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Communication systems are in place at Howard County General [Commentary]

The way Howard County General Hospital operates has changed in recent years, and we recognize that some of those changes can be confusing. But at the heart of every move lies a goal of making your experience better – and making sure we deliver the right care, in the right setting.

We agree with the conclusion reached by Dr. Andy Lazris in last week's Howard County Times ("Healthy communication needed between physicians"): Communication is critical in health care and in hospitals.

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But in raising ungrounded fears about long hospital stays, unnecessary tests and patients leaving in poor condition – outcomes no one wants — the commentary paints an incomplete picture about systems in place so that important patient information is always available to our community partners to ensure quality care.

It is true that if you need to be admitted to our hospital, the physicians who treat you here will be HCGH staff, in a position called a hospitalist.

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Our hospitalist program was designed to provide 24/7 care to patients. While years ago community doctors cared for their patients in both outpatient and inpatient settings, it has become challenging for them to see patients in both locations.

The professionalism and continuity of care provided by these in-house doctors is widely appreciated, and most hospitals across the nation have similar programs so patients receive prompt attention.

While Dr. Lazris writes that hospital-based doctors "know nothing about the patients they serve," the reality is that electronic medical records and other systems mean more information is available than ever before about patients.

In an op-ed in the Howard County Times and Columbia Flier, Andy Lazris writes, "we in primary care, and our patients, hope that Howard County General Hospital compels hospitalists to contact primary care doctors on admission and, if desired by the patient, at points of medical decision making. This should not be voluntary."

Community doctors are notified electronically of every patient admission in real time, and can view all patient records – including the latest chart notes of hospitalists – from their desktops. Additionally, Maryland has created a secure texting system that allows hospital doctors to share information with community doctors instantly, so test results and other data can be reviewed on the spot.

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We completely agree that regular and reliable communication between a primary care physician and a hospitalist is a vital part of any treatment plan. This communication provides hospital doctors with additional elements of a patient's medical history which may not be apparent in electronic records, and helps share the desires of patients and their families. This is especially true for older patients who may be regularly treated by a gerontologist.

As Dr. Lazris points out, gaps sometimes occur. So in consultation with him and other Howard County physicians, we have refined and improved the interaction process.

We can now give community doctors the ability to view a daily census of the patients in their care who are in the hospital, and the doctors' office can reach out directly to the hospitalist who is caring for the patient to provide additional information. This will allow the hospitalist and the primary care doctor to be in communication as regularly as needed to discuss treatment decisions and next steps.

We believe this process will provide the level of communication the community needs, and we are making it available to all primary care groups we work with. What's more, we have established regular forums where primary doctors interact with the hospital and work on further solutions.

It is also important to note that HCGH recently improved our hospitalist program, working from the guidance of physician leaders at the hospital and in the community, so that we now work with a single group of doctors, affiliated with Johns Hopkins Medicine, to provide highest level of care.

This is just one of many areas where we are strengthening connections between the hospital and community providers, because our ultimate goal is to move beyond treating illness in the hospital to keeping our community healthy. That's what our population health work – the future of health care here and elsewhere – is all about.

All of us who provide treatment at HCGH have the same aim: to deliver compassionate care centered on the needs of patients and their families, and to be a trusted part of a broader health care delivery system.

We want you to feel comfortable about any encounter with us, and about our ability to provide you and your loved ones with the care and support you need. Rest assured, we will be here when you need us.

Stephen Villanyi, MD, is president of the HCGH professional staff; Melinda Kantsiper, MD, is director of Collaborative Inpatient Medical Services at HCGH; and Michael Silverman, MD, is chairman of the HCGH Department of Medicine.



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