A diagnosis of chronic obstructive pulmonary disease (COPD) might bring fear and uncertainty. But Leah Knabe, APRN, a family nurse practitioner in pulmonology at OSF HealthCare, is reminding you that treatment has progressed in recent years, and a diagnosis doesn’t automatically mean a reduced quality of life.

A recap

First, a recap. Knabe says COPD is an obstruction in the airways, typically caused by inflammation from an outside irritant.

“Symptoms typically are cough, shortness of breath and excess mucus production. There’s wheezing from inflammation in the airways. The little bronchioles in our lungs get tight. Good airflow and gas exchanges aren’t happening. It leads to that shortness of breath. The disease typically progresses [gets worse] over time,” Knabe explains.

Knabe says COPD is the third leading cause of death worldwide, and around 81% of cases are undiagnosed. That makes it all the more important for people with COPD to see their primary care provider or pulmonologist regularly. A person could be treated with steroids, antibiotics or go on oxygen. Smoking is the biggest risk factor for COPD, so you should avoid cigarettes and vapes to preserve lung function. People who work around chemicals, like farmers, custodians and factory workers, are also at a higher risk.

More on treatment

Knabe says that just in the last year, COPD treatment has gotten better, leading to more options for the patient.

“We’ve had biologics become approved for use in COPD patients. They’re an injection that helps manage the inflammation that flares up the symptoms,” Knabe outlines. “There are new inhalers. There are nebulized medications that have come onto the scene in the past year. Those help with shortness of breath. There are other recommendations through the Global Initiative For Chronic Obstructive Lung Disease. Those include the antibiotic medication azithromycin three times per week for really severe cases.

“Inhaler technique is something that is overlooked a lot for COPD patients. We need to make sure they have the right technique to get the medication where it needs to go,” Knabe adds. “If that’s an issue for our severe COPD patients, they do make medication for the nebulizer that can help. If you can’t pull that medicine from the inhaler down into your lungs, there’s the nebulizer machine that fumes the medication. They sit and breathe that in versus trying to physically pull it down with the inhaler.”

In other words, there is hope, Knabe says. The goal is to help the person breathe easier for a long time. But early detection is key.

Learn more

Read more about keeping your lungs healthy on the OSF HealthCare website.

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Living rent-free: Tips for mold in your home

Signs you might be having a reaction to mold: runny nose, coughing, sneezing, wheezing, tiredness, brain fog and itching or burning around your mouth. These symptoms could be worse if you have a condition like asthma or chronic obstructive pulmonary disease (COPD). If the symptoms don’t get better in a few days or you notice them in a certain location (for example, you only feel bad when at a certain house), it’s time to act.

“There are steroids taken through the nose or mouth. There are antihistamines,” Dr. Zasada says, outlining what a provider might prescribe. “There are anti-mold antibiotics, but cases are usually not that severe.”

Dr. Zasada says if mold exposure isn’t treated quickly, in rare cases it can progress to more serious health issues. One is pulmonary fibrosis, where scarring of the lungs makes it hard to breathe.

Getting rid of mold hotspots

“A fungus likes to grow in areas that are damp, dark and have a stable room temperature,” Dr. Zasada says. Two hotspots he points out are showers and air conditioning units. He adds that mold can be more prevalent in the south and southeast United States where it’s warmer and more humid.

If you see brown, black or fuzzy white spots, you might be looking at mold. A stale, musky odor is also a sign.

“Bleach and water in a one to 10 ratio is actually very effective in removing mold,” Dr. Zasada says. One to 10 refers to one part bleach and 10 parts water. “If you can spot one area that’s less than 10 square feet or so, you can clean that yourself. But if you don’t see one area and you’re still having symptoms, it might be time to call a professional mold remediator.”

Clean and ventilate your home regularly, too. Get rid of dead leaves from household plants. Consider buying a dehumidifier. It’s all to prevent dirty, dusty environments where fungi can thrive, Dr. Zasada says.

