Reimagining Chronic Condition Care in the Age of COVID-19
2020 will be a year to remember. The United States was faced with not just COVID-19, but another health crisis, too: chronic condition care. What does this mean for employers and their workforce? In this episode, you’ll learn how virtual healthcare exploded overnight, and the role employers played in its acceleration.
Matt Hodes with OneDrop, a SentryHealth program partner, discusses why it’s critical to supplement virtual healthcare with virtual chronic condition care. Also, he offers actionable takeaways to support your employees through chronic disease management.
Implementing a good chronic condition care management strategy is vital to your success during COVID-19 and beyond. It will help your employees lower their out-of-pocket health care expenses and facilitate healthier lifestyles. It will also improve employee satisfaction with your benefits offerings and help you directly control the rising costs of employee health care. Read this blog post to learn more.
In This Podcast
With more than a decade of experience in the health innovation space, Matt works with employers, brokers, and partners to bring One Drop’s self-care program to employees with chronic conditions. Prior to joining One Drop, he led the professional services team at Zipnosis where he partnered with health systems in creating virtual care strategies.
Everyone, thanks for joining this episode of For Your Benefit. I’m Meghan Henry, Director of Marketing for SentryHealth, creators of Well On My Way, one of the industry’s leading employee health and wellbeing solutions. We recently hosted a webinar with Matt Hodes from One Drop, a SentryHealth program partner. He spoke about reimagining chronic condition care in the age of COVID-19.
During this webinar, he talked about how the health care landscape transformed from in-person to virtual care overnight and how employers can take this as an opportunity to better support employees living with chronic conditions. It was great information and we wanted to share this on our podcast as well.
I really appreciate everyone joining us today. In terms of our discussion, I have three sections I’m going to cover up front.
I’m going to share how I’ve seen care change over the past year, especially for those living with chronic conditions. Before I joined One Drop, I worked with health systems to set up and start the virtual care programs. And I’ve seen the terminology change from telemedicine to virtual care. And now I want to talk a little bit about what I see as the next evolution. Then I’ll cover, “Why Now?” More than ever, a health coach is an essential partner in the journey for individuals as they try and reach their health goals. And I’ll finish by providing an overview of One Drop and some actionable takeaways as you as an employer on how you can support your employees with chronic conditions.
Chronic Condition Care and COVID-19
So I want to start by covering a major health crisis that we have here in this country, but also globally. And that’s really been amplified because of COVID-19 and even prior to COVID, when we looked at the population, 60% of Americans are living with one chronic condition, 40% are living with two or more chronic conditions. And I know as employers you felt that pain over the past number of years where you’re looking at health care costs, seeing three and a half times more spend for individuals with chronic conditions compared to a healthy employee. And that’s just on average, I’m sure there’s those stories where there’s those outliers costing a lot more.
As we look at individuals who are familiar with the term, I can talk to my peers and they’re very well aware, aware of what it means when I say I used to work in virtual care. But when I look and see kind of that evolution, I really start thinking about what, where did it start? It started with telemedicine over 20 years ago, a patient and provider or two doctors could talk over video.
And really that started to help open up the system wherein a rural community hospital, if a patient arrives with stroke-like symptoms, the neurologist is in a health hub somewhere else and able to video with that patient to evaluate them for a stroke. And that’s what telemedicine was really to people physically separate, evaluating somebody through video. Virtual Care came around a few years ago and became a much more inclusive term.
It means any way a provider and patient can interact over a smartphone or computer. It might mean that somebody doesn’t even talk to their provider. So you can have a rash on your arm and you take a picture of that rash and you send that to your provider with a couple of questions being answered. And your provider can look at that and potentially send a prescription to your pharmacy without even having a conversation for you. So the term virtual care really became much more encompassing.
Origins of Virtual Health Care
I want to talk now about kind of what led to this large explosion. And I think it’s no mystery that there is definitely some demand at the beginning of the pandemic when we started looking at not feeling safe, going into in-person care.
But that’s not the only thing, the reason that virtual care, I think, exploded overnight.
