Montana Health Network provides care coordination for chronic disease management

Francine (name changed to ensure privacy), a diabetes patient in rural Montana, lives about 30 miles away from her provider. She is unable to visit a diabetic educator due to transportation-related challenges and financial limitations. Instead, she receives check-ins from a registered nurse. She told the RN, Gina Delaney, that she used to test her blood sugar only once a day. Since Delaney has started checking in with her, Francine now tests three times a day. Thanks to Delaney's work, this patient was able to lower her hemoglobin A1C.

As a Regional Care Coordinator, Delaney works with six or...