For air conditioning units, Dr. Zasada says to change the filter at least once per year. In between, do a few checks to see if moisture has built up inside the unit. Depending on the unit, that could be as simple as popping off the front panel and shining a flashlight inside.

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It’s something Michael Daley, MD, sees in the emergency department often and especially this time of year: chronic obstructive pulmonary disease, or COPD.

Dr. Daley, who provides care at OSF HealthCare, says while there’s no cure for COPD, medicine has come a long way to improve your quality of life with the disease.

COPD basics

Dr. Daley says more than 300 million people suffer from COPD, and it’s is the fourth leading cause of death worldwide.

“It’s a destruction of the lung tissue in the airways. A lot of inflammation and destruction over time that causes the condition to manifest itself in people in different ways,” Dr. Daley says.

Those ways include shortness of breath, chest tightness, coughing and fever. Dr. Daley points out that those symptoms overlap with a similar disease: asthma. But each has their differences, too.

“Asthma is seen as a disease of the young. People with asthma usually have that diagnosis at a much earlier age than someone with COPD,” Dr. Daley explains. “The textbooks will tell you that you typically see COPD in the sixth decade of life. So, people in their 60s, 70s and 80s.”

Treatment

Dr. Daley says many of the people he sees know they are having a COPD flare up.

“We immediately get them into a room. We put them on oxygen. We initiate various therapies that have been shown throughout the years to work well,” he says. “We’d give them steroids, antibiotics and inhalers over the course of one to three hours. We observe them and watch them improve.”

Though Dr. Daley says it’s not frequent, people can come to the hospital with a severe COPD flare up.

“They’re not moving any air at all. They’re in extreme distress,” he says.

That person would go on a ventilator to, first and foremost, save their life, but also to get them breathing more easily again. Dr. Daley says after a few days on a ventilator, health care providers would then tap into other treatments.

Long-term, a person may go on a nebulizer. It’s a machine that delivers a mist of medicine inside your body through a mouthpiece or mask. The medicine helps your airways to relax and expand, allowing you to breathe easier. This is different from an oxygen tank.

Pulmonary rehabilitation in a hospital or clinic is also a common part of treatment. Like lifting weights to build up muscle, pulmonary rehab involves exercises to work your way back to as normal breathing as possible.

“Often they’ll do what’s called chest physiotherapy. They wear a percussion vest. That helps them cough up a lot of mucus and phlegm inside their lungs that’s preventing them from breathing [well],” Dr. Daley says. “They also do a lot of breathing exercises that will help their airways expand. That leads to a better quality of life.”

Prevention

Dr. Daley says smoking tobacco is a leading cause of COPD, especially in the United States. Worldwide, air pollution is also a trigger, whether that’s outdoor smog or indoor dust and dander.

“We’re actually seeing a much younger population presenting with COPD. People in their 30s and 40s. Just because of very heavy tobacco usage,” Dr. Daley says.

So if you’re a smoker, make a plan to stop. If you live in a smoggy area, avoid prolonged exposure. Consider wearing a mask when outside. And keep your home clean and well-ventilated.

Dr. Daley adds that respiratory viruses like influenza can make COPD worse, leading to an uptick of cases in the winter. So, take basic hygiene steps to avoid those seasonal illnesses: wash your hands, cough and sneeze into your elbow, stay home when sick and be up to date on vaccinations.

Learn more

Read more about how OSF helps people with conditions like COPD recover at home.

Interview clips

Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

The basics

Fred Burke, MD, an emergency medicine physician who treats people at OSF HealthCare, says pneumonia is a lung infection caused by a virus or bacteria.

“The most common bacteria that causes it is strep pneumonia [in medical terms, streptococcus pneumoniae or pneumococcus]. The viruses that cause it are things like RSV [respiratory syncytial virus], flu [influenza] and COVID-19 [coronavirus],” Dr. Burke says.

