Healthcare Collaborative Serving High-Needs Residents of Local Counties Welcomes New Executive Director

Lanham, Maryland – Launched in 2015, Totally Linking Care in Maryland (TLC-MD) is a consortium of medical organizations that serve as a care coordination bridge between community residents, post-acute care providers and primary care doctors.  This free service advances the continuum of care for high-risk and high-needs patients who are admitted into hospitals located in Prince George’s, Calvert and St. Mary’s Counties in Maryland.  Given the growth of this initiative, TLC-MD welcomed David Chernov as its first executive director in June 2018.

Chernov’s experience combines healthcare delivery and medical information technology, which contributes to his in-depth understanding of the evolving healthcare industry.  Most recently, he served as a managing partner at MidAtlantic Consultants, LLC, assisting senior-level healthcare leaders develop and execute strategic business plans.  His clients included HealthShare Exchange of Southeast Pennsylvania (HSX) and Chesapeake Regional Information Systems for Patients (CRISP). 

Additionally, Chernov held vice president leadership roles at Fortune 500 companies including Cardinal Health, CareFusion and DaVita Healthcare Partners.  He has a Bachelor of Science degree in microbiology from the University of Maryland. 

After serving on the advisory board and as the committee chair of the data integration committee for TLC-MD, Chernov recently accepted the position of executive director.  His acceptance of this role was motivated by key principles of the organization.  “Hospitals in this area are committed to supporting physician practices and post-acute care providers to elevate the coordination of care, especially for high-needs patients – people who have challenges managing chronic diseases or those who seek repeated care in area emergency rooms. These types of concerns are shared by healthcare leaders throughout the country.  I am excited to be a part of TLC-MD – an organization that is making a significant difference in people’s lives.  What we are doing could very well be a template or gold standard practiced throughout the country,” stated Chernov.

TLC-MD’s participating hospitals use eQHealth’s population health module to identify high-risk and high-needs patients during hospital admissions.  As part of this process, a certified clinical coordinator collaborates with patients and their primary care physicians by:

  • Collaborating to develop personalized care plans
  • Providing disease, medication and nutrition management education
  • Helping patients address obstacles (e.g. transportation, housing, food, etc.) that may hamper their ability to receive needed health care
  • Conducting depression and other screenings while recommending related community resources
  • Assisting with the scheduling of follow-up appointments and the refilling of prescriptions

For example, medication management is a major program focus.  According to Chernov, “Some people who frequent emergency rooms to help manage their chronic diseases often leave the hospital with new prescriptions and also have numerous medications at home.  For others, they may have received prescriptions, but did not fill them at their local pharmacies.  Yet others may have picked up their prescriptions, but are not taking them as prescribed.  So, we encourage patients to inform their doctors about all the medications or prescriptions they have.  We even give patients ‘blue bags’ and ask them to place all such items in the bags.  Then, we instruct patients to share the bags with their doctors during primary care appointments or home visits to receive medication management counseling.  By doing so, patients can get clearer guidance on how to manage their medications.  At the same time, doctors have more complete insights about their patients’ medication adherence behaviors.”

To help monitor patients’ short- and long-term outcomes, the TLC-MD team uses CRISP.  CRISP is the state’s health information exchange designated by the Maryland Health Care Commission.  CRISP allows clinical information to be securely and electronically collected.  Additionally, data is shared with and assessed by the respective patients’ care teams to help ensure effective and efficient care coordination.  The TLC-MD program also aligns with the Maryland Total Cost of Care Model implemented in the state to maintain and lower the growth in Medicare costs in comparison to national rates. 

“TLC-MD is driven to help people stop the cycle of preventable hospital readmissions and declining health outcomes, which are regional concerns, especially within underserved areas of the community.  At the same time, TLC-MD serves as a bridge between patients and their primary care physicians and post-acute providers to strengthen those relationships, improve the quality of people’s lives and reduce the overall cost of health care while simultaneously improving patient outcomes,” stated Chernov.  “We are encouraged by the successes that TLC-MD has accomplished thus far, and we are excited about the greater impact that we will have in people’s lives in the future.”

###

About Totally Linking Care in Maryland (TLC-MD)

TLC-MD is a population health consortium.  Its mission is to identify residents of Prince George’s, Calvert and St. Mary’s Counties who are high-risk and high-needs patients.  At the same time, the collaboration aims to develop tools that help medical providers improve the coordination of patient care, elevate short- and long-term patient outcomes and lower overall healthcare costs. 

This program is funded by an annual grant provided by the Maryland Health Services Cost Review Commission and the Maryland Department of Health and Mental Hygiene. TLC-MD’s advisory board includes:

  • Calvert Health Medical Center
  • Community Health Partners (home health organizations, nursing homes, pharmacies, etc.)
  • Doctors Community Hospital
  • Fort Washington Medical Center
  • Health Quality Innovators, CMS QIO
  • MedStar Southern Maryland Hospital Center
  • MedStar St. Mary’s Hospital
  • University of Maryland Prince George’s Hospital Center
  • University of Maryland Laurel Regional Hospital
  • Area Agencies on Aging
  • Calvert County Health Department
  • Maryland State Medical Society and Primary Care Providers
  • Prince George’s County Health Department

For more information about TLC-MD, contact David Chernov, executive director, at 301-788-2237 or david.chernov@tlc-md.org.