Software tool boosts health coach program effectiveness, drives greater savings

Several northeastern Massachusetts hospitals are significantly reducing readmission rates of at-risk Medicare patients and saving more than $100 a month per patient thanks to a health coach program incorporating a patient tracking app deployed on tablet devices.

A six-month program at Elder Services, based in Merrimack Valley, reveals the software component played a pivotal role in decreasing readmission rates and boosting cost savings compared to a health coach program that did not use the technology, according to study results published at the U.S. Department of Health & Human Services' Agency for Healthcare Research and Quality website.

Readmissions were cut by 39.6 percent among at-risk patients and there was a 5.9 percent reduction in all-cause readmission among Medicare patients. The net savings averaged $109 per patient, per month, with a gross savings of $600,000 in the six-month trial that involved 561 patients.

As FierceMobileHealthcare recently reported, successful mHealth projects are those that are easy to use, provide fast response and prove reliable. The technology effort also illustrates why apps and mHealth device innovation must focus on patient outcome rather than 'coolness' factor.

The initial program involved health coaches with nursing or social work degrees using a "hub-and-spoke" care coordination model directed by a nurse care coordinator. The software lets coaches capture and relay data about patient health status and track care coordination activities. The technology added $30,500 to the program's initial cost of $205,000. The tech cost included software, tablet training and data connectivity costs.

The study provides several tips for healthcare facilities considering a health coach effort using a tablet app tool, including:

  • Choose software that will work on multiple platforms to keep hardware costs low
  • Be ready to be flexible as the program moves forward, and conduct Plan-Do-Study-Act cycles to improve the program over time
  • Work with the software maker to boost effectiveness

"For example, in consultation with staff, the software developers are now adapting and integrating the initial risk screening assessment into the software application, allowing for more effective screening by lay health coaches as well as better tracking and faster home visits for those at highest risk," the study results stated.

Going forward, the program's software developers are adding features to track the risk level of patients by alerting nurse case managers if someone who has been triggering alerts does not have a visit planned.

For more information:
- read the study

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