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When traditional channels of health care don’t work, what else do you try?

When traditional channels of health care don’t work, what else do you try?

Whatever works, says Amy Vance, CareOregon health resilience specialist.

Amy is part of a new generation of health care workers who look outside the medical offices for solutions to patients’ health and wellness issues.

CareOregon’s health resilience specialists help the most vulnerable members address the social determinants of health that often prevent them from being well. This population is characterized by complex medical co-morbidities compounded by issues such as poverty, unstable housing, mental health and addiction challenges, cognitive impairment and often trauma histories. They are some of the 10 percent of CareOregon members who account for 50 percent of medical expenses. They are among our most challenging members, requiring the most intensive services.

Amy’s work in this area was recognized this spring when she was named the fifth recipient of the “Making a Difference” award from the Association for Community Affiliated Plans (ACAP).

“Amy’s ability to build rapport and trust with our most difficult-to-reach members is exemplary,” says CareOregon CEO Patrick Curran. “She meets with them on their turf and on their terms wherever they are experiencing their lives—in their homes, in shelters, under bridges, in care facilities, or in the hospital. She lives and breathes ACAP’s principles of advocacy, care, access and public good.”

The award honors a single person, but the recognition is really for the entire Health Resilience team and the concept of the work, Amy says.

“I’m glad that a program like ours is deemed valuable and seen as an important change,” she says. “By engaging patients in their homes, we uncover a different aspect of health that can’t be identified in a visit to a care provider or the hospital.

“One thing we’ve learned is that people want to be healthy and have good lives.

Addressing the underlying issues outside the medical office is a catalyst to making prescribed treatment succeed.

“People don’t want to be going to the hospital and utilizing health care resources,” she says. “They want to commit to things that make life better.”

One patient of Amy’s is an example. He’s now in his mid-50s. Having lived a life with significant family trauma as a child and conflicts with authority figures as an adult, he was very wary. He’d had repeated issues with substance abuse and spent a significant time in the ED and has been hospitalized for unidentified stomach pain. His positive experiences with health care professionals were rare.

To overcome this distrust, Amy discovered that this patient found playing pool relaxing and enjoyable, so she set up their first meeting over a game. Here, he managed a comfortable level of eye contact and could do something he enjoyed, while slowly disclosing the troubles he was having. After listening and learning of his life and health barriers, Amy worked with him to create collaborative strategies to address the barriers and helped him move toward self-sufficiency around matters of health and well-being.