Table 1.
Example Clinic A | Example Clinic B | Example Clinic C | Example Clinic D | |
---|---|---|---|---|
Provider team | Pediatric hematologist + adolescent medicine NP | HTC NP + adolescent medicine physician | HTC pediatric hematologist + adolescent gynecologist | HTC pediatric hematologist + adolescent medicine physician |
Location | HTC clinic | Adolescent medicine clinic | HTC clinic and gynecology clinic | HTC clinic |
Clinic frequency | Two half-days/month | Four half-days/month | Asynchronous visits | One half-day/quarter in combination with HTC comprehensive clinic |
Patient populations | Anyone diagnosed with IBD and HMB | Anyone with HMB needing evaluation for underlying bleeding disorder | Each provider sees patient with HMB, either with or without diagnosed IBD | Anyone with HMB needing evaluation for an underlying IBD; anyone diagnosed with IBD and HMB |
Bonus features | Access to nutritionist on-site | On-site/day-of visit; intrauterine device insertion | HTC social worker evaluates each patient for underlying anxiety/depression | Access to all HTC services; space for IV infusions |
Challenges | Growing patient population; no clinic rooms to expand to | Getting coagulation lab work, since coagulation lab is off-site | Visits are asynchronous; specialists consult with one another via multiple platforms | No access to gynecologic procedures |
Opportunity | Add telehealth option; consider outreach clinic | Arrange labs to be done at HTC; coordinate referrals to other HTC services as needed | Organize pre- and post-clinic time to discuss patients, create treatment plans, and assign follow-up tasks | Arrange for procedures with a gynecologist who primarily sees adolescents |
HMB, heavy menstrual bleeding; HTC, Hemophilia Treatment Center; IBD, inherited bleeding disorder; NP, nurse practitioner.