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Connecting Digital Care to the Heart of Care Management

One of the keys to health care transformation is meaningful, goal-oriented connection between care managers and the people they support. A care manager is like a quarterback, working closely with high-risk patients to help call the right play at the right time. Regular interaction with a care manager helps consumers manage their conditions and avoid complications that could lead to an ER visit or hospital admission.

But people lead their lives between phone calls and clinical visits. They have different motivations, distractions and goals. And ultimately, they want to quarterback their own care. So what would happen if we could connect the expertise and guidance of a care manager with a consumer’s own efforts to manage her health?

Cynthia’s Story

We call this connection Aetna MyPulseSM. Aetna MyPulse links health data, online tools and live nurse support to drive meaningful connections that improve health care outcomes and reduce costs. 
 
Let’s take a look at how this might work for Cynthia*. Cynthia is a 52-year-old single mother with type 2 diabetes. Her stress level goes through the roof at times, due to her busy work schedule and caregiving responsibilities. Cynthia hasn’t always been able to stay on track with her medications. She signed up for an online stress management program with the best intentions, but is only able to interact with it when she feels like has time to step back and invest in herself.
 
Bridging the Gap to Revolutionize Care Management 
One day, Cynthia gets dizzy and ends up in the ER. When she is discharged, her clinical and claims data are immediately sent to the Aetna Care Management platform, and her Personal Health Record. The update triggers an alert to Sara, an Aetna nurse. 
 
Aetna MyPulse connects Sara’s nurse dashboard to all of Cynthia’s online program activities and health information. So Sara knows that managing stress is a key concern for Cynthia before she even picks up the phone. She also is able to learn from the pattern of Cynthia’s activity that while she would like to better manage her stress and her health, there are a lot of things that get in her way.
 
When Sara calls Cynthia, they have a shared knowledge of Cynthia’s priorities and how she wants to manage both her stress and her diabetes. Together they set new priorities, including resuming the online stress management program. Sara stays in touch to check on Cynthia’s progress and even sends tips and reminders to her health dashboard. She suggests that digital visits with a provider might be a good option in the future vs. the ER. With Sara’s help, Cynthia feels both supported and empowered to get on the right track. 
 
Digital Care Gets Personal 
In health care, there’s no shortage of data and tools like personal health assessments, wellness programs and fitness trackers. But so often they’re disconnected, and thus not usable to make the right decision at the right time.
 
What we’ve learned is that digital care doesn’t and shouldn’t stand on its own. Digital engagement is most powerful when it is integrated with traditional interactions with health care professionals, such as a phone call with a care management nurse. Innovative connections like Aetna MyPulse point to the possibilities of making the digital more human – not just by integrating data, but by putting it in the hands of the people that need it most. 
 
*For illustrative purposes only
 

Categories: Care Management

 

Dan Greden
Head of eHealth Product and Clinical Innovation, Aetna

Dan Greden heads the eHealth and Clinical Innovations team at Aetna.  In addition to the eHealth suite of products, new care management models such as Aetna In Touch Care are developed and managed by Dan and his team. Dan joined Aetna in 2003, and has worked in various roles before helping found the eHealth team when it was formed in 2006. Prior to joining Aetna, Dan worked at Microsoft in various product management roles on the MSN and eLearning teams, and came to Microsoft from Travelocity and their parent company Sabre. Dan has an MBA from Vanderbilt University, and lives in West Hartford Connecticut and is the proud father of two children.

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