In other words, you could get the flu, and it could progress to pneumonia. The phrase double pneumonia means it’s impacting both lungs. Dr. Burke says people with pneumonia could experience coughing, fever, chills and weakness.

“It can cause a consolidation in the lungs. That interferes with air movement,” Dr. Burke says. “You can also get fluid buildup and scarring in the lungs.” Consolidation refers to inflamed cells that form a mass.

Diagnosis and treatment

Dr. Burke says when someone comes to the emergency department with pneumonia symptoms, a health care provider could do a chest X-ray or CAT scan to confirm the diagnosis.

“If we find it’s from a viral infection, people have to ride it out. There’s no treatment for [the ailment itself]. But we can treat the symptoms. We can give Tylenol for fever or an inhaler for shortness of breath or wheezing,” Dr. Burke explains. “If it’s from a bacterial infection, we give antibiotic medication.”

The person could take antibiotics by mouth for one to two weeks. Or, if they are having trouble breathing, the medicine would be given through intravenous (IV) therapy. Either way, the goal is to stop the bacteria in the lungs from growing.

Another tactic is a bronchoscope, where a pulmonologist inserts a tube down your throat to break up mucus in your airways.

But Dr. Burke cautions: don’t let the guidance of some “ride it out” fool you. Pneumonia is a common cause of hospitalization and death worldwide.

“One complication is sepsis, when the infection spreads to the blood. That can cause organ failure,” Dr. Burke warns. “Pneumonia can also cause respiratory failure [when the lungs aren’t working properly]. Those people might require additional oxygen. Or if it serious enough, they might require intubation [a breathing tube down the throat] or be placed on life support.”



Is it contagious?

Yes, pneumonia can spread from person to person, Dr. Burke says. It’s often transmitted through respiratory droplets (coughing or sneezing on someone), but it can spread on surfaces as well. A child could touch a dirty doorknob then put their hands in their mouth, for example.

That’s why everyday hygiene is important. Wash your hands with soap and warm water thoroughly and often. Cough or sneeze into your elbow or a tissue. Stay home and away from others if you’re sick. These are especially important for people at higher risk for pneumonia: people with a history of strokes or seizures, people suffering from substance abuse, people with a compromised immune system (those with HIV or a transplanted organ, for example), smokers and people with chronic obstructive pulmonary disease (COPD).

The United States Centers for Disease Control and Prevention also outlines the guidelines for the pneumococcal vaccine. Talk to your primary care provider if you have questions about the shot.

“The vaccine comes from evidence-based medicine. Experts have done studies. It’s shown to be very effective in decreasing the severity of pneumonia,” Dr. Burke explains. “I would recommend people take the vaccine.”

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Fall and winter could be renamed “coughing season” with seasonal illnesses in the air. But there’s more to coughing than the brief but annoying impact on your day.

Some coughing is normal. But you should see a health care provider quickly when you cough up things you shouldn’t.

The basics: Why do you cough?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, says coughing is one way your body protects your lungs and airways from irritants. You expel the bad stuff out of our system, she says.

Some everyday things that can make you cough: breathing in smoke, allergies and mucus dripping down to your throat and irritating it. Or, you may just wake up in the morning and cough a few times to lighten your chest. These shouldn’t alarm you, Dr. Ogun says.

“We have cough receptors in our airways and lungs,” Dr. Ogun explains. “If we have mucus or an irritant, there’s a signal sent to our brain. The brain activates those receptors to have the cough action happen. So that’s why you clear your throat or cough in the morning. You’re trying to clear out your airways.”

If your cough is associated with an illness (like a cold, flu, RSV, COVID, bronchitis or pertussis, also called whooping cough) or a chronic condition (like asthma or COPD), you should be seeing a provider as often as needed to learn how to manage things.

Coughing up things you shouldn’t

Watch for signs that your cough may be linked to a more serious problem, Dr. Ogun says.

