At noon (EST) at www.dailypress.com on Wednesday, Oct. 19, readers met Dr. Kyle Allen, the new head of gerontology at Riverside, and asked him about senior medicine and services at Riverside.

 Ask the Experts: Meet Dr. Kyle Allen, Riverside chief of gerontology(10/19/2011) 
11:56
Prue: 
In today's live online chat, we're interviewing Dr. Kyle Allen, the recently appointed director of Geriatric Medicine Services at Riverside Health System in Newport News.
Wednesday October 19, 2011 11:56 Prue
11:57
Prue: 
Readers: This is your opportunity to ask questions of Dr. Allen about senior medical care and services -- what Riverside has to offer and any changes or additions that he has in mind.
Wednesday October 19, 2011 11:57 Prue
11:57
Prue: 
Dr. Allen, Please let readers know when you're online and they can start asking questions.
Wednesday October 19, 2011 11:57 Prue
11:58
Prue: 
Readers: Do you have a question about senior care? Have you taken advantage of any of Riverside's programs? are you familiar with the PACE program?
Wednesday October 19, 2011 11:58 Prue
11:58
Kyle Allen DO: 
This is Dr Allen and I am on line.
Wednesday October 19, 2011 11:58 Kyle Allen DO
11:58
Prue: 
For all your health news, go to www.dailypress.com/health or to www.dailypress.com/healthnotes, my daily blog, to keep up with what's happening in health both nationally and locally.
Wednesday October 19, 2011 11:58 Prue
12:00
Prue: 
Welcome Dr. Allen. Could you tell readers something about your background before joining Riverside and the national role you play in geriatric care policy.
Wednesday October 19, 2011 12:00 Prue
12:02
Kyle Allen DO: 
For the past seventeen years, I have been with Summa Health System in Akron, OH, where I served as the Medical Director of Summa's Institute for Senior and Post Accute Care. I have been a researcher a policy advocate clinician and teacher regarding older adults and those with chronic and complex illness.
Wednesday October 19, 2011 12:02 Kyle Allen DO
12:02
Prue: 
What attracted you to Riverside?
Wednesday October 19, 2011 12:02 Prue
12:03
[Comment From DHBDHB: ] 
Dr. Allen, how do you hope to make a major impact on senior care at Riverside over the next 18 months?
Wednesday October 19, 2011 12:03 DHB
12:04
Kyle Allen DO: 
Summa Health System is a large not for profit integrated delivery system that also includes a health plan and five hospitals. Riverside has a unique culture vision and services that are specifically oriented to improving the health and well being of older adults.
Wednesday October 19, 2011 12:04 Kyle Allen DO
12:05
Kyle Allen DO: 
There is already a great degree of work that has been going on at Riverside in this area and I hope to join that team and bring some of my experience and knowledge to advance care, quality, and safety for older adults and those with chronic and complex illness.
Wednesday October 19, 2011 12:05 Kyle Allen DO
12:06
[Comment From GuestGuest: ] 
What is the PACE program and is it unique to this area?
Wednesday October 19, 2011 12:06 Guest
12:07
Kyle Allen DO: 
PACE stands for the Program of All Inclusive Care of the Elderly, and is a sucessful model of how best to deliver a team based approach of care to older adults
Wednesday October 19, 2011 12:07 Kyle Allen DO
12:08
Prue: 
What exactly does PACE involve. Do you need insurance to participate?
Wednesday October 19, 2011 12:08 Prue
12:09
[Comment From GuestGuest: ] 
Do you think health care reform has helped or hurt senior care
Wednesday October 19, 2011 12:09 Guest
12:10
Kyle Allen DO: 
PACE enrolls individuals that are age 50 or greater, are of low income and have complex and chronic illnesses. This is paid for via a unique combination of Medicare and Medicaid insurance systems. Thus persons must qualify.
Wednesday October 19, 2011 12:10 Kyle Allen DO
12:11
[Comment From GuestGuest: ] 
Are there any new trends in senior care?
Wednesday October 19, 2011 12:11 Guest
12:11
Kyle Allen DO: 
Heath care reform has some promise for improving care for seniors by creating and testing some new models in payment and programs that are not currently covered by Medicare. I think there is much that needs to change and at least this was a first step to trying to do something different.
Wednesday October 19, 2011 12:11 Kyle Allen DO
12:12
Prue: 
Could you be specific about ONE change that you would like to see.
Wednesday October 19, 2011 12:12 Prue
12:13
Prue: 
What are those "new models in payment and programs"?
Wednesday October 19, 2011 12:13 Prue
12:13
Kyle Allen DO: 
New trends are beginning to emerge in areas of supporting transitions of care for example from hospital to home as well as innovative ways to better coordinate and support care.
Wednesday October 19, 2011 12:13 Kyle Allen DO
12:15
Kyle Allen DO: 
The one change that I have been working on as a clinician, researcher, and health policy advocate is to demonstrate that the medicare benefit needs to include payment for care coordination which does not today.
Wednesday October 19, 2011 12:15 Kyle Allen DO
12:16
Prue: 
So would that be the responsibility of the primary care physician or another person?
Wednesday October 19, 2011 12:16 Prue
12:17
Kyle Allen DO: 
New models include things like adding case managers to physician offices to work in teams to better coordinate care and teach patients about self care of their chronic conditions. Specific models include CARE TRANSITIONS, GUIDED CARE, THE GRACE PROGRAM.
