Learning Session Urges Deeper Understanding of Chronic Disease Patients

Published on June 8, 2016 by

Reaching a deeper understanding of patients and their lives became a dominant theme during last week’s Maine Patient Centered Medical Home/Health Home/ Behavioral Health Home learning session. More than 350 people attended the session as it unfolded at six sites across the State simultaneously, linked together through live streaming video of keynote speakers Rob Chamberlin, Arabella Perez and presenters from MaineCare.

Entitled “Finding Focus within the System: Population Health for People with Chronic Conditions,” the session’s commitment to hearing and understanding patients was reflected in the first moments of the day when Maine Quality Counts’ Lisa Letourneau cued up a short video produced especially for the session that featured Marcus Brown, a patient at Portland Internal Medicine. With members of his multi-disciplinary and multi-agency care team, Marcus discussed the healing power that a vibrant medical neighborhood had had on both his physical and behavioral health care.

Watch the video:

The medical neighborhood is important to a patient, reflected Rob Chamberlin in his keynote speech, particularly when you’re able to quickly assess the impact that social determinants of health are having on that patient’s chronic disease. Chamberlin, a primary care physician and Medical Director at Maine Medical Partners, offered insights into the system that he and his former colleagues at Cambridge Health Alliance developed to uncover and address social determinants during the standard 15-minute patient visit, including:

  • Encouraging patients to tell their larger story to uncover social, economic or environmental underpinnings of their disease
  • Allowing the story to unfold over multiple visits
  • Framing a goal for conversations, like reducing frustration or building a relationship
  • Identifying actionable items in the patient’s story that can be worked into his/her care plan

“I think primary care is the best place to be in the health care system because we get to understand disease and fix problems in relationship with patients,” said Chamberlin. “We get to integrate medicine, pathology and treatment in the context of relationships.”

Watch Rob Chamberlin’s keynote address:

As we strive to develop a therapeutic relationship between patient and provider, it’s important to keep in mind that a patient’s past life experience can have a profound impact on disease and the effectiveness of medical treatment. That was one message of the day’s second keynote speaker, Arabella Perez. A social worker and UNE faculty member, Perez introduced participants to the prevalence of trauma in patients’ lives, the impact that trauma can have on both physical and behavioral health, and techniques for providing trauma informed care, like:

  • Creating a safe physical space like comfortable waiting rooms and private bathrooms
  • Acting in a trustworthy and transparent manner
  • Giving patients voice and choice


Beyond the keynotes, attendees participated in case studies, a demo of point-of-care diabetes testing and a breakout on understanding and addressing compassion fatigue. The take away message for the day? Allowing the time and setting up systems to hear patients well and understand their chronic diseases in the broader context of their lives and environments can often lead to a better experience for both patient and provider.

The next Maine Quality Counts learning session for Maine PCMH/HH/BHH participants happens at the Augusta Civic Center on Thursday. September 29th and will explore resiliency and sustainability.


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