When health care professionals collaborate on care, Minnesotans win

Just like on the basketball court or the football field, one player can’t carry the team. The same goes for your health care and well-being.

According to a study published in the Journal of Interprofessional Care, integrated healthcare yields 30% better health outcomes compared to non-integrated approaches.

“We address the whole person,” said Rahshana Price-Isuk, MD, clinical services director at NorthPoint Health & Wellness Center. “We know things like food, housing, and transportation are indicators of our health. So yes, we help with childcare. We help people find housing. We have a food pantry with fresh produce on site where folks can shop as if they were in a store, and we provide medical, mental health care, dental care, and human services, addressing all the social needs, including employment, transportation, and food.

NorthPoint uses a whole-person, integrated care model, an approach that recognizes chronic disease is not just a medical issue. It is deeply connected to stress, access to healthy food, transportation, housing stability, mental well-being, and family responsibilities. NorthPoint, with locations in Minneapolis and a main campus in Plymouth, was founded in 1968 with a mission to increase access to health care and social services for Twin Cities residents.

“We had a middle-aged gentleman who wanted to get into treatment because he had cancer, but couldn’t have surgery while he was using,” recalled Anne Buchwald, LMFT, integration specialist at NorthPoint Health & Wellness. “We called a treatment center and got him in. He then completed his treatment, got his procedure taken care of, and got housing after treatment. Now we do a monthly phone call to check in and see how things are going.”

Studies show care coordination is linked to better outcomes. For example, patients who received care coordination had a 19% lower probability of hospitalization, according to a PubMed study. According to a study published in the National Institutes of Health, only 7% of healthcare executives, clinical leaders, and clinicians indicated that their patients’ care is fully coordinated across various health settings.

What exactly is coordinated care? “It’s hard to explain, because it is so individualized to the patient,” Buchwald said. With each case, she performs a brief needs assessment to look at the patient’s immediate needs. “It could be social needs, it could be medical, dental, whatever. Then I’ll do a longer health and wellness assessment to really get into more detail.”

Price-Isuk said care is pieced together like a puzzle because many patients have multiple doctors for chronic conditions like diabetes, asthma, or heart disease. One primary care provider will drive the care that is managed by the care coordinator, who will follow up.

“The care coordinator is the one who connects the dots and closes the loop to make sure everything is happening seamlessly and the patient isn’t lost in the shuffle of our complex health care system,” Price-Isuk explained. She said NorthPoint also teams up with outside sources like family members, support systems, case workers, and medical professionals from other agencies. “People might have a lot of touches from us, different phone calls from different people, but most of our patients really appreciate the extra care.”

For more information about NorthPoint Health & Wellness, go to www.northpointhealth.org. You can also call 612-543-2500 to learn more.