A lot of it also had to do with providers finally offering this option to their patients. So prior to COVID, there was a lot of resistance from providers to offer virtual care solutions. Some of the reasons were there are technology challenges as well as reimbursement challenges. Well, when COVID started, the regulations really loosened up. So now you could Facetime with your provider. Your provider could get fully reimbursed for that visit, similar to if they were going to get in-person care. So really, you saw all providers, both in the health system as well as standalone practices starting to open this up and offering virtual care to their patients.
Accelerating Virtual Health Care
And if you look at the graphs and the trends of virtual care in late March and April, both supply and demand, you’re really seeing that hockey stick appearance where providers are starting to offer it, starting to communicate it, that’s available to their patients. And then patients are demanding it because they don’t feel safe going to get in-person care.
One of the early leaders in virtual care has always been the employer space, so even in 2018, 86% of large employers offered virtual care options to their employees. And just five years prior, that was as low as 11%. And we continue to see that expansion this year where 52% of large employers continue to evaluate solutions and plan to offer more solutions to their employees.
And that makes a lot of sense when you think about it. If an employee is able to get quick care, they don’t have to miss work because they’re able to get care virtually. If they do have to get a prescription, they’re able to get started on that prescription sooner so they can get back to work sooner.
So employee productivity, as well as employee satisfaction, has been increased by employers offering virtual care solutions. So maybe you’re in that bucket considering more virtual care solutions for your employees this year. And I want to talk about a little bit what to look at as you’re evaluating solutions, especially if you’re looking at solutions for your employees with chronic conditions.
Reactive “Sick Care”
So that brings us, really looking at what is virtual care today and what are you offering to your employees. Unfortunately, a lot of virtual care still has replicated our traditional health care system, which is what I like to call a “sick care” system. It’s only activated once somebody is sick. So your child has pinkeye and you now want to get that child seen by a doctor, you are able to use virtual care to set up a video appointment with a doctor who evaluates your child. Ideally, you get a prescription. The prescription sent to the pharmacy. Hopefully that pharmacy comes to your house and delivers that prescription. And now you and your child are able to start treating pinkeye without having to leave your home. And that’s what works.
Why virtual care works so well is if all of that is able to happen correctly. But when you start thinking about, “Well, how do I apply that to folks who have chronic conditions?” it becomes a little bit more complicated. Because people with chronic conditions, if you’re waiting for symptoms to arise, you’re too late. That’s really where you see the high costs associated with chronic conditions, where those employees are going to the emergency room, going to an urgent care setting or the hospital you really want to address.
How do you support employees with chronic conditions on a day-to-day basis so that you’re avoiding those symptoms? And how do you do that? That’s really where the employee, the individual with chronic conditions needs support on a day-to-day basis. So when challenges arise, they’re able to navigate those challenges with that support, and then long term, they’re able to reach their health goals.
Virtual Health Care to Virtual Self-Care
So that’s where I want to talk a little bit about, kind of then, what is our next evolution of virtual care and what does that look like?
So there’s still a lot of those benefits, like I mentioned, of virtual care. It’s definitely more efficient and it can take place anywhere so you can get quicker care. But historically, virtual care has to continue to be episodic care. It’s revolving around an acute event that occurs. And each time you might be having a visit, it might be with a different provider. So you might be calling into a pool of providers or you might be scheduling an appointment with somebody. But then even if it’s your primary care provider or your specialist that you’re having an appointment with after that visit, you get your information, you’re going home and you’re you have to enact everything that they told you. There’s not a lot of ongoing support in that traditional virtual care setting.
So I’d like to introduce you to the concept that we call virtual self-care at One Drop. And virtual self-care is the ability for an employee for somebody to get care when they need it in real-time.
And what I like to lay out in how I think about this is in virtual health care or even our health care system, an individual who gets care is really seen as a patient. And when we think about it for all the times we are a patient, which is a very small percentage of our life, more often than not, we are just people. We are parents, we are spouses, an employee, a friend, an athlete, someone who’s trying to live their day to day life with lots of competing priorities, wearing many different hats and trying to overcome obstacles that come in our way.
