Outcomes Data

1. LOWER READMISSIONS2. LESS ER USE3. SATISFACTION

• Patient• Staff

4. IMPROVED BIOMETRICS• Diabetes• Blood Pressure• Weight Loss

5. BEHAVIOR CHANGE6. STAFF PRODUCTIVITY7. COST SAVINGS

Seven parameters tested in Care Kit studies to date

Statistical reliability: The probability that the results were due to chance is less than 1%An improvement greater than 15%. The American Society of Quality Control says this level of change is breakthrough innovationA validated measurement. When you measure one way, then measure another way and get the same result, your initial measurement is valid.Success where others have failed. If you achieve results where national authorities say results are hardest to achieve

What Makes an Outcome Compelling?

Results are replicated. When you not only do it once, but over and over and over and over and…

>99%

>15%

✔

On the outcomes report slides that

follow, watch for a Ribbon Symbol

to see which of these 5 reasons

make that outcome

compelling

95%

0

7.4%

BEFORE: Vitas Medical Center NJ had used books from the American Lung Association, so clinical accuracy was assured.

WITH CARE KITS: Distributing the Care Kits, with no other changes or interventions, •More than doubled adherence•Eliminated readmissions•Reduced ER use by 72%

Persistence 6 mo 44%

Readmissions 16%

Use of the ER 26%

Asthma Care Kits aloneEliminated Readmissions

BEFORE AFTER

EVIDENCE that CLINCAL ACCURACY by itself is not adequate

for effective PATIENT

COMMUNICATION

The probability that the outcome was chance is less than 1%. That means if you adopt Care Kits, it’s 99% likely you’ll see comparable results See Appendix for calculations

>99%

• Data collected from each group at 6 months• Study designed & conducted by hospital staff

BEFORE: Northwest Community Medical Center had failed to change behavior with a year-long Disease Management program

Heart Failure Care Kits Changed Behavior

Weighing Daily

Taking Blood Pressure

Medication Compliance

27%

14%

77%

86%

14% 59%

BEFORE AFTER IMPROVEMENT

514%

321%

185%

EVIDENCE: CARE KITS ARE

MORE EFFECTIVE AT ENGAGEMENT

BEFORE AFTER

The probability that the outcome was chance is less than 1%. That means if you adopt Care Kits, it’s 99% likely you’ll see comparable results See Appendix for calculations

>99%

J Reeves, MD Director Nevada State QIO

J Ambulatory Care ManagementV36, No. 2, pp. 108-120 March 2013

Multiple Conditions in a Medical Home Care Kits saved $1.5 million

TOTAL MEDICAL COST

Blood pressure Cholesterol Blood sugar

Emergency Room visits

In-hospital days

Health Plan net savings exceeded $56 PMPM $1.5 million / 1000 members

Member savings = 30% lower out-of-pocket cost than the alternate PPO plan

54%

“Breakthrough Innovation” says the American Society for Quality

>15%

712 participants 24 months

85% better scores

23% lower

16% fewer visits

Imaging services 35% lower use

fewer days

COMPARED TO BASELINE YEAR

Prescription cost per member 18% lower cost

Discharge Teaching Time Care Kits Improve Quality & Productivity

144% improvement in standardization

of time spent at discharge

“Breakthrough Innovation” says the American Society for Quality

>15%

Care Kits

Care Kits

Care Kits

BEFORE AFTER

17%

0% 0%

92%

ER Returns Readmissions in less than 31 days

After Prostate Surgery Care Kits eliminated ER Returns and ReadmitsControl and Intervention Groups were concurrent

BEFORE AFTER

in less than 31 daysSt. Joseph Mercy HospitalAnn Arbor Michigan

“Breakthrough Innovation” says the American Society for Quality

>15%

TIME OUT!

“These results are not credible. They’re too good.” “There must be flaws in the study designs.”

Communication Science researchers shadow hundreds of patients at home, in the workplace and around the community. For each condition, they find the problem preventing adherence and they fix it just as the consumer products industry has done for decades. Observational research increases consumer products sales by giant proportions. Why not health care?

The model for fixing adherence is not clinical, where a new treatment may improve a condition by a small percentage.The model is mechanical, where you take a broken machine to the mechanics and they fix it.

But let’s not argue. Set up your own study for Care Kits. See for yourself, on your own terms

AFTER BEFORE

XX CSI

Over 140/90 88%

Below 140/80 12%

Employer Wellness Initiative: Prior year home visit program had failed

Home visit outcome: 12% in controlCare Kit outcome: 88% in control

All readings confirmed at clinic after six months

6%

88%

Hypertension Care Kits

performed 6 X better than face-to-face visits

Results were measured one way, then confirmed by measuring a different way = valid results

✔

We took them on in South Carolina using outcomes analysis software

CMS: “Truckers are the most difficult employee group to effect behavior change.”

