Dartmouth Health Connect a new primary care practice for Dartmouth health care beneficiaries and their families opened in Hanover on March 13. Health Connect is the result of a partnership between the College, Dartmouth-Hitchcock Medical Center and Massachusetts-based health care company Iora Health to improve preventative health care and patient experiences and outcomes by redesigning primary care practices.
Located on Allen Street, Health Connect has been well received since its opening two weeks ago, according to Health Connect staff members. Thus far, the practice has registered 285 new patients and seen a steady stream of 12 to 16 patients each day, according to Iora Health founder Rushik Fernandopulle.
"We actually have more people signed up than we thought we would by this point in time," Fernandopulle said. "People feel like this is something they want to check out and try. After trying it out, I think patients are feeling well taken care of. I think that they feel like they have enough time with the team to actually get to know us."
Increased patient interaction and involvement are essential to the primary care model presented by Health Connect, which is available to all current and retired Dartmouth employees and their families, Fernandopulle said. Health Connect replaces the old physician-centered model with a new health care team composed of a nurse practitioner, a social worker, four health coaches, a practice coordinator and two physicians who split their time between the clinic and DHMC.
"I think the sense of team engagement with the patient at the center is much more prominent here," Joel Lazar, chief of the DHMC family medicine section and a Health Connect physician, said. "While the traditional primary care model certainly focuses on wellness and preventative care, I think that the nature of Health Connect allows us to focus on wellness in a way that seems more palpable."
Health Connect physician Brooke Herndon said the team model, in which health coaches support doctors, expands the number of resources available to both physicians and patients.
"While at a fundamental level, the patient-doctor relationship is the same it's still the same practice of sitting down with a patient and trying to listen to what matters to them the difference is that now I have more support around that," Herndon said. "It's what happens after and between visits that is different."
Health coaches provide support and are regularly in contact with patients both with and without chronic conditions to ensure that patients are consistently taking medications and maintaining healthy practices, Fernandopulle said. Hiring for Health Connect took into account not only medical background but also the ability of candidates to relate to others and maintain a positive attitude, he said.
Health Connect's new approach to billing underscores the emphasis on patient interaction. Unlike the existing fee-for-service model, the practice receives a flat fee per patient, eliminating administrative hassles associated with billing and patient copays, Fernandopulle said.
"Because we aren't paid per visit, we can interact with our patients in a whole lot of ways, including phone, email and video chat," Fernandopulle said. "This allows us to be proactive rather than reactive."
Fernandopulle said that this new primary care model is possible due to Health Connect's small size and affiliation with DHMC.
"We have the benefits of being a part of a big mother ship while still in a small, friendly location," Fernandopulle said.
As doctors associated with DHMC, Herndon and Lazar provide the practice with access to DHMC electronic patient records, specialist referrals and lab results, according to DHMC Executive Medical Director John Butterly.
Following positive patient reception, Health Connect is likely to grow, Fernandopulle said. The practice will probably reach its maximum registered patient load in the next year, though Fernandopulle said he is wary of allowing the practice to grow too quickly.
"We are being very careful not to grow it too fast because we want to take good care of people coming in," Fernandopulle said. "Initially, it takes more time. We need to get to know people and establish a health care plan."
Since opening, the practice has already made changes to improve patient experiences and will continue to respond to patient needs, he said.
Health Connect is one of the first clinics of its kind among college employee health care options. At many universities, such as Harvard University, employees utilize student health services. Other institutions, like the University of New Hampshire, have or are building dedicated practices for their employees, which operate like independent practices, according to Fernandopulle.
"A lot of people realize that we need to transform health care, and that primary care is the place to start, but it's very rare to have places to actually try to fix it," Fernandopulle said. "It's very exciting that Dartmouth is paving the way and establishing such a unique practice for its beneficiaries."
Dartmouth Health Connect, the brainchild of College President Jim Yong Kim, was planned in 2011 as a means of improving preventative health care practices on campus and across the country.
