About This Blog

 

Sherri Dorfman, CEO, Stepping Stone Partners, Connected & Digital Health Innovation Specialist

My blog is designed to spotlight healthcare organizations with innovative uses of technology & data to drive Care Coordination, Collaboration & Patient Engagement.

These new approaches may influence your product & service roadmap, experiences, partnerships and marketing strategies.

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While consulting, I leverage my extensive experience, knowledge and professional network to help companies make the right strategic product and marketing decisions. Services include:

> Strategic Planning Market Review: Competitive Assessments, Partnership Evaluations. Workshop facilitation. Insight drives product, partnership and marketing strategies

> Product Roadmap & Consumer Experience Planning: Conceptualizes, defines and validates solutions/experiences through Marketing Research and journey mapping.  Utilizes new innovative online and mobile research tools to co-create with target buyers and users, gathering input while understanding context to guide the development of personalized solutions & experiences.

> Strategic Product Marketing: Differentiated value proposition story incorporated into marketing & sales assets

Find out how I can help you. Call me at 508-655-6585. Email me at SDorfman@Stepping-Stone.net to set up an exploratory discussion.

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    Entries in personalization for health and wellness (22)

    Oncology Patients experience a personalized journey with interventions and education for better care

    The National Cancer Institute reports 2017 U.S. cancer care expenditures were $147+ billion, with anticipated increases from our aging population. 

    According to Deloitte’s report in Evidence Based Oncology ( The American Journal of Managed Care publication), many organizations are exploring ways to control costs and enhance care quality for oncology patients (e.g. Patient Centered Medical Homes, CMS’ Oncology Care Model).

    With many different types of cancer and treatment options, each patient embarks on a personal care journey.

    Oncology patients often experience a long journey. Although some steps entail engaging with care staff at a hospital or clinic, most of the time patients are challenged with managing their disease on a daily basis away from the health system.

    Healthcare organizations need to closely monitor oncology patients to determine when care and support is required. To be proactive and stay aligned with patient needs, health systems must collect patient information (e.g. Patient Reported Outcomes/PROMs, Patient reported experiences/PREMs). This patient information can guide the care team to intervene, reducing hospitalizations and costs.  

    Northwestern Medicine’s Oncology Program

    “We wanted to take a holistic approach with our oncology patients; mind, body and spirit”, explains Dr. Martha L. Twaddle MD FACP FAAHPM HMDC, Medical Director - Palliative Medicine & Supportive Care, Northwestern Medicine, Lake Forest North Region. “We wanted to help our patients navigate their oncology journey, figure out their new normal and participate in their care”.

    “A few years ago, we successfully used a patient engagement care tool with our palliative patients. Our palliative team is embedded within Oncology. Eighteen months ago, we introduced this telehealth type of application to our oncology patients. We felt it would be valuable to extend TapCloud to our general oncology patients because we had seen such a positive response using it for those with high symptom burden and advance disease. We believe many patients and caregivers will benefit from having this tool available to use”.

    Patient Experience

    How does TapCloud support the oncology patient? What is the patient experience?

    Last month, Robert (not his real name), a 77 year old patient was diagnosed with prostate cancer. Dr. Twaddle and her staff worked closely with Robert through the onboarding process to provide an overview, demonstrate how to use TapCloud, help him download the TapCloud app onto his phone and iPad and discuss what symptoms they will manage to personalize the app for his specific condition.

    The Nurse Coordinator explained “Robert, with this tool (TapCloud), we can think about you when you are not in front of us, get a sense of how you are doing and that we are on the same page”.  Robert was relieved to get a message from his Nurse Coordinator confirming that she can see Robert listed on the dashboard to keep a close eye on him.

    Most of Dr. Twaddle’s seventy active patients using the TapCloud App are in their 60s and 70s, with a few in their 80s and 90s.

    Through the TapCloud app Care Plan, patients like Robert are asked a set of questions. How are you feeling today compared with yesterday? Which of these meds are you taking? Which symptoms are you experiencing today? Symptoms that were selected the prior day are displayed bold. Patients can add symptom(s) which typically takes less than a minute to provide this critical information. 

