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SCHENECTADY COUNTY
New health record bank to have all the answers
Program will help identify more of a patient’s needs
BY BETHANY BUMP Gazette Reporter

    A man being treated for a mental illness began showing up at his local emergency room every day. He was already meeting with a mental health professional on a scheduled basis for the proper care, so his daily visits had ER staff wondering why he kept showing up with no real emergency.
    Another patient was diagnosed a diabetic. But after being discharged from Ellis Hospital, he continued to be readmitted. For some reason, he couldn’t maintain his blood sugar levels. His doctor questioned why if the man was eating the right foods at the right times.
    Local medical professionals will soon have answers.
    A new model of care beginning Feb. 1 will give care providers access to the bigger picture of a patient’s well-being. Schenectady County is one of 10 in the state to roll out the innovative case management program, after the Visiting Nurse Service of Schenectady and Saratoga counties was recently designated a state Health Home.
    The new program will be a virtual repository, known locally as Care Central, that hosts a secure and shared electronic patient record through which one person can coordinate all the facets of a person’s well being.
    Through Care Central, the ER might have learned that the man with the mental illness just wanted someone with whom to talk. And the diabetic’s doctor might have discovered his patient just couldn’t fi nd a ride to the pharmacy to pick up glucose strips.
    As soon as next week, some residents will have a single contact to turn to for these needs. Maybe they’re not feeling well, need a doctor, have a basic health question, are looking for mental health services or specialty services like dental care or diabetes management, or just need social services like transportation, housing or food.
    Care Central will provide that person with a “navigator” who can help them find the support services they’re missing to help prevent rehospitalization down the road.
    The state-funded program is currently available at no cost for Medicaid enrollees with chronic conditions, but will likely expand over time to include Medicare enrollees, and anyone who has been hospitalized and then discharged.
THREE PHASES
    In its first year, the state program will be implemented in three phases. The Schenectady-based VNS was chosen for the first phase because community officials had actually begun several years ago to draft a similar model of care, said VNS President Joseph Twardy. It will be run in partnership with Ellis Medicine and Hometown Health Center.
    “Oftentimes the medical community provides good care, but not necessarily timely care, or care that could best avoid an adverse event like rehospitalization,” said Twardy. “And the result is we have a lot of individuals who end up falling through the cracks.”
    Of the 5.4 million enrollees in New York’s Medicaid program, nearly one fifth have been identifi ed as high cost or high need — meaning they have two or more chronic conditions and/or a serious mental illness that requires high cost services like inpatient or institutional care.
    Meanwhile, social issues like a lack of permanent housing among this population often causes them to prioritize their own health last — meaning a missed trip to the pharmacy or doctor’s office is less urgent than finding a place to keep warm.
    The state expects that by Health Homes coordinating these medical and social services for patients, health care costs can be controlled in the future and ultimately improve the health outcomes for these populations.
    And it relies on existing services within the community. More than 30 clinical and social service organizations serving Schenectady County will participate, including the City Mission of Schenectady, Mohawk Opportunities Inc., Catholic Charities, the McPike Addiction Treatment Center, and the Schenectady Community Action Program Inc., among others.
    “It will be different case by case,” said Twardy. “So with this interdisciplinary team — everything from pharmacists to nurses to social workers — we can direct a patient to organizations that already exist in our community. Right now, [organizations] don’t have the ability to coordinate with each other regarding a patient. So this gives them a way. There’s a lot of core competencies within our community, and it would be a shame if we went out there and built new programs and hired new people when those jobs already exist.”
SHARED INFORMATION
    The virtual repository will be hosted through the Healthcare Information Xchange New York, an interoperable network that allows health plans, hospitals, practices and others to electronically share medical information. So far, the Latham-based organization has only utilized hospital records, Twardy said. But with the creation of Care Central, the already-existing network can be used to a fuller extent.
    “There’s all sorts of information that can be shared on it — appointments, pharmacy information, medication information, a patient’s care plan,” said Twardy. “So if a doctor is linked into this system, they can pull it right up and see not only a patient’s primary care, but also their behavioral care. These are things that infl uence someone’s overall medical care, and it’s important for care providers to see it in real time.”
    The state saw a need for the program after several years of monitoring avoidable hospital readmissions. The leading causes were a lack of medication compliance by patients or follow-up by physicians. And because about 80 percent of all health care costs are spent on 20 percent of patients, the medical community was looking for ways to drive those costs down.........................>>>>.......................>>>>.................http://www.dailygazette.net/De.....r00100&AppName=1

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“There’s all sorts of information that can be shared on it — appointments, pharmacy information, medication information, a patient’s care plan,” said Twardy. “So if a doctor is linked into this system, they can pull it right up and see not only a patient’s primary care, but also their behavioral care. These are things that infl uence someone’s overall medical care, and it’s important for care providers to see it in real time.”

