Iora Health - We Are Here

OUR PEOPLE, OUR CULTURE, OUR STORIES 2016

here for each other we are here to restore humanity to health care we sponsors we are here to offer a different kind of health system we are hmmunity we are here to listen we are here to transform health care w d relationships we are here for you we are here to help we are here k we are here to do whatever it takes we are here to deliver high-impac here for our partners we are here for our neighbors we are here for ou here on a mission we are here to teach we are here to provide relatione we are here to improve lives we are here for our patients we are he e problem in health care we are here for each other we are here to res ealth care we are here for our sponsors we are here to offer a different em we are here for our community we are here to listen we are here th care we are here to build relationships we are here for you we are are here walking the walk we are here to teach we are here to do what are here to deliver high-impact results we are here for our partners weghbors we are here for our teams we are here on a mission we are h tionship-based care we are here to improve lives we are here for our p here to tackle a huge problem in health care we are here for each other estore humanity to health care we are here for our sponsors we are heerent kind of health system we are here for our community we are here here to listen we are here to transform health care we are here to build are here for you we are here to help we are here walking the walk watever it takes we are here to deliver high-impact results we are here fo are here for our neighbors we are here for our teams we are here on a

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INTRODUCTION2

WE ARE HERE. This is our story of where we came from and how The industry has taken notice. We have teamed up with newwe got to where we are today—and it’s our story of how, every sponsors, received a number of awards and secured numerousday, we are here for each other, for our patients and members, high-profile articles in local, national and international pressand for our sponsors. Being here means we’re showing up. We’re including The New York Times, Financial Times, Forbes, and Inc.transforming health care with our incredible model of care, our We are here in numbers too. They are ever-evolving but rightpassionate and empathetic teams, our clear mission of restoring now we are here in 29 locations around the country and we arehumanity to health care and our no-compromise values. here—every day—for our 43,000 patients. We believe the best When Chris McKown and I founded Iora Health in 2010, way to demonstrate how we are here is by celebrating our peoplewe had a bold vision, we found incredible team members and and our culture through our stories.investors who took a leap with us and sowed this seed of a Everyone has a story and each of our stories make up thecompany we call Iora Health. We started in a small room with just greater Iora Health story. This special book includes stories ofa handful of people with big ideas. Being where we are today is humility, creativity, passion, empathy and courage. It highlightsunfathomable and inspirational to many. We knew it would be our patients, our teams and the joy we have in our work.hard, yet we knew that with the right people and right culture, we This book is our story of how we are here, transforming healthcould do it. What we’ve done includes maintaining consistent- care every day. We’re doing this - not by talking about it, not byly high - and industry leading - net promoter scores; improved thinking about it. We’re transforming health care by being here,outcomes for chronic diseases like hypertension; decreased by delivering high impact relationship-based care every singleutilization of emergency room visits, hospitalizations and day across the country, in every community we serve, in everyreadmissions and more. And, we’ve accomplished this with a location, in every patient touch.focus on our culture and joy of practice. Thank you for being a part of our journey to restoring humanity to health care. Thank you for being here. Rushika Fernandopulle CEO & CO-FOUNDER AT IORA HEALTH JUNE 2016 3

CONTENTSourstories 4

s WE SERVE WITH HUMILITY PAGE 6 WE BRING CREATIVITY PAGE 20 WE ACT WITH PASSION PAGE 34 WE FEEL EMPATHY PAGE 50 WE DEMONSTRATE COURAGE PAGE 66 5

OUR STORIESListening, being of service “AFTER HER FIRST VISIT with Matt and me, 83 year old Opal saidto whoever needs it, (something like), “In all my visits with doctors, I have never hadrecognizing opportunities anyone listen to me the way you guys have.”for improvement, keepingone’s ego in check, Lyle HEALTH COACHcelebrating each other SEATTLE6 humility

“AFTER SEVERAL MONTHS of struggling with increasing anxiety Patient with Patand depression, one of our patients Sheri has begun to talk moreabout how she’s feeling, how it’s affecting her life and beginningto allow us to help her intervene and work toward solutions. Whenwe met today, Sheri reflected on how she and Dr. K. reviewed theMayo Clinic’s guide to antidepressant medication and weighedthe pros and cons together, something unusual in her experienceand how “...his taking the time made me feel good, like I had anopinion and a say in which medication I’m putting into my body,instead of being handed a script and told ‘I want you to take this’.”Karen BEHAVIORAL HEALTH SPECIALIST HARTFORD humility 7

OUR STORIES Class at Iora Primary Care in Phoenix, AZ “I AM TAKEN SERIOUSLY, treated promptly and never rushed.” Patient ATLANTA8 humility

“IF YOU LIVE IN NEW YORK, you will often see women and men recycling on the street at all hours of the dayand night. This is how some of our patients survive in the city. They typically receive 5 cents per bottle and oftenwork 10 to 12 hours a day to get $50 to $70 a week. At Grameen VidaSana we have multiple patients that maketheir living this way. They often express a feeling of shame as they describe this work as “collecting garbage.” Inresponse, we have created a system of collecting bottles from both patients and staff and alert these womenwhen we have bags available for pick up. Also, we try to anticipate having recycling available to them when theycome for a medical visit or participate in group activities. Having bottles here not only helps them financially, butalso helps to normalize this difficult and demoralizing work among our community.”The care team at Grameen VidaSana QUEENSGrameen Team with Nobel Peace Prize winner Muhammad Yunus humility 9

OUR STORIES IORA GLOSSARY “EVERYONE WAS SO FRIENDLY and actually listened to my needs. I felt like I was important and more than just another patient. I also iora like the aesthetics of the Center and that everyone just uses first names.” [ahy-ohr-uh] n. Patient ATLANTA A small bird species found in India and Southeast Asia. Iora “I TOOK A FEW PHONE CALLS last night and documented for Health CEO & Co-Founder the first time in Chirp. This documentation experience was the Rushika Fernandopulle hails first time since starting to work on EMRs 10 years ago that I felt from Sri Lanka where an iora like I was using software that was made this decade (and not bird can be found, and thus the 1990s!). It was quick and easy to sign on and the interface where he came up with the dis- is refreshingly simple — easy to navigate, type, alter what you’ve tinctive name, Iora Health. He typed or selected, be vague if needed, etc. I seriously felt a sense liked it because it was unique, of excitement when using it — like the designers considered easy to say and holds no mean- my needs as a user when creating the product. I’m sure the ing for most—the company Engineering Team doesn’t get thanked enough. Once users are would define the brand and here long enough, we probably think more about what can be meaning. improved, but as a new user, I am thrilled to be working with Chirp. Thanks for everything you guys do!”1 0 humility Jeff CENTER MEDICAL DIRECTOR CHICAGO

Charlotte and Ed Mini Ioran, Madalyn SchutzbankBoston Mayor Marty Walsh visits The Nest humility 1 1