    Symptom tracking is made easy by using a word cloud. Each day, the patient sees a personalized word cloud containing symptoms.  This personalized symptom cloud incorporates his condition and medications and his list is continuously enhanced from machine learning. TapCloud’s predictive symptoms cover 100+ conditions and 14,000+ side effects.  The patient simply touches those symptoms he is noticing. Additionally, he views personalized education based on his journey stage (e.g. tips for managing chemo side effects) and what he is experiencing. He can also upload this biometric information (e.g. vitals, etc.).

    How has Northwestern Medicine used the TapCloud tool to deliver better care to Oncology Patients?

    Dashboard displays demo data only

    • Prioritize Patient Outreach. The TapCloud platform analyzes all the patient clinical and self- reported data in real time.  Using advanced algorithms, patients with a clinical need are identified and alerts are sent to the care team. Patients are prioritized based on alerts, severity and risk. Nurses use the TapCloud Triage Dashboard to efficiently track, monitor and respond to patients requiring an intervention. Nurses can drill down on a specific patient to see how many days since check in, recent events (e.g. vitals, medication usage), pain and anxiety levels. 
    • Intervene on specific symptoms: Instead of “fishing” for information about how a patient is feeling or having the patient end up in the ER, Nurse Terri can call the patient and say “I've noticed that you've had increased pain the past 2 days…”.  TapCloud can also be set up to send alerts for symptoms associated with a patient’s treatment. Patients can send a picture within the TapCloud app with a secure message about their concern.
    • In the Patient’s Words: “We had one patient who didn’t feel pain but entered ‘yuk’. He selected that to communicate in his words what he was feeling. One of the features that I really like is journaling. A patient may share that today he is ‘discouraged by his illness’.  Although he does not expect us to respond, it gives us insight into how he is doing and the support that he may need from us”, shares Dr. Twaddle. 
    • Stay Connected with patients who do not come in regularly: When patients are going through infusion treatment, Dr. Twaddle explained that her team sees them on a frequent basis. “However, when our patients are on oral chemo, we feel that TapCloud is especially valuable to give us a window into their experience. We risk losing them because they cannot tolerate the medications and stop without communicating to us.”
    • Address Patient Needs with Right Resource: When patients are not in the Clinic or Hospital, it is important to understand what they need. “We may see in a patient’s journaling that she is feeling afraid which is not physical but may be best addressed through our psych- social resource. Or a patient may be ‘running out of her medication’ or ‘checking in on an upcoming appointment’, which can be managed by our Nurse Coordinator."

    Measuring Success

    Dr. Twaddle uses a set of quantitative and qualitative measures to evaluate the success for the TapCloud solution for oncology patients including:

    1) Patient Engagement. How involved are patients in participating in their care?  How often did they check in with the app?  Which symptoms are most common? What are the new symptoms that have been added by the patient? 

    2) Improved symptom management. Was pain successfully controlled (e.g. pain scores, pain direction)?  Were negative symptoms (e.g. fatigue, bloated, shoulder pain) managed in a timely and effective manner?

    3) Cost reduction. How much money was saved by avoiding ER through interventions on symptoms? “When one of our cancer patient ends up in the ER, we explain that we may be able to help avoid the admission with a check in on the TapCloud tool. We had one patient with a side effect that we could have spotted and intervened since it was dangerous for her”.

    “We have found that TapCloud is helpful both with cancer patients who have declining function (e.g. pancreatic, advanced lung, brain tumor) and with those that may be curable (e.g. head & neck, breast)", shares Dr. Twaddle.

    AMITA Health’s Program will leverage TapCloud

    AMITA Health, one of Illinois’s largest health systems is in the process of planning their program which will use TapCloud.