Mr./Ms. Smith, we shall deduct 20units from your money card until you go to your appointment, or you shall be incarcerated in 'the ward' until you are able to be seen.

dont laugh....this IS THE TRICKLE DOWN EFFECT.....DONT BOTHER MOVING UP.....THE TOILET HAS BEEN FLUSHED AND WE WILL ALL BE SUCKED DOWN.....PAY ATTENTION

Bad.

Quoted from GrahamBonnet

Bad.

we have no idea.....duck and run and hide....run to the hills run for your life......

if they promote enough cymbalta/zoloft/ambien/lunesta/xanax etc etc....folks will go willingly......and I think they would then say "atleast I didn't drink"...sad sad sad.....

Senior Health Care...

So you're a sick senior citizen and the government says there is no nursing home available for you, what do you do?

Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot four Congressmen.

Of course, this means you will be sent to prison where you will get three meals a day, a roof over your head, central heating, air conditioning and all the health care you need! Need new teeth? No problem. Need glasses? That's great. Need a new hip, knees, kidney, lungs or heart? They're all covered. And, as an added bonus, your kids can come and visit you as often as they do now.

And who will be paying for all of this? It's the same government that just told you that you they cannot afford for you to go into a home.

Plus, because you are a prisoner, you don't have to pay any income taxes anymore.

Is this a great country or what?  

Quoted from Shadow

Senior Health Care...

So you're a sick senior citizen and the government says there is no nursing home available for you, what do you do?

Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot four Congressmen.

Of course, this means you will be sent to prison where you will get three meals a day, a roof over your head, central heating, air conditioning and all the health care you need! Need new teeth? No problem. Need glasses? That's great. Need a new hip, knees, kidney, lungs or heart? They're all covered. And, as an added bonus, your kids can come and visit you as often as they do now.

And who will be paying for all of this? It's the same government that just told you that you they cannot afford for you to go into a home.

Plus, because you are a prisoner, you don't have to pay any income taxes anymore.

Is this a great country or what?  

senior healthcare used to be 'free'.....via the barefoot homemakers.......I'm not sure what the crime was that they didn't get paid for their work?..... I dont know which will the homemaker between
'my 2 dads' and 'my 2 moms'....

I say shoot the congresspersons and your local clergy.......

as we age we get expensive for ourselves.....and the snake oil salesman is at every commercial.....

Quoted from Shadow

Senior Health Care...

So you're a sick senior citizen and the government says there is no nursing home available for you, what do you do?

Our plan gives anyone 65 years or older a gun and 4 bullets. You are allowed to shoot four Congressmen.

Of course, this means you will be sent to prison where you will get three meals a day, a roof over your head, central heating, air conditioning and all the health care you need! Need new teeth? No problem. Need glasses? That's great. Need a new hip, knees, kidney, lungs or heart? They're all covered. And, as an added bonus, your kids can come and visit you as often as they do now.

And who will be paying for all of this? It's the same government that just told you that you they cannot afford for you to go into a home.

Plus, because you are a prisoner, you don't have to pay any income taxes anymore.

Is this a great country or what?  

Strange............I had exactly the same thought not too long ago..................as I near officially being classified as "elderly", and the realization that my "life cycle" is in it's decline, and there may come a day when I can no longer care for myself........I thought why not jail? ......free food.........a little more respect because of your age...............sort of like Brooks..............yeah why not jail..............

I also once prescribed to the K-Mart retirement plan..............................a box of shotgun shells from the Sporting Goods section.................Thankfully I've grown wiser

Quoted from 1251

Strange............I had exactly the same thought not too long ago..................as I near officially being classified as "elderly", and the realization that my "life cycle" is in it's decline, and there may come a day when I can no longer care for myself........I thought why not jail? ......free food.........a little more respect because of your age...............sort of like Brooks..............yeah why not jail..............

