Rebuilding Place in the Urban Space

"A community’s physical form, rather than its land uses, is its most intrinsic and enduring characteristic." [Katz, EPA] This blog focuses on place and placemaking and all that makes it work--historic preservation, urban design, transportation, asset-based community development, arts & cultural development, commercial district revitalization, tourism & destination development, and quality of life advocacy--along with doses of civic engagement and good governance watchdogging.

Friday, July 22, 2011

Area health care planning

1. The debacle in Prince George's County over the cost of providing care to the uninsured is finally being addressed as the University of Maryland Medical System has agreed to take over the county hospital facilities and build a new teaching hospital located where it can also get patients (and revenues) from other counties in Southern Maryland. See "Pr. George's to get teaching hospital" from the Post.
Bread for the City, Washington, DC
Flickr photo by tedytan. Bread for the City is an innovative nonprofit (almost an oxymoron in DC) that does a lot of interesting things, focused on providing "vulnerable residents of Washington, DC, with comprehensive services, including food, clothing, medical care, and legal and social services."

2. The Associated Press reports, "‘Medical home’ health care model, focusing on prevention, shows results and cuts costs," on a concept that it happens that the DC Department of Health is already doing at a national best practice level. From the article:

Patient-centered medical homes focus on keeping patients healthy, which saves money by reducing hospital visits, especially for chronic conditions such as diabetes. ... Under the medical home approach, doctors use electronic records to track patients between visits and act as the central point of communication between specialists, nutritionists and others. They monitor blood pressure, blood sugar and other tests and whether patients are exercising and taking their medication. They also exchange emails with patients.

Instead of simply telling someone to exercise or stop smoking, a doctor or member of the patient’s care team might devise a plan with the patient and then check to see that he sticks to it.

The system in DC refashions health clinics targeting low income populations, and repositions clinics as primary care facilities for people who might otherwise rely on emergency rooms for care or avoid receiving medical care at all because of cost.

I have been meaning to write about this but AP has beat me to it. (I toured Bread for the City a couple weeks ago, and one of the these days I plan on seeing the new Mary's Center facility on Georgia Avenue NW.)

Instead of pissing about Tobacco Settlement monies like other states, the DC DOH has been using these monies to invest in the medical home project in the city.

3. The United Medical Center in DC needs a solution comparable to what is happening in Prince George's County. See "D.C. taps RSM McGladrey to look over United Medical Center" from the Washington Business Journal, which states:

Gray said an "action plan" will be developed based on recommendations from the review. Gray said he would not guess what those steps are. "We'll wait for the study to be completed," he said during his weekly media briefing.

"United Medical Center is an anchor in Ward 8 and the ward's largest employer," Gray said in an earlier news release. "My administration is fully aware of its importance in providing much-needed services to the residents of the District and in particular, Ward 8. I am fully confident that the Department of Health Care Finance did its due diligence in selecting this firm, which will conduct an objective sustainability review of the United Medical Center."

For years I have made the point that DC and Prince George's County's health care provision issues are linked. But jurisdictional boundaries prevent the creation of regional and innovative solutions.

4. Duane Read pharmacy (now owned by Walgreens) has opened an amazing store on Wall Street, with a doctor on the premises--no appointment required, along with juice and sushi bars, and hair, nail, and shoe shine salons. The doctor piece is an extension of the "minute clinic" type operations that supermarkets, big boxes, and pharmacies have been integrating into their operations. See "Duane Read opens big on Wall Street" from Chain Store Age.

The next step for DC's "medical homes" would be to make them more retail-like in operation, as I suggested years ago, in "Disruptive innovation (once again)" and "Bods/Cuerpos."

5. While some health care facilities in DC and Prince George's County languish, Montgomery County has faced a battle between Holy Cross Hospital and Washington Adventist Center over opening facilities in Upper Montgomery County, to better position their systems to get higher income patients. Holy Cross has pretty much won the battle. Although, in any case, Washington Adventist Center is relocating from Takoma Park to White Oak to better position their facility to be able to reach more patients than the residential, physically constrained, and practically in DC location in Takoma Park. See "Washington Adventist hospital would boost east county" from the Gazette.

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