    “When I first heard about TapCloud, I was on board immediately”, explains Dr. Robert O. Maganini, Breast Cancer Specialist at AMITA Health. “We have a compliance problem with our breast cancer patients. Although the hormone therapy treatment (e.g. Tamoxifen, Class Aromatase inhibitor) is for five years, some patients will stop after two years because of the side effects. Our working theory is if we have insights into where these patients struggle and when, we can do more aggressive interventions instead of waiting for their next appointment”.

    “Our plan is to offer TapCloud to all 200 patients who want to use it, from newly diagnosed to those in year two when we experience a drop in treatment adherence”.  After describing his patient population – mostly women 40-75 years old, Dr. Maganini expects a high opt- in rate since it is “ideal for them because it enables faster and more convenient access to their provider”.

    Like Dr. Twaddle, Dr. Maganini is planning to use a patient- centric approach when introducing TapCloud, ensuring that patients understand why they are using TapCloud, how to use it, and when to use it. 

    Dr. Maganini plans to introduce TapCloud to patients at the time of diagnosis. Nurses (e.g. NPs, Navigators) will get patients set up and show them how to use the digital health application. “Since surgery is typically the first step, we plan to use as a follow up with discharge instructions. For those in going through chemo treatments, we will monitor their symptoms. We want to get our patients accustomed to using TapCloud and then they will be using it for the long run with hormone therapy”.

    As part of the planning process, Dr. Maganini is working with his team to define the list of side effects including the words that these patients use to describe them. He is leveraging his own and his nursing staff’s patient experiences to devise the TapCloud  symptom list in “patient speak”. This is helpful to patients who often struggle to describe their symptoms and feelings.

    From this program, Dr. Managini expects to learn about the top side effects, interventions and the effectiveness of the interventions. He will be looking at different success factors – “increase in the therapy completion (3, 4, 5 years) and longer term (beyond the 2 years) hopefully a decrease in mortality rate and reoccurrence”.

    “With a program showing demonstrative effectiveness, we envision scaling this to the AMITA Health 2.0, 19 hospitals”, concludes Dr. Managini.

    Northwell Health’s Patients engage with AI ChatBot for guidance & support through their care journey

    Throughout the recent Connected Health Conference, the key theme was the need to balance technology with the human element.

    Northwell Health, New York’s large integrated health system with 22 hospitals and 550+ outpatient facilities, recognizes the importance of leveraging technology to extend the care team and personalize the patient journey.

    With the launch Northwell Health Chats (powered by Conversa Health), patients are empowered to connect, communicate and collaborate with their care team, while their clinicians closely monitor the patient’s evolving needs. 

    Think about a patient’s journey today.  Pamela, a 78 year old Medicare patient has just been discharged from a Northwell Hospital for a heart failure episode.

    Fortunately for Pamela, Northwell’s Health Chats, a new conversational AI platform will help support her during her recovery. With this text based chatbot, Pamela receives many more outreaches from her care team, a three- fold increase from about five times to fifteen during the 30 days post discharge period. 

    When she returns home, Pamela starts receiving notifications through SMS text message and clicks on the link to begin her chat about how she is doing. These chats continue to support Pamela through her recovery.

    Pamela is asked to confirm her weight uploaded automatically from her Withings scale. She sees her weight trending map with an educational message about working towards her goal. Next, Pamela responds how she is doing with her leg swelling and then about any difficulty breathing.

    Finally, the chat asks Pamela to indicate any side effects of her new medication. Based on her responses, she may be connected with her nurse to discuss any medication adjustments.  All of the information that Pamela provided to the chatbot is shared with her nurse for their discussion.

    Since this patient engagement solution is seamlessly integrated into Northwell’s work flow (e.g. care management tool/HIE), Pamela receives these personalized chats from her specific Nurse Navigator at Northwell and the chat content is tailored for her specific care journey. Pamela trusts the information that she receives and can respond with questions and concerns at any time. Pamela’s Nurse Navigator will determine if she needs to come right in to the office or if they can address her issues through a text, email, call or telehealth visit.

