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M.Michelle Hood, FACHE
EMHS, President and CEO
Bangor Beacon Community
Statewide Advisory Committee
Chair
Erik Steele, DO
EMHS, Vice President and Chief Medical Officer
Bangor Beacon Community Principal Investigator
Leadership
Catherine Bruno, FACHE
Bangor Beacon Community Executive Sponsor
EMHS, Chief Information Officer Lead
Dale Hamilton Executive Director, Community Health and Counseling Services Alternate
Clincial Transformation
Jim Raczek, MD
EMMC, Chief Medical Officer Lead
Robert Allen, MD
Penobscot Community Health Center, Executive Medical Director
Alternate Evaluation Barbara Sorondo, MD EMMC, Director Clinical Research Center Lead
Frank Bragg, MD
EMMC, General Internist
Alternate Meaningful Use Dev Culver HealthInfoNet, Executive Director Lead
Sustainability
Mike Donahue, MBA
EMHS, Vice President, Payor Contracting and Relations
Lead
Donald Krause, MD
St. Joseph Healthcare
Internal Medicine
Alternate
Bangor Beacon Staff
Mac Hilton
Program Director
Melanie Pearson
Project Manager
Lanie Abbott
Senior Communications and Outreach Specialist
Andrea Littlefield
Senior Communications and Outreach Specialist
Amy Bates
Project Coordinator
Sharon LaBrie
Data Analyst
Heather Broussard
Data Analyst
Samantha Haynes
Administrative Assistant |

Stay up to date with the Bangor Beacon Community! |
Care Manager Forum a Beacon Bright Spot
The Care Manager Forum is one of the many bright spots for our Bangor Beacon Community. The group recently met for the tenth time and learned more about the data being collected by Eastern Maine Medical Center's (EMMC) Clinical Research Center for Beacon patients, focus groups with providers regarding the benefits of care management in their practice, updates on HealthInfoNet (HIN), and care transitions within the community.
Barbara Sorondo, MD, director of EMMC's Clinical Research Center, updated the group regarding performance improvement metrics on diabetes for patients tracked in Beacon and through the ACO. She also shared publication topics
that are being proposed for peer reviewed journals and general dissemination about the Bangor Beacon Community.
As part of the evaluation of care management interventions, focus groups were held with providers to discuss how care management is helping their practice. The following quotes from providers regarding their experience were shared with the group:
"Care management helped to reach those patients who had not effectively managed their health before without a care manager because we did not have the time."
"Increased communication about patients reduces my workload and clearing things off of my desktop."
"Patients feel like there is a group of people taking care of them instead of only one person."
"They are able to reach patients on a more personal level and help them."
Todd Rogow, director of information technology, HIN, presented the most recent data collected by the exchange, including clinical portal use statistics, population, and daily data feed numbers. Todd also discussed the improvements HIN is making based on the feedback from care managers and providers.
At the beginning of our Bangor Beacon Community collaboration, care transitions were highlighted as a significant area to improve among our partners. Kathy Bragdon, RN, Penobscot Community Health Care (PCHC), transitions care manager, shared her experiences with care transitions and working with care managers across the community.
HealthInfoNet is the Focus on MaineWatch |
How Maine providers are using electronic records to improve care.
Have You Watched Our Videos?
Please feel free to share the link as they reinforce our mission and vision for a healthy community.
Clinical Leadership
Mental Health
HIT / Meaningful Use
Rick and Diana's Story
Performance Improvement
Patti's Story
Bangor Beacon Leadership
Eric's Story | |
Beacon to Beacon Collaboration
The Bangor Beacon Community was invited to participate as a pilot site for a diabetic tool developed by the southeast Minnesota Beacon Community. The tool was developed as a part of their Beacon project. The PROQOL (Patient Reported Outcome Quality of Life) tool was tested at Penobscot Community Health Care's (PCHC) Union Street location and was administered by medical assistant health coach.
