Posts Tagged: restoring humanity to health care

Venezuela donations

Values in Action: Addressing Needs in Venezuela

At Iora Health, our mission is to restore humanity to health care. Each day, our teams lead the way by showing courage, creativity, empathy, humility and passion.

We see these values embodied in large and small ways every day. A compassionate encounter with a patient, an empathetic ear for a colleague, or recently, through a passion project by an Iora employee.

Gabrielena (Gaby) Alcala, director of Medicare Risk Operations, saw the decline in quality of life in Venezuela with her own eyes. Her father was ill and she saw the struggle to get his basic medical supplies. Unfortunately, his situation was not unique in Venezuela. Once-controlled diseases like diphtheria and measles have returned due to insufficient vaccines and antibiotics and Venezuelans suffering from chronic illnesses like cancer or diabetes must often forgo treatment for lack of supplies.

Motivated by the struggles of Venezuelans to access basic healthcare, Gaby reached out to her fellow Iorans for aid. The response she received was overwhelming.

In an email to Iorans, she described how Venezuela is experiencing one of the biggest humanitarian crises in the world. She shared that Venezuela is facing an 85 percent shortage of medicine, an economic crisis, severe hyperinflation and food scarcity. She contrasted this with the United States, where two out of three dispensed medications go unused and are discarded. National projected costs range from $2.4 billion to $5.4 billion in wasted prescriptions.

Gaby had a simple ask, “Do you have unused prescriptions or medical supplies you can donate?”

Here are some of the responses:

“I have a box of things that I’d like to go to a good cause!”

“Thank you for finding this opportunity for us, we really appreciate the honor to be able to do this.”

“I would much rather send to places that need things than throw things away.”

“Definitely!! Thanks for reaching out to the practices. Perfect timing too for our Earth Day efforts…love it!”

“This should be something that happens every six months so that things don’t go to waste.”

Gaby coordinated the supply donation to the Programa de Ayuda Humanitaria para Venezuela, which has strong ties with health providers and hospitals in Venezuela. With the program’s aid, the items were sent to where they were needed most. Now, Iora Primary Care practices are aware of the donation opportunities for unused medical supplies and can continue to support places in need on a regular basis.

There is a tradition at Iora Health that on your company anniversary you can reflect on your time at Iora. In Gaby’s reflection she said, “I have learned many things during my tenure at Iora, but the most important one is that I work with the kindest people I have ever met.”

Everyone rallying together in support of Venezuela demonstrated Iora Health’s mission and the passion that Iorans bring to their work every day.

 Thank you to Gaby and the local care team members for their efforts! It’s inspiring to work with you!

Ellsworth-Team-Venezuela-DonationsEllsworth-Team-Venezuela-Donations (3)
Interested in joining a team that is committed to making a difference? Check out our current job openings and apply!

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The Economics of Patient Focused Care

“Inpatient admissions were 5% higher, or favorable, compared to the prior year” reads a quote that appeared in a recent report for a nonprofit hospital. This sums up the fundamental problem with the U.S. healthcare industry; incentives of the system, providers and payers under a fee-for-service construct are not aligned with those of the most important person: the patient. While it’s noble for hospitals to care for someone during their time of need, a higher volume of admissions is not good for actual patients or the economy. The “healthcare” industry has in fact become a “sickness” industry in which medical costs and industry profits have spiraled out of control, while quality and health outcomes have severely lagged.

The challenge is: how do we create a system that aligns the incentives of patients, providers and payers while focusing on optimizing health?

A solution starts by changing the system from the ground up. Instead of operating under a fee-for-service structure, we need to invest in value-based primary care that puts an emphasis on keeping people healthy, rather than simply reacting when they’re sick. There are a few companies that are doing this and making a noticeable difference in this space – Iora Health is leading the charge and that’s what attracted me to join the company three years ago.

Iora’s high-impact, relationship-based care model is brilliantly and simply built around the patient and is tackling the enormous societal and economic problems of the U.S. healthcare system. By combining people, process and technology, Iora is able to save money, bring joy back to the practice of care, and improve the health of all patients (especially the most vulnerable – older adults).  

The first question people often ask me after learning about what Iora is working to achieve is, “How do you do this?”

It takes starting from scratch in built-for-purpose primary care practices that serve patients under value-based care arrangements with sponsors that share our vision of transforming healthcare. Rather than buying an electronic medical record off the shelf, we support these practices with our proprietary technology platform, called Chirp, that integrates population health workflows and clinical documentation. What you get is a care team and technology that support a care model that is built around people rather than billing codes.

The second question asked of me: “Is it working?”

Results have been amazing so far. Iora’s average Net Promoter Score for patients (a measure of customer satisfaction, with  a range of -100 to 100) is around 90, while the typical primary care doctor’s office hovers around 4. Our care teams love taking care of patients under this model, and hospital admission rates have dropped by 30-40% for patients who have had Iora’s care for a year or more. All of this shows that the Iora model is working by being able to keep patients happy, healthy, and out of the hospital.

This is the solution for the misalignment of incentives in today’s healthcare industry.  By spending more time and building deeper relationships with people, Iora is proving that we can educate and empower others to optimize their own health, while also encouraging health systems to follow suit. At the end of the day, we all want what’s best for people and that means focusing on the one part of the equation that matters most: the patient.

Health Coaches, Cori & Audra

Medicine Coupled with Compassion

Modern medicine is incredible. We can give you a pill and lower your cholesterol, give you a pill and lower your blood pressure. We can set a broken bone. We can save lives; we can extend lives. We can fix so many problems. It’s totally amazing.