    Northwell is leveraging their Health Chats for population health. For example, the chat support patients as they prepare for a colonoscopy in their own language, ensuring the patient understands the instructions and knows how important this screening is to their health. This chat helps increase the patient’s health literacy and confirms that the patient knows how to prepare, reducing delays in diagnosis and additional health costs.

    Positive Results with Northwell Health Chats

    Sabina Zak, VP Northwell Community Health believes this chatbot is a “way to engage patients, by embedding information that is accurate, actionable and enables them to make more informed decisions which leads to better outcomes”.  

    As Northwell rolls out their Health Chats across the enterprise, they will be monitoring care quality, care cost and patient satisfaction measures.   With Northwell Health Chats, they are seeing a 97% patient satisfaction rate and lower post-acute care expenses in some of its hospitals. Northwell management is particularity interested in the reduced costs from fewer outreach calls since the bot engages patients and brings back needed information.

    Patient Comment:

    “These conversations were great and supportive emotionally as well as medically”.  

    Nurse Leader Comment:   

    “Conversa gives me reassurance that my patients are ok because I can see that they are responding to the health chats. It gives me piece of mind knowing that they are alright without having to always call them.”

     Clinical Leader Comment:

    “Innovative technologies like Northwell Health Chats are critical assets in our journey towards providing excellent clinical care and an outstanding personalized patient experience”, explains Northwell Health physician Dr. Zenobia Brown, VP Population Health. 

    Expanding Conversational Chat at Northwell Health

    In addition to supporting patients through procedures such as Colonoscopies, Northwell will be using this conversational chatbot to gather social determinants of health before the patient’s annual office visit. This information will be shared with their care team for their appointment.  

    Beyond population health, Northwell is expanding their Health Chats into Oncology, starting with head and neck and expanding to breast and prostate cancer patients. Northwell’s Health Chats will help patients prepare for the treatment, manage symptoms and check in once the treatment has concluded.

    In the future, Northwell is planning to use their Health Chats in the areas of bundled payments for patients with Coronary Artery bypass, Acute MI, Pneumonia, Stroke and Heart Failure.

    “Conversa’s conversational AI powering Northwell Health Chats enables us to improve care coordination, patient satisfaction and our ongoing patient relationship, resulting in the improved well-being of our customers while reducing costs. This high-tech, high touch, scalable approach benefits our patients, our nurses and our health system”, concludes Joseph Schulman, SVP Regional Executive Director at Northwell Health.

    Dartmouth- Hitchcock’s ImagineCare Platform Leverages Wearables, Connected Health & Analytics for Personalized Patient Care

    Dartmouth-Hitchcock (D-H), an innovative New England healthcare system with 1,000+ providers is committed to creating a “sustainable health system”, which proactively engages patients through new care models to achieve the triple aim.

    Over the years, D-H has invested in technologies that empower patients to collaborate with providers through shared decision tools and Telehealth, treating “patients and their families as partners in care”.

    D-H has been a pioneer in innovative payment models with both the government and commercial payers.

    In early 2015, D-H’s leadership team committed to create a truly patient-centric healthcare organization, which delivers high quality proactive personalized care to the patient beyond the hospital walls.

    “Dartmouth-Hitchcock purposefully set out to assemble a team of employees with backgrounds from other consumer industries like hospitality and retail that would augment the world-class capabilities of our clinical staff, to improve the health care delivery experience”, explains Vin Fusca, COO, ImagineCare.

    With their consumer- centric “healthcare without boundaries” vision, D-H management has designed a truly “care- driven” solution.  ImagineCare, a cloud- based platform, enables providers to closely collaborate with each patient to meet her care goals at any time and from anywhere.

    ImagineCare treats the patient holistically through the active and passive collection of a comprehensive set of patient data. In addition to condition specific evidence-based care pathways (i.e. ImagineCare Hypertension Pathway, COPD Pathway, CHF Pathway, Diabetes Pathway), D-H incorporates a “Core Health Pathway” to capture steps, heart-rate activity, sleep, and stress (Behavioral Health), providing contextual insight into the patient’s health.  

