EMT's and paramedics with Brighton Ambulance could soon be making house calls for basis medical care. It's a program called Community Paramedicine.

It's been happening in some rural areas for years, simply because of the difficulty of getting to healthcare facilities.

The director of operations for Brighton Ambulance says Community Paramedicine could work in our area, saving you time and money and easing the congestion and wait in local emergency departments.

The Center for Disease Control says $136 million people nationwide wait in emergency departments for care every year and not only are those visits increasing, Press Ganey, an advocacy agency for healthcare organizations says the average wait is 6 hours.

News10NBC heard a plan from Brighton Volunteer Ambulance aimed at solving this program and we wanted to know if it could work here.

Jonathan Smith, Brighton Volunteer Ambulance, said, “We see patients who call us on a regular basis for simple things for instance falls.”

Jonathan Smith says that's about 15 percent of the calls that come in to Brighton ambulance everyday are calls from people who need care, but not necessarily emergency care. Many of these people end up in a local emergency department. Smith, who is the director of operations for Brighton Volunteer Ambulance, thinks there's a better way.

Smith said, “Realistically, we're look to extend the reach of primary care physicians and also reduce the need for emergency visits, by providing that care in the home or at least assisting in the provision of the primary care.”

It's a relatively novel program called Community Paramedicine. Paramedics and EMT's would make essentially house calls providing basic medical care to people who are chronically ill, freeing up doctor offices and emergency departments.

Smith said, “EMS is the interface between public safety and the healthcare industry. So we are out there, in the homes in their natural environment which the physician doesn't do in his office. That puts us at a great advantage. We can see them in their natural home, the way they normally need. We see more likely their compliance with their medications. We see what they help, they need and what they can benefit from.”

News10NBC's Lynette Adams said, “A lot of people worry about who would make the decision. Do we take this person to the emergency department or do we care for them at home?”

Smith said, “To decide which patients would be a part of our service would be a collaborative effort between us as the group offering the service and your primary care physician that you already see. so your physician would be an active component of that program.”

So what do physicians think of this idea?
Dr. Janet Williams is a board certified emergency physician who runs Rochester Immediate Care in Greece.

Dr. Janet Williams said, “The partnership with the primary care physician is very important. It could be very successful.”

Smith says there is a program that could be implemented, but he says the financing part still has not been worked out. For example how much it would cost? Who would pay? How would the ambulance company get reimbursed? He says they hope to get insurance companies and the state health department on board.

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As soon as you walk into Rochester Immediate Care, a flu station greets you at the door.

The station is equipped with masks and sanitizer.

“We're seeing a lot of people coming in with shortness of breath and wheezing,” Medical Director for Rochester Immediate care Janet Williams said.

Because emergency rooms are filling up, hospitals are asking those with non -life threatening flu symptoms to go to urgent care centers.

It seems patients are listening.

“We're setting records here in our urgent care center in terms of the number of patients that we're seeing per day,” Williams said.

Williams said since Christmas, the number of sick patients has jumped.

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Eight people have died from the flu and the number of flu cases in Monroe County is growing at an alarming rate.

The Monroe County Health Department confirms more than 1,300 flu cases this season. 226 people have been hospitalized.

Seven of those deaths happened within the past two weeks. The health department confirmed 183 cases of the flu during the entire season last year. We are already at 1,348 and it's only the beginning of January.

The national flu epidemic is getting worse by the day. Some area hospitals are flooded with patients and have no space left in their emergency rooms. That's why they're urging sick people to go urgent care facilities, like Rochester Immediate Care.

"We have been breaking all sorts of records here with the volume of patients that we are seeing and the majority present themselves with flu-like symptoms," said Dr. Janet Williams, Rochester Immediate Care Medical Director

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The Monroe County Health Department tells News10NBC there have been seven deaths in just the last two weeks due to the flu and eight deaths overall.

Officials also say they have seen at least 400 more cases in the last week alone. There have been more than 1,300 confirmed cases of the flu this season in Monroe County, 350 confirmed cases in Ontario County and 234 in Wayne County. Last year, Wayne County officials say there was less than 100 cases.

