Natalie Crouse, Community Feature in Pittsburgh Magazine

When the shutdown order that changed life as we know it came, Natalie Crouse was ready to get work.

“I remember in particular the weekend when the bomb dropped on everyone’s lives,” the nurse practitioner and director of Clinical Operations at Adagio Health, recalls. But after talks with senior management and her team, she knew, “We can handle this. We can manage it.”

Adagio Health provides health and wellness services in Pennsylvania and West Virginia, with a particular focus on women’s health. The organization serves patients and clients from all walks of life, including those who are uninsured or underinsured. Telehealth was seen as one solution to meeting patient needs while keeping staff safe.

Crouse had attended a conference in the fall where she participated in numerous sessions on the topic and had been pushing Adagio Health to adopt telehealth as quickly as possible, which at the time meant in the next one to two years.

But the pandemic changed that timeline.

“We talked about it as an organization, and essentially what we had to is … move quickly,” Crouse says. “Amazingly, to the credit of the people who lead the company, they gave us support and authority to act. And we were ready.”

Policies were written, technology was implemented and the staff was trained.

“Literally within days, we had telehealth set up,” Crouse says.

The rapid implementation was combined with keeping clinics open with new safety procedures, such as triage in the parking lots.

“There was a lot of focus in making sure that it wasn’t a big deal for patients,” Crouse says. “I always think of the least common denominator. I think of that person. The disenfranchised person is who I’ve spent my career serving for 20 years.”

While Crouse could take pride in all those accomplishments, she becomes emotional when she talks about her coworkers.

“I’m so proud of everyone. I could get choked up.”

She notes that not one staff member chose to step away from the challenges.

“We are all in this together,” Crouse says. To emphasize that point, she instituted another change: She brought together the entire clinical staff from the nine medical offices for a weekly conference call.

“Anyone in health care knows that we are change agents. I’ve spent the last 20 years virtually hanging onto a roller coaster bar. Sometimes I’ve had my hands up, but most of the time you’re holding onto the bar.”

She says the pandemic has sparked growth in everyone in health care, from medical assistants to people working in a hospital laundry to surgeons.

“I was a poor kid from a gritty, second-generation immigrant background. And I learned one thing, and that is you cannot grow when you’re comfortable.”

Still, she is glad she is past those nights she spent laying in bed wondering what was going to happen next.

“We’re at a very good place right now,” in part due to a culture at Adagio Health that is patient-friendly, promoting access and reducing obstacles, Crouse says.

“We had been getting ready for this pandemic for a few years,” she says. “We just didn’t know it.”