Category: Healthcare

Category: Healthcare
West Corporation

Posted on July 29, 2015 by West Corporation 

Interoperable Sensors: The Key to Chronic Care Management

The subject of Chronic Care Management is getting a lot of attention these days, and for good reason. With the adoption of the Affordable Care Act and new Medicare reimbursement standards from CMS, the industry is moving away from traditional fee-for-service toward a more encompassing fee-for-value model.

As the management of the chronically ill transitions away from clinics and hospitals to become increasingly home-based, the use of electronic sensors that collect biometric data will be crucial for the next generation of Chronic Care Management. Devices like blood pressure cuffs, glucometers, and weight scales all can be equipped with wireless remote sensors that capture biometric readings and send them to a system that can then act upon the data; automatically issuing alarms and instructions if readings are out of range.

But despite the available technology, the fact is that most patients today are asked to collect and report their readings manually. As a result, patients often include incorrect data; sometimes by mistake, but often deliberately to make their health appear better than it is. Biometric sensors can change all that by automating the collection of data and ensuring more accurate patient information.

Sensors make the collection of biometric data more accurate and reliable, but it will take a higher degree of device interoperability to make it work for high-risk patients and providers. Consider a chronically ill patient with COPD that is on oxygen at home. They must provide oxygen level readings via an oximeter, as well as blood pressure readings and their weight. The sensors are separate devices and do not talk to each other, requiring the patient to collect and communicate each bit of information manually.

We need better industry standards regarding sensor interoperability. That is why West supports The Center for Medical Interoperability, an organization working to accelerate the seamless exchange of healthcare data and sensor information. Organizations like the Commonwell Health Alliance are devoted to making health data available to patients, clinicians and providers regardless of where care is sought or given. Groups like Health Level Seven International are focused on developing standards for data exchange and interoperability in Healthcare.

Interoperability is crucial for next generation Chronic Care Management and at West we are doing our part. We help organizations to better activate and engage patients beyond the clinical setting through a unique combination of patient-based technologies focused on delivering solutions that solve complex communication challenges. When it comes to sensor interoperability our ultimate success industry-wide depends upon making advances on a number of related technical fronts, including medical devices, electronic health records and the technical infrastructures powering our health systems.

West Corporation

Posted on by West Corporation 

Applied Lessons: How West Can Teach Healthcare How to Talk to Patients

In both mHealth and telehealth, efforts at reducing cost, improving quality and driving better consumer experiences will be increasingly dependent on technology integration and a unified engagement experience across the continuum of care and all communications channels.

Unless organizations start coordinating patient engagement modalities from portals to video calls to geographically distributed human resources, investments in these and other technologies simply won’t pay off. Why? Because patients may well end up suffering “engagement fatigue” from being over contacted, or they’ll lose confidence and tune out due to redundant or irrelevant information or their inability to reach the right human when they need one.

How do we know this? History. Thanks to value-based care, patient experience executives in healthcare are thinking more like their counterparts in retail, travel and financial services. Five years ago, those industries woke up to consumers who had, among other things, started Tweeting customer service requests, often because they weren’t getting the service they expected when they dialed the company’s 800 number. Many consumers even began showing a preference for companies who had “an app for that.”

Consequently, companies created Twitter and Facebook accounts and staffed them with social-savvy customer service folks. They built mobile applications. In pretty short order, though, companies realized that in their effort to respond to consumer demands, they had essentially created stovepipes of uncoordinated consumer engagement. The result: disjointed, redundant and often inconsistent communication from the company. Not exactly the outcome they wanted.

While many companies are still grappling with the archaeological record of those technology decisions, some are getting it right and making good strides in connecting the dots between channels of engagement, while also working toward creating more unified engagement environments.

In one example, West worked with Vanderbilt to improve appointment confirmation rates across the voice and text channels, simply by allowing patients to indicate their preferred channel for receiving the notification. In another example, West helped Utah Spine Care achieve a 500% increase in patient Portal registrations through targeted messaging of patients with upcoming appointments.