OUR STORIES“AS AN OPERATIONS ASSISTANT I did not expect to connect or he did not know his way from the clinic to the store. I am notbond with the patients as well as I have. I have realized Operations from around Phoenix or Scottsdale, so I honestly had no idea. IAssistants are not simply receptionists; we are companions and then went on my computer and looked up directions and printedlisteners to our patients as they wait, the little time they do, for their them out for him. He looked at me and was surprised that I didHealth Coaches. One encounter that continues to make me smile that. In my opinion, it was a small task and nothing complicated.was with a patient’s husband. The patient went in the exam room However, that small notion caught him off guard. He then stated,with her Health Coach and her husband stayed in the reception “Wow. You guys do everything and more for your patients andarea. He began talking about how he was going to spend his day their families. No other doctor’s office would print out directionsshopping around with his wife. He then quickly looked at me and for me or let alone give me company while my wife is in with theasked for the specific location of a Macy’s in Scottsdale because doctor. Thank you.” Vanessa OPERATIONS ASSISTANT PHOENIXTeam huddle in Boston1 2 humility

“ON NOVEMBER 6TH, an email with subject “elf” popped up “It sounds like you canin my inbox. The sender? Rushika Fernandopulle. Intrigued, I go to work and beopened the email and was delighted to find that after a recent your full self.”conversation about our mutual adoration for the movie “Elf”,Rushika had found a deal for Elf the Musical tickets. He proposedthat we get a group together and attend a show. A few weekslater, 8 of us (including significant others and Rushika’s daughterKathryn) dressed up in elf-esque holiday attire and enjoyed aFriday evening outing to the beautiful Citi Wang theater. When talking to friends and family about my job, I tell themstories about the amazing people I look forward to seeing atwork everyday. Recently, someone responded “it sounds like youcan go to work and be your full self.” Whether it’s interviewingsomeone in a bear onesie costume or going to see Elf the Musicalwith my silly and fun work friends, I couldn’t agree more.”Annie LEARNING & DEVELOPMENT ANALYST THE NEST “BEING A HEALTH COACH is such a privilege because my patients allow me to walk on their journey along with them.” Lisa HEALTH COACH PHOENIX Patient with Jenalyn humility 1 3

OUR STORIES IORA GLOSSARY Arthur and Tyler Erinn, Ana and Karen Harken Health Wicker Park Team huddle [huhd-l] n.A daily, morning meeting heldby our care teams in each ofour practices; it consists of re-viewing the daily patient sched-ule, updates on and plans forhigh-risk patients, group/classschedule, operational needs ofthe practice, patient story high-lights and activities that offermotivation and intention forthe day. The leader of huddle isrotated through each memberof the care team daily becauseeveryone has ownership in ourpatients and our care.1 4 humility

“She now tells the care team,‘I’m not ready to die, yet.’”“ONE OF OUR 70 YEAR OLD PATIENTS came to us with of time and required additional hospitalization to stabilize her.fatigue, nausea and vomiting. She reported only drinking a glass Eventually she came through and was able to resume her detoxof wine each day, but diagnostic workup revealed severe liver and inpatient treatment. During the course of treatment, the caredamage consistent with long-term alcohol dependence. Using team maintained contact with the patient’s daughters, providingempathic skills and creating an environment of acceptance, our emotional support and assistance with coordinating the patient’sdoctor, Health Coach and social worker all took time to uncover future care needs. One week after her discharge home, the patientthe underpinnings of her alcohol use. She had struggled with and her daughter came in for a follow up visit with her doctordepression since she was a teenager, and her alcohol use had and Health Coach. The patient, still sober, reported a much morebeen present for so long, that she had virtually no relationship positive outlook on her future. She has renewed engagementwith her children or grandchildren to look forward to. When with her family members and continues with several counselingwe began expressing our concern that she enter a treatment sessions each week to manage her addiction. She now tells theprogram, the patient was very hopeless about a future life worth care team, “I’m not ready to die, yet.” Her daughter shares theliving, and she was reluctant to enter treatment. Over a series following remarks: “We are all very grateful for her progressof visits with the patient and her two daughters, she eventually and recovery. She appreciated your call yesterday, and we allagreed to treatment. Treatment for alcohol abuse is not easily very much appreciate all your hard work over the past severalcovered by insurance, but with persistence and advocacy for the months.” The work doesn’t end here, but it is so encouragingpatient, our clinical team was able to get her detoxification and and energizing to see the dramatic shift this patient has made ininpatient treatment authorized. Patient’s detoxification proved her life.”especially challenging as she became unresponsive for a period Adam BEHAVIORAL HEALTH SPECIALIST SEATTLE humility 1 5

OUR STORIES “My Health Coach has been there for me through every step of my journey.”“SEVEN MONTHS AGO when I started my journey “I HAVE ALWAYS been treated with respect and dignity andwith Iora Health, I was unsure exactly how my role as a all my questions always answered. Dr. K genuinely cares aboutHealth Coach would shape my life. I find that every new the patient and it doesn’t feel like I’m just a number. My Healthadventure is another chance to learn more about who I am. Coach has been there for me through every step of my journey I am reminded daily how simply having compassion towards and even accompanied me to consulting appointments. I cannota patient is enough to make flu-like symptoms feel not so bad. I speak enough kind words about my experience at the Hartfordhave learned how rallying as a team on a busy day in the clinic Healthcare Health Center.”can make running from room to room feel less like a whirlwindand more like an exciting challenge to see how many patients Patient HARTFORDwe can help feel better in just one day. I have also learned that inthose few short minutes between huddle and care coordination,I can reflect on ways I can make a difference in a person’s life,even my own. I am humbled by knowing that if I can change justone life during my time with Iora, I can consider my journey herea success.”Kelsey HEALTH COACH HANOVER1 6 humility

Visiting the (new) Nest in downtown Boston“IN MY FIRST YEAR WITH IORA, I was fortunate enough to visit the patient, the transition was seamless as he was shown howour Seattle practices. During which, I had the opportunity to the team works in concert to provide the best possible care. Asshadow a few of our incredible Health Coaches. time went on, I could see that the patient was pleasantly surprised One patient encounter particularly stands out when to find himself in an environment where he had a Health Coachshadowing Cori from the Shoreline practice. Her patient that day and physician who were patient and attentive to his condition.was a first time appointment. He had a vivacious personality, but I looked at the clock at end of the patient visit. The encounteralso displayed real apprehension about coming to a new doctor. It ended up being two hours long. I really had never seen anythingwas obvious from the get-go that he was very much accustomed like it.to the style of care that he’s received for nearly 30 years at a local Walking out of the room and speaking to Cori, she likelyacademic medical center. could sense that my emotions and reactions mirrored that of her I looked on as Cori was conscientious and thoughtful with patient. Seeing Iora in action and how with one appointment ourevery response and action she took, assuaging his doubts care team is able to take real steps towards changing a person’sand concerns, causing him to relax and feel right at home. He life is remarkable. It was truly a rewarding experience that instantlyaffectionately began to refer to her throughout the appointment brought home the reason why we all do what we do.”as, ‘Ms. Cori’. As Dr. Marty Levine eventually came in to meet withJamal PROGRAM MANAGER OF ACCOUNTABLE CARE OPERATIONS humility 1 7 THE NEST

