Patrick J. Carguello, D.O.

ConnextCare’s chief medical officer talks about growth of organization, new name and the services it provides to rural Oswego County

By Chris Motola

CarguelloQ: It’s been awhile since we’ve talked. Since then, Northern Oswego County Health Services has become ConnextCare. What brought about the change?

A: I think we last talked about 10 years ago? We’ve gone through a lot of changes over the past few years. ConnextCare is a really exciting place to work. We’ve expanded throughout Oswego County after working on stabilizing other healthcare facilities that were having financial difficulties. Our federal designation gives us some financial stability and gives us a lot of federal dollars to take care of patients regardless of their ability to pay. So this helped us assist some health centers is Fulton, Oswego, Parish, Mexico and Phoenix. Now we’ve really become this network with 13 locations throughout the county. We all now share this federal designation and that financial stability that allows us to help patients who are uninsured or underinsured. This rebranding is meant to show that we’re not just northern Oswego County anymore. We’re a bigger entity connecting the entire county.

Q: Can you elaborate on what the federal designation is?

A: We are a federally-qualified health center. The designation came about in the ‘60s and ‘70s when the federal government realized urban and rural poor locations had a major disparity in health outcomes. So they stepped up to either open or improve health centers to help improve these outcomes. We’ll be at our 50-year mark next year for this designation. We’ve been getting stronger over the years and getting more federal support to help us improve healthcare for our patients. So now it’s throughout our whole county.

Q: How were you able to get those other clinics federal status? Did you absorb them? Are they still semi-autonomous?

A: It was a few-year process that evolved. Due to their financial struggles, they recognized that our federal status would be beneficial to them. They’ve more or less fallen under our governance, so we’re all the same team now. It used to be Oswego Hospital running some clinics, Oswego County Opportunities operating some clinics. Now we’re all running under the original Northern Oswego County Health Care location, but are now known as ConnextCare. And we’re all part of the same federally qualified health center.

Q: With more locations, have you been focused on providing the same care at each location or having locations specialize?

A: Initially it was about stabilization, but now it’s about expanding care and maximizing the ability of each location to take care of the relentless demands of patients. There’s a national shortage of primary care providers. By stabilizing these locations, we’re keeping care in these communities, especially smaller ones like Mexico and Parish. They’re hard to keep going without a larger network that can assist. So we’re keeping care in these communities, but supporting larger staffs. It’s a battle in primary care to see all the patients you need to see, and there are less and less of us. We’ve been able to, over the years, train and recruit some really outstanding nurse practitioners and teammates to assist given the shortage of primary care physicians. We’ve added some additional services over the last few years. We have a behavioral health program and even some psychiatric services, which are usually really hard to deliver to rural areas.

Q: What are the major health challenges facing rural Oswego County?

A: Unfortunately, Oswego County statistics do not look the best. Smoking rates are pretty high. Obesity rates are pretty high. Higher levels of diabetes. Higher risk of cardiovascular disease. As we’ve grown we’ve added certain quality designations like being a patient-centered medical home (PCMH) level 3, which is really a significant quality benchmark for a health center. We have a very robust quality program, which helps us reach out to all of our providers across our network, to look at health outcomes, look at control of our diabetic patients, drill down into our digital medical records, and see which location offers the best care for their diabetes. We can also work together to share best practices across our networks. So it’s not just one provider just helping their patients, but helping providers throughout the county care for their patients.

Q: And that’s kind of the purpose of the health center?

A: Absolutely. As we’ve grown, our quality program has helped us grow care teams and managers. One healthcare provider, for example, needs lots of assistance with complex patients with diabetes, high-blood pressure and who smoke to get those outcomes that we want in rural and urban underserved areas. We can look at our best practices, study that, help to apply it at a different location and get all teammates — not just medical staff—to help that patient meet their healthcare goals.

Q: Do you see ConnextCare being a model for other rural health clinic networks?

A: Absolutely. We’ve been on electronic health records for more than 10 years. Many centers are on different systems that don’t communicate as well, that lack the interface. We have all of our providers on the same system throughout the county, so we have pretty seamless communication. So if a patient is seen at Pulaski one time and then Oswego, we can still track testing and results. Back in the day, you’d order a mammogram, hope the patient follows through with the test, hope I got the results back. But now we can track the test electronically. If they’re not getting the test, we can follow up with the patient. If they do get it, we can get the results.


Name: Patrick John Carguello, D.O.
Position: Senior vice president/chief medical officer at ConnextCare, based in Pulaski. With the organization since 2003
Hometown: Rochester; currently lives in Sandy Creek
Education: New York College of Osteopathic Medicine; Syracuse University; residency: Sisters of Charity Hospital, Buffalo
Affiliations: ConnextCare
Organizations: American Osteopathic Association; American College of Osteopathic Physicians; American Academy of Family Physicians
Family: Married to Wendy, three children
Hobbies: Skiing, boating, fishing, hiking