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A Better Day with Medical Home

Jeannette Brekke of East Grand Forks, Minn., felt overwhelmed by mounting medical issues. For years she’d taken pills to manage her diabetes, but now she needed insulin injections. She had rheumatoid arthritis and suffered flare-ups.

An appointment in late 2011 with Dr. Jon Bradbury, primary care physician at Sanford Health in East Grand Forks set her on a new path.

“When he suggested the Medical Home Program, I said yes,” says 74-year-old Jeannette. “It’s the best thing that ever happened. I’ve never experienced medical care like this anywhere.”

Launched in 2011 at Sanford East Grand Forks, Medical Home helps patients who struggle with chronic conditions such as high blood pressure, diabetes, heart disease, depression and others. Good management goes far in reducing complications and improving quality of life.

Teaming up for better health<
Innovative and growing, Medical Home focuses on:

  • The whole person, not just the disease.
  • Well-coordinated care that meets the patient’s specific needs. Patients with chronic disease often require care from several specialists, services and therapists. li>A team approach, including an RN health coach who works one-on-one with each patient.

“This program is patient-driven, and no two patients are the same,” says Ann Grossbauer, RN health coach at Sanford East Grand Forks. “The tool that works for one person may not work for another. Part of my job is to figure out what will work and what the patient is ready for. This process begins with building a relationship of trust.”

Jeannette met with Ann the very same day Dr. Bradbury suggested Medical Home. They sat down and talked at length.

“She was so kind and helpful,” says Jeannette. “She really took the time to understand me. She also helped me understand what was involved in my care. So much of it was within my power. I don’t know where I’d be today if it weren’t for her.”

Ann is quick to give Jeannette the credit: “She worked very hard to take charge of her health and it shows. What a difference when a patient feels empowered!”

A step at a time
Patients in Medical Home set their own goals. Jeannette’s early goals included regularly checking her blood sugar and learning to give herself insulin injections. Jeannette’s husband learned, too, so he could fill in when Jeannette’s arthritis flared up.

“Ann was so patient in teaching us what we needed to know,” says Jeannette. “Even today we always know we can go to her with questions.”

Jeannette and Ann met frequently to evaluate progress and problem-solve. They also communicated by phone and email. With Ann’s help, Jeannette took disease management a step further. She faithfully tracked her blood sugar numbers, identifying patterns and realizing stress played a major role in blood sugar spikes.

“Ann gave me great ideas for how to manage stress,” says Jeannette. “I never imagined I’d be a person who meditates, but she explained how to do it. It’s really helped. Walks help, too.”

Within months the diabetes was well controlled. Her arthritis has improved, too. At the recommendation of her arthritis specialists at Sanford Rheumatology in Fargo, Jeannette receives intravenous medication every four weeks. With Ann’s help, she’s able to receive the infusions in East Grand Forks rather than Fargo.

All on the same page
Jeannette’s care involves several medical professionals. She has peace of mind knowing her RN health coach has a complete picture.

“Ann knows about all my conditions, tests and treatments,” she says. “It’s a good feeling to know everyone is on the same page.”

Today Jeannette meets with Ann far less frequently because of her dramatically improved health. She feels better than she’s felt in years, including more energy, good diabetes control and improved mobility. Her family has noticed, too. “I love them dearly,” she says. “They’re very happy I’m taking better care of myself. So am I!”

Is Medical Home right for you?
Jeannette is one of 130 patients currently participating in Medical Home in East Grand Forks. Free of charge, it’s available in the departments of Internal Medicine, Family Medicine and Pediatrics. Medical Home is available at several other Sanford locations, too. Your doctor can tell you more.

“If you have a long-term health issue, you owe it to yourself to get the help you need so you can be as healthy as possible,” says Jeannette.

That goes for a healthy attitude, too. Jeannette describes one more tip she picked up: “One day as I was leaving the clinic I said, ‘Have a good day.’ Ann said to me, ‘Jeannette, make it a good day!’ That was the best piece of advice,” she says. “ It’s not always easy, but every day I do all I can to make it a good day!”

Posted Date: April 2013