Humana Cares recently launched a pilot project aimed at better care for members with congestive heart failure. The project employs the Intel Health Guide, a home monitoring technology that Humana Cares has deployed to 2,000 members with congestive heart failure.
[See: Humana launches congestive heart failure pilot.]
Humana Cares, a division of health insurer Humana, opened in St. Petersburg, Fla. in February 2009 to implement chronic condition management programs Today, the division employs more than 800 associates who provide integrated complex and chronic care management for about 123,000 Humana members across the country.
Kate Barnes heads the congestive heart failure pilot. She spoke with Healthcare IT News about the benefits, the challenges, and the anticipated outcomes.
Why has Humana decided to participate in this pilot?
Humana Cares is an organization that provides chronic condition care and complex care management to a select membership of Humana – those folks who have more chronic conditions. The model that we use is that we have a nurse who establishes a relationship with a member over time. The nurse calls the member at least once a month, assesses the member's condition and then intervenes with anything from helping the member get medication, setting them up with community resources throughout the country. We also work as a team, so we have our social worker or nurse who may be located in the member's state or city that can visit the member's home, do a safety evaluation, and do an evaluation of the member's diet, help them choose good food. We also have what we call a community health educator who is someone who works with finding the resources and following up with the nurse and the social worker.
What about the Intel Health Guide component?
Humana Cares partnered with Intel to work with our congestive heart failure members to really determine whether we could decrease admissions and re-admissions for this population. They are high-cost, high-admission type populations that need a lot of care and really benefit from learning how to manage their condition in there home. So the added element of working with the Intel Health Guide and telehealth is that we have actionable data at the fingertips of the nurses. Members take their blood pressure and weigh themselves daily and that information is then securely transmitted via either the telephone line or an Internet connection to a web-based interface where the nurse can view the data. Customized settings for each member can be set. If the member's data is within the expected limits for them, no action occurs. If the readings are outside of what's expected, the nurse responds by calling up the member to perform an evaluation.
[See also: Global market for telehealth tech on upswing.]
Are the members receptive to the new technology?
The videoconferencing is a really nice component to be able to reach out to the member. The member and the nurse feel even more connected than they do telephonically. The nurse can see the member, and they can see if the member is short of breath, if there are any changes in their color and they really have another level of interaction with that member.
What will be most challenging at the start?
I think if anything it's challenging for the members because it's a new component in their life. It's set up so the guide reminds the members once a day at the same time (via an audible and visual alarm) to begin their session. But once they get use to it, they really like it. They like having that connection with their nurse. The session can be customized by Humana Cares. We can determine the content of the session. Generally, we'll ask them how they're feeling. We'll ask them if they've taken all their medication in the past 24 hours. We ask them to take their weight and their blood pressure.
How much information do you gather from the member?
It's a branching technology, so if you step on the scale and your weight is three pounds greater than expected, it will ask if you are having any of these symptoms – are you short of breath, are you noticing any swelling in your extremities? And, then it can offer up a video at that time on sudden weight gain. So the member, at the point in their life where they're experiencing the condition, they're able to get some real-time education on it. We find that members are more ready to listen at that time than they might be if somebody is just sharing genetic information about their condition because they're really experiencing it. They went out for Chinese food last night. They get on the scale. They see that their weight is up. They see the relationship between a high sodium diet and how it really affects their condition. And now they are ready to listen.
What are some other benefits?
We have set up the device in rural areas already, and it's really nice for those members who have limited transportation who may find it difficult to get to their physician office two hours away to have the ability to be monitored. We work closely with the physician and the member to support the member's treatment plan. We provide reports to the physicians. We'll fax them over before the member shows up for their appointment, so they can see exactly what the measurements have been over the last month. They can see what's happened since the member's last visit.
What are the cost savings?
As part of a pilot, we are looking at what the outcomes will be and that's the kind of information we'll be collecting. We're expecting results consistent with the overall experience with Humana Cares, which is lower hospital re-admission, shorter length of stay, fewer ER visits and significantly reduced medical claims expenses.
When will you decide whether to expand this as a model for use in managing other chronic diseases?
We will work with this first group of members for six months. It takes a good three months to get a handle on claims data for these members. So it will be anywhere from nine months to a year after we pilot to have some really good data to understand if we're going to expand.