Augusta Health managing health outcomes program improves lives of the underserved

Patients suffering from chronic diseases such as congestive heart failure, asthma, hypertension and obesity are learning to control their conditions through self-monitoring equipment. The program is managed by caregivers at Augusta Care Partners.

Patients who are underserved and qualify for financial assistance are provided with self-monitoring equipment such as a blood pressure cuff, scale or pulse oximeter to help manage their disease.   Qualifying patients meet with case managers who teach them to use the equipment and record daily results.  Goals, such as a target blood pressure, are established for each patient.  Over a 90 day period, case managers call the patients to check their progress and results, and answer any questions they may have.  When the 90 day program ends, the patient may keep the equipment to continue to monitor their condition and progress.

“Grant funds have allowed our case managers to improve patient outcomes through teaching and promoting personal responsibility in disease management skills.  This encourages a partnership with their providers that will hopefully lead to decreased or delayed disease progression,” said Kim Galloway, RN BSN, Case Management Coordinator, Augusta Health.

Hundreds of patients have participated in the Managing Health Outcomes program; currently there are 233 registered and monitoring.   In 2015, 87% of the patients with hypertension who received blood pressure cuffs began to regularly monitor their blood pressure, and 52% actually improved their blood pressure readings through regular monitoring.

The program is fully funded by generous gifts to the Augusta Health Foundation.

Any community physician can refer a patient for the program.  Patients may also self-refer by calling Augusta Care Partners at 540.245.7570.

“I learned about (the program) at a visit with my doctor,” said Brenda Terrell, a patient of Dr. Amrita DeZoysa of Augusta Health Primary Care in Fishersville. “She said I would qualify for the program and I got equipment to check my sugar and blood pressure and a scale.  It’s easy to use.  I check my sugar in the morning and evening and my blood pressure in the morning.  I write the numbers down and take them to my doctor’s appointments.  They say I’m doing really well.  I keep the numbers where they should be, and I couldn’t do that without the equipment.”

Ms. Terrell adds that she believes monitoring her blood sugar and blood pressure has helped her stay healthy, and helped her recover better when she has become sick.   She recommends that anyone who needs to monitor their blood pressure or sugar ask their doctor about the program.

The Managing Health Outcomes Program has collaborated with other community programs such as the Weight Loss Program at Augusta Regional Clinic.