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Outreach

In 1925 James B. Duke willed $4 million to establish Duke Hospital and its medical school. His goal: to improve health care in the Carolinas, then a relatively poor region lacking in hospitals and care providers.

Duke Medicine has devoted itself to that goal ever since, making sure that people across the region are able to get the medical care they need regardless of their ability to pay.

In fiscal year 2011, DUHS provided $323.5 million in charity care and other community benefit investments. This includes charity medical care provided to low-income patients at a cost of $64.7 million, health professionals' education of $46.8 million, and in-kind service contributions and direct support payments of $9.5 million ($8.7 million to Lincoln Community Health Center and EMS). DUHS also absorbed Medicaid program losses of $89.2 million, Medicare program losses of $90.3 million, and unrecoverable patient debt at a cost of $23 million.

Community Partnership Facts

Duke works with many community partners to improve health care in its hometown, Durham, North Carolina. Examples of local outreach programs include:

  • Primary care Wellness Centers within four Durham public schools, serving mostly low-income youngsters: George Watts Elementary, Glenn Elementary, EK Powe Elementary, and Southern High schools. Clinics operate during the school year and provide medical and mental health services. The elementary school clinics also provide bilingual mental health services. All four Wellness Centers offer medical coverage during weekends and school holidays.
  • Just for Us/Promising Practices, providing primary care, case management, nutrition counseling, and occupational therapy services for frail, medically complex elderly patients and adults with disabilities in their apartments, based in 13 public or subsidized senior housing sites
  • Lyon Park Clinic, a neighborhood clinic providing primary care to low-income Durham patients in a community center in Durham's West End, operated in conjunction with Lincoln Community Health Center
  • Walltown Neighborhood Clinic, providing primary care to low-income patients at 815 Broad Street in Durham’s Walltown neighborhood, operated in conjunction with Lincoln Community Health Center and offering a clinic for teens on Thursday evenings
  • Durham Community Health Network, providing in-home chronic-disease management, patient support, health education, and patient advocacy to 24,000 Medicaid patients who are enrolled at eight Duke and community primary care practices
  • Local Access to Coordinated Healthcare (LATCH), providing bilingual in-home health education on chronic disease, patient support, and advocacy for uninsured Durham residents; since 2002, more than 18,000 uninsured residents have enrolled in LATCH
  • Learning Together, providing health education in selected public schools, assistance to patients to apply for public benefits, and support to Duke’s partner agencies through Duke staff and trained health learners
  • Chronic Disease Education, with materials prepared for and taught to physical education teachers of Durham middle and high school children
  • ALMA (Amigas Latinas Motivando el Alma), a joint research program with the University of North Carolina at Chapel Hill to train Latinas in mental health coping skills and teaching those skills to their peers in Durham and Chatham counties
  • BieneSTAR, a bilingual mental health service for Latino families and children enrolled in the school-based clinics at EK Powe, George Watts, and Glenn elementary schools
  • African American Health Improvement Partnership, a community-based participatory research program serving African American adult patients with diabetes through church-based support groups, in-home diabetes coaching, and education
  • AACORN, a research project to reduce pediatric obesity by testing better ways of improving food choices by children and parents, conducted in partnership with the John Avery Boys & Girls Club of Durham
  • Holton Wellness Center, located in the Holton Career and Resource Center, a neighborhood clinic providing primary care to low-income patients in conjunction with Lincoln Community Health Center

Beyond Durham, Duke is making strides to improve the health of communities throughout the Carolinas:

  • CommunityCare Partners (formerly Five County Community Care), providing chronic disease management, patient support, and patient advocacy to 24,000 Medicaid patients enrolled in 31 practices in Vance, Warren, Granville, Person, and Franklin counties
  • IN4Kids, a statewide research project funded by the NC Health and Wellness Trust Fund Commission that will test the efficacy of nutritionists in pediatric and family medicine practices to reduce childhood obesity
  • Caregiver, a support group and Web-based resource for communities throughout the United States, teaching family caregivers to better care for themselves and their loved ones

Regional Outreach Facts

Duke works with care providers to bring advanced technology, treatment, and educational programs into rural areas. A few examples:

  • The Duke Heart Network comprises over 30 affiliated programs throughout the Southeast with the goal of working collaboratively with affiliates to provide the highest level of cardiovascular care as close to home as possible.

    The Duke Heart Network is supported by a dedicated team of clinicians and administrators with over 100 cumulative years of experience in building and enhancing cardiovascular programs. Services supported by the network include mobile cath lab sites, outpatient clinics staffed by Duke physicians and hospital-based cardiovascular program affiliations, our most comprehensive relationships which have been collaboratively developed with five affiliated hospitals throughout the Southeast.

    These unique programs facilitate community and academic partnerships through intensive clinical and programmatic guidance including new program development, implementation of evidence-based standards of care, strategic growth planning and regional differentiation, as well as marketing, clinical business, and operational management. Quality oversight is a hallmark of this program with the goal of participating in and meeting and exceeding the benchmark measures of certified and HIPAA-compliant registries, including the National Cardiovascular Data Registry and the Society of Thoracic Surgeons National Databank.

  • The Duke Oncology Network establishes clinical, educational, and research relationships with hospitals throughout the Southeast. Within North Carolina and Virginia, DON has established and operates eight community oncology programs. In four of these communities, Duke has placed full-time Duke oncologists. In two of the communities, Duke also operates a radiation oncology program with Duke radiation oncologists on site.

    In 2008 more than 1,700 new patients were seen by Duke oncologists in their home communities. More than 160 patients have been enrolled in clinical trials at these sites over the past four years and screening has increased 40 percent in the past five years. In addition to these clinical affiliates, Duke Oncology Network has 11 research and two program development affiliates throughout the Southeast. In 2007 patient accrual through DON accounted for more than half of Duke's total CALGB (a national clinical research group) enrollment.

  • Each year Duke brings hundreds of continuing education classes to physicians and other providers in dozens of regional communities; the School of Nursing also offers online degree programs so nurses can pursue advanced training while remaining in their home communities.