Benefits of Virtual Self-Care
And that’s where virtual self-care comes into play. Is that on-demand support? Not when you’re a patient, but for everyday life. A couple important aspects of virtual self-care is that it’s personalized. So it’s tailored to you as an individual. It’s tailored based on the conditions that you have, your past interactions with your health care provider and what they know about you, as well as your real-time health data. So your health care professional is able to monitor that real-time health data. They’re able to spot trends, for example, that you might be exercising. And all of a sudden over the past week, you’ve fallen off and you are no longer exercising.
Your health care provider is able to reach out to you and start having a conversation about why that is. Instead of waiting six months for you, then get go back and see that you’ve fallen off the wagon. Next time you have your visit with your health care provider in a virtual care setting or your primary care provider in this virtual self-care setting, someone is reaching out to you more proactively and helping you create a plan that’s specific to you and all the unique aspects and challenges that you’re facing.
Chronic Condition Care: The COVID-19 Effect
And one of the ways you really do that is through a dedicated coach. So someone who is dedicated to your care, who knows you and is the same person through each visit. And that’s where I want to spend a little bit more time talking. Today is really the power of coaching and how we see that as a big step forward if you’re able to get the support on a regular basis and to look at that.
I want to just talk a little bit about what my coaches have been sharing with me on the experiences of their participants during COVID, because I think this highlights the unique challenges that each individual might face as they’re trying to reach their health goals. So just a couple examples. As I said, as I’ve talked to my coaches over the past year and what some of their participants are saying and why a personalized approach is really important. So some of our participants are living in neighborhoods where they’re unable to engage in outdoor activity because they don’t feel safe. But at the same time, they don’t have access to the gym because those are closed due to a lockdown. So our coaches have been working with these participants to understand how can they still remain active based on their current situation. And this is really important to know.
Power of Chronic Condition Care Coaching: COVID-19 and Beyond
As I said in my example earlier, if your participant has fallen off their exercise routine and you didn’t know this information about them and you reached out to have a conversation, you’re starting from square one. But when you have a personal relationship with the coach and the participant, they’re really able then to create a new plan based on the barriers that are in place.
Another example, and maybe this is something that the folks on the phone also can relate to, is that as people have felt unsettled due to COVID, poor food choices have been made. So our coaches are really working to identify what these triggers are and then creating a plan with our participants to manage these triggers and figure out what can they control in this time.
Some of our participants also have these complex family challenges. Maybe they have an additional family member living with them right now, or they used to have support from their family members, but they no longer have that support because they can’t see those family members anymore. So our coaches are able to discuss how do they set healthy boundaries? How do you weigh the pros and cons and risks in this complicated time.
And then the last example I want to talk about, unfortunately, some of our participants have residual side effects from COVID, which means that exercise for extended periods of time is very challenging. So now our coaches are talking to those participants about how can they move their body in a way and still be active knowing the challenges that they have.
So these are just a few examples where I feel like it really highlights the importance of a personalized approach to care.
One-On-One Chronic Condition Care Support
And next, I just want to talk a little bit about now, when you’re thinking about evaluating solutions and virtual care options, why I feel one-on-one coaching is so important. So that was an example that I just shared in terms of why I think personalized outreach is really important. But I also think it’s important that the participant has access to their coach at all times because challenges in real life don’t wait for the next visit. And it’s those day-to-day moments, like I shared earlier, that are really going to determine the success of someone reaching their health goals.
So that means real-time access to their coach when something comes up that they can message their coach and they can get the support they need in real-time. Coaches then are also, and we talked about this a little, monitoring that participants data in real-time and as they spot trends, they’re able to proactively reach out.
So they’re not waiting for six months when the participant goes to their doctor to get their lab tests to make changes in the program that may or may not be working. We’re really suggesting is to shorten that feedback loop when something’s going well, the coach can reach out to that participant and start encouraging them to continue those behaviors. And if something’s not going well, and the coach sees that through the data, then the coach is able to encourage some changes to behavior. And we’re not wasting that time that we could be making new changes and heading in the right direction for our health goals.