OUR STORIES Ana and Hillary1 8 humility “...you could sense her calming down.” “A PATIENT CAME TO CLINIC very anxious and concerned about a breast issue. We discussed extensively the range of possi- ble diagnoses and further possible tests and spent a great deal of time regarding her fears. Unfortunately, after further testing at a breast clinic, her biopsy returned positive for breast cancer. After she was told the diagnosis over the phone by the breast clinic ARNP, she immediately called our clinic and wanted to go over the results. It was clear that she wasn’t looking for us to tell her what to do, but that she just needed someone to help her process this new information. As a result, the patient, her Health Coach, and I spent a half hour discussing the results; you could sense her calming down. I think it is a testament to the Iora model and the ability to forge strong relationships with patients that the patient trusted us, turned to us, and further deepened the relationship through this challenging time for her.“ Matt PHYSICIAN SEATTLE

“ONE OF OUR PATIENTS, 72 year old Richard (former bull rider and all around inter- IORA GLOSSARYesting guy), came to us in November. His A1C with his previous physician was 14 (as ofmid-September) and by engaging with his Health Coach - Nancy, Physician - Joe, and AIROperations Assistant - Caroline, he has started to take his medications and three monthsafter joining our practice, his A1C is down to 7.9. He has remarked that he has never had (All Iora Retreat)a healthcare team that has listened to him. A great story of building a deep relationshipwith a patient and having an enormous impact in such a short time.“ [air] n.Aaron DIRECTOR OF OPERATIONS A company-wide gathering wh- DENVER & SEATTLE ere team members from across the country have come together“WHAT HAS HAD the most profound impact on my time at Iora is (in 2013, and again in 2015) tothe pure goodness of our care teams, and the passion they have further deepen One Iora; whereto improve patients’ lives. And this is a universal truth—from coast we spend some time learningto coast; new teams and team members that have been with Iora about where we’ve been andfrom the beginning—there is a consistent thread amongst teams, where we’re going as a company,and their gratefulness to be part of something this extraordinary. and the majority of the timeIt’s a humbling reminder every time I visit a practice.” bonding, team building and re-energizing.Dave CHIEF FINANCIAL OFFICER THE NEST humility 1 9

creativOURSTORIESSeeking alternative solutions,finding new ways, turningideas into reality, transforminghealth care “CECILIA, A VIBRANT 60 YEAR OLD was losing the love of her life to cancer, she used to tell me stories of how they would spend every moment they could in what she called her magic garden listening to their waterfall in the beautiful mornings in Arizona. When she told me he died, I asked her if I could make a home visit to do her INR that was due and sit with her in her magic garden? She cried and said, “You can do that? Iora is a little piece of heaven.” Karla HEALTH COACH PHOENIX2 0 creativity

vity “A PATIENT’S BROTHER drove the patient to Iora because she had a dislocated shoulder. She dislocated it when she was riding the bus. When she arrived she was helped out of the car, onto a wheelchair and straight into the exam room. Dr. Levine was able to put her shoulder back in place. When she left a few minutes later I asked her how she felt and she said “I feel much better, I didn’t want to go to the ER.” She was able to save time and an expensive ER co-payment.” Debbie BEHAVIORAL HEALTH SPECIALIST SEATTLEAlex and Vasanth creativity 2 1

OUR STORIES“Our tech team was inspired andempowered enough to springinto action.”“LAST APRIL, Eliot Kristan, Iora Health’s Devops and Systems and imported the medication data so that he could quickly buildManager, was in the middle of his week-long on-call rotation a report for any patients with a history of both drugs. The resultswhen he received a support ticket from Stephen Dahmer, a indicated that, according to our data, there weren’t any patients inphysician in our Manhattan practice. Stephen wanted help Manhattan with the dangerous combination in our system. Eliotquerying our electronic prescription service for a list of our informed Stephen and our Chief Medical Officer.patients taking a specific combination of medications due to a So at Iora, the story wasn’t over. Eliot and Gerardo did not stopreport in the New England Journal of Medicine which concluded with just the Manhattan practice; they decided to do similar workthat the coadministration of trimethoprim-sulfamethoxazole and for all our practices. And good thing. They identified 13 patientsspironolactone “confers excess risk of sudden death.” in total across Iora Health and informed the appropriate teams. Unfortunately, the two vendors we use for electronic Those teams were then able to very quickly look through 12prescriptions do not provide a way to query a patient panel for patients one at a time (instead of thousands) and determine thatthose who have a specific combination. But the Iora practice only 1 patient was potentially at risk for the interaction. Our careteam could go through each drug and cross reference them but team contacted the patient and confirmed that he was not takingthat would be time consuming and error prone. the combination. Eliot understood that this manual search was going to be An Iora physician reads about a newly published druga huge burden on the Manhattan team so he consulted with interaction, submits a support ticket and our tech team wasGerardo Pis-Lopez, a Senior Software Engineer, who had recently inspired and empowered enough to spring into action to checkbeen working on integrations with our electronic prescription on our patients nationwide. Only hours after first becoming awarevendors (and who happens to sit right beside Eliot). After a quick that this interaction existed, we had a care team on the phonespike (that means a time-boxed experiment), Gerardo was able with a patient thousands of miles away to prevent the possibilityto download the medication history for each patient at our of sudden death.”Manhattan practice. Eliot provisioned an Elasticsearch system Will DIRECTOR OF ENGINEERING THE NEST2 2 creativity

“WHAT’S SPECIAL about being part of Iora Health? Lots. Working with patients in an IORA GLOSSARYenvironment that’s designed to support prevention, healing, and behavior change is abiggie. We actually have the time to listen to people’s concerns and to follow up with the nestthem. As many times as they need.  And, it’s the close connection that I share with my talented and dedicated teammates [th-uh] [nest] n.that makes it truly unique. It’s the chocolate fruit fondue parties to celebrate colleagues’birthdays, it’s going white water rafting down the Connecticut River at our annual staff Affectionate name for ourretreat, it’s watching our CEO successfully drive a golf cart over a cardboard bridge that downtown Boston head-the entire company built together in 90 minutes, and it’s working together (at Huddle, in quarters; where teams servepatient visits, out in the community at workshops) to transform healthcare. Working at patients by developing andIora is energizing and inspiring. Each and every day.” supporting technology, hir- ing and training new teamLisa HEALTH COACH members, improving Iora’s HANOVER clinical/operating model, creating tools to enroll and engage new patients, designing and building new locations, and providing data, insights, support and other administrative re- sources to ensure each care team success.Natalie, Cara, Renee, Gianna, Eunice, Kathryn and Arthur creativity 2 3