And finally, West worked with a top US airline to architect a customer-centric contact center solution that leverages a Natural Language speech application to handle inbound calls, provides intelligent call routing across three geographically distributed contact centers, and provides a CTI screen pop to pass data from the voice response system to the agent desktop. The solution decreased call handle time by 9 percent, meaning customers were able to get the information they needed much more quickly, and call abandon rate decreased by 60%, meaning caller frustration plummeted because they had greater confidence that they would be able to get their needs met.

Our hope is that by sharing the experiences we have gained, we can help patient experience executives in healthcare avoid unnecessary pain and derive the full value of their patient engagement technology investments.

West Corporation

Posted on by West Corporation 

Encouraging Patient Accountability in Prevention and Wellness

In this brave new world of value-based healthcare delivery, hospitals and health systems are focused on prevention and wellness as one of the primary goals for improving health outcomes.

The problem: patients often don’t heed doctors’ advice for following preventive-focused lifestyle or treatment plans. According to the Healthy World Report, “A Fragile Nation in Poor Health,” 83 percent of people say they don’t do what their doctors tell them. Moreover, a mere five percent of doctors said they would give their patients an A grade for following through.

Many patients, however, want to do better, as almost 40 percent say they would follow doctors’ advice if they got some kind of reminder or nudge from those doctors between their visits. Basically, patients are saying, “I am having a really hard time doing this. But, I would do a better job sticking to it if my doctor helped by reminding me and encouraging me along the way.”

The solution: stop being reactive. Health systems can proactively engage patients, but they need a systematic approach to do so – one that helps them assess a patient’s risk level and automate personalized communications so they can engage more, if not all, of their patients on a regular basis. Engagement communications can take the form of automated phone calls, text messages or emails between visits to keep patients on track with their treatment plans, prompt them to refill prescriptions or remind them to schedule preventive screenings and keep already-scheduled appointments.

Activating patients for wellness and prevention is easier than it sounds. Ochsner Health System, for example, is using its appointment reminder system to engage and activate patients to get the colorectal cancer screenings their doctors have ordered. The strategy is simple: send an automated phone notification letting patients know they are eligible and remind them to schedule the test. The results are impressive. In just two months, Ochsner scheduled 578 colorectal test screenings. More importantly, since there is an expected 25 percent pre-cancerous polyp detection rate, an estimated 145 patients benefited from early detection as a result of these exams. Not surprisingly, patients expressed appreciation for this outreach, saying if they were not nudged or reminded, they would not have completed this important preventive test.

Take a page out of the Ochsner book and get started by leveraging automated technology to successfully prompt patients to schedule important preventive screenings. Like Ochsner, the majority of health systems already have appointment reminder systems in place. Taking your program to the next level is a simple matter of maximizing that technology to engage and empower patients to take a more proactive role in their own prevention and wellness. Don’t wait. Start where you are, use what you have and do what you can. When you take that approach, everyone wins.

West Corporation

Posted on by West Corporation 

How Chronic Care Management is Like Going to the Gym

For people with chronic health conditions like Diabetes, Alzheimer’s and Cardiovascular disease, taking care of your health and following your treatment plan can be a matter of life or death. But don’t feel like you are alone. Nearly half of all American adults — about 117 million people—suffer from one or more chronic health conditions and all of them struggle with the enduring health challenges.

Whether it’s adhering to your medications, monitoring your personal biometrics, or attending regular doctor visits, effectively managing chronic health conditions requires coordination and discipline. But it’s easy to slip. Here are a few of the common excuses: “I’m too busy”…”It’s not convenient”…”I try, but I lose interest.”

Sound familiar? It’s a lot like going to the gym. We all start with good intentions to work out regularly, but it’s easy to find an excuse to not go. We all know we need to exercise in order to lose weight, stay healthy and relieve stress, but to achieve those goals you’ve actually got to get up off of the couch and get active.

