Clinical And Community Partners

• ECU Health

ECU Health provides services that reach more than 1.5 million people across 29 counties in Eastern N.C. Their system of care includes ECU Health Medical Center, a 974-bed, Level I trauma center and teaching hospital for the Brody School of Medicine, ECUCON, ECU Health Medical Group primary care and specialty services, ECU Health Home Health and Hospice, ECU Health Wellness Centers, ECU Health Foundation, and seven community hospitals. ECU Health Medical Center is a Magnet Hospital recognized by the American Nurses Credentialing Center (ANCC) for nursing excellence and high-quality patient care. Only 8% of U.S. hospitals have Magnet designation. ECU Health Medical Center provides comprehensive acute, intermediate, rehabilitation care and outpatient health services to more than 1.5 million people who reside in their 29-county service area located in ENC, which is largely rural and poor (estimated 18.5% live in poverty). Many residents in ECU Health’s service area are uninsured (estimated 22% underinsured; estimated 19% Medicaid eligible) and are burdened with economic hardships which are compounded by limited access to private or public transportation. The majority (93%) of the counties in ECU Health’s service area have been designated as medically underserved areas. Many of the programs sponsored by ECU Health in partnership with local leaders have been established to increase access to care and reduce health disparities in the communities they serve. This commitment to improve access to services is congruent with the mission of ECU Health Medical Center and ECU Health, which is “to improve the health and well-being of eastern North Carolina.”

The ECU Health Office of Patient and Family Experience provides specially trained patient-family advisors throughout the system who volunteer their time and share their insights to help improve the patient experience, ensure effective communications, and inform decision-making. Volunteers from this office will be a part of the Innovation Lab during the on-campus immersion experience to provide their perspectives as healthcare consumers.

The ECU Health Care Transformation departments serve as the health system-wide platform for population health and will play a major role in the CNS clinical experience for this project, particularly in transitional care, care management, patient and family engagement in ECU Health clinics, as well as community health improvement. The departments encompass cross-continuum care settings and delivery including inpatient, ambulatory, transitional, and community care. Programs and services within the Care Transformation departments include:

• Transitional Care
  This program provides cross continuum follow up for patients that are transitioning from acute care to community-based care
• Telehealth
  This program provides remote home monitoring for patients in the community. Biometric data, including blood pressure, pulse, weight, blood glucose, and oxygen saturation, is collected by the patient using equipment in the home and is transmitted to Registered Nurses for clinical monitoring. Registered Nurses provide case management of the patient and disease management education in close collaboration with the patient’s provider team. In addition to telepsychiatry experiences, CNS students will also have an opportunity to participate in this telehealth program
• Care Management
  This program provides comprehensive care management to moderate and high-risk Accountable Care Organization (ACO) patients. Services include disease management education and oversight, assistance with identifying and eliminating barriers to effective care, and optimizing the value of care through promoting high quality and cost-effective care
• Patient-Centered Medical Home
  This department works collaboratively with ECU Health Medical Group primary care practices to implement the required criteria to achieve and maintain recognition as a patient-centered medical home as designated by the National Committee for Quality Assurance (NCQA)
• Inpatient Case Management
  This department provides discharge planning and case management to patients in the acute care setting. The team interacts closely with Transitional Care Coordinators to identify patients that are at risk for a negative outcome, such as readmission, following acute care discharge
• Community Health Improvement
  This area of Care Transformation engages communities in health promotion, disease prevention and management, and education. Activities include leading and active participation in state-required Community Health Needs Assessments (CHNA), community risk mapping, and partnerships with faith communities, schools, and health departments
• Patient and Family Engagement
  This department focuses on system transformation of the resources, tools, and methods related to patient education and engagement. The aim is to improve the education, information, tools, resources, and methods provided that can help patients and families increase their knowledge, skills, and confidence to manage their care

ECU Health will be the primary ECU Health partner in the primary care clinical education of project APRN students. The hospital system is a reputable and established multi-specialty physician group that provides care for the health and wellness needs of residents of ENC. ECU Health includes more than 500 primary and specialty care providers, including APRNs, in more than 90 locations throughout ENC. The 8 ECU Health primary care training sites listed below were selected for this project based on their rural and underserved location and capacity to provide diverse and quality primary care learning experiences that meet clinical competencies and course and program objectives for each APRN program. All counties where these clinical sites are located have been designated as Tier 1 (highest need) by the NC Department of Commerce except for Onslow County which is Tier 2. All the clinical site counties have been designated as HPSAs related to primary care based on their geographic location and/or low-income population. We will place students in 6 VH clinics in Year 1 (Jacksonville, Kinston Medical Specialists, Tarboro, Edenton, Washington, and Belhaven) and add the remaining 2 clinics (Ahoskie and Wilson Healthplex) in Year 2. View the ECU Health Primary and Specialty Care locations.

Jacksonville (Onslow County): ECU Health Family Medicine in Jacksonville provides healthcare services for adults and children, including women’s services. In FY ‘18 they had a total of 5,778 patient encounters. The most common conditions treated/services were: type 2 diabetes, gynecological examinations, urinary tract infections, chronic fatigue, and hypertension. A health coach will be joining the practice in January 2019.

Kinston Medical Specialists (Lenoir, Onslow and Greene County): Kinston Medical Specialists joined Vidant Medical Group in May 2018. This added five additional primary care offices in Kinston, La Grange, Pink Hill, Richlands, and Snow Hill. From May through September 2018 they had a total of 25,431 patient encounters. The most common conditions treated at all clinics were: hypertension, type 2 diabetes, hyperlipidemia, hypercholesterolemia, kidney disease, hypothyroidism, vitamin B12 deficiency, and urinary tract infections.