    With ImagineCare, the Provider and patient have a window into the latest health status for insight and action. In the background, ImagineCare collects information from the patient (i.e. sensor- based devices, apps), combines it with EMR data (i.e. patient visits, labs, meds) and processes it through complex clinical care algorithms with machine intelligence to pinpoint when the patient is at risk. High tech meets high touch when ImagineCare notifies the RN or Health Navigator to reach out to the patient for real-time support and intervention. 

    “ImagineCare leverages the best available technologies to assist with care, but does not replace the importance of the human touch to drive behavior change. ImagineCare seamlessly combines these components to help patients achieve their health goals”, shares Dr. Ethan Berke, Chief Medical Officer, ImagineCare.

     Patient Experience

    During her recent doctor’s visit, (patient) Pam decides to participate in D-H’s new ImagineCare Program to help her lose weight and proactively manage her hypertension.

    Within 48 hours, Pam receives an email to quickly enroll in ImagineCare and a welcome call to discuss her personal health goals. Two days later a personalized ImagineCare Kit (box) is delivered to her door containing a program overview, a wireless blood pressure cuff and an activity band, devices which fit her selected health goals. Pam follows the instructions to connect her devices to the ImagineCare app.

    During enrollment, Pam’s shares her profile information such as personal health goals, challenges, communication preferences, family support, and defines her “medical neighborhood” (i.e. Providers, pharmacy, caregivers). She adds more information when responding to daily questions to create a rich picture about her health needs and resources required to tackle care plan activities.

    Anxious about her attempts to lose weight, Pam indicates in the mobile app that she only wants to receive texts to help her stay on track with her weight-management goal.

    Through the ImagineCare mobile app, Pam answers daily questions about how she is really doing, while her wireless blood pressure cuff and activity band retrieve and send real-time measures. Pam receives nudges, encouraging messages and digital check-ins to ensure she stays on track with her care plan. Yesterday’s text asked Pam if she was okay since she hadn’t provided her blood pressure as expected.

    D-H’s RNs and Health Navigators continuously monitor Pam’s health status, review her trends, and respond to risk warnings by reaching out via text which is her communication preference. Since Pam designates her daughter as a personal health representative within the mobile app, ImagineCare’s RNs are permitted to speak with her about Pam’s health.

    ImagineCare Success Measurement

    ImagineCare is designed to empower a health care organization to right-size provider visits, lower ED utilization and decrease admission and re-admissions. ImagineCare provides a more engaging solution to help health care delivery systems increase quality of care, decrease cost and improve patient experience.  

    In addition to these quantitative measures, D-H actively gathers qualitative patient feedback to understand the patient experience. Comments from patients about engaging in the ImagineCare program include:

    “I monitor my blood pressure every day, and after a particularly stressful day at the office I went home, took my blood pressure, and five minutes later one of the nurses called and talked me through an immediate care protocol.”

    “It has improved my ability to manage my health…The ability to connect with people for support and also send information to my healthcare providers, makes it easier.”

    "I am extremely impressed with the ImagineCare phone app. It is very easy to use and seems very intuitive”.

    ImagineCare Future

    ImagineCare is constantly updating its services and products based on patience engagement data, clinical data, and new technological capabilities coming to market. In a digital health landscape that is becoming more fragmented, ImagineCare will continually create holistic, customer-centered health services to better care for patient populations.

    D-H’s team has packaged up the ImagineCare platform for other providers, payers and (self- insured) employers to deliver personalized patient care for better outcomes.  

    Virtua Navigates Orthopedic Patients Pre- & Post-Surgery with Improved Patient Engagement and Care Coordination

    WELLBE PLATFORM FOR PATIENT ENGAGEMENTWith an aging population and increase in chronic conditions including obesity, the demand for hip and knee operation is increasing dramatically. A study in the Journal of Bone & Joint Surgery estimates by 2030 “demand for total hip arthroplasties to grow by 174% to 572,000 and demand for primary total knee arthroplasties by 673% to 3.48 million procedures”.

