CELEBRATING 10 YEARS OF IMPACT IORA HEALTH 2020 OUR PEOPLE, OUR CULTURE, OUR STORIES
IORA IO CELEBRATING 10 YEARS OF IMPACT OUR PEOPLE, OUR CULTURE, OUR STORIES YEARS 1
CELEBRATING 10 YEARS OF IMPACT “To be a person is to have a story to tell.” —Isak Dinesen (Karen Blixen) 2
INTRODUCTION AT IORA HEALTH, storytelling is a key part of our culture and a navigate important healthcare choices. Our hope is that through cherished tradition. Over the last ten years, we have shared with our work together, they will have stories of feeling heard, of each other thousands of stories that bring to life the care we success and of being supported through challenging times. deliver and the way we work. Stories are a form of teaching, of This book is quite special because it was truly created by telling, of celebrating and of honoring. By sharing a story, we all of Iora. Over 400 employees across the company, across all take a moment to deeply appreciate a moment of humanity. markets and teams, in all different roles contributed stories and Stories help us demonstrate our shared values to new Iora photos to this edition. Even former colleagues are highlighted colleagues, and they might even remind us of why we each as this is a true celebration of our 10 years of impact. It is a joined Iora. While most of our stories are shared within the beautiful testament to each member of the Iora team and the walls and people of Iora—around the Huddle room table or in a culture we build together every day. The work we do is always Zoom team meeting—we also believe they are a powerful tool difficult, but in the midst of a global public health crisis, it has for conveying to people outside the company our unique way been even more challenging. I’m incredibly proud to be a part of of serving patients. Perhaps by having a glimpse inside our high this team and to share these remarkable stories of our collective impact, relationship-based care model, the recipient of one work and impact. of these stories might become a new Iora patient, employee, Welcome to Iora’s Culture Book: Celebrating 10 Years community partner, investor or champion of this critical, indus- of Impact. try-changing work. Our patients tell us incredible stories from their decades of ZANDER PACKARD lived experiences. Some are painful and raw; others are uplifting and inspiring. Each story is a gift and a remarkable testament to President the journey that person has traveled. We are privileged to accom- December 2020 pany our patients on this part of their life journey, helping them 3
TABLE OF CONTENTS Ten years of impact. Thousands of stories. 4
To celebrate 10 years of impact, we’ve assembled stories 6 from our teammates and patients on these 10 topics: 14 22 01 Our Impact 30 02 Overcoming Obstacles During COVID-19 36 03 We Never Stop Learning 44 04 Wisdom From Our Patients 52 05 The Values That Drive Us 58 06 Moments the Matter from Classes and Events 66 07 The Important Role of Caregivers 78 08 Memorable Patients 09 Choosing Iora 5 10 The Future is Bright
01 Our Impact 6
WHILE IORA HAS PROVIDED ME with endless experiences that CHAPTER ONE I will never forget, there is one patient who sticks in the fore- front of my mind whenever I think about the biggest impact I seen in the practice for follow up, she was beyond grateful for have made here. As a nurse and a provider, making the smallest the care we provided her, and she was very appreciative of the difference in a single person’s life is the greatest achievement constant touchpoints I had with her, her son and her care team we can strive to accomplish. When I first met this particular pa- in the hospital. tient, she was very skeptical about the healthcare system, hated From that point forward, she would call me to get my per- the hospital and never trusted her primary care providers, only spective after every specialist visit to make sure I agreed with her specialists. When I met her, she was very candid about her the plan of care. My opinion regarding her health “meant hesitations regarding healthcare and even expressed her lack of everything to her” and she put “every ounce of trust” in me. Sad- faith in my role as a nurse practitioner versus a physician. Luck- ly, her insurance had to be changed and she was no longer able ily, I had a supportive care team behind me who had known the to see us at Iora. At her last visit prior to the insurance change, patient prior to me joining the practice. she expressed that she felt as though I treated her as if she were Through multiple visits, complete transparency, and doing family. With a warm embrace and a few tears, she thanked me my best to make her health a priority, I started to gain her trust for showing her that she can trust the healthcare system. Upon and acceptance. When she fell ill, I acted no differently than I finding out that our practice was closing six months later, she would have for any other patient and developed a plan of care made it a priority to find a ride (previously a difficult task for her) to which the care team acted on as quickly as possible. She ex- so she could come back one last time and say thank you for the pressed her wish to avoid the hospital as much as possible, and amazing care she received. She had since agreed to have var- therefore, after extensive decision making, we created a new ious screenings she objected to in the past. After another hug, care plan which kept her from the hospital. She was extremely she thanked all of us in her care team for letting her “see the grateful for the extra effort to keep her wishes in mind. Unfortu- good in those who are trying to help her” and giving her con- nately, a few months later she decompensated from a chronic trol over her health. As a provider, we have all had challenging health condition and had to be admitted to the hospital. While patients who we fear we will never be able to connect with. It’s admitted, I made sure to communicate with her, her son and because of Iora’s mission and culture that I was able to take the the hospitalist daily so she would feel comfortable and not want time necessary to build that relationship with the patient. Be- to leave against medical advice. After she was discharged and cause of this, we were able to allay a patient’s extreme fear and anxiety as well as total distrust of the healthcare system which has now given her control of her health which she has desper- ately wanted. While she was ever grateful for the care we pro- vided, I will forever be grateful for the motivation to continue helping others in their journey of taking control of their health. MATT Medical Director of Patient Safety/ MRO Clinical Lead/Nurse Practitioner | Nest 7
OUR IMPACT PRE-COVID-19, the Tucker, Georgia team was able to offer many in-person classes for our patients - from SilverSneak- I’VE BEEN BLESSED TO WORK FOR THIS ORGANIZATION that ers Yoga and Classic, to Bingo, to Valentine’s socials and many Rushika and Chris founded, and that Zander has led for the others. Through these classes we have made an impact on both past 10 years, and I’ve had the privilege to spend significant their physical and mental health. time in both the Nest and in the practices, wrestling with I have the honor of leading the Tucker Chair Yoga class the challenges that arise in both settings. Transforming the which is a time of physical exertion and mental letting go. Pa- broken healthcare system into a system that patients can tients have reported that their stress levels have decreased, as navigate, and that is actually sustainable for healthcare em- have the number of falls they have had. One patient even said ployees, is really hard. If it were easy, someone else would that the Chair Yoga class was “lit” - our greatest compliment yet! have already done it. We’ve reached a scale and a degree We are continuing to offer classes virtually, but can’t wait to get of brand recognition (thanks Kathleen Haley), at least in the back in the group room again with our patient and friends. healthcare policy world, where there seem to be articles written about Iora every week. And that’s great. FRAN But nobody writing or reading those articles truly un- derstands what it is like under the hood at Iora to care for Health Coach | Georgia these challenging patients on a daily basis on the frontlines at an Iora practice. They also don’t truly understand what Hand addressing mailers it is like to see a couple dance on their 50th anniversary at at the Nest for Iora’s first their doctor’s office or give a patient a haircut in their prac- Annual Enrollment Period tice, or see a patient in tears after we’ve stabilized her after in 2014 she revealed her plan to take her own life, or see the soli- darity of our teams in the Huddle room following the death of a patient. They don’t know what it is like to face the very challenging task of building the central technological and process infrastructure necessary to support Iora’s practices well, or balancing the urgent requests that come every day from the practices with the important but not urgent work that needs to be done to better support those practices and patients. But we do. We know that it is the hard work and teamwork that results in the best primary care available to the people who need us. PAUL Senior Director, Market Operations | Northeast 8