Personal trainers understand this basic human frailty when it comes to working out and staying healthy. As a result, a number of techniques are commonly used to keep folks engaged and actively working on their fitness goals. Finding a workout buddy, journaling your workouts, and setting goals and rewarding your accomplishments all work to motivate and activate.

Accountability is Key

These same strategies work in Chronic Care Management as well. And it all boils down to accountability. CMS recognizes the value of accountability and incentives. As our healthcare transitions to value based outcomes, the healthcare industry will benefit by utilizing many of the same strategies used in the weight management and fitness industry. The workout buddy becomes a Care Coordinator. Journaling workouts becomes journaling biometrics. Setting goals and monitoring progress becomes a Care Plan. And finally, the incentives and rewards become value based outcomes.

In this new model of healthcare, everyone wins, even physicians. CMS recently released the new CTP code 99490 that provides a financial incentive for physicians to take care of comorbidity patients outside of traditional office visits. The new code allows payment at an average of $40 per beneficiary per month for services performed for Medicare beneficiaries. The practice must implement an ongoing care plan and a clinical staff member must spend at least 20 minutes during a calendar month coordinating care and communicating with the patient.

Moving Forward

West Healthcare Practice has several tools and services available to help physicians and clinics take advantage of the new CMS reimbursement – like our technology enabled communications, automated notifications and case management tools, and supplemental services that make a difference. In whatever way you move forward, look for providers and partners with the right combination of capabilities, vision and experience that will help you employ meaningful strategies regarding Chronic Care Management and CPT 99490.

West Corporation

Posted on by West Corporation 

Challenges of Chronic Care Management Factored into CPT Code

Half of all American adults — about 117 million people—suffer from one or more chronic health conditions. Indeed, seven of the top 10 causes of death in the U.S. today are a result of chronic conditions like Diabetes, Alzheimer’s and Cardiovascular disease. As a result, Chronic Care Management (CCM) has taken the spotlight in the healthcare industry and new Medicare payment guidelines reflect the new focus on CCM.

CPT Code 99490

The Centers for Medicare and Medicaid Services (CMS) recognize CCM as a critical component of primary care that contributes to better patient health while reducing healthcare costs overall. So beginning in January 2015, CMS established CPT code 99490 as an incentive to foster CCM and to help cover the costs of chronic care management. The new code allows payment at an average of ~$40 per beneficiary per month for services performed for Medicare beneficiaries.

The good news is that CPT 99490 will significantly broaden Medicare payments for remote patient monitoring of chronic conditions. In order to be eligible the patient must have two or more significant chronic problems that pose a real risk to the patient’s health and well-being. The practice must implement an ongoing care plan that addresses these conditions, and a clinical staff member must spend at least 20 minutes during a calendar month coordinating care and communicating with the patient.

Historically, Medicare has provided limited coverage for this type of service and the new code could result in a profitable advantage for providers, especially smaller physician practices and / or community-based facilities that work with chronically ill patients. These providers now have a financial incentive to promote CCM among their constituents and to retain "control" over those patients; once they refer on to an enterprise healthcare system they stand to potentially lose control as the PCP.

But there is some bad news, too, which is that CPT 99490 may unwittingly provide a disincentive for larger enterprise healthcare organizations when it comes to CCM. Most hospitals and clinics are considered a “facility” and, therefore, are not eligible for payment under the new code. Complex billing systems can work around the red tape but it’s a nightmare to administer. The fact that many physicians are actually paid employees of the enterprise works to cloud the administrative waters even further. The truth is that it would be more profitable for these larger organizations to simply release the patient and readmit if/when the condition recurs.

Moving Forward

If your practice is a direct, patient-centered practice that is already providing case management for a group of chronically ill patients, you are in a great position to benefit from the new CPT 99490 code.

It will take more time to sort out the implications of the new code for larger enterprise organizations, however; and more thoughtful and technology-enabled strategies will be needed in order to use the code advantageously. In the meantime, look for providers and partners with the right combination of technologies, capabilities, vision and experience that will help you employ meaningful strategies regarding Chronic Care Management and CPT 99490.

