Forgetfulness Doesn’t Have to Mean Missed Care

By: Diana Carolina Guerra

I first met Franklin, a 55-year old North Carolinian native, when he was referred to Lena by his primary care team. I was surprised as I enrolled him into the Lena Health program and introduced myself as his Personal Health Assistant that he was tech-savvy - an avid user of his smartphone, frequently texting friends and family rather than calling them. My surprise stemmed from my preconceived bias that tech-savvy meant he would independently be able to navigate the available Epic MyWakeHealth app to keep up with his care plan and appointment follow-ups. Like many older adults, he just wouldn’t download it or use it.


Franklin suffered from memory challenges, often missing appointments and forgetting what he was supposed to do next, despite getting thorough instructions from his family doctor. Having access to his EHR, I noticed many instances of missed appointments due to him forgetting to schedule transportation.


As his Lena Health Assistant, I knew where I could immediately transform his relationship with his care plan. All through SMS-text (Franklin’s favorite form of communication), I scheduled his primary care follow-up appointment, and then coordinated a few options for his transportation with Trans-aid, his local public transportation. On the day before his appointment, I’d leverage the Lena Health Conversational technology to ensure Franklin was receiving a timely reminder to be ready for his upcoming appointment.


Franklin and I performed this cohesive dance for over 30 navigations including appointments, transportation, finding in-network dentists, coordinating prescription refills, finding specialists, relaying notes to his primary care provider, and so much more. Now, when Franklin needs anything relating to his health, I’m his number one point of contact. He trusts I’ll get it taken care of.


He often shares notes of appreciation for my help. This is one of my favorites: Thank you Diana so very much. You help me keep up with so much and I appreciate everything you do. If they were giving out Oscar Awards you would definitely get one on my behalf. I’m lucky that as a Health Advocate at Lena, I get to touch the lives of patients like Franklin’s every day.


 

About the Author

Diana Carolina Guerra

Health Advocate Lead



Diana (Carolina) leads Lena's team of Health Advocates and helps design the user experience for the interaction between the member and their Lena Assistant. Aside from her leadership, she also cares for her panel of patients and members and provides world class concierge care navigation. Diana has over 7 years experience in health and wellness counseling for socially and economically disadvantaged individuals. She holds a degree in Dietetics and Nutrition from the University of Texas at Austin.

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