When a diabetic patient was seen in the practice they were instructed to use an online tool that asked them several additional questions to learn more about the specific concerns that were present during that appointment. The concerns focused on finances, emotional, personal relationships, monitoring health, health behaviors, medicine, getting healthcare, work, physical health, or any other topic that may be on the patient's mind. By asking patients to select one of these key concerns, the health coach was better able to help respond to all of the patient's needs and issues that may influence their overall well-being.
Those who used the tool found it to be useful with the patients in the pilot project. We were able to provide helpful feedback to the SE Minnesota Beacon project so they can strengthen the tool and make it available to other healthcare systems.
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Greetings!
Two and a half years ago 12 partners sat down together to develop a plan to improve healthcare while decreasing cost and improving the quality of life for some of our sickest friends and neighbors. The Bangor Beacon Community grant is proving to hundreds of chronic disease patients and their families to be money well spent. To our local healthcare providers it demonstrates that a team approach to healthcare aided by health information technology is the right way to care for patients. And to organizations, it is highlighting that competitors can successfully collaborate for the benefit of the communities we serve.
Now with just six months remaining on our grant, we are really seeing the depth of our work and how it is going to shape the future of how healthcare is delivered, not only in Maine but also throughout our country!
And while sometimes we focus on the big picture of change, it is always important to remember that individual lives are improving. I was driving home the other day and saw a Bangor Beacon patient from Community Health and Counseling Services (CHCS) that I had interviewed last year walking down the street picking up returnables. Ernie Mudgett is living better with his diabetes than he ever has and he looked great. According to his care manager Stacey Baude, RN, he's lost weight and his A1Cs are "normal." So, yes while it is exciting to be a part of building the foundation of a new healthcare system, it's still all about the patients and building a healthy community for generations to come.
Warm regards,
Lanie Abbott
Senior Communications and Outreach Coordinator |
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Living Healthy with Asthma... It's Possible |
Two years and no trips to the emergency room! And to celebrate Lindsey Ginn now makes time to exercise every day. What a turnaround for a teacher in Orrington that thought she would never see the day when a winter would come that she wouldn't end up in the emergency room. Asthma has been a part of her life since she was child. "Even when I was asleep, I'd wake up to use my inhaler - I constantly felt like I couldn't catch my breath. It's not a good way to live."
When Lindsey moved to the Bangor area in May of 2010 it was a chance to start fresh. She gave up her two pack a day smoking habit and started blazing a trail of better health accompanied by better choices. "It was time to make something of myself and my life." That's why she took the advice of her provider at Penobscot Community Health Care (PCHC) and started working with Wendy Perkins, RN, care manager and her care team. "She made me realize I can't live using an emergency inhaler the rest of my life - that there are better ways to manage my symptoms."
Lindsey got the proof she needed within months. Wendy taught her how to consistently use an inhaler and how to make changes in her environment to help keep her asthma triggers at bay. "I haven't been in the hospital or the emergency room since I started working with Wendy, it's incredible." No bronchitis and no pneumonia this past winter, Lindsey had no idea her life didn't have to be tethered to her asthma and her inhaler. "I can go up and down the stairs without feeling winded now - I visited my parents in New Jersey with their two dogs and I was fine."
Lindsey believes the changes made were possible because of the relationship between herself and her care manager. "She helped me make a life style choice, not a quick fix. Wendy is there when I have questions and she helped with my insurance company - she helped make me turn a corner." Life is becoming more enjoyable and for this third grade teacher the possibilities seem more exciting! |
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Helping Prepare Future Healthcare Workers
By 2014, the federal government is requiring that all health records are available electronically. Based on estimates from the Bureau of Labor Statistics, Department of Education, and independent studies we'll need another 51,000 qualified health information technology (IT) workers over the next five years to meet the needs of hospitals and providers as we adopt an electronic healthcare system, facilitated by the Health Information Technology for Economic and Clinical Health (HITECH) Act to promote the adoption and meaningful use of health information technology.
