Health care innovator: Dr. Melanie Blake

Dr. Melanie Blake, assistant chief medical officer of ambulatory care, is shown Friday, July 13, 2018 at Erlanger Medical Center in Chattanooga, Tennessee.

Champions of Health Care

In our third annual edition of Champions of Health Care, Edge magazine received nearly 200 recommendations from the public about health care providers, administrators and volunteers who are making health care better in Chattanooga.From among those nominations, a panel of judges comprised of top leaders from the Chattanooga/Hamilton County Medical Society and each of Chattanooga's three major hospital systems - Erlanger Health System, CHI Memorial Hospital and Parkridge Health System - picked nine winners in eight different classifications of health care.The Champions of Health Care award winners this year have tackled major community health problems, started or promoted programs to better coordinate care and expanded initiatives for wellness and disease detection. Others are recognized for new approaches, strong leadership and simple acts of kindness during their lifetimes of achievement and service. In a variety of volunteer and professional roles across many of Chattanooga's major health care institutions, the honorees have distinguished themselves and the community for improving the health of individuals and Chattanooga as a whole.This year's Champions of Health Care will be honored at an awards luncheon at The Chattanoogan on Wednesday, September 5.

Someone once told Melanie Blake that the truest test of a doctor-in-the-making is: "If you can't imagine doing anything else."

The daughter of a cardiovascular nurse and a dentist, Dr. Blake, 39, has become the embodiment of that theory. She is this year's Champions of Heath Care award recipient in the "Innovation in Health Care" category for her work advancing a patient-centered approach to primary care.

Innovation in Health Care Award

Honors a company or person primarily responsible for a scientific discovery or new processes, device or service that can save lives or improve the quality of lives.Accomplishments: Blake has led the development of Erlanger’s Patient-Centered Medical Home (PCMH) program to better coordinate care and give physicians more time for patient care by lifting some of their administrative duties and relying upon other health care professionals to aid in the overall care model.

In her spare time, Dr. Blake, a native of Birmingham and a former college athlete at Florida State University, is a national champion Masters sprint hurdler - which is an apt metaphor for her work at Erlanger, clearing hurdles through grit and focus.

Blake, who spends half her time in her medical practice and half her time on administrative duties, has been instrumental in helping retool many of the practices in Erlanger Medical Group. A new model, called Patient-Centered Medical Homes (or PCMH, for short) emphasizes improving patient outcomes and giving physicians more time for patient care by lifting some of their administrative duties.

It's easier said than done.

"The task of advancing PCMH is not easy when you have 60-plus providers with many different ideas," says Julia McKay, project manager for Erlanger's Primary Care Medical Home program. "She (Dr. Blake) is very open minded, a great listener with sharp critical and analytical thinking skills. She is a very brilliant person, being the combination of doctor and business person gives her an edge in her ability to look futuristically at primary care."

McKay said Blake "digs in, does the work, and works out all the bugs" before asking others to be a part of the work, traits which have gained her trust among physicians.

"She will not ask you to do anything she is not willing to do," McKay says of Blake. "She sets herself as not just a leader, but the 'first boots on the ground.'"

The PCMH care model aims to consolidate health care functions under one delivery system, hence the "home" analogy. Such a practice combines traditional doctors and nurses along with pharmacists, nutritionists, social workers and care coordinators. It's multi-faceted care that takes into account the "whole person," experts say.

This team approach means that patients aren't left on their own to navigate the sometimes confusing and overlapping health-care system. Instead, patients are led down a path to better follow-ups and outcomes.

"For example, we have a social worker and a pharmacist and a care coordinator," Dr. Blake explains. "If (a patient) misses their cardiologist appointment (and needs to reschedule), we can facilitate that. Or if they go in in the hospital we call them to follow up on how they are doing."

Part of the transition is building a system of integrated medicine to improve outcomes, Dr. Blake says. At one point the Erlanger team converted 15 practices in 18 months, a herculean task.

"We started looking at quality measures," Dr. Blake says of the Erlanger PCMH model. "Some (practices) were doing really well on diabetic control and blood pressure, and some weren't doing well at all. It had a lot to do with geography and resources. It also had to do with communicating with patients and getting them in more often."

Dr. Blake says she was drawn to the quality and safety aspects of medicine by a family experience. When she was in medical school an aunt was diagnosed with Stage IV breast cancer.

"Unfortunately, the mammogram she had at age 37 was not fully read by her gynecologist, resulting in a delay of a year in her diagnosis," Dr. Blake says. "If it had been caught the year before, her prognosis would have been much better.

"Medical mistakes like that are often a system issue, not a result of a doctor being inattentive. Bolstering the system so that such mistakes are less likely is very important to me, and along with other measures, establishing PCMH fortified Erlanger Health System against that type of error."

Nurses are central to the Patient-Centered Medical Home model, Dr Blake says, because they are called on to do important work such as screenings for depression and determining which patients may be at risk of falls.

"She (Dr. Blake) recognized that the majority of the principles centered on nursing care," says Sondra McGinnis, chief nursing officer of Erlanger Medical Group. "She prioritized by first focusing on the metrics the nurses could impact if they functioned at the top of their license. Her strategic approach to first focus on training the nursing staff accelerated the implementation process of team-based, patient-centered medical homes that provide quality care for our patients."

Dr. Blake, whose husband Dr. Rett Blake is an anesthesiologist, moved to Chattanooga in 2009. The couple met while attending medical school together at the University of Alabama at Birmingham.

In addition to her medical training, Dr. Blake received an MBA from the University of Tennessee at Chattanooga.

In 2013, Dr. Blake began to train with the Chattanooga Track Club and competes in the Masters Division of the USA Track Federation. She runs the 100-meter, 400-meter and 60-meter hurdles in national and international competitions.