Kirkpatrick Family Care's new programs

CHRONIC CARE MANAGEMENT (CCM)
Elissa Brentano has been named our Chronic Care Management Coordinator.  Elissa will contact make follow up calls to Medicare patients who have 2 or more chronic illnesses or conditions.  This is a Medicare program that is free to most Medicare patients, and helps patients to better participate in the treatment programs for their chronic conditions.

CONTINUOUS GLUCOSE MONITOR TESTS
The ”C.G.M.” system measures one’s blood sugars every 15 minutes for 2 full weeks, nearly 1100 readings.  These are downloaded onto a 6 page report that is discussed with the patient by the provider.  We have seen many patients who run dangerously high or low levels without symptoms.  This is augmenting or replacing the A1-C, which is an average of all sugar levels over a 3 month period.  This test is covered for patients with diabetes and can be repeated as needed to disclose the effects of changes in diet, exercise, or medications (or all 3). 

NIOX TEST
Nitric Oxide is exhaled when we breathe out.  High scores correlate with allergies/asthma.  These results help us to decide whether the patient needs cortisone or not, when they deteriorate.   Surprisingly, many people with “COPD” (emphysema) have a high NIOX score, and hence are suffering from asthma in addition to the emphysema.  For a positive NIOX score above 24, we add oral or inhaled corticosteroid (ICS); for low scores, we would ad a Long Acting Muscarinic Antagonist (LAMA) to the usual Long Acting Beta Agonist (LABA).  Combination LABA-LAMA drugs include Anoro, Bevespi, Utibron, Stiolto.  LABA-ICS drugs include Symbicort, Dulera, Breo.

DIABETIC EYE EXAMS
In the near future, we will be doing these exams at KFC, and sending the images to be interpreted by a board certified ophthalmologist.  Annual exams are mandated by Medicare and all Diabetic groups.  Having the camera in house will facilitate compliance with these regulations.