But then there are all these health problems that biomedicine doesn’t have a quick-fix pill for. There’s no pill for loneliness, and it’s a common problem that definitely affects your wellbeing. There’s no quick answer for losing weight, or getting fit. Balance is a really important issue at our clinic. So many of our patients are afraid of falling and feel unsteady. There’s often not a quick fix for improving balance. I think that most of the time, when it comes to health problems like these, patients are kind of left to go it alone. Part of the health coach role is to support patients with problems that take more time. No doubt they have to put in the legwork, but they don’t have to do it alone.

Sometimes the role of the health coach is just to hear the patient and understand what they’re going through. At the Shoreline clinic we have two patients named Dan and Mary Ann. They have been married for a long time. And it is really obvious when you meet them that there’s a lot of love. They just have a very kind way of interacting with one another.

Dan was diagnosed with Alzheimer’s disease at a fairly young age: in his mid-sixties, which was devastating for Mary Ann. And this last year was particularly hard because Dan’s condition worsened quite rapidly. And as it worsened Mary Ann had to take on more and more caregiving responsibilities.

Audra is a health coach who works in Shoreline with me: Mary Ann and Dan are on her patient panel. For any of you that have been caregivers, you know it can be really taxing work. At one point Mary Ann was sending emails to her health coach, Audra, nearly every day. Often Audra would have really solid advice for her, or something tangible to offer. With the support of Dr. Levine and Debbie Yoro, our clinical social worker, the team provided care that was so far above and beyond the status quo. But sometimes Mary Ann would come to Audra with problems that didn’t have a clear answer. When this happened Audra would just hear her out and be there with her. What resulted was really special. Mary Ann developed a very trusting relationship with Audra and the care team as a whole. It was clear that Mary Ann felt like we were on her side: that we were a team. She knew we had her best interests at heart.

There’s no cure for Alzheimer’s disease. But what is so great about the Iora model is that it recognizes that, yes there is value in fixing people’s problems, but there is also so much value in helping them cope when their problems can’t be fixed. Mary Ann sent us a note recently and it included a quote from the poem ‘Kindness’ by Naomi Shihab Nye. It read, “Then it is only kindness that makes any sense anymore; only kindness that ties your shoes and sends you out into the day.” What I love about Iora is that it’s not just medicine. It’s medicine coupled with compassion. It’s difficult to measure the value of human compassion in medicine. But when you hear stories of real human experiences, it just intuitively makes sense. The care that is provided at Iora is so exceptional partly because we recognize the value of the healing relationship and actively work to foster meaningful connections.

Scott Jacobson

One Coffee at a Time

The work we do is challenging and sometimes it is easy to succumb to feelings of doubt, thinking that all our hard work is in vain. However, there are examples that highlight the difference we make. One such example is one of our Health Coaches, Vero’s, most challenging patients.

She is a 23 year old patient. When she came to us it was clear that she was suffering. She has type 1 diabetes, difficult enough for a young adult to handle yet she also suffers from ulcerative colitis. After an extended hospital stay and major bowel surgery, she was left with an ostomy, a difficult situation for anyone and particularly debilitating for a 23 year old.

Her surgeon told her she would have to get her sugars under controlled before they would reverse the ostomy. Dealing with an ostomy bag was not only a hindrance on her social life, it limited her job opportunities.

Not surprisingly, she also suffered from major depression which became a compounding factor in managing her multiple medical problems. She tried talk therapy but never really felt comfortable opening up. Antidepressants didn’t make a dent. She was mired in despair and despite our efforts to engage her in managing her blood sugars, Vero’s texts often went unanswered. We knew she would spend days in her room, crying and isolating herself. She would frequently break down while at work. We begged her to come in to talk to us.

Finally, one day without prompting, she did. We could tell she was on the edge and didn’t know where to turn. She had decided to put her trust in us as a last resort. She opened up to us and all her emotional and physical traumas began to trickle out. It was a very emotional meeting and it was only the beginning. We offered more therapy from a professional, but she really just wanted to talk to her Health Coach. We decided that coffee with Vero every other week would be a start. She left that meeting only a step back from the edge but she was moving in the right direction.

And then, Vero received a gift of beautiful flowers.

One Coffee at a Time Vero

The note reads:

I HONESTLY WANT TO THANK YOU FOR EVERYTHING THAT YOU HAVE DONE FOR ME EVEN THOUGH I AM A PAIN IN THE BUTT I’M SO GRATEFUL THAT YOU HAVEN’T GIVEN UP ON ME YOU TRULY ARE A GODSEND

Over the past couple of months Vero’s coffee meetings have been a huge success. She has shared some of her deepest secrets that have clearly been weighing her down and blocking her from moving forward. She has felt comfortable enough to establish care with Nina, our social worker, so she can get the trained help she needs in dealing with her significant past traumas. From a medical standpoint we are still working on her sugars with the goal of reversing her ostomy. She is by no means a picture of health, but we are taking baby steps, in the right direction.

This patient has been a huge reminder to me that despite the monumental task we have in front of us, we do make a difference in people’s lives, everyday. Because of the unconventional resources we have to help us connect with our patients, we are able to continue to find creative ways to make breakthroughs and put our most challenging patients on the track to leading healthier and more fulfilling lives. I know that there are times we feel like no matter how much we try to help our most challenging patients, that they can’t or won’t change. It is so wonderful to be reminded that by showing our patients that we truly care about them and that we won’t give up on them, our positive attitude can have an impact. Great job Vero!