West Corporation

Posted on by West Corporation 

Helping Patients Graduate to Good Health

With high school graduation season in full swing, many seniors are turning their attention to college. While most college freshman successfully make the transition, nearly a third don’t—many of those return home and create a sometimes stressful and financially burdensome situation for the family. Those students who fail to make the leap to college often underestimate the transition or don’t receive the right support to get there.

Making the Transition

Transitioning from high school to college is not unlike medical transitions of care. When patients are discharged from the hospital or other institutional setting, many handle the transition to self-care just fine. But one in five underestimate the transition and are readmitted within 30 days of discharge. For them, making the change from an environment where medications and meals are administered on schedule and visiting hours are structured around rest and recovery proves too difficult. Medication errors, missed follow-up appointments and gaps in self-care are all major contributors to readmission and higher costs.

Improved Transition Care Management

Readmission rates highlight the opportunity to improve the quality and effectiveness of Transition Care Management and reduce the cost of avoidable readmissions. One way to do that is to simply do more patient outreach after discharge. But that is not always easy, and only fairly recently has there been a financial incentive to do so. In October,2012, Medicare introduced “the stick” by levying hospital readmission penalties. Then, in January, 2013, Medicare applied “the carrot” by offering reimbursements to providers for eligible Transition Care Management services (in the range of $172.66 to $243.60) billed under CPT codes 99495 and 99496. And still, relatively few provider organizations are capitalizing on it.

Many practices lack the resources to perform even the most rudimentary transitional care activities. But over the last 24 months, companies like West have recognized the need in the market and are working hard to deliver solutions that combine patient engagement technology with the human touch to enable providers and their networks to quickly and cost-effectively deliver more robust transitional care services.

Incentives to Improve

With CMS expected to spend well over $1 billion annually on Transitional Care Management payments, the potential up-side incentive for providers working to improve transitional care is significant. But the downside for those who do not is also very real. CMS is ratcheting up readmission penalties to 3% of payments this year and organizations are finding it increasingly difficult to ignore the call.

If you’re the parent of a graduating senior attending college this fall, best of luck in this exciting time of transition! If you’re also responsible for the successful transition of patients from one setting to another, you have your hands full, but perhaps there’s more help out there than you thought. Click here to learn more about West Engagement Center solutions which are focused on patient engagement and activation.

West Corporation

Posted on April 10, 2015 by West Corporation 

Providers Accelerate Patient Engagement with West Corporation

While much of healthcare reform involves providers and other organizations within the sector improving upon what they’ve been doing for quite a long time, there’s one aspect of reform that could be considered new: patient engagement.

That might seem strange to say, given that doctors and patients have been “engaging” for years, but in many ways “patient engagement” as it’s currently understood means something very different from what it’s usually meant in the past.  Specifically, healthcare organizations are now being called upon to incorporate into their businesses the “customer service” thinking that has long been a staple of other sectors of the economy.

As Laura Bramschreiber, vice president of marketing strategy for West Healthcare, summed it up recently, “Healthcare organizations are realizing that in order to succeed, they need their patients to do the right thing.  Come to the doctor.  Take their meds.  Do the things that promote health and well-being. Their success, then, involves activating and engaging patients across the continuum of care and beyond the four walls of the healthcare organization.”

With more than 25 years of customer engagement experience in sectors as divergent as financial services and travel, to name just a couple, West has identified four critical areas where the company believes it can help healthcare organizations meet the complex communications challenges involved in getting the new patient-consumer engaged.

Patient Access Center
“The contact, or access, center is the front door to many healthcare organizations,” Bramschreiber observed.  “The problem, however, is that many contact centers operate on platforms and technologies that reflect an old school approach to patient engagement.”  Among other things, she continued, this can mean that there are multiple 800 numbers and access points, and “it’s not uncommon for callers to be repeatedly transferred, boomeranged from one access point to another, and then finally lost in the shuffle.”