    Responding to this strong demand and high procedure expense, CMS launched the Comprehensive Care for Joint Replacement (CJR) payment bundle April 1st, focusing on cost and quality over a 90-day period beginning with the hospital admission. The CMS CJR Payment bundle is initially for about 800 selected hospitals across the country. 

    Although Virtua, one of New Jersey’s largest health systems with hospitals, surgical and rehabilitation centers, is voluntarily participating in the BPCI payment bundle, their investment in the orthopedic patient experience at their Joint Replacement Institute (JRI) started long before the payment model changes. 

    Virtua Health’s Orthopedic Patient Care Journey 

    Back in 2000, Virtua adopted the Six Sigma methodology and launched the STAR initiative to deliver an "outstanding patient experience”.

    “When we look at how we can change and improve a process, we focus on the patient and understand what they need, not what we think they need,” explains Kate Gillespie, AVP of Virtua’s Orthopedic Service Line. 

    With a commitment to enhancing the orthopedic (hip, knee) surgery experience, Virtua listened to patients discuss their challenges and needs. Through focus group research (Spring 2015), Virtua learned:
    • Orthopedic patients need a lot of information to get ready for their surgery but are overwhelmed when inundated with too much at one time.
    • Patients place a high value on their doctor’s suggestions to achieve best results.
    • Patients that are prepared are more confident and will participate in the process leading to improved outcomes.
      
    “We learned that as patients prepared for surgery, they were asked many of the same questions by different members of our care team,” said Gillespie. “We needed to improve the patient experience and ensure the consistency of information shared along the patient journey. We also wanted to engage the family to support the patient before and after surgery and decided to require that each patient has a ‘care partner’.” 

    The Virtua JRI team looked for technology to continuously engage patients and families, from on-boarding before surgery, to educating and guiding them from discharge through recovery.  The tool needed to be actionable, collecting essential information from the patient (i.e. concerns, pain levels) and informing Nurse Navigators when patients fall off track.

    Virtua JRI chose to implement a Connected CarePath for Total Joint Replacement from Wellbe, a solution provider in Madison, Wisconsin. Working closely with Wellbe, Virtua customized their CarePath with their own health history and sleep apnea surveys, scheduling and care plan content (delivered via “CareCards”). 

    Patient Journey 

    PATIENT CREATES CARECIRCLE ON WELLBEDuring the initial visit to the surgeon’s office, patient Patty is given information about Wellbe, a personalized care plan for her pre-and post-surgical journey. She signs up with the Nurse Navigator and receives a Welcome email. Patty shares this information and invites her family ‘Care Partner’ to join her CareCircle to access her resources.
     
    Pre- Surgery: Beginning 4-6 weeks prior to surgery, Patty views a care plan with a personalized set of “CareCards” explaining the operation and process to successfully prepare including preadmissions testing and health clearance forms. She receives a “CareCard” introduction to her Nurse Navigator. Every CareCard is delivered “from” her doctor or another member of her care team to motivate compliance. Patty receives reminder messages and checklist items leading up to the surgery and can refer to any completed CareCards in the “library” such as “How to prepare for the day of surgery.”  

    “Our patients really like the library feature. Before we launched the Wellbe platform, patients were given a Joint Replacement booklet. Now patients and families have all the surgery information at their fingertips.  Patients traveling to our Institute can prepare for their surgery by viewing videos instead of attending an in-person class,” adds Gillespie.  

    Post –Surgery: Within Wellbe, Patty views discharge information such as symptoms to watch for and completes surveys so that her care team can manage her recovery. Patty’s Nurse Navigator monitors her “Progress Report” with required actions and contacts her with any concerns. 

    “We believe this post-surgery engagement is important to prevent readmissions by ensuring the patient understands how to take medications, manage pain and follow outpatient physical therapy,” Gillespie shares.
     
    Patient Engagement Results

    Since launching the Wellbe platform in December 2015, Virtua JRI has enrolled 700 patients.  Patients span every socio-economic level and range from 40- 90 years old, with the majority in their 70s. 