• Mucus: Our airways produce mucus to trap irritants, Dr. Ogun says. So it’s not out of the ordinary to cough up mucus from time to time. But if the mucus is thick or a different color (green or yellow), it could be a sign of pneumonia or bronchitis.
  
  “When it’s persistent [cough with mucus] and it’s affecting your breathing, you definitely want to be seen [by a provider,]” Dr. Ogun says.
   
• Vomit: Dr. Ogun says sometimes, you just cough hard enough to bring up some vomit. If it’s a “one-off,” as she calls it, you should still see a provider, but it may not be cause for great concern. But persistent vomiting while coughing could be a sign of whooping cough, acid reflux or aspiration (when food or drink gets into the lungs).
   
• Blood: Coughing blood brings a high level of concern, Dr. Ogun says.
  
  “Sometimes you have the common cold, you’re coughing for a long period and you irritated your airways. Maybe you nick the capillary artery [leading to coughing blood.] That’s fine,” Dr. Ogun says. “But more serious conditions would be a blood clot in the lung or tuberculosis.”
  
  Heart failure, lung cancer or infections are also associated with coughing up blood.
   

Diagnosis and treatment

When you see a provider for an abnormal cough, they’ll ask about your health history, specifically about your cough. How long have you been coughing? Did something trigger it? What are you coughing up? Do you have other symptoms, like a fever?

“Then the provider could do a physical examination. They look at the back of your throat. They listen to your lungs to see if they hear anything concerning. Depending on what they find, they could order a chest X-ray or a CT scan to see what’s going on inside your chest,” Dr. Ogun says.

Treatment will depend on what the provider finds. For example, acid reflux can be tamped down by an antacid or a proton pump inhibitor (PPI). For an infection like pneumonia, you’ll get an antibiotic. If it is just an irritating tickle in your throat, you may get a steroid like Flonase.

What you can do

Some advice from Dr. Ogun to ensure coughs don’t derail your health:

• Parents should keep a close eye on kids and their coughing.
   
• No matter the age, don’t shake off one instance of a bad cough and assume things will go back to normal. See a provider right away.
   
• While vaccines don’t prevent coughing, Dr. Ogun says they are critically important to stomp out the illnesses associated with coughing. Talk to your health care provider about when you’re due for flu, COVID, RSV, pneumonia and Tdap (tetanus, diphtheria and pertussis) vaccines.
  
  “Pertussis is dangerous in immunocompromised people and kids,” Dr. Ogun warns. “RSV is highly contagious, as well. It’s life-threating in infants and older adults.
  
  “What vaccines do is help prevent getting to the very severe stage [of an illness,]” she adds. “You’re trying to prevent ending up in the hospital. You’re also reducing the risk of infection. And you’re protecting people around you who may be sicker than you.”
   
• Daily hygiene habits also go a long way. Sneeze or cough into your elbow or a tissue. Wash your hands often. Stay home and away from others when sick. Again, these don’t prevent coughs. But they can help prevent the spread of illness that brings those rough coughing fits.

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The success of the OSF OnCall Digital Hospital in Peoria has paved the way for expansion to Rockford, Illinois.

OSF HealthCare Saint Anthony Medical Center is preparing to launch OSF OnCall Digital Hospital – an option to receive hospital-level care at home for some patients such as those with heart failure, COPD, COVID, infections, pneumonia, or other illnesses. Patients who qualify have been admitted through the emergency department or referred for admission directly by their provider.

Courtney Dahnert, MSN, RN, supervisor of Clinical Digital Care for OSF OnCall Digital Hospital in Rockford, says the care team at the OSF OnCall Command Center in Peoria will identify patients aged 18 and older who could be enrolled. Criteria to be enrolled includes their diagnosis, condition stability, they live within 30 minutes of OSF Saint Anthony, and have an insurer that covers hospital care at home. Medicare is among the payers willing to support home-based acute care.

