Using Technology to Expand Services

In: Main

26 Apr 2010

Expand ServicesIntroduction

The development and application of new and improved technology have had a dramatic impact in the health care field. Advances in diagnostic procedures and devices, medical implants, and surgical techniques are revolutionizing medical care. However, technology has been slow to assist patients living in remote service areas and segments of the population who have historically had difficulty gaining access to quality health care.

This picture may soon be changing. New machines and processes are allowing health care providers to broaden their reach into rural communities and to offer access to prescription drugs for low-income patients while improving efficiency through better inventory control. canadian pharmacy viagra

This article presents a case study of a community health center’s effort to extend its distribution system by using remote drug-dispensing technology to reach difficult-to-serve communities and patient groups.


Over the past two decades, the health care industry has increased in size and scope, with expenditures for health care rising by 530%, from $245 billion in 1980 to more than $1.5 trillion in 2002. Over the same period, per capita health care expenditures rose by 275°%, from $2,800 to nearly $10,500/ but the mean household income rose by only 175%, from $21,063 in 1980 to $57,852 in 2002. As a percentage of the gross national product, health care expenditures increased from 8.8% to 14.9%. The cost of prescription medications has grown more rapidly than general health care costs, increasing from $12 billion in 1980 to $162.4 billion in 2002, a 1,250% increase. Despite these changes, the ability to afford the rising costs of health care is not equally shared among consumers. Nationally, nearly 45 million citizens (16% of the U.S. population) do not have health insurance. An additional 25% of Americans are dependent on government insurance programs through Medicare and Medicaid.

Nearly 25% of all adult Americans read at or below a fifth grade level. This low level of literacy has resulted in increased health care expenditures. Many patients are unable to decipher instructions and warnings accompanying medical prescriptions; as a result, nearly 50% of patients are not taking their medications as directed.
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Initially located in the center of an old textile mill city, Thundermist Health Center, in Woonsocket, Rhode Island, was founded in 1969 as a private, not-for-profit family-planning clinic. The center’s original mission was to provide comprehensive primary medical care in an affordable manner to a diverse local patient population. Over time, program offerings have increased to serve the needs of the local community. Adult medicine, pediatric care, and dental care were added to the mix of services. Partnerships with local health organizations and local schools were developed. In 1998, the organization achieved national accreditation from the Joint Commission on Accreditation of Healthcare Organiza-tions.

Thundermist is driven by the needs of the community, most specifically those of underserved citizens. Its mission is predicated on the philosophy that health care is a right to be enjoyed by all. To adhere to its mission, Thundermist believes that it must supply underserved local citizens with health care services that are of the same quality as those services bought by others with greater financial means.

Thundermist has grown to become one of the largest community health centers within the state of Rhode Island, providing medical, dental, and social services to nearly 25,000 patients. It is part of the federal community health center program and offers a comprehensive array of primary care services. Staff physicians who have admitting privileges to local hospitals provide primary medical care. Thundermist employs dentists and dental hygienists, and it is the only health center in the state to offer mental health services.

The organization employs multilingual staff members who can communicate with patients speaking Spanish and Portuguese and with those of Asian ancestry. A large team of social workers assists clients in overcoming social barriers. Through partnerships with other agencies, Thundermist provides food assistance through a food pantry, nutritional counseling, psychological counseling, social service case management, extended support services to people living with human immunodeficiency virus (HIV) infection, home visits, patient education, and disease-prevention programs. These personnel assist patients in obtaining services from public assistance programs and other social service agencies and facilitate participation in a wide range of preventive health programs.

Thundermist targets clients throughout the state who are living in poverty, who have no health insurance, and who are descended from minority populations or from a cultural or socioeconomic status that creates a barrier for obtaining primary health care services. Its patient population is disproportionately poor, with 29% from nonwhite ethnic origins. More than 85% of clients in the northern sector of the service area and 73% of clients in the southern part of the service area are at or below 200% of the federal poverty limit.
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Within the targeted market served by Thundermist, nearly 17% of patients are without any type of health insurance; an additional 29% are dependent on Medicare or Medicaid.

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