The majority of the deaths were elderly people, but the health department is still urging residents to get a flu shot if they haven't already. Overall, there have been 1,300 flu cases and more than 200 people have been hospitalized as a result.

Officials say they don't want people to panic, but they do want people to take this very seriously. They tell News10NBC that local hospitals are practically bursting at the seams with patients sick with the flu. They are calling this one of the worst flu seasons they have see in a very long time. Health officials say they do want people to get vaccinated.

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Earlier this year I wrote a column about the sorry state of customer service in medical care. But recently I had the pleasure (how often can you use that word in the context of health care?) of being treated, literally, to a striking exception.

Last week I was getting ready for a business trip to Asia and got a sore throat the day before leaving. Preferring not to go without antibiotics if I needed them -- or worse, wind up needing medical care in China or Vietnam -- I stopped, without an appointment, into a nearby Immediate Care facility (division of TeamHealth holdings, NYSE: TMH). The company is one of a growing number of chains providing an alternative to emergency room visits and a range of other common outpatient services, from sniffles to stitches, fever to fractures, and more. But unlike any typical ER, it provides these services with as much of a focus on the patient/customer experience as on quality medical care.

Immediate Care promises minimal wait times, immaculate facilities and pleasant, compassionate people, and during my visit they delivered flawlessly. The building looked more like a day spa than a doctor's office. I was checked in quickly and efficiently and seen within 20 minutes, and every person I dealt with -- from the front desk to the clinicians -- was smiling and unfailingly courteous, attentive and caring.

I was so impressed by the experience that I contacted the corporate office to learn more. In keeping with the company's name and ethic, I got an immediate response. Salvatore Durante, the company's Urgent Care Operations manager, gave me a five-point summary of what makes the business tick. Interestingly -- but not surprisingly -- it's all about humans as beings, not bodies:

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One could say that Jennifer Rhoney keeps herself busy. She is a wife and mother of two. She is a Registered Nurse with Western New York Immediate Care, practicing at the Transit Road location in Williamsville. Jennifer also serves her country as a Major and Assistant Chief Nurse at the 914 Aeromedical Staging Squadron located at the Niagara Falls Air Reserve Station.

Rhoney graduated from the State University of New York at Buffalo Nursing School in 2000. Following graduation, she started working at Erie County Medical Center while earning her Master’s Degree in Counseling Education from Canisius College. Upon earning her master’s, she took a position as a school nurse at John Kennedy Elementary in Batavia where she stayed for eight years. In 2010, she returned to Western New York and joined the WNY Immediate Care team.

“I really enjoy working at WNY Immediate Care because of the diversity from day to day; each shift always brings something different,” Rhoney says. “The staff and management have been very supportive, being flexible and accommodating with regards to my reserve schedule.”

Simultaneous to her professional career, she established a military career path that began when she joined the Air Force Reserves in 2001. She has done two overseas tours including a seven-month deployment in Baghdad, Iraq, in 2003 and a three-month deployment in 2007 to Balad, Iraq, a major connection point where patients were gathered and transported. Rhoney is from a patriotic family with relatives who have served their country and this influenced her decision to join.

“My brother is on active duty in the Navy and I was inspired to join when I attended his graduation. In addition, my uncle is a Ret. Colonel in the Army Reserve,” Rhoney says. “I love my country and enjoy performing the missions. The camaraderie with my unit is very fulfilling.”

Rhoney describes some parallels between the positions.

“In both arenas, it is important to quickly assess and triage the patients under my care,” Rhoney says. “It is a profession that offers a lot of satisfaction, helping people stateside or abroad to get back on their feet.”

Jennifer is married to Phil Rhoney; together with sons Liam (2) and Quinn (1), they reside in the City of Buffalo.

Rochester, N.Y. (October 24, 2012) -- Unity Health System and Rochester Immediate Care will partner to provide superior quality urgent care services to the Rochester community. Together they will develop new and more innovative ways to increase access and control the cost of health care.

Unity and Rochester Immediate Care will extend their access and capabilities to provide a more clinically integrated solution for patients who require episodic care.