OSF OnCall Digital Care Manager Melissa Meier, MSN, RN, says patients are also screened to make sure their home environment is safe and that they have the ability to be cared for at home. Once enrolled, a tech kit, providing 24/7 instant connection, is set up in the home before a patient arrives.

“A tablet, which is how we do our video visits, as well as Bluetooth enabled biometric equipment for us to be able to do vital signs remotely. We also bring a backup power source as well as a backup internet source and a device which is a personal emergency response system, which functions much like a Life Alert button.”

For potential candidates worried they’re not tech savvy, Pam Anderson, a patient from Morton enrolled in the program through OSF HealthCare Saint Francis Medical Center in Peoria says everything is so easy to use.

“The phone … you don't dial it. You just pick it up and it rings directly to the (digital health) center. And once you do that, then somebody will appear on the iPad. So, if you do need something, you're actually speaking to someone (you can see). You're not just talking on the phone. And they're extremely prompt in answering. So there really isn't, in my opinion, a lot of technology involved. Thank heavens,” Anderson gladly reports.

There is a minimum of two visits from a nurse each day. Patients receive three meals a day and individuals can live alone or with family members. Costs are the same as for a hospital stay.

Meier says OSF OnCall Digital Hospital helps both the health system and the patient.

Research also shows patients in digital hospital programs recover faster, fewer are re-admitted to the hospital and they avoid hospital-acquired infections.

OSF is currently recruiting and training nurses for the digital hospital program in Rockford with special curriculum developed by OSF Innovation. It includes simulation for real-life scenarios, so nurses are prepared for any challenges. Dahnert says most nurses enjoy this new way of caring for patients that harkens back to the days of house calls.

“It takes us back to being able to provide that really good care; getting to know someone even though we're only caring for them for two or three days and making their health relevant to them. And it gives us time to breathe. So it's an amazing opportunity for both the patient and the provider.”

For patients concerned about their care and safety at home, the first-ever digital hospital patient for OSF, Jim Stickelmaier, says being at home was the best medicine.

“I would say definitely try it. I think they’ll find out that it was a lot easier and a lot nicer to be at home than in the hospital.” 

OSF OnCall has cared for nearly 370 patients in the Peoria area since launching its digital hospital program in August of 2022. The first digital hospital patient at OSF Saint Anthony Medical Center could be admitted after the program launches for Rockford area patients on February 27.

Melissa Meier and Courtney Dahnert

OSF OnCall Digital Hospital Peoria-area patients Pam Anderson and Jim Stickelmaier

B-roll OSF OnCall Digital Hospital

Fall can be seen as a reset period. From changes to our breathing and sleeping habits, to the way we take care of ourselves. 

It's also a grea ttime to try something new. And that doesn't just mean the newest pumpkin spice latte. But, that could be part of the equation!

The seven pillars are a great place to start when it comes to putting together a wellness routine. They are mental, emotional, physical, environmental, spiritual, recreational and social. 

It's important to make each pillar your own and try for as many pillars you can for your overall wellness. Many of these naturally intertwine. 

OSF HealthCare psychotherapist Sara Bennett says quieting your mind is a great way to boost mental health. 

“It’s really nice when things slow down and you can just cuddle up in front of a fire with a blanket and some hot chocolate,” Bennett says. “Just enjoy the slowness. Being able to quiet your mind is a really great aspect of self-care.”

Bennett says getting outside for a hike with friends can help with the recreational, environmental and physical pillars. While volunteering in your community can improve your social and spiritual health. 

The cooler fall breeze sweeping through the Midwest can be a welcome sight for some, but to those with severe breathing disorders, it can be a challenging time. 

Dr. Juanbosco Ayala, a pulmonologist with OSF HealthCare, says getting the flu vaccine is a great way to protect yourself. 

He says you need to keep an eye on your breathing habits and if they're changing with the cooler weather. 

“Especially people with asthma or patients with emphysema or COPD, we notice some of their symptoms may come to the forefront with this change in weather. Things such as cough, shortness of breath and wheezing are common symptoms that may unfold during this timeframe," Dr. Ayala says. 

