The road from illness to recovery is often difficult. In the middle of a major health crisis, patients are expected to navigate the complicated health care system. A pilot program called Alaska Innovative Medicine in Anchorage is rounding out its first year trying to improve that journey for patients while also spending less on health care.
In the early morning hours of April 8th, Brian Saum felt horrible.
“Every time I laid down I could feel something boiling in my chest. And then I’d throw up and lay back down, and went through this process three or four or five times,” he remembers.
It was a heart attack and it nearly killed Saum. While he was recovering in the hospital he got a call from a social worker who said she was with Alaska Innovative Medicine and her services were free. She visited Saum at home. At first, he was skeptical.
“I didn’t know who she was or what this was. All’s I know is I was real sick and I had just got home from the hospital after two weeks.”
That medical social worker was Gigi Rygh and it didn’t take long for her to win Saum over. Rygh gave Saum her cellphone number. When his medication made him feel strange, he called Rygh and she found a nurse who could troubleshoot the issue.
Another time, Saum’s hand swelled up strangely — the type of episode that could have easily sent him to the ER. Instead, he called Rygh and she connected him with a doctor.
“We want to fill something that doesn’t exist, so people don’t have to navigate this very confusing medical system alone,” Rygh says.
Rygh even went to appointments with Saum, as another set of eyes and ears and to help translate complicated medical jargon. Rygh’s goal, and the goal of Alaska Innovative Medicine, is to keep patients on track.
“It’s just a hard thing to do alone and it’s hard to figure out when you don’t know the health care system. I think family and support systems try to be helpful, but it’s like, ‘OK, now we’re going to speak Japanese in the house… Wait! I don’t know Japanese! But I’m going to try!'”
A group of Anchorage doctors established Alaska Innovative Medicine, or AIM, in January. It’s a pilot project funded by the insurer Premera Alaska and focused on their members. So far, AIM has worked with more than 800 patients.
Noah Laufer is a primary care doctor in Anchorage who helped establish AIM and is now a board member. He says the idea is to coordinate care between different doctors and reduce barriers that prevent patients from getting better. And who is best suited to do that? Not the doctors — Laufer says that was one big lesson from this experiment.
“It turns out that the social worker or case manager is often the most important person on the team, by far,” he says.
Social workers and case managers are problem-solvers. They can communicate with a team of doctors, the insurer and the patient to address pesky issues that seem simple, but can quickly derail a recovery. Laufer gives the example of a patient who shows up at a pharmacy with a prescription to take a pill three times a day, but the benefits management company will only allow the medicine two times a day.
“The pharmacist is behind the counter for 20 minutes and comes back and says it’s not covered. There’s no one for them to go to so they throw up their hands, sometimes in despair, and leave without the medicine they need. And this is exactly the kind of systemic hurdle. No one is intentionally doing something bad, but the outcome is not acceptable.” he says.
Insurer Premera Alaska thinks AIM can give their members better care at a manageable cost. Patients love the program. And Premera is encouraged by preliminary data that shows the pilot project is beginning to help reduce hospital re-admissions and trips to the ER.
That’s certainly been Brian Saum’s experience. He hasn’t had to return to the hospital or had an ER visit since he was discharged nearly eight months ago. He’s starting to think about getting back to work. And Saum’s made some big personal changes.
“I used to drink quite a bit when I came home from work. I don’t drink or smoke anymore. Big change!” he laughs. “When someone tells you it will kill you, you’ll stop doing it.”
Saum says on a bad day, he thinks about having a drink or a smoke, but he’s not about to let that happen.
This story is part of a reporting partnership between NPR, APRN and Kasier Health News.
Annie Feidt is the broadcast managing editor at Alaska Public Media. Reach her atafeidt@alaskapublic.org. Read more about Anniehere.