IORA CHAPTER ONE ASKS What did you do prior to joining Iora? The Iora team is wonderfully diverse! It’s no surprise that most team members came from healthcare, but within that, the variation is vast! This diversity of thought and experience is part of why we can achieve so much at Iora! “I ran an ER and owned an ice cream shop!” Weston with a patient “I managed a partnership between a professional I AM ALWAYS HAPPY WHEN I can assess a patient’s mood and sports franchise and educate them about the symptoms of depression and anxiety, healthcare system.” teaching them specific skills to help manage their mood. There are many patients living with the illnesses of chronic depression “I was a “I was a Medical and generalized anxiety disorder. They know that something is Genius at the Assistant at a “not right”. We can help them identify the issues and teach them Apple Store.” neurology clinic what they can do to resolve them. and cared for “I was a barista patients.” DEBRA at Starbucks.” Behavioral health Specialist | Phoenix 9
OUR IMPACT I only have to call and they are more than happy to help, thanks guys, you will never know how much your services mean to me during this virus. God bless you all. —NORTH CAROLINA PATIENT Rebecca helping a new Iora patient with paperwork 10
CHAPTER ONE Teamwork WE HAVE AN 80 YEAR OLD PATIENT who started seeing us at I HAD MY FIRST APPOINTMENT last week. First impression, ex- Pusch View in 2019. She has a history of anxiety and depression. cellent. Instead of being slid a stack of papers anonymously The summer of 2020 with the pandemic was difficult for her. from someone behind a frosted glass window a lady came out She was experiencing higher levels of anxiety and was afraid. and introduced herself then sat down with me and showed me The team put her in touch with me via the triage line. I followed the new patient paperwork that she would like me to fill out and the triage process to the letter and, to ease the patient’s anx- answered any questions I might have prior to my appointment. iety, I stayed in close contact with this patient over a number My appointment was for 11 o’clock and at exactly 11 I was taken of phone calls. I coordinated a change in her meds with the to the room where I was to have my appointment which com- provider that the patient was able to pick up before the end of menced immediately. I met with a team, not exclusively with the that day. doctor. As a new patient they patiently and methodically asked The patient was so grateful and relieved, she called the next me about my medical history, current state of health, asked day—not with a need or an ask—but with a lot of affection and what my health goals are and together we began to form a plan. to express her gratitude. I was on the other line, but when my I feel confident that I made the right choice in finding a PCP. teammate asked her what she needed, she said “tell her I love —TEXAS PATIENT her.” She wanted to thank me. And the best part was that the patient sounded a lot better, calmer. 11 MARSHA Team Nurse | Tucson
OUR IMPACT The Arizona Charged Up event “Iora is the first company I VOLUNTEERED TO DEVELOP A CLASS and enlisted help from that has allowed me to be two of my colleagues, thus forming the Blood Pressure Aware- engaged in this type of care ness Program. This consisted of weekly classes and spanned regardless of my job title.” over the course of two months. We brought together a group of strangers from various life paths and successfully lowered all 12 of their blood pressures to a maximum of 130/80. It was vital for each of them not to exceed that blood pressure threshold in order to reduce their risk of secondary health conditions like stroke, heart and kidney disease. I provided the participants with dietary information, exercise, wellness plans and an overall safe place for them to talk in a group setting. We were able to keep the class exciting by creating fun trivia games like “Hyperten- sion Jeopardy”. This mirrored the original game and contained trivia questions that educated patients about various aspects of hypertension, the risks and prevention. I quizzed them on day one to gauge their knowledge, and in the last class we played jeopardy—the increase in knowledge was remarkable! We made the information we provided easy to grasp and less clinical to
CHAPTER ONE HAVING THE OPPORTUNITY to participate in the launch of our Houston market has left a lasting impression on me. I felt a real connection with who, at the time, was a group of strangers. We had fun learning about Iora and building a culture that the teams wanted to be a part of. From doing escape rooms to OSHA trainings with chocolate syrup, each memory is one that I will carry with me. Not to mention the INCREDIBLE group of people that traveled across the country to support training. We got to eat ALL OF THE BBQ and spend mornings together in the car singing to 90’s pop music. I am proud to be an Ioran. SUMMER Care Team Manager | Colorado North Carolina cohort training Jenalyn folding chairs for the Vietnam Veteran Pinning Ceremony achieve engagement from everyone regardless of their educa- tional background. The class empowered all of the participants to take charge of their lives and actively create healthier habits. The participants were able to learn from each other and openly discuss their personal barriers in healthcare which allowed us to collectively brainstorm ideas that helped them. After the success of that event, we followed it with an infor- mational class on Valentine’s Day called “The Iora You Event”. We utilized one of our locums, who was also a veteran cardiol- ogist, as a speaker. In this class we discussed heart health and hypertension. It is an amazing feeling to know that you are actively con- tributing in making positive changes in patients’ lives. Iora is the first company that has allowed me to be engaged in this type of care regardless of my job title. HEIRALAND Operations Assistant/Phlebotomist | Phoenix 13
02 Overcoming Obstacles During COVID-19 14
IT GOES WITHOUT SAYING that COVID-19 changed the way we CHAPTER TWO live our lives. The impact is felt on multiple levels, including the way we deliver healthcare. Nearly overnight, we tremendously IN THE MIDST OF COVID-19, our patients are concerned and reduced our face-to-face visits to begin the implementation of scared for what’s to come. Because of social-distancing, our virtual healthcare. Our patient outreach made a world of differ- patients have had to put a pause on their weekly golfing with ence; our patients felt cared for. friends, daily morning gathering for coffee or pickleball tourna- We were using mostly telephone communication to serve ments. Many patients have reported feeling lonely and anxious, our patients, however, something was missing. We missed however, countless patients have reached out saying that they seeing our patients. Next came the challenge of teaching our can trust that Iora will always be there. patients how to use a smart device to access our virtual video We’ve been able to overcome the many challenges that platform. I recall a patient of mine having difficulty navigating COVID-19 has thrown our way, especially when it comes to the new world of virtual visits. I called her and slowly walked connecting with our patients even though we aren’t seeing her through the steps to connect with us. Just as we were them in person nearly as much. To ensure that our patients are about to connect our videos to see each other, we came to doing okay, and to help them when needed, we’ve conducted a halt. She said, “But Zach, I cannot go on camera, my hair countless outreach calls and have received many enlighten- is a disaster!” I replied, “not a worry, mine is too.” The slight ing words of encouragement and positive feedback. A single delay gave me a moment to push my hair around to appear outreach call has brought comfort to many patients who have unkempt. When our cameras finally connected, the sight of felt worried and scared during this uncertain time. Some of the our hair gave both of us a laugh. Since our orientation call, many comments we’ve received from patients during our out- this patient has used the virtual platform with ease. She credits reach calls are: our virtual visits for keeping her family safe. This was my first “Thanks so much for calling to check in on my mom. She is COVID-19 virtual visit win. 90, and we want her to get through this crisis as much as you guys want her to. We see how much you care about her, and ZACH all of the good things you have been doing is noticed and is appreciated.” Health Coach | Tucson “This is Sunday! I’ve never had a doctor’s office call me on a Sunday. I am so lucky. Thank you very much for the call!” “Wow, thank you so much for calling. I am so happy I had made the decision to switch to Iora when I did. My former PCP office is now closed, and my husband is jealous that I get frequent follow up calls from Iora to make sure I am well. He will be switching over to Iora now.” MEG Health Coach | Phoenix 15