Dr. Ayala adds if you have a persistent cough that won't go away, or a fever, chills and night sweats, it's important to see your doctor right away. 

For those who love to sleep with the windows open in the fall, Dr. Ayala says that's totally fine.

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Pharmacies are dealing with a shortage nationwide of the medication used to treat breathing conditions as result of an Illinois manufacturer shutting down three facilities this year, and filing for bankruptcy in 2020.

Melody Bauman, a physician assistant with OSF Medical Group – Lung & Pulmonology, is keeping in close contact with pharmacies because of the shortage.

“They’re letting us know they have a backorder of albuterol,” Bauman says. “The good thing so far- is that it seems it’s only impacting the nebulize solution of albuterol. It’s a liquid vial that patients would put in a nebulizer to give themselves a breathing treatment or a mist."

Bauman says there are inhalers with the same medication her office can still prescribe patients. She says it’s important to take a deep breath during this shortage, and talk with your health care provider.

“The biggest thing I’d say is not to panic,” she says. “We are here to help patients navigate that process. Through the pandemic, we’ve had more and more issues with medication shortages in general. We’ve been able to find pivots along the way.”

Another tip Bauman shares is to check your albuterol stockpile at home.

“Make sure those medications are up to date. Usually for the nebulizer solution and the rescue inhalers, most of those will expire after a year,” Bauman says. “They’ve found with research that most of those medications aren’t harmful to use after their expiration date, but they probably won’t be as effective.”

Now that spring has arrived, allergy season has come along with it. Bauman offers to advice on how to breathe easier in the coming months.

“Limit that outside exposure if you know pollen is affecting you. Especially in the midday hours when we find that pollen tends to increase as the day goes on,” Bauman says. “Try to keep pets away from your bedroom and sleeping on your bed. Pets will bring pollen in, we don’t want that to be around as people are sleeping. Try to limit the windows being open, especially in the bedroom at night.”

Bauman also says air purifiers are a great help to make sure the air is safe to breathe inside your home.

There are other conditions that can affect someone’s breathing, such as asthma and chronic obstructive pulmonary disease (COPD).

While Bauman says the two conditions share a lot of the same symptoms, there are some key differences.

“Both have similar symptoms of shortness of breath, wheezing, coughing chest tightness,” Bauman says. “The main differences are with asthma, there’s some airway remodeling. The airways tend to get very inflamed and constrict. That’s usually either due to either genetics and/or environmental triggers patients experience.”

She adds while the airway obstruction can be partially reversible, that’s not the case with COPD.

“COPD is a group of lung diseases that most people will know either as emphysema or chronic bronchitis,” she says. “Those are progressive type diseases, in which the airway obstruction is usually irreversible. Most commonly, we see COPD because of people who have smoked long term.” 

If you are dealing with asthma or COPD symptoms, or other breathing difficulties, you can get help through lung & pulmonology services offered by OSF HealthCare.

Video Interview Clips

Most people would rather be in their own bed than in the unfamiliar surroundings of a hospital room and experiencing anxiety that can often come with a hospital stay.

OSF OnCall, the digital arm of OSF HealthCare, launched its Digital Hospital in August. At launch, eligible patients with certain conditions who end up in the Emergency Department at OSF HealthCare Saint Francis Medical Center in Peoria could be admitted to the OSF OnCall Digital Hospital where they receive hospital-level care in the comfort of their own home. Now, OSF OnCall is expanding this care to include patients who have been admitted to a larger variety of OSF Saint Francis inpatient departments, including those transitioning out of ICU, with more continuing to be added. Eligible patients must meet medical, geographic and insurance requirements.

Pam Anderson of Morton was eager to try the Digital Hospital program almost immediately. Anderson works a part-time job at a moving and storage business and lives with her retired husband, Mike. She has chronic obstructive pulmonary disease (COPD) and atrial fibrillation. The day after Thanksgiving, Anderson woke up and was having trouble catching her breath. Her oxygen level had fallen to about 80%. She was sent to the Emergency Department at OSF Saint Francis.