Multiple Conditions Care Kits are the first to achieve ROI with Truckers

Return on InvestmentFor every $1 the trucking company invested, they received $1.79 in savings

--to our knowledge, the first successful trucker health intervention

Success exceeding levels previously achieved by all others

Diabetes Care Kits could

serve well as curriculum for classes

P= 97%

CARE KITCLASSES

9.3 8.7

New York City

Cleveland, OH Readmissions

in 30 days 10.4% <1%

9.6% 5.9%Emergency in 30 days

Head-to-Head with Diabetic Education Classes

CARE KITCLASSES

Impact after three months

A1c Score

Care Kits were >90% better at preventing readmits

39% better at preventing ER returns

Care Kits brought down A1C numbersafter classes had not impacted population

Success exceeding levels previously achieved by all others

Success exceeding levels previously achieved by all others

Patient Satisfaction Care Kitsachieved 33% higher scores “Were you satisfied with the materials for self care?” “Did they help you manage your condition?”

Hypertension

Yes – 94.9% No – 2.9%

Diabetes

Yes – 93.6% No – 6.4%

CAD

Yes –100%University of Pittsburgh Health Plan

Press-Ganey national 5-year average = 72%Care Kit UPMC 5-year average = 96%

Heart Failure

Yes – 97.3% No – 1.8%  Asthma

Yes – 92.5% No – 2.5% 

AMA said getting >33% of the population to comprehend = impossible

154 Patients from Orthopedic and Abdominal Surgery Nurses called one week after discharge, “Were you able to follow your instructions without asking anyone for help or calling back the doctor or the hospital?”

Before Care Kits

After Care Kits

“How satisfied were you with discharge?”

Before Care Kits

After Care Kits

35%100%

92%

4%

RUSH Medical Center “Patient Satisfaction”

Hospital Peer Review Journal September 2000

Post Surgical Dressings Care Kits outperformed Education Committee

Success exceeding levels previously achieved by all others

St. Joseph, Lexington KY

St. Joseph, Elgin IL

NWC, Arlington Hts. ILDRG 127 ONLY

NWC, Arlington Hts. ILALL CHF-RELATED DRGs

Aurora, Milwaukee WI

Great Plains, Elk City OK

Mercy Hospital, Chicago

VA, Ann Arbor MI

BEFORE AFTER REDUCED BY

6.4% 4.0% 38%

16.7% 7.7% 54%

13.2% 8.7% 34%

22.2% 6.3% 72%

8.6% 2.2% 73%

23.4% 6.9% 74%

>28% 0% 100%

90 daysThompson-Reuters Statistical Analysis

Heart Failure Care Kits Reduce or Eliminate Readmissions

58.2% 35.5% 39%

30 days

60 days

When you achieve outcomes over and over and over and over again

Summary: Compelling ResultsStatistical Reliability

Breakthrough Innovation

Validated Measurement

Exceeded authorities’ threshholds

for success

We have achieved >99% reliability in Diabetes, Hypertension, HF, Asthma, Post-Surgery, et.al.Our worst performance, 34% = more than

double the “breakthrough” definition. Many outcomes >70%, even 100%

Self-reported confirmed by clinic measurement Self-reported confirmed by software analysis Self-reported confirmed by Thompson-ReutersCMS: Truckers most resistant; achieved ROI

National average 72%; Care Kit average 96%

AMA prediction = 66%; Care Kit result = 92%

“If you were a drug, you’d be approved”--F. I. Orkin, former Corporate Director of Quality and Regulatory, Baxter Healthcare

Replicated Results Dozens of studies, all with breakthrough results

>99%

>15%

✔

√

READMISSIONS

P >99%

USE OF THE ER

Appendix: Statistical Reliability

P >99%

P >99%

PERSISTENCE at 6 MONTHS

As many times as you repeat a study, statistics says 99% of the outcomes will fall within + or – 3 standard deviations of the initial result. The chance of a result outside ±3Σ is less than 1%

1550 Barclay BoulevardBuffalo Grove IL 60089847-850-7500www.carekit.com

Michael Weiss President

Shirley Grey RN MSN VP Health Plans

Carol Outland RN MSN VP Home Care

Judith Farah Director of Operations

Sylvia Aruffo PhD Chief Content Officer

7.10.13