Sister Mary Boiselle--Patient-Centered Medical Home

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For Sister Mary Boiselle, diabetes was the dark shadow around every corner –her mother, father and brother had developed the condition as adults. But when she learned that she had diabetes in the summer of 2009, it still came as a shock.

"Even though I had lived with the concept of diabetes all my life, there’s so much you don’t know," she says. "I was frightened."

Marie Sandoval, M.D., Mary’s primary care physician, referred her to the Vermont Blueprint for Health patient-centered medical home community health team. Within days, Mary was taking a class with Pam Farnham, R.N. "I call it Diabetes 101," says Mary.

In the class, Mary learned all about her condition and how to manage it, with a focus on the role of exercise and weight loss.

"It was kind of fun," says Mary. "Pam was low-key and reassuring. She showed us how to test our blood sugar and the role of carbohydrates in managing this condition."

From there, Mary began the hard work of changing her lifestyle. She ate less and exercised more. At home in the Sisters of Mercy convent, she began taking the stairs and started taking long walks around the neighborhood, gradually upping her distance from one to two miles.

After a month, she had lost 10 pounds.

Mary continued to meet regularly with Pam, who helped her fine-tune her routine to attain a sustainable weight while managing her blood sugar. "It’s all about changing your choices and practices," she says. "Pam taught me how to do this sensibly and in a way that fit into my life."

Today, Mary has lost a total of 15 pounds and plans on losing 10 more. But her weight loss is just part of the story. She wants everyone to know how important prevention is.

"Without this program, I’d probably be on medication, I’d have more doctor appointments, and I might even be hospitalized. Thanks to the Blueprint community health team, I’m not going to need any of that, which is better for me and is less of a burden on our health care system. It’s a wonderful model of health care."

Fletcher Allen’s Aesculapius Medical Center is one of two pilot sites in Vermont designated as a patient-centered medical home, providing enhanced services to patients with, or at risk of, a chronic disease.

The goals of the patient-centered medical home are to improve patient outcomes by improving quality, educating and empowering patients, and fostering a team approach to care.

The program is an outgrowth of the Vermont Blueprint for Health, a statewide partnership to change health care to a system focused on preventing illness and complications, rather than reacting to health emergencies.

As the health care reform discussion continues, this program is receiving national attention.

In the fall of 2009, Vermont Governor Jim Douglas and Blueprint for Health Director Craig Jones, M.D., joined Federal Health and Human Services Secretary Kathleen Sebelius at the White House for the announcement of a federal initiative modeled after the Vermont Blueprint for Health.