Written by Marybeth Kotrodimos, University Health Partners of Hawaii
Leah Taylor photo by Vina Cristobal
As Business Director of UHP\u2019s Family Medicine Clinic, you know that even in the best of times, though ever-cheerful and friendly, Leah Taylor, MBA, has got to be one busy person.\u00a0\u00a0
Among her many duties, she handles contracts and large purchases for the clinic, budget agreements with vendors, HR, credentialing for faculty; she\u2019s on the COA [Council of Administrators], as well as JABSOM committees.<\/p>\n\n\n\n
\u201cOf course now, I\u2019m working on the move,\u201d she tells us, referring to Family Medicine\u2019s relocation from their facility in Mililani to their new clinic next to Pali Momi Medical Center. \u201cPlanning with architects and the Department Chair on developing the architectural plan, working with an interior designer, working with the contractor, getting supplies moved over . . .\u201d and you sense that the list goes on.<\/p>\n\n\n\n
This would be a big move even without dealing with the concerns and constraints of a world pandemic, but in the time of COVID-19, it had to be extra challenging. How did the coronavirus affect Family Medicine\u2019s operations?<\/p>\n\n\n\n
\u201cWe have lots of meetings now,\u201d Leah says. \u201cWhen the COVID first started, \u2013 there was an internal department COVID group of us: Desiree Navarro (Clinic Manager), Dr. Allen Hixon (Dept Chair), Dr. Chien-Wen Tseng (Senior Researcher), Dr. Komal Soin (Director of Women\u2019s Health), Dr. Robert Carlisle (Clinic Medical Director), Dr. Lydia Rolita (Residency Program Director), Heidi Kubo (Residency Program Administrator), and myself \u2013 in mid-March for about six weeks every morning at 7:00 and every afternoon at 4:00, we\u2019d have a zoom meeting to discuss how COVID affects our clinic, residents and patient care. We now have update meetings only twice a week. Before we were changing operations & work flows on almost a daily basis. If it wasn\u2019t for those who were on these recurring calls, telemedicine would never have gotten off the ground. I simply bought IT equipment, but the others in the meetings were the integral ones in developing and implementing telemedicine for our department.\u201d <\/p>\n\n\n\n
At this point, they were already in the middle of moving the entire clinic to another location. Although planning for the physical relocation was a lot of work, Leah says she \u201ccouldn\u2019t have survived without the guidance of the Department Chair, Dr. Allen (Chip) Hixon and the clinical expertise of the Clinic Operations Manager, Desiree Navarro.\u201d<\/p>\n\n\n\n
Has telemedicine helped them through the crisis? \u201cIt definitely has,\u201d Leah says. \u201cIt took us a while to get into the groove of it. I think the big challenge, initially, was we\u2019re not just a faculty clinic, we\u2019re a residency clinic, so what they have to do is have the residents on zoom, the attending faculty on zoom, and the patients on video via doxy.me.\u201d There are some extra steps needed for them to coordinate a telemedicine visit with a patient, but, she said, it\u2019s been totally worth it.<\/p>\n\n\n\n
As with all healthcare practices, during the pandemic, Family Medicine has, of course, had to limit the number of people who can be seen at once in the clinic, so telemedicine has helped greatly in that it has enabled them to see patients who might have otherwise had to wait much longer for an appointment. In fact, she says, when they go back to being able to see patients as they did before COVID, they want to continue incorporating telemedicine into their practice.<\/p>\n\n\n\n
\u201cWe are limited to five residents seeing patients at a time in the clinic,\u201d Leah explains, \u201cbut if they are doing telehealth, they can see more patients and not be constrained by the number of rooms the clinic has available.\u201d<\/p>\n\n\n\n
In their new location in the Pali Momi Outpatient Center, Family Medicine had its first telehealth visit on June 12, saw it\u2019s first in-person patient on June 13, and officially opened on June 15. <\/strong><\/p>\n\n\n\n By all accounts, the move went amazingly well, owing in no small part to Leah, according to Family Medicine Department Chair, Dr. Allen (Chip) Hixon: \u201cI think Leah Taylor deserves a lot of credit for being involved in every step of the operational planning timelines and coordinating all the pieces. And you know, it\u2019s a big deal.\u201d<\/p>\n\n\n\n So what is the reason for the move anyway? \u201cAbout four years ago,\u201d Leah says, the Department of Family Medicine and Community Health, started looking for new location for the Family Medicine clinic, so this move marks the end of long journey home for them. <\/p>\n\n\n\n Family Medicine\u2019s residency program, Leah tells us, began in 1994 with Wahiawa General Hospital as their sponsoring hospital. In 2015, the Mililani clinic became a part of UHP. <\/p>\n\n\n\n \u201cSo now that UHP owned the clinic, Family Medicine still needed a sponsoring hospital. HPH\/Pali Momi raised their hand and said that they would sponsor our residency program. So now a lot of our residents do their rotations at Pali Momi,\u201d she explains. \u201cThey do their rotations there in the morning, then need to eat lunch and drive to Mililani so they can start seeing patients at 1:30 [p.m.]. That doesn\u2019t leave time much time for eating and commuting.\u201d <\/p>\n\n\n\n So she and Dr. Hixon started meeting with Pali Momi\u2019s vice-president of real estate. They looked at \u201cabout five different locations\u201d before they found the one that would meet all their needs and be close enough to Pali Momi Medical Center so that their residents would not be in such a time crunch during the course of their day.