OUR STORIES“ONE OF OUR HEALTH COACHES, Jessica, has a patient who Annie, Cara, Suzanne and Peteis on chronic opioids, is a driver for another job and has severesomnolence issues (falling asleep at the wheel on a regular basis). “CHANTELL IS A non-obese 51-year-old woman whoThe patient could not afford a CPAP machine, but went through a has diabetes since her early 20s. Over the years her insulinsleep study and was diagnosed with severe sleep apnea. Through requirements have increased to the point where she neededworking with Natalie, another Health Coach, Jessica found a 500 units daily, with or without oral medications. She hadresource for a sleep apnea machine for $100 through a program been evaluated by multiple endocrinologists and had extensivewith the American Sleep Apnea Association for a brand new workups for rare insulin resistance syndromes, with no significantmachine that would have cost the patient $500 which he could changes in her medication regimen. When she established withnot afford. Iora Primary Care, her hemoglobin A1c was close to 15%, which She advocated for him and didn’t give up. She worked with was consistent with her home blood sugar readings of being inthe Sleep Specialist to get the prescription based on the sleep the 400s, and she was applying for financial assistance to affordstudy even before he was able to be seen. She called the program highly-concentrated insulin (typically >$1000/bottle). The careto get information about requirements for the program. She filled team brought her in to do basic diabetes review, and asked her toout all the paperwork. She kept reassuring the patient we would try demonstrate how she injected herself. Almost all of the 60 units ofour best. Today, the patient’s CPAP machine arrived to our office. insulin she was instructed to inject dribbled down her abdomen. We are so proud of the way Jessica stood up for her patient Once we recognized that technique was the culprit (not insulinand the way she was able to find creative resources to help her resistance), we reduced her insulin dosage by 60-70%. Over thepatient be safer and healthier.“ next several weeks, her home blood sugar readings were as low as 65, and typically in the 100s-200s range. Two months afterVasanth PHYSICIAN implementing that single, low-tech change in her regimen, her HARTFORD hemoglobin A1c returned at 8.5%.”“I NEVER BELIEVED my previous doctors but here it is different.”Patient QUEENS2 4 creativity Ed PHYSICIAN PHOENIX

“NURSE HEALTH COACH JENNIFER and Dr. Ravi had been began to acknowledge his part in his illness. With space in theworking closely with a Carpenter patient recently diagnosed conversation for the patient to think through his thoughts hewith severe cardiomyopathy, most likely a result of his history of began to recognize and reach out for help. He acknowledgedalcoholism, and his continued abuse of alcohol. that he is depressed, and uses alcohol to help manage those This patient had been in denial of his illness and the possibility feelings. This patient was able to open up, and was tearful at timesthat some of his lifestyle choices may have contributed to and may on the phone when given the time and space to sort throughbe worsening his current state of health. It has been challenging his feelings. This was the result of a powerful collaborationworking with this patient as he was unable and unwilling to between the teamlet of provider, Health Coach and patient.recognize his part in his illness and therefore, change was not on The decision making process was driven entirely by the patient.the horizon. The process of collaboration, empathy, evoking change Over a period of months, and continued meetings and according to the patient’s desires, and autonomy has laid thesupport from the entire team, this patient reached a turning point groundwork for him to be in control of his health crisis and feelrecently with a virtual visit, in true Iora fashion. supported in the decisions that he chooses for himself. On a recent telephone call with Jennifer and Ravi, while using A simple gesture, often not so simple to do... listening, is thethe techniques learned in Motivational Interviewing, the patient first step towards acceptance and healing for this man.”Wendy CLINICAL LEARNING AND DEVELOPMENT SPECIALIST THE NESTMembers of our Harken Health Atlanta Team A commitment from AIR 2015 creativity 2 5

OUR STORIES “LAST YEAR CONNIE, a 76-year-old patient at Iora Primary Care Shoreline moved to Washington to live with her daughter Laurie. Patients celebrating their 50th Anniversary Connie was born in Guatemala, but moved to California with her at Iora Primary Care in Phoenix husband when she was 27-years-old. She lived in San Fernando2 6 creativity Valley of California for over 40 years where she had a large social support network. Her neighborhood was very walkable. She also drove her own car and used city transit. When she moved to Seattle she gave her car to her son. Her new house with her daughter is in a residential neighborhood on the periphery of Seattle. Connie was reluctant to use the bus system because she was unfamiliar with the area and she feared she would get lost. Connie’s daughter Laurie has told Connie that she is happy to give her rides to wherever she wants to go. But Connie knows that Laurie is busy and doesn’t want to be a burden. Connie recounted all of this to Dr. Jacobs and me at her doctor’s appointment. We were concerned that she was needing more social interaction and suggested she take one of the classes that our clinic offers. Connie felt that getting to the clinic was a barrier to her coming to a class. We all decided that it was best for Connie to learn how to use the bus. The next week our clinic was hosting a class called, “It’s my life: sharing our story” led by our Behavioral Health Specialist, Debbie Yoro. Our plan was to send a Health Coach to Connie’s house to make the trip to Iora with her. I met Connie on her porch and we walked to the bus stop. On the way to the clinic, I showed her where to walk, what bus to take and where to get off. We traced the route on a printed map. On the way back, Connie led the way. On the bus ride home she recounted sharing her story with the other patients in class. Connie looked very joyful and told me that she found the class to be valuable. Connie continued to come to class with Debbie and feels confident taking the bus by herself.” Cori HEALTH COACH SEATTLE

“‘We can really help Iora’s band MegaHelththese people.’ And Isaid yes. We can andwe are, every day.”“I CONSIDER MYSELF EXTREMELY LUCKY to have found and tell me about it. The first man started that he would wake upIora Health. After learning a lot after years of working in big without too much pain, he would take his pills, get his cane andcompanies, I discovered Iora at the end of 2013 and joined in go about his day. I pushed the next person - your perfect day2014. As the first full-time marketer at the company, it’s been without constraints of your reality. I heard more about less pain,an amazing journey, learning all about Iora, the health care fewer aches, getting by a bit easier. Then I came to a woman withindustry, what we’ve done and what needs to be done. I had a a big smile, sitting in a wheelchair, obese with diabetes. I pushedsteep learning curve coming in and quickly spent time visiting a bit more and she came through that she would wake up andpractices, meeting team members and patients and I was able run out of her chair - her imagination ran with the story and sheto see how marketing can help in very concrete ways. And that’s described a pretty great day - for her and for anyone. That wasall great. And then I led some focus groups in Phoenix. I spent a impactful.Saturday talking to groups of underserved seniors - one group And what was even more important for me was shortly afterin Spanish and one in English and I learned about their everyday this at our All Nest meeting, Zander asked that I share the focusstruggles, what made them happy and details about how each of group experience. I did - but not without getting emotional - andthem lived their lives. What was most impactful to me, though, that’s when Hannah, sitting next to me, said “we can really helpwas when I asked a simple question: Imagine your perfect day these people.” And I said yes. We can and we are, every day.”Kathleen VICE PRESIDENT OF MARKETING & COMMUNICATIONS THE NEST creativity 2 7

