Attribute 7 – Part One

Ahead of the Thanksgiving holiday, we are thankful for the many people who have helped make this Ten Attributes of Health Literate Health Care Organizations interview and discussion series a success.

This week, in particular, we are grateful to Dr. Douglas Reich, Chairman of the Department of Family Medicine at the Bronx Lebanon Hospital Center, who spoke to us about meeting the health literacy needs of patients facing multiple challenges in Part 1 of our 2-part pice on Attribute 7 .

We are also grateful for the reunion this interview brought with Arafat Omidiran, MPH, the Research and Data Analyst at Bronx Lebanon Hospital’s Department of Family Medicine. Ms. Omidiran, an original administrator of the Health Literacy NY, conducted the interview.

Attribute 7: A Health Literate Health Care Organization Provides Easy Access to Health Information and Services and Navigation Assistance.

Say Ah!: The Bronx has some of the most complex populations from a health literacy perspective, can you tell us about some of the challenges you face in providing easy access to health information and services and what you are doing to meet these challenges?

Dr. Reich: More than a third of adults in our community have not completed high school, and many of our patients have a general reading level between 3rd and 5th grade. As a result we have had to dramatically adjust how we provide information to our patients. Coupled with the fact that our patient population speaks a multitude of languages, communication can be difficult. We are aware of these complexities and as a result we hire physicians and staff that reflect the community we serve and are sensitive to the needs and issues of our clients. We are trying to elevate the Health Literacy of our community through our community health workers and community partnerships.

Say Ah!: How does Bronx Lebanon Hospital Center engage the community – individuals or community based organizations – in improving access to health information and services.

Dr. Reich: In 2012, the family medicine department and Healthfirst helped anchor a novel cross-sector collaboration known as the Claremont Healthy Village Initiative (CHVI). Community Partners include the Tenant Associations of Webster-Morrisania, Morris, and Butler Houses (NYCHA), Claremont Neighborhood Center, William Hodson Senior Center, Directions For Our Youth, GrowNYC, Street Soccer USA, Casita Maria Center for Arts and Education, Bronx Documentary Center, Bronx District Public Health Office and Claremont in Motion (bike program).

CHVI is focused on proactively addressing health disparities and sustaining a shared culture of health promotion and wellbeing in the Claremont community, one of the poorest neighborhoods of the Bronx. Each partner organization provides programs and services consistent with their expertise and mission. Through CHVI, these programs and services are integrated, which facilitates reinforcement of health-related messaging; as well as expanded outreach and impact. Though many partners are active on Social Media, CHVI has recently started utilizing social media to engage more individuals. Our mission is to improve the quality of life in the Bronx, one person at a time!

Say Ah!: Technology is playing an ever larger role in assisting patients navigate the system. What technology have you found to be effective, and what hasn’t worked (i.e. automated appointment reminders).

Dr. Reich: One of our most powerful tools has been Health Leads, an online resource that points us in the direction of the community-based resources our patients need. This gives patients information and access to services that help reduce the many socio-economic barriers that inhibit their quality of life. Our Electronic Medical Record has also been a powerful tool. It has helped us to manage population health and improve health screenings. Though telehealth has been a success among certain populations, it has been a struggle to use with others. This is also true of other technologies, i.e. automated appointment reminders text messages, telephone calls and emails. However, our department has Community Health Workers who are available to make home visits to the patients if we are unable to connect to them using technology.

Say Ah!: What are the top three lessons you would impart to a health care system trying to improve its own health literacy?

Dr. Reich: The top three lessons are:
You need to offer a variety of methods when educating your patients because when it comes to health literacy education one size certainly does not fit all. You need to consider culture, language, age, etc.
Keep the message as simple as possible with palpable and definable outcomes, goals, and results in mind
Utilize Peers to disseminate your information! It is very important that your language is understood by your patient population/demographic. Having peers that match the population is an extremely powerful resource. They will assist in both the development and implementation phases.

About Douglas Reich, M.D.
Dr. Reich has been practicing family medicine for more than 30 years, and has been Chair of the Department of Family Medicine at Bronx-Lebanon Hospital Center since 2006. As Chair, Dr. Reich serves as Medical Director for Family Medicine’s five clinic locations and the Dr. Martin Luther King, Jr. Health Center. Under Dr. Reich’s leadership, the Department of Family Medicine has been the recipient of numerous grants, from both public and private funding sources. Dr. Reich was previously the Program Director for the Family Medicine Residency Training Program, and the Medical Director of Bronx Lebanon Integrated Services System, a Federally Qualified Health Center. Prior to his current position, Dr. Reich worked at Wyckoff Heights Medical Center, The Brooklyn Hospital Center, and in private practice. In addition to his clinical practice, Dr. Reich has held multiple academic and professional appointments, including as an Adjunct Clinical Associate Professor of Family Practice at the New York College of Osteopathic Medicine. Dr. Reich continues to collaborate with attending and resident physicians to conduct research on a variety of topics related to Family Medicine including child asthma, opioid use disorder and pain management, community health, and creative interventions to improve the quality and delivery of healthcare.

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