New Medical Home Model: Places Patient at Center of Health Care

Kim Seidel | Apr 1, 2014, 10:30 a.m.

And it starts with one patient at a time. Care providers and patients who’ve experienced care provided in a Medical Home can share countless success stories, such as reduced cholesterol, lower blood pressure and better controlled asthma. In cases of diabetes, patients are encouraged to take diabetes education classes and meet with a dietitian.

Diabetes patients “have routine follow-up calls or visits with care coordinators,” Blommel continues. “In some patients, we’ve seen significant weight loss and glucose levels returning to normal.”

Weight loss through Medical Home

Heiska-Ryan’s achievement of weight loss is among those success stories.

For many years, Heiska-Ryan lived in chronic pain that prevented her from keeping active, contributing to an unhealthy weight. A 2012 knee replacement surgery left her feeling better than ever, and she knew it was time to lose weight and further improve her health.

For patients like Heiska-Ryan having a Medical Home can lead to a path to better health, because it motivates people to participate in preventive care and proactive management of chronic illnesses. Together with the patient, the care team sets health goals based on the patient’s values and priorities, discusses how to achieve those goals, develops a care plan and answers questions.

At her initial appointment to lose weight, Heiska-Ryan learned to set goals and count calories. “I was already eating healthy foods, but I learned about portion control,” says Heiska-Ryan. Her nurse care coordinator, Edith Kolberg, of Froedtert & the Medical College of Wisconsin Hartford Health Center, taught her about wholesome recipes, alternatives to favorite dishes, and lunch and snack ideas to bring to work. Heiska-Ryan was especially impressed with having personal contact with Edith during weekly check-ins, as well as the consistent caring, inspiration and motivation she provided.

Among the many tools she’s learned to help along the way is “setting a bunch of small goals, instead of a single, long-term goal. Celebrating each small milestone has kept me going,” says the 52-year-old wife, mother and grandmother of Iron Ridge. “My ultimate goal has been to embrace this process as a lifestyle change, and that has been the only way I’ve lasted for almost a year.”

Heiska-Ryan’s “bunch of small goals” included reaching a 10 percent weight loss; weighing less than her husband; and reaching “one-derland” – to weigh under 200 pounds. Her current goal is to be in maintenance mode by summer’s end. Another key to succeeding was stepping up her exercise regime. She walked on a treadmill and exercised on an elliptical machine, working her way from five to 43 minutes each day.

Her 54-year-old husband also got into the act. In the past year, he’s improved his health with weight loss as well. The couple “is the talk of the company” they both work for, Heiska-Ryan shares. “It’s a whole new life,” she says. “Now I can go sledding and get on the floor with my grandkids. I love to travel and now it is more adventurous. Just a few months ago, I would have been over the weight limit, but I recently zip-lined in Mexico and loved it.”

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