OUR STORIES“A GENTLEMAN CAME IN following a hospitalization. He had “A FEW WEEKS AGO we celebrated Valentine’s day with ournot seen a physician for over a year and had multiple medical patients. Carah Campini and her community engagement teamproblems. Early in the visit it was clear he had some cognitive put together an amazing party for all of our patients who wereimpairment and, on further evaluation, it became evident he had encouraged to bring any family or friends they wanted. Two of oursignificant difficulties with managing his medications. Over a few patients just so happened to be celebrating their 50th anniversaryvisits, he and his Health Coach were able to clean up his multiple that same day. Patrick Vinck stood and congratulated them onexpired and duplicate pill bottles from home, appropriately get his their 50 years together and we had a special dance dedicatedpill box filled out for a month at a time, and significantly cut down to them. They came in for a visit last week to check up on a fewon his prescription drug cost by changing to covered generics different issues and I started asking the wife some questionsand using the mail order pharmacy.” about her fears in life right now. She opened up to me about her battles with cancer. She’s battled cancer three different times andMatt PHYSICIAN recently has been terrified that it has come back. She said she SEATTLE just wanted to make it to their 50th wedding anniversary which they chose to spend with us, and said that they had “the best time ever.” She also said the only thing missing at the party was her mother who died last year. She said all she wanted to do after the party was call her mom and tell her about what an amazing anniversary they had at their doctor’s office. I honestly sat in that room and just felt so grateful for the work we do. I mean if we really are trying to change health care by improving people’s lives one by one, I think this is a pretty amazing example of that. They told me they never would have thought they would’ve spent their 50th anniversary dancing together in the lobby of their doctor’s office but they were so happy they did.” Hillary HEALTH COACH PHOENIX Dartmouth Health Connect Team2 8 creativity

“SOUTH LOOP received a phone call from a husband of a patient Evabecause she had been having severe abdominal pain that hadbeen going on for two days. Dave Gellis took the call to triage.There was an opening at 6pm at South Loop, 1pm at Edgewaterbut Wicker Park had an 11am opening. The husband brought herthere to be seen. The Health Coach, Nicole, stated that she tookher in the room and in the middle of speaking with the patientshe doubled over in pain and was crying. Jeff, the provider camein and they decided the patient needed to be seen in the ED. Thehusband did not want the team to call an ambulance. The HealthCoach hopped in the car and went with the patient and herhusband to the ED a few blocks away. Upon arriving, the HealthCoach advocated for the patient and got her back and seen ina timely manner. The patient had a potentially life threateningcondition and was taken to surgery. The Health Coach was goingto call today to check on the patient. This is an awesome exampleof market teamwork for the patients of Harken Health, Chicago!!”Kathleen CLINICAL TEAM MANAGER HARTFORD“NEVER IN MY LIFE has anyone cared for me the way you do here.”Patient PHOENIX creativity 2 9

OUR STORIES“This time, everyone came andmost wore pajamas.”“ONE OF MY FONDEST MEMORIES that speaks to our culture is drawing the card that instructed me to “without saying anythingthe time our team spent together in a cabin at the first AIR. While else, announce to everyone, ‘I will be right back.’ And then go tothe energy and enthusiasm being generated by all of Iora coming the bathroom. Do not return or communicate with other playerstogether for the first time was amazing, our team members until someone comes to get you.” I spent 30 minutes in thatnaturally found themselves sitting around a table playing a board bathroom while everyone had a great time.game together. This is worth sharing because it speaks to our incredible team The game was called Quelf, and playing it meant persistently chemistry and bond. While many of us had great connectionscarrying out a number of highly entertaining and painfully from around the country, and certainly enjoyed connecting withembarrassing actions in front of your peers. While the highlights them, it was important for us to share this time together—awaywere numerous, several have to be told in this book. from the great pressures of the work we do. Dave Peckinpaugh spontaneously built a blanket fort and The game was played again at AIR 2015. This time, everyonethen played from within that fort. Elizabeth Wolfe stood in the came and most wore pajamas. Visitors stopped by and surprisinglyshape of an X and continued to play in that position. Every word hung around to watch us play. We entertained ourselves and ourGabe spoke had to be spoken through a sock puppet (who she colleagues. Most importantly, we celebrated our team chemistry.named Britney) AND she had to pretend she was a cheerleader In a way, what seems most special about recounting this isn’t theevery time another team member spoke. Joel showed us his specifics of the game together, but the realization that we do thiswild side by listing off a series of unmentionables that shall not every day, right here in our practice.”be written in this text. My least favorite part of the game was Chris HEALTH COACH/PRACTICE OPERATIONS MANAGER HANOVER3 0 creativity

“ON A TUESDAY toward the end of the Annual Enrollment Period, the Community Engagement team went outdropping bags with a Daily Star article, flyer, hand sanitizer, and ticket to an open house. We were out until lateafternoon dropping these packets at people’s doorsteps and driveways. The next day, a lady called asking aboutour practice. She had been at the hospital the night before and after being discharged she went home and sawour bag hanging from the door knob. She called us because she was feeling sick. We were able to schedule anappointment for her the same day and see her. She was thankful that we had the time for her. If it wasn’t for thebag she received and making a call, she would have gone to the urgent care, but we were able to take care of her.”Emmanuel COMMUNITY ENGAGEMENT LEADER TUCSON The Nest Team creativity 3 1

OUR STORIES “A DEAF PATIENT who has had severe asthma exacerbations couldn’t follow-up because of some diarrhea she has been having and when she coughs, has some leakage. We had IORA GLOSSARY been worried about her and set her up with a video appointment after finding out she couldn’t come in, and were able to use American Sign Language and communicate with snowflake her to assess the response to treatment of her recent asthma exacerbation before we went into the long weekend. She was so happy to use the video platform, especially for [snoh-fleyk] n. someone who relies on visuals for communication.” Iora’s authentication service Vasanth PHYSICIAN that identifies who you are and HARTFORD what role you play (Provider, Health Coach, Patient, etc.) and just like people, every snowflake is unique.3 2 creativity Eliot and Alex

“ONE OF OUR PATIENTS, Sylvia, hasn’t left her house in over “CUIDATE MUCHO MIJA, para que nos3 years; she suffers from agoraphobia (Fear of crowded spaces sigas cuidando a todos los viejitos poror enclosed public places) plus multiple medical issues, and had muchos años más.”been assigned to a primary care provider who refused to prescribeher medication without her coming into his office. Sylvia’s nurse Patient PHOENIXcase manager referred her to our clinic. Sam, one of our HealthCoaches and Nancy, one of our physicians, went on a home “A PATIENT WENT to a nursing facility for hospice. Patients whovisit and discovered that she weighed 92 lbs, she had low vision go to nursing homes are usually assigned to the medical direc-and a neighbor was stealing her money. We were able to see tor at the nursing facility. The medical directors are not able toher with her trusted neighbor (not the one stealing money), we engage with the patient on a regular basis and typically sees pa-were able to designate him as her health care proxy and gave him tients once a month. For our Iora patient, Dr. Levine and Nursethe medication to dispense to her. At the next visit, we brought Jill were able to still provide care and monitoring for the patienther a magnifying glass with a light and a microfiche machine for at the nursing facility. The Iora medical team including Dr. Levine,reading. We’ve coordinated with her Tufts nurse case manager RN Jill, Coach Cori, and Social Worker Debbie visited her at theand were able to get her Ensure. Her current weight is 118 lbs. The facility during her stay there. We were able to provide the con-biggest accomplishment is that she answers the phone and door! tinuity for the patient and her family while the patient was notWhen we first saw her, we had to just ‘show up’ and hope that able to come to the clinic. Oftentimes, patients and family feelshe would allow us into her house. She recently said that what abandoned from their medical care team when they sign on toshe wants for Christmas is good health and would like to ‘walk hospice. Not at Iora. We focus on whole health.”through my door.’”Sam HEALTH COACH & OLGA, CLINICAL TEAM MANAGER BOSTON Debbie BEHAVIORAL HEALTH SPECIALIST SEATTLELyle and Adam creativity 3 3