OVERCOMING OBSTACLES DURING COVID-19 bit to get the systems up and running—was a feat and yet, it was so very important. Just like being there The impact this communication had was real. Not only did but I didn’t even have we do more for our patients than most doctors did, we provided to put pants on! practical information for them to stay safe, taught them what to look out for in terms of symptoms and more. The most import- —COLORADO PATIENT ant thing we did was provide a bit of peace of mind. We are on their side, ready to help, especially when there’s a pandemic. IT WAS MID-MARCH, 2020. The world as we knew was changing Here are just a few of the responses we received from the fast. first few emails we sent: We realized, seemingly overnight, that we needed to talk to every one of our patients to help them understand COVID-19 “Yes, Doctor, I just stay home with my sister, and do the same and their heightened risk. And we wanted them to know that way as your advice. We are still in good condition now. We Iora was here for them—whether that was for medical concerns have enough food, medication...Thank you very much. God or something else. We wanted to make sure that our patients bless you, and your family, and your assistants.” had what they needed to stay safe at home. Our care teams quickly hopped on the phones (which were now ringing on “Thank you for your clarity about virtual appts. We clearly their laptops!) and our newest team at Iora, the patient expe- need healthy healthcare staff at Iora, especially for us old folks rience team, started doing what we needed to do. We emailed in this pandemic.” every patient we could and sent letters to those we couldn’t email. Email was best as it was fast, but we couldn’t stop there “You ALL are great...Thank you for the reminder call on or- as we wanted to touch every single person we’re responsible dering my prescriptions and calling them in for me. We for, to make sure that patients heard from Iora at least once, (meaning my husband also), are so impressed with your ser- ideally more times, at the beginning of the pandemic. vice, kindness, caring, “in touch” service you give...you all The ability to pivot so quickly—and run on adrenaline for a stay well too.” 16 This was a true team effort and this story isn’t complete without some shout outs to the Communications and Patient Experience team (Katie McGowan and Millie Evidente), Christina Pelligrino for her help getting the emails out and the entire COVID-19 re- sponse team, especially Sheila Antony and Dave Gellis. KATHLEEN Vice President, Communications & Patient Experience | Nest
CHAPTER TWO I can’t wait for all of this to be over, so I can come in and see all of you guys! -HYANNIS PATIENT To those who brave the danger, I SPOKE WITH A PROSPECTIVE PATIENT back in January of 2020 we are grateful when she had first learned about Iora while visiting Arizona. At that time, she was curious about our care but declined an ap- WORKING WITH IORA during a pandemic has been such a great pointment. I reached back out to her in June, but she was back experience. Everyone has come together to help each other out in South Carolina, unsure when she’d go back to Arizona due to both personally and professionally. I feel lucky to be a part of COVID-19. She was delighted that I called and told me that she a company that cares as much for their employees as they do felt like everyone involved in caring for her health was failing her. their patients. I told her about our use of virtual appointments, and she was more than happy to schedule one. I followed up with her after ANNA her virtual visit, and she was full of hope and enthusiasm, and wanted to continue virtual care with Iora. Her feedback was: Operations Assistant/Phlebotomist | Phoenix “I like that there was some prep with the Health Coach before the provider joined. The provider was focused on me, good suggestions and great goals were set. There was a concern about the distance but we will work together on this. I had better experience virtually with Iora than I have with a provid- er sitting across from me, that says it all. I love the connection with my care team.” This is a true testament to the care we provide at Iora and to our ability to overcome the many obstacles that COVID-19 has thrown our way. Our care teams deliver exceptional care, even virtually! EMELINE Patient Enrollment Coordinator | Phoenix 17
OVERCOMING OBSTACLES DURING COVID-19 2020 mammogram screening van OCTOBER IS BREAST CANCER AWARENESS MONTH. One in eight women will have breast cancer in their lifetime. With On the day of the screenings, we arrived early to make sure more widespread testing, the mortality rate has decreased there were parking spaces blocked off for the van and that over time, but early detection is key to having the best possi- our practice looked nice for potential visitors. We also booked ble outcome. physician appointments and flu shots for some patients who Over the past six months, many of our patients were were going to be coming to the mammovan anyway! It was a scared to get their routine screening tests in a large, busy busy day, but all the positive energy made it fun! The team also healthcare facility and risk a possible COVID-19 exposure. Our had the opportunity to tour the van at the end of the day and quality metrics were suffering, but more importantly, patients take a picture. We all ended the day feeling very accomplished were averting tests that are essential for the early detection due to having successfully served our patients! of the second most common cancer among women in the Overall, we were able to get 32 patients screened who United States! Our leadership team in North Carolina worked had not had a mammogram in over two years. After receiving tirelessly with Charlotte Radiology to schedule a mammogram her screening results, one patient at the MoRa practice said, screening van to come to our offices. The teams spent many “Thank you for the good news. If having a mammogram can hours calling patients who needed testing, getting them on be a pleasant experience, this one was right up there. The re- the schedule and filling out required intake forms to ensure ceptionist & the technician couldn’t have been nicer & the at- appropriate testing and billing. The van provided an environ- mosphere was cozy and inviting. I will do it again next year if ment where patients could wait in their car until their appoint- you decide to have them come back.” ed time, have minimal interaction with just two staff members and get screened quickly in a clean facility. MELANIE 18 Care Team Medical Director | North Carolina
IORA CHAPTER TWO ASKS I AM EXTREMELY IMPRESSED with the care I receive here! They Name one silver lining have contacted me 3 times since the COVID-19 outbreak to from this past year. make sure I’m okay and if I need anything! I am so thankful that I switched to them, they certainly show they care about their The bear of the year we call 2020 has had some patients!! pretty great silver linings despite the obstacles and —PHOENIX PATIENT challenges! Of the responses we received, we saw Ahunna, Markisha, Hannah, Rushika, some interesting trends: Aaron, Meredith, Mary and Adrienne WITH THIS GLOBAL CRISIS, this is a most innovative way for the 23% doctor to assess how well a patient is. I enjoyed being able to communicate this way. getting to spend more -PHOENIX PATIENT time with family 16% seeing our ability to provide great care despite the pandemic 10% getting to know teammates better even while seeing them in person less 19
TOiyVsEa,RSCteOpMhaInNieG, MOaBrcS,TAAleCxLisE, S D U R I N G C O V I D - 1 9 LeVette and Casey ABOUT A WEEK INTO VIRTUAL LIFE, I WAS ON CALL: him take a few deep breaths through his nose.” (Then, to my- “My daddy is miserable”, said one of my patient’s daugh- self, “He’s in Afib with RVR!...things we don’t usually manage in ters. My patient had lung and heart problems and was having primary care, much less by phone while feeding an infant…”). trouble breathing. He had been hospitalized every month for “This is dangerous. It might be best to go to a hospital.” the last four months before becoming my patient a few weeks Patient’s daughter: “He won’t do it. He does NOT want to before this call—each time for shortness of breath like this. be in a hospital.” “He stopped taking his water pills. He kicked his oxygen Me: “His heart is angry because his oxygen is low. Keep his off. And he does NOT want to go to the hospital” his daughter oxygen on, and it might calm down. Just have him keep taking said. I didn’t blame him, but he was sick. His heart rate was those deep breaths.” in the 150s, his oxygen in the low 80s, and he was feeling We did. And two hours later, the octogenarian had suc- light-headed and confused. Not normal and not good. cessfully kept his oxygen on long enough that his heart Me: “He took his oxygen off to do his nebulizer treatment.” stopped protesting. My 8-month-old had filled her belly and (My husband knocked sheepishly at the door. It was time for stopped her protesting, too. And this primary care doc went my daughter’s supper, and he didn’t have the requisite anato- to sleep figuring that if we can handle this, we can handle any- my to serve it up). thing. And so far, we have. Patient’s daughter: “He doesn’t feel well.” Me: “Put his oxygen back on.” (My daughter continued to SA R A H cry and I asked my husband to give her to me). “Now have Care Team Medical Director | Texas 20