Once she was stabilized and admitted, the next day Anderson was approached about transferring into the Digital Hospital. She was immediately sold. By the time she returned home after discharge, a team had set up the equipment, technology and supplies she needed, including oxygen. An OSF OnCall Mission Partner (employee) walked her through using the equipment. Anderson, who describes herself as not computer literate, says everything was so easy to use.

Easy-to-use technology

“The phone … you don't dial it. You just pick it up and it rings directly to the (digital health) center. And once you do that, then somebody will appear on the iPad. So, if you do need something, you're actually speaking to someone (you can see). You're not just talking on the phone. And, they're extremely prompt in answering. So there really isn't, in my opinion, a lot of technology involved. Thank heavens,” Anderson says with a laugh.

Anderson never had to use that phone in the middle of the night, but she was comforted knowing she could and that she would be instantly connected. Patients also wear a bracelet with a button they can press to be connected immediately to a care team member. Readings Anderson took on her own from a blood pressure cuff or pulse oximeter went directly to caregivers and her electronic health record. Anderson says she felt, “completely connected and safe.”

Her schedule for the day appeared every morning on the tablet, which is provided to individuals admitted to the OSF OnCall Digital Hospital. She laughs about actually looking forward to the twice-daily visits from nurses who checked her medication, took vitals, and made sure she was on the road to recovery, all while smiling and sharing laughs.

“The nurses and aides are absolutely fabulous. They're friendly; they're well informed. They explain everything to you. Always cheerful. I mean I absolutely adored them. I missed them when they were no longer coming.”

Home-delivered meals

Like other patients who’ve been able to qualify for the at-home admission, Anderson says it was great to be home with her three dogs and husband and to have three meals a day delivered right to her door from the hospital kitchen.

“I found the food really good. So yeah, that really worked out nice also. My husband doesn't really know how to cook much. He tries but he's not very good at it. So that was absolutely ideal.”

Anderson says at-home hospital care is easier on family and friends because there’s no need to worry about navigating hospital parking or bad weather. She recalls her in-laws and friends casually stopping by for short visits because it was so easy. And then there’s the ability to sleep so much better – all wins for Anderson who is fully recovered and back at her part-time job.

“I think a lot of times with illness, your frame of mind also helps. And I think this just puts you in a more positive frame of mind and I think you recover sooner. You're more relaxed. You're not worried. ‘When am I going home? When am I going home?’ You're already there!,” Anderson says as she smiles widely.

OSF OnCall Digital Hospital also provides other clinical services typically delivered in a hospital such as physical, speech and occupational therapy and IV infusion services. It helps keep bed space available for those who need it most. That was a lesson reinforced during the peak of the COVID-19 pandemic when hospitals were strained to capacity. Research reveals hospital-at-home programs also reduce hospital readmissions and can reduce care delivery costs by as much as 30%.

OSF OnCall leaders say the goal is to continue to increase the average daily Digital Hospital patient count at OSF Saint Francis, and then expand to other hospitals and medical centers in the OSF HealthCare Ministry.

Video clips with OSF OnCall Digital Hospital patient Pam Anderson of Morton

OSF OnCall Digital Hospital B-roll

The Medicaid Innovation Collaborative (MIC) – a partnership between Peoria-based OSF HealthCare and four Federally Qualified Health Centers (FQHCs), celebrated its one-year anniversary by highlighting a long list of milestones achieved. MIC provides a variety of digital care services and personalized support for Illinois Medicaid patients through programs developed by OSF OnCall.

The state-funded, five-year initiative is designed to transform health care delivery to improve outcomes, decrease disparities and reduce costs using sustainable programs.

The FQHC partners in the program include Heartland Health Services (Peoria, Illinois), Chestnut Health Systems, Inc. (Bloomington, Illinois), Eagle View Community Health System, Inc. (Oquawka, Illinois), and Aunt Martha’s Health & Wellness (Danville, Illinois).

