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Improving Health - Medical-Legal Partnerships

 

Medical-Legal Partnership

University of Nebraska Medical Center

To gain a better understanding of cross-sectoral approaches to addressing the social determinants of health, AAHC is interviewing individuals from organizations that utilize non-healthcare approaches to improve health. Here, we look at organizations involved in medical-legal partnerships.

An interview with Kerry Rodabaugh, MD
Associate Professor, Obstetrics and Gynecology, Principle Investigator, Gynelogic Oncology Group, University of Nebraska Medical Center


Describe what you do for work and the vision/mission of your organization.

I am an academic gynecologic oncologist, providing care for women diagnosed with gynecologic malignancies – including surgery, provision of chemotherapy, and end of life care. I am also board certified in hospice and palliative care and have a strong focus on quality of life issues. Beyond providing exemplary patient care, the further mission of my university is to educate medical students and residents, as well as conduct research.

Tell us about the socio-demographic and socioeconomic factors and conditions in the community, population, or constituency you or your organization serves.

The Nebraska Medical Center is the academic center for the school of medicine, which serves the population of Omaha, a Midwestern midsize city. We have a significant population of uninsured, homeless, and minority patients from the region; and as the only level III trauma center in the area, we care for victims of domestic or gang violence and other trauma. We are also nationally renowned for our lymphoma and small bowel transplant programs, and have patients from across the country and world referred to us.

What is the link between the social determinants of health and your work?

As an oncologist, I have seen social determinants interfere with a patient’s ability to receive the necessary care for life saving treatment. I view that addressing the social determinants of health is important to solving upstream problems, which can prevent other health problems from occurring.

How is your work aimed at addressing an aspect of the social determinants of health?

Our Medical-Legal Partnership (MLP) addresses social determinants of health by resolving civil legal needs that patients may have. This in turn allows the patients to devote their resources towards their medical care.

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What are your goals for the program(s)? How do you measure and evaluate these goals?

The goal of our program is to improve the quality of life for patients needing assistance. We measure the financial return on investment to the hospital, which provides the hospital with the incentive to continue funding the program. We have been quite successful with this measurement, but this is not my long-term goal for the program. More importantly, I would like to measure and prove the health benefit of the medical-legal partnership. We are in the preliminary stages of this measurement and are currently developing a plan to collect data. We are also participating in a project at the National Center for Medical-Legal Partnerships, which is looking at developing additional tools for measurement of outcomes.

How do you financially sustain these programs?

We are 100 percent hospital funded, with a budget of $235,000 per year, which provides legal services to oncology, solid organ transplant, emergency department, and trauma patients, as well as two primary care clinics in the community. We are planning for continued growth, and hope to eventually expand to all Nebraska Medicine patients.

Are there additional resources or partners needed to accomplish these goals? What are they?

Eventually we would like to be able to connect to other MLP programs at other hospitals in the city and statewide.

What opportunities do you see for connecting your work with the work of academic health centers?

Our MLP is already embedded within the University of Nebraska Medical Center. However, as a board member for Iowa Legal Aid, I have lobbied the University of Iowa to develop an MLP at their academic medical center. Through connections with the National Center for MLP’s I continually collaborate and network with other investigators from academic health centers across the country doing similar work.

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“The goal of our program is to improve the quality of life of patients needing assistance.”

 

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