brown2020

Plenary Presentation at the DMAA – Disease Management Association of America Annual Meeting entitled New Models of Disease Management: Improving Quality and Access through Remote Health Monitoring Technology

DMAA Transcript

• Slide 1: New Models of Disease Management: Improving Quality and Access through Remote Health Monitoring Technology Presented by: Steve Brown President and CEO Health Hero Network Inc. Saturday, October 26, 2002 DMAA Annual Meeting, San Antonio TX
• Slide 2: Technology Advances… “In the old days we would do nothing and he had a 50-50 chance. With all this high tech equipment the odds are even.” From OKBridge HMO DMAA Keynote – Health Hero Network 2
• Slide 3: The Promise • A better model of care is possible • Crisis care  Coordinated care • Higher quality with lower cost DMAA Keynote – Health Hero Network 3
• Slide 4: Role of Technology •  Move the point of service closer to the user -  Convenience -  Timeliness -  Access •  Increase productivity of service providers -  Timely, relevant, actionable information -  Process improvement -  Quality assurance •  Change behavior -  Better self-care -  Better treatment compliance -  More appropriate utilization DMAA Keynote – Health Hero Network 4
• Slide 5: Changing Behavior… DMAA Keynote – Health Hero Network 5
• Slide 6: Health Hero Network Example: Internet- Based Services for Disease Managers Secure Data Center DMAA Keynote – Health Hero Network 6
• Slide 7: Health Hero Network Example: Daily Dialogues with the Patient DMAA Keynote – Health Hero Network 7
• Slide 8: Health Hero Network Example: Patient Stratification and Management Tools DMAA Keynote – Health Hero Network 8
• Slide 9: AMAC Example: Disease Management with Personal Emergency Response *American Medical Alert is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 9
• Slide 10: Philips Telehealth Solutions Example: Comprehensive CHF Solution with Peripheral Devices * *Philips is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 10
• Slide 11: TheraSense Example: FreeStyle Tracker Diabetes Management System *Therasense is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 11
• Slide 12: Some Results DMAA Keynote – Health Hero Network 12
• Slide 13: Oakland Asthma Study •  Oakland Children’s Hospital, Oakland, California •  Asthma self-management program using telemedicine technology for high-risk population with asthma •  Randomized controlled trial compared to traditional patient education for 90 day intervention •  66 patients in intervention group, 68 in control group, ages 8-16 DMAA Keynote – Health Hero Network 13
• Slide 14: Oakland Asthma Results •  Significant reduction in Activity Limitation (p = .03) •  Significant reduction in reported high peak flow readings (p = .01) •  Significant reduction in urgent calls to hospital (p = .05) •  Improved self-care behaviors •  Published in: Arch Pediatr Adolesc Med. 2002; 156:114-120 DMAA Keynote – Health Hero Network 14
• Slide 15: Veterans Demonstration •  Veterans Health Administration Community Care Coordination Service, Florida •  Telemedicine-based care coordination demonstration project •  791 veterans enrolled for 1 year, compared to comparison group data •  Elderly, high-risk, high-cost veterans with hypertension, heart failure, COPD, and diabetes DMAA Keynote – Health Hero Network 15
• Slide 16: Veterans Results •  40% reduction in Emergency Room visits •  63% reduction in Hospital Admissions •  60% reduction in hospital bed days of care •  64% reduction in nursing home admissions •  88% reduction in nursing home bed days of care •  Significant improvement in Quality of Life SF36V •  Published in: Disease Management, Volume 5, Number 2, 2002 DMAA Keynote – Health Hero Network 16
• Slide 17: Mercy Diabetes Study •  Mercy Health System in Laredo, Texas •  Home-based telemedicine program for uninsured, high- risk, underserved population with diabetes •  One year study period using comparative cohort data from previous calendar year •  Total of 169 patients – 130 females and 39 males with average age of 53 years in both genders DMAA Keynote – Health Hero Network 17
• Slide 18: Mercy Diabetes Results •  Inpatient Admissions reduced 32% (p < 0.07) •  Emergency Room Encounters reduced 34% (p < 0.06) •  Outpatient visits reduced 49% (p < 0.001) •  In press: Diabetes Technology & Therapeutics Journal, December 2002 DMAA Keynote - Health Hero Network 18
• Slide 19: Mercy Results: Patient Satisfaction DMAA Keynote – Health Hero Network 19
• Slide 20: Mercy Results: Patient Compliance DMAA Keynote – Health Hero Network 20
• Slide 21: Traditional Process •  Scheduled calls based on diagnosis and initial assessment: “hit or miss” •  Technology used for scheduling, documentation, reporting •  More time spent on assessment than on intervention: -  Care manager with 100 patients -  Scheduled call once per week to assess patient status and needs -  20 successful calls per day -  20 – 30 minutes per call, including set-up, rapport building, etc. -  7 – 10 hours per day, no time for lunch DMAA Keynote – Health Hero Network 21
• Slide 22: Technology-enabled Process •  Communicate with patients daily, especially those with complex conditions and the frail elderly •  Encourage, teach, reinforce, and remind patients to improve self-care and change behavior •  Stratify patients by risk and need in order to and target calls and interventions on those most in need: -  Care manager with 400 patients -  Monitor once per day and risk stratify results -  20 – 40 calls per day to check in with patients who report elevated risk -  3 – 6 minutes per call because most patients have already taken action -  2 – 4 hour job to coordinate care DMAA Keynote – Health Hero Network 22
• Slide 23: Criteria for Success Simplicity and Focus [Remember who needs care the most] Personal, Relevant, Actionable Information [What matters most to care providers] Support Self-Care and Behavior Change [What makes the biggest difference to quality of life and overall outcomes] DMAA Keynote – Health Hero Network 23
• Slide 24: DM and Technology: Empower Patients and the People Who Care for Them DMAA Keynote – Health Hero Network 24