Health Care

New GraceMed initiative aims to help understand patients’ living conditions

GraceMed Health Clinic plans to start collecting data on patients’ living conditions.

Doing so will help the clinic connect patients with resources that address their physical, mental and emotional health in a more holistic way, said CEO David Sanford.

Checking patients’ height, weight and blood pressure is standard practice, but these routine measurements do little to provide healthcare workers with an understanding of the conditions that contribute to patients’ overall well being.

“More and more health providers are integrating questions like, “Do you have enough food to eat? Are you living in a safe neighborhood?’” said Martha McCabe, grant specialist for GraceMed.

These factors, termed the social determinants of health, also include income, housing, environment, access to transportation and access to recreation, McCabe said.

All of those factors are intertwined and affect people’s health, she said.

During the intake process, GraceMed patients will be asked about their living conditions, Sanford said. He said patients won’t be overwhelmed with too many prying questions.

“We’ve found out that five to seven is probably the right number,” Sanford said.

“That gives our staff the opportunity to identify more than just what they need from a physical health perspective or a mental health perspective, but what else is going on in their built environment that needs to be addressed.”

Dr. Karen Countryman-Roswurm teaches social work at Wichita State University and is director of the Center for Combating Human Trafficking. She’s developed a model for fighting human trafficking that addresses potential barriers people face in their lives.

She said it’s “rooted in best practice” to incorporate the social determinants of health into treatment.

“Ultimately, you can’t just treat one aspect of a person because we’re holistic beings,” she said. “We’re biological, psychological, social and spiritual beings.”

Countryman-Roswurm said traumatic experiences are detrimental to people’s health.

“When there’s a stressful experience like I lose my house or maybe I’m raped or I’m in an abusive relationship or I’m sold for sex or labor, we know that there’s a chemical reaction within the body that then affects health,” she said.

Around the country, community health centers are compiling data and hiring case managers to identify and address deficits in patients’ lives outside of the realm of medical care, Sanford said.

GraceMed just received a $30,000 grant from the Sunflower Foundation for technology needed to include questions related to the social determinants of health in their electronic health record.

Once the data collection is in full swing, the clinic can start connecting patients with resources on a case-by-case basis, Sanford said.

McCabe, who wrote the Sunflower Foundation grant proposal, said GraceMed will spend a few months observing other clinics and determining questions before implementing them.

She said the new initiative should be up and running no later than Jan. 1 in GraceMed’s 12 Wichita clinics. Implementation at the Topeka, McPherson and Clearwater locations could be delayed until July 2020.

Sanford said the idea of incorporating holistic questions into the patient intake process is just now reaching the region.

“It’s relatively new to Wichita. It’s relatively new to Kansas,” Sanford said.

“We go boldly where everyone else has been before.”

He said he expects GraceMed’s patients to be receptive to the outreach.

“The population that we primarily serve are people that know that they need help, and so, because of the situation that they’re in, they really are very open to sharing,” he said.

Countryman-Roswurm said patients will be more guarded if they worry what they say could be used against them. She said GraceMed and other health clinics must protect patient privacy.

“We have to be very clear on what are the policies and procedures around confidentiality and mandated reporting,” she said.

“Especially when you’re talking about people who by reporting, for example, that they’re in an abusive relationship or that they are without certain, maybe food or housing et cetera, they may be putting their children at risk,” she said.

Sanford said GraceMed’s data will be reported back to the Sunflower Foundation in aggregate, but that patients’ personal information will be kept confidential.