November 22, 2021
(Blog) – In 1978, Delta Airlines pioneered the “Hub and Spoke” model, following deregulation of the airline industry, with the goal of increasing access and efficiency of air travel. Atlanta, GA was established as the hub through which most flights were routed while other airports were designated as spokes where travelers might begin or complete their routes. In healthcare, the Hub and Spoke Model has been used to increase access to specialized care within primary care settings, in addition to the traditional offering at a hospital or specialty clinic. CommUnityCare’ s Care Connections (CareCo) Clinic serves as both a hub (for complex procedures) and a spoke (for key services), bringing together a remarkable array of services for our patients with the highest burden of clinical illness as well as people experiencing homelessness. With this model we are boldly and safely challenging traditional notions of “right care, right place, right time.” Some of these services include the following:
1. Paracentesis is a procedure that is typically provided in a hospital setting that provides relief to individuals by draining fluid that has accumulated in the abdomen. This procedure helps avoid visits to the emergency room or hospital, and patients prefer the calm setting of our clinic with their trusted providers and team.
2. Hepatitis C treatment was traditionally provided exclusively by a GI or Infectious Disease specialist, but with newer hepatitis C medications, treatment protocols have been simplified allowing for treatment in the primary care setting. CareCo is one of a number of sites at CommUnityCare to offer Hep C screening, diagnosis, and treatment within the convenience of our patients’ primary care experience.
3. Medication Assisted Treatment (MAT) combines medication and behavioral therapy to treat substance use disorder, including the remarkably effective medication, buprenorphine, for the treatment of opioid use disorder. Initiation of this treatment requires intensive support, however, once a patient has stabilized on buprenorphine at our SEHWC hub, they are then transferred to a spoke site, including CareCo, for continued treatment. This exciting work is led by our MAT lead, Emily Humphrey.
4. HIV care has traditionally been delivered out of our hub site, the David Powell Clinic. Timely linkage to care is critical in the treatment of HIV, and CareCo Clinic has been developed as a spoke site to provide HIV care. Through additional HRSA grant funding, a HIV case manager and community health worker will be hired to assist with the spoke model work. This exciting addition is led by our Sexual Health Associate Director, Dr. Mike Stefanowicz.