Dr. Thomas Coburn, a KentuckyOne Health primary care physician, cares for patients in Wilmore Ky. He and his office staff have been very receptive to having RN Population Health Coach, Adona Burress, BSN, and Outpatient Care Coordinator, Shannon Nally, LSW, working with their patients. Dr. Coburn sees the value of having additional resources available to his patients.
One of the first patients Dr. Coburn asked the care management team to connect with was very socially and medically challenging. Adona and Shannon visited this patient several times at his home, hospital and skilled rehab facility in order to coordinate his care.
Over the past few months of working with this patient, Adona has focused on home medication reconciliation and blood glucose monitoring. Also, Shannon was able to find placement for him in an appropriate rehabilitation facility. Working closely with Dr. Coburn was critical. Ongoing collaboration with Dr. Coburn allowed this patient’s insulin to be adjusted as needed in the comfort of his home – which was more convenient, efficient and less costly for the patient.
Dr. Coburn and his office nurse, Susan, have been instrumental in effectively incorporating the RN Health Coach and other members of the care management team, knowing that by doing so, they are able to provide Better Health, Better Care, and a Better Experience at a Lower Cost. Our care management team can help our physicians extend care beyond their clinic walls – providing care where patients are.
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