<\/p>\n\n\n\n The new Family Medicine clinic is a four-minute walk to Pali Momi Medical Center. (\u201cI know! I timed it!\u201d Leah says.) \u201cSo now what happens is our residents finish their rotations about 12:30 p.m. or so, they get to eat their lunch, and then walk over to our clinic.\u201d<\/p>\n\n\n\n Also, she adds, there are a lot of meetings, trainings, and workshops given at the hospital which their residents and faculty couldn\u2019t attend previously because they needed to drive to Mililani. Now they can benefit from participating in these educational events.<\/p>\n\n\n\n Though this is undoubtedly a good move for Family Medicine, \u201cIt\u2019s been kind of hard too,\u201d she says, \u201cbecause we had a lot of patients from Mililani and Wahiawa that may have difficulty to keep coming to us because of the commute. You know, we\u2019ve been around for about 25 years, so it will be hard if we lose them as patients. The new site, however, will allow the provision of many coordinated health services for our patients and a better clinical learning environment for the residents and faculty.\u201d <\/p>\n\n\n\n \u201cWe were supposed to have a big grand opening,\u201d Leah tells us, but because of COVID-19, they were unable to do that. However, on June 5, they had two kahu to bless the clinic. Only ten people could attend, she tells us, referring to regulations to prevent the spread of COVID. It was important that they \u201cclear the room spiritually,\u201d following Hawaiian tradition, Leah says. \u201cBut we talked to the kahu about having another blessing when things calm down so that all the people within our department, our partners, and our supporters can attend that.\u201d Leah first began working in Family Medicine in 2006, as a Research Corporation of the University of Hawaii (RCUH) student intern in UH\u2019s Department of Family Medicine Research Division with principal investigators Dr. Lee Buenconsejo-Lum and Dr. Neal Palafox. She\u2019s had other jobs since her internship but returned to the Department in 2014. Most of her employment with the Department had been \u201con the research administration side\u201d she says. The clinical side is \u201ccompletely new\u201d to her, which is why coordinating with Dr. Hixon and Desiree was so instrumental in the success of the clinic relocation.<\/p>\n\n\n\n Healthcare can be \u201ca difficult industry to be in\u201d she said, but \u201cevery industry has its issues.\u201d Overall, it has been an interesting and educational journey for her. However, her feelings for the work of family medicine are clearly unambiguous.<\/p>\n\n\n\n \u201cWe go by \u2018Family Medicine\u2019 for our UHP clinic, but our JABSOM department is really \u2018Family Medicine and Community Health,\u2019\u201d Leah explains. \u201cThe goal is that we see all ages at all stages, which is really kind of our tag line. We see babies all the way to geriatric patients. Family medicine is not just about looking at the physical health of the patient. It is also incorporating all the social determinants of health. How\u2019s the family life? How\u2019s their economic situation? Do they have housing? Because you know someone who doesn\u2019t have housing or doesn\u2019t have a stable family life, it\u2019s a lot more difficult for them to make healthy decisions.<\/p>\n\n\n\n \u201cA mom that has three kids and working two jobs, it\u2019s much more difficult for her to make a healthy meal than to just grab a McDonald\u2019s meal and give it to her kids. It\u2019s not because she doesn\u2019t care or doesn\u2019t want to. She just doesn\u2019t have the time to do it.<\/p>\n\n\n\n \u201cIt\u2019s not just how do you treat their diseases, but how can you be preventative? How can you provide social services? How can you get them in touch with the food banks? The job fairs? Things like that. The basic needs. So that\u2019s family medicine \u2013 [we] look at the whole, not just the ‘why’.”<\/p>\n","protected":false},"excerpt":{"rendered":" July 2, 2020 — UHP Family Medicine\u2019s Leah Taylor talks about the real reason for their big move to Pali Momi, doing it all during COVID, and the vision and the practice of Family Medicine.<\/p>\n","protected":false},"author":14,"featured_media":13537,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-13522","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/uhphawaii.org\/wp-content\/uploads\/2020\/07\/IMG_7347-scaled.jpg?fit=2560%2C1706&ssl=1","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/13522","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/users\/14"}],"replies":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/comments?post=13522"}],"version-history":[{"count":7,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/13522\/revisions"}],"predecessor-version":[{"id":13541,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/posts\/13522\/revisions\/13541"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/media\/13537"}],"wp:attachment":[{"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/media?parent=13522"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/categories?post=13522"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/uhphawaii.org\/index.php\/wp-json\/wp\/v2\/tags?post=13522"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
Included in that event, she says, will be UHP leadership, JABSOM leadership, Pali Momi hospital leadership, HPH leadership, Queen\u2019s leadership, and members of the legislature who have supported them.<\/p>\n\n\n\n