The Bangor Beacon Community, through its partnership with Eastern Maine Community College (EMCC), is helping to prepare the future workforce for the challenges electronic medical records and health information technology pose to primary care practices, clinics, hospitals, and other health care facilities. EMCC launched its electronic medical records course this semester as part of its Associate of Applied Science degree in Medical Office Technology. The community college, with monies from the Beacon grant, was able to purchase the health information technology used by local healthcare professionals to their students. EMHS, provided staff to set up the equipment and Frank Bragg, MD, at EMMC's Husson Internal Medicine created a training data base for students to get practical hands on experience using the technology.
Career opportunities with this specialty include office manager, office assistant/administrative assistant, medical secretary, transcriptionist, coder, billing manager, billing clerk, medical records clerk, unit secretary, patient registration, office clerk, or receptionist. |
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Building a Better Safety Net
By Kathy Bragdon, RN, Transitions Care Manager
Penobscot Community Health Care (PCHC) |
I have been a registered nurse for more than 24 years working in various specialty areas across the continuum of care, including orthopedics, surgery, post anesthesia recovery, outpatient surgery, pain management, home health, and discharge planning from acute care. I started as a nurse care manager in June of 2010, when the Bangor Beacon Community began enrolling patients. Through the work done by Beacon, one specific area identified as problematical for patients was the transition process from hospital to home or skilled care to home. For the last five months, I have been working strictly on the transition process for these patients, and I can honestly say that this is how healthcare should be. Support the patients with self management of any health challenges they may be dealing with, and surround them with support when they are the most vulnerable; during all transition phase. The Transitions Care Management position is challenging and rewarding.
Each day is different, but each week contains the same components. I round at Eastern Maine Medical Center (EMMC) daily and at St. Joseph's Hospital three times a week. At both hospitals, I meet with care managers who are doing discharge planning to discuss the patients' progress and plans for discharge. I am able to communicate that information back to the primary care practice. This coordination of care helps us better support our patients when they leave the hospital.
For example, if a patient is discharged with a high risk medication like Coumadin, I share that information with their primary care team so that a quicker follow up call will occur to answer questions, arrange for lab work, and provide any needed education. By building relationships with the inpatient care managers, I can also share any concerns they have about patients with primary care staff to specifically address those concerns during our follow up phone calls. Additionally, if the inpatient care manager feels that a referral to home health is needed but the patient declines, we can address those concerns during the follow up call in order to make sure that the patient hasn't changed their mind or provide additional information. If the patient changes their mind, we can quickly make a referral.
One thing I didn't anticipate when I started this position was how much time I would spend assisting people with connecting to a primary care provider. For many of these people that are currently in the hospital, they are underinsured or uninsured and financial issues are of huge concern for them. I am able to meet with them in the hospital, talk a little bit out PCHC and our mission, and get them scheduled with a primary care practice after discharge. The most amazing part is that I get to look them in the eye and say sincerely, I don't want you to worry about not having insurance. We will help you take care of yourself no matter what. You can see the relief in their eyes. To date I have helped 29 patients get into a primary care practice, patients who had none, and 96 percent of those patients showed up for their first appointment.
I am continuing to build relationships with the eight area skilled nursing facilities and the two acute psychiatric hospitals in the area. Nurturing relationships and building trust is the key to my success. Recognizing the fact that staff at these facilities are very busy and convincing them that this position has value to them as well as the patient, is a slow process but well worth the effort. We now have a consistent flow of information about the patients' progress and possible barriers for discharge. I am able to communicate this information back to the practice team and the primary care provider. This type of exchange is the ideal.
For as long as I can remember, the focus and philosophy of healthcare has been to focus on their "market share." Through the Bangor Beacon Community project, relationships have been formed and the lines of communication have been opened. Now it feels as if the philosophy is now about how we can "share the market" and keep people healthier. We, as healthcare providers, are now doing a better job of supporting our patients as they navigate and move along the continuum of care. |
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The 12 Bangor Beacon Community partners:
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