August 14, 2024
SPMC currently partners with CareSignal though the Summit Pacific Care Connect (SPCC) program, a free service to our patients with Wellpoint insurance, providing health notifications and inquiries with a goal of catching disease progression early, avoiding emergency department visits and hospitalizations. Patients are eligible for SPCC if they were recently discharged from the hospital or have chronic conditions such as diabetes, congestive heart failure, chronic obstructive pulmonary disease (including emphysema and chronic bronchitis), and depression.
Participating patients receive at least weekly texts or phone calls asking a few brief questions about their medical condition and their general health. If there are concerns, a member of SPMC’s population health team is notified who follows up with the patient.
Recently Chronic Care RN, Tracie Moen, received an alert about a patient with shortness of breath during activity and a more than 5 lb. weight gain. Tracie called the patient, quickly realizing that she needed medical care. The patient’s primary care provider was unavailable, so Tracie encouraged her to visit our Urgent Care where she was found to have an elevated d-dimer which is often associated with blood clots. She was then transferred to our Emergency Department where a pulmonary embolus (a blood clot in the lungs) and associated right heart failure was confirmed. She received the appropriate treatment including blood thinners to prevent another clot. Our patient was able to go home from the Emergency Department and is doing much better thanks to the great care from Tracie and the rest of the SPMC team.