OUR STORIES Caring deeply, striving for more, never settling, doing what’s right, helping beyond our walls, exuding excitement and commitmentLisa, Angela and Jay3 4 passion

“DURING OUR ATLANTA TEAM TRAINING, Carolina and I asked So, why did he choose Harken? In his words, he felt Harken wasthe Clinical Team Managers and Center Medical Directors to “personalized,” that the pricing was very favorable, and that it wasmeet with us in the lobby to share their feedback on the training much easier to navigate than any other plans on the exchange.so far. We found a sitting area that was perfectly situated, and He was impressed with the broad provider network. He felt it wasasked a gentleman seated there if we could join him. He offered a “fair value proposition.”to leave, but Carolina urged him to stay. We engaged in a spirited It was so wonderful watching our leadership team engagediscussion of how things were going, what questions people were him in a dialogue about his goals, health and experiences. Theyasking, how we could better answer them, etc. connected with him in that impersonal setting in a way that was After about 10 minutes, the gentleman raised his hand. so genuine and caring. He lives in Marietta, and Lynn, one of our He asked if we were “with Harken”. Clinical Team Managers immediately introduced herself and told We said yes, indeed we are with Harken. him how excited they would be to work with him and his wife. He replied, “I just signed up with Harken!” We collectively Tanya suggested asking him to speak to our full group. And hegasped and expressed our surprise and delight. Carolina asked him did! It was unbelievable. He stepped in front of our group of 60+why he chose Harken, and he proceeded to share his experience team members and told his story. He described how he waswith health care and how he was so excited to find something working on his laptop and stopped working and started listeningdifferent this year. He is an entrepreneur, and has purchased when he heard us say “Harken.” He was happy to hear thatinsurance on the exchange for the last two years. He had changed “Harken was real,” and listened for awhile before raising his handplans twice, and was very dissatisfied with the level of service and and introducing himself. When he was on the Harken website, hethe cost. He paid more than $4000 last year for himself and his told himself, “This is too good to be true!” The room erupted inwife, and neither of them went to a physician even once, or filled applause and laughter at that point, since so many of us felt thea single prescription in 2014. He felt medicine had become a same way when we first heard about Iora. Each member of thebusiness that tried to “milk” money out of patients. He felt that he East Cobb team rose to shake his hand and introduce themselves.was just a membership number to his insurance company. It was a magical experience.”“He was so excited to Hogai MEDICAL DIRECTOR ATLANTAfind something differentthis year.” passion 3 5

OUR STORIES“I SPEND A LOT OF MY TIME talking to existing and potential (the friend) what might happen if one of them had an emergency,sponsors. One of the most exciting aspects of my job is when he shared that they would go to the hospital and be well takensponsors come to visit our practices, meet our teams, and really care of. When they asked Eddie that question, he shared that heexperience Iora in action. It is truly transformative for these would personally go to the hospital with them to make sure thatpeople who are so hopeful based on what they see our amazing they were being well taken care of. They couldn’t believe it.teams doing. This was a couple who had only one visit with the Iora team, In one sponsor visit to Phoenix, we had two patients agree to and they shared their enthusiasm about Eddie, Iora, and theirspend time with our guests. The story they shared was something own health that shocked the sponsors. This interaction was a keythat you could not have scripted. Their former doctor was one of reason why Iora moved forward with the sponsor.their best friends, but once they heard about Iora (from Health A big part of what Iora is doing is demonstrating a vision forCoach Eddie), they knew that they needed something more in the future. These patients showed that it was not just a vision, butcase bad things happened in their life. When they asked their PCP a reality that Iora can make happen today.” Duncan VICE PRESIDENT OF BUSINESS DEVELOPMENT THE NESTErin and Maribel The Nest Team at AIR 20133 6 passion

“I HAVE BEEN A PATIENT at Iora since they opened their doors “I ENROLLED A NEW PATIENT and she also requested to enrollon Grant and Alvernon in Tucson. I have never been involved her husband. I told her that I could make their appointments onwith a healthcare system such as this, it is all encompassing, The the same day so they can come together. She was amazed andlevel of care, the concern, the follow-up is something that I have so was the patient’s daughter. They said most places don’t offernever experienced with healthcare professionals before now. I that. They started expressing that transportation is very difficulthave had some problems with my pacemaker lately and had an for them because they have to coordinate with other familyappointment with a electrophysiologist in December, I was very members. I asked them if they lived close by and they do, and Ivery nervous. My Health Coach actually came to my appointment offered them our courtesy transportation. The new patient literallywith me and I cannot express how much that meant to me. Not started crying, and she asked me I quote “Are you from God?” Sheonly did she provide support and comfort for me but she was an was just so excited about everything we offer and said that youextra set of ears in case I missed or did not understand something never hear or see patients laughing and happy at doctor’s officesthat the doctor said. like you do here.” I do not feel that I have found a new doctor and office staff, Ifeel as though I have found new friends who care about me andsupport me.”Sue PATIENT Ana Cristina OPERATIONS ASSISTANT TUCSON PHOENIXCarroll, Chidimma, Erin, Baude, Natalie, Josh and Marbe passion 3 7

OUR STORIES“It probably sounds hokey, but honestlyIora, for me, is a dream come true.”“THE STORY YOU ARE ABOUT TO READ IS TRUE. You might of citations and fines, fear of government regulators, fear of thefind yourself wondering if it is embellished for optimal effect. power of social media...fear. How can we care for humans from aIt is not. This is my story. I first encountered the healthcare fear based reality? To those that are providing the care the answerfield when I became a nursing assistant in 1981. I fell hard for is obvious… we can’t! No wonder nurses are burnt out and tiredthe residents of the nursing home where I worked. I loved the of ignoring patient needs in order to be in regulatory compliance.environment and the chance to support and care for people at a Nurses know how to care for their patients and not being able tovulnerable but very rich time in their lives. I went on to college, provide that care is a horrible feeling. When I first saw the Iora jobbecame an RN and continued to work in the skilled nursing posting for the Nurse Health Coach position I thought I must befield with short term rehab and long term care patients. I loved dreaming. It probably sounds hokey, but honestly Iora, for me,my work because I loved my patients. Over the years as the is a dream come true. After years of trying to talk people intoregulations were increased and nurses spent more and more providing patient-centered care I am now in an environmenttime on paperwork and less time providing care it really took its where people are way ahead of me in doing so! I felt behind fortoll. Somehow nursing became more about completing tasks the first time. What a wonderful feeling! After starting at Iora Iand less about patient relationships. Through my 30 years as an found that I was harboring more cynicism towards the systemRN I have seen so many nurses switch from loving their work than I realized. That parts of my heart had become so desiccatedto just putting in time until they could retire; burned out by all by the years of diminishing hope that until they were refreshedthe rules, guidelines and regulations that had turned them into by my work at Iora I had forgotten they even existed. Even afterautomatons and removed them from the bedside of those they two months on the job, my husband still marvels when I comecared about and wanted to care for. Because I had moved into home with a smile on my face and a feeling of contentment. Onemanagement early in my career maybe I was removed from that day I realized that while driving to work I no longer dreamed oflevel of stress, but somehow I managed to hold on to the belief winning the lottery--I was happy to have a job I loved! At Iorathat a better healthcare system was possible. I always had hope we are committed to restoring humanity to healthcare and thatwe could find a way to get back to caring for people with heart means all of healthcare, not just for patients, but for healthcareand not out of fear of doing something wrong. So many aspects providers too!”of healthcare have become driven by fear: fear of lawsuits, fear3 8 passion Susan HEALTH COACH SEATTLE

