Medical newspaper online, 11.10.2019
Direct-to-place prevention: Health kiosk manufacturers provide access to small thresholds to people in Hamburg's socially disadvantaged neighborhoods about prevention and health advice.
By Taina Ebert-Rall
Billstedt / Horn Health Kiosk Counseling Session: Patients are often told again about medical reports.
© Klaus Balzer
Hamburg. From sports groups for people with diabetes or heart disease to courses on healthy eating to advice for cancer patients or for mental health: The Billstedt / Horn Health Kiosk offers a wide range of services for people in these socially deprived neighborhoods of Hamburg.
Between the mobile phone shops and the Turkish vegetable market, Billstedter makes it easy for health kiosk operators to just go in and get free medical advice. "This is about attracting people and making prevention as easy as possible," says health economist Alexander Fischer, who runs the Billstedt / Horn Health business. "This is how we reach groups that don't respond to prevention otherwise."
Diabetes occurs ten years earlier
The project, which began in 2017 in the Billstedt Hamburg district, will be funded by the Innovation Fund until the end of 2019 and is part of a health network called "Gesundheit für Billstedt / Horn UG" with a major shareholder, Billstedt-Horn Medical Network, AOK Rheinland / Hamburg , DAK as well as Barmer in Billstedt and Horn counties, along with partners from the region on or expanding.
The importance of operating a health kiosk in the area is shown by the presentation of the disease. According to the AOK Rhine / Hamburg, chronic illnesses like diabetes in Billstedt / Horn occur almost ten years earlier than the Hamburg average. To change this, AOK Rheinland / Hamburg also supports the project by promoting a management and network structure, taking into account the measurement of quality and profitability, as well as the coordination and further development of standardized supply modules.
Patients can easily become members: they visit a health kiosk or one of the participating doctors, discuss a declaration of participation, a nice sticker to confirm their participation in a health card, and they can reap the benefits of the network for free. These include – in addition to support in therapy – making contacts in the healthcare system, clear explanation of medical reports, assistance in difficult family situations, and more.
For a wide range of counseling centers, the health kiosk works closely with other social institutions. Courses offered by external providers at the health kiosk premises include, among others, "Mental Health Consultations", "Hamburger Wegbereiter Consultations", "Hamburg-Mitte Consultation Center", cancer counseling and "youth and youth addiction counseling".
"Because of our low-threshold offerings and central location, the health kiosk has been well received," says Fischer, referring in the meantime to more than 3,500 registered members and more than 5,700 consultations that have already taken place at the kiosk. According to Fischer, topics of "weight", "diet" and "exercise" are listed in the "list" of discussions, followed by questions about "diabetes", "psyche" and "care".
Doctors switch to the kiosk
Fischer: "Nearly half of the patients treated here are doctors who refer us. Most of them are chroniclers, trained to become managers of their disease. This is a great vote of confidence for us. Doctors now know that well-educated people work here and give patients, for example, longer consultations with us "This applies, for example, to the intake of medicines that have been taken to a doctor or to a rehabilitation request. Other patients come from self-driving "because they've heard that we're helping people help themselves and giving us a lot of time to counsel," he says. Still others were familiar with social institutions such as primary schools or nursing homes at the health kiosk. "Even schools point to us, for example, when a child is constantly tired because he or she has to take care of a sick relative."
27 medical practices, three clinics and ten care providers are now partners in the project, 60 physicians belong to a network of physicians. The number of collaboration partners has since grown to 100. The health kiosk model is based on models from the US and Finland; In retail clinics and Terveyskioski health and counseling services are provided in shopping malls, supermarkets and drug stores.
Counseling in eight languages
The Billstedt Health Kiosk has six full-time health professionals working in the community nursing profession – including nurses, nurses, health care workers and nursing assistants. In preparation, they have undergone a comprehensive training program at the Institute of General Medicine and Clinic (IPA) of the University of Hamburg-Eppendorf and are seated with doctors, district institutions and associations established in Billstedt and Horn.
After all, employees often encounter difficult conversational situations during counseling, such as when the patient shows no insight into the disease or refuses to accept help. Therefore, counselors are regularly provided with further training and supervision. The emphasis of regular training courses is to discuss the patient and personally handle patients who have a complex need for care.
Consultants come from different cultures and can respond to patients in a culturally sensitive way. With eight languages in the team (Polish, Turkish, Russian, Farsi / Dari, Portuguese, Spanish and English), which are particularly common in the district, many of those seeking advice can also take care in their own language. After all, the proportion of people with a migrant background in the district is over 50 percent.
"By agreement IV, we signal that the new cross-sectoral model of care can, in our view, be permanently integrated into care," said Matthias Mohrmann, AOK Rheinland / Hamburg board member.
Further contributions from this topic