Author Archives: Vignesh Eswaramoorthy

DPRP – An Initiative To Control Diabetes

It is estimated that more than twenty-nine million of the population in the United States are affected by diabetes and it is listed as the seventh leading death causing disease.

Diabetes Mellitus is a high blood glucose level that results in either because of inadequate insulin secretion or body cells that do not respond to insulin. This disease without treatment will damage many body parts leading to complications such as strokes, heart disease, and kidney failure.

Prediabetes is a stage before diabetes. An elevated blood sugar level but below the threshold of diabetes condition is a symptom of prediabetes and it is becoming more common in America. One out of every three Americans have prediabetes and many of them are not aware of it. Prediabetes can gradually develop to Type 2 diabetes.

The other condition called Type 1 diabetes, where the human body does not secrete insulin. This type is referred to as insulin-dependent diabetes, juvenile diabetes, or early-onset diabetes. Type 1 is not common as Type 2 diabetes. On average 5% of diabetes patients belongs to Type 1.

In an effort to prevent this, the Centers for Disease Control and Prevention (CDC) established a program called Diabetes Prevention and Recognition Program (DPRP).

Diabetes Prevention and Recognition Program (DPRP)

Diabetes Prevention and Recognition Program (DPRP) is a program facilitated by CDC. It provides information about Type 2 diabetes to people who are at risk, providers and also to the health insurers. The motive of this initiative is to recognize and give quality assurance measures for organizations to effectively deliver the Lifestyle Change Programs.

DPRP program is initiated based on many studies, and it is a part of a successful program called Diabetes Prevention Program (DPP).

The focus of DPRP is to provide assistance to people who are expected to be affected by Type 2 diabetes and to educate them about diabetes prevention measures.

CDC gives a detailed description of DPRP standards for Type 2 diabetes prevention lifestyle intervention program and it explains how to apply, earn and maintain recognition.

Organizations which have the knowledge and skilled staff for lifestyle coaching can apply for recognition. After getting approval from CDC the organization should implement the lifestyle program, regularly monitor the program, provide guidance to coaches and ensure the program achieves the desired results.

Like any other program, DPRP also ensures quality reporting, recognized organizations are expected to submit data every 12 months to CDC. Organizations who fail to submit the evaluation data will lose their recognition and need to re-apply for it.

The organization will enroll the participants if they are

1. A minimum of 18 years old with BMI of ≥24 kg/m2 or ≥22 kg/m2, if Asian.

2. A minimum of 50% participants must have self-blood test report or any claim code that indicates they have prediabetes within the past year (maybe self-reported)
a. Fasting glucose of 100 to 125 mg/dl
b. Plasma glucose measured 2 hours after a 75 gm glucose load of 140 to 199 mg/dl
c. A1c of 5.7 to 6.4
d. Clinically diagnosed GDM during a previous pregnancy (maybe self-reported)

3. A maximum of 50% eligible participants is from CDC Prediabetes Screening Test of the American Diabetes Association Type 2 Diabetes Risk Test or on a claims-based risk assessment.

Diabetes is a preventable disease. The fluctuation in blood sugar level can be controlled so people can live a normal life. But when it is not controlled the condition gets worse sometimes even causes death.

The importance of DPRP program is to postpone diabetes and its terrible side effects. The main reason for this increase in diabetes population is primarily due to lack of awareness. DPRP is employed to create awareness in order to control the disease.

Redesigning the Healthcare Delivery Model To Suit The Future

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The WHO predicts that in the decades to come to the population of people above 65 will surpass that of children under 5 years of age. Analyzing the current trends, it can be concluded that many of these senior citizens are prone to have one or more chronic conditions.

Chronic conditions could mean more expenses for the payers and more pressure to the system. This is a volatile situation, where the social and demographic changes resulting will have a negative impact on efficiency and per capita cost factor.

To cope with this rise in senior population with chronic conditions, healthcare systems will have to manage the following:

1. Adding human resources:
Perhaps the most obvious but the most important step to adapt is to invest in human resources. It has been observed that human interactions cannot be substituted, healthcare delivery centers who focus on having optimum qualified resources in their care delivery system have more often proved to deliver the better patient experience.

