Behind every Accredo patient is a scaffolding of support, a team of experts on call to help patients with a range of needs.
In addition to more than 800 specialty pharmacists trained in the medications that treat specific disease states and about 600 field nurses who care for patients in their homes, Accredo specialty pharmacy employs teams of social workers, dietitians, and patient care advocates who support patients and help with a wide range of issues.
They work within Accredo’s 15 Therapeutic Resource Centers (TRCs), which specialize in numerous conditions and diseases, including oncology, rare diseases, blood disorders, inflammatory conditions, neurological disorders, and more. “The TRC model allows teams of pharmacists, nurses, dieticians, social workers, patient care advocates, and physician engagement advisors to focus on specific conditions to develop a heightened understanding about individual diseases, their treatments, and factors that can impact therapy outcomes,” said Susan Peppers, Evernorth’s vice president of Pharmacy Practice.
Read on to meet some of the social workers, dietitians, and patient care advocates who work in myriad ways to maximize patient care.
Social workers: Identifying resources to help the whole patient thrive
“We’re trying to look at the big picture,” Jaime Gomez said. “We want to know about people’s support systems, their ability to secure reliable transportation, to find food, to pay their monthly utilities and housing expenses.”
Jaime Gomez, social worker at Accredo
This means paying attention to a patient’s mental health needs as well as their physical health. “We can help people identify potential resources that are going to make something easier in their life, even if it’s not directly related to their therapy through Accredo,” Gomez said.
Another social worker, Jennifer McLaughlin, works with patients being treated for cancer, inflammatory conditions, and neurological conditions, including multiple sclerosis and rheumatoid arthritis. Many patients are referred by a pharmacist or a nurse who identifies serious challenges during a call or visit. The patient might have indicated they were depressed or struggling with their health condition, or they might need help finding resources that can help them navigate challenges caused by their health issues.
Jennifer McLaughlin, social worker at Accredo
“We triage the situation with them, find out what's going on and what is needed, and then we try to help them navigate by providing them with the names and numbers of sources in their community,” McLaughlin said. Sometimes a wealth of help is available, especially in metropolitan areas. Assistance can be harder to find in rural communities, but McLaughlin and her team know where to look.
At times, the social workers need to overcome a language barrier. For example, McLaughlin recently worked with an elderly widow whose husband had taken care of everything they needed. She spoke a rare Asian dialect, knew no English, and was illiterate in her own language. “Her basic needs were not being met,” McLaughlin said. “She literally did not know how she was getting food or how to pay for anything.” Fortunately, the patient lived near a city with a large Asian population. Working with an interpreter service, McLaughlin was able to connect with an organization that could help the patient. “I kept trying and it paid off – they had just hired someone who spoke her dialect,” she said. “The case managers who took over were able to help her.”
At times, the patient’s caregiver also needs help from a social worker, especially when the caregiver is the parent of a young child, Gomez said. “When I'm talking to a parent, at the end of our call I might just say, how are you doing, what are you doing, to make sure that you're taking care of yourself? Then they start talking about their stress levels, and we have a chance to look into support for the caregiver and not just the patient.”
Dietitians: Providing guidance in a way that’s easy to consume
Patients with a variety of medical conditions can have problems getting the nutrition they need, when they need it. That’s where the registered dietitians attached to Accredo TRCs come in.
Sally Kate Collins works with many patients who have been diagnosed with short bowel syndrome, a condition that limits the absorption of nutrients from food, and frequently have been getting their nutrition through an IV. Most of her patients have been prescribed a medication that helps them absorb nutrients from solid foods, and Collins helps them transition from the IV. That includes explaining which foods can provide the fluids and nutrition they need while avoiding unpleasant side effects.
Sally Kate Collins, clinical dietitian at Accredo
“Everything is very individualized,” she said. For example, “their doctor may have prescribed the maximum amount of protein they can eat. I can tell them how to meet that. I’m not prescribing a meal plan, I’m helping them meet the recommendations.”
Getting enough fluid is another issue, yet patients may not be aware of how much liquid they need each day. “It may be that they haven’t thought about that,” she said. “Maybe it’s not on their radar at the moment, so we might set some goals to help them meet their hydration needs.”
Collins and Accredo’s other registered dietitians work as part of the extended care team, meeting with them weekly, quarterly, or at another cadence – whatever is best for the patient.
Patient care advocates: Providing a wealth of knowledge in a phone call
When an Accredo patient picks up the phone, the first person they speak with is usually a patient care advocate (PCA). Like their coworkers across Accredo, PCAs are educated on the disease states covered by a specific TRC.
“We go through extensive training,” said Tiffany Cooper, who assists patients taking medications for a variety of rare diseases. “Job-specific learning lasts four to five weeks, and on-the-job training can last from four to six weeks.”
Tiffany Cooper, patient care advocate at Accredo
PCAs who are new to a TRC learn about medical conditions and the medications that treat them, including the importance of filling prescriptions on time and using the medications exactly as prescribed.
To help patients stay on track, PCAs reach out when it’s time for a medication refill. They also make sure patients are aware of the services available to them, such as speaking with a specialty pharmacist, social worker, or dietitian. If medication cost is an issue, PCAs can supply information about patient assistance programs and other financial resources that may be able to cover all or most of the expense.
As an employee with nine years of experience, Cooper sometimes talks with patients who recognize her from previous calls. Some patients have requested that she be their permanent point of contact. Whether it’s the first conversation or someone she’s spoken with over time, Cooper always is happy to help – and she particularly enjoys hearing their success stories. “Some patients call their medication a miracle drug,” she said, because it’s given them relief after years of seeking answers to their medical issues. “They’ll say, ‘I’ve tried everything, and this is the only thing that helps.’ It just makes you feel good knowing that, even though it’s a small piece of help, it’s still help.”