As part of a broader alignment of WellSpan Health’s services with its patient populations, WellSpan Health offers patients in South Central Pennsylvania a program that encompasses virtually every healthcare service a woman may need throughout her life, all available close to home.
“We provide a complete package of women’s care across the system,” says Scott Grob, Interim Vice President of Women & Children Services at WellSpan Health. “We believe all health care should be local, and we work to provide patient-focused care to women in their own communities. We provide specialized services that are not only comprehensive, but also unique.”
Experts Around the Corner
Different from the classic hub-and-spoke model in which patients travel distances to access specialty services usually located at referral centers, WellSpan has developed a regional network of women’s specialty services available in local communities — York, Adams, Lancaster, Lebanon and Franklin counties. This model allows a patient to find specialty and subspecialty care in close proximity to her home.
Ann Orndorff, CNM, WellSpan Certified Nurse-Midwives, performs an ultrasound on one of her patients.
“For example, our Women & Children service line provides continuity across our entire health system. Individual primary and specialty services are situated in each local community to provide convenience to patients,” explains Mary Keperling, DO, OB/GYN and lead physician at WellSpan OB/GYN in New Freedom. “For instance, we provide basic urologic workups for incontinence as well as some minor urologic procedures in our OB/GYN offices. When a woman’s needs extend beyond the generalist’s abilities, WellSpan fills in the gaps with additional services at a WellSpan Urogynecology & Pelvic Reconstructive Surgery office located in the same community.”
In order to develop a women’s care program that is both comprehensive and community-based, WellSpan has created a visiting specialist model that allows the system to share resources across the service line’s offices. WellSpan’s team of fellowship-trained specialists and subspecialists in women’s care rotate through the various community offices to provide coverage in areas that would not otherwise have nearby access to those services. In cases for which specialized diagnostic equipment or procedures are necessary, WellSpan’s coordinated approach ensures that patients who are referred to the hospitals are carefully tracked in their transition from primary to specialty care and back again.
“If you’re an OB/GYN referring a patient for urogynecologic issues, but the closest available urogynecologist is 25, 50, sometimes 100 miles away, that is a real hardship for the patient,” Grob says. “She may have young children or a working spouse, and everyone has to take off work to make that medical visit possible. Today, we provide that specialty service locally.”
One of the key tools in tracking this referral process is WellSpan’s electronic health record (EHR). The database has been in place at WellSpan hospitals for several years and has also been implemented at the health system’s ambulatory locations and physician practices. This enhances communication among providers and coordinates care across the continuum.
“With our EHR and picture-archiving capabilities, we can send echocardiograms, ultrasounds, mammograms and other images electronically to an office in another county so it can be reviewed by a radiologist or the patient’s primary care provider,” Grob says. “If a specialist needs to see consult notes from the referring physician, he or she can pull those up alongside the imaging test and talk through it with the patient.”
Both the geographic and virtual localization of care across the WellSpan system help safeguard female patients from dropping off the radar and creating gaps in care that can be a challenge for providers following a patient’s referral to a specialist. Providers who refer patients to the health system maintain the ability to monitor their patients’ medical care fully through the streamlined sharing of test results and notes, while the specialist on the other end of care delivery is prompted by WellSpan’s system of patient-centered care to ensure proper handoff of the patient back to the primary care provider.
“Team-based care delivery is intended to provide the services a woman needs, when and where she needs them during the course of her life. As patients, we all want to have that single point of contact — someone who knows us, knows our family and understands our needs. That is what WellSpan offers.”
— Scott Grob, Interim Vice President of Women & Children Services at WellSpan Health
“WellSpan is actively creating a seamless experience for its patients by training its providers to view each patient holistically,” Dr. Keperling says. “If I see a patient who needs a colonoscopy, I’ll make sure the screening is scheduled even though I’m her OB/GYN. Additionally, we refer women back to their primary care providers and work collaboratively with those providers to address issues.”
Among the many specialized services that help round out WellSpan’s comprehensive care for women is its outpatient breastfeeding support initiative. WellSpan’s dedication to breastfeeding as a best practice has led to significantly higher rates of successful breastfeeding compared with the national average, with up to 80 percent of mothers establishing breastfeeding prior to discharge from WellSpan hospitals.
Another valuable service offering is treatment for neonatal substance abuse. The number of pregnant women with chemical addictions in local communities has increased steadily in recent years. WellSpan’s perinatologists have partnered with behavioral health practitioners to provide screenings and education about perinatal substance abuse and to treat women after delivery to prevent relapse during subsequent pregnancies.
WellSpan also offers specialized gynecologic services for children and teenagers, including evaluation, treatment and counseling for menstrual problems, developmental disorders and contraception.
An Investment in Women
WellSpan is further demonstrating its commitment to women’s health by hiring three new OB/GYNs in 2015, and it plans to expand its OB/GYN office in York County beginning in November. This will result in even greater access to women’s services and will complement the team of certified nurse midwives that assists in deliveries and outpatient obstetric care.
“WellSpan’s priority is community health,” Dr. Keperling says. “We’ve invested in building practices that share that priority. Having all of the women’s services under the same umbrella moves us as a community to a much healthier place.”
(L–R) Dominique El-Khawand, MD, FACOG, Director of WellSpan Urogynecology & Pelvic Reconstructive Surgery; Mary Jo Johnson, MD, perinatologist at WellSpan Maternal-Fetal Medicine; and Timothy McGuinness, DO, gynecologic oncologist at WellSpan Gynecologic Oncology
The Neighborhood Approach
The patient-centered medical home (PCMH) is an evidence-based model of care that emphasizes the patient’s ongoing, vested partnership with the primary care provider as the foundation for healthcare access and decision-making. Less known is the patient-centered medical neighborhood (PCMN), an emerging approach that extends the PCMH model into the realm of specialty care. In a PCMN, specialists and subspecialists develop enduring relationships with patients, much as their primary care providers do, creating a familiar “neighborhood” of providers, though one in which the patient and her medical home still represent the nucleus of care.
Embracing the PCMH and PCMN models, WellWomen at WellSpan Health fosters patient-provider relationships that are accessible, comprehensive, family-centered and team-based — the ultimate goal being to reduce healthcare costs while increasing patient wellness and engagement.
“Being part of this neighborhood means every provider looks at the patient holistically,” says Mary Keperling, DO, OB/GYN and lead physician at WellSpan OB/GYN in New Freedom. “No matter where the patient touches the healthcare system, she can expect to experience the same coordinated, evidence-based care. Part of the beauty of this model is that the patient repeatedly hears a unified message and has consistent guidance concerning her health, which increases the likelihood of her acting upon that guidance.”
For information about specific women’s health specialty practices at WellSpan Health, visit www.WellSpan.org/WellWomen.