Suboxone management for opioid patients. The latest in oral alternatives for diabetes. Liver-sparing medications to treat alcohol addiction. These are just a few of the life-saving lessons Chandima Deegala, B.S., PharmD, NCPS-PP, CTTS, will take back to Northern Navajo Medical Center in Shiprock, New Mexico, part of the Indian Health Service (IHS), after a week of hands-on mentoring from practitioners at Brigham and Women’s Hospital and Brigham and Women’s Faulkner Hospital (BWFH) this July.

Deegala, known as Chad, was here as part of the 10-year-old Brigham and Women’s Outreach Program with IHS. The program extends the expertise of the Brigham and BWFH care providers to IHS hospitals in the Navajo Nation, which address the unique needs of an underserved patient population. The essential goal of the program is to enhance the expertise of IHS physicians, the vast majority of whom are primary care-trained. Physicians in the vast Navajo Nation, which spans three states but includes 175,00 people, lack immediate access to specialty continuing medical education (CME) opportunities as they tackle high rates of complex, chronic illness including diabetes, chronic liver disease, mental health conditions and unintentional injury.

IHS clinical pharmacist practitioner, Chandima Deegala, BS, PharmD, NCPS-PP, CTTS, meets with Saria El Haddad, MD, Director of the Dual Diagnosis Partial Hospital Program and attending psychiatrist for the Outpatient Suboxone Program

The Outreach Program prepares IHS PCPs to more proficiently treat a broader range of conditions across specialties, such as cardiology, pulmonology, rheumatology, endocrinology and addiction medicine. To that end, the program includes three core initiatives: on-site visits from the Brigham and BWFH physicians to IHS hospitals; a remote, interactive CME teaching program broadcast from Boston; and mentoring at the Brigham and BWFH for IHS practitioners. The idea is that the best practices the IHS practitioners learn from the participating Partners HealthCare providers can be made sustainable as the IHS practitioners share them on the ground in their hospitals. To date, more than 250 Brigham Health volunteers have participated in the opportunity and 20 IHS providers have come to Boston for more focused training and education.

For Chad, the week in Boston culminated his multi-year involvement with the program—he serves as its IHS CME coordinator, helping to match provider and patients’ needs with Partners resources. As a pharmacist practitioner focused on patients with cardiovascular risk and addiction, he spent his time with Partners shadowing addiction experts at the Brigham, sitting in on patient consultations at BWFH’s Diabetes Clinic, and meeting with a Brigham motivational interviewing expert to hone those techniques for patients with addiction disorders.

“I had coordinated many remote learning opportunities, so the final step was for me to come over and meet these providers in person and see how they take care of their patients through many different scenarios in their own surroundings,” he says.

The benefits of the program for Chad and others at both IHS and Brigham Health say the program’s champions lie in its mutual benefits. “At our hospital, we see in one week the kinds of cases they may see over the course of a full year,” says Tom Sequist, MD, Partners HealthCare Chief Quality and Safety Officer and Brigham physician. “And our providers, in turn, benefit from ready volunteer opportunities with real impact.

“Working with our IHS partners provides a deep sense of satisfaction—many of our providers have called the experience their ‘antidote to burnout.’ It reminds them why they became physicians in the first place.”

Read more or watch the video below to learn more about the Brigham Outreach Program with Indian Health Service.

Topics: Integrated Care, Patient Experience, Academic Medical Centers, Health Professions, Access to Care

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