“I CAN NOT COUNT the number of times we have heard the story of how a patient IORA GLOSSARYeither marries into our practice, decides not to take positions outside of the Collegeso as to not lose us as their providers, or who have passed up thousands of dollars of teamlethealth care dollar incentives in order to continue to be a part of our clinic. So manyof our patients  state that the single most important reason for staying at their job is [teem-lit] n.because of the health care benefit of being a part of our practice. When our patientsmove on to their next professional or life journey away from our sponsor, they have often A small team at an Iora practicecommented that they will miss being a patient at Dartmouth Health Connect, wish they that together helps support thecould take us with them, promise to come back and visit, and welcome us to visit them same group of patients. By work-in their new homes around the world. We have received postcards from Germany, Italy, ing in teamlets within a singleand across the United States to keep in touch, asking to let them know when Iora plans practice, care teams are able toto open up a clinic near them. When our patients retire out of their benefits, they bemoan develop strong relationshipsthe fact that medicare has not embraced our model allowing them to remain part of our with each other and a smallerpractice into their golden years.   group of patients. Those lucky folks who have worked with us for a short 3 years get what a uniquerelationship they have with a team of people who know them intimately and supportthem in their health goals.   To them, I always reply that we are all lucky to be part of a health care model thatvalues our humanity over all else.”Laura PHYSICIAN HANOVER Dave, Stephen, Pete, Suzanne and Eunice passion 3 9

OUR STORIES“I knew by hiring thisone person, they wouldbe reaching more thanI could ever do alone.”“WHY DID YOU JOIN IORA?” This is a question I receive oftenfrom candidates during their interview process and my answergoes back to when I was in college. My degree is in ExerciseScience and I loved working with people and helping them reachtheir health and wellness goals. After five years in various positionsas personal trainer, group fitness instructor, and my most recentas Senior General Manager of a corporate fitness center, I felt Iwasn’t reaching as many people as I could. Part of my positionwas hiring and onboarding our fitness staff and that is reallywhere I was drawn in, because I knew by hiring this one person,they would be reaching more than I could ever do alone. As partof the Talent and Culture team at Iora I am able to help (indirectlyof course) thousands of patients by hiring amazing care teams, soalthough I am more on the recruiting side of the business, I amstill able to help people reach their wellness goals.”Libby CAREER MANAGER THE NEST4 0 passion Harken Health Decatur Team

“THOUGH I HAD NOT NEEDED to come in for appointments often over the last couple IORA GLOSSARYof years, when I did, I always felt at ease and treated like a human being. The wholeapproach was comforting and straightforward in a way that I didn’t get from previous one ioradoctor experiences. Part of that had to do with the patient centered approach but mostlyhad to do with the intrinsic quality of care that you and the other staff have to begin with.“ [wuhn] [ahy-ohr-uh] n.Patient BROOKLYN The notion that at the end of each day, on every project, ev- Maribel, Mallory, Tyler, ery hard case, and every win, we Mark, Erin and Marty are one entity, one team, one company with one mission: to restore humanity to health care. passion 4 1

OUR STORIES“EARLY IN MY CAREER as a software engineer I listened to mymom give a retirement speech to a bunch of her fellow elementaryschool teachers. It powerfully underscored how important thework that they were doing can be to each and every kid theyhave the opportunity to teach. In addition to deepening myrespect for my mom’s work, it made me painfully aware of a giantmissing piece I had always had in my work life: I was doing whatI was good at, but it wasn’t really aimed at helping people. Afterdoing some searching for this missing piece, I eventually gave up.Finding a career writing software that helps actual human beingswas just too unlikely, I decided. Then came Iora. Bam! The opportunity seemed to come outof nowhere. John (Norman) compared the decision I (and Joel)would be making to the Steve Jobs quote from when Steve wasrecruiting an exec from Pepsi: “Do you want to sell sugar waterfor the rest of your life, or do you want to come with me andchange the world?” I thought this was a little melodramatic at thetime, but the more I read about Iora, the more I realized it wasright on (minus maybe the sugar water part). Hearing - and, on occasion, seeing - how well patients arebeing cared for has been energizing and having the opportunityto help improve the software that supports those providing suchgreat care on a daily basis is a real honor.”Trent SENIOR SOFTWARE ENGINEER Liz with patients THE MINNENEST4 2 passion

“HERE AT IORA everyone has a voice. Weare quick to spot a good idea, and not afraidto put it into action. It is our mission thatdrives us, but our teams that sustain us.”Mary CLINICAL TEAM MANAGER BOSTON“I HAVE A PATIENT who had a stroke and was rushed to thehospital. The Behavioral Health Specialist and I, her Health Coach,went to the hospital to visit the patient. The patient was veryexcited to see us and she felt wonderful to see we cared enough.The patient was discharged from the hospital and I continuedto to follow up with the patient daily. We were able to get herphysical therapy, a shower chair and different medical suppliesshe needed to help her get better and be more independent. Oneday on a daily call, the patient started crying and said she lovedIora because she has been on this earth for over 70 years and shenever had anyone fight for her the way we do, she feels so lovedand she appreciates us.”Dewanzer HEALTH COACH PHOENIX Sonya and Neil passion 4 3

