February 16, 2022

How a Team of Care Guides Helped Save a Member’s Life

A few months ago Nick*, a Castlight member, was having trouble sleeping. Recently diagnosed with COVID-19, his cough became so persistent it kept him up at night.

At his wit’s end, he reached out to one of our Castlight Care Guides, our team of highly trained and experienced clinical and benefits experts that Nick has access to through his benefits. Jenny, a non-clinical Care Guide, picked up. Realizing his concern was medical, she connected him with Trina, a clinical Care Guide with years of nursing experience.

Trina learned that Nick and his entire family tested positive for COVID-19 a few weeks earlier. But while his wife and kids had since recovered, he hadn’t. In addition to the coughing, he was also experiencing shortness of breath. Trina offered to send Nick to the emergency room or urgent care, but he didn’t want to go to either location. When she probed a bit more, she learned that he felt hesitant about doctors; he’d never really had a great patient experience.

What Nick really wanted was medicine to help him stop coughing so he could sleep. Because Care Guides can’t recommend or prescribe medications, Trina suggested he leverage the telehealth service available to him through his benefits, as they could evaluate his condition and set him up with medicine if they determined it was needed. She even offered to provide a “warm transfer” in which she’d call the telehealth provider, get them up to speed, then add Nick to the line. He turned down the offer but wrote down the telehealth information in case he decided to call them later.

“He was sick and knew he needed help—that’s why he called us. But I don’t think he realized how sick he really was.”

— Trina, Castlight Care Guide

Before wrapping up her call with Nick, Trina informed him about signs and symptoms to watch for, such as chest pain, feeling faint, loss of consciousness, coughing up blood, and fever. If he experienced any of these—or if his current symptoms (coughing and shortness of breath) worsened—he should go to the ER immediately.

A few days later, she called him to see how he was doing.

As it turns out, since they’d last spoken, Nick had taken himself to the ER because his coughing didn’t let up and his chest started to hurt. Because of his prior conversations with Trina, he knew this meant he needed to seek help as soon as possible. At the ER, they gave him a CT scan and discovered a blood clot in his lungs (also known as a pulmonary embolism), which can be fatal if not treated.

“He was sick and knew he needed help—that’s why he called us,” says Trina. “But I don’t think he realized how sick he really was.”

The ER doctors prescribed a blood thinner, which would help with the blood clot, and cough medicine. They also referred him to a specialist to follow up with, as the pulmonary embolism required monitoring.

After hearing Nick’s updates, Trina made sure he understood the blood-thinning medication, including potential side effects and how to be compliant (i.e., taking the pill at the same time every day). She also sent him more information on pulmonary embolisms, what recovery is like, and signs it was worsening, and offered to set him up with a primary care physician (PCP) to follow up with since he didn’t have one. He said no, and that he was going to reach out to the specialist the ER had referred him to.

The next day, Trina’s supervisor, Misti, listened in on Trina and Nick’s phone calls. In her role, Misti listens to a random selection of calls and any unique cases her team flags for her, like Nick’s. When Misti learned that Nick didn’t have a PCP, she called him to try again. She shared with Nick how helpful a PCP could have been in this situation.

“When you’re young and healthy—as Nick was prior to contracting COVID-19—you don’t really think you need a primary care physician,” says Misti. “But if he’d had one during this episode, he may have been able to not only cut costs, but he would have automatically had someone to follow up with after his ER visit.” This last part is especially important, as Nick did reach out to the specialist he was referred to, but the specialist never called him back.

In addition, Misti explained that PCPs are critical to an individual’s health and wellbeing throughout their entire life. Primary care providers aren’t only for older people with chronic conditions—they help people navigate unexpected injury or illness and play a key role in patients’ preventive health. In other words, PCPs are important for healthy people, too.

After this discussion, Nick gave Misti permission to connect him with a PCP. She gathered his provider preferences and arranged to speak with him later that day. Leveraging Castlight’s provider search, she looked for PCPs who were in Nick’s area, covered by his insurance, and had exceptional quality per Castlight’s Q-Score. Upon finding someone who fit those criteria, she dug into the patient reviews and saw several patients had mentioned that this specific provider took a lot of time to listen and truly hear their concerns. Misti made an appointment for Nick at the provider’s earliest available appointment two weeks away. 

The day of the appointment, Misti followed up to check in. She was overjoyed to hear Nick absolutely loved his new PCP. He said the doctor spent so much time with him and he was incredibly thankful for that. He was also feeling a lot better, too. The coughing had improved and he was able to sleep. He was still on the blood thinner, which his PCP would monitor until Nick didn’t need it anymore.

Nick was very happy with his Care Guides experience. In a review of his interactions with Misti, he said, “Misti was an unbelievable resource! When I really needed someone to guide me, she took charge and put me at ease.”

Together, our team of Care Guides was able to help Nick address this urgent need and change the trajectory of his overall approach to his health. “I think he’s done a complete 360,” says Trina. He’s realized “life is precious. It can end at any second. You have to take care of it, especially when you’re sick. You have to seek out the medical resources out there for you.”

“Misti was an unbelievable resource! When I really needed someone to guide me, she took charge and put me at ease.”

— Nick, Castlight Member

We’re absolutely thrilled Nick reached out to our amazing Care Guides, who are always ready to put their heads and experience together to help members navigate their personal health journey, whether they’re facing an issue similar to Nick’s or something completely different.

“Every time something like this happens—and it does happen often—it confirms for me that, as a nurse, I’m still doing good for people even though I’m not doing hands-on nursing anymore,” says Misti. “I still make a difference in people’s lives. It also confirms that people truly need Care Guides. One person at a time, we are really making a difference.” 

*Member’s name has been changed for confidentiality.

Visit our COVID-19 resource center here.

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