Avoiding Systemic Collapse: Increasing Deployment of Community Health Workers is a Just in Time Response to a Dwindling Healthcare Workforce

By the year 2033, the U.S. will experience a shortage of up to 139,000 physicians. The brave professionals who are doing their best amidst the growing shortage are feeling the burden. Nearly 50% of primary care physicians are experiencing burnout.

Meanwhile, experts predict a shortage of more than 78,000 registered nurses next year. Almost two-thirds of nurses are experiencing burnout.

In a system that is already buckling beneath the onslaught of demands from an aging population, the rates of professional shortages and burnout are even more alarming and problematic. We are operating within an environment that is increasingly fragmented, inefficient and expensive. There is inadequate access. Care coordination and quality are inconsistent. Social determinants of health largely go undetected and unaddressed.

With this backdrop, it is no surprise that we are seeing the deployment of non-clinical resources to extend the reach of medical professionals.  In many cases, these resources are being sent directly to the homes of individuals who are struggling with chronic disease.

In many situations, an individual’s health plan, and/or local community, offer valuable programs and resources, but members need guidance in order to find and engage with these offerings. As a result, we are seeing the rise of the Community Health Workers (CHW) as a profession. CHWs can serve as a liaison to care, and as a resource that is the eyes and ears of the clinical care team. This is particularly true when they are deployed to the home.

There is mounting evidence that lay people can effectively address basic medical needs and boost engagement in the process. Studies have shown that in some ways, a lay person might even be more effective than credentialed medical professionals in motivating healthy behaviors. Often seen as peers, lay people can put individuals at ease and successfully influence them. Instead of an authoritative relationship with someone in a white coat or with medical degrees hanging on a wall, the interaction is with someone more relatable – a friend, even. It creates an entirely different interpersonal dynamic.

Typically, a CHW is hired by a healthcare organization to serve the communities where they reside. This means CHWs are usually demographically and socio-economically similar to the patients they support. CHWs can be a mission-critical part of healthcare teams because they’re able to relate with patients, build trust and improve overall care coordination for individuals, incorporating not only medical needs but also social determinants of health.

When sending a peer to the home, it should be someone who can relate, empathize and connect with the member. We’ve found that listening skills and empathy are the two biggest predictors of positive engagement by a peer resource. Given the intricacies and sensitivities of healthcare, the right training curriculum is critical. For example, peers should be educated on HIPAA and how to keep PHI secure. Technology can also play a vital role. Automating tasks or providing technology-guided assistance, such as a mobile app that prompts them through the completion of a health assessment, significantly increases success rates.

At Belle, we’ve essentially integrated the CHW role into the responsibilities of our nail technicians, who go into the homes of older adults and provide them with medical pedicures. While we focus first on foot care, we train our technicians to conduct whole health assessments, which include an evaluation of lower extremities, clinical screenings, social determinants of health and fall risk screenings. Within 4 hours, our remote nurses review visit data and, if warranted, open a clinical case to ensure members are connected with support and care coordination with PCPs, podiatrists, case management and other in-home care providers.

Our model is just one example of innovative programs that leverage previously untapped resources to ease the burden on providers amidst an unprecedented professional shortage.  We believe there is more to come with regard to this trend, as we try to accommodate individuals’ desire to age well at home amidst a shrinking healthcare workforce.

Want to learn more about how Belle deploys CHW resources to extend care to the home? Contact us today for a 1:1 consultation.