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Population Health: Carlos

By Dr. David C. Pate, News and Community
June 2, 2015
Editor’s note: This is the seventh part of an eight-part series that previously appeared in an abridged form in Becker’s Hospital Review. The example below illustrates the segmentation and care of one subpopulation; others were shared last week and will round out the series.

Carlos is a 57-year-old man experiencing a stroke. He was at work when he noticed that his hand was weak and he couldn’t pick up his coffee cup. A colleague remarked that his speech was slurred.

His colleague called 911 and Carlos was taken to one of your health system’s emergency rooms. The ER team had already been notified and was ready for Carlos’ arrival. He was whisked into a room where a quick assessment was performed.

A nurse hit the “e-ICU” button on the wall. A camera came on and a stroke neurologist from another location in your system appeared on the monitor. The stroke neurologist could watch the ER physician conducting the neurologic exam.

The medical team quickly moved Carlos to radiology for a scan. The images were visible to the neurologist online and a diagnosis of stroke was made.

It was determined that Carlos was an excellent candidate for clot-busting drugs and the medication was administered. And whereas before, an air ambulance would have been dispatched to pick up Carlos and fly him for further treatment, the remote monitoring means that Carlos is able to remain in the hospital close to home and his family, saving significant expense.

Carlos recovers well from his stroke and is able to be discharged home with a treatment plan of physical therapy, speech therapy, occupational therapy, and a nurse care coordinator. Once he returned to work, Carlos’ nurse practitioner monitored his weight, blood pressure, and fitness to ensure that he would be at minimal risk for another stroke.

Carlos’ capitated health plan means he can pay a monthly premium without additional charges for his hospital stay, scans, blood tests, therapy, and follow-up visits. He receives regular messages from your health system about vaccinations and screening tests following his stroke. A daily medication alarm reminds him to take his aspirin and other medications.

Next, we’ll look at the most costly subpopulation, the chronically ill.

About The Author

David C. Pate, M.D., J.D., is president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.