How Disease Management, Case
Management And Corporate Health
Programs Can Support HR
Dr. Alfons Grabosch
Director Health S...
Agenda







A Paradigm Shift in Health Care
Stakeholders in Health Care Today
Disease Management Programs
Case Man...
A Paradigm Shift in Health Care
Acute
diseases

Chronic
conditions

Like accidents, infections,
communicable diseases

Lik...
Chronic Diseases








(Challenge and Chance)

more or less predictable
self management required
very much relate...
Stakeholders in Health Care Today
HR
Manager

Doctor

Medical
professionals

Patient

Health Insurance

Regulator
Medical Intervention
Classical Treatment
 Medication
 Surgery
 Medical procedures
Self-management
 Supported by
 Medi...
Disease Management Definition

DM is the concept to reduce healthcare costs and/or
improve quality of life for individuals...
Disease Management Objectives
Individual Level
 Encourage self-management of chronic conditions
 Reduce or avoid complic...
Disease Management Daman Concept

TeleCoaching

Training

Tele
monitoring
DMP “Diabetes” Training tool
Daman offers an Interactive Group
trainings for Diabetes and Obesity
through the MEDIAS 2 pro...
DMP “Diabetes” Telecoaching
Daman provides patients with a personalized health coach who
calls them regularly encouraging ...
DMP “Diabetes” Telemonitoring
Telemonitoring refers to the continuous monitoring of a patient’s
condition to enable coachi...
DMP “Diabetes”
Effectiveness – lowering HbA1c
HbA1c is the average blood sugar level for the past
three months

For a diab...
DMP “Diabetes”
Effectiveness – lowering HbA1c
 N=360
 Inclusion Criteria: HbA1c ≥ 7%
 Observation period:18 months
 t0...
DMP “Diabetes” (achieved targets after 12 months)
Diabetes Mellitus Predicted Cost
Diabetic UAE Nationals 2008-2019

2008

2009

2010

2011

2012
outpatient

2013

2014

in...
Case Management Definition
…is a collaborative process of assessment, planning, facilitation
and advocacy for options and ...
Case Management Concept
Evaluation
Clinical Results
Effectiveness
Network quality assessment
Cost effeciency

Assessment
N...
Case Management Daman Services
Oncology






Breast Cancer
Colorectal Cancer
Cervical Cancer
Prostate Cancer
Leukemi...
Case Management Decision Trees
Corporate Health Programs
Daman’s Concept
Stress
Management

Disease/Case

Fitness
Weight
Management

Management
Health su...
Corporate Health Programs
Health Risk Assessment - Content
•
•
•
•
•
•
•

Lifestyle
Physical Activity
Nutritional habits
H...
Corporate Health Programs
Health Risk Assessment - Example
Exercising

Occupational well-being

Light physical exertion (h...
Corporate Health Programs
Health Screening








Weight/BMI
Body Composition (Water/Fat/Muscle)
Blood pressure
Bl...
Corporate Health Programs
HRA

Screening

Individual
Health Profile

Individual
Health Profile

Individual
Health Profile
...
Corporate Health Program Result
8.62

8.62
8.22

8.08

7.92
7.42

All personnel

Activation

MET PRE

Health Lab

MET POST...
Corporate Health Programs Benefits








Improve Quality of Life of employees
Retention of employees
Avoid/reduce...
The Role of HR Managers in Health Care








Knowing possible interventions
Having knowledge of the corporate hea...
Conclusion
In the future HR Manager will play an active role in supporting
staff to maintain and improve individual health...
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How Disease Management, Case Management And Corporate Health Programs Can Support HR, Alfons Grabosch

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This seminar will explain the paradigm shift in health care from acute diseases to chronic conditions. Based on this understanding the importance and potential of disease and case management programs as well as corporate health programs will be described. The role of self-management and the tremendous impact of HR on health and disease related costs will be highlighted. The relationship of patients to physicians is no longer the unique interaction in health care, but health coaches and HR interventions play a more and more important and effective role. At the end of the seminar HR representatives will be able
• To understand what is a Disease Management and Case management program
• To know how preventive Corporate Health Programs add value to HR functions
• To evaluate which programs may support HR in controlling health insurance premium

This presentation was used at HR Summit and Expo 2013 www.hrsummitexpo.com

Published in: Business, Health & Medicine
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How Disease Management, Case Management And Corporate Health Programs Can Support HR, Alfons Grabosch