Wednesday October 19, 2011 12:17 Kyle Allen DO
12:17
[Comment From GuestGuest: ] 
Do you think that there will be a shortage of qualified individuals to provide care to seniors and if so do you have any thoughts on how Riverside can meet this challenge.
Wednesday October 19, 2011 12:17 Guest
12:18
Prue: 
Guest's question mirrors one I was going to ask about Medicare reimbursements and how they're affecting quality of care.
Wednesday October 19, 2011 12:18 Prue
12:19
Kyle Allen DO: 
Yes the Primary Care Physician would be responsible for organizing and ensuring that care coordination and best practice for chronic illness care occurs. Many have been using the term the patient centered medical home concept which describes this fundamental change of how primary care and specialty care needs to be reorganized.
Wednesday October 19, 2011 12:19 Kyle Allen DO
12:22
Kyle Allen DO: 
Yes I believe one of the greatest issues facing our ability to organize to these new models is a lack of trained health professionals and allied professionals regarding the unique care aspects of those of older adults with chronic and complex illness.
Currently Medicare policy rewards procedures and episodic illness care not comprehensive and coordinative care.
Wednesday October 19, 2011 12:22 Kyle Allen DO
12:22
Prue: 
Readers: we are talking to Dr. Kyle Allen, DO, the new director of geriatric medicine services at Riverside Health System. You have 5 minutes left to ask your questions.
Wednesday October 19, 2011 12:22 Prue
12:23
[Comment From GuestGuest: ] 
Do you think the well visits now paid for by Medicare will reduce chronic illnesses in seniors?
Wednesday October 19, 2011 12:23 Guest
12:24
Prue: 
For general health information, both local and national, go to www.dailypress.com/health for daily updates.
Wednesday October 19, 2011 12:24 Prue
12:25
Prue: 
Join us every Wednesday at noon for a health-related chat. Next week's chat is on hearing loss and the latest developments in assistive devices and hearing aids.
Wednesday October 19, 2011 12:25 Prue
12:25
Prue: 
We're now talking to Dr. Kyle Allen, head of geriatric services at Riverside.
Wednesday October 19, 2011 12:25 Prue
12:25
Kyle Allen DO: 
Great question. I believe only this will occur if the appropriate patient education, patient goals, and activation of patients in self care occur. So often today we miss the opportunity of the well visits to really focus on wellness and planning and remain too diseased focused.
Wednesday October 19, 2011 12:25 Kyle Allen DO
12:26
Prue: 
What do you think is Riverside's greatest strength when it comes to senior care/services?
What is your top priority to add/change at Riverside regarding senior care.
Wednesday October 19, 2011 12:26 Prue
12:27
Prue: 
What can patients do to effect the changes -- such as patient-centered medical care and payment for ancillary staff -- that you advocate?
Wednesday October 19, 2011 12:27 Prue
12:28
Prue: 
Could you answer the question about a shortage of qualified individuals/Medicare reimbursements.
Wednesday October 19, 2011 12:28 Prue
12:29
Prue: 
Readers - we are just waiting for Dr. Allen to answer the last couple of questions.
Wednesday October 19, 2011 12:29 Prue
12:29
Kyle Allen DO: 
It's vision, committment, and it's investment in developing post acute services for older adults and those with chronic and complex illness. My major focus will be bringing evidence based models of care for older adults and those with chronic and complex illness to the acute hospitals and linking all parts and continum together.
Wednesday October 19, 2011 12:29 Kyle Allen DO
12:30
Prue: 
Dr. Allen, After you answer the last question, could you tell readers how to reach Riverside and learn more about the services it has for geriatric medicine.
Wednesday October 19, 2011 12:30 Prue
12:31
Kyle Allen DO: 
Patients need to get involved in talking about what doesn't work and what does work to their legislative officials and where possible get involved in community groups or support groups that can carry uniformed messages forward.
Wednesday October 19, 2011 12:31 Kyle Allen DO
12:32
Prue: 
Are there any specific advocacy groups you can recommend that people get involved with?
Wednesday October 19, 2011 12:32 Prue
12:33
Kyle Allen DO: 
We hope to address the shortages at Riverside by exploring advanced training programs and fellowships for nurses, physicians and other allied health professionals in Geriatric Medicine, Pallative Care Medicine and Hospice. This training and education has already started.
Wednesday October 19, 2011 12:33 Kyle Allen DO
12:35
Prue: 
Great. Dr. Allen -- thanks very much for your participation and letting readers know some of what's going on at Riverside in terms of geriatric services. Please give contact information and then I'll close the chat.
Wednesday October 19, 2011 12:35 Prue
12:36
Prue: 
Readers: Don't forget to join us next week at noon on Wednesday when we talk to audiologist Deborah Minnis about hearing loss and what to do about it.
Wednesday October 19, 2011 12:36 Prue
12:37
Kyle Allen DO: 
Parkinsons Disease support groups, Alzheimers association. The area agencies on aging, national council on aging, and many others.
Contact information please contact Denise Staples @ 757-534-6101.
Wednesday October 19, 2011 12:37 Kyle Allen DO
12:37
Prue: 
Thanks very much. Bye.
Wednesday October 19, 2011 12:37 Prue
12:37