Employee spotlight: How nurse practitioner Cathy Del Buono is thriving in her transition to virtual care

‍At Cadence, we believe that a better quality of life begins with better care. No matter what role at the company, our team is on a mission to give everyone consistent, proactive healthcare every day. In our Employee Perspectives series, you will hear how different Cadence team members are meeting the company's mission and why they are passionate about their work.
‍

This week, Nurse Practitioner Cathy Del Buono discusses her work on the Care Delivery team. If you’re interested in learning more about Cadence and current job opportunities, check out our careers page to learn more.

‍
1. Tell us a little bit about what you do here at Cadence. What are your core responsibilities?

I am a nurse practitioner responsible for assisting in the care of patients with type 2 diabetes, hypertension, and congestive heart failure. This is done remotely through our technology that enables patients to transmit their blood pressure, weight, and glucose measurements to Cadence from the comfort of their homes.
 

I interact with patients through scheduled phone visits at a frequency that depends on their acuity. I make suggestions for lifestyle modifications to improve their condition as well as medication adjustments. I respond to vital sign escalations and suggest any further intervention/evaluation that may be needed. I also communicate with the ordering providers for all clinical evaluations, and as needed, to address any patient concerns. In this way, I like to think that I serve as a resource for both patients as well as ordering providers.
  

Another core responsibility is being a supportive and engaged team member. I enjoy using Slack as a way to communicate with my team, and around the company, for both work and social purposes. I have learned how to manage Slack to do my job while also still feeling like I can have chats with my coworkers, just like I would do in a brick-and-mortar office. 

2. What gets you most excited about your job at Cadence and about the company at large?

Cadence excites me because we have a wonderful group of highly specialized, educated, experienced, and passionate people who are very interested in disrupting how health care is delivered and using remote patient monitoring to make that happen. Our nurse practitioners provide specialized care to help support patients across many areas where access to care may be limited due to a lack of primary care providers and specialists and/or lack of transportation. These patients may also need care more often than what may be available with their usual primary care provider, or it may be months before they can see them. We are another touch point that can provide a check-in with patients in between their in-person visits and actively make changes in their care as needed. In my view, we are providing more than remote care monitoring, we are providing remote care management.

I also get excited about my interactions with the Cadence team. We are a small and mighty organization driven by a few key shared values, such as: bring positive energy, be a driver, and be curious. We are all vitally important and everyone at Cadence can give input into decisions. In this way, we are collectively able to make Cadence flourish.

3. Why are you so passionate about using remote monitoring to help extend access to specialized care for people with chronic conditions?

I am very passionate about improving the health of our patients, those with type 2 diabetes, hypertension, and heart failure. It takes a village to improve care for people with chronic illnesses, and I am thrilled to be part of that village here at Cadence. My background is in endocrinology, including type 2 diabetes. At Cadence, I am able to share my expertise with a wide range of patients in distant areas, regardless of their address and zip code, all while I work from my own home.

Our patients often live in rural and underserved areas, and remote monitoring can help improve their health dramatically because we have access to the data to evaluate and make decisions to change their medications, treatment, and lifestyle if needed. Whereas patients typically must wait 3-6 months to have adjustments made to their treatments during in-person visits, we can do this in consultation with their providers much faster.


4. How have you found the transition to virtual patient care and management? Can you specifically talk about the impact you feel you are having, specifically with patients facing conditions such as type 2 diabetes?

I was concerned about the transition from in-person care to remote care, especially since our interactions are by phone and not by video. I retired from a thriving primary practice and worried about how I would make relationships with these new patients in a relatively new manner of care delivery. It has proven to be less difficult than I imagined.

Patients recognize my voice, and I recognize theirs. I get excited for my patients when they stop smoking, or see improvements in their diabetes, and I grieve with them when they share news of an ill family member or the loss of a beloved pet. I keep brief notes to help me keep track of these facts to ensure I can briefly follow up on our next call. This personal touch goes a long way to feeling like I am making a difference, even virtually.

For patients with diabetes, specifically, I was concerned about how I could talk to someone about how to check their sugar properly, but patients have been wonderfully receptive to my verbal coaching. I have helped patients learn how to use an insulin pen remotely on the phone, with careful directions and patience, and they are so appreciative. I recall one patient who asked their pharmacist how to use their injection device and was given a 10-page pamphlet. They went home and waited for me to call! I had the patient injecting their medicine in a matter of minutes, and they were so relieved.

5. For anyone who's considering joining Cadence, in particular those in clinical roles, what would you tell them about based on your experience?

Work at Cadence as a clinician is fast-paced and exciting. You will work hard, and just because we’re working from home, doesn’t mean we don’t still have fun. For example, I shared a family tradition by decorating my home office space with a cardboard fireplace at Christmas to share with my coworkers during virtual meetings.You will learn to define work time and non-work time. You have to be comfortable with learning new technology and software, knowing there is a lot of support for that along the way. You also have to be willing to ask questions and reach out when help is needed. It is great to know that there is always someone on this team who is willing to answer your questions, point you in the right direction, or just be there to listen.