AT IORA, WE BELIEVE THAT RELATIONSHIPS are our stron- CHAPTER TWO gest tool in supporting our patients during a stressful time. As COVID-19 has slowed face-to-face care in practices, we’ve been “All are grateful, appreciative, and especially happy to have able to transition to mostly virtual visits, still allowing us to provide someone to talk to, even if for a short while.” great patient-centered care to our patients. “Patients have been very thankful and say this is why they are Not only are the patients we serve at a higher risk for con- glad they chose Iora.” tracting COVID-19, but they are at a higher risk for serious com- Although our care teams are now physically divided, our plications if infected. Our Health Coaches have been leading the core values and the way we deliver care as a team remain intact charge in making outreach calls to patients to ensure that they and have allowed us to bridge the virtual chasm. Our Operations stay safe and healthy at home during this crisis. Assistants are manning the practice phones like champs, while In the broadest sense, our clinical goals are multifold, how- keeping entire teams up to date. Outreach calls have been the ever, on a more interpersonal level, one message rings through catalyst for additional triaging by our Team Nurses. Medication re- again and again. We are truly transforming healthcare, because fills, clinical advice and follow up phone visits are being addressed we truly care about our patients. The following are comments by our providers, and our behavioral health team has been busy taken directly from Georgia Health Coaches after conducting ensuring patients’ psychosocial needs are being addressed. outreach: MARY Mary, Markisha, Hannah, Adrienne, Aaron and Meredith Trainer | Georgia 21
03 We Never Stop Learning 22
CHAPTER THREE “I didn’t cry, but my eyes were full the whole time.” THE HARDEST THING I HAVE EXPERIENCED at Iora was par- everything together and sent it all back to the Nest in Boston. ticipating in the closing of a practice—it was the Freelancers’ Of course, I had participated in Huddle meetings in New practice in Brooklyn. It was emotionally wrenching, and I’ll just York before, but this time, emotions were frayed and everyone cut to the chase and say that my learning was that Iora survives was rushing. Yet, I had never seen a team be such a team—there such events, and the team members will survive. Indeed, I dis- was a lot of care in those rooms. In some cases, staff was say- covered that some team members who were awesome in the ing goodbye to patients. I didn’t cry, but my eyes were full the practice setting came to work at the Nest, and in some cases, whole time. we’ve seen a practice close with staff moving to another prac- In the evening on the last day, there was a bittersweet sea- tice or people who leave and come back to Iora. The resilien- food dinner in Red Hook. Everyone looked radiant because cy of the organization makes that possible, and closings often they had been working, thinking and feeling to their utmost. mean that Iora DNA gets spread around the country—a good (And there was some crazy stuff: Dr. Neil Patel had obligations thing if the mission is to transform healthcare. Andy Seale with the handover of the physical space to another provider (then the Privacy Officer) and I (as Security Officer) had trav- organization. He was on call until midnight and got a call from eled to New York, he from New Hampshire, I from Minnesota. a patient regarding a reaction to soft cheese and said he had We had to pick up all of the laptops and networking equipment tripped over his Vespa scooter.) We ate, made merry and said and make a tour of the practice to ensure that all protected our goodbyes. health information was collected or destroyed; we also had to secure drugs and make sure that any expired meds were de- JOHN stroyed. We worked from dawn until night for two days to get Vice President, Technology | MinneNest 23
WE NEVER STOP LEARNING “Regret only the things you don’t do, and appreciate all that you have.” COMING TO IORA HAS GIVEN ME the opportunity to grow both it reinforced this principle. My roles have changed vastly since personally and professionally. With such a positive and support- I first started, and without taking a chance, or simply asking for ive culture, I have learned so much. While having come from an opportunity, I could not have accomplished what I have. an organization with an outdated healthcare system and a pa- Something as simple as baking a holiday family treat for the ternalistic approach to patient care, I always believed that how Nest Bake Off would introduce me to so many new Nest mem- I practiced nursing and medicine was the way it was supposed bers I never had the fantastic pleasure of interacting with. It was a to be, not against the grain of what currently existed. When I bridge to a broader sense of community and professional friend- came to Iora, I felt at home. It was where I belonged because ships that I had never experienced in a work setting before. Rais- it allowed me to provide care in a manner that was congruent ing my hand for projects I was never previously a part of forced with my own approach; patient-centered care using shared de- me to learn new skills and subject matter which now are familiar cision-making, with a strong clinical foundation. topics. I have come to appreciate all that Iora has taught me in But in doing so, my role evolved progressively through- the two years I have been part of the organization. As a nurse out my career at Iora. I have been given opportunities to grow; and a Nurse Practitioner, I have heard countless amounts of sage something I was craving while in my previous provider roles. advice from patients in the later years of their lives. In the end, With supportive leadership and encouraging colleagues, I it always boiled down to one statement…Regret only the things learned that all you need to do is put yourself in a situation that you don’t do, and appreciate all that you have. Iora has shown might feel foreign, and it will change you for the better. I tend to this to be true for me professionally, and I will continue to survey put myself in “unfamiliar situations” in my personal life to grow my surroundings and experiences for those opportunities to help as a human, however, in a professional setting, as most of us do, me grow. I appreciate every opportunity, every colleague, and I always shied away from it. The culture at Iora has taught me every experience Iora continues to offer me. that without taking risk and putting yourself into an unfamiliar situation, you will never grow and could only regret opportu- MATT nities you never sought out. I was beyond fortunate to learn this lesson early on at Iora, because with each chance I took, Medical Director of Patient Safety/MRO Clinical Lead Nurse Practitioner | Nest 24
IORA CHAPTER THREE ASKS What is the most important lesson you’ve learned while at Iora? Iora is nothing if not a learning organization. The lessons we’ve learned are vast. Here are just a few of our favorite responses. “to keep listening....to my patients, to my team members, to my leaders...I learn every day from all of them”. Maggie Care Team Medical Director | Washington Julie and Rushika ringing the bell “Collaborate and capitalize on the expertise of your I AM ELATED TO CALL THIS TEAM my all-time favorite. They lis- colleagues.” ten to all of my concerns, provide a safe environment with no rushed appointments. You will not be dismissed whatsoever by Melanie any staff members. The doctors and Health Coaches are the Team Physician | Phoenix most respectful warm people I’ve ever met in healthcare. Finally, be sure to come in with a good sense of humor. Love you guys “Listen more, talk less.” at Iora!!! —COLORADO PATIENT Zach Health Coach | Tucson 25