    “We are signing up 86% of our surgery patients which is much higher than we expected. The remaining patients either did not have an email address or didn’t have a friend or family member to help them,” explains Gillespie.
     
    Virtua is evaluating success based on a few factors. Through a Wellbe survey, they are measuring how prepared the patient feels using the platform. With Wellbe reporting, Virtua is also measuring the patient’s engagement and compliance with required CareCards.

    Patients have shared positive comments about their experience using the tool - “grateful for the support received”. Nurse Navigators have also provided feedback - the Wellbe platform has helped them be more efficient in their patient care. Through “one tool”, nurses are able to “organize and track patient progress and communicate with the rest of the team” (i.e. physician office, pre-admission testing department). 

    Virtua has received suggested enhancements such as “defining an end time for a patient to be on the platform” and removing the medication form since patients “already gave the medication list to my surgeon.” Virtua has also added a link to the “Virtua Orthopedic Endowment”, giving patients an opportunity to give back. 

    Future Opportunities 

    Virtua initially launched the Wellbe platform without tying it into their Electronic Medical Record. “We are considering integrating Wellbe into our EMR so that the patient’s surgical chart will be easily available on one site for our Nurse Navigator.”   

    “Wellbe provides a key to patient engagement by keeping them engaged and participating towards a successful surgical journey. Virtua is determining where we can use this tool in other service lines such as Spine, Bariatric, Oncology and Maternity, which are all education-intensive clinical episodes.” 

    “This program aligns with our vision in keeping our focus on the patient /family experience, and provides us with an opportunities to participate in their surgical journey”, Gillespie concludes.  

     

    UnitedHealthcare Empowers Caregivers with Personalized Tools for Guidance, eCommerce & Connection

    At the 2016 Consumer Electronics Show (CES) in January, UnitedHealthcare launched Solutions for Caregivers, an online program that provides resources for caregivers and their family; personalized information, a discounted marketplace of products and services and care circle community for ongoing support.

    UnitedHealthcare is addressing the evolving needs of a large population of caregivers. According to the Caregiving in the U.S. 2015 report by the National Alliance for Caregiving (NAC) and AARP Public Policy Institute, an estimated 43.5 million adults have provided unpaid care during the prior 12 months,  34.2 million (79%) offering care for an adult age 50+.

    “Many caregivers are searching for relevant resources but often don’t know where to start. Solutions for Caregivers addresses the needs of family caregivers through case management services and online resources that help caregivers more effectively care for their loved ones,” shares Dr. Richard Migliori, EVP and Chief Medical Officer, UnitedHealth Group.

    Caregiving Burden

    According to the Caregiving in the U.S. 2015 report, caregivers spend an average of 24 hours each week helping their loved ones. Many caregivers experience their own physical, emotional and financial strain as a result of their caregiving role. Half of the caregivers indicated “they had no choice in taking on their caregiving responsibilities,” and 40% report being in high-burden situations. When asked about their health, 17% said ”it is fair or poor”, compared with 10% of the general adult population.

    Many caregivers (60%) admit they had to make a workplace accommodation, such as taking time off or reducing work hours. On average, caregivers assist with “4.2 out of 7 Instrumental Activities of Daily Living (IADLs),” including transportation, grocery/other shopping, or housework. Most caregivers (84%) report an interest in receiving more information such as “keeping their loved one safe at home” and “managing their own stress.”  

    UnitedHealthcare has conducted extensive research with family caregivers to understand their challenges around caring for a loved one. Vidya Raman-Tangella, M.D., head of UnitedHealthcare’s Innovation Center of Excellence, explains, “We heard that each journey is a ‘unique’ and ‘personal’ experience. Family caregivers are often not prepared and do not know where to begin, which causes anxiety. Some caregivers need support recognizing ‘what is good’ when making decisions for their loved one. Finally, UnitedHealthcare heard that the family caregivers did not want to feel alone and wanted to work together with others in their care circle.”