Tarboro (Edgecombe County): ECU Health Multispecialty Clinic provides family and internal medicine in Edgecombe County. In FY ‘18 they had a total of 30,418 patient encounters between the two services. The main conditions treated between family and internal medicine were: hypertension, type 2 diabetes, deficiency of b group vitamins, hyperlipidemia, type 2 diabetes with hyperglycemia, osteoarthritis. A health coach is present and works with family and internal medicine assisting in health maintenance for at-risk patients and annual wellness visits. In addition, ECU Health Women’s Care in Tarboro had a total of 9,053 patient encounters in the same timeframe. The conditions treated/services were: gynecological exams, pregnancy supervision, injectable contraceptive, postpartum follow ups, amenorrhea, and antenatal screening for malformations.

Edenton (Chowan County): ECU Health currently has two internal medicine, two family medicine, and two women’s health clinics in Edenton. The internal medicine clinics had a total of 7,368 patient encounters in FY ‘18. The most common conditions treated were: hypertension, type 2 diabetes, diabetic chronic kidney disease, diabetic polyneuropathy, prediabetes, and osteoporosis. The family medicine clinics had a FY ‘18 patient encounter total of 21,173. The most common conditions treated at those clinics were: type 2 diabetes, hyperlipidemia, type 2 diabetes with diabetic polyneuropathy, prediabetes, dysuria, and anemia. A health coach is present and works with family and internal medicine providers assisting in health maintenance for at-risk patients and annual wellness visits. The two women’s care clinics in Edenton had a total of 7,188 patient encounters. The most common services provided, and conditions treated were: gynecological exams, pregnancy supervision, postpartum follow ups, inflammatory disorders of the vagina, and intrauterine contraceptive device.

Washington (Beaufort County): ECU Health provides both family medicine and internal medicine in Washington. Combined the two clinics had a total of 24,607 patient encounters in FY ‘18. The most common conditions treated were: hypertension, type 2 diabetes, type 2 diabetes with other diabetic kidney complication, atrial fibrillation, and atherosclerotic heart disease. A health coach is present and works with family and internal medicine assisting in health maintenance for at risk patients and annual wellness visits. In addition, ECU Health Women’s Care in Washington had a total of 7,900 patient encounters in the same timeframe. The conditions treated/services were: gynecological exams, pregnancy supervision, injectable contraceptive, postpartum follow ups, amenorrhea, and antenatal screening for malformations.

Belhaven (Beaufort County): ECU Health’s Multispecialty Clinic in Belhaven provides family medicine services to the area. In FY ‘18 they had a total of 10,209 patient encounters. The most common conditions treated were: hypertension, type 2 diabetes, hyperlipidemia, and testicular hypofunction. A health coach is present and works with family medicine assisting in health maintenance for at-risk patients and annual wellness visits.

Ahoskie (Hertford County): ECU Health provides Women’s Care to the Ahoskie region. There is not currently an ECU Health primary care practice in that area. The women’s care practice had a total of 5,392 patient encounters in FY ‘18. The most common conditions treated/services were: gynecological exam, pregnancy supervision, injectable contraceptive, postpartum follow ups, and amenorrhea.

Wilson Healthplex (Wilson County): ECU Health Wilson Healthplex is a new state-of-the-art medical practice that opened in November 2018. The practice offers primary care, an on-site pharmacy, lab and diagnostic services, and specialty care in the areas of cardiology, neurology, neurosurgery, nephrology, and pulmonology. Future services will include endocrinology, surgical oncology, and dermatology. A health coach is present and works with primary care providers assisting in health maintenance for at-risk patients and annual wellness visits. It is anticipated that annual primary care encounters will be around 25,000 at this site.

North Carolina Agromedicine Institute

The North Carolina Agromedicine Institute (NCAI) is a University of North Carolina inter-institutional Institute which includes East Carolina University, North Carolina State University, and North Carolina Agricultural and Technical State University. The goal of NCAI is to reduce injury and illness through research that leads to practical solutions and effective educational approaches that can benefit consumers.

East Carolina University Center For Telepsychiatry And E-behavioral Health

The East Carolina University Center for Telepsychiatry and E-Behavioral Health (CTeBH) is the home of the North Carolina Statewide Telepsychiatry Program (NC-STeP). Telepsychiatry services at ECU Brody School of Medicine were first provided by psychiatrists in the Department of Psychiatry in the mid-1990s to residents of ENC. The NC-STeP program provides psychiatric assessments and consultations using telemedicine technologies to patients in hospital Emergency Departments and community-based clinics across the state of NC. NC-STeP is in its 6th year of successful operations and continues to extend its services. As of March 31, 2019, the NC-STeP has conducted a total of 36,959 telepsychiatry assessments. The program estimated a cumulative cost saving of $26,686,800 from overturned involuntary commitments alone, which benefits state psychiatric facilities, law enforcement agencies, Medicare, Medicaid, and other stakeholders.

Eastern Area Health Education Center

Eastern Area Health Education Center (AHEC) is part of the NC AHEC Program whose mission is to provide support and educational activities and services that focus on primary care in rural communities. With locations in Greenville and Elizabeth City, Eastern AHEC is one of nine centers in the NC AHEC Program and partners with ECU and other educational and health organizations to serve 23 counties in the eastern part of North Carolina.