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How Field Clinics Reduce One Hospital's ED Strain

Alexandra Wilson Pecci, for HealthLeaders Media, May 11, 2011

Albemarle Health serves people across a 1,947 square-mile swath of one of the country's poorest regions. While a portion of the community is made up of migrant and seasonal workers, others are uninsured permanent residents without access to primary care. Supported by grants and donated healthcare services, Albemarle Health and its Albemarle Hospital Foundation is trying to confront those issues and improve the health of its community—as well as its own bottom line.

Problem: Migrant and seasonal farm workers across nearly 2,000 square miles.

Solution: Although there are programs serving migrant and seasonal farm workers throughout the country, Easterday says theirs is unique in North Carolina. Beginning last year, Albemarle Health started delivering healthcare directly to the workers, setting up field clinics about once a week during the growing season, which runs about May-November. She says whereas other programs provide workers with transportation to health clinics, Albemarle's large geographical area makes doing that impractical.

Since workers don't typically get out of the fields until 6 or 7 pm, "if we were giving them a ride to the clinic, it would be 8 or 9 o'clock, and that's just really difficult," she says. Instead, Albemarle staff perform health screenings in the field and provide needed follow-up care, such as giving free medication or even facilitating surgery, like they did for one worker with an abdominal hernia. "We were able to get him into a local surgeon right away," Easterday says.

Problem: Uninsured and low-income population

Solution: Albemarle Project Access was introduced in September 2010 in an effort to increase access to primary care and specialty services. The program uses physicians who actually volunteer their services to care for patients. Some physicians pledge a number of visits, others a dollar amount. During the first six months of the program, physicians—many of whom are not employed within the Albemarle system—provided $90,000 of donated services. In addition to reducing the strain on the Albemarle ED, the program also links patients with other resources; for example, it might help patients realize their eligibility for and enroll in Medicaid or disability benefits.

One patient who repeatedly visited the ED with dental issues was able to received donated treatment from an oral surgeon. Another was able to receive treatment for colon cancer, which otherwise would have likely gone undetected for a long time. Easterday says the program should reduce at least some of the strain from patients arriving at the ED with minor medical problems. "It can't fix the entire issue," she says. "But it certainly makes a difference."

Healthcare leaders: we'd love to hear from you. What are some of the ways you are confronting the unique care challenges that face your organization?


Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.

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2 comments on "How Field Clinics Reduce One Hospital's ED Strain"


stefani (5/20/2011 at 9:53 AM)
In addition to residencies in hospitals, medical education should includes residencies in private primary care practice, clinics, public health units. Hospitals only see the acute care patient - but if this country is moving toward preventation and health, then medical education should put interns and residents where it all begins.....in the field.

Bill Gustafson (5/14/2011 at 4:39 PM)
My company sells medical equipment and I get to talk to people across the USA. I am always happy to hear or read where a group has the commitment to provide solutions to real world problems. I hope Albemarle Health gets the recognition it deserves for a job well done.