2. Precision Medicine:
Precision medicine is understanding and acknowledging that different patients react to medication and treatment differently due to genetic disposition. Treatment and medication must be engineered to get the best result as possible.

Connected devices and health monitoring equipment that aids in gathering patient information near to real-time helps best possible health outcomes achievable even in the most complex scenarios.

3. Overcoming impending shortage of healthcare professionals:

The proportion of healthcare providers to that of the population is already less than ideal. This trend is said to continue even as the number and necessity of patients multiply. Healthcare providers must find a way to bridge the gap between demand and supply in healthcare. One way to do it is to create new models of care delivery using technology to stretch help across geographic distances. Telemedicine is a viable option available for healthcare professionals to augment their services in order to do more with less time and resources.

4. Holistic Medicine:

Decades of focus on specialization has made healthcare professionals see a disease or its symptom as an isolated case, and the patients are considered cured by only removing the disease. In practice, a person might be suffering from multiple health issues and a simplified isolated view might do more harm than good to a patient.

5. Leading cause and concentrated efforts

In the coming years and even now, termination of a patient’s life is more likely to occur due to traceable lifestyle choices or practices than from any infection or diseases. For example the relation between obesity and disease has for long been proven beyond any doubt, furthermore, obesity and related illness will increase the cost of treating a patient. Therefore a concentrated effort to reduce obesity can bring about a positive result in reducing the possibility of heart disease and stroke.

Like obesity, scientific observation can identify key causes of a disease and healthcare providers can make a concentrated effort in reducing the causes in a population.

These are the most important steps a healthcare provider will have to consider in improving healthcare outcomes.

The transition to a more technology involved healthcare delivery management can tremendously help providers be agiler and more effective with necessary amendments.
Healthcare strategies must be relooked to have a more holistic & flexible approach not only to accommodate CMS led changes but also to benefit the entire population.

Era of A Personalized Care

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Humans differ in terms of DNA & Genome Composition. This factor may not necessarily surface as a disorder or a disability but will create variations in the manner each person responds to drugs and treatment for a disease or a condition. In any given population, there is a chance that a group exists who do not respond to any given medication in the desired manner.

Personalized medicine is the practice of designing and conducting medicine tailored to suit an individual patient’s needs with procedures, drugs and treatment approaches. Personalized medicine has been the war cry for many healthcare reformists for decades, but now there is more likelihood of the general healthcare practice widely adopting the idea because of the following reasons.

Change in regulation
Change in attitude
Healthcare technology
The current model is ineffective

Change in regulations:

The US healthcare regulations are changing giving way to implement the new methodology of care delivery and management. The provider reimbursement is being made flexible allowing healthcare professionals the space to adopt their practice for the benefit of each individual. Change in regulations also will lead way to alterations in the structure of organizations; the organizations will be revamped to be more collaborative and serve a population that is demanding quality and services that match any other industry’s methodology.

Change in attitude:

Providers of today have many tools at their disposal and partially due to this reason providers are more willing to embrace change and improve the lives of those whom they serve. The complexity that the modern medicine requires and the practice of handling a large amount of data is almost impossible to manage and generate result without healthcare IT.

Healthcare Technology:

Healthcare Technology is improving and evolving tremendously, allowing both providers and the patients not only to keep track but actively engage in Care Management. The data that is collected by connected devices and the quality of information that is gathered by hospital systems allows for an in-depth analysis of healthcare conditions and concerns.
For those not residing in cities, Healthcare IT means fast care with the focus on those suffering from chronic conditions. In personalized medicine, Healthcare IT can be used to gather personal information and monitor the effects of treatment and medication, and also play as a channel to direct personalized care.

The current model is inefficient:

The current model is inefficient and rigid to incorporate the necessary changes that need to be made to accommodate all the variations required in care delivery. The results are varying and the outcome cannot be accurately predicted. The healthcare sector now works under the assumption that reaction to a medication or procedure is the same for every individual. This is a risky assumption and one which is costing the public their health and money.

Personalized medicine is the future of healthcare, it is the next big idea that is going to shape healthcare delivery for the times to come incorporating technology. We at HealthViewX understand this, and we are determined to create healthcare delivery tools that collect useful patient information to help providers make choose the right path always.

