Solving CHF Readmissions Using Psychographics + Technology
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Slides from a webinar hosted by PatientBond, the American Heart Association and FierceMarkets discussing the challenges of hospital readmissions for Congestive Heart Failure and innovations helping to solve the issue. Also presented are patient engagement solutions for preventing the progression of heart disease being developed through a collaboration between PatientBond and the AHA.
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Solving CHF Readmissions Using Psychographics + Technology
- 2. • Introduc8ons & Objec8ve • Heart Failure and the Opportunity for Reducing Hospital Readmissions • The Role of Psychographic Segmenta8on and Adap8ve Technology • Case Study: Significantly Reduced 30-Day CHF Readmissions • Going Forward: Preven8on of Disease Progression • Q&A Agenda
- 5. A large, and growing popula6on • 6.5 million Americans live with heart failure • 1 million hospital discharges per year • Expected to grow 46% by 2020 to 8 million
- 8. • Get With The Guidelines 2006-2009 readmission rate 20% 2009-2012 readmission rate 19% 1 of 70 hospitals achieved a 20% reduc8on How is 20% reduction in heart failure readmission rates strategy working? 5%
- 9. • Hospital Compare 2006-2009 readmission rate 24.7% 2009-2012 readmission rate 23.1% 2.6% of hospitals achieved a 20% reduc8on 6.4% How is 20% reduction in heart failure readmission rates strategy working?
- 11. AHA CarePlan Solutions Derived from the evidence based guidelines
- 12. What is a CarePlan? A Care Plan is a way to execute evidence based guidelines. • Type & frequency of assessments such as electrocardiogram, cardiac enzymes, and blood pressure • Decision making (and shared decision making) in regards to treatments & interven@ons such as open heart surgery vs. stent • Medica@on management • Pa@ent & family educa@on • Coordina@on of care CENTER FOR HEALTH TECHNOLOGY & INNOVATION 12 Beyond taking their medica@ons, many pa@ents have ques@ons like to know: What should I eat? What are my physical ac$vity limita$ons? What are common signs and symptoms? How do I communicate informa$on to my healthcare team?
- 13. 13 Yet We Have The Typical Post-Acute Experience n Too much informa8on n Too many choices n Everything is hard n I feel all alone n Who can I trust?
- 15. Background
- 16. Is Education the Answer?
- 18. Five Healthcare Psychographic Segments Segment Description Engagement Strategy Self Achievers 24% I take ownership of my health and I actively take steps to be healthy. I focus on achieving my goals and objectives. A disease is another challenge to be overcome. Achieve the goal Balance Seekers 18% I am open to many ideas and options, as long as they make sense for me. I need context to understand ideas and recommendations. Context, Candor and Choices to be made Priority Jugglers 18% I worry more about my family’s health than my own. I am constantly on the go, juggling many responsibilities, so getting sick is not an option. How the family/others will benefit; Commitment & duty Direction Takers 13% I look to my physician and other health care professionals for guidance and direction on what I need to do to address my disease. Doing what I ask of you Willful Endurers 27% There are more important things in my life to focus on than improving my health. I live in the “here and now”. Living for today
- 19. The Segments Are Among Every Population and Health Condition 0% 5% 10% 15% 20% 25% 30% 35% 40% Gen Pop 18-24 Hispanic Medicaid Uninsured HMO Health Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers 0 10 20 30 40 50 60 70 Total Rep Pneumonia* Chronic Obstructive Pulmonary Disease (COPD) Heart Attack/ Failure* Had A Hip Replacement Had A Knee Replacement Balance Seekers Willful Endurers Priority Jugglers Self Achievers Direction Takers Issues tied to 30 day readmission
- 20. PatientBond: Consumer Psychology + Adaptive Technology Dear Trevor, I want to personally thank you for being a pa9ent at Priority Care. As you probably know, our number one goal here is to provide the absolute best healthcare possible in a comfortable seAng. Did you know that new pa9ents generally find out about our prac9ce through word-of-mouth from pa9ents like you? So that brings me to a favor I would like to ask you. Could you please take a few minutes to think of some friends and family members of yours who may be looking for a medical clinic and let them know about us? Whether it's one person, ten people or even more, your referral would be greatly appreciated. So, please feel free to introduce them to our office, and I promise we will take very good care of them. If you have any ques9ons at all, please feel free to call us at 312 402 4006. Thanking you very much in advance! Very truly yours, Dr. Kalpana Narang P.S. The referral of a friend or a loved one is the ul9mate compliment you can give us. Thanks again! This email is provided as a service by Priority Care. Click here to Unsubscribe. This message contains information which may be confidential and/or privileged. Unless you are the intended recipient (or authorized to receive for the intended recipient), you may not read, use, copy or disclose to anyone the message or any information contained in the message. If you have received the message in error, please delete the message thereto without retaining any copies. Powered by PatientBond Email Text Interac@ve Voice Response Your Healthcare Consumer Audience Pa@entBond segments your pa@ents/consumers Pa@entBond modifies pa@ent behavior using a preference based, outbound communica8ons plajorm
- 21. Who? Why? What? How? Who is this patient What are they doing? Why are they doing what they do? How should we reach out to them? Healthcare focuses here Psychographics add focus here • Healthcare historically knows “WHAT” pa$ents are doing • To change behavior you must know “WHY” pa$ents are doing things Healthcare Behavior Change Foundation Pa@entBond executes here
- 22. • Large, nonprofit hospital system • Objec8ves - Use the Pa8entBond plajorm to: • Primary: Reduce Readmission Rates aker CHF Discharge currently at 18.5% • Secondary: Improve pa8ent experience & engagement while op8mizing nurse 8me CHF 30 Day Readmissions Reduction Pilot
- 23. Discharges by Segment Type Direc&on Taker 37% Self Achiever 31% Priority Juggler 15% Willful Endurer 14% Balance Seeker 3% Remember, all 5 segments are usually there…just the distribu8on changes
- 24. Communication Sequence Over 30 Days 1! 3! 5! 10! 15! 20! 30! Discharge instructions and Welcome to 30 day program! How to track recovery and symptoms! Medication Adherence! Follow up Appointment and access questions! Monitoring your weight! When to seek medical attention! Your recovery zone! Salt and Fluid in your diet! Appointment Follow Up! Making Changes in your Diet! Activity, Smoking, Drinking Tips! Congratulations!! 2! 4! 7! 12! 17! 25! Days after Discharge! Medication Status & Access!