I also once prescribed to the K-Mart retirement plan..............................a box of shotgun shells from the Sporting Goods section.................Thankfully I've grown wiser

skydiving/deep sea diving/snow boarding what ever one wants to do....DO IT WITH GUSTO!!!!!!!!!!!!!!!!!!!!!!!!!!!!

you my computer friend Alias have your work cut out for you with your talent.......GUSTO...GUSTO...GUSTO!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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“Somebody needs to intervene when there is a case that’s not headed down the right path,” Twardy said. “Either someone wasn’t taking their pills correctly or wasn’t taking their medication at all. By educating, following up, ensuring they get to their primary care physician, these are all lower cost options than hospital readmission. So we are very aware of the fact that we can do that by providing better and more timely care.”
    The development of Health Homes for Medicaid enrollees with chronic conditions was recommended by Gov. Andrew Cuomo’s Medicaid Redesign Team and adopted into law in April 2011.
    Saratoga and Albany counties will see similar state-funded Health Home programs in their communities on or about April 1. Fulton, Montgomery and Schoharie counties are tentatively scheduled for July 1.
    For more information about Care Central, contact the VNS at 382-8050 ext. 244 or visit http://www. carecentral.org.

So who exactly will be 'intervening'???? And by the way......thank you gov cuomo for this compliance with obamacare!!

Here's the only way to post pone the inevitable.....WORK AS LONG AS YOU POSSIBLY CAN!! STAY ON PRIVATE INSURANCE AS LONG AS YOU CAN! STAY 'AWAY' FROM GOVERNMENT HEALTHCARE AS LONG AS YOU CAN!!! As long as you are working, and your employer provides health care....DO NOT force you to sign up for medicare when you are 65!! POST PONE THE INEVITABLE AS LONG AS YOU POSSIBLY CAN!!

For some odd reason I think this may belong in this thread.............

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Police: Porter Corners man killed wife, then shot self
Tuesday, January 31, 2012

PORTER CORNERS — An elderly Porter Corners man shot his wife on Sunday and then took his own life, investigators said Monday.

The shootings took place at 36 North Creek Mobile Village on North Creek Road in the hamlet in the town of Greenfi eld.

The Saratoga County Sheriff’s Office said Kenneth P. Sherman, 86, and his wife, Anna Wadsley Sherman, 83, were both pronounced dead at the scene by a county coroner.

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lack of medication compliance by patients

I don't like this.  

I have "fought" with my drs NOT to take the conventional shots for multiple sclerosis.  

i take an alterative that costs less then 30 dollars a month compared to thousands a month for the shots. I pay for my medication out of my own pocket, so medicare is not paying for any of my meds.

I recently went to the ER twice.  Just got results and can tell you I'm scared  

Stay healthy my friends. If you are in good health enjoy every day to the fullest.

My ambulance bill one way was $880.00.  My echo and holter over $2,200. Then there are the ER bills, the dr bills, the radiologist bills, the cardiologist bills etc etc.  Now I have to see one or two more specialists.

As I refuse to apply for medicaid , I will pay my bills a little every month until they are paid off.

Ron Paul has it so very right regarding health care with government involvement and the high cost.

Unfortuneately as the Health-Care Law takes more control things will get worse and the costs of care will go much higher. The costs are too high now and example, eye drops needed after cataract surgery $128 for a small vial.

A friend of ours has had severe neck, back and arm pain. The doctors just give her pain meds and send her on her way with no diagnosis. (they say maybe a muscle, pinched nerve, disc issue...etc)This has been going on for months. She is sick of taking pain meds (she still works) and requested an MRI. As it stands today......she needs to go see another new doctor FIRST, which won't be until the end of February.

They all tell her that they are following the 'government' guidelines!! And she has private pay insurance! All of her info is transmitted to a 'government entity' that monitors doctors. If the doctors don't follow the 'government guidelines'....they are rated accordingly which reflects their payments.

rpfpres is correct..................'stay well my friends'.
And my best to you rpfpres!!
And VOTE FOR RON PAUL!!

As was pointed out when the Health-Care Law was passed any savings will be done by denying treatment for seniors and the lies that were told to those same seniors in order to gain the passage of this law should be a criminal offense.

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A friend of ours has had severe neck, back and arm pain. The doctors just give her pain meds and send her on her way with no diagnosis. (they say maybe a muscle, pinched nerve, disc issue...etc)This has been going on for months. She is sick of taking pain meds (she still works) and requested an MRI. As it stands today......she needs to go see another new doctor FIRST, which won't be until the end of February.

And they wonder why people get addicted to pain meds  

She should not have to wait that long to see the doctor.  Tell her to call her insurance and regular doc and bug the hel* out of them. Tell her to tell them how much pain she is in and that she can't take it anymore.

Many times in woman pain is ignored or "medicated"

thanks bumble : )