Browsing by Author "Hernandez, Ruben"

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    Prenatal Care Cards: Imparting Patient Autonomy During Pregnancy.
    (2022-03-30) Qureshi, Hamna; Brown, Lucy; Hernandez, Ruben; Ford, Lauren; Carson, Katie
    Introduction/Problem: Indiana University Student Outreach Clinic (IU-SOC) has been providing medical care to vulnerable populations for the past 12 years. In that time, students have witnessed barriers to care impacting the neighbors in the community, including lack of health insurance due to financial limitations or limited residency documentation. These barriers are particularly burdensome to pregnant patients, and the bimonthly Prenatal Clinic was created five years ago to address this need. A major limitation is ensuring effective communication between the IU-SOC Electronic Medical Record (EMR), Practice Fusion, and the multiple health systems in the community. Intervention: After reviewing the Pan American Health Organization (P.A.H.O) recommendations for similar communities, we created a tool that can be utilized at all outreach clinics: the prenatal care card. These care cards contain all relevant prenatal information such as first, second, and third trimester prenatal labs, blood pressure measurements, fetal anatomy ultrasound results, and other tests that will allow providers to establish baseline values that determine future care. The card can be easily translated for improved clarity and is printed on sturdy, laminated cardstock. IU-SOC contact information is included on the bottom of the card in case future providers have concerns, and patients receive a photocopy of the card for safekeeping. Our copy is uploaded to Practice Fusion for future reference at IU-SOC. Conclusion: The IU-SOC prenatal care card has been implemented as a way to communicate between the clinic and other healthcare providers, in accordance with P.A.H.O. standards of perinatal care. Since September 2021, four IU-SOC patients have been offered the prenatal care card and have expressed overall satisfaction so far. The value of the prenatal card is three-fold: to provide patients with ownership of their medical information, to be easily shareable with any medical center, and to enhance their pregnancy experience overall. The utility of the prenatal card will be further established as more pregnant patients are provided this tool.
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    Understanding Traumatic Brain Injury in the Primary Care Setting
    (Office of the Vice Chancellor for Research, 2016-04-08) Gano, Laura; Kean, Jacob; Renshaw, Scott E.; Hernandez, Ruben; Willis, DeAnna
    Background: TBI is being re-conceptualized as a chronic disease causative agent rather than as a single, acute event. This study examined how familiar family medicine physicians (PCPs) are with TBI and their level of confidence in treating TBI sequelae likely to be seen in primary care. We also examined PCP attitudes regarding care for post-acute mild TBI and moderate/severe TBI in primary care and how recently the respondent had cared for a mild TBI and/or moderate/severe TBI patient. Methods: The study featured a mixed methods study design. A survey was administered on paper and electronically. A semi-structured qualitative interview guide was developed based upon survey responses. Descriptive statistics were calculated. Results: Most respondents associated neurological symptoms/conditions as TBI sequelae: irritability, 100.0%, fatigue, 98.0%; insomnia, 88.2%, depression, 98.0%, headaches, 98.0%, anxiety, 80.4%. Two-thirds (66.7%) identified epilepsy as a condition associated with TBI. Just over one-half associated tinnitus (51.0%) or loss of libido (52.9%) with TBI while only one-third (33.3%) associated incontinence with TBI. Most physicians felt confident treating depression (84.0%), anxiety (82.4%), headache (80.4%) and insomnia (76.0%). Physicians felt less confident in treating fatigue (68.0%), irritability (68.0%), incontinence (51.2%) and loss of libido (50.0%). The least amount of confidence was claimed in treating epilepsy (37.5%) and tinnitus (36.4%). All respondents (100.0%) believed that a PCP can manage post-acute mild TBI (concussion) care while 52.0% agreed that a PCP can manage post-acute care for moderate/severe TBI. Only one respondent (2.0%) had never cared for a mild TBI patient. Most (70.6%) had cared for a moderate/severe TBI patient within the past two years while 5.9% had cared for one of these patients more than a year ago. Nearly twenty percent (19.7%) had never cared for a moderate/severe TBI patient and 3.9% were unsure if they had.