It’s a paradox of modern medicine that the more advanced technology and treatment become, the harder they can be to use. As care becomes more specialized, communication among providers can be lacking. Add in a few layers of health insurance bureaucracy and it’s no wonder patients feel lost managing their own care.
School Health Clinics of Santa Clara County's Melissa Trujillo sees this every day. As SHC’s Patient Navigator, she helps patients trouble-shoot problems that stand in the way of the care they need.
Navigators provide personal guidance to patients as they move through the healthcare system, helping them overcome challenges and barriers, especially when they are referred for specialty care. These challenges are especially hard for patients who don’t speak English, those who don’t understand how the U.S. healthcare system works, or those too ill to make numerous follow-up phone calls. Melissa’s training and familiarity with local medical service systems helps her cut through issues, saving patients time and frustration. And clearly the need is there - Melissa assists roughly 25 SHC patients each day.
One morning last month the mother of a School Health Clinics’ patient contacted Melissa desperately trying to sort out her 10 year-old daughter’s chemotherapy appointment, which was scheduled for the following day at U.C. San Francisco. The treatments had been going along just fine until the mother was told they did not have the proper authorization for care. Since regularly scheduled doses are critical for chemotherapy's effectiveness, she was frantic about getting her daughter to the appointment. To compound the situation, the mom’s car broke down and she didn’t have a way to get there.
Even for Melissa, who is well-versed with these types of challenges, it took many, many phone calls throughout the day to sort out the administrative snafu, but by late afternoon she had the authorization back in place and transportation arranged for the family.
“It brings me joy to help patients with these problems; it makes such a difference for them and they are always so grateful,” says Melissa.
Helping patients stay on course is just one of the many ways School Health Clinics of Santa Clara County is working hard every day to ensure patients receive the highest quality and effective care possible.
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The numbers are in on homelessness, and the news is not good: since 2017, a 42 percent increase in San Jose, and a 31 percent increase county-wide, according to a preliminary report recently released by Santa Clara County.
The lack of affordable housing and the high cost of living are obviously key factors, but for the chronically homeless, it is health issues - particularly mental illness and substance abuse - that drive many people to the streets. Living outside without shelter can make medical conditions worse; and homeless people often delay seeing a doctor until they are seriously ill. It is no surprise they end up at the ER or hospitalized at disproportionate rates. And although services may be available, they are often delivered in a siloed fashion by providers who do not regularly communicate or coordinate care, even though they may be serving the same individuals and families.
While School Health Clinics of Santa Clara County can’t fix the housing crisis, we do play an important role in helping support and stabilize these vulnerable populations.
School Health Clinics is participating in a pilot project coordinated by Santa Clara Valley Health and Hospital System to provide “Whole Person Care” specifically targeted at populations that lack the resources to maintain stable housing and are frequent emergency room users. By better coordinating health, behavioral health, and social services in a patient-centered manner, the project's goal is to improve patient health and well-being through a better use of resources.
Patients who participate are designated a medical home, like School Health Clinics' Washington Neighborhood Health Clinic, where they receive all of their primary care and additional supports to address their specific needs. Staff keep in touch with patients regularly to monitor their visits and progress, and encourage them to stay engaged in their personal health and wellness.
Having local, familiar healthcare providers who are attuned to their unique health challenges is critical to establishing the trust necessary to work with high-needs populations. Whole Person Care is about making each visit helpful and reinforcing a patient’s ability to receive the right care in the right setting.
Every part of the program is aimed at improving patient access to primary care so that patients can ultimately enjoy healthier lives.
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