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IHS’ Improving Patient Care Program Reflects a Growing Trend in Patient Outreach

A new personalized approach to patient outreach is encouraging American Indian and Alaska Native women to schedule and keep important yearly appointments such as mammograms and physicals. Through convenient, extended clinic hours and targeted communications in Native American publications promoting the importance of maintaining annual checkups, tactics such as these are encouraging Native women to take over the management of their health care.

The results of this targeted outreach model, known as the Improving Patient Care (IPC) program, the brainchild of Indian Health Service (IHS) practitioners at the Cherokee Indian Hospital in Cherokee, North Carolina, are now widely shared among 100 other Indian health facilities—from the Bristol Bay Area Health Corp. in Dillingham, Alaska, and Blackfeet Community Hospital in Browning, Montana, to the Lionel R. John Health Center in Salamanca, New York.

Developed in 2009 through a partnership among IHS, Tribal and Urban Indian health programs, the IPC program’s aim is to improve the quality of health care while promoting timely access to care and enhanced communication between the provider and patient and, oftentimes, the patient’s family.

At the heart of the IPC model is a “medical home”—in which an interdisciplinary team, led by a patient’s personal physician, collectively takes responsibility for a patient’s ongoing care, including communicating his or her progress among each other and working off of the same “chart” through the electronic health record (EHR) system. The relationship between a prepared, proactive care team and an informed, activated patient provides a one-stop-shop approach to patient-centered care and can be applied to a variety of health care settings, preventive services, chronic illnesses and priority populations. The IPC program further supports Indian health by integrating the culture and values of the Tribes and communities served into the facility and the delivery of care.

Cherokee Indian Hospital, which is managed by the Eastern band of the Cherokee Nation and annually serves 11,500 patients, is an active participant in the program.

“The IPC program is an opportunity to build a network of highly motivated health care practitioners who work as a team to ensure patient-centered care at each stage of the patient visit,” explains Casey Cooper, Cherokee Indian Hospital’s CEO.

Key to the success of the program is a concerted effort to create and implement unique and targeted tactics aimed at not only improving the health of medically underserved American Indians and Alaska Natives, but also to promote awareness of and share these tactics through the IPC across the entire Indian health care system. This sharing of best practices means improved rates of screening for the most pervasive chronic diseases seen in the American Indian and Alaska Native communities: depression, cholesterol, hypertension, substance abuse and diabetes.

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Building an Ideal Medical Home

Now in its third year, the IPC program focuses on building a medical home for each patient through the patient-centered care model.

“The idea is that every patient needs a good medical home—a primary care doctor with whom they have a good relationship and a primary care team to coordinate all their services,” explains Teresa Chaudoin, MA, MPH and Director of the Cherokee Nation Diabetes Program. “Studies have shown that when patients have a strong relationship with their health care provider and have established trust in them, they are more likely to participate in their own care.”

In addition to continuity of care, inherent in the IPC model is a team approach, which frees the participating physician to concentrate solely on direct patient care. “The idea here is that the medical team members work together to make it possible for the physician to spend as much time as possible focused on the patient,” Chaudoin says. “In addition, planned visits ensure that when a patient arrives, the team isn’t looking for test results. Everything is right there.”

And the patients are taking notice.

“I see comments patients submit on their care experience surveys,” Chaudoin says. “They’re saying things like, ‘I could go anywhere, but I know this is the best place for care,’ and ‘It takes less time to get through appointments.’”

The health care practitioners who are bringing the IPC model to life are also touting its advantages.

“Health care providers find this model intrinsically motivating,” Cooper says. “They want to make a difference and prove that they did so objectively.”

Cooper and his team are sharing the results of the IPC program not only with management, government and Tribal leadership, but also with those benefiting from it the most—the community at large.

And Indian health care practitioners agree, encouraging patients to recognize the importance of taking charge of their health care is incentive alone to expand the IPC program to an even greater number of facilities throughout the country.