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