By Susan Sexton
Truman Medical Center Lakewood gained an invaluable resource when, after 27 years, Tracy Rogers chose to retire from her profession as a Speech/Language Pathologist in the Independence School District. Not quite ready to stop working, Tracy began collaborating with Charlie Shields, President and CEO of TMC Lakewood, to develop a Coordinated Care Program for a select group of patients.
Tracy has been the Health Coach that heads up the Coordinated Care Program for four years now. She works with patients who have utilized the ER on a number of occasions and/or have had major health episodes due to chronic conditions. Although Tracy works business hours at the hospital, she’s available to her patients 24/7.
Tracy works with 12-18 patients at any one time to help them navigate through the health care system and take charge of their own health through helping patients
• learn self-management strategies,
• learn and use all communication tools at their disposal including MyTrueHealth (online health management tool)
• develop a good working relationship with health care professionals,
• manage medication needs with pharmacies,
• coordinate their care between agencies and departments,
• ascertain comprehensive care for their chronic conditions,
• provide learning opportunities about chronic conditions and possible associated health risks,
• learn about community resources available for their circumstances, and
• explore further support such as Medicaid or Social Security Income.
As the patients become more self-sufficient in managing their own healthcare, they will cycle out of the program while new patients cycle in.
Since Truman Medical Center is a learning hospital, Tracy trains incoming medical residents in understanding, supporting, and implementing the Coordinated Care Program into their routines and practices.
Kim Patton, a Nurse Practitioner who moved to the area a year and a half ago, says that Tracy is such a caring person and an excellent resource for her and the patients in the program. “Tracy knows the community resources available and has helped patients with housing, transportation, medication, and many other things. She has been a true friend to me and to the patients, even helping find resources for patients who are not in the program.”
Tracy often attends healthcare visits with her patients in order to make sure they understand what their doctor is saying and to model asking questions when further clarification is needed. She often triages with the patients prior to an appointment to help them gather their thoughts and consolidate their questions/concerns down to the three - five most important questions or concerns to discuss with their healthcare provider.
One patient, who is currently in the program and whose husband was one of the first patients in the program, works full time and was trying to care for her chronically ill and disabled husband. “I don’t know what I would’ve done without her! My life became so organized after working with Tracy. She taught me coping mechanisms and set up and attended doctor appointments with us. I feel like I can breathe again!”
“TMC found the perfect person for this job,” Tracy’s patient says. “It’s an amazing gift for us to have someone who truly cares about us.”