Breaking the sickle cell crisis cycle
A 24-year-old with sickle cell disease averaging a crisis every 6 weeks was matched with a hematology-integrated care plan, a pain contract respected across facilities, and a home hydration protocol.
Member
Deja
Who we help
Adult High Utilizers
Location
Solano County, CA
Timeframe
12-month program
What changed
The outcome for Deja
8 → 2
Crisis admissions per year
75% reduction sustained.
22 → 4
Missed workdays
Employment preserved.
100%
Hydroxyurea adherence
Verified via delivery + refill tracking.
0
Pain-plan overrides
Care plan honored at every ED encounter.
Where things started
The situation.
Deja had 8 crisis-related admissions in the prior 12 months and repeatedly encountered stigma at multiple EDs that assumed drug-seeking rather than genuine pain.
“The first time an ER doctor read my care plan instead of my chart, I cried. I stopped being a suspect and started being a patient.”
The hard part
What stood in the way.
- 1
8 hospitalizations per year for pain crises.
- 2
Stigma-driven under-treatment at multiple EDs.
- 3
Missed hydroxyurea doses tied to inconsistent transportation to pharmacy.
- 4
Missed workdays threatening her employment.
Our approach
How we built the plan.
Step 1
Hematology-led care plan documented and shared across ED networks.
Step 2
Standing pain-management protocol respected across facilities.
Step 3
Medication delivery to her home; hydration and trigger education.
The support
What we actually did.
- 01
Month 1 — Care plan lock
Documented hematology-led plan uploaded to the shared network; care manager introduced at every partner ED.
- 02
Months 2–6 — Medication + hydration
Hydroxyurea delivered monthly; hydration coaching; trigger identification (cold exposure, dehydration) built into a self-management plan.
- 03
Months 7–12 — Employment continuity
Coordinated with employer HR for reasonable accommodations; missed workdays dropped from 22 to 4.
Behind the scenes
The team and services on this case.
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