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Insurance Patient Health Coordination ClickMedix 2015

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This presentation provides overview of care coordination and patient engagement program to better improve population health outcomes.

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Insurance Patient Health Coordination ClickMedix 2015

  1. 1. ClickMedix Right care, at the right time, to improve population health outcomes while lowering costs. Ting Shih - Founder & CEO (ting@clickmedix.com) Ms Jodi Lyons – Healthcare Advisor Dr Andrew Pumerantz – Medical Advisor http://clickmedix.com
  2. 2. Problem: Patients don’t know how to navigate the complex healthcare system – when to get what care and why Health Complications Pharmacy Gym / Wellness Programs Nutrition Psychiatrist
  3. 3. Currently: Longitudinal Healthcare Tools Are Insufficient Across Fragmented Services Patients have to navigate care pathways across multiple providers and health services in multiple geographic sites and a variety of health record charting (electronic and paper) Average patient with multimorbidity has 11 providers Fax is the predominant method of referring patients amongst providers In the ideal world, navigating the healthcare system to find the right care should be as easy as navigating with a GPS
  4. 4. How it Works: Guided Patient Journey Discovery I don’t feel well Easy to Understand At-a-glance health status and guided pathway to get better Increase Adherence Guidance and support through treatment plan See Results Measure Impact Patient perspective Company perspective Physician perspective Self assessment or facilitated
  5. 5. 1 <7.0 (<53 mmol/mol) SBP < 130 DBP < 80 <100 or <70 with CVD No Symptoms & No Structural Heart Disease At risk; chronic cough, sputum production; normal spirometry No Nephropath y No Retinopathy No Dental Infection No Neuropathy & No PAD 18.5-24.9 No Depressio n PHQ-9 score 0 2 7.0-7.9 (53-63 mmol/mol) SBP 130- 139 DBP < 90 101-130 No Symptoms & +Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 30-299 mg/g Non- Proliferative Mild Mild Gingival Inflammatio n Neuropathy 25-29.9 Minimal Depressio n PHQ-9 score 1-4 3 8.0-8.9 (64-74 mmol/mol) SBP 140- 149 DBP < 90 131-160 Symptomati c & + Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a 300-999 or eGFR 30- 60 Non- Proliferative Moderate Moderate Gingival Inflammatio n +PAD & +/- Neuropathy 30-34.9 Mild Depressio n PHQ-9 score 5-9 4 9.0-9.9 (75-85 mmol/mol) SBP <150 DBP 90-99 161-190 Symptomati c w/ Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 1000-2999 or eGFR 15-29 Non- Proliferative Severe/ Inactive Proliferative Severe Gingival Inflammatio n + Ulcer History 35-39.9 Moderate Depressio n PHQ-9 score 10- 14 5 > 10.0 (≥86 mmol/mol) SBP > 150 -or- DBP > 100 >191 Refractor y Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a >3,000 or eGFR ≤15 Active Proliferative Acute Dental Infection Previous Amputation ≥40 or <18.5 Severe Depressio n PHQ-9 score ≥15   Patient Receives Health Score Card, along with Care Plans and Service Referrals BMI
  6. 6. 1 <7.0 (<53 mmol/mol) SBP < 130 DBP < 80 <100 or <70 with CVD No Symptoms & No Structural Heart Disease At risk; chronic cough, sputum production; normal spirometry No Nephropath y No Retinopathy No Dental Infection No Neuropathy & No PAD 18.5-24.9 No Depressio n PHQ-9 score 0 2 7.0-7.9 (53-63 mmol/mol) SBP 130- 139 DBP < 90 101-130 No Symptoms & +Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 30-299 mg/g Non- Proliferative Mild Mild Gingival Inflammatio n Neuropathy 25-29.9 Minimal Depressio n PHQ-9 score 1-4 3 8.0-8.9 (64-74 mmol/mol) SBP 140- 149 DBP < 90 131-160 Symptomati c & + Structural Heart Disease GOLD 1 or 2 & 0-1 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a 300-999 or eGFR 30- 60 Non- Proliferative Moderate Moderate Gingival Inflammatio n +PAD & +/- Neuropathy 30-34.9 Mild Depressio n PHQ-9 score 5-9 4 9.0-9.9 (75-85 mmol/mol) SBP <150 DBP 90-99 161-190 Symptomati c w/ Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC 0-1 & CAT<10 Albuminuri a 1000-2999 or eGFR 15-29 Non- Proliferative Severe/ Inactive Proliferative Severe Gingival Inflammatio n + Ulcer History 35-39.9 Moderate Depressio n PHQ-9 score 10- 14 5 > 10.0 (≥86 mmol/mol) SBP > 150 -or- DBP > 100 >191 Refractor y Heart Failure GOLD 3 or 4 & ≥2 exacerbation s/yr & mMRC ≥2 & CAT≥10 Albuminuri a >3,000 or eGFR ≤15 Active Proliferative Acute Dental Infection Previous Amputation ≥40 or <18.5 Severe Depressio n PHQ-9 score ≥15   Patient Follows a Care Plan and Improves Their Health Metrics and Score Card BMI
  7. 7. Live-Action Care Coordination Across Health System
  8. 8. Collaboration with Insurers • Enhance patient experience o Single-point of contact to guide patient through care (via technology or coordinator) o Increase treatment adherence o Increase ability to self-manage o Provide longitudinal healthcare data to improve health outcomes • Demonstrate ROI o Increased workforce productivity o Decrease use of unnecessary ER visits o Correlate payments to patient outcomes
  9. 9. Care Coordinators, Patients, Providers Easy, One-Click Interface Tailored to User Needs
  10. 10. Mobile Applications to Enable Patients to Fill Out Self Assessments
  11. 11. Easily Capture Comprehensive Data for Remote Management by Specialists Via Mobile Devices
  12. 12. Consumer Medication Adherence Tracking (any language)
  13. 13. Medical Experts Hub Phar- macies Clinics HomesPhar- macies Clinics Homes Phar- macies Homes Clinics Payers & Third- Party Data Systems Aggregate Real-Time Population Health Data While Guiding Each Patient through the Optimal Care Pathway

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