Karen Koenig has been a Registered Nurse for seven years, and a Licensed Athletic Trainer for 18 years. Since 2015, she has worked with patients and her community in value-based care in Oscoda, MI at the Alcona Health Center (Alcona). Alcona has participated in a Caravan ACO since 2014 and is currently a member of the Collaborative ACO.

Recently, we talked with Karen to learn more about her work which resulted in receiving the Nurse of the Year designation.

Tell us what winning the Pioneer Award meant to you and your Alcona teammates. 
“It meant so much to me for my staff to get recognition for all of their hard work. They always strive to do all they can to help their patients improve their health, but the extra commitment they showed, and continue to show, during the pandemic is inspiring. The award was presented in my name but is representative of all of their hard work and dedication.”
 
Were you surprised to receive the Nurse of the Year award? 
“Very much so. I was very confused when I received the email from Ron Palmer with the subject “YOU ARE A WINNER! 2020 Population Health Pioneer Award”. I saw that my supervisor was included on the email, so I reached out to her to ask if she knew what it was. She replied that yes, she did, that she nominated me for it.”

You said this award is representative of all the hard work from you staff. Can you share a bit of the ‘behind the scenes’ work that went into winning? 
“When the pandemic hit, it caught everyone off guard to an extent. We knew it was out there in the world and that it had made its way to the states, but I don’t think anyone was ready for the impact of it. Our organization (very) briefly paused, assessed, and came up with a plan on how we could move forward in providing quality care to our patients while keeping in mind the safety of our patients and staff. Telehealth was quickly implemented by our HI and IT teams. Our care managers were able to provide this option to patients who were either uncomfortable coming in due to the pandemic, or those for which it was potentially unsafe due to their chronic medical conditions. Through the use of telehealth and phone call appointments, the care managers were able to keep patients engaged until they were able to, or comfortable with, coming back into the clinic for face-to-face visits.”
 
Alcona has been a member of a Caravan ACO since 2014. What has your experience been like? 
“It’s been great. Prior to accepting my current position, I worked as Dr. Kathleen Dunckel’s medical support staff performing AWV’s with her. To see the ACO grow to what it is now speaks volumes for Caravan, the health centers, and the staff who have dedicated their time and efforts to improving the health and lives of ACO patient populations.”

Has anything surprised you about delivering value-based care? 
“Our mission statement states, ‘The purpose of Alcona Citizens for Health, Inc. (Alcona Health Center), shall be to promote, develop and operate such facilities and programs as are necessary to provide quality health care to all residents of Alcona County and the surrounding areas, regardless of ability to pay.’​ Providing high quality, affordable health care, has been the foundation of Alcona Health Center for over 40 years so I do not feel we really had any surprises when it came to population health or value based care. The concept fit very well with, and supported, our mission as a health center.”
 
Alcona has weathered the pandemic and hopefully this experience will soon be in our rearview mirror. Where is your Alcona headed? What lies ahead for you and your staff?
“Speaking as the Population Health Manager, I would like to see the department continue to grow. We have almost doubled in size since I started in this position in December 2015. Care management and population health are essential to helping our patients successfully manage their chronic conditions. While we will always focus on those with chronic conditions, we are also shifting toward more preventive care with an additional focus on those who have the potential to develop chronic conditions like diabetes, hypertension or obesity.”

Do you have a favorite success story that you’d like to share? 
“Yes, this success story comes from Amber Benson, RN, Care Manager at our Harbor Springs clinic: 
Earlier this year I called a patient for his first discharge tracking call. His discharge diagnosis was CVA and he said he was doing fine. I reviewed his discharge instructions and he understood. But then I reviewed his discharge medications, and I noticed a duplication – he had been prescribed multiple blood thinners. He said that the pharmacist had questioned him also, but he had explained to her that he still had a clot in his heart that they had told him to take all of the prescriptions. 
It still didn't seem right to me. I had never seen a patient take four blood thinning agents at once. I asked the patient to wait until he heard back from me and I started making calls to multiple providers including one who was short with me for questioning the instructions. But we got to the bottom of it. There had been a change of medications and unfortunately both prescriptions were sent to the pharmacy. The patient was taking double the amount of blood thinners. The physicians thanked me for catching the error and we contacted the patient, his PCP and the pharmacist to get everything corrected. On his next follow up, the patient was doing well. This is what team-based care is all about. Mistakes will invariably be made whenever humans are involved but our system of checks and balances allows us to respond quickly.”


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Deadline to join a Caravan-supported ACO is July 7. Speak with a Caravan expert to learn more.

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