Specialty Disease Management Programs
Integrated’s Carelogics program started its focus in disease management by providing at risk insurance plans with assessment and disease management of chronic and complex respiratory patients. Integrated continues to expand, Carelogics, its disease management/population health program, and is starting to develop many initiatives for the management of all types of chronic diseases. Presently Carelogics helps many hospitals and payors improve the quality of life of patients, and substantially reduce the typical spend related to this specialty population.
Carelogics specialty disease management program applies detailed care plan protocols and logics to manage, support, and oversee the chronic/complex respiratory patients in the home. This advanced program significantly improves health outcomes and reduces events of hospital readmission and unnecessary utilization. The program additionally collects and tabulates all patient data and information on an ongoing basis, while producing data specific to readmission, well-being, compliance, and patient contact, with an emphasis around key measures that track and manage patients breathing, activity, medication management, and self-management skills. Carelogics detailed care algorithm helps manage the entire clinical process of a patient. These protocols promote better quality of life, training and education, track key signs and symptoms, and facilitate better communication among the healthcare continuum. See below a detailed understanding of the highlights and general process of the Carelogics program.
Program Highlights
- RT(Respiratory Therapist) Led care initiative at home focused on managing chronic/complex respiratory patients using “GOLD Best Practices”
- Specific high-touch clinical program – offering comprehensive management, education, instruction, and intervention
- Continued care oversite through home visits, phone calls, triage, and automated assessment monitoring
- Validated assessments track and measure patient breathing, activities of daily living, proper medication usage, and ability to manage symptoms
- Robust patient management system with “best practices” protocol software, simplified dashboards, program analytics, and data outcomes reporting
Program Process
- Risk Stratification/Inclusion Criteria – Payor Data Query to Identify Population
- Home Evaluation & Care Plan Assignment – 2 Primary Criteria Needed
- Severity Staging – Very Severe, Severe, Moderate, Mild – Care Term Authorization
- Monthly Home Visits, Health Coaching, Monitoring, Automated Assessment Based on Severity
- Case Conferences and Ongoing Staging After Term Authorization – Improvement, Stability, Decline
- Data Collection, Program Analytics, and Outcomes Reporting
Program Example
Disease Management Program Example – Monthly Services Activity by Disease State Risk Level
Very Severe Risk Level –
- Day 1: Respiratory Evaluation – Initial Clinical Visit Month 1(Home)
- Day 1: Spirometry(Home)
- Day 3: Automated Phone Call – IVR(Phone)
- Day 7: Live Phone Encounter by CRT(Phone)
- Day 14: Respiratory Evaluation – Follow-Up Clinical Visit(Home)
- Day 14: Spirometry(Home)
- Day 21: Live Phone Encounter by CRT(Phone)
- Day 28: Automated Phone Call – IVR(Phone)