A “ one-stop-shop ” for healthcare in Asian immigrant communities

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AHA News: A 'one-stop-shop' for healthcare in Asian immigrant communities

Nelson Zhao grew up in Chinatown San Francisco and as a child began attending a nonprofit community health center. Today, at 29 years old and with a good job in the financial sector, he has never hesitated to go elsewhere.

With 12 clinics in the San Francisco Bay Area, North East Medical Services serves patients of many nationalities, many of whom are uninsured or low-income.

“It gives me a connection to my community,” said Zhao, the son of Chinese immigrants. “The whole building has my dentist, my vision and my doctor there too. Sometimes I’m going to do an annual checkup and get my teeth cleaned, and it’s like one stop shopping.

Zhao’s parents – who are also NEMS patients – do not speak English and the staff at the health center are fluent in a wide variety of languages ​​and dialects: Cantonese, Mandarin, Toishan, Vietnamese, Burmese, Tagalog, Spanish and Hindi.

“Now that I’m older, I’ve really started to notice every time I go there, that the people around me, the patients who are sitting next to me are lining up, they look like my community,” he said. “It’s reassuring to me that there are people who come here for exams when they don’t feel they are receiving the same service if not because they don’t feel comfortable elsewhere.

“Doctors are multilingual and look like the people they serve, which I think is very important.”

The NEMS served up to 70,000 patients per year before the COVID-19 pandemic. For many, the transition to telehealth services was not seamless, and keeping pace with patients became a challenge when companies closed; besides language and cultural barriers, access to technology has also become a problem.

“A lot of patients were struggling with the technology they had,” said Andrey Chow, director of programs and administration at NEMS. “For some of the people who used cell phones, that was the limit to the technology they could access. They did not have Internet access or broadband access at home.

As the pandemic began to rage, there were significant communication problems. “Most of the information is in English,” Chow said. “It’s very common for our patients to just come in, come in and say, ‘I got this in the mail. I don’t know what that says. Please help me.’ But there are many. patients lost that lifeline when they had to take shelter in place and feared they would be exposed to COVID-19 just by leaving their homes. “

And if those hurdles weren’t enough, NEMS staff members also needed to find new ways to educate their diverse clientele on everything from county-specific health guidelines to basic information about healthy eating and food choices. lifestyle to control chronic disease.

“We have to try to demystify some of the misinformation about general hypertension guidelines,” said Wai-Hang Jackie Lam, medical director and director of quality improvement at NEMS. “Before the pandemic, we had patient health coaches who were there to take extensive training on how to diagnose hypertension, how to take care of their diet, how to exercise – just to talk about changes in their. lifestyle they can do to control their blood pressure.

“We had to put a stop to it, but it was a pretty successful program when we got it.”

Lam said patients who continued high blood pressure treatment on remote visits often showed high readings when they were able to return to the center in person, highlighting challenges with self-monitoring and practice. of medicine in a telehealth setting.

“If everything had gone smoothly in 2020, one of our organizational goals was supposed to be to focus on hypertension,” Chow said. “At this point, almost 13,000 of our 70,000 patients have hypertension. It is quite important in the community.

NEMS recently received funding from the Bernard J. Tyson Impact Fund of the American Heart Association, which helps organizations seeking to reduce social and economic barriers to health equity.

The funding has been a welcome boon for an organization that relies on community support and an effective business model.

“We don’t have an annual gala where we go out and do the Rubber Chicken Dinner to raise money,” Chow said. “A lot of how we operate is based on the services we provide and whether or not we can charge whether or not different insurance or health coverage programs pay.

NEMS was quick to offer COVID-19 driving tests when the pandemic began. And when there was a shortage of personal protective equipment, “we had a lot of support from the community, just individuals and businesses and many groups who formed to respond to the PPE shortage,” said she declared. “It was an incredible thing.”

With COVID-19 vaccines now available, the NEMS faces the new challenge of vaccinating its patients.

“On the one hand, we have patients who are clamoring to be vaccinated,” Chow said, “and on the other hand, there will be patients who are afraid or wary of something so new. will be our job to connect with everyone, in their language and in an accessible manner, to ensure they get what they need for their continued health. ”


Almost all telehealth clinic appointments for low-income Americans were audio-only


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