Patient Engagement – A Key To Reduce Readmission

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Many buzzwords are battling around healthcare practices and patient engagement is not new. Healthcare is reforming constantly by implementing new technologies and methods. The reforms in technology make hospitals function better while the changes made in quality measures bring better care quality. The bottom line of any provider is to provide quality care to improve the health outcome through cost-effective methodologies.

Though hospitals have been trying to bring out transitions in patient care with emerging technology they are constantly facing same issues over a period of time called readmission. Hospitals that are registered under Medicare bears the pain of being penalized if their patients get readmitted. In Chronic Care Management, patients get 20 minute of care after their discharge and CMS pays for it. The reason behind this payment is to reduce preventable readmission, and emergency room visits.

Each individual’s health outcome depends on the consistent effort taken by primary care physicians, registered nurses, care coordinators, community health workers, family members and the patients themselves. If there is a readmission then it means there is either a gap in care flow or in communication flow. The only solution to this problem is to engage patients in their own care through simple user-friendly technologies.

Smartphones to engage patients

The smartphone is a good companion for every single individual. People spend most of their time interacting with their smartphones. After smartphones hit the market it has opened a door for many portable health devices which now act as an effective tool in engaging patients in their own health.

It is found that 1 out of every 6 people who are aged above 65 have access to tech devices. Growing population adapt technology faster which means many of them in the next Medicare age group will have smartphones. If the providers pay attention to this stat then it is easy to reduce the readmission. The answer to the question “How smartphones can reduce readmission?” is engaging patients through smartphones.

Mobile technology allows the patient to know about the details of their disease, medication plan, sends appointment reminders to both patient and doctor if any wrong occurs, it helps physicians to create care plans and communicate any time with their patients. At the same time, monitoring devices help to continuously observe the health conditions and send messages to the hospital providers to get instant care.

Educating Patients

Some mobile applications have an inbuilt library which has all the details of medical diseases with their causes, symptoms, medications, treatment procedures, risk factors, and preventive measures. This acts as a reference resource for the patients and they have access to all information in one small handy device. Some tracking and monitoring apps take one step further to engage patients more effectively.

Proper Communication

Some hospitals have also seen a positive outcome in simple and secure text messaging. The message will be sent to the patient and physician as an appointment reminder. Patients who reply back are considered as active patients and they have the low possibility of getting readmitted. These responses will also help providers to check the patient availability to fix up the meeting, also it saves time.
Mobile technology also facilitates timely follow up with patients. Chronic Care Patients who have early follow-up within 7 days have lowered the readmission rate.

CCM Readmission Preventive Measures

1. Send the detailed patient medical summary to outpatient care team immediately after discharge
2. Knowing the patient’s immediate point of contact
3. Follow-up with a week after discharge
4. Educating patient about their health condition before discharging
5. Maintain EHR in such a way to reduce medical errors

Better outcomes come from a better system. Collecting proper patient data and involving patients in engagement activities will help in reducing readmissions.

Profiting From Chronic Care Management

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Chronic patients care requirements are different when compared to regular patients. In case of chronic patients, the provider should create, and maintain continuous yet flexible care delivery model to accommodate various healthcare requirements. Until the recent past, the provider’s reimbursement plans for Medicare was not flexible enough to hold all the post and pre ER visit care that is necessary for health and well-being of people with chronic diseases.

Chronic Care Management CMS has given providers the needed elasticity and space to work best with their chronic patients. Under the scheme, providers can charge CMS for 20 minutes of non-hospital, non-face-to-face care that they give to patients over a month. This is a great leap in the right direction but given the strict parameters of the program, many providers are concerned that being a part of it will do more harm than good financially. But here are a few steps that can ensure the greater chance of financial success.

Start with the program
Design a standard approach
Employ resources
Review

Start with the program

Yes, this is the less obvious but important step, less obvious because no provider would want to get into a program with outcome unknown. Chronic Care Management has a few unique features such as only one provider shall charge for CCM services. This means by the time a provider makes his mind and assigns resources their patients would have already gone to a different provider.