To date, MIC has been able to stand up several programs to expand services by:

• Providing pregnancy and postpartum support 24/7 to enrolled patients; featured on this Health Accelerated podcast.
• Offering remote patient monitoring for chronic disease management including asthma, diabetes hypertension, COPD and heart failure.
• In a collaboration with Illinois Central College, training OSF digitally-enabled health navigators to be embedded within communities across the state and FQHC community health workers; within their facilities and co-located in community-based organizations, including homeless shelters. 
• Expanding breast cancer screenings through digital outreach, making it easy for patients to schedule this important test
• Extending health and wellness education with the goal of reducing chronic disease risks associated with diet and nutrition, exercise, unhealthy weight and smoking
• Launching culturally sensitive, easy-to-use communication tools.
• Developing a systematic approach to assessing social determinants of health and tracking data to prioritize patient outreach, optimize workflow and to identify which patients might fit into specific programs. Future work will integrate all information with a patient’s electronic record for providers to have a holistic view of their patients.

Jennifer Junis, senior vice president for OSF OnCall who also chairs the MIC Governance Council, says community health workers embedded in vulnerable communities also screen individuals for social service needs and they’re connected with local resources to provide support for food, transportation, child care and affordable housing, among other factors that contribute to improved health and wellness.

During a day-long session earlier this week, FQHC leaders and frontline employees reviewed progress toward goals outlined for the first year.

Chestnut Health Systems in Bloomington:

•  Began work on a building renovation and hiring for a new dental clinic that will serve Medicaid participants. 
•  Collaborated with a local homelessness service provider/food pantry to organize and implement a Food Pharmacy. Providers at Chestnut screen patients for eligibility criteria and prescribe use of the food pharmacy services. The pharmacy provides fresh and healthy food options often worth hundreds of dollars.
• The CHW program has solidified co-locations for staff at six partnering agencies.

Heartland Health Services in Peoria:

• Built a new team within HHS and the framework to support digital care programs and to provide virtual primary care in homeless shelters.
• Began building trust with leaders and residents of homeless shelters through food and clothing drives and providing COVID-19 rapid kits.
• Hired a digital support manager and community health navigators who have also been trained on tele-diagnostic equipment that can be used to support virtual visits.
   

Aunt Martha's Health and Wellness in Danville: 

•  Trained and hired community health workers.
•  Established monthly Healthy Behavior meetings at the YMCA and Public Library.
•  Educated more than 100 people in the community about resources and how to take control of their health.
•  Expanded training for CHWs on cultural diversity, domestic violence and sexual assault.

Eagle View Community Health System in Oquawka:

• Deployed CHWs who are providing services in three locations in the community.
• Implemented a new electronic health record system (Epic) that allows for better data collection and reporting on health outcomes.
• Hired a new transportation van and hired a transportation director.

Junis says these efforts are designed to wrap a 24/7 digital safety net around patients that is available 365 days a year

“So if you have a question in the middle of the night, you don't have to go to an emergency department, or you don't know who to call. You can reach out to us and it's through text messaging or calls and we're available. So that's really the transformation piece. Is that we're not episodic but we're really meeting patients where they are and where they need us the most, at the times that they need us.”

The effort is expected to lower health care costs by keeping people out of the emergency department or the hospital, the most costly point of care. Savings can also be created by scaling the effort with telehealth providers overseeing care for many patients at a time.

MIC will continue into year two with goals of improving dental care for patients, providing virtual health to residents of homeless shelters, and enrolling new patients in existing MIC programs. Junis says it’s also about improving based on feedback.

“Year two is about optimization, and coordination and collaboration, and really continuing to work together to understand all of our different components of the holistic care of a patient and how we all play such a big role in that.”

Video Clips with Jennifer Junis, Senior Vice President for OSF OnCall Digital Health