Alexis Devone, Keshia Jones, Ana Conroy and Cassandra Glenn are among the first Certified Community Health Workers in North Carolina. They focus on patients who struggle with social determinants of health—transportation, food insecurities, health literacy and housing. They connect these patients with resources in the community, and meet them where they are.
“We’re the bridge between providers and patients,” Alexis said. “We’re a little more personable and relaxed, and patients open up about things that they wouldn’t necessarily tell a doctor on their own. We share that knowledge with the provider to improve care.”
Guides and Educators for Patients
Each community health worker has a different focus. Alexis works with patients at Downtown Health Plaza, CarePlus, while Keshia works with Internal Medicine and Infectious Disease. Cassandra is focused on Family Medicine, and Ana works with Winston East Pediatrics and Downtown Health Plaza Internal Medicine. They receive referrals from specialties, social workers and pharmacists.
“Ultimately, we would like to be embedded in all clinics,” said Keya Eaton, MPH, BSN, RN, CHPN, Director of Population Health – Ambulatory Care Management. Keya said community health workers fall under the umbrella of Population Health. “We look at the whole patient, not just a singular request.”
Reaching health equity isn’t a given for this population. It’s more of a matter of striving toward health equity, Alexis said. “We serve as guides to our patients. We may be spending one day with a patient, or several months to a year with that same patient.”
They also educate patients. “Someone may have health insurance and not even realize they have the benefits they do,” Cassandra said. “One patient I helped with Medicaid, Trans-Aid, repairs to his apartment through the housing authority, and even how to order groceries online because he had no transportation to get to the grocery store.”
Eyes and Ears for Providers
Often these patients may feel intimidated and afraid to speak up about their concerns, such as side effects from a medication, Cassandra said. That’s when community health workers become the eyes and ears for the provider.
Alexis gave the example of having a home visit with an elderly patient who called and said she couldn’t make the visit because she was going to the Emergency Department. “I knew the ED was not the place for her to go, as she was elderly and a lot of patients with COVID-19 were going there. I was able to arrange a same-day appointment for her in the clinic instead. Because she felt comfortable with me to tell me she was going to the ED, I was able to help her navigate the health system.”
“My background is psychology, and I speak Spanish,” Ana said. “I try to build rapport with my patients first to get all the information I need about their challenges. I have lupus, an autoimmune disease, which is another way I connect with them as a patient myself.”
Ana had a patient who had burned the right side of her body when her house burned down. She was living at a hotel and not changing her dressings. “The burns looked so bad,” Ana said. “I helped her come to the clinic every day to have her wounds dressed. She couldn’t afford to pay for her medications, and I helped her with this, too.”
Keshia, who is also a medical assistant, said she’s able to connect with patients because of her own personal experiences in life. “I had a baby at 17,” she said. “I’ve had family members with chronic diseases who died young.”
Alexis has a father who is a leukemia survivor, and she has been a diabetic for 28 years. “I understand what it’s like to be a patient,” she said.
Cassandra said knows what it’s like to have family members who are single mothers or just coming out of jail. “We all need advocates to navigate the health system and life. We all may need help ourselves one day.”
“Little by little, we’re moving forward in making changes and helping our community,” Ana said. “In the future, we’ll be able to say we were there as we achieved change.”