Web chat transript: Meet Dr. Kyle Allen, new head of gerontology at Riverside

In today’s live online chat, we’re interviewing Dr. Kyle Allen, the recently appointed director of Geriatric Medicine Services at Riverside Health System in Newport News.

Readers: This is your opportunity to ask questions of Dr. Allen about senior medical care and services — what Riverside has to offer and any changes or additions that he has in mind.

Dr. Allen, Please let readers know when you’re online and they can start asking questions.

Readers: Do you have a question about senior care? Have you taken advantage of any of Riverside’s programs? are you familiar with the PACE program?

This is Dr Allen and I am on line.

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Welcome Dr. Allen. Could you tell readers something about your background before joining Riverside and the national role you play in geriatric care policy.

For the past seventeen years, I have been with Summa Health System in Akron, OH, where I served as the Medical Director of Summa’s Institute for Senior and Post Accute Care. I have been a researcher a policy advocate clinician and teacher regarding older adults and those with chronic and complex illness.

What attracted you to Riverside?

Summa Health System is a large not for profit integrated delivery system that also includes a health plan and five hospitals. Riverside has a unique culture vision and services that are specifically oriented to improving the health and well being of older adults.

There is already a great degree of work that has been going on at Riverside in this area and I hope to join that team and bring some of my experience and knowledge to advance care, quality, and safety for older adults and those with chronic and complex illness.

PACE stands for the Program of All Inclusive Care of the Elderly, and is a sucessful model of how best to deliver a team based approach of care to older adults

What exactly does PACE involve. Do you need insurance to participate?

PACE enrolls individuals that are age 50 or greater, are of low income and have complex and chronic illnesses. This is paid for via a unique combination of Medicare and Medicaid insurance systems. Thus persons must qualify.

Heath care reform has some promise for improving care for seniors by creating and testing some new models in payment and programs that are not currently covered by Medicare. I think there is much that needs to change and at least this was a first step to trying to do something different.

Could you be specific about ONE change that you would like to see.

What are those “new models in payment and programs”?

New trends are beginning to emerge in areas of supporting transitions of care for example from hospital to home as well as innovative ways to better coordinate and support care.

The one change that I have been working on as a clinician, researcher, and health policy advocate is to demonstrate that the medicare benefit needs to include payment for care coordination which does not today.

So would that be the responsibility of the primary care physician or another person?

New models include things like adding case managers to physician offices to work in teams to better coordinate care and teach patients about self care of their chronic conditions. Specific models include CARE TRANSITIONS, GUIDED CARE, THE GRACE PROGRAM.

Guest’s question mirrors one I was going to ask about Medicare reimbursements and how they’re affecting quality of care.

Yes the Primary Care Physician would be responsible for organizing and ensuring that care coordination and best practice for chronic illness care occurs. Many have been using the term the patient centered medical home concept which describes this fundamental change of how primary care and specialty care needs to be reorganized.

Yes I believe one of the greatest issues facing our ability to organize to these new models is a lack of trained health professionals and allied professionals regarding the unique care aspects of those of older adults with chronic and complex illness.

Currently Medicare policy rewards procedures and episodic illness care not comprehensive and coordinative care.

Readers: we are talking to Dr. Kyle Allen, DO, the new director of geriatric medicine services at Riverside Health System. You have 5 minutes left to ask your questions.

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We’re now talking to Dr. Kyle Allen, head of geriatric services at Riverside.

Great question. I believe only this will occur if the appropriate patient education, patient goals, and activation of patients in self care occur. So often today we miss the opportunity of the well visits to really focus on wellness and planning and remain too diseased focused.

What do you think is Riverside’s greatest strength when it comes to senior care/services?

What is your top priority to add/change at Riverside regarding senior care.

What can patients do to effect the changes — such as patient-centered medical care and payment for ancillary staff — that you advocate?

Could you answer the question about a shortage of qualified individuals/Medicare reimbursements.

Readers – we are just waiting for Dr. Allen to answer the last couple of questions.

It’s vision, committment, and it’s investment in developing post acute services for older adults and those with chronic and complex illness. My major focus will be bringing evidence based models of care for older adults and those with chronic and complex illness to the acute hospitals and linking all parts and continum together.

Dr. Allen, After you answer the last question, could you tell readers how to reach Riverside and learn more about the services it has for geriatric medicine.

Patients need to get involved in talking about what doesn’t work and what does work to their legislative officials and where possible get involved in community groups or support groups that can carry uniformed messages forward.

Are there any specific advocacy groups you can recommend that people get involved with?

We hope to address the shortages at Riverside by exploring advanced training programs and fellowships for nurses, physicians and other allied health professionals in Geriatric Medicine, Pallative Care Medicine and Hospice. This training and education has already started.

Great. Dr. Allen — thanks very much for your participation and letting readers know some of what’s going on at Riverside in terms of geriatric services. Please give contact information and then I’ll close the chat.

Readers: Don’t forget to join us next week at noon on Wednesday when we talk to audiologist Deborah Minnis about hearing loss and what to do about it.

Parkinsons Disease support groups, Alzheimers association. The area agencies on aging, national council on aging, and many others.

Contact information please contact Denise Staples @ 757-534-6101.

Thanks very much. Bye.