A Winning Approach to Caring For Anxiety

More and more, digital patient engagement tools allow MIH teams to enhance patient care and raise health outcomes for those who need help outside of the hospital – especially in rural areas, and outside of regular hours. Remote patient monitoring (RPM), a patient engagement strategy where the patient uses internet-connected devices in their home to take readings, can give MIH teams a detailed picture of the patient’s physical health. Recently, however, Palm Beach County Fire Rescue (PBCFR) in Florida has found further success with a novel approach: using RPM to treat chronic anxiety.

Digital patient engagement tools have been used in healthcare for many years to provide better, more proactive care. Typical examples include appointment reminders, automated health risk assessments, patient satisfaction surveys, and remote patient monitoring (RPM). When properly implemented, digital patient engagement tools are a seamless extension of the healthcare provider, allowing for assessment, communication, and positive reinforcement even when the team cannot meet the patient in person. For their patient engagement needs, Palm Beach County Fire Rescue (PBCFR) uses the HealthCall APR Assistant™, which helps coordinate proactive care, manage chronic disease, provide health education, and foster healthier self-care behaviors. PBCFR also uses HealthCall’s integrated remote patient monitoring (RPM) system to automatically receive readings from devices in the patient’s home, including blood pressure, blood glucose levels, and pulse oximetry. This works well for the chronic diseases that the program has focused on for years, but MIH Coordinator Lauren Young-Work thinks it leaves one illness unaddressed: chronic anxiety.

According to the National Institute of Mental Health (analyzing comorbidity data from 2001-2003), 31% of adults will suffer an anxiety disorder within their lifetime. 19% have suffered an anxiety disorder in the past year. Unfortunately, despite its frequent occurrence, many chronic disease programs don’t account for chronic anxiety. Not only does this leave a significant illness untreated, it complicates the treatment of other illnesses, as chronic anxiety is often co-occurring with other conditions. Anxiety can hinder communication, lower patient adherence to a treatment plan, and lead to unnecessary 911 calls as the patient struggles to differentiate between actual symptoms and anxiety-induced fear.

Coordinator Young-Work, drawing on her experience as a medical social worker, supposed that the same HealthCall RPM system which helps their patients manage physical conditions could also help them manage their anxiety. “If you connect remote patient monitoring in a way that makes sense for the symptoms they’re experiencing,” says Young-Work, “it can help them differentiate between what is happening in their body and what’s happening in their brain.” Young-Work theorized that an MIH team could build trust with a patient, and give them greater confidence in their own health, by working with them to establish a routine of taking readings and providing regular positive reinforcement.

Young-Work’s team selected a patient, “Julie”, who seemed like she could particularly benefit from this synergy. Julie suffered from a wide variety of chronic diseases, including diabetes, asthma, and heart issues, with an anxiety disorder adding to and complicating the rest. Julie was also a high 911 utilizer, with 49 calls in the last twelve months and 19 in the last ninety days. The PBCFR team took a multifaceted approach to her care, including a full mental health assessment on the initial visit, setting specific goals with the patient, training for the devices, regular follow-ups (both in-person and digital) to reinforce lessons and build trust, and collaborating with the other healthcare providers on Julie’s care team to ensure they understood and were onboard with the program. Not only was Julie immensely grateful to have her anxiety taken seriously, but she also saw great results: by the time she graduated from PBCFR’s program and moved on to long-term solutions with her care team, Julie’s emergency calls had dropped by 86%.

The team even taught Julie that her anxious tendencies could be a source of strength: “Who better to task with following instructions to make sure they stay healthy than a person who’s anxious about staying healthy?” Young-Work says. “You tap into their repetitive thinking and show them how it can actually be a superpower: ‘it’s awesome that you thought of this; that means you’re going to have a much easier time remembering that this is something you need
to do’.”

While purchasing RPM devices is an extra cost, Young-Work has a few recommended paths for funding and reimbursement. Rural health clinics sometimes provide a per-patient fee to programs that partner with them. The Centers for Medicare and Medicaid Services can also help, though it’s important to partner with a patient’s primary care provider to ensure the patient is considered “established”, and thus eligible for reimbursement. If your organization works with an EHR provider like HealthCall, Young-Work also recommends asking whether they have complementary RPM systems that could be integrated into your setup.

Of course, if RPM devices are not an option, there are other digital patient engagement tools that can help you establish the kind of positive feedback and trust that Young-Work’s team achieved. If the patient owns wearable devices, such as a smart watch or fitness tracker, they may use those devices to self-report relevant activities and readings. Device-free monitoring solutions like the HealthCall APR Assistant™ can help your team reach out to patients, either via automatic outreach (including calls, emails, and texts) or scheduled live calls with a member of your team. HealthCall in particular, provides a patient-centric record of each interaction, along with decision support tools to help you identify when a patient is trending outside of limits. Your team may also want to consider Remote Therapeutic Management (RTM), a similar method of providing care and building trust that connects the patient with a social worker (who can be reimbursed for the service) using simple telephone and video-call check-ins.

Palm Beach County Fire Rescue plans to use the techniques they learned with Julie to help many more patients manage their chronic anxiety. We at HealthCall are happy to support them and share their story, and we hope their success will inspire other MIH teams throughout the country. Chronic anxiety is a serious, often unaddressed health need – but by educating patients, showing compassion, and building trust, you can make a profound impact.

About Lauren Young-Work
Lauren Young-Work is a Licensed Clinical Social Worker (LCSW) and the Medical Social Work Coordinator at Palm Beach County Fire Rescue (PBCFR). She has a Bachelor’s Degree in Rehabilitation Counseling specializing in adjustment to disability and grief, and a Master’s in Social Work with a specialization in medical trauma, crisis, and bereavement. With over 24 years of professional experience, she provides assessment, counseling, crisis intervention, care coordination, teaching, program development/management, and supervision. Lauren co-manages the Mobile Integrated Health Team, which provides clinical services to patients who call 911 and serves on the PBCFR Critical Incident Stress Management (CISM) Team. Lauren’s work focuses on addressing both medical and mental health, ensuring that the whole patient is considered in terms of safety and care.

Lauren recently presented at the 2025 Atrium Health Mobile Integrated Health and Community Paramedicine Clinical and Leadership Summit, where she discussed her novel approach of using PRM in the care of patients with anxiety.

Young-Work, L. (2025, March 27). Anxiety and Remote Patient Monitoring: A Winning MIH Telemedicine Solution [Group Presentation: Atrium Health Mobile Integrated Health Conference, Marriott Riverfront Hotel, Savannah, GA, USA]. https://reg.mihconference.org/atrium2025/pages /age. Lauren Young- Work LCSW is a Medical Social Worker & MIH Coordinator with Palm Beach County Fire Rescue.