A 30-something Hispanic male, who at one point weighed over 400 pounds, made visits to the Emergency Room more than 70 times in the last three years. He was on a fateful path to cardiac disease. “I was going through a little bit of a rough time losing my mother and grandmother, so there were a lot of things that I stopped caring about. Like for instance, my health issue, it didn’t really matter, so I started doing a whole bunch of stupid stuff that I shouldn’t have been doing,” said Alfredo.
That’s when Rob Anderson came into the picture.
A transitional care coordinator from INTEGRIS SW Medical Center in Oklahoma City, Rob’s job is to prioritize patients once they leave the hospital. He makes sure they are being cared for at the next level of care, whether it being another healthcare provider or home. Rob took an interest in Alfredo’s case. He became committed to finding a root cause for Alfredo’s declining health and changing it for the better.
He found that Alfredo had been taking medication intermittently to make them last longer, or not filling them at all due to cost barriers. Alfredo also didn’t have a primary care physician to care for him on a regular basis. This, coupled with his lingering issues, didn’t do anything positive for his health and led to the high volume of emergency room visits.
Rob connected with Variety Care to interview Alfredo and go through his medications and treatment options. It naturally worked out that Variety Care would act as Alfredo’s primary care physician office.
“We write the drugs, but we never take the time to ask them ‘can you afford to fill this?’ says Variety Care director of medical quality, Mike Crutcher.
After working with Alfredo, Rob and the staff at Variety Care empowered Alfredo to “help himself” and develop a routine centering on a healthy diet and becoming compliant with medication use.
Alfredo recalls, “The last gathering with my family was Easter, and they were wondering where I’d been. I didn’t realize until then how much family mattered. They missed me, so it made me try a lot harder, and that’s what I did.”
After eight months of being proactive with his health and embracing his new routine, Alfredo lost more than 80 pounds. Now, he uses medications as directed, sees a primary care physician regularly, participates in diabetes education, consumes a healthier diet and has gone more than two months without a hospital readmission.
“It’s all about taking extra time and extra care for the patient,” says Rob. “He may relapse, but don’t give up on him. You always care,” he concludes.