integrating self-direction with provider support
DESCRIPTION
T H E A C T I V A T E D P A T I E N T. Integrating Self-Direction with Provider Support. RESULTS. Shirley Grey RN MSN. Outcomes: Diabetes. XX CSI. Low-Income Latinos— Sanofi Aventis. COMPREHENSIVE PROGRAM - PowerPoint PPT PresentationTRANSCRIPT
T H E A C T I V A T E D P A T I E N T
Integrating Self-Direction with Provider Support
Shirley Grey RN MSN
RESULTS
XX CSILow-Income Latinos—Sanofi Aventis
COMPREHENSIVE PROGRAM
• Ethnographic Research Patients at home and in doctor appointments
• SelfCareKit
• IVR and Dashboard
• Continuing Medical Education Three sessions in three cities
Outcomes: Diabetes
Average A1c score after SIX months
99.7% Confidence Level
AFTER BEFORE
9.3 8.7
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• Data collected from each group at 6 months• Study designed & conducted
by hospital staff
Suburban Medical Center DM program had failed Multiplied compliance rates
Patient Adherence Results: Heart Failure
Weighing Daily
Taking Blood Pressure
Medication Compliance
27%
14%
77%
86%
14% 59%
BEFORE AFTER IMPROVEMENT
514%
321%
185%
EVIDENCE: MORE EFFECTIVE AT ENGAGEMENT
BEFORE AFTER
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We took them on in South Carolina!
LOWER CLAIMS COSTChallenge: CMS said, "Truckers are the most difficult employees to influence for healthy change.”
Outcome: For every $1 invested, the company saved $1.79--to our knowledge, the first trucker health success!
Evidence It Works:
BETTER SCORESChallenge: Employer said, “We only brought 12% of our hypertensives into normal range after a year of live coaching”
Outcome:88% of employees reduced their BP scores below the threshold in six months!
AFTER BEFORE
Over 140/90 88%
Below 140/80 12%
6%
88%
Clinic confirmed BP after six months
Increased medication compliance
EVIDENCE SELF REPORTING
IS RELIABLE
We took them on in Illinois!
Before After
95%
0
7.4%
Medical Center NJ previously used instructions from the American Lung Association
OutcomeAdvantage program more than doubled the medication compliance rate
Persistence 6 mo 44%
Readmissions 16%
Use of the ER 26%
Evidence Our Program Works: Asthma
EVIDENCE CLINCAL ACCURACY
IS NOT ADEQUATE COMMUNICATION
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St. Joseph, Lexington KY
St. Joseph, Elgin IL
NWC, Arlington Hts. ILDRG 127 ONLY
NWC, Arlington Hts. ILALL CHF-RELATED DRGs
Aurora, Milwaukee WI
Great Plains, Elk City OK
VA, Ann Arbor MI
Mercy Hospital, Chicago IL
6.4% 4.0% 38%
16.7% 7.7% 54%
22.2% 6.3% 72%
8.6% 2.2% 73%
23.4% 6.9% 74%
54.5% 33.3% 38%
13.2% 8.7% 34%
BEFORE AFTER
REDUCED BY
38% 54% 34% 74% 72% 73% 38% 100%>28% 0%
BEFORE AFTER
At Mercy only: N = insufficient for highest level of statistical
significance, but indicative, especially given overall trend
Reduce 30-day Heart Failure
Readmission Rates
Results: Satisfaction
“Did the program help you manage your condition?”
Hypertension
Yes – 94.9% No – 2.9%
Diabetes
Yes – 93.6% No – 6.4%
CAD
Yes –100%
5-year kit average = 96%Press Ganey 5-year average = 72%
Heart Failure
Yes – 97.3% No – 1.8% Asthma
Yes – 92.5% No – 2.5%
UPMC Health Plan 71 5 5 0 B a r c l a y B l v d B u f f a l o G r o v e , I L
“After 24 months, for 712 participants, total medical costs were 23% lower than the baseline year Blood pressure, cholesterol, and blood sugar improved more than 85%ER visits decreased by 16% and hospital days decreased by 54%
There were substantial reductions in imaging services (-35%), procedure services (-10%), and average prescription costs per member (-18%). Physician office visits increased by 19%. The net savings at two years exceeded $56 PMPMMembers had 30% lower out-of-pocket cost comparedto the alternate PPO plan.”
TESTIMONY TO THE NEVADA STATE LEGISLATURE RE: KITS AND CONNECTION PROGRAM
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FINANCIAL RESULTS: LONG TERM ROI