involves,” Captain Harrell said. “For example, if someone from LRS comes into the clinic with back pain from carrying around heavy equipment, I know what their job involves and it will give me a better understanding of what I should restrict him from doing until his health improves.”
The Air Force-wide initiative began in 2008 and has progressively rolled out to bases worldwide with staggering results. At Scott Air Force Base, Ill., one of the early adopters of FHI, patients were only seen by the same provider approximately 35 percent of the time. Two years after the implementation, patients are seen by their assigned provider close to 75 percent of the time and by a provider on the same team about 85 percent of the time.
“This is our way of bringing the spotlight back onto the patient and provide the proactive care they need,” Colonel Zimmerer said.
Since it is still early in the execution phase here at Ramstein, no immediate impact results are available. However, as the initiative continues to rollout the base will monitor, or “grade,” the initiative on four key aspects of patient care: patient satisfaction, outcome measures, patient continuity and patient urgent care visits.
“We need to keep an eye on these things to make sure the patient is getting what they need from their provider and that we are gaining some effects from those efforts,” Colonel Zimmerer said. “The early indication from Airmen and their families is that they are really enjoying seeing the same providers and the same is true of the providers being happy seeing the same patients.”
Practitioners are also finding efficiencies by seeing the same patients.
“Take for example an Airmen that comes in with an acute issue like a sprained knee,” Colonel Zimmerer said. “I don’t just treat the sprained knee, I look at their entire history and notice that they are late on their cholesterol labs. Before I would have to tell them to set up an appointment with their provider, now I am their provider and can take care of this.”
Many patients may not notice this monumental change since the initiative will be a seamless integration into the way the 86th MDOS does business. Also, it won’t affect anyone who is currently assigned to a provider outside of their squadron’s PCM team. Airmen will soon, however, begin to notice that when they do visit a provider, it is “their” provider.
