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Changing lives with Coram

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Meet Amy Braglia-Tarpey, MS, RD, CNSC

Amy Braglia-Tarpey believes wholeheartedly that nutrition has the power to change our lives for good. As the leader of nutrition programs at Coram® CVS Specialty® Infusion Services (Coram) and a mom to two daughters under age five, her life is busy. But this avid runner is used to moving fast — and she wouldn’t have it any other way.

Amy took a few minutes to slow down recently and share what she loves about working at Coram and why she believes her nutrition teams are the very best.

What drives your passion as a registered dietitian (RD)?

I got really excited about nutrition support during my internship at the University of Michigan, where I worked with top dietitians and physicians and learned how nutrition support can truly change people’s lives. I've been a registered dietitian for 20 years, with Coram since 2013 and currently work as the Senior Advisor for our nutrition programs.

I’m passionate about how nutrition can make our lives better and how everything that we put into our bodies really impacts our day-to-day lives and our long-term health. That’s why I'm always looking for ways to improve the health of our Coram patients so they can live their best lives.

How does Coram make people’s lives better?

We have teams of nurses, pharmacists and dietitians who provide a holistic approach to care by addressing the needs of the whole patient. This means not only making clinical modifications to therapy to help improve a patient’s quality of life, but also practical considerations like the number of hours a day they’re receiving their therapy.

We're providing the best possible care to avoid infections at all costs — we know that when people go home from the hospital, they have no desire to go back.

So, we strive to keep patients safe at home with preventive measures including keeping in close contact with the patient and their physician and educating on self-monitoring for potential problems like dehydration or fever that could lead to rehospitalization. Our year-over-year clinical outcomes are outstanding.

How does the Coram care team support patients?

We provide 24/7 support and we have specialized clinicians on call. If it's the weekend or the middle of the night, we have nurses who can help resolve issues related to the patient's dressing or catheter site, dietitians who can help with tolerance or connection issues, and technicians and pharmacists who can help troubleshoot pumps.

Anything we can do to keep a patient from having to go to the emergency room or back to the hospital — whether it’s calling the physician to develop a plan or talking a patient through how to get their TPN pump started again — those are all things that we strive to do to keep our patients at home.

We think of our team as being the home nutrition support team consisting of the pharmacist, the dietitian, the Coram nurse, and our patient advocate. And we consider the patient and their physician to be a part of that team too. Communication with the physician is really critical to helping ensure the patient's success. For example, sometimes the patient shares information with us that might be helpful to the physician when making adjustments to therapy.

How does Coram help navigate with insurance companies and insurance coverage?

Navigating insurance is challenging for many people. Our Coram team has a dedicated group of insurance benefit specialists who verify benefits and work to get a very quick and accurate determination of what the out-of-pocket costs will be before the patient starts therapy.

And we have a whole dietitian team that really know the CMS guidelines for Medicare qualification, and they work hard to gather all the documentation needed to ensure the patient would have coverage for their therapy. We also have benefits specialists who help investigate what other financial assistance might be available to help ensure that the patient can afford to pay for their therapy.

Coram clinicians are certified nutrition support clinicians. Why does this matter?

At Coram, we're really proud that our dietitians are certified nutrition support clinicians (CNSCs), a designation that’s achieved through years of clinical experience as well as passing a rigorous exam.

We also have pharmacists who are board-certified in nutrition support, which is really exciting because that's a little less common.

Can you tell us about the Coram travel program?

We have infusion pharmacies in nearly every state and multiple pharmacies in some larger states — this allows patients to travel within the United States more easily while staying on therapy. One of the many great benefits for patients and their families is our travel program, as well as our nationwide presence.

We’ve helped patients realize all kinds of travel plans. One patient was able to go on a six-week camping trip and another, with a lot of help and determination, biked cross-country without interrupting his therapy. If patients are traveling overseas, we advise on how they can prepare so they can feel confident. We even helped one patient take the trip of a lifetime to Egypt — she sent us a photo of herself riding a camel!

We also have a liaison who works directly with the Transportation Security Administration (TSA) to make it a little easier to prepare and get through security checkpoints at the airport with formula, pump and supplies.

Coram is a leader in infusion services, but how do you keep it personal when interacting with patients?

Even though we have a very large clinician team and Coram stretches across the nation, we have many nurses, dietitians and pharmacists who work with patients at the local level. Often, these patient-clinician relationships last many years over the course of therapy.

Our clinical support specialists touch base with patients every week to review their supplies and their formula needs. And our clinical dietitians collaborate with patients on a regular basis, with individualized supply lists and a tailored formula unique to the patient to address their specific nutrition needs.

Are there any other outreach programs you’d like to highlight?

Our patient advocate program offers even more of a personal touch, which is a critical component to helping ensure the well-being of the patient who is at home on nutrition support.

Michael Medwar is our Coram Patient Advocate. He’s been on total parenteral nutrition (TPN) therapy, as well as tube feeding therapy at different points in his life, so he can answer questions and help patients prepare for doctor visits. Sharing his journey really helps newer patients understand that there is life beyond therapy.

And, you know, any of our nutrition support patients can access our patient advocate, but he has a special relationship with our long-term patients. Michael touches base with those patients regularly to see how things are going, how their therapy is progressing, if they're achieving the goals that they set for themselves. He’s there to ensure that they get any assistance they need to support their quality of life, and to provide a shoulder to lean on if they have questions or just want to talk about some challenges they're facing as a result of being on a long-term chronic therapy like TPN or tube feeding.

What’s the one thing you’d say to a patient who is considering Coram as their home nutrition provider?

We will be 100% committed to doing everything we can to make your life better and will work side by side with you and your physician to optimize your therapy and quality of life. Our teams really are the best.



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