Medicare patients are getting sicker and older.
That was the takeaway message of an AHA TrendWatch report published in December 2012. The American Hospital Association found that in 2008, two-thirds of all Medicare beneficiaries had at least two chronic conditions, and this number is expected to increase. Furthermore, overall healthcare spending for someone with one chronic condition is nearly three times more than for someone without any chronic conditions, and approximately 17 times greater for someone with five or more chronic conditions, according to the report.
As a result of the increasing prevalence of patients with chronic conditions, the high costs of treating these conditions and a focus on population health management, hospitals and health systems are beginning to focus more on caring for patients with chronic conditions who need to be managed throughout their life. Summa Health Network, the physician hospital organization affiliated with Akron, Ohio-based Summa Health System, launched a three-week initiative in September 2012 focused on preventive care for diabetes patients.
Preventing diabetic retinopathy
Under the initiative, automatic, interactive voice response calls were made to Summa Health Network diabetic patients asking if they had had an eye exam for diabetic retinopathy, a disease that affects nearly half of people with diabetes. The interactive voice response program, called EmmiPrevent and created by Emmi Solutions, would then walk patients through a series of yes-or-no questions with the ultimate goal of having the patient either contact his or her optometrist to send the patient's eye exam records to the PHO or schedule an eye exam.
If a patient had not had an eye exam, EmmiPrevent provided education on the importance of regular eye exams for diabetic patients and helped the patient schedule an eye exam. If a patient did have an eye exam, the interactive voice response system asked the patient to call his or her optometrist to send the records to their primary care provider. This instruction enabled Summa Health Network to obtain complete records for their diabetic patients more easily than before; the optometrists are not part of the PHO, which makes it difficult to share information, according to David Littlejohn, RN, the quality improvement director of Summa Health Network.
Benefits for patients and providers
In the program, EmmiPrevent was able to successfully contact 105 of 289 diabetic patients. Reasons for unsuccessful contacts were wrong or missing phone numbers or no answer after three attempts. Of the 105 patients, 24 patients (23 percent) followed the instructions: Eighteen patients asked their eye physician to send their exams to the PHO, and six patients got an eye exam. This initiative benefited patients because it helped prevent diabetic retinopathy.
The program also benefited Summa Health Network because it relieved physicians of an administrative task, allowing them to focus more on their patients. The PHO provided a list of patient names to EmmiPrevent, which managed the calling process. "We're trying to alleviate a lot of the burden on primary care staff's shoulders," Mr. Littlejohn says. "With the roll-out of so many new things like the patient-centered medical home and [New Health Collaborative, Summa's accountable care organization], they just really don't have time to be doing anything else."
By automating an administrative task, Summa Health Network was able to make progress toward its goals for diabetes patients. "Diabetes is one of biggest metrics we contract for. Diabetes is one of the chronic disease states that affects so many other disease states; if we can get a grip on this one, it will help solve a lot of other problems," Mr. Littlejohn says.
In addition to relieving an administrative burden, the diabetic retinopathy program helped engage patients in their care, which is critical to improve population health. Summa Health Network can study patients' responses to the interactive voice response system to identify other needs and provide other services for patients. Proactively communicating with patients about preventive measures such as regular eye exams can help patients learn to self-manage their disease, which can reduce healthcare costs over time.
Future prevention goals
Due to the success of the diabetic retinopathy outreach, Summa Health Network is planning future call campaigns on preventive measures such as the A1C test, which measures the average blood glucose level for the past two to three months, mammographies, colorectal cancer screening and hypertension screening. In these future projects, Summa Health Network aims to increase the capture rate of patients contacted. The PHO will work to improve data collection to minimize missing or incorrect contact information such as phone numbers and email addresses.
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That was the takeaway message of an AHA TrendWatch report published in December 2012. The American Hospital Association found that in 2008, two-thirds of all Medicare beneficiaries had at least two chronic conditions, and this number is expected to increase. Furthermore, overall healthcare spending for someone with one chronic condition is nearly three times more than for someone without any chronic conditions, and approximately 17 times greater for someone with five or more chronic conditions, according to the report.
As a result of the increasing prevalence of patients with chronic conditions, the high costs of treating these conditions and a focus on population health management, hospitals and health systems are beginning to focus more on caring for patients with chronic conditions who need to be managed throughout their life. Summa Health Network, the physician hospital organization affiliated with Akron, Ohio-based Summa Health System, launched a three-week initiative in September 2012 focused on preventive care for diabetes patients. Preventing diabetic retinopathy
Under the initiative, automatic, interactive voice response calls were made to Summa Health Network diabetic patients asking if they had had an eye exam for diabetic retinopathy, a disease that affects nearly half of people with diabetes. The interactive voice response program, called EmmiPrevent and created by Emmi Solutions, would then walk patients through a series of yes-or-no questions with the ultimate goal of having the patient either contact his or her optometrist to send the patient's eye exam records to the PHO or schedule an eye exam.
If a patient had not had an eye exam, EmmiPrevent provided education on the importance of regular eye exams for diabetic patients and helped the patient schedule an eye exam. If a patient did have an eye exam, the interactive voice response system asked the patient to call his or her optometrist to send the records to their primary care provider. This instruction enabled Summa Health Network to obtain complete records for their diabetic patients more easily than before; the optometrists are not part of the PHO, which makes it difficult to share information, according to David Littlejohn, RN, the quality improvement director of Summa Health Network.
Benefits for patients and providers
In the program, EmmiPrevent was able to successfully contact 105 of 289 diabetic patients. Reasons for unsuccessful contacts were wrong or missing phone numbers or no answer after three attempts. Of the 105 patients, 24 patients (23 percent) followed the instructions: Eighteen patients asked their eye physician to send their exams to the PHO, and six patients got an eye exam. This initiative benefited patients because it helped prevent diabetic retinopathy.
The program also benefited Summa Health Network because it relieved physicians of an administrative task, allowing them to focus more on their patients. The PHO provided a list of patient names to EmmiPrevent, which managed the calling process. "We're trying to alleviate a lot of the burden on primary care staff's shoulders," Mr. Littlejohn says. "With the roll-out of so many new things like the patient-centered medical home and [New Health Collaborative, Summa's accountable care organization], they just really don't have time to be doing anything else."
By automating an administrative task, Summa Health Network was able to make progress toward its goals for diabetes patients. "Diabetes is one of biggest metrics we contract for. Diabetes is one of the chronic disease states that affects so many other disease states; if we can get a grip on this one, it will help solve a lot of other problems," Mr. Littlejohn says.
In addition to relieving an administrative burden, the diabetic retinopathy program helped engage patients in their care, which is critical to improve population health. Summa Health Network can study patients' responses to the interactive voice response system to identify other needs and provide other services for patients. Proactively communicating with patients about preventive measures such as regular eye exams can help patients learn to self-manage their disease, which can reduce healthcare costs over time.
Future prevention goals
Due to the success of the diabetic retinopathy outreach, Summa Health Network is planning future call campaigns on preventive measures such as the A1C test, which measures the average blood glucose level for the past two to three months, mammographies, colorectal cancer screening and hypertension screening. In these future projects, Summa Health Network aims to increase the capture rate of patients contacted. The PHO will work to improve data collection to minimize missing or incorrect contact information such as phone numbers and email addresses.
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