Patient Success Stories
Partners HealthCare has made a system-wide commitment to Population Health Management (PHM)– a new approach to delivering care that can keep patients healthier while reducing overall costs. PHM comprises the latest advances in health care technology combined with some old-fashioned touches, such as frequent conversations with patients who require more attention due to their illness.
Over the coming months, Partners HealthCare will devote this special section of partners.org to provide rolling updates and patient stories that track progress of PHM. We hope our employees and guests who visit our website will gain a better knowledge of PHM and an appreciation for its potential to transform health care and improve patients’ lives.
A Time to Celebrate
October 10, 2014
On a recent Sunday in August, Philip Tropeano gathered with nearly 50 family members and friends to celebrate his 92nd birthday. There was also an extra reason to blow out the candles – the birth of Tropeano’s great great grandson, Nicholas.
“My birthday is on Aug. 11th,” said Tropeano, “and also my daughter’s birthday. Now we have another August birthday. He’s a cute little baby.”
The party came a few weeks after Tropeano met with his longtime physician, Dr. Richard Alexander. The regularly scheduled office visit had also yielded good news. Tropeano, who suffers from diabetes, congestive heart failure and kidney failure, showed no changes in his condition.
Dr. Alexander, who had treated Tropeano since 1980, says a big part of his success is the use of a telemedicine monitor. For three years, Tropeano starts each day by weighing himself and measuring his blood pressure and blood oxygen saturation level, using a console supplied by Partners HealthCare. The readings are automatically transmitted to a nurse care manager at North Shore Medical Center, who can instantly spot deviations that could be warning signs.
Home Care: A key link in the PHM chain
September 15, 2014
It was late spring of this year when Shirley Hutchin’s chronic breathing problems suddenly got worse. She had been diagnosed with pulmonary hypertension, or high blood pressure in the lungs, and pulmonary fibrosis, a kind of scarring on her lung tissue.
But even after using oxygen on a part-time basis for nearly a year, things were getting worse. She couldn’t catch her breath. Walking up and down the stairs to her second-floor apartment in an East Boston triple-decker was all but impossible.
Mrs. Hutchins, 75, called her primary care physician, who told her to immediately check herself into Massachusetts General Hospital. She spent six days in the hospital, followed by a week in Spaulding North Shore, a rehabilitation hospital in the Partners HealthCare network.
But now that Mrs. Hutchins is out of the hospital, she still needs help. She must adapt to being tethered full-time to an oxygen tank. She has to build up her lung capacity so she can perform daily chores without becoming winded. And she must re-learn how to function in the modest apartment she has lived in for 35 years.
But, she is not alone. Twice a week, an occupational therapist from Partners HealthCare at Home visits Mrs. Hutchins.
One patient's transformation through Population Health Management
April 2, 2014
In the fall of 2012, Normie Allen of Roxbury wasn’t doing well. She was nearly 70 years old, and it seemed as though a combination of chronic ailments was going to overwhelm her.
First, there were her main conditions: diabetes and congestive heart failure. On top of that, she suffered from osteoarthritis in her knees. Combined with obesity, this was causing excruciating pain. She could barely walk, and often used a wheelchair.
Bill Theisen, RN was getting concerned. Theisen is a nurse care manager who oversees Mrs. Allen’s treatment as part of the Integrated Care Management Program (iCMP) at Brigham and Women’s Hospital. He noticed that she was showing up frequently at the Brigham Emergency Room for pain in her knees and injuries from falls. Those visits didn’t help treat the underlying causes of symptoms and injuries – and they were adding untold costs to her care.
It's been a good year for Philip Tropeano
October 24, 2013
It’s been a good year for Philip Tropeano. The Beverly resident celebrated his 91st birthday in August. He got to see his beloved Red Sox make it to the World Series after David Ortiz – his “idol” – slammed a game-tying grand slam in Game 2 of the American League Championship Series.
And most importantly, Tropeano has stayed healthy and out of the hospital.
Tropeano is one of the participants in Partners HealthCare’s Integrated Care Management Program, in which medically complex, high-risk patients are monitored by nurse care managers who are intimately familiar with their medical condition and needs.
How health care “huddles” keep some of Partners' sickest patients out of the emergency room
September 9, 2013
Six health care professionals crowded into an office meant to accommodate three people. They had a long list of names to go through, and a half an hour in which to do it.
Dr. Asaf Bitton led the rapid-fire, free-wheeling discussion.
“This next patient,” he said, “has Type 1 diabetes, and his LDL is over 100, so it is not at goal.”
Dr. Bitton is a member of Brigham and Women’s Advanced Primary Care Associates, South Huntington, a patient-centered medical home that opened two years ago and now treats 5,500 patients from the Boston area and surrounding towns. The huddle is one of South Huntington’s tools to keep patients healthier and out of emergency rooms.
Population Health Management: The care manager’s role
August 15, 2013
In his nearly 30-year nursing career, Bill Theisen, RN, has helped treat cancer patients, those with HIV, and people recovering from complex orthopedic surgery. He has even worked with patients just after open-heart surgery.
But he says nothing compares to his current role as a care manager at The Phyllis Jen Center, a physician group located within Brigham and Women’s Hospital that treats about 18,000 patients. That’s because as the caregiver overseeing the entire treatment of patients with complex medical conditions, he can have an enormous impact on the way people live.
How PHM is making a difference for one patient
June 3, 2013
"I'm fighting to stay out of the hospital. That's where sick people go." -- Philip Tropeano, iCMP patient
Learn how PHM has helped Philip Tropeano, a high-risk, medically complex patient, received the personal care he needs and stay out of the hospital.
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