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LBJ launches Care Management Service to combat territory's NCD problems

LBJ Medical Center’s new Care Management Service began operating Monday this week with the goal of combating non-communicable diseases (NCDs) which have been a long standing health issue for American Samoa.

“This exciting program is designed to provide a safety net for our most at-risk patients, to assure that their health needs do not get lost in the system. These patients have complex medical problems, often complicated by social and family issues,” said LBJ chief executive officer Mike Gerstenberger in an Oct. 1 memo to hospital management and staff.

“Keeping them out of the weeds requires talented clinicians. We are lucky that long-time Chief Medical Officer and Internal Medicine Specialist Dr. Alo Anesi has agreed to direct this Service,” said Gerstenberger.

He said Anesi’s “significant background as a clinician and as a health services leader brings a unique and very welcome perspective to assist these patients.” He also said that Anesi has selected “two of our most experienced nurses,” Annette Zodiacal, RN and Aolele Ta’afua, RN to join him in launching LBJ Care Management. 

“They, too, bring strong records of leadership and clinical practice to this new Service,” said Gerstenberger.

“We believe their intervention can break the downward spiral of many of our patients afflicted with non-communicable diseases. Initially, the Service will focus on the pre-dialysis population,” he said adding that Care Management is located within the Medical Clinic.

Gerstenberger first revealed publicly this new LBJ division at last month’s Fono budget hearings, saying that everyone has long talked about the epidemic of non communicable disease.

“It's getting worse, it's not getting better,” he said, adding that LBJ has seen a large problem with non compliance of patients, such as not getting their prescriptions filled, not making clinic appointments or laboratory testing.

Among the duties of this new department is to follow up on each case to ensure patient compliance and if LBJ needs to, “we will come to your house and help you understand why you need to be taking that medication or getting that lab work done,” he said.

Replacing Anesi as Chief Medical Officer (CMO)  is Dr. Akapusi Ledua, who is currently serving as the Vice Chief of Staff, the Chief of the Orthopedic Surgery Service and the Chair of the Quality Improvement Committee, according to Gerstenberger’s memo.

It also states that Ledua “brings a strong record of clinical expertise and demonstrated leadership skills to the CMO role”. Additionally, Ledua, will split his time between the practice of Orthopedic Surgery and his new CMO role.