Post-partum, the team stays available to provide the same level of care/guidance in support of each mother and her child for the child’s first year of life.
The care of frail elders with chronic disease or significant disabilities is a major challenge for both health care systems, health care professionals, families and caregivers.
Racial and ethnic minorities in low-income communities experience higher prevalence of chronic illness, yet, are less likely to access palliative care and hospice.
They wish to live as independently as they can, for as long as they can—at home. Remote monitoring as a supplement to scheduled doctors’ appointments can make a difference in their care at home.
H.E.R.’s Community Care Connection nurse practitioner-led remote monitoring teams monitor and transmit health data and report symptoms to providers via the H.E.R.-GTS Platform and the related App, allowing for early detection through critical alerts about changes in health conditions.
Data collected overtime enables providers to better manage and treat chronic conditions in a way that is timely, meaningful, and realistic for patients suffering from cancer, coronary artery disease, chronic heart failure, COPD, diabetes and hypertension.
H.E.R.’s “Stay-at-Home” Strategies also include:
Goal: lower costs, decreased hospitalizations and ICU days, and increased hospice utilization while improving care quality and patient satisfaction.
Goal: enable frail elders with chronic disease or significant disabilities to as independently as possible—at home through improved access to care and supportive services.
Goal: Reduce loneliness and isolation.
H.E.R.’s Community Care Connection community-based “Cut It!” Initiative will address through innovation the epidemic of unrecognized high blood pressure in underserved urban and rural communities.
The program, modeled after a successful community-based blood pressure program operating in Oakland, CA., is centered in barbershops where community health workers deployed by Community Care Connection administer blood pressure checks bi-weekly or monthly.
Participants will be given a me.Health blood pressure cuff and a BodiMetrics Circul+ Ring to monitor their BP between visits. Community health workers train participants on how to use the cuff and calibrate the ring for monitoring while on the move.
Goal: promote awareness and self-care.
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