Ochsner Health System in New Orleans has been using mobile technology to monitor and manage chronic disease patients since 2015. In that time, the doctors behind the program have learned a lot about how to implement such a system, as well as about how effective it can be.
“We’ve learned a lot,” said Dr. Richard Milani, Ochsner's chief clinical transformation officer and medical director of innovationOschner. “Now we’re dealing with thousands of people in our program. We have probably 4,000 plus that are submitting data and getting interventions. … And we now have outcome data that gets into medication adherence, we now have outcome data that’s looking at total cost of care, and of course we have outcome data looking at the control measures for people with chronic disease. And it’s good news on all fronts.”
At HIMSS19 in Orlando, Milani will share some data from the program and some advice for other health systems.
Milani says the value of a virtual care intervention is that it’s convenient for the patient, so an intervention needs to be designed to highlight that.
“Don’t ask the patient to do a whole lot,” he said. “Make it easy for them and convenient. Because patients will respond more to convenience than their own health. If you advertise your program as preventing a stroke or a heart attack, that’s compelling, but that doesn’t drive people to do a lot. When you say ‘convenience’? Oh my god, sign me up. That’s a big driver. Make sure you make things as convenient as you can. Make sure the value proposition is tilted toward the individual patient and not just the provider.”
For Ochsner, that means making the data flow seamlessly to providers, making appointments on the patient’s schedule rather than the doctor’s, and giving patients as much freedom as possible about when to take their readings. Ochsner’s program also doesn’t require the patient to pay a co-pay, something Milani believes is essential to a program geared toward lifelong, passive care.
In administering the program, Ochsner is finding unexpected insights in the data it has collected.
“We also learned about the power of social determinants in these chronic disease patients,” he said. “And again, it’s worth pointing out that most of these social determinants are not collected in a routine healthcare delivery assessment. So if we look in the medical records of most physician offices or delivery systems, you’re not going to find a lot of the social determinants that we collect. And when we look at our data they turn out to be very powerful in terms of predicting outcomes and predicting control.”
They’re also finding efficacy data which, Milani says, is less unexpected.
“We now have actual medication adherence data which shows strong improvements in medication adherence compared to standard of care,” he said. “And more recently we have the financial data to show that we’re reducing in-patient costs significantly in patients in our program, which is what you’d expect. That’s not a surprise, it’s just— it wasn’t a matter of if that would happen, it was a matter of when that would happen in terms of collecting that information. But we do have it now.”
Milani will speak at HIMSS19 in a session titled “Reengineering Healthcare Delivery through Innovation.” It’s scheduled for Monday, February 11 from 10:00-11:00 a.m. in room W304E.