In this episode, Dr. Amanda Du Sablon from FryeCare joins to share her experience helping rural North Carolina patients, who often have difficulty accessing quality healthcare, improve their health outcomes by utilizing the Cadence platform, which offers cost-effective monitoring and interventions with engaging, visual data.
This episode is hosted by Denise Streppa, Provider Relations Specialist at Cadence, in conversation with Dr. Amanda Du Sablon from FryeCare Family Medicine in Lenoir North Carolina.
Their conversation focuses on:
For more information on Cadence, visit https://cadence.care/
Introduction: Welcome to Cadence Conversations where we're talking with prominent physicians, healthcare leaders and tech entrepreneurs about their experiences driving innovation and progress. This week, we will hear from Doctor Amanda DuSublon from FryeCare Family Medicine. Over the course of the episode, Dr. Du Sublon shares her initial experience with the Cadence platform and discusses the key benefits she is seeing for both her and her staff. First up, you will hear her describe the early and positive outcomes her patients are seeing from working with us. So let's get to this week's Cadence Conversation.
Dr. Amanda Du Sablon (AD): What initially intrigued me about Cadence was the ability to monitor my patients without having to bring them into the office as frequently. We have many patients who have constraints such as transportation difficulties or even difficulties paying their copays. So to be able to monitor them from home with minimal cost and burden to them helps us be able to take care of them better.
Over the past six months since we've been enrolling patients, we've had a great experience. I think we've enrolled roughly 75 patients into the program and we've been having very good outcomes. I think our average reduction in systolic blood pressure has been 20 points, which has been great helping these patients get closer to their blood pressure goals. We've had a diastolic drop of at least 10 points. We've also seen an average weight reduction of about 20 pounds in our patients, so this is helping reduce other comorbidities as well, which we are really excited to see.
AD: The patients themselves have actually told me that they feel that this program makes them more accountable. So having to weigh in and check their blood pressure daily, they know that somebody's going to be looking at that. So they say that it's motivation to make sure they take their medicine appropriately, to make sure that they make these changes to stay on track. One patient actually told me earlier this week that just stepping on the scale daily gives her motivation to keep going because she likes seeing that number trend downward and she's feeling much better. She's told her friends about the program who've come to us actually asking to be enrolled, so that's been great as well.
The devices are so simple to use that even my older patients with minimal education are able to navigate those devices very easily. They don't have to have a smartphone. It can be equipped with the most basic flip phone, which has been really beneficial for this patient population.
I have a large patient population who drives trucks and that usually requires a DOT physical. They're very strict blood pressure parameters for maintaining your DOT license and for a lot of patients this is their livelihood. If they don't have their DOT med card, they can't work and that drastically impacts their family. I had a patient who when he enrolled, his average blood pressures were 170/105 and just on five months of the Cadence program, he's been able to reduce his blood pressure averaged systolic to about 110 to 130 with a diastolic of 70 to 80. Passed his DOT this year on the first try, didn't have to come back and make any adjustments, which was a huge goal for him.
Interlude: In addition to all the benefits for patients, Cadence is also a win-win for providers. Next up, listen as Doctor Du Sablon discusses some of the benefits she is seeing for both her and her clinical staff.
AD: I would encourage other providers to get involved because it does improve patient outcomes. It also decreases some of those unnecessary phone calls to your office of a patient calling saying, hey, my blood pressure's elevated, do I need to come in? With the Cadence program, you all already have someone on board seeing those abnormal values and reaching out to the patient, so it's less time consuming for your staff and yourself. Somebody else is already intervening. They will escalate anything necessary to the providers. So I still have the autonomy to make those decisions for my patients as to what medication changes they have, what lab work they need and when they need to come into the office.
Also the Cadence program data will come directly into the patient's chart in Athena, so I'm able to review that, review the trends, and I'm able to sit down with the patients and show them their graphs so they get a better idea and understanding of their trends and patients really like that. It's very engaging to have those conversations in the clinic to help motivate the patients further.