“In this new era of health care delivery, collaborations such as this one play a critical role in reducing the rate of rise of health care costs. Through this historic agreement we will deliver greater value for patients with a laser focus on quality, safety and patient satisfaction,” said Gregory Daniel, M.D., founder and CEO of Rochester Immediate Care and President of Exigence of TeamHealth.

Unity Health System offers comprehensive health care with over 70 locations in Rochester and Monroe County, including Unity Hospital, located on the Unity Park Ridge Health Care Campus in the town of Greece and the Unity St. Mary’s Campus in Rochester. One goal of the urgent care partnership is to reduce overcrowding and inappropriate use of Emergency Department resources.  This goal is in alignment with our commitment to the Finger Lakes Health System Agency’s goals to reduce low-acuity Emergency Department visits outlined in the 2020 Performance Commission Report

“We are pleased to offer a high quality urgent care option to our patients,” said Wendy Wilts, Senior Vice President of Clinical Service Lines for Unity Health System. “This partnership is a winning combination and assists Unity in continuing our journey toward more accountable care. Our choice to invest in an existing urgent care operation–versus building our own–reflects Unity’s commitment to being fiscally responsible while utilizing quality community resources.”

About Unity Health System

At Unity Health System you’ll find the friendliest and most compassionate people dedicated to providing the best possible health care experience. Key programs include our Joint Replacement Center, Family Birth Place, Spine Center, Diabetes Center, Stroke Center, Brain Injury & Physical Rehabilitation, and Chemical Dependency. Our Center for Aging has the area’s most comprehensive range of services for older adults which includes specialized care for dementia, a chronic ventilator unit, three skilled nursing facilities, assisted living, a short-stay transitional care center, home health services, adult day programs, and The Villages at Unity – an independent senior living community.  ACM Medical Laboratory is a world leader of patient and clinical trials testing, with locations in western New York, York, England, and India, and lab partnerships across the globe.   Our shared commitment to delivering health care the way it should be is reflected in our overall employee and patient satisfaction ratings and quality outcomes.  For more information, visit www.unityhealth.org.

About Rochester Immediate Care

Rochester Immediate Care has two locations, 2745 West Ridge Road in Greece and 1065 Ridge Road in Webster. Plans are underway to open a third center in the Rochester area in 2013. The centers are open 365 days a year. Rochester Immediate Care employs approximately 60 full- and part-time health care professionals.

At its state-of-the-art centers, Rochester Immediate Care provides access to cost-effective healthcare when a patient’s illness or injury is beyond the scope or availability of the typical primary care practice or retail clinic. Rochester Immediate Care centers offer digital x-ray, CLIA certified laboratory capabilities, an advanced urgent care medication formulary and integrated information technology systems enabling connectivity at all points across the continuum of care. Over 35,000 patients choose Rochester Immediate Care each year, with most patients treated in about an hour. 

In February 2012, Rochester Immediate Care joined the highly select ranks of urgent care centers nationwide that have received accreditation from The Joint Commission and are proud to display its Gold Seal of Approval™. This accreditation conveys Rochester Immediate Care’s commitment to quality and patient safety, setting it apart from all other competitors and making it the provider of choice for episodic care.

Rochester Immediate Care was founded by The Exigence Group of Amherst, NY, which was acquired by TeamHealth in May 2012. TeamHealth is one of the largest providers of outsourced physician staffing solutions in the United States. In addition to Rochester Immediate Care, Exigence of TeamHealth manages five Immediate Care centers in the Buffalo area and one in Austin, Texas.

For more information, visit www.rochesterimmediatecare.com.

Rochester Immediate Care announces the appointment of Site Administrator, Joseph Coluccelli for its Greece location. Coluccelli is responsible for day-to-day operations, leadership of clinical and clerical staff in addition to patient satisfaction at the urgent care center.

 

Prior to joining Rochester Immediate Care, Coluccelli was a Case Manager for Rochester Home Care where he was responsible for the overall plan and outcome of nursing staff. Previously he was Emergency Department Clinical Nurse Leader at Rochester General Hospital. Coluccelli holds a Bachelor of Science degree in Nursing as well as a Bachelor of Arts degree in Political Science from St. John Fisher College.