It is also true that the program and the approach with which it is designed is rather new in the industry today and it will do good for providers to understand and be used to the change.

Design a standard approach

Like all programs CCM would benefit from a standard approach, it will make it easier for providers to alter and adapt it later. A standard approach will also make billing easier & less troublesome. The main idea here is to spot what works best for a practice and if it doesn’t then how it can be changed to arrive at the result that the provider hopes to achieve.

Employ Resources

Provider/ Practice must designate and assign a resource for CCM program. Resources which include human can achieve the objectives better if the program is taken seriously and not like a side assignment without any defined parameters. In most cases, resources are already available and assigned to chronic patients care but adjustments need to be made so that such systems will meet the program parameters.

Review

This step is evident and for the right reasons. The review can help in understanding the causes of malfunction if any. And what is required to make it right and more importantly to know the aim of the exercise – that is improved care quality, is achieved. The introduction of this program CMS has laid the groundwork for healthcare industry’s transformation into a quality based industry in which profitability has linked quality and vice versa. Schedule a demo with us to learn more about Chronic Care Management.

What to Look for in a Care Management Solution?

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As the population grows older, the number of Medicare and Medicaid eligible adult age groups increase. This raise inpatient population will increase the probability of readmissions, unnecessary hospitalization and wrong treatment rate. Patient health needs have to be monitored continuously to avoid all these problems.

Care Management provides the right care at the required time for patients to avoid re-hospitalization. In recent days, Care Management has become a must option for all providers to reduce readmission.

The triple goal of care management is to,

Achieve Population Health
Decrease Health Risk
Reduce Healthcare Cost

To achieve this goal, patients have to be actively engaged in their care process. Some physicians fail to explain to patients about their health condition and the others fail in communicating it properly. But the aim of any physician is to improve the health outcome of the patients. They want their patients to follow the instructions, however considering their health conditions patients often forget things. And, this problem is never-ending.

The solution to solve this problem is the usage of technology in health practices. Easy to use applications and remote monitoring tools will ease the process and help providers to keep an eye on patient’s health status.

So what are all the features a care management solution should have?

1. A solution that helps provider & physicians to create a good Care Plan
A care management solution allows providers to create a customized care plan for all the enrolled patients based on patient’s medical conditions. These care plans are pushed to patient’s integrated health devices so it allows providers to track the patient’s condition endlessly to provide instant care services.
For example, a care plan goal is created and pushed to a diabetes patient. Any changes in blood glucose level will be intimated to the respective physician. A physician will immediately communicate with a patient to identify what has happened and give proper guidance. This will not only help to improve the patient wellness but also keeps patients away from entering into any risk state.

2. A solution which allows physicians to communicate with patients securely
Telehealth- a solution to reduce a communication gap in healthcare. Though Telehealth feature is not new in healthcare sector it is getting popular only in recent years. This feature helps physicians connect to their patients and care coordinators through telecommunication network or through video conferencing. Remote monitoring technology helps physicians to have a track on the patient’s health status and provide treatment from anywhere. This feature also helps rural providers to consult with a specialist before and after treatment.

3. A dashboard that explains everything

With the actionable dashboard, a provider can view details of the total number of patients, risk stratification, disease management heat map, care plan chart, goal adherence chart, and appointments. Each component should be given the option to be filtered and further drill down to know more details.

4. A Tool that will send notifications for the appointment, and alerts on Threshold Breach

It allows to schedule an appointment online in no time, reminds both patients and physicians, and alerts physicians by sending notifications if their patients are at risk.

For example, if a diabetes patient’s blood glucose level goes up, an alert will be sent to the physician. A physician will view the patient details by clicking on the notification. The physician has three options- Call, Chat or Video call- tapping any one of the options will connect physician with the patient.

5. One solution to manage and monitor the whole population health

Similarly, the number of patients near to real-time health status can be tracked simultaneously. The patient’s data will be gathered and recorded to act upon immediately. This way a care management solution helps for the betterment of the overall health of the population.

In simple words, a Care Management Platform should come with features that have the ability to Create Care Plan, Engage patients in a meaningful way & Extend Care beyond the hospital walls.