The Hidden Work of Primary Care

I sat at my desk astonished after her exit. By all current billing standards, I had done nothing. I had spent no more than fifteen minutes with Alice and had done nothing more than explain in layman’s terms what had taken place in her recent ER visit.

A Cup of Coffee Can Go A Long Way

A few weeks ago, our team reached out to a member of our national network with whom we hadn’t connected in more than five years. Over scones and lattes, a question was posed, “How are you?” His response left me speechless.

Healthcare Hotspotting Meets High-Utilizing Patients

Healthcare hotspotting is an innovative model of care through which health professionals across disciplines work as a team to identify healthcare super-utilizers – people who are admitted to the hospital multiple times a year, frequently for avoidable complications of chronic conditions, and who often have social barriers to adhering to their care plan. Hotspotters proactively bring additional attention, follow-up, resources, and care to these patients in their homes and communities to help keep them out of the hospital.