1. Connecting Hypertensive Patients at the Physican’s Free Clinic to a Primary Care Provider Ariel Kanevsky, Ranjit Ganguly, Brittany Shrefler, Maarten Galantowicz and Daniel Martin The Ohio State University College of Medicine Class of 2016 Needs Assessment Background and PurposeResults Future Directions Program Implementation ●Of the 28 patients who were screened, 57% (16/28) had hypertension which is almost double the 2011 nationwide prevalence of 30.9%. ●Of the patients who had hypertension, 50% (8/16) did not have a PCP. Interestingly, several of those who did identify as having a PCP had been recently linked to one from the linkage counselor at the PFC. ●Of the hypertensive patients without a PCP, 75% (6/8) were interested in being linked with a medical center home. ●The nationwide prevalence of hypertension (diagnosed by a healthcare professional) among adults in 2011 was 30.9% or about 68 million individuals. Every year hypertension contributes to one out of every seven deaths in the United States. ●In Ohio, the prevalence of hypertension is 32.7% in the adult population, placing it in the top half of all states. It is estimated that it costs approximately $1,600 annually to treat a patient with hypertension in central Ohio, totaling $1.5 billion dollars per year. ●The mission of the Physician’s Free Clinic (PFC) is to provide uninsured individuals access to healthcare. Although the PFC aims to provide coordinated care, it is not a primary care home, which is important for patients with chronic diseases such as hypertension ●The purpose of this study is to screen patients at the PFC with uncontrolled hypertension without a primary care home and link them with the two federally subsidized healthcare clinics located in Columbus, OH. To verify and quantify the needs of the hypertensive patients at the PFC, our team created and administered a questionnaire. The questionnaire was given to patients who had a systolic blood pressure (BP) greater than or equal to 140 mmHg and/or a diastolic BP greater than or equal to 90 mmHg. This questionnaire was administered on two separate PFC sessions in December 2012. Combining insight from our key informants and the data collected from the questionnaire revealed the following unmet and met needs in the PFC population. ●All patients attending the Physician’s Free Clinic on December 9, 2013 were screened for hypertension. This screening was limited to asking all patients if they had high blood pressure, which means our data may underestimates patients with hypertension asit does not include undiagnosed hypertension. ●If patients identified as having hypertension, they were asked if they had a primary care provider (PCP). ●Hypertensive patients who did not have a PCP were asked if they would be interested in being connected with a medical center home that sees patients without insurance and operates on a sliding scale fee system. ●Hypertensive patients interested in being connected with a primary care home were then connected with the Physician’s Free Clinic Linkage Counselor who helped the patient make their first appointment at one of the two federally subsidized healthcare clinics in Columbus. References Needs Met by the PFC Needs Unmet by the PFC ●Blood Pressure Readings – At each visit to the PFC patient blood pressure is taken and recorded. ●Healthcare Resources – The majority of patients at the PFC are at or below the federal poverty line and thus these patients have limited or no health insurance. ●Language – Language can be a barrier to providing healthcare in any setting. The PFC has translators on staff each week as well as access to several MARTI video interpreter units. ●Transportation – The PFC provides patients with a transportation network that allows them to use the municipal bus systems and taxi services to visit the clinic. ●Longitudinal, Individualized Care – This type of care is vital to the management of hypertension and 77.27% of the surveyed patients do not have access to individualized care primarily due to financial issues. ●Access to Care and Drugs – The majority of surveyed patients are heavily dependent upon the PFC for care and medication. ●Disease Management Advising – This is limited to short sessions at the PFC itself. This does not allot sufficient time for patients to be counseled on disease management strategies. Additionally, exercise and diet changes are more easily facilitated through a longitudinal relationship via a primary care home. ●Physician’s Care Connection, “Report to the Community 2011- 2012”. ●CDC. American Heart Month: February 2007—United States, 2007. MMWR 2007; 56(06): 113-118. ●Center for Disease Control. CDC Grand Rounds: The Million Hearts Initiative—United States, 2012. MMWR 2012; 61(50): 1017-1021. Our intervention helped the PFC to link patients with primary care homes. We would like to continue the implementation of our project at the PFC, as a stable patient-physician relationship is the most efficacious for managing chronic conditions such as hypertension. In addition, we would like to collect these additional data to help quantify the strengths of our project and areas for improvement: ●Number of patients who followed up with the PCP ●Quantitative outcomes of hypertension management with a PCP versus at PFC ●Patient satisfaction