A problem that can require both technological and organizational/cultural solutions, Bramschreiber said West is bringing its customer service and contact center modernization background to bear helping healthcare organizations figure out what needs to be put in place.

Routine Care Management
Of course, patient engagement means much more than just smoothing the way for an initial contact.  It’s about understanding where patients are on the care continuum and driving outreach, in their channel of choice, to drive desired behaviors. Whether its ensuring immunizations and screenings are current or providing greater levels of support around smoking cessation, keeping healthy patients healthy, deepening patient relationships and proactively capturing revenue opportunities are key goals. Bramschreiber says that many providers simply lack the means to do effective outreach and this is an important focus and application of West’s technologies.

Transition Care Management
As Bramschreiber describes it, this solution area is “all about keeping patients from going back into the hospital during that critical 30-day post-discharge timeframe.”  To that end, West helps providers manage patient transitions of care beginning as early after discharge as possible. In view of the potential impact on penalties and reimbursements, Bramschreiber said West has seen a significant increase in “people thinking, ‘How do I more effectively manage transitions of care?’”  To that end, West designs patient-centered programs, focused specifically on the first 30 days, that leverage a combination of technology enabled communication and clinical resources to monitor key aspects of post-discharge care such as patient medications, ensuring necessary follow up care is received and detecting possible complicating issues as soon as possible.

Chronic Care Management
Another area where West’s recent expansion of its clinical resources is having an impact revolves around chronic care.  “Many transition of care patients end up in chronic care programs,” Bramschreiber said, “so in this area we focus more on longer-term and continuous engagement of patients.”  She said specific services can include applying remote tele-monitoring and leveraging outsourced clinical resources to help manage follow-up care and lab needs, while adding scale and capacity to their in-house care coordinators.

West Corporation

Posted on October 28, 2014 by West Corporation 

Exploring The Care Coordinator’s Dilemma

Nurse care coordinators are a special breed, with many choosing the profession out of the desire for greater patient intimacy and the chance to spend more time educating and coaching patients toward a path of a healthier, happier life. In the new era of accountable care, where patients will take greater ownership of their health, the kind of patient advocacy that care coordinators bring to the table is just what the doctor ordered.

But in the wake of accountable care, the care coordinator’s role has become less proactive patient coach and more reactive administrator. Increases in nurse-to-patient ratios, more panels of chronically ill patients, and steady cost pressures are giving many care coordinators pause as they slide down the ladder and operate at ever-lower rungs of their license.

The typical care coordinator’s day is consumed with responding to alerts they’ve set up to manage their most critical patients and there’s only time for broad-brush education, like the “watch your diet” variety. If accountable care is truly about getting patients to take greater ownership, the dosage of intimacy and advocacy should be increased, not decreased.

So how can we help solve the care coordinator’s dilemma?

This is the question the Vanderbilt University Medical Center (VUMC), in partnership with West Corporation and West Health, is solving today.  On the heels of its CMS Innovation Award, VUMC embarked on an innovative, technology-driven project with West with three goals:

  1. Increase care coordination efficiency
  2. Raise the number of patients receiving services
  3. Enable care coordinators to spend more valuable time with patients

The approach? Technology-enabled care applications that offload care coordinators with automated interactions that empower and activate patients, as demonstrated in this video. Sure, communication like automated phone calls to patients to remind them of their appointments, or two-way SMS messages to collect blood pressure and other readings, may seem simple and obvious at first blush. But it is what’s under the covers that VUMC and West believe could represent the future of care coordination in particular, and population health management in general.

Envisioned is a sophisticated coordinated care management protocol engine that combines evidence-based medical guidelines with automated workflows and patient outreach. Think of it as a “clinical brain” with multi-modal communication capabilities.  The whole process will not only free care coordinators and their counterparts from the monotony of administrative, low-value tasks, but smarter, protocol driven patient communication will reduce practice variation and improve the quality of care and lower the cost of delivering care overall.

If you are a provider, how are you solving the care coordinator’s dilemma?