BWFH experts share best practices with visiting IHS provider

Chandima Deegala, BS, PharmD, NCPS-PP, CTTS, is a pharmacist practitioner at the Northern Navajo Medical Center in Shiprock, New Mexico, and a Motivation Interviewing (MI) instructor. He sees patients in the primary care setting and also works with patients with substance abuse disorder (opioids, alcohol and tobacco). As a provider in the Indian Health Service (IHS), a federal agency within the Department of Health and Human Services, he delivers care to patients living in remote areas of the country with limited access to specialty services.

As an IHS provider, Dr. Deegala faces many challenges. In addition to the limited availability of specialty services, the IHS is underfunded compared to other federal healthcare programs and providers do not have access to new medications available in a large academic medical setting like Brigham Health.

Recognizing the lack of resources available to American Indian/Alaskan Natives, Brigham Health offers an outreach program to the IHS where our experts share best practices with their providers via video conferencing and in-person visits to IHS hospitals on the Navajo reservation. The program also includes hosting IHS providers at Brigham Health. Dr. Deegala recently visited Brigham and Women’s Faulkner Hospital as part of a five-day trip to Boston that also included meetings at Brigham and Women’s Hospital.

Here at BWFH, Dr. Deegala visited Brigham and Women’s Sleep Medicine and Endocrinology Center where he shadowed Colleen Smith, NP. “In the Diabetes Clinic, I got to see all of the latest medications Brigham Health providers have access to,” says Dr. Deegala. “We currently have very limited resources as far as medications go. We’re in the process of trying to get access to some of these medications and I was able to learn more about them. That was great!”

Smith, who specializes in the treatment of patients with diabetes, was thrilled to be part of the program. “It was a pleasure meeting Chad and hearing about the amazing work he does and the challenges in providing care,” she says. “His energy and enthusiasm for providing the best care for patients was contagious!”

The next day, Dr. Deegala met with Director of Addiction Services Claudia Rodriquez, MD, psychiatrist Claire Twark, MD, and Social Work Supervisor Julia Trumble, LICSW, in the Outpatient Suboxone Practice for Opioid Addiction. “I got to see how the providers use Suboxone to treat alcohol dependence and I was able sit in on some patient interactions. That was very valuable information that I will take back to New Mexico,” he says. “I was also interested in learning more about Vivitrol (naltrexone), which I use with my alcohol-dependent patients. I had questions about alternative medications for patients with liver problems.”

On his last day at BWFH, Dr. Deegala spent time with Director of the Dual Diagnosis Partial Hospital Program and attending psychiatrist for the Outpatient Suboxone Program Saria El Haddad, MD, learning more about medication-assisted therapy for substance use disorder. “I really enjoyed meeting Chad and learning about the work he does with IHS,” she says. “Being a public health officer, Chad shared some of the touching experiences he has had in the field and told me that his work with IHS has been one of the most gratifying experiences he has had. I am now looking forward to doing a site visit to New Mexico.”

Overall, Dr. Deegala says his time spent in Boston was well worth the travel. “It has been amazing visiting Brigham Health through the Outreach Program. The information that we get from your experts is invaluable,” he says.

To learn more about opportunities with the Brigham Health Outreach Program with Indian Health Service, please contact Medical Director Tom Sequist, MD, MPH, or Senior Project Manager Ellen Bell. To learn more about the program, watch this video.