Often, talk of effective medical innovation means something high-tech and high price, but a report out
today in the Journal of the American Medical Association highlights one that's anything but: The low-tech, low-price lay community health worker.
For about $15 an hour, community health workers are doing what much better paid doctors, nurses and social workers struggle to do: keep sick patients from returning to the hospital again and again.
To understand what a community health worker does, let’s talk about a real case -- a woman who kept showing up to the hospital with high blood pressure, a little overweight, complaining of chest pain.
"Automatically, people worry she’s having a heart attack," says Dr. Shreya Kangovi , an internist with the University of Pennsylvania Medical System, and lead author of the new study. "She comes in, she gets stress tests, she gets EKGs, she gets cardiac catheterization she gets medication."
After six months of expensive hospitalizations, Kangovi says the patient was paired with a community health worker. It was at that point the patient opened up about a sexual assault.
"This had really traumatized her and it was leading to these feelings of panic and social anxiety," Kangovi says.
Ferreting out the source of the problem, says Kangovi, is really what the patient needed -- not going to the hospital every month. In fact, the patient returned just once after that. Kangovi says her randomly controlled trial found high-cost patients who were matched with health workers felt better, and were less likely to be readmitted multiple times.
http://www.marketplace.org/topics/health-care/delivering-better-medical-care-15-hour
University of Pennsylvania news release:
In response to results from the trial, the University of Pennsylvania Health System has created the Penn Center for Community Health Workers to help integrate the IMPaCT model into routine healthcare delivery. The model, housed within Penn Home Care and Hospice Services, currently serves 1,000 patients per year and is expected to triple by the end of 2014. The Center has also developed resources to help organizations outside of Penn to implement the IMPaCT model, including an open-access toolkit, online workflow systems and technical support.
Abstract in JAMA Internal Medicine: Patient-Centered Community Health Worker Intervention to Improve Posthospital Outcomes -- A Randomized Clinical Trial
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