Beginning on July 1, a new pediatric service ensures that a board-certified pediatrician will see children during times when most pediatricians’ offices are closed

New service represents a new model in Monroe County for extending access and availability of pediatric care

The pain and agony of a child’s ear ache, violent cough or injury is often complicated by another factor: bad timing. A child’s illness or injury can occur anytime, including times when the pediatrician may not be available or when their offices are closed, such as on Saturday and Sunday afternoons and evenings.

To ensure timely and appropriate weekend care for infants and children, Rochester Immediate Care - Greece will launch a pediatric urgent care program on Fridays from 5:00 p.m. to 9:00 p.m., and on Saturdays and Sundays from noon to 8:00 p.m. During these times, a board-certified pediatrician will be on duty for the express purpose of treating children – the very times when most pediatric offices are closed.

At all other times, pediatric patients are welcome at Rochester Immediate Care and are treated by board-certified emergency medicine, internal medicine or primary care physicians and other highly qualified providers.

The service begins on Friday, July 1, 2011 at Rochester Immediate Care’s Greece facility (2745 West Ridge Road, next to Ridgemont Plaza; 585.225.5252).

The pediatricians staffing the weekend hours at Rochester Immediate Care are Tim Hessert, M.D., Gretchen Smith Burke, M.D., Paul LeHoullier, M.D., Monica Henoch, M.D. and Dana Work, D.O. These pediatricians will augment Rochester Immediate Care’s own medical staff of physicians, nurse practitioners, physician assistants and technicians.

Drs. Hessert and Burke are part of Parkway Pediatrics & Adolescent Medicine (353 Island Cottage Road in Greece; 585.225.2610), whose own office will be closed Saturday and Sunday afternoons and evenings. Drs. LeHoullier is on the pediatrics staff at Rochester General Hospital. Dr. Work is a former chief resident and currently a pediatric fellow at the University of Rochester. Dr. Henoch sees patients at Lifetime Health Medical Group.

New Model of Care

This pediatric service introduces a new model of pediatric care to the Rochester area “as it extends the scope and reach of private pediatric offices in an efficient and cost-effective manner,” says Rochester Immediate Care medical director Janet Williams, M.D. “Now, when their offices are closed, all area pediatricians can refer patients to Rochester Immediate Care, where they’ll be seen by board-certified pediatricians, enabling parents to avoid the high-cost long-wait scenario of an emergency department.

“Even though our own staff physicians are trained to care for both adults and children, the availability of a board certified pediatrician goes a long way to reassuring area pediatricians and parents that their infants and children will receive expert and appropriate care,” says Dr. Williams.

Typically, infants and children need immediate attention for ear ache, respiratory problems including pneumonia, asthma, digestive issues, cuts and lacerations, animal bites, sports injuries and “just about anything else that needs immediate attention but doesn’t require hospitalization,” says Dr. Williams.

No appointments are necessary at Rochester Immediate Care and most patients are treated in about an hour. Insurance plans accepted at Rochester Immediate Care include MVP (formerly Preferred Care), Excellus BlueCross BlueShield, CIGNA, POMCO and Medicare plans. When compared to a visit to an emergency department, a visit to Rochester Immediate Care typically requires a significantly lower out-of-pocket co-pay.

Collegial, Non-Competitive Approach

The pediatricians who rotate through Rochester Immediate Care have a collegial, non-competitive approach to caring for other practices’ patients. “By our participation in this new service, we assure appropriate urgent care for all the infants and children we see,” says Parkway’s Dr. Tim Hessert. “Plus, we’re helping our pediatric colleagues from other practices enjoy a Saturday or Sunday afternoon off knowing their patients will be seen in a state-of-the-art facility by qualified colleagues.

“Further, we’ll invite pediatricians from other practices to participate with us by taking a shift on a Saturday or Sunday,” he added.

