Case Example
Telemedicine Triage
Situation
- VNSNY Care360° Solutions nurse practitioner (NP) receives alert via telehealth about member in her 90s with multiple chronic conditions presenting with low-grade fever and shortness of breath
Customized Interventions
- VNSNY Care360° NP immediately triages member telephonically, assessing for conditions, including COVID-19, sepsis, and adverse drug reaction
- Given member’s age, underlying conditions, and symptoms, NP taps into VNSNY’s collaboration with Community Paramedicine to deploy clinician to member’s home
- NP and paramedic consult via phone; determine member is stable, does not need ED transfer, and can remain safely at home; likely cause of symptoms is allergy to a newly prescribed antibiotic for UTI
- NP coordinates with member’s PCP and pharmacy to obtain Rx for new antibiotic, and update member’s list of allergies
Impact
- Member was assessed and symptoms managed safely at home
- Avoided potential ER visit and possible exposure to COVID-19
- Information shared across care team members to avoid future antibiotic reaction
Case Example
Asthma Alert
Situation
- Member with severe asthma comes under the care of the VNSNY Care360° Solutions team
- Remote monitoring technology set up in member’s home
- Within a few weeks, the VNSNY Care360° Solutions team receives real-time alerts indicating abnormal drops in member’s blood oxygen levels
Customized Interventions
- VNSNY Care360° Solutions Care Manager promptly contacts member and learns she is self-medicating asthma with cough medicine
- Nurse Practitioner is engaged to educate member and provide coaching on proper use of rescue inhalers instead of cough medicine for symptom relief
Impact
- Member learns effective self-care techniques
- Avoided asthma exacerbation
- Prevented potential emergency room visit
Case Example
Diabetes Dilemma
Situation
- Member with multiple comorbidities including diabetes, chronic kidney disease, and heart failure reports low blood sugar measurement to VNSNY Care360° Solutions Care Manager, noting that she had been in bed all day
Customized Interventions
- Care Manager engages Nurse Practitioner (NP) and reviews member’s medications
- NP initiates a consult with member’s Primary Care Physician (PCP) via a three-way conference call
- PCP, NP, and member discuss appropriate adjustments to current diabetes medication regimen
- NP follows up with member to educate on medication action plan for avoiding medications known to lower blood sugar levels in specific situations
Impact
- Avoided serious hypoglycemic event and potential hospitalization or ED visit
- Successful physician engagement
Case Example
Summer Suffering
Situation
- Member with partially removed lung and COPD diagnosis is under care of VNSNY Care360⁰ Solutions
- During a routine check-in, the VNSNY Care360⁰ Solutions Care Manager notices member experiencing periodic shortness of breath
Customized Interventions
- After assessing the situation, it is determined that the extreme summer heat and poor apartment ventilation are likely exacerbating member’s condition
- Care Manager connects member to NYC’s Cooling Assistance program, which facilitated access to air conditioning unit
Impact
- Improved member outcomes by addressing key social determinants of health
- Member is able to manage through the summer remaining safe and comfortable at home
Case Example
A Rash Resolved
Situation
- Member experiences unusual, persistent, and painful rash over the course of several days
- Not wanting to go to the ED, but with their PCP out of town, the member alerts their VNSNY Care360⁰ Solutions Care Manager
Customized Interventions
- VNSNY Care360⁰ Solutions Nurse Practitioner (NP) quickly deployed to evaluate rash, provide a prescription, and teach proper rash care
- NP links member to a home visiting-MD practice for follow-up
Impact
- Improved quality of life through symptom management and increased comfort
- Avoided ED visit