Steve Snelgrove, president of Howard County General Hospital, said transforming hospital care is necessary as the county's population grows.
Steve Snelgrove, president of Howard County General Hospital, said transforming hospital care is necessary as the county's population grows. (Courtesy of Howard County Health)

Howard County's local health initiatives must adapt as the national health care model shifts to more digital-friendly care and more patients struggle with chronic illnesses, according to local and state health care leaders and professionals.

Nationwide, hospitals are grappling to meet the growing number of patients with chronic illnesses and embrace a health care model that brings care as quickly to patients as possible, said Rick Pollack, president of the American Hospital Association.


Health care must adapt by shifting from "episodic" care that requires longer patient wait times to care with "constant patient engagement," Pollack said, joining other health care professionals at a forum organized by the county's Local Health Improvement Coalition Thursday.

The coalition, a group of more than 40 organizations focused on addressing health disparities and improving health and wellness in the county, formed in 2011.

For the county's homeless population, the problem of chronic illness is "spinning out of control," said Andrea Ingram, director of Grassroots Crisis Intervention Center, a nonprofit organization that serves the homeless.

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Robert Gavin, as a Howard High School student, saw three options for his life. Either he was going to jail, he was going to kill himself, or the opioids were going to kill him.

Over the last 25 years, chronic illness is becoming a cause of homelessness, not simply a characteristic of it, Ingram said. Without financial and family support, people who are homeless are trapped in a cycle that is difficult to break, she said.

In an effort to reduce use of Howard County General Hospital's emergency services, the hospital launched a targeted program to coordinate care for patients who frequently visit the emergency room.

The program targets around 2,700 people, half of whom are 80 years or older. Almost 41 percent of those individuals used the hospital for conditions that could have been managed by seeking other care, said Elizabeth Edsall Kromm, the hospital's vice president of population health and advancement.

Kromm said these programs are critical to address patient crowding in the hospital's emergency room.

A handful of Howard County public schools have embraced digital-friendly care.

Six Title I public schools offer telehealth care where licensed health care professional can video conference with elementary school students to treat acute health conditions like rashes and pink eye, said Sharon Hobson, the school system's telemedicine coordinator.

The school system hopes to expand those services to cover conditions like asthma, ADHD and obesity, Hobson said. The goal of the program, part of a school-based wellness policy that aims to holistically improve student health, is to reduce missed class-time, Hobson said.

Hobson said several homeless students in the county's public schools struggle to receive health care. Others cannot attend high school because they have not had shots required for attendance, she said.

The county's health department is in the early phases of launching an overdose recovery program that connects people struggling with substance abuse problems with the county's recovery specialists.

Roe Rodgers-Bonaccorsy, director of the county's bureau of behavioral health, said the health department is already working with the police department to provide on-call services if police encounter a substance-abuse issue.

The department has similar partnerships with the county's Department of Fire and Rescue Services and the county's detention center and plans to expand peer support to community organizations.


Rodgers-Bonaccorsy said the program is expected to launch in January,

The county also plans to hire a coordinator that would help the county's agencies coordinate information and resources as deaths from opioid use increase statewide.