A tenent of Rochester Immediate Care’s care model is to send a follow-up report to the patient’s primary care physician within 24 hours, so the PCP is fully informed and can direct continuing care as needed.

New facility in Webster offers a faster alternative to the emergency room for treatment of non-life threatening illness and injury, improves access to care in the face of an expected shortage of primary care physicians in the Rochester area

On June 20, 2011, adults, teenagers and children living, working, and playing in Webster, New York and its surrounding areas will have a new and fast option for the treatment of non-life threatening illness and injury: Rochester Immediate Care - Webster.

Located at 1065 Ridge Road (across from Dick’s/Target Plaza), Rochester Immediate Care - Webster is a new, fully appointed and staffed medical facility providing medical care for non-life threatening injuries and illness, offering both access and speed when a personal physician is not available and a trip to the emergency department will likely disrupt an entire day or evening and cost significantly more.

The opening of Rochester Immediate Care – Webster comes at a time when economic forces and practice trends are changing how care is delivered. A 2010 report by Excellus on the use of emergency rooms in upstate New York found at least 43% of emergency room visits in the Finger Lakes Region were not necessary, wasting millions of healthcare dollars, and could have been conducted in other settings. However, Medical Society and medical school surveys of the number of primary care physicians in practice, such as internists (who care for adults), show their numbers are declining. As these two forces converge, problems of access to care emerge. Who will provide care to people with non-life threatening illness and injury if ER visits are discouraged and fewer physicians are in private practice? One answer, both locally and nationwide, can be found with urgent or immediate care facilities.

The newly constructed Webster facility features a warm and welcoming lobby and waiting area, 12 new exam and two treatment rooms, and is equipped with X-ray, laboratory and other diagnostic capabilities. Led by medical director Pam Sullivan, M.D., nurses, physician assistants and other board certified physicians care for all patients. RIC accepts most insurance coverage, including Excellus BlueCross BlueShield, MVP, Medicare, POMCO, CIGNA and other health care plans.

Rochester Immediate Care – Webster is open from 9:00 am to 9:00 pm Monday through Friday and 9:00 am to 8:00 pm on weekends, 365 days a year. No appointments are required. In most cases, patients are treated and released in about an hour. The cost to both the patient and insurance provider is significantly lower than the cost of a visit to an emergency room. The phone number is 585-872-2273; the web site is www.rochesterimmediatecare.com

Typical of the illnesses and injuries treated at Rochester Immediate Care are cuts and lacerations, animal and insect bites, sprains and fractures, eye injuries, minor burns, ear infections, cold and flu symptoms, pneumonia and bronchitis, urinary tract and other infections, abdominal and back pain. In addition, Rochester Immediate Care conducts school, employment and sports-related physical exams.

Managed by The Exigence Group, LLC of Amherst, NY, Rochester Immediate Care - Webster is the company’s second facility in the Rochester area and eighth facility overall; it manages four Immediate Care facilities in the Buffalo area and one in Austin, Texas. Rochester Immediate Care – Greece (2745 West Ridge Road, next to Wegmans/Ridgemont Plaza) opened in May of 2010.

“The communities we serve have embraced the Immediate Care concept and we fully expect the Webster area to do the same,” said Gregory Daniel, M.D., M.B.A., Chief Executive Officer of The Exigence Group. “By providing convenient, quality healthcare by board certified physicians and experienced staff, and a friendly and welcoming experience, Rochester Immediate Care in Webster will meet consumer demand for this kind of medical service.”

“We’re pleased have Dr. Pam Sullivan as our medical director in Webster,” he adds. “She’s an experienced emergency medicine physician who has worked in a variety of emergency department settings in Rochester and has great rapport with both patients and the area’s physicians.

“Dr. Sullivan assures that each and every patient receives high quality medical care and has a comfortable and satisfying experience at our new Webster facility, the same way Dr. Janet Williams does for patients seeking care at our Greece facility.”

Rochester Immediate Care is in the process of earning accreditation by the Joint Commission, the only national organization that sets standards for quality and safety in full service urgent care centers.

