“CONNECTING THE DOTS” 

 Novel Community Healthcare System / Public Health Model

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The model is developed during the 2020 Covid-19 Pandemic and created based on immediate response services provided by Georgian community members

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Community Crisis Center is the novel version of the system that was utilized by “Tvistomi Association Medical Group” in slightly different model on regular basis since 2003 and was improved and adjusted to current pandemic situation. On that note, this improved model can significantly enhance effectiveness of future community health care services and improve public health status in local ethnic communities and minorities, as well as, in whole local society.

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The main goal of our Preventive Care Methods utilized by this model including ,but not limited to: active community health screenings, patients feedback monitoring and phone call-based follow ups, remote, home care monitoring services , active case management for also uninsured residents is the minimizing emergency hospitalizations and re-admissions and other urgent medical services , which reduces the financial burden on Federal , State and City healthcare systems.

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We have developed and now implementing the Community Health Monitoring Management System (CHMS) for our community in Tristate area

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During the Covid-19 Pandemic Tvistomi Association Medical Group developed and organized “Community Crisis Center” to help the community members to overcome and properly deal with the heavy psychological, social and health related problems during the viral pandemic in local society.

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Community Crisis Center is organized as the team of community volunteers with different responsibilities and different roles. There are several divisions:

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1. Mobile Group – including 5 cars with the drivers who are delivering the food, medications, medical devices like thermometers, oximeters, inhalers etc. to Covid-19 patients who are isolated during the “Stay Home” policy and don’t have the access to the needed services and goods. So far, the Mobile Group made hundreds of deliveries during this period and helped hundreds of people in need to fight the Pandemic outcome. The funds for all supporting activities were obtained through donations from our fellow members of local community.

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3. Psychological Support Group – the group of professional psychologists / therapists who are in 24/7 contact with people with or without the virus, who are experiencing the frequent panic attacks, anxiety and depression in connection with the self-isolation and lone less, since the large part of the population are alone , living without their family members and loved ones to support them in this difficult time. There are hundreds of active cases which are under the monitoring and control from the Support Group specialists until now.

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5. Case Management Group – the group of professionals, with health care background and training who are taking care of the entire process of proper Symptoms Management At Home. Based on information obtained from the caller they are evaluating and dividing each case into High, Medium and Low Risk Group category and taking care of further monitoring process involving Licensed Healthcare Professionals connecting the dots between healthcare providers, including primary care physicians , other specialty doctors, medical diagnostic facilities, imaging and radiology centers , labs , Urgent Care Centers as well as hospitals and other ambulatory clinics. The main idea and purpose of such management is to control and monitor the Covid-19 and other patients to prevent them from complications which can lead them to hospitalizations and even highly complicated intubation with poor prognosis.

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7. Based on remote monitoring process including phone calls and follow ups, telemedicine- based consultations involving US based licensed clinicians, intensive care workers and hospitalists we achieved the zero lethality in our cases shows the high effectiveness of our approach as a mini model of proper Public Health Management in Community Healthcare.

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9. Recent updates from NIH and CDC shows that the outcome of the intubation ( patients on Ventilators) of the Covid-19 patients has high 87% mortality rate , therefore , proper pre-hospital supervision , “At-home Care Health Management and Accommodation” are the main live saving measures and we are proud to say, that hundreds of our community members have avoided health complications based on above mentioned strategies.

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