- 25. Communications Include Patient Response Prompts
- 26. Patients Answer the Five Questions
- 28. Patient Responses Across Engagement Timeline
- 29. Responses By Segment FTEs WILL MANAGE THE EXCEPTIONS ! 86.9%! 78.3%! 80.0%! 91.7%! 89.1%! 83.5%! 65.0%! 70.0%! 75.0%! 80.0%! 85.0%! 90.0%! 95.0%! 100.0%! 0! 100! 200! 300! 400! 500! 600! 700! 800! All Patients! Balance Seeker! Willful Endurer! Priority Juggler! Self Achiever! Directiion Taker! Total Responses! Green Responses! Red Respnses! % Green Responses!
- 30. • 315 CHF discharges over 5 months • 90% reduc@on in 30 days all-cause readmissions (from 18.5% to <2%) • 62% pa8ent response rate to 14 waves of psychographic communica8ons • 94% of pa8ents (age 65+) liked the electronic discharge process and digital communica8ons Results
- 31. • 315 CHF discharges over 5 months • 90% reduc@on in 30 days all-cause readmissions (from 18.5% to <2%) • 62% pa8ent response rate to 14 waves of psychographic communica8ons • 94% of pa8ents (age 65+) liked the electronic discharge process and digital communica8ons Results
- 32. What is the Opportunity? Discharges per Month Current System Readmission Rate Expected System Readmissions ENTER Costs per Readmission Expected Costs ENTER Projected Reduc@on Percentage Readmission Savings CHF 30 24% 7 $9,000 $64,000 30% $19,200 AMI 20 20% 4 $5,000 $20,000 30% $6,000 CABG 10 23% 2 $10,000 $20,000 30% $6,000 Mo. Savings $31,200
- 35. Lessons learned? • Heart failure pa8ent have mul8ple co-morbidi8es • Plan must be personalized, and relevant • Cannot be one-size-fits-all
- 36. 36 AHA Inside: Improving health outcomes with personalized, engaging tools Using a research-based personalized experience helps pa@ents create durable behavior change. AHA’s Life’s Simple 7TM the seven most important predictors of heart health Get Ac@ve Eat Bejer Manage Weight Stop Smoking Reduce Blood Sugar Control Blood Pressure Control Cholesterol • Connected Heart Health was developed to improve the quality of life for pa8ents by: • Connec@ng pa8ents to the healthcare providers, caregivers, and other pa8ents • Transla@ng the AHA guidelines in easy to understand steps to promote self-care • Accessing pa8ents educa8on resources, developed by the AHA, designed to improve knowledge, health literacy, and behaviors, leading to improved outcomes • Sharing pa8ent reported measures with healthcare providers
- 38. Why pa@ent person centric? • Person can overcome odds, the disease cannot • Person: • Nothing to do with illness and disease • It is not about disease, it is about life. “do the things I like to do” “I want to be happy”
- 39. HMA-Personalized Care Plans Health Mo@va@on Assessment (HMA) Sets the Priori@es Personalizes Communica@ons Psychographic Segmenta@on AHA’s Life’s Simple 7TM the seven most important predictors of heart health Get Ac4ve Eat Be9er Manage Weight Stop Smoking Reduce Blood Sugar Control Blood Pressure Control Cholesterol Self Achiever Balance Seeker Priority Juggler Direc8on Taker W illful Endurer Glucose Physical Ac8vity Nutri8on Weight Smoking Cholesterol Blood Pressure 12-52 week program with segment specific messaging & frequency
- 40. • Cardiac 30 Day Readmission Reduc8on programs • CHF • AMI • CABG • 12 week Wellness Program • Targeted toward General Popula8on • 12 month Management Program • Heart Failure • CABG • CAD • AMI • Arrhythmia • Stroke Collabora6ng in Cardiovascular Disease Preven6on
- 42. Thank You! Patrick Dunn Casey Albertson pat.dunn@heart.org casey@pa8entbond.com AHA@pa8entbond.com