Integrating self direction with provider support
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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

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Integrating Self-Direction with Provider Support

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Integrating self direction with provider support

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


Integrating self direction with provider support

Outcomes: Diabetes

XX CSI

Low-Income Latinos—Sanofi Aventis

  • COMPREHENSIVE PROGRAM

  • Ethnographic ResearchPatients at home and in doctor appointments

  • SelfCareKit

  • IVR and Dashboard

  • Continuing Medical EducationThree sessions in three cities

BEFORE

AFTER

9.3 8.7

Average A1c score after SIX months

99.7% Confidence Level

1 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


Integrating self direction with provider support

Patient Adherence Results: Heart Failure

Suburban Medical Center DM program had failed Multiplied compliance rates

BEFOREAFTER

BEFOREAFTER

IMPROVEMENT

185%

27%

77%

Weighing Daily

Taking Blood Pressure

Medication Compliance

86%

514%

14%

59%

14%

321%

• Data collected from each group at 6 months

• Study designed & conducted by hospital staff

EVIDENCE:

MORE EFFECTIVE AT ENGAGEMENT

1 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


Integrating self direction with provider support

Evidence It Works:

LOWER CLAIMS COST

Challenge: CMS said, "Truckers are the most difficult employees to influence for healthy change.”

BETTER SCORES

Challenge: Employer said, “We only brought 12% of our hypertensives into normal range after a year of live coaching”

We took them on in Illinois!

We took them on in South Carolina!

Outcome:For every $1 invested, the company saved $1.79--to our knowledge, the first trucker health success!

Outcome:

88% of employees reduced their BP scores below the threshold in six months!

BEFORE

AFTER

6%

88%

Over 140/90 88%

Below 140/8012%

Clinic confirmed BP after six months

Increased medication compliance

EVIDENCE

SELF REPORTING

IS RELIABLE


Integrating self direction with provider support

Evidence Our Program Works: Asthma

Medical Center NJ previously used instructions from the American Lung Association OutcomeAdvantage program more than doubled the medication compliance rate

EVIDENCE CLINCAL ACCURACY

IS NOT ADEQUATE COMMUNICATION

Before After

Persistence 6 mo44%

Readmissions 16%

Use of the ER 26%

95%

0

7.4%

1 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


Integrating self direction with provider support

Reduce 30-day Heart FailureReadmission Rates

BEFOREAFTER

REDUCED BY

BEFORE AFTER

38%

54%

34%

74%

72%

73%

38%

100%

St. Joseph, Lexington KY

St. Joseph, Elgin IL

NWC, ArlingtonHts. ILDRG 127 ONLY

NWC, Arlington Hts. IL

ALL CHF-RELATED DRGs

Aurora, Milwaukee WI

Great Plains, ElkCity OK

VA, AnnArbor MI

Mercy Hospital, Chicago IL

6.4% 4.0% 38%

16.7% 7.7% 54%

13.2% 8.7% 34%

23.4% 6.9% 74%

22.2% 6.3% 72%

8.6% 2.2% 73%

54.5% 33.3% 38%

At Mercy only: N = insufficient for highest level of statistical significance, but indicative, especially given overall trend

>28% 0%


Integrating self direction with provider support

Results: Satisfaction

5-year kit average = 96%

Press Ganey 5-year average = 72%

“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%

Heart Failure

Yes – 97.3%

No – 1.8%

Asthma

Yes – 92.5%

No – 2.5%

UPMC Health Plan

1 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


Integrating self direction with provider support

FINANCIAL RESULTS: LONG TERM ROI

TESTIMONY TO THE NEVADA STATE LEGISLATURE RE: KITS AND CONNECTION PROGRAM

“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 PMPM

Members had 30% lower out-of-pocket cost comparedto the alternate PPO plan.”

1 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 C O N F I D E N T A L 2 0 1 2


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