Why Specialty Care?

The need for specialty care services for Partnership HealthPlan (PHC) patients in the RCHC region far exceeds the supply of available providers in multiple specialty areas.  RCHC, PHC, the Sonoma County Medical Association and representatives from RCHC member health center CMOs/Medical Directors and Specialty Care Coordinators have participated in the Specialty Care Access Improvement Group in Sonoma County since 2014. This  collaborative is convened and chaired by RCHC and has met monthly to develop strategies and share best practices for improving access to specialty care for PHC members served by community health centers in Sonoma County.  RCHC is working to improve specialty care access through a grant from PHC in Marin, Napa, Yolo and Sonoma counties through 5 coordinated activities.

PROGRAM

Clinical Guidelines

End Stage Liver Disease (Cirrhosis) Guidelines

Clinical Decision Support

Under Development

Promising Practices

Under Development

Trainings

RCHC Training Calendar

What We Do – 5 Coordinated Activities

Activity 1: Specialty Care Visioning Session

RCHC conducted a Visioning Session in September 2016 to engage in a structured 4-county multi-stakeholder innovation process and feasibility analysis to develop regional systems-based strategies for improving specialty care access.

Activity 2: Combined Electronic and In-Person Specialty Consultation Models

RCHC will work with at least two local specialists in the Partnership network to explore options, test feasibility and pilot the addition of electronic consultation to current model of in-person specialty consultation.

Activity 3: Establish 3 Specialty Clinics in Local Health Centers with Specialist Physicians from Annadel Medical Group

RCHC and local health centers have initiated conversations to establish at least three specialty clinics at a local community health center to provide access to Sonoma County health center patients.

Activity 4: Reduce Demand for Gastroenterology Specialty Consultation through through Evidence-Based Guidelines for Primary Care Management of Hepatitis C, Cirrhosis and Colorectal Screening Across Health Centers

Consistent evidence-based primary care management of hepatitis C, cirrhosis, and colorectal cancer screening across RCHC member health centers.

Activity 5: Convene Monthly Specialty Care Access Improvement Group

RCHC, Partnership HealthPlan, Sonoma County Medical Association, health center executive leadership and referral coordinators, and local specialist champions will meet monthly to monitor progress and inform the other strategies of this project.

Who We Serve

Redwood Community Health Coalition (RCHC) has been working with member health centers, Partnership Health Plan, local multi specialty groups, community-based organizations, medical societies and others to address the challenging issues and disruptive market forces impacting access to specialty care for 153,559 vulnerable patients in Marin, Napa, Sonoma and Yolo counties facing challenges in obtaining specialty care.

While there have been many attempts from dedicated local health care organizations and individual physicians to improve access to specialty care, it is imperative to thread these individual attempts together and collectively stretch cross-county thinking to define an innovative systems-based specialty care vision for vulnerable populations served by these multi-county health centers.

Funders

This project is funded by Partnership HealthPlan of California.

Project Timeline

March 2016 through December 2018

 Initial Results

Activity 1: Specialty Care Visioning Session

Our Improving Specialty Care Access Visioning Session was held on September 9, 2016. We had 47 healthcare innovators across 27 organizations spend a day imagining what the future of specialty care access could look like on a regional level. Center for Care Innovations along with RCHC spent several weeks synthesizing data from the visioning session to get guiding principles, building blocks and a strategy going forward to 2017 and beyond.

Guiding Principles

Building Blocks

Strategy

Activity 2: Combined Electronic and In-Person Specialty Consultation Models

Petaluma Health Center has piloted neurology consults with a local neurologist over internet.

Activity 3: Establish 3 Specialty Clinics in Local Health Centers with Specialist Physicians from Annadel Medical Group

Petaluma Health Center has begun a regional urology hub as of September 2016. Dr. Jim Palleschi joins Dr. David Rudnik at the health center to provide in-person urology consults to health center patients from our entire 4-county region. Plans are continuing for Endocrinology and Rheumatology specialty hubs in 2017.

Activity 4: Reduce Demand for Gastroenterology Specialty Consultation through through Evidence-Based Guidelines for Primary Care Management of Hepatitis C, Cirrhosis and Colorectal Screening Across Health Centers

Hep C, Cirrhosis and Colorectal Cancer workgroup has brought forth standardized treatment, medication, and screening guidelines. In conjunction with California Department of Public Health to create trainings for health centers around best practices for colorectal cancer screenings for 2017.

Activity 5: Convene Monthly Specialty Care Access Improvement Group

During the duration of this grant RCHC has chaired and coordinated this workgroup.

PROJECT PARTNERS

RCHC Health Centers:

  • Alexander Valley Healthcare
  • Alliance Medical Center
  • Coastal Health Alliance
  • CommuniCare Health Centers
  • OLE Health
  • Jewish Community Free Clinic
  • Marin City Health and Wellness Center
  • Marin Community Clinics
  • Petaluma Health Center
  • Santa Rosa Community Health Centers
  • Sonoma Valley Community Health Centers
  • Sonoma County Indian Health Project
  • West County Health Centers
  • Winters Healthcare Foundation Inc.

Strategic Partners:

  • Center for Care Innovations
  • Partnership HealthPlan

Community Partners:

  • Kaiser Permanente
  • Sutter Healthcare Foundation
  • California Primary Care Association
  • MAVEN Project
  • Operation Access
  • Shasta Community Health Center
  • St. Joseph Medical Group
  • Open Door Health Center
  • Petaluma Health Center English Patient Advisory Board
  • Petaluma Health Center Spanish Patient Advisory Board

PROJECT CONTACT

For more information, please contact Michelle Rosaschi

ADDITIONAL RESOURCES AND COMPANION DOCUMENTS