Adventist Health Castle | Windward Health | Fall 2021

Easier access to quality healthcare Virtual wellness visit exceeds expectations When Ellen Abrams received a call earlier this year from Ryan Tenn, APRN, to schedule an annual wellness visit, she expected it would be similar to the routine physicals she had in the past. But this visit would be conducted virtually over a Zoom video session, without Ellen even having to leave home. Tenn is one of Adventist Health Castle’s growing team of advanced practice providers partnering with Castle’s primary care physicians to enhance patient access to quality care through telehealth and in-home visits. Most of his patients are seniors. He says that although telehealth has been around for some time, virtual visits have been a game-changer for seeing patients during the pandemic, rocketing telehealth years ahead. Whether by Zoom or in person, Tenn strives to make his visits as interactive as possible. “I always try to find a connection with my patients, to get conversations going and build trust,” he says. For Ellen, the virtual wellness visit exceeded every expectation. “Ryan was completely collaborative and kind; I could hear the caring in his voice,” recalls the Kailua resident. A self-described “healthy beach chick and naturalist,” Ellen was struck by the scope of topics covered during their visit, including not only her physical health but also her mental and emotional well-being. “Ryan asked so many great questions and gave me new perspectives, bringing out the best in me,” she says. “We discussed a deep, generational addiction issue in my family and made back-up plans should I need support in the future, and even made sure I completed an advance healthcare directive. It’s amazing what we covered, and I loved that Ryan was wellness-focused. Our visit really turned my head around from avoiding such appointments in the future!” Ellen’s positive experience reinforced everything she already loves about Castle, including the care she received during a previous hospital stay. She moved around Hawai‘i a lot while raising her children, until settling in Kailua 25 years ago. Now she lives just a few miles from Castle and says it’s the main reason she wouldn’t live anywhere else in this season of her life. “It’s the best care there is. Why would I leave Kailua?” ADVANCED PRACTICE PROVIDER CARE AS PHYSICIANS NATIONWIDE face increased demand due to the tide of aging baby boomers, a rise in chronic health conditions and, more recently, the COVID-19 pandemic, the vital role of physician assistants, nurse practitioners and other advanced practice providers is more important than ever to ensure patients receive the care they need. These highly skilled professionals are trained to take on many of the patient care responsibilities usually performed by physicians, from routine wellness evaluations to diagnosis and treatment plans for a broad range of acute and chronic health issues. Their patients benefit from increased access to care, and physicians gain the capacity to see more patients. Advanced practice providers have long been part of Adventist Health Castle’s healthcare network, both in the hospital and in clinic settings. A comprehensive, new patient-centered program initiated earlier this year further elevates the role these providers play in making quality healthcare more accessible to our community. Castle’s Advanced Practice Provider Care “The challenges of COVID-19 compelled us to think outside the box and make changes in the way we deliver care, including wider use of telehealth technology and in- home visits by a team of advanced practice registered nurses (APRNs),” explains Kate Saavedra, operations executive at Adventist Health Castle. “I’m pleased to say those changes are here to stay and are part of a new, multifaceted Advanced Practice Provider Care program to assist primary care physicians and home care providers while making it easier, and often quicker, for patients to receive care.” APRNs bring versatile skill sets to the program, including the authority to order diagnostic tests, prescribe medications, develop treatment plans and serve as primary care providers for patients who don’t have one. Physicians can refer their patients to the program for an annual wellness visit with an APRN, either virtually or at their home, like an old-fashioned house call. APRNs arrive equipped to take lab samples, if needed, and they have access to the patient’s medical history and any health issues that need to be addressed. They also may be called upon to visit patients at home a few days after being discharged from the hospital to check vital signs and medications and to see that arrangements have been made for follow-up visits with the physician. Each visit is followed with detailed notes added to the patient’s medical record to keep all members of the care team informed. Partners in home care Saavedra is especially excited about the program’s outreach to home care patients, Find a healthcare provider for you at AdventistHealthCastle.org/Doctors . Ellen Abrams 4 | WINDWARD HEALTH