OUR STORIES“He knows we’re here for him.I’m so honored to be a partof his journey.”“I HAVE A PATIENT who I am so proud of, and love working with. diary, including snacks, desserts, and drinks.He came to one of our coffee parties back in September with a We went through it together and came up with 3 simplevery long list of medications and ailments. He walked in with his adjustments to start. Eat veggies once a day, eat fruit 3 times abig tank of oxygen, and his cane and was very overweight. He was week, and cut back on carbs. And then he decided he should alsogray in the face and could only walk at a very slow pace. He had cut back on dessert. He asked if it was okay for him to eat just alots of aches and pains, chronic conditions that he is dealing with bite of dessert each day, cause it’s nice to have something sweet.as well as major depression. I suggested he try having a bite each day, and if that was too hard We scheduled him for an initial visit, did his routine lab work to stop, then have just 1 whole dessert per week. He was thrilled.and discovered that his pre-diabetes had developed into diabetes. It’s now been almost 2 months, and he has lost 20 pounds! At hisHe was crushed to hear the news. Yet another thing in his life last Health Coach appointment, he still had his cane and oxygen,spiraling out of control. He told me he wanted to come in for a but his weight loss was noticeable, he had a great big smile on hisHealth Coach appointment and figure out a way to get healthy face, and he could walk a little faster.again. He set his new weight loss goal for 10 pounds lighter by We started with a 5 day food diary keeping track of what January, and his non-scale goal of losing his cane. He’s doing allhe ate and drank. But then, he rescheduled his Health Coach the hard work by coming up with a routine and following through.appointment for a week later than we originally planned, so I was I asked him at his last Health Coaching appointment how I cana little concerned that he might be more talk than do. But I knew best continue supporting him, and he told me what he loves besthe needed support no matter what. Well, the day came for his is that he can call me anytime and I’m there to talk to him andappointment, and he walked in with nearly 2 full weeks of a food support him over the phone. He knows we’re here for him. I’m so honored to be a part of his journey.” Mallory HEALTH COACH DENVER4 4 passion

Nest Team packing for AIR Sue Ellen with a patientAdam and Annelise passion 4 5

OUR STORIES“MID-MORNING, DAY 2 at our East Cobb practice, Ka’Sandra call a primary care office that they haven’t even met yet for help?Sherrod (Operations Assistant) received a call from a young But of course, given the seriousness of the issue, Clarise and Igentleman with uncontrolled diabetes with about 24 hours of agreed that she would call him back at 3 to make sure everythingsignificant difficulty seeing out of his left eye “like a curtain came went smoothly. He was a little shocked that we called, informeddown over my eye.” He waited a whole day to seek care because us that he had not been seen. Once again Clarise jumped intoonly the day before could he finally afford insurance. action and was able to clean up the insurance issue with the Ka’Sandra, recognizing the seriousness of the call, quickly Ophthalmologist Group, and obtain a 4:10 appointment. Yourecruited Rachel Kacos, Behavioral Health Specialist (and jack should have heard her on the phone. Calm, patient, persistentof all trades!) to grab the closest provider. After a few minutes and persuasive. Advocating gently but mightily for a person sheon the phone it was clear that this gentleman needed an urgent had not yet even met. Hurray! I wish the story ended here.Ophthalmology eye evaluation as he was still in the window By this time all of this was sorted, our patient was just too farwhere permanent blindness could be prevented. Clarise Jordan away in famous Atlanta traffic to make it in time. And we were(who won the honor because she was next to me in the bullpen told that he had to be there in time. Not wanting to send himand was on the phone with a Membership Assistant) jumped on a fool’s errand, we relented and sadly advised him to go tointo action, first working with a Membership Assistant to find a an emergency room. A little deflated, I sadly said goodbye to anpreferred ophthalmologist near the patient’s home. It turns out amazing team and headed through the same awful traffic to thethat even for emergencies, being seen in the office is much better airport. I am glad the story didn’t end here.than being seen in the emergency room (most of their equipment So impressed with our dedication to our patient, theis huge and immobile). Clarise, on her second day as a Health Ophthalmologist group stayed open, reached out to the patientCoach, was able to get through the regular bureaucracy of a large themselves and made sure to see him this afternoon. He was seeneye group, get an emergent appointment at 1:45pm, convince and sent home safely, and we will find out at his first appointmentthe patient it was worth dropping everything and helped him find with Dr. Shameka Hunt-McElhaney and Clarise tomorrowhis way. I wish the story ended here. morning exactly how he is doing. Unfortunately upon arriving to the Ophthalmologist, our In our practices and centers, new and old, we are goingpatient showed his old insurance card, was told he was inactive the extra mile for our patients, navigating the pitfalls of modernand that he couldn’t be seen. Unfortunately, used to a healthcare healthcare, literally saving life and limb. And we are doing it onsystem before Harken Health, he just kind of listened, did not call our second day at work…”us, and headed back home, vision still at risk. I mean, who wouldAndrew VICE PRESIDENT OF PRODUCT DEVELOPMENT THE NEST4 6 passion

Jill Myke, Scott and Joel“OUR TUCSON COMMUNITY ENGAGEMENT TEAM hosted Summer, one of the Community Engagement Coordinators, tookan open house for prospective patients. We spent some time the couple to a consult room and sat down with them. The ladyinviting people, re-confirming their attendance to the event and was feeling much better and she started to share how she hadmaking sure we prepared our practice for their arrival. On the day lost her doctor and needed a new one who would care about her.of the open house, a couple came in. The wife shared she dealt Both wife and husband shared that having a consult room wouldwith anxiety among other mental health problems and in the make appointments easier and bring down the anxiety levels.middle of the practice tour she asked if they could sit down and They loved our practice and care team, and ended up switchingtalk because her anxiety was not making her feel comfortable. to our practice because we made them feel safe.”Emmanuel COMMUNITY ENGAGEMENT LEADER TUCSON passion 4 7

OUR STORIES“Everyone is just so “I CAME TO IORA from a long history of working in multiple areashappy here.” of healthcare. My first job in high school that carried me through college was as a Certified Pharmacy Technician at a retail pharmacy. ”A 94 YEAR OLD PATIENT’S WIFE called the office stating her After that, I worked in several doctor’s offices around Colorado, husband was sleepwalking during the night and fell. The patient’s eventually landing at the clinic that occupied our Glendale space wife explains to the Health Coach she wasn’t able to pick him up before we did. If there is one thing that you will hear from people so he dragged himself to the room and now has rug burns on working in medical fields, it is that people are usually unhappy. his arms and legs. His Health Coach found the patient a same Patients, providers, ancillary staff, everybody just seems drained all day appointment. Once the patient, wife, and daughter arrived of the time. It is an atmosphere that makes you want to just do the to the practice, the doctor stated we will have to do wound care bare minimum to get through a particular event, and then move on treatment on the patient. The nurse, Mari steps in the room and to get to the end of your day as fast as possible. And that’s not how begins to treat the wounds with the Health Coach’s help. As both it should be. team members are doing wound treatment, the patient’s wife The thing that I noticed immediately after starting with Iora says “This is the help I have always dreamed of, you guys are was the extreme focus on Patient Engagement, and how much great!” At the end of the visit, the daughter who is a nurse in New that directly impacts people’s lives. Granted, I had the crash course York, asked “Where can I go to rate you guys, you deserve 10 stars because I started as part of our Denver Community Engagement and also where do I apply to work for you guys? Everyone is just Team, so I probably saw it a lot more than most other people. so happy here.” Having worked in medical offices in the area prior to Iora’s arrival, it was amazing to see the change in the level of care that people received and how it changed people’s lives. I would see familiar faces with smiles larger than I had ever seen, a change in posture, an excitement to coming to their doctor’s office. It is a good change.” Mark OPERATIONS ASSISTANT DENVERLiz HEALTH COACH PHOENIX4 8 passion