By Ms. Suzanne Ovel (Army Medicine)July 10, 2015
The newest Soldier-Centered Medical Home under Madigan Army Medical Center opened its doors in May, serving about 4500 Soldiers with the 3rd Brigade, 2nd Infantry Division right in their backyard.
The SCMH model draws the uniformed U.S. Forces Command healthcare providers out of their battalion aid stations (which still perform sick call duties) and combine them with U.S. Medical Command civilian nurses and other support staff to provide Soldiers with more robust care at their primary care clinic.
The idea is to improve Soldiers' quality of care, access to care, and overall health while staying close to where the Soldiers work.
"We're a soft landing between FORSCOM and MEDCOM," said Tina Dorner, the lead nurse for the 3rd Bde., 2nd Inf. SCMH.
The SCMH team extends to specialty services such as a small pharmacy, and in-house physical therapy and behavioral health services. Maj. Evan Trivette, the 3rd Bde., 2nd Inf. Brigade Surgeon, hopes to add other services such as a part-time nutritionist to teach classes and consult with Soldiers.
The on-site physical therapy, however, is already addressing common issues such as chronic overuse injuries, which may include torn anterior cruciate ligaments, post-operative therapy, and knee, back, and shoulder pain.
Likewise, the in-house behavioral health services offer help for a variety of issues, to include relationship and sleep problems as well as anxiety and depression. Embedding behavioral health in the SCMH reduces stigma because it enforces the idea that psychological fitness is just as important as physical fitness, said Capt. Ryan Black, a clinical social worker with the 3rd Bde., 2nd Inf. SCMH. In fact, the SCMH "levels the playing field" because there's no obvious difference in the waiting area between the Soldier getting physical help or the one getting behavioral health help, he said.
Trivette said that "it's very facile, it's very user-friendly" for a provider to walk a Soldier down the hall to meet a behavioral health specialist.
"It works the other way too; they may be seeing someone in counseling and say, 'I think this Soldier could benefit from medication'," said Trivette. "That interface does a lot for the quality of care that Soldiers get."
In addition to more robust on-site services, Soldiers at the SCMH benefit from better access to care. The SCMH is tied into the national Nurse Advice Line, which connects patients to their local nurses and providers, who then have 24 hours to follow up directly with their patients.
Preventative healthcare gets a boost too, since better access to care means that providers have more opportunities to provide health education to their patients. Soldiers will get more care after appointments as well as there's an increased emphasis on follow up care, whether it is checking on their health status after an emergency room visit or checking on concerns about medication side effects.
"Part of our model is even if they don't follow-up, we follow up with them," said Michael Tartaglia, the chief nurse officer in charge of the 3rd Bde., 2nd Inf. SCMH.
This increased emphasis on providing better care to Soldiers, and with more continuity of care, is expected to lead to greater Soldier satisfaction with their healthcare, according to Tartaglia.
The hope is for Soldiers to feel that now "I really feel cared for, and it's somebody I know, it's somebody who's right down the street."