Clinical Health Coach Profile - Connie Meisgeier

Clinical Health Coach Profile
Connie Meisgeier

Julie:	Tell me about your job and who you work with.
Connie:	I’m a seasoned RN. About 29 years. I work in a Family Practice Clinic with 11 providers. I’m a health coach, provide education for new diabetic patients and work on making lifestyle changes with patients. There is an education we have to provide when we are starting insulin for new diabetics, but then we are also goal setting. I may meet with them several times regarding insulin adjustments and lifestyle changes.
Julie:	How long have you been using clinical health coaching?
Connie:	Personally, I can remember back in home health years ago, trying to get patients to do lifestyle changes. The initiative here has been going on for about 2-3 years. I have been in this position for about 2 years.
Julie:	Do your physicians refer patients to you?
Connie:	Yes, because not all patients are interested in change. Some of them have a good handle on things that are going on. For those patients who have agreed to be, need to be or want to be, are referred to us. Once you get to know a patient, many will agree to meet. We have 861 diabetics we look at for quality measures.
Julie:	How long do you get to spend with your patients?
Connie:	I am really blessed. My initial visit will/can last an hour. They need that time. There is a lot of stuff that I need to give a broad overview with. After that, I let the patient lead with that. Could be 1/2 hour to 1 hour. Some patients can be a really quick visit. They may want to come in for a visit to be weighed etc. and be held accountable.
Julie:	How do you measure your successes?
Connie:	We have quality measure reports. We try to keep track of the patients that we interact with. We also have the patient centered medical home standards that we are working to meet.
Julie:	How long to you follow your patients?
Connie:	Totally up to the patients. I have some patients who could be long term.
Julie:	Can you remember a success that you have had with a patient?
Connie:	One I have right now is a gentleman that is over 400 lbs. I really didn’t think we would see any changes with him at all. He was very non-compliant and didn’t really care at our initial visits. All of the sudden, he decided to make some changes and has lost 65 lbs. He is so motivated and so proud. He wants to come in every couple weeks for visits. He said, he couldn’t have done it without the encouragement of the team. He is off of short acting insulin and cut down on long acting insulin.
Julie:	What did you do differently to start him down this path?
Connie:	I think being there and letting him know that we were here to work with him when he was ready. Our MedFit program was very helpful for him. I talked to him about it for 2-3 months. He was very stagnant with everything and then all of the sudden something clicked. With many patients, I feel it is that continual interaction. No pushing or pressuring. Another gentlemen, who I met with had been self-adjusting his insulin. Finally, after one of the provider visits, he decided he would visit with me. He was very off base. I asked him to give me two weeks to get things in order. He has brought his insulin down from 11 to 6.5. He still does some self-regulating, but things finally clicked with him and he is really trying. I think he realized that I was very interested in his goals and I was going to be here for him. He realized I wasn’t here to judge him.
Julie:	Have the physicians been on board with clinical health coaching?
Connie:	Yes, and I can’t say that would have happened initially. I’m sure they were pretty leery. Even the ones that were just a little hesitant have brought us patients that we can help. I think they are really on board with it now.
Julie:	What was one thing that excited you about what you learned in the Clinical Health Coach training?
Connie:	It was the overview of how to lead a path with the patient. To try and be more confident as I approach some of the health issues of the patients. It has helped to direct the whole conversation so that we could come to some sort of collaboration.
Julie:	How did your approach change when working with patients?
Connie:	We do a lot of diabetic education. I take more of a backseat approach to let the patient lead into what areas they would like to focus on.
Julie:	What have you found to be most helpful from the training to achieve the successes you have had?
Connie:	A lot of reflective statements. Trying to dive a little deeper with my patients. I also enjoyed the videos and critiquing of the videos. They were very helpful.