Jan. 6, 2012 OHA Director's messages on the web
To: All OHA employees
From: Bruce Goldberg, M.D., Director

Inspiration for the new year

"The more original a discovery, the more obvious it seems afterwards." ~ Arthur Koestler

I want to start this week by wishing a happy new year to everyone. I began the week continuing to meet with OHA employees to talk about what the coming transformation in health care means for our clients, our communities and our staff. I was struck by the excitement and interest from our staff about the opportunities before us. I also greatly appreciate that people were willing to talk about what they think these changes might mean for them. These meetings will be continuing over the next several weeks; if there hasn't been one in your section, there will be soon.

It's clear to me from these conversations that there is a deep commitment to our clients and an understanding of how better-coordinated care can improve people's lives. For example, look at asthma.

Asthma is the most common chronic disease among children - and it is especially prevalent in low-income households. Although asthma can be well controlled by medication and preventive measures, Oregon children went to hospital emergency rooms for asthma attacks 550 times in 2006, according to the state Asthma Program. The average cost of a hospital visit for asthma was $12,000. The Oregon Health Plan paid more than $5.5 million in 2007 for hospital care of asthma.

Recently a story came across my desk that highlights how simply changing the way we deliver care and the services we pay for can reduce those costs and make children's lives better.

Malik lives in the Portland area. He is 8 years old, is in the third grade and also has asthma. This can severely affect his health. A dust mite, cigarette fumes or a chemical additive in scented soap can trigger a severe reaction in his nose, throat, windpipe or lungs. He starts to wheeze and gasp for breath.

In the past, asthma attacks used to send him to the emergency room once or twice a month because he would get to the point where he couldn't breathe.

Today, that almost never happens.

His mom enrolled him in Multnomah County's Healthy Homes program, which helps children with asthma get control over their disease through careful choice of medications and reduction of environmental hazards in the home.

Together with his primary care team at Portland's Northeast Health Center, it has helped Malik bring his asthma under control and drastically reduce his trips to the hospital. The new coordinated approach involves reduced exposure to household asthma "triggers,' a home nebulizer to convert his medication into a quicker-acting mist, and a portable mini-inhaler to help him overcome wheezing attacks at school or on the playground.

Healthy Homes visited the Wilkerson home to search for asthma triggers and recommend preventive steps such as natural cleaning agents, mold prevention, non-allergenic bedding and a special vacuum cleaner that captures dust without releasing any into the air.

Since Malik started using the nebulizer and special bedding and since his mom substituted vinegar-based cleaners for scented detergents, he has made only two visits to the hospital for asthma.

This is the kind of hands-on, low-cost prevention work that needs to happen across the state. And it's exactly what we are looking toward with Coordinated Care Organizations so that the Maliks in every part of Oregon will have healthier, happier lives.

OHA on the web