    CAREGIVERS MARKETPLACEVidya and her innovation team set out to define a solution based on these caregiver needs. The team started with a portal front end to house a set of tools to help caregivers:

    Personalized Information – educational articles and videos that are tailored to the specific medical issues and needs of the care recipient and caregiver. UnitedHealthcare’s articles support the topics requested by caregivers (i.e. safety, stress). Users can save an article for future reference or share with others (i.e. siblings, health coach and clinician).

    Marketplace – set of vetted discounted products and services to support the caregiver and care recipient’s conditions and challenges. Product categories include “assistive products”, “home monitoring”, “home safety” and “medication management.” Service categories span “financial”, “in-home care”, “nutrition” and “transportation”. Regarding “nutrition,” caregivers can order meals that are tailored to the care recipient’s health condition (i.e. low salt, low sugar). UnitedHealthcare’s marketplace is designed to support caregivers for activities they undertake on a regular basis, including transportation, shopping and house work. 

    One service option is for a “Care Manager” who can help the family plan or respond to care recipient/caregiver needs, via online, phone or consult (secure messaging). Some caregivers may have a health plan benefit that covers the care manager service, while others have the option of paying the hourly fee.

    Currently, UnitedHealthcare has mostly national companies and a growing number of regional and local offerings in the marketplace. Based on the care recipient’s zip code, there may be a national service provider such as CareLinx, which offers services in the specified geography.

    Community Support – centralized place where caregivers and friends of a loved one can connect, share insights and concerns (i.e. how does mom look today), add and view medical appointments & meetings on a daily/weekly/monthly calendar, post and assign tasks (i.e. a ride to the doctor’s appointment) and access a library of documents such as medication lists, doctors list, health records and a living will. The solution serves as a repository of this information, however there is no integration with the EMR or any clinical information 

    Caregivers can also invite others, such as clinicians and in-home caregivers, and enable them to securely access information and communicate on a common platform.

    Although other companies promote online caregiver offerings today, UnitedHealthcare has designed a 'personalized caregiver solution'. During the sign-up process, the caregiver creates a profile by responding to set of questions about the care recipient; relationship, age, zip code, conditions and challenges. The caregiver also indicates their own health conditions and challenges. 

    For example, when family caregiver Carla responds that her 86-year-old mother has hypertension and diabetes and is dealing with mobility issues, and she (the caregiver) is experiencing depression, Carla will see articles, videos, products and services that are relevant to both of their needs.

    Caregiver Solution Pilot

    UnitedHealthcare is providing the Solutions for Caregivers program to large employers at no additional cost for employees to access the online services. As of January 2016, Solutions for Caregivers is being promoted to over 1 million employees. Currently, Solutions for Caregivers is also accessible to the public. For people using the employer-sponsored version, the company can cover the costs associated with care management services, enabling caregivers to access more holistic support. In comparison, people accessing the consumer site, or instances where the employer has not purchased the additional care management services, can pay out of pocket for these resources. In both versions, caregivers can access customized content, shop from the marketplace, and use the myCommunity resources.

    UnitedHealthcare has received positive comments about their Caregiver solution, that it “saves time” and they would “recommend it to other caregivers”.  To date, UnitedHealthcare has also noticed that many users are in the early stages of caregiving.

    Future Solutions for Caregivers

    “While it will take the rest of 2016 to build the volume of users, we will continue to grow our marketplace through strategic partnerships with product and service companies. We are especially interested in technology solutions for caregivers”, shares Dr. Vidya Raman-Tangella.

    UnitedHealthcare is planning to leverage all customer service touch points to identify caregivers who are currently moving along the care journey or will be on the journey soon as potential users of the solution.

    “Throughout the year, we will learn how this program is delivering value to caregivers and care recipients. With Boomers turning 70, we will be particularly interested to see how our offering will be used to support the boomers as they retire as well care for their loved ones”, explains Dr. Raman-Tangella.

    “This program and others from UnitedHealthcare are making it easier and more convenient to people to take charge of their health and the health of their loved ones. By using technology and personalized resources, we are helping people to live healthier lives”, Dr. Migliori concludes.