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Technology From The Health Plan Perspective: Innovation Health’s Implications in Technology on Healthcare
Sunil Budhrani, MD, MPH, MBA
Chief Medical Officer/CMIO Oct 22-24, 2018
Innovation HealthAn Aetna-Inova Joint Venture
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Sunil Budhrani
University of Pennsylvania
George Washington University School of
Public Health
George Washington University School of Medicine
Tufts/Baystate Medical Center
University of Baltimore
Chairman, Dept. of
Emergency Medicine
Independent Healthcare Consultant
PrimeMedUrgent Care
Systems
Evergreen Health
Cooperative Insurance
Fort Belvoir Community
Hospital
CareClixTelemedicine
Innovation Health
1995 1999 1999 2002 2003 2004 2007 2012 2012 2013 2013 2016
As leaders in healthcare, we are redefining the future through:
• Innovation in technology• Information sharing• Advanced healthcare delivery systems • Aligned incentives
Our unique partnership allows us to deliver better health and an improved healthcare experience at an affordable price.
The Innovation Health Vision
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Improved Care, Cost and Quality
A Unique Collaboration
The Aetna and Inova partnership combines
longstanding
local, regional and national experience to help
improve health care costs and quality.
Aetna provides:
‣ Health plan administration services‣ A broad, national network‣ Sophisticated data analytics ‣ Care management services
Inova and it’s partners provides:
‣ Integrated and coordinated patient care‣ Market-leading unit costs available only to
Innovation Health customers‣ Nationally recognized hospitals and physicians
INNOVATION HEALTH PARTNERSHIP
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Innovation Health Collaborations and Innovations
AbleTo
•Behavioral Health and chronic disease management
•Program training for all CM groups, GMIG and IMG practices with embedded behavioral health
Apple
•Mobility study and completed enrollment 30 members
CHF
•Evaluate the clinical efficacy of a Tele-monitoring System to improve CHF treatment and management.
ER/Inpatient Flagging Program
•Flagging system in EMR for IH members when acute event occurs (ED, inpatient)
•Validate savings calculation and opportunity size
Clinical Platform
•Real-time Aggregation of Member Claims and EMR data
•Data Analytics and Outcomes measurements to identify Care Gaps and Quality Metrics
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Innovation Health Collaborations and Innovations
Pharmacogenetics
• Pharmacogenomics testing to determine correct medication selection for select behavioral health drugs
• Modify medication regimen of this population to improve medication adherence, compliance, and reduce unnecessary cost of care
Sanofi Diabetes
• Evaluate the clinical efficacy of a technology monitoring system to improve diabetes treatment, management and medication adherence/dosing.
• IRB study and prospective study approved
Telemedicine
• Telemedicine Pilot for Chronic Disease (diabetes, HTN and depression)
• Using EMR for platform to provide real-time video encounters
IH Mobile Application
• Single member facing portal for doctor identification, symptom assessment, claims review, and care management navigation
Bluetooth technology will share patient’s compliance with health professionalsHow It Works•Blue Cap technology linked to Bluetooth to assess accuracy in medication administration
•Services will be personalized, leverage technology, and education will be provided as needed or requested
•Analytics leveraged to provide•Personalized patient support
•Digital therapeutic intervention
Optimize medication administration and adherence for behavioral improvementOutcomes•Medication adherence
•Benefit of insulin over oral antidiabetic agents
•Patient use of Tele-monitoring devices
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Innovation Health-Sanofi-Healthagen Collaboration
Technology Monitoring System to Improve Diabetes Treatment
Objectives of Sanofi Collaboration
1. Retrospectively characterize the Innovation Health Type 2 diabetic (T2DM) population in order to identify significant opportunities to improve
glycemic control
2. Prospectively study the impact of analytics, specific diabetes technology tools and personalized patient/caregiver support to improve
self-care, medication adherence and glycemic outcomes
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Innovation Health-Sanofi-Healthagen Collaboration
Inception Expansion Growth Scalability
Exist within Aetna and Sanofi ecosystem
Expansion of similar studies geographically amongst accountable
care organizations and joint ventures
Collaboration with other pharmaceuticals/ health industries utilizing similar
workflow and partner dynamics
Integration of current systems to facilitate scale
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Innovation Health-Sanofi-Healthagen Collaboration
National Press Release and Response
Prevalence of type 2 diabetes (T2DM) is rising in the U.S. population Project
Overview
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Digital Diabetic Therapeutic Initiative
• Patients are not following their drug regimen
• Patients are not being educated or informed about their conditions and the long term consequences
Management and treatment adherence fall short of evidence-
based optimal
• Glycemic control
• Micro- and macro-vascular complications
Substantial opportunity to improve outcomes
• What to do, how to do it, confident one can do it
• Performance is tracked and quantified
• The individual can continue in the safe zone or take corrective action Utilize Patient Activation
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Intervention Programs
Two interventions will be implemented
OneDrop
• Cloud-connected glucose self-monitoring device that measures, stores, transmits, and trends blood glucose information.
Gocap
• Monitors and shares eligible injection pen use.
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Nurse Concierge Program
Patient is discharged with follow-up instructions and
nurse concierge information attached
Innovation Health receives flag of patient discharged
Nurse concierge provides proactive outreach to
member
Inbound program allows for patient to outreach or
contact us
Nurse concierge will assess the member’s need for
specialty programs
Nurse will provide pharmacy
education/adherence and allow for general
questions to be asked
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Emergency Department Discharge
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PharmacogeneticsDrug-gene Testing
Outcomes
•Determines whether a medication could be an effective treatment for you
•Unveils side effects of medication specific to your genetic code
How It Works
•Saliva sample is taken
•Screening will look at 61+ drugs with focus on psychiatric drugs
•Application to the Innovation Health Behavioral Health population
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Congestive Heart Failure-Remote Patient MonitoringTelehealth Initiative Providing Remote Monitoring to Improve Treatment and Management
Technology vendor shares patient’s compliance with
health professionals.
Tools will measure vitals manually and with
integrated Bluetooth devices (scale, blood
pressure, activity monitor, etc.)
Provide professional caregivers with monitoring capabilities and dashboard leveraging technology to
automate and extend caregivers reach and
effectiveness
System walk through and training will be provided
Medication Adherence
Patient Surveying
Composite Outcomes (Reduced or
eliminated length of stay for ER visits, observation stays, and inpatient CHR
related issues)
Decrease in required
face to face visits
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Opportunities
Exchange of Information between electronic medical
record and claims data
Subject matter experts represent multiple health industries
• Pharmaceutical, Hospital, Insurance, Health System
Comprehensive Data Analytics
Integration of care and leap to value based
care