WE NEVER STOP LEARNING “...not only is Iora going to transform healthcare, but we will have done so in a way that makes us proud.” THE GREATEST THING I HAVE LEARNED at Iora is that it is not mattered. We are all so busy. It would have been understandable just about what we do, but how we do it: the “what & the how”. for this person to leave the meeting, feel underwhelmed by my I had worked at Iora for about 6 months when I first experienced presentation and simply move on to the next task. And the ad- this philosophy in action. I had just presented an assessment on vice could have been presented in a demotivating way—a critique a current process and proposed next steps for improvement. My of what I did wrong rather than an affirmation of my ability to audience was a group of leaders, and I was still figuring out my achieve something better. I have reflected on this conversation role within them. many times over the years and called upon it for inspiration: in- After the meeting, one of the individuals sought me out and spiration to believe in myself, inspiration to be the type of leader said something to the effect of, “I know what you are capable that takes the time to give motivating feedback and inspiration of, and you can do better than that.” It was an “ah ha” moment that if we continue to apply the “what & the how” to everything for me. The “what” - the constructive criticism - was accurate. I we do, not only is Iora going to transform healthcare, but we will knew when I left that meeting that I had held back. I was nervous have done so in a way that makes us proud. about being perceived as coming on too strong. But the “how”— that this person made the effort to follow up with me and offered BLAIRE advice in a way that was affirming and encouraging—is what General Counsel | Nest 26
CHAPTER THREE I HAVE LEARNED AND GROWN so much since I started working Spirit Week at Surprise-Cotton Lane at Iora. I am not even sure where to begin! One area in which Iora’s Medical Director on TV I have grown tremendously is with discussing advanced care planning with patients—discovering patients’ values, what they truly want at the end of their life and what is important to them. I’ve also learned to be brave enough to speak the truth when I know that their condition is worsening and that doing more aggressive treatments might actually cause more suffering. Before coming to Iora, I worked with patients age 18 and up, and I cared for only a handful of complex seniors near end of life. Talking about end of life was somewhat uncomfortable for me, because I somehow felt like I was failing as their provider or giving up—after all, my training as a Nurse Practitioner is to solve problems and help patients “get better”! What I discovered by the training I received at Iora and working with Iora patients as they are approaching end of life, is that it truly is a GIFT to have these conversations with patients and to provide support and compassion during their very most vulnerable times. I know that our patients appreciate it, and I now feel much better equipped to have these conversations. Thank you, Iora, for providing me this opportunity and for creating such a compassionate environment for both patients and employees. MELISSA Team Nurse Practitioner | Colorado 27
WE NEVER STOP LEARNING Colleen with an Iora patient HAPPY BIRTHDAY IORA. Ten years is quite young in the grand scheme of things, but every day I learn from you. Almost 2 years ago I came to Iora as Chief Medical Officer in search of a place where people held tightly to a real vision and lived and carried out a mission on a daily basis. To aspire to transform health- care is more than a noble cause. It’s a vision that comes from a conviction that the conventional system of healthcare is broken and that a small group of people can make a difference. When times are tough, I remember that we’re an underdog in a larger ecosystem of transactional healthcare, that our tough journey is expected and just as important as the great things we will do together. I’ve been classically trained that a mission is what you do every day. What I’ve learned at Iora is that we restore humanity to patients with every interaction, with our wisdom and guidance, with empowerment and kindness, and with all the small steps towards building a trusting relationship. Happy birthday Iora, thank you for the gift. TYLER Chief Medical Officer 28
CHAPTER THREE “Iora truly lives a #oneteamonedream mantra” I HAD MY FIRST APPOINTMENT yesterday and must say that the MY BIGGEST LEARNING AT IORA came from launching the patient is truly cared for. Each patient has a Health Coach as Houston market. I had the honor of working across many func- well as a PCP. I’m 71 and for the first time feel listened to. I rec- tional teams to build and set up new practices, hire amazing ommend Dartmouth Health Connect where the whole person people, build a culture consistent with Iora (with its own Texas rather than the symptom is treated. flair), train teams on the Iora way and so much more. All leading —DARTMOUTH HEALTH CONNECT PATIENT to 6 practices opening within about a month of each other. It was a whirlwind and a huge learning experience for myself as Blaire and Fleurette well as our Houston care teams. In reflection, there were two things that were truly special about that experience that I believe are unique to Iora: ALL of us launched the Houston market—Iora truly lives a #oneteamonedream mantra. In Houston, we learned from each other and had support from more people than I can begin to list. Every single person that contributed exemplified our val- ues and gave me inspiration that I had made the right choice to demonstrate courage and make a move to Houston. People from all over the country flew to/moved to Texas to help us learn and succeed in making this new market a reality. I have never been surrounded by such an incredible group of humans. EMILY Market Operations Leader | Colorado & Texas 29
04 Wisdom From Our Patients 30
“Restoring humanity to CHAPTER FOUR healthcare is hard work. And it involves some ups tice closing. We had served her community for over 3 years. I and downs.” took a deep breath. This part of the conversation might be more complicated than the part about her sore gums. I PULLED INTO A SUNNY STRIP MALL parking lot on a Satur- We talked about the Hyde Park practice and how sad we day afternoon in order to answer the on-call message. The kids were to be closing. I explained my role and that I felt lucky that were used to sitting quietly in the back seats while their father I would continue to serve Iora patients even after Hyde Park took patient calls on the weekend. Dolores was a patient of our closes. Dolores asked me, “Is it ok for me to give you some ad- Hyde Park practice in Boston. She was feeling soreness on her vice, doctor?” gums that had gotten worse since Friday night. She wanted to Dolores had been a nurse before she retired. She had been know if she should start antibiotics right away. We made a plan part of a team that took wonderful care of patients until her sec- to watch it carefully through the weekend. I would be here by tion of the hospital closed about 15 years ago. She said to me, phone if it got worse. We made an appointment for Monday “Doctor, when we found out that we were going to have to close morning in the office. All would be well. I asked her, “Do you down, boy did it hurt. We were sad that our patients were losing have any more questions for me?”. their home, and I felt horrible that my team was losing their jobs. “Doctor, are you going to be losing your job when the prac- I know how you feel. But let me give you this advice: It’s ok to be tice closes?” sad. Give yourself permission to feel whatever it is that you are Like the rest of our Hyde Park patients, by now Dolores had feeling—but always know that it’ll all be ok in the end.” gotten a notice and talked to her Health Coach about the prac- Dolores explained that she had retired when they closed, but she stayed in touch with her team. They all did alright. They brought what they had learned together to their new jobs, and they helped many patients in many new places with the same spirit that had brought them together. “You’ve got a fantastic team in Hyde Park - they will also be ok. They took great care of me and the other patients, and they’ll continue to take great care of their new patients in new places.” Restoring humanity to healthcare is hard work. And it in- volves some ups and downs. Thank you, Dolores. Thank you for having the passion and courage to extend your kindness to me. Thank you for role modeling empathy. And thank you for this lesson in humility: Our mission moves forward with each practice we open; and with each practice we close. NEIL Market Medical Director | Northeast 31
