Massachusetts General Hospital

Presenting healthy Spanish recipes on Chelsea Community Cable TV 

Funded by MA Department of Public health, our Care Coordination Program provides quality care and help for enrolled patients at MGH Chelsea to receive recommended screening tests, such as mammograms, pap tests, colorectal and prostate cancer screening, blood pressure, cholesterol and diabetes screening. Patient Navigators guide patients through the system from scheduling appointments, transportation, escorting to tests to linking with community and health center resources.  The Nurse Case Manager follows up on abnormal test results while the Risk Reduction Educator refers or works directly with the patient to help him/her make or improve healthy lifestyle choices.

The Care Coordination Team and the patient’s doctor or Nurse Practitioner work closely to help the patient get connected with services and stay healthy.  The process of care coordination involves:

• The patient who leads the decision-making process
• The Patient’s Doctor or Nurse Practitioner
• The Patient Navigator who supports the patient in making appointments, finding transportation, getting tests done, and connecting the patient to other needed services.
• The Nurse Case Manager who helps the patient understand test results and get the treatment the patient needs
• The Risk Reduction Educator who helps the patient make lifestyle choices like eating well, being active, and not smoking.

For more information or to enroll a patient, please call 1-800-449-0344