insurance patient health coordination clickmedix 2015
TRANSCRIPT
ClickMedix
Right care, at the right time, to improve population health outcomes while lowering costs.
Ting Shih - Founder & CEO ([email protected])
Ms Jodi Lyons – Healthcare Advisor
Dr Andrew Pumerantz – Medical Advisor
http://clickmedix.com
Problem: Patients don’t know how to navigate the complex healthcare system – when to get what care and why
Health Complications
PharmacyGym /
Wellness Programs
Nutrition
Psychiatrist
Currently: Longitudinal Healthcare Tools Are Insufficient Across Fragmented Services
Patients have to navigate care pathways across multiple providers and health services in multiple geographic sites and a variety of health record charting (electronic and paper)
Average patient with multimorbidity has 11 providers
Fax is the predominant method of referring patients amongst providers
In the ideal world, navigating the healthcare system to find the right care should be as easy as navigating with a GPS
How it Works: Guided Patient Journey
DiscoveryI don’t feel well
Easy to UnderstandAt-a-glance health status and guided pathway to
get better
Increase AdherenceGuidance and support
through treatment planSee Results
Measure ImpactPatient perspective
Company perspectivePhysician perspective
Self assessment or facilitated
1<7.0(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70 with
CVD
No Symptom
s & No Structural
Heart Disease
At risk; chronic cough, sputum
production; normal spirometr
y
NoNephropa
thy
NoRetinopat
hy
No Dental Infection
No Neuropath
y&
No PAD
18.5-24.9
No Depressi
onPHQ-9 score 0
2
7.0-7.9(53-63
mmol/mol)
SBP 130-139
DBP < 90101-130
No Symptom
s & +Structural Heart Disease
GOLD 1 or 2
& 0-1 exacerbations/yr &
mMRC 0-1 &
CAT<10
Albuminuria
30-299 mg/g
Non- Proliferati
veMild
Mild Gingival
Inflammation
Neuropathy 25-29.9
Minimal Depressi
onPHQ-9
score 1-4
38.0-8.9(64-74
mmol/mol)
SBP 140-149
DBP < 90131-160
Symptomatic&+
Structural Heart
Disease
GOLD 1 or 2 & 0-1
exacerbations/yr &
mMRC ≥2 &
CAT≥10
Albuminuria
300-999or
eGFR 30- 60
Non-Proliferati
veModerate
Moderate Gingival
Inflammation
+PAD&
+/-Neuropath
y
30-34.9
Mild Depressi
onPHQ-9
score 5-9
4
9.0-9.9(75-85
mmol/mol)
SBP <150DBP 90-
99161-190
Symptomaticw/
Heart Failure
GOLD 3 or 4
& ≥2 exacerbations/yr &
mMRC 0-1 &
CAT<10
Albuminuria
1000-2999or
eGFR 15-29
Non-Proliferati
veSevere/ Inactive
Proliferative
Severe Gingival
Inflammation
+ Ulcer History 35-39.9
Moderate
Depression
PHQ-9 score 10-
14
5
> 10.0(≥86
mmol/mol)
SBP > 150 -or-
DBP > 100
>191Refractory Heart Failure
GOLD 3 or 4
& ≥2 exacerbations/yr &
mMRC ≥2 &
CAT≥10
Albuminuria
>3,000or
eGFR ≤15
Active Proliferati
ve
Acute Dental
Infection
Previous Amputatio
n
≥40 or <18.5
Severe Depressi
onPHQ-9 score ≥15
Patient Receives Health Score Card, along with Care Plans and Service Referrals
BMI
1<7.0(<53
mmol/mol)
SBP < 130
DBP < 80
<100 or <70 with
CVD
No Symptom
s & No Structural
Heart Disease
At risk; chronic cough, sputum
production; normal spirometr
y
NoNephropa
thy
NoRetinopat
hy
No Dental Infection
No Neuropath
y&
No PAD
18.5-24.9
No Depressi
onPHQ-9 score 0
2
7.0-7.9(53-63
mmol/mol)
SBP 130-139
DBP < 90101-130
No Symptom
s & +Structural Heart Disease
GOLD 1 or 2
& 0-1 exacerbations/yr &
mMRC 0-1 &
CAT<10
Albuminuria
30-299 mg/g
Non- Proliferati
veMild
Mild Gingival
Inflammation
Neuropathy 25-29.9
Minimal Depressi
onPHQ-9
score 1-4
38.0-8.9(64-74
mmol/mol)
SBP 140-149
DBP < 90131-160
Symptomatic&+
Structural Heart
Disease
GOLD 1 or 2 & 0-1
exacerbations/yr &
mMRC ≥2 &
CAT≥10
Albuminuria
300-999or
eGFR 30- 60
Non-Proliferati
veModerate
Moderate Gingival
Inflammation
+PAD&
+/-Neuropath
y
30-34.9
Mild Depressi
onPHQ-9
score 5-9
4
9.0-9.9(75-85
mmol/mol)
SBP <150DBP 90-
99161-190
Symptomaticw/
Heart Failure
GOLD 3 or 4
& ≥2 exacerbations/yr &
mMRC 0-1 &
CAT<10
Albuminuria
1000-2999or
eGFR 15-29
Non-Proliferati
veSevere/ Inactive
Proliferative
Severe Gingival
Inflammation
+ Ulcer History 35-39.9
Moderate
Depression
PHQ-9 score 10-
14
5
> 10.0(≥86
mmol/mol)
SBP > 150 -or-
DBP > 100
>191Refractory Heart Failure
GOLD 3 or 4
& ≥2 exacerbations/yr &
mMRC ≥2 &
CAT≥10
Albuminuria
>3,000or
eGFR ≤15
Active Proliferati
ve
Acute Dental
Infection
Previous Amputatio
n
≥40 or <18.5
Severe Depressi
onPHQ-9 score ≥15
Patient Follows a Care Plan and Improves Their Health Metrics and Score Card
BMI
Live-Action Care Coordination Across Health System
Collaboration with Insurers
• Enhance patient experienceo Single-point of contact to guide patient through care (via technology
or coordinator)
o Increase treatment adherence
o Increase ability to self-manage
o Provide longitudinal healthcare data to improve health outcomes
• Demonstrate ROIo Increased workforce productivity
o Decrease use of unnecessary ER visits
o Correlate payments to patient outcomes
Care Coordinators
, Patients, Providers
Easy, One-Click Interface Tailored to User Needs
Mobile Applications to Enable Patients to Fill Out Self Assessments
Mobile Applications to Enable Patients to Fill Out Self Assessments
Easily Capture Comprehensive Data for Remote Management by Specialists Via Mobile DevicesEasily Capture Comprehensive Data for Remote Management by Specialists Via Mobile Devices
Consumer Medication Adherence Tracking (any language)
Medical Experts
Hub
Phar-macie
s
Clinics
Homes
Phar-macie
s
Clinics
Homes
Phar-macie
s
Homes
Clinics
Payers &
Third-Party Data
Systems
BMI
Aggregate Real-Time Population Health Data While Guiding Each Patient through the Optimal Care Pathway