WISDOM FROM OUR PATIENTS “The advice I learned by A PATIENT RECENTLY transferred to one of our Phoenix practic- caring for him is to try your es since we were closer than his previous doctor, and because best to understand, be it would benefit his current medical condition. He was resistant patient, persistent, mindful to the change, did not trust easily and would directly tell others and humble.” what he expected and wanted. After several calls and time spent building trust, he finally THROUGH ALL MY CAREERS, anyone that needs help, I help agreed to come in. His smile was better in person, and it was them. I’ve never had a fear of anything. I use a little common apparent that he went through a lot during his recent hospital sense. I’ve never had to pull my gun. I never wanted to ask for stay, as he had lost a lot of weight. When he arrived, his future anything. I wanted to help people. I’m in it to help people. Health Coach, Denise, greeted him and noticed that his pants —TEXAS PATIENT would not stay up. He had great humor about it, and it was 32 heartwarming that Denise held his pants up by the belt loop as he walked around our practice. The best part was hearing stories from him about his cane. It was uniquely engraved, and his father had given it to him. Now he had the privilege to use it. During our visit, he asked several times how he could get a pair of suspenders to help keep his pants in place. At the end of the tour, he agreed to come back and become an Iora patient. We scheduled his future appointments. I had a pair of suspenders for him that I was excited to give him. He called one day because he was not feeling great and wanted to know if I could see him. Without hesitation, I brought him into the office...I’ll end the story here. It was a privilege to be part of this patient’s care team. The advice I learned by caring for him is to try your best to under- stand, be patient, persistent, mindful and humble. MARIVEL Team Nurse | Phoenix
CHAPTER FOUR Iora patients and for the months to come, she is working on creating a per- fect Christmas for her family. She is sewing new stockings for WHEN COVID-19 HIT, patients began to struggle with their so- her grandchildren, perfecting old dishes she has made and pre- cial, physical and emotional needs, as millions of other individ- paring everything to be perfect in December. uals across the country did. As a Health Coach for the Phoenix I immediately realized that this patient had an outlook on market, I was calling several patients everyday—checking in on life (and the future) unlike most people. When put in such a sad them, delivering lab results, scheduling appointments and so on. and lonely situation, she was not sad or sulking. She was not A common theme in all of my conversations with patients even talking about all the things she CAN’T do, but instead, what was how they felt lonely, isolated and depressed. It was a true she CAN do. She can prepare for the holidays with her fami- challenge to keep peoples’ spirits alive and well. One day I ly. She can make handmade gifts for her grandchildren. She is picked up the phone for a routine call to deliver lab results to a looking forward to something, she has purpose, and this keeps patient I had never spoken with. Within our 15 minute call she her going. When I got off this call I thought about how I can changed my outlook on life. This patient was 90 years old and apply her positivity and outlook into my own life. I know her joy completely alone. She told me she is widowed and has chil- and positivity will stay with me forever. dren and grandchildren in Phoenix, but she hadn’t seen them in months due to the outbreak. This patient sounded more chip- DANAH per than others, especially after just telling me this. I asked her if she has any hobbies or things she does at home to keep busy. Health Coach | Phoenix Excitedly, this patient told me that for the past few months, 33
WISDOM FROM OUR PATIENTS If your spouse makes you mad, just say, ‘Honey, can I get you a cup of tea?’ and then go into the kitchen. —PHOENIX PATIENT Celebrating the Georgia launch Dhale and Zahra teaching patients TO CELEBRATE “OLDER AMERICAN’S MONTH” in May 2020, we how to eat healthy on a budget celebrated patients who had endured a difficult time in life but came out stronger having lived through it. Many Health Coach- MY ADVICE TO OTHERS who may be going through a tough es nominated patients for these stories, and I had the pleasure medical situation is to do what you need to do, in order to do of interviewing our patient Benny. Benny survived the Holocaust what needs to be done. If you’re looking at physical or occupa- by escaping Germany in 1939 and being rescued by Italians in a tional therapy, for heaven sakes DO IT. Don’t sit around thinking small village with 75 other refugee children. The Italians hid the or saying “why did this happen to me?” Instead focus on: “how children in churches, hospitals and farms. Benny came to the am I going to deal with what’s happened and move forward”. It states in 1949. He’s overcome so many obstacles in his life, and doesn’t matter why I broke my femurs, it matters how I go for- his attitude about COVID-19 is so inspirational. He said “well I ward from it. It’s easy to get stuck in a “poor pitiful me” attitude survived the Holocaust, so this should be nothing”. His perspec- and it just makes it worse. Yes, I have those days still, but you tive really helped me and taught me that a positive outlook on can’t stay there for long. life can have such a big impact on one’s ability to overcome the —IORA PATIENT challenges life throws you! 34 MILLIE Manager, Communications & Patient Experience | Nest
IORA CHAPTER FOUR ASKS “Everyone wants to live to What motivates you 100, but it is very hard to to go to work each day? get old....” Hands down, the most common responses from Iorans OUR PATIENTS HUMBLE ME EVERY DAY when I am privileged about what motivates them were our patients and our to witness the depth of their wisdom. Even as a psychologist, I teams. Here are just a few of our favorite responses: often feel like I benefit from our discussions more than they do. A 97 year old man who still drives, and is sharp cognitively, gave “Working with my team. So much of me this advice: “Everyone wants to live to 100, but it is very hard primary care in my former experience to get old. AARP makes it look so easy, but what they don’t tell had been like a solo. But Iora is an you is you will have medical issues, everyone you love (includ- orchestra. And when everything’s ing your children) will pass before you, and you will be left with tuned up, the work we do just sings.” this sadness that doesn’t go away. If you want to live long, make sure you keep rebuilding friendships and a support network be- Sarah | Texas cause you will need to do that over and over again as you age.” Other random nuggets of advice: “My team—they remind me “One day you will stop wearing high heels because it just every day through their doesn’t make sense.” actions and compassion why “It is the little things in life that make us happy. Spend time we work here. Bottom line: everyday noticing those things.” better patient care.” MONIKA Sarah | Tucson Regional Director Behavioral Health | Phoenix “I know that I am surrounded by passionate, caring people who want to transform healthcare, and are not afraid to put in the grit to do it together.” Lindsay | Texas 35
05 The Values That Drive Us 36
CHAPTER FIVE “I am honored to work for a company that walks the walk and offers holistic care.” PRE-COVID-19, I worked in the Iora Washington flag- to understanding the impact of substance abuse, homeless- ship practice located in the Central District. The Central ness, racism, sexism and homophobia as contributing factors District is a historically Black/African American neighborhood to community marginalization and health disparities. Late in in Seattle that has been rapidly changing in demographics life, the patient struggled with a pain condition and reliance on due to gentrification, influx of younger families and other opioids. It was a privilege to hear the patient’s story about work economic factors. Prior to joining Iora, I had volunteered for and develop empathy for the patient’s perception of self and eight years as a community researcher for the Village Spirit the meaning of health. The Iora care team worked to educate Center, a housing community for previously homeless persons the patient, support the patient’s health goals and witnessed with a specific focus on Black and African American families, both progress and regression with the patient while continu- that was located adjacent to Iora. The founder and director ing to value the patient as a person with a unique story and of Village Spirit Center had been a mentor and tremendous personal history. influence on me as I learned about the Black/African American Iora is a company that truly works to diminish health dis- community in Seattle and how it formed. In joining Iora, I met parities while valuing each individual patient. I am honored to numerous patients who identified as Black/African American work for a company that walks the talk and offers holistic care, and served as leaders for social justice reform within the com- especially for persons that, due to a number of factors, have munity prior to retirement. never experienced evidenced based, reliable primary care. One patient was the former director of a local social ser- vice agency originally rooted in HIV/AIDS prevention and inter- BILL vention for people of color. Over time, the agency expanded Market Behavioral Health Specialist Lead | Washington 37