I’d like to transition a little bit and now talk about how One Drop can support your employees with chronic conditions through our health care program and what I like to share our program. I start with the importance of it is one program that is customized for the individual participant based on their one or multiple conditions, because it’s not like your employees are dealing with pre-diabetes on Friday, today, and maybe on next Monday. They’re dealing with high blood pressure every day. They’re dealing with all the conditions that they have and trying to make the best decisions to reach their health goals. So that’s why when a participant signs up for the one drug program, we send them one or multiple devices based on the conditions that they have.
So for pre-diabetes, we send them a weight scale, for diabetes, a blood glucose meter, and for hypertension, a blood pressure cuff. And then everything from the mobile app experience to educational experience is all customized around those conditions that individual has, as well as the coach that they get assigned.
All of our coaches are certified health and health coaches. So that means diabetes educators for individuals with diabetes or registered dietitians and registered nurses to support the individual with around all their conditions. So they’re not reaching out to multiple coaches who might be giving different information. And the participant and coach can build that relationship over time. Our coaches understand the unique challenges that each of our participants is going through as they create a plan. And then important for you, we try and make the implementation as turnkey as possible.
Predictive, Proactive Self-Care Models
Working with SentryHealth, we’re able to get the eligibility file and understand which of your employees might benefit most from a program like One Drop and then market to them directly. And then once they sign up in our program, we have a robust onboarding process. The average age of our participants at One Drop is over 50, so we walk them through, how do you download your app? How do you connect your Bluetooth device? How do you message your coach? What are all the features in our mobile app experience, so that they’re comfortable with the technology that they have? And then on the back end, we also recognize how important it is to share the data so Sentry is able to share reports on what engagement looks like, as well as what are the health outcomes.
So what I want to end with today is the understanding and philosophy One Drop takes to really changing the message from being a retrospective health care model that we’re used to, to how we’re we’re changing to be predictive and empowering the individual to take the best actions on a day to day basis through that self-care model.
And what I like to compare this to is maybe going to the dentist in a traditional model. You go to the dentist and you find out how you did brushing your teeth over the past six months. Do you have a cavity or not? Well, in a predictive model, you would get an alert maybe two months into, saying, a cavity is starting to form. If you floss and brush your teeth well, every day you can avoid that cavity. Think about how that changes your mindset. It puts you in power to make something happen and avoid a problem from occurring versus going to the dentist and maybe feeling dread because you knew you could have done a little bit better over the past six months.
And that’s really the model we’re taking with One Drop’s program is instead of waiting for problems to happen, instead of waiting for a participant to go to their doctor and get their agency tests if they have diabetes, which is going to look at the past three months at how they did managing their diabetes to see if they did a good job or bad job.
We’re empowering the participants and their coach to see in real-time what is their estimated A1C, and if it’s not what they want it to be, how can they make changes? But most importantly, as they make changes and they start seeing improvements, how can they be encouraged by having that feedback loop shorten where the coach can celebrate those small wins with them over time?
Another way we’re doing this is for individuals with diabetes, we’re able to show up to 12 hours in advance what their blood glucose predictions are so that instead of waiting for their blood glucose to go higher, low, they’re able to see where their blood glucose is trending in the next 12 hours and take and get some feedback to take action if it’s going too high or too low.
So, again, these are a few examples on how we’re really trying to change the message around. Don’t wait for a problem to occur and empowering the individual to take action and make changes based on the data that we know about them. So in summary, we believe the best way to start reversing the health care trends today around round cost is really to focus on improving the lives of your employees, living with chronic conditions, and giving them the day to day support through a virtual self-care program.
And if you like what you heard today and you want to hear more. Don’t forget to subscribe to our podcast. We’ll continue to keep you on the cutting edge of what’s happening in the world of corporate well-being. Thanks for joining us. See you next time.
Want to learn more about SentryHealth? Simply fill out this form to request a consultation and learn more about our solutions.
Want to learn more about SentryHealth? Simply fill out this form to request a consultation and learn more about our solutions.