RED HOT Contributors

 

Episode 21: An Engaging Future for Care Management

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Health plan care managers are putting down the phone, and picking up the mobile. Spearheading this effort is Boston-based Wellframe. A technology company partnering with leading health plans and providers to drive down costs, improve care outcomes, and take healthcare management to the next level.

At HIMSS17, BCBS of Nebraska reported surprising results via integrating Wellframe’s mobile solution, including a:

  • 63% average weekly patient engagement mark;
  • 400% increase in touchpoints between BCBS care managers and patients, with less time spent per patient encounter; AND
  • Savings of between 35 to 49% in medical costs

Wellframe’s co-founder and CEO Jacob Sattelmair is a Harvard and Oxford-trained public health scientist and technologist; and in this episode, Steve and Jacob discuss:

Friction and effect on cost

Why today’s care management deliver poor engagement + low ROI

Running up against EHR patient portals

The importance of segmenting & patient engagement

Wellframe’s victory at BCBSNE

A unique take on artificial intelligence

Below is a short clip from Dr. Steve’s interview with CEO Jacob Sattelmair on RED HOT HEALTHCARE:

JACOB: “We’re really giving the plan’s care managers a new way to engage and support members. The post-acute program is focused on the 30 to 60 days after discharge from the hospital. That could be a medical or surgical admission.

It’s been very encouraging to see those members on our mobile service; we’re seeing higher engagement and sustainment levels; and greater retention, as compared to old [care management]telephonic model.

We’ve been able to show improved efficiency for the care manager – so they’re ultimately spending less time with each member, but having many more touch points or interactions with that member. We’re tightening the feedback loop, where we’re able to pick up indications of need…or risk…or symptoms – and then intervene on them more efficiently and more proactively.

For the member, that’s great because they feel like someone is checking up on them regularly. For the care manager, that’s great so that health issues don’t start going out of control.

Ultimately, we work closely with payers to evaluate impact on effectiveness of their management services. Their traditional model works, but we can, through our mobile approach, augment the effectiveness of their services, and help them save even more money per person. This adds to their existing positive outcomes.”

STEVE: “You did bring up a key word…augmentation. Are you now using, or planning to integrate some aspects of artificial intelligence into Wellframe?”

JACOB: “Our view from the beginning has been – let’s use computers to do what they’re good at…so we can free humans to do what they’re good at.”

STEVE: “Well said.”

JACOB: “On the one hand I would say what we don’t envision doing is completely taking over the role of the nurse or the care manager with artificial intelligence. Because no matter how good that is, knowing there is a real human providing empathic support is very important.

That said, we’re already started task shifting some rote aspects of what a care manager does, using technology. So, a lot of the information collection and documentation that they would otherwise have to do by asking a member questions on the phone and then typing that into their workflow system. We’re doing through the delivery of automatic, but dynamic and personalized care plans to the member.

Then we’re running real-time analytics on the data that we’re capturing – telling our payer clients, ‘here is who has need today…and here’s why.’ As we start to map those alerts and priorities relative to the interventions and outcomes that we measure through their claims data or otherwise, our system can get smarter about who we prioritize dynamically, why…and what actions we recommend with them.

It’s very easy for people to overspeak relative to their reliance on machine learning and artificial intelligence – those are clearly buzzwords these days. We can deliver a lot of value with relatively focused and straightforward data analytics approaches; and it puts us in the position as we get more patients, to get smarter and smarter on how we do that.”

 

CONTRIBUTE & INFLUENCE

 I have had the privilege and pleasure of working with Steve Ambrose on a podcast that covered a range of topics in healthcare information technology. The podcast logistics – communications, interview questions, scheduling and production – were every well managed.
A great experience that I would do again in an instance.

Dr. John Glaser
SVP, Population Health at CERNER

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