THE VALUES THAT DRIVE US Emily getting ready for training Andrew and John at a provider recruiting event AS THE BELVEDERE CARE TEAM was about to wrap up their day to continue to charge. While at Kroger, the care team saw an one Friday, one of our patients proceeded to ring the doorbell. opportunity to get them a free government issued phone. The care team wasn’t expecting any face to face visits and did However, something still didn’t sit well with the team. Glen- not know the nature of the person’s need. Alexis and Glenda da reached out to some of the team members who lived in the noticed it was one of our patients and opened the door to assist. area to share her concern. Leon and his fiancé were in the area It turned out the patient’s electric wheelchair had run out of and saw the patient out of power again. They approached the charge, and they were stranded on the side of the road. A good patient and offered to transport them and the wheelchair home. samaritan saw them pushing their electric wheelchair and of- This is the reason why I enjoy working at Iora! I’m so proud fered them a ride. When the gentleman asked where they were of how the team exhibited Iora’s values of empathy, creativity, going, they asked to be taken to Iora. The patient told the care passion and courage. They didn’t turn the patient away because team that they had run out of power and needed help. The pa- it was the end of the day. They creatively solved all of the pa- tient said, “I knew if I made it to Iora they would help me.” tient’s issues and worked collaboratively to ensure the patient The care team charged the wheelchair for 30 minutes. As made it home safe. Thank you to the Belvedere team for show- the clock quickly approached 5pm, the wheelchair still did not ing how much you care for our patients. have enough charge, and the patient did not have a phone in case of an emergency on their way home. Alexis and Glenda TISYA decided to follow the patient to Kroger where their plan was Care Team Manager | Georgia 38
“...we exemplified the IORA CHAPTER FIVE Iora spirit and values every step along the way!” ASKS AT IORA, WE MAKE THINGS WORK for our patients! We have What is your favorite two patients who live together, Mark and Mary. Mary is Mark’s Iora value? primary caregiver and suffers from anxiety and panic related to the stress of caring for Mark. Meanwhile, Mark exhibited signs Our values are at the core of how we work. They work of severe dementia and reportedly became frustrated with his together and can be at odds with each other at times. medications, and the team could not get a clear grasp on what They are often why we love working at Iora. We had a was truly happening with his care. good mix of our ‘favorite’ value as you can see below. Home visits to the rescue! Dr. Fernando and I drove out to the family’s home. It required both courage and creativity to get 20% 30% this patient into long term care (not to mention persistence, teamwork, and a can-do spirit)! After administering a Montreal we act with we serve with Cognitive Assessment (MoCA) in the home, taking inventory of passion humility medications and organizing and discarding any incorrect med- ications and getting the caregiver’s perspective of the hurdles 30% 10% related to Mark’s care, Dr. Fernando and I hopped in the car and headed back to the practice. we feel we Ultimately, Mark was placed in a long term care facility. The empathy demonstrate team continued to work tirelessly to complete the necessary courage paperwork for him to be eligible for his VA benefits, and he is 20% now awaiting placement in a VA facility. The care team has a lot 39 to be proud of in this story, and we exemplified the Iora spirit we bring and values every step along the way! creativity EMILY Behavioral Health Specialist | Georgia
THE VALUES THAT DRIVE US Alisa, Alexus, Meredith, Kathryn and Renae tice with the dangerous combination in our system. Eliot informed Stephen and our Chief Medical Officer. ELIOT, IORA HEALTH’S DEVOPS AND SYSTEMS MANAGER, was The work wasn’t over. Eliot and Gerardo did similar work in the middle of his week-long on-call rotation when he for all our practices and identified 13 patients in total at Iora. received a support ticket from Stephen, a physician in one The appropriate care teams were able to very quickly look of our practices. Stephen wanted help querying our elec- through the patients one at a time and determine that only tronic prescription service for a list of our patients taking a one patient was potentially at risk for the interaction. Our specific combination of medications due to a report in The care team contacted the patient and confirmed that he was New England Journal of Medicine which concluded that the not taking the combination. coadministration of trimethoprim-sulfamethoxazole and Iora’s culture is something that is hard to define but spironolactone “confers excess risk of sudden death.” I believe it is rooted in a desire to serve others first and Unfortunately, the two vendors we use for electronic foremost. Eliot and Gerardo felt empowered to solve the prescriptions do not provide a way to query a patient panel problem, even though they were not asked to do this. for those who have a specific combination. The Iora prac- I consider myself lucky to work as an engineer at Iora tice team could go through each drug and cross reference Health. Not only is the mission of the company noble, I get them, but that would be time consuming and error prone. to create solutions to difficult problems—with people like Eliot understood that this manual search was going to Eliot and Gerardo—which is rewarding when seeing the be a huge burden on the practice team, so he consulted impact to Iora, our colleagues and most importantly, to with Gerardo, a Senior Software Engineer, who had recently our patients. been working on integrations with our electronic prescrip- tion vendors. After a quick spike (that means a time-boxed WILL experiment), Gerardo was able to download the medication history for each patient at that practice, and Eliot was able Vice President, Engineering | Nest to determine that there weren’t any patients at the prac- 40
CHAPTER FIVE “I felt so much empathy and passion in the room, and it was the most special moment that I can think of in my time at Iora.” TIM HAD BEEN OUR PATIENT since we first opened. He came by OUR NORTHEAST CARE TEAM MANAGERS inspire me, as they the practice often, and everybody knew him well. It was a pain- are great examples of leaders who live our values: ful day for everybody in the office when we heard that Tim had The courage of Dave Peckinpaugh - acting more swiftly died. Tim’s long-time Health Coach had recently left Iora, but and decisively than most in service of our Dartmouth Health saw Tim’s obituary in the newspaper. She called us and made Connect patients during highly uncertain times early in the sure that we knew that Tim had some specific asks in his “5 COVID-19 pandemic back in March. Wishes” that we could look to honor. The humility of Tricia Louis - forever curious, hungry for Tim had asked for those close to him to have a big party to feedback and continuous learning through our Avery practice celebrate his life instead of a funeral. That day, we all got to- operations and closure, and now through Original Medicare gether after hours and spent the time playing games, watching Direct. zombie movies (one of Tim’s favorite activities), and sharing our The passion of Kathleen Meleedy - her relentless drive to favorite stories of Tim. I felt so much empathy and passion in restore humanity to healthcare in Hyannis and each Iora market the room, and it was the most special moment that I can think she has served in. of in my time at Iora. I have never seen a memory honored so directly in line with somebody’s wishes, and who would have PAUL thought it would be a primary care office that did it. Senior Director, Market Operations | Northeast MARK 41 Care Team Manager | Colorado
THE VALUES THAT DRIVE US WHEN I JOINED IORA ONE YEAR AGO, I was so excited to join a team. I had no coworkers at my previous job and was blown The caring and support I away my first week to see how welcoming everyone was. Ev- receive is the best I have eryone looks out for—and learns from—each other daily. I feel ever had and I am 75 lucky to have a strong team to back me up when I am out sick years young. Thank you or overwhelmed. Recently, I tested positive for COVID-19, and for everything. I look it was scary at times, but I had so many colleagues checking in forward to a long lasting on me to see how I was doing. It was so comforting and really relationship. Bless you. showed me that we not only exhibit the Iora values with our patients, but also with each other. I look forward to being back —COLORADO PATIENT in the office as a team again. KARA Health Coach | Phoenix Rushika, Jessica and Ana during Launch Training I STARTED SEEING Iora Primary Care after a search for doctors who specialize in treating people at my stage of life. I have been very pleasantly impressed with their attitudes, professionalism, and personal care for me as a patient. I can’t imagine a better place to provide the care you would need as a patient over 65. I love their team approach... —NORTH CAROLINA PATIENT 42