  1. 1. How Disease Management, Case Management And Corporate Health Programs Can Support HR Dr. Alfons Grabosch Director Health Support Daman National Health Insurance Company, Abu Dhabi
  2. 2. Agenda       A Paradigm Shift in Health Care Stakeholders in Health Care Today Disease Management Programs Case Management Programs Corporate Health Programs The role of HR Managers in Health Care
  3. 3. A Paradigm Shift in Health Care Acute diseases Chronic conditions Like accidents, infections, communicable diseases Like obesity, diabetes, hypertension, heart diseases sudden onset, lasting for a specific period of time, more or less unpredictable insidious development, lifelong lasting, quite predictable
  4. 4. Chronic Diseases        (Challenge and Chance) more or less predictable self management required very much related to behavior and lifestyle awareness and knowledge required motivation to change help to change overcome of fragmentation
  5. 5. Stakeholders in Health Care Today HR Manager Doctor Medical professionals Patient Health Insurance Regulator
  6. 6. Medical Intervention Classical Treatment  Medication  Surgery  Medical procedures Self-management  Supported by  Medical Education  Disease Management  Case Management  (Corporate) Health Programs
  7. 7. Disease Management Definition DM is the concept to reduce healthcare costs and/or improve quality of life for individuals with chronic disease conditions by preventing or minimizing the effects of a disease or chronic condition through integrative care…
  8. 8. Disease Management Objectives Individual Level  Encourage self-management of chronic conditions  Reduce or avoid complications  Better quality of life System Level  Monitor treatment (clinical pathways, evidence based guidelines)  Cost containment
  9. 9. Disease Management Daman Concept TeleCoaching Training Tele monitoring
  10. 10. DMP “Diabetes” Training tool Daman offers an Interactive Group trainings for Diabetes and Obesity through the MEDIAS 2 program which is translated into Arabic/English and adapted to the Gulf/Arabian culture. Daman’s Service: 3 month course with (12 lessons, 1 lesson/week, 10-20 Patients / group) In order to:      Understand diabetes Change lifestyle Lose weight Live on healthy diet Avoid diabetes complications
  11. 11. DMP “Diabetes” Telecoaching Daman provides patients with a personalized health coach who calls them regularly encouraging them to shift to a healthier lifestyle using ProvidinCare® software:  to motivate,  to educate,  to set targets and helping patients to achieve them and  to evaluate health status. Daman’s Service:  Structured phone calls lasting 15-20 min.  Initially one call per month  After one year one quarterly call •Permanent service
  12. 12. DMP “Diabetes” Telemonitoring Telemonitoring refers to the continuous monitoring of a patient’s condition to enable coaching, lifestyle changes and patient selfmanagement. Daman’s Service: Telemonitoring of diabetes:     Check patient Data, alert functions etc. Real-time data transmission Bluetooth transmission Glucose measurement
  13. 13. DMP “Diabetes” Effectiveness – lowering HbA1c HbA1c is the average blood sugar level for the past three months For a diabetic patient it should be lower than 6.0% Lowering HbA1c by 1% can reduce the risk of: Myocardial infarction 14% Stroke 10% Heart Failure 16% Any diabetes related death 21%
  14. 14. DMP “Diabetes” Effectiveness – lowering HbA1c  N=360  Inclusion Criteria: HbA1c ≥ 7%  Observation period:18 months  t0= HbA1c starting the program  t1= HbA1c after 18 months  HbA1c reduction is comparable for males and females A reduction of 0.6 % points was achieved after 18 months
  15. 15. DMP “Diabetes” (achieved targets after 12 months)
  16. 16. Diabetes Mellitus Predicted Cost Diabetic UAE Nationals 2008-2019 2008 2009 2010 2011 2012 outpatient 2013 2014 inpatient 2015 total 2016 2017 2018 2019
  17. 17. Case Management Definition …is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet member’s health needs through communication and available resources to promote highest quality care. Case Management Society of America
  18. 18. Case Management Concept Evaluation Clinical Results Effectiveness Network quality assessment Cost effeciency Assessment Network Patients Case selection Planning Monitoring Treatment plan Review with patients Treatment options Reassessment Provider options Implementation Facilitation Tracking Coordinate Collaborate Evidence based guidelines Communication Incentives Software
  19. 19. Case Management Daman Services Oncology      Breast Cancer Colorectal Cancer Cervical Cancer Prostate Cancer Leukemia Rheumatology  Rheumatoid Arthritis
  20. 20. Case Management Decision Trees
  21. 21. Corporate Health Programs Daman’s Concept Stress Management Disease/Case Fitness Weight Management Management Health support modules Recommendations Member portal (web, smart Phones) Health Screening Health Risk Assessment (HRA) Smoking cessation
  22. 22. Corporate Health Programs Health Risk Assessment - Content • • • • • • • Lifestyle Physical Activity Nutritional habits Health Risks Sleep Stress Occupational well being
  23. 23. Corporate Health Programs Health Risk Assessment - Example Exercising Occupational well-being Light physical exertion (h/day) Conflict management by superior
  24. 24. Corporate Health Programs Health Screening        Weight/BMI Body Composition (Water/Fat/Muscle) Blood pressure Blood Sugar Lipid panel Diabetes risk (Find Risk/Ezscan) VO2 max /Fitness/Heart age
  25. 25. Corporate Health Programs HRA Screening Individual Health Profile Individual Health Profile Individual Health Profile Corporate Health Profile Corporate Health Profile Consultancy Corporate Health Program
  26. 26. Corporate Health Program Result 8.62 8.62 8.22 8.08 7.92 7.42 All personnel Activation MET PRE Health Lab MET POST 9.58 4.32 2.36 All personnel Activation Improvement in heart age (average) Health Lab
  27. 27. Corporate Health Programs Benefits        Improve Quality of Life of employees Retention of employees Avoid/reduce chronic conditions Avoid/reduce complications of chronic conditions Reduce absenteeism Reduce claims cost Improve productivity
  28. 28. The Role of HR Managers in Health Care        Knowing possible interventions Having knowledge of the corporate health profile Selecting the right programs Reduce absenteeism Improving productivity Reducing claims cost Reducing premium
  29. 29. Conclusion In the future HR Manager will play an active role in supporting staff to maintain and improve individual health and by that improve corporate health. On a corporate and even community level the HR Manager will be as important as the doctor. HR Manager can substantially influence the health care system.

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