The workflow with Cadence has been phenomenal. They will tell us which patients are eligible in Athena. Sometimes they will put an order in that I can review and approve, or sometimes I'll just put the order in right there in the clinic with the patient in the office. Once that order goes through, our enroller reaches out very quickly. She usually has the patients enrolled within the first couple weeks after the referral's placed. We'll get patient cases or even sometimes Athena text to let us know what's going on with our patients. When they enroll, the enroller is great about letting us know what their blood pressure is in the office that day, if it's elevated, and finding out in the interventions that we may want to go ahead and initiate so they're successful in the program from the start.
We have seen the ease of those burdens from those unnecessary phone calls as well as reduced phone calls from the emergency room saying, hey, your patient's here in a hypertensive crisis, we're able to stop that before it happens. I can think of one patient in particularly who would have to call multiple times. They would call relaying information that their blood pressure was elevated. We would give them instructions on what to do. They would call back within one to two hours with updated readings. But now with the Cadence program, the Cadence team is able to intercept those calls and give advice to those patients without us having to take away from our day-to-day activities in the clinic, and then we can check in on those patients if escalation is needed from the Cadence team.
I think the most beneficial thing that I've seen is just the patient engagement. The patients are excited to see these numbers trend towards their goals. They have this concrete data that they can see, visualize to show that they're doing the right things. It's easy to get discouraged when you're not seeing those weight goals or blood pressure goals, but with the data through Cadence and seeing these graphs, they can see that they're trending downward and that keeps them motivated to make those changes. Just the attitude towards the program and seeing some of these patients who have struggled for so long finally be successful and see their reaction to it is so rewarding.
Interlude: Using Cadence, clinicians can manage patients with four different chronic conditions: Hypertension, Heart Failure, COPD, and Type 2 Diabetes. To conclude, you will hear Doctor Du Sablon describe Cadence's type 2 diabetes program in more depth and discuss the benefits she is seeing for those patients.
AD: The diabetes program has made such a big impact in our community, and I'm excited to see the growth and improvement that we have in our numbers. Our area is a more poor rural area, so patients have trouble affording their diabetic testing supplies. And many of the Medicaid and Medicare programs will only pay for them to test once daily, but many of my patients are needing to test more than one time daily. So this program allows them the freedom to do that so we can get better control of these fluctuations that occur in between when they were typically taking their blood sugars before. This has been taken a lot of burden off of the patients, both financially and just mentally because they know that they can check their sugar at any time and they're not going to have to skip checking the next two days to ration their test strips.
The nutritional counseling that has been provided by the Cadence team has been very impactful for my patients. There are very few diabetic educators in our area, and I know specifically Medicaid in our area does not cover diabetic education. A few of the Medicare plans will, but not all of them, and when they are able to, the transportation difficulties have a big bearing on patients being able to get to these programs. The Cadence program, being able to do that education in person in the office, or even over the phone gets these patient tips and the tools to be successful that they may not have otherwise. I've had several patients who weren't aware that carbs and starches played a part in their sugar. They just thought that it was all sweets and they were still eating pasta daily because it was easily accessible. So these classes have really taught them how to better themselves and make these lifestyle changes that are necessary for them to meet their goals long term and maintain those goals.
I think the most beneficial thing that I've seen is just the patient engagement. The patients are excited to see these numbers trend towards their goals. They have this concrete data that they can see, visualize to show that they're doing the right things. It's easy to get discouraged when you're not seeing those weight goals or blood pressure goals, but with the data through Cadence and seeing these graphs, they can see that they're trending downward and that keeps them motivated to make those changes. Just the attitude towards the program and seeing some of these patients who have struggled for so long finally be successful and see their reaction to it is so rewarding.
Conclusion: Thanks again to Dr. DuSublon for taking the time to talk with us this week about her positive experience working with Cadence. If you're interested in learning more information about Cadence and how to get involved, visit Cadence.care and please get in touch with our team. To make sure you get updates on our future conversations, please subscribe to Cadence Conversations wherever you listen to podcasts. At Cadence, we believe that everyone deserves to receive the best care possible and we won't stop working until that vision becomes reality.