CHAPTER FIVE The Grant team FOR OUR “WE ARE HERE” 2016 CULTURE BOOK, I wrote about I WAS SO PROUD OF ONE OF MY TEAMMATES, Daniel Cama- how Iora was restoring humanity to me as a healthcare provid- cho (now Care Team Manager, but at that time Health Coach) er, and on the occasion of my 5-year Ioraversary, I reflected on in helping one of our patients who had a slew of health issues. this topic. I still feel incredibly energized to be part of a com- This was the last patient to come into our practice one day and, pany where we do our best to put people first and center the on top of the chronic issues he was experiencing, he also had healthcare system around human lives instead of money. bedbugs on him. After the care team donned personal protec- Throughout my five years, I have talked with so many Iorans tive equipment to complete this patient’s visit, Daniel went out who also feel that the work we do and the way we do it makes a to get some new clothes and shoes for this patient. I could not huge difference in the quality of their experience as healthcare have been prouder of my teammate in exemplifying our values providers. We are encouraged to proceed with open minds and in that moment. In this act, I witnessed the empathy and humil- hearts, to care about each other, to dedicate ourselves to our ity of literally providing another human being with the ‘clothes patients, to stand up for what is right, to ask ‘why’ and to bring off our back’, I witnessed the passion and courage to address our passion to work with us every day. his immediate needs and the creativity that was needed to deal Five years later I am still here, still committed to our mission with this bedbug issue. It made me realize, you could genuinely to improve our patients’ lives and the U.S. healthcare system, look at any team member at Iora, and they too would not hes- and still so grateful to be a part of this epic journey. itate to exhibit these values. It makes me so proud to be here! SUSAN GOPAL Manager, Patient Safety | Nest Care Team Manager | Phoenix 43
06 Moments that Matter from Classes and Events 44
CHAPTER SIX I CREATED WHAT WAS SUPPOSED to be an 8 week group for ON SEPTEMBER 4 AND 5 OF 2019, Iora hosted an event for all older adults suffering from COVID-19-related isolation. It was of our new Care Team Managers (CTMs), including new CTMs hard doing a group with some members on the phone and oth- from Georgia, North Carolina, Texas and Washington. The event ers on video! I had to throw away most activities and process- was held at our Belvedere practice in Atlanta and provided a fo- es I had learned as an in-person group therapist—no visuals, rum for our new CTMs to learn more about Iora and their roles, no talking stick, no artistic activities. The first few weeks were as well as connect with one another and other peers across frustrating, with people talking over each other and accidentally Iora. A couple of memories from this event stand out for me: muting themselves. Many of our experienced CTMs and Market Operations But what emerged was something bigger—a literal lifeline Leaders demonstrated incredible humility and empathy by be- for seniors who were isolated. One of my less social patients ing vulnerable about what they’ve experienced during open confessed to the group during a particularly emotional session, Q&A panels. The audience had lots of questions, and these “I look forward to this all week...This is my only outlet.” I was CTMs were willing to share their advice from their collective ex- touched that this patient, who struggled to find connection, perience here at Iora. was able to be vulnerable. She was touched when others in the The passion and courage displayed by our new CTMs was group agreed with her sentiment. inspiring. All of them appreciated they were about to launch and It takes a lot of courage to admit that you are lonely, but iso- support new care teams—and were clear that there was going lation is a common problem for older adults, and it is a common to be some discomfort during the launch process. They knew problem that Iora is uniquely poised to help solve. we were still imperfect, but their commitment to our vision and mission gave them hope for the future and a deep desire to be HANNAH part of the solution. One of my favorite quotes is from John Quincy Adams, “If Behavioral Health Specialist | North Carolina your actions inspire others to dream more, learn more, do more and become more, you are a leader.” The event, and all the team members that made it possible, demonstrated how many Iorans are truly leaders. I’m so grateful to have the opportunity to be with Iora as we dream and learn together! SUZANNE Chief Operating Officer 45
MOMENTS THAT MATTER FROM CLASSES AND EVENTS “I will always choose AFTER 20 YEARS IN HEALTHCARE, I encountered something tru- Iora... because we are ly unique when I joined Iora. Despite working closely together all FAMILY no matter what.” day long in our Huddle room, my team doesn’t tire of each oth- er. We have had many team building activities after hours - trivia 46 nights at a local brewery, an arcade downtown, bbq’s at a family ranch and simple dinners as well. My favorite team event is our annual hockey night. Every year we get together to support our local AHL hockey team. Even our non-hockey fans join us for this outing, and it’s a real treat to put this together every year. This year, we got to hang out with Dusty, the mascot of the Tucson Roadrunners, and his pals after the game. We call it Iora on Ice! MELISSA Team Nurse Practitioner | Tucson
CHAPTER SIX HAVING NEVER EVEN WATCHED golf on TV before, I attended EVERY YEAR, ATLANTA HOSTS a massive event for all seniors a golf event with Iora. It was outside of my comfort zone, but I in the community to socialize, learn and party with each oth- had an amazing time. It was an event that allowed me to travel er. Iora always has a presence as one of the sponsors and is from Phoenix to Tucson with my great friend and trainer, Liz given an opportunity to table at the event. This past year, I was (small fry) to learn about golf, and to network, however, it did amazed when a few attendees began to speak on our behalf to not feel like a work event. their friends in line about what makes us different. So much so The agents that were there felt like family. It felt like we had that everyone in line wanted to join! Folks spoke highly of our all known each other for years. We ate, we laughed, and time engagement, the way we encourage patients to reclaim their just flew by. I love being at a place where work does not feel like independence, the relationships formed with care teams and work (we do work though). I will always choose Iora as long as more. Their kind words were a testament to Iora and the work they will have me, because we are FAMILY no matter what. we do each and every day. JUANITA JEREMY Patient Enrollment Lead | Phoenix Market Operations Analyst | Georgia 47
MOMENTS THAT MATTER FROM CLASSES AND EVENTS “There was MY MOST MEMORABLE EVENT was our GO TEXAN DAY! We not a dry eye in celebrated the first day of the Houston livestock show and the room.” rodeo with our patients. We had a BBQ themed party with some gifts for our Bingo winners! DIANA Operations Assistant/Phlebotomist | Texas Go Texan Day THE LITTLETON PRACTICE CO-HOSTED an event with the THIS IS HOW EVERY DOCTOR’S OFFICE SHOULD BE! Would you Alzheimer’s Association and the senior living facility next drop in to your doctor’s office when you do not have a medical door - A Walk to End Alzheimer’s. As part of the event, I asked appointment? We do. We go for free weekly exercise classes, a current patient to share his experience as a patient with the monthly fun events, educational seminars, or just to have a cup other attendees. of tea and read. Other patients are now friends. Best of all, the He was a WWII veteran and could be a bit rough around the doctors, Health Coaches, and other staff are so friendly and edges, but when he spoke about his care team, his hard edges helpful. It’s like a big family, and we love it! Come in for a free softened. He talked about the difference his provider and Health tour and give it a try! Coach made in his life and in his wife’s life. He got emotional halfway through his speech and paused to catch his breath. —WASHINGTON PATIENT There was not a dry eye in the room. That day I felt how truly special it is to work for Iora and to contribute, even in a small way, to the impact we can have on peoples’ lives. MELISSA Senior Strategic Account Executive | Nest 48
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