Health coaching can play an especially important role for patients with complex needs, who may struggle to manage multiple conditions, multiple providers, and services outside the health system.
Four key interventions are essential to create an age-friendly system of care. If care providers consistently do these four things for every older adult, every time, across care settings, we believe we will save lives and avoid harm.
Most care delivery systems don’t proactively identify and meaningfully engage or support family caregivers in visits or care plans. Jennifer Wolff, PhD, a gerontologist and health services researcher shares how complex care programs can better engage families in care for patients.
Christine Vogeli shares insights about how Partners HealthCare launched the Integrated Care Management Program, how the program is managed, and her advice for others getting started with care for people with complex needs.
Christine Vogeli, PhD, Director of Evaluation and Research at Partners HealthCare Center for Population Health, shares how their Integrated Care Management Program uses predictive analytics to identify patients to enroll.