 

Occupational Medicine

Sharing space with Rochester Immediate Care is another Exigence–managed company, Pulse Occupational Medicine, which helps businesses reduce injuries, lower costs, and promote a safe workplace. Pulse offers customized programs and individual case management support to hundreds of companies, from small start-ups to large corporations with thousands of employees.

Led by Karl Auerbach, M.D., a locally and nationally prominent occupational health specialist, Pulse’s occupational health team includes specially trained nurses and technicians who stay current with Federal and State workplace safety and workers compensation regulations. Pulse offers a range of customized services including injury care, case management, pre-placement evaluation, drug screening, DOT physicals, Medical Review Officer (MRO) services, executive physicals, educational programs and health and wellness programs.

Pam Sullivan, M.D., a well known emergency medicine physician who has practiced at Rochester General Hospital and Highland Hospital since 1993, has been appointed medical director of Rochester Immediate Care – Webster, the new urgent care center opening in Webster in June.

Board certified in internal medicine and with certifications in pediatric advanced life support, advanced trauma life support and advanced cardiac life support, Dr. Sullivan will direct a staff of nurses, nurse practitioners, physician assistants and other physicians who will treat patients at Rochester Immediate Care.

“We’re pleased have Dr. Sullivan as our medical director in Webster,” says Dr. Gregory Daniel, CEO of The Exigence Group, LLC, which manages Rochester Immediate Care. “She’s an experienced emergency medicine physician who has worked in a variety of emergency department settings in Rochester and has great rapport with both patients and the area’s physicians.

“Dr. Sullivan will assure that each and every patient receives high quality medical care and has a comfortable and satisfying experience at our new Webster facility.”

A New York City native, Dr. Sullivan earned a bachelor’s degree in physical therapy at Ithaca College and her medical degree at the Medical College of Philadelphia; she served an internship and residency in primary care internal medicine at the University of Rochester School of Medicine and Dentistry. While employed by the medical school, she held an academic appointment as senior instructor of clinical emergency medicine.

Dr. Sullivan is a Fellow of the American College of Physicians and serves as a council member and as chair of the membership committee of the New York ACP.

The Exigence Group, LLC of Amherst, NY (www.theexigencegroup.com) manages two Rochester Immediate Care centers: Rochester Immediate Care – Greece, located at 2745 West Ridge Road, which opened in May of 2010; Rochester Immediate Care – Webster, located at 1065 Ridge Road, which will open on June 20, 2011. The Exigence Group expects to care for more than 100,000 urgent care patients in 2011 at its seven facilities in New York and Texas.

Karl Auerbach, M.D., a board certified physician in preventive and occupational medicine who serves as medical director of Pulse Occupational Medicine, PLLC, in Rochester, has been elected to the position of president-elect of the American College of Occupational and Environmental Medicine (ACOEM).

Founded in 1916, ACOEM is the nation's largest medical society dedicated to promoting the health of workers through preventive medicine, clinical care, research, and education. Physicians encompassing specialists in a variety of medical practices are united via the College to develop positions and policies on vital issues relevant to the practice of preventive medicine both within and outside of the workplace.

Dr. Auerbach will begin his term as president-elect on March 28, 2011 at the ACOEM’s annual meeting in Washington, DC. He’ll assume the presidency in 2012.

An occupational health specialist long known in the Rochester area, Dr. Auerbach has provided occupational health services and consulting to many of Rochester’s well-known companies since the early 1980s. Prior to joining Pulse, Dr. Auerbach practiced at Strong Memorial and Highland hospitals on their Emergency Medicine and Environmental and Occupational Medicine services. He continues to practice as an emergency department physician at both hospitals.

Dr. Auerbach retains his academic appointment as Clinical Associate Professor of Environmental and Occupational Medicine at the University of Rochester School of Medicine and Dentistry.

Pulse Occupational Medicine is located in a free-standing urgent-care facility – Rochester Immediate Care, 2745 West Ridge Road in Greece, NY – and is part of a network of occupational medicine services managed by The Exigence Group (www.theexigencegroup.com), which runs Pulse services in Buffalo, NY, Austin, TX, and Las Vegas, NV.