Stories of Impact

Signature Health

Reducing Barriers to Care - Signature Health Lakewood Provides Pathway to Hepatitis C Diagnosis and Treatment

On a recent day, an individual accessing behavioral health services visited Signature Health Lakewood. As she entered, a poster promoting hepatitis C screening services was a quick reminder of her own diagnosis and the fact that she had yet to pursue any medical care. With the help and support of the infectious disease team, the patient expeditiously received basic elements of care including lab work and a FibroScan all at the same Lakewood facility. Despite her anxiety, the flexibility of the medical team at that moment in time resulted in immediate care and the treatment needed to manage her hepatitis C ─ with medications facilitated by an onsite pharmacist and follow-up appointments scheduled via telehealth for continued ease. This collaboration is reflective of the proactive steps Signature Health is taking to increase and improve patient care outcomes across Lakewood and other Northeast Ohio communities.

A non-profit, Federally Qualified Health Center (FQHC) Signature Health provides mental health, addiction recovery, primary care, and infectious disease services while aiming to eliminate health disparities. In addition to the Lakewood facility, Signature Health has seven care locations throughout Northeast Ohio serving patients regardless of ability to pay. Signature Health is committed to creating an environment that treats the whole person. Those seeking addiction recovery and mental health support have a link to infectious disease care but are often reluctant to seek out medical treatment for various reasons. Patients may face barriers to comprehensive health care due to negative experiences, social stigma and discrimination, transportation issues, lack of safe spaces, and many others. 

The Infectious Disease Department at Signature Health Lakewood aims to eliminate these barriers by delivering full-time care alongside addiction and mental health services. With a dedicated team in place, the department has grown significantly in its ability to provide comprehensive care that allows patients to be treated where they feel most comfortable ─ with immediate services and flexibility unlike traditional medical settings that can be intimidating and very disparate. This success is largely attributed to the clinic staff that creates an environment where people feel safe, coupled with their initial intake assessments that help establish the referral cycle for a range of healthcare needs. Rachel Austermiller, RN and Manager of Infectious Disease Clinical Services states, “Approximately 75% of individuals who achieve a first visit in our program successfully start medications.”

One of the most common screenings done is for hepatitis C, a liver infection caused by the hepatitis C virus (HCV).  According to the CDC, hepatitis C is spread through contact with blood from an infected person with most people infected by sharing needles or other equipment used to prepare and inject drugs. For some, hepatitis C is a short-term illness, but for most that become infected with the virus, it becomes a long-term, chronic infection. Dr. Sarah Hoehnen, Medical Director of Infectious Disease at Signature Health shares, “Patient unawareness of infection is one of the greatest obstacles to treatment. Regardless of insurance status, when new patients visit us for treatment, they receive all of the basic elements of care at their first consultation – including labs and scans.” With many patients walking in without insurance, financial counselors are available to evaluate situations and help identify available resources, including Medicaid eligibility and other options. Another important part of the care team are the onsite clinical pharmacists that converse with patients about their prescribed medications and assist with identifying reduced or free payment sources, while providing education and guidance along the way. This model and team collaboration not only makes it easy for the patient to get treatment, but has resulted in increased adherence and successful outcomes.

Thanks to a grant received from Three Arches Foundation, the addition of a dedicated FibroScan machine at Signature Health Lakewood is making it easier and reducing challenges for the Infections Disease team to expand hepatitis C treatment. The acquisition of this specialized, noninvasive equipment that detects liver scarring is now part of the comprehensive treatment process aimed to decrease the amount of hepatitis C in the community overall through increased diagnostics and treatment. “The onsite FibroScan machine has significantly improved our ability to treat hepatitis C in Lakewood without the need to send patients elsewhere,” adds Dr. Hoehnen. “Moreover, people can walk in for confidential free screening and have their results thirty minutes later ─ a huge advantage especially for those facing immense barriers and obstacles to care.”

Beginning in January 2022, individuals that have an initial diagnostic assessment with a counselor will automatically be offered both hepatitis C and HIV testing as part of normal procedures for every patient. While they may choose to opt-out, the team is viewing this step as a small window, yet hopeful glimmer of opportunity to engage with more people and connect them to wrap-around care. “If we view these tests like we would a routine blood test or cholesterol check we can help to avoid the stigmas,” comments Austermiller. “Our goal is to normalize this testing by reaching out to those who come to us.”

The good news is that with treatment hepatitis C can be cured. “It’s a quick and easy process with patients’ lives improving with oral medication over the span of 8-12 weeks,” says Dr. Hoehnen. “Our focus is to provide equitable care to the community without judgment and to help people understand that infectious diseases are both treatable and preventable.”  With collaborative work growing among primary care providers across Lakewood, including the Center for LGBTQ+ Care at Lakewood Family Health Center, Signature Health Lakewood is hopeful that more individuals will proactively seek out infectious disease screening and prevention services. Dr. Hoehnen adds, “If they are willing to come, we’ll provide compassionate care to help keep them healthy and safe, regardless of risk behavior.

To learn more about Signature Health Lakewood visit signaturehealthinc.org/locations/lakewood

 Photos courtesy of Signature Health

Published November 2021