The 12 weeks of cardiac rehab that patients who have had heart surgery are prescribed is critical. It can make all the difference in a patient’s outcome. But despite improving referrals and attendance at orientation, participation tends to be on the low side. Janssen Healthcare Innovation is piloting a care coordination program, Care4Today Heart Health Solutions, that’s entered its second year. It anticipates that accountable care organizations will top its list of likely customers.
Although the main goal is to improve outcomes by changing behavior, the financial incentive for hospitals is to reduce readmission rates. They are currently penalized if their rates are higher than the national average for certain conditions.
Henry Ford Health System is hosting one pilot which began in August last year. It’s expected to have preliminary data in February. That will dovetail with a second, more rigorous version with testing and data points involving five hospitals around the country.
The program tracks patients’ progress from referral as they work with therapy staff to improve heart health. There’s also an online educational component for patients to better understand their condition, and the need for changes in diet and exercise.
Kim Park, a partner with JHI, said another pilot of the care coordination platform is taking place at a hospital in High Wycombe in England. Park said although the platform is kept as a record separate from electronic health records, it’s talking to several hospitals interested in integrating the two systems.
The national average for attendance for cardiac rehab programs tends to hover around the 30 percent to 40 percent mark, according to Steven Keteyian. He’s a program director for preventive cardiology at the Henry Ford Health System in Michigan and is leading the pilot. Although he notes increased referrals have helped boost attendance levels from the teens, there is a lot of room for improvement, namely by improving care coordination.
The reasons people give for not participating “are as long as your right arm,” said Keteyian in a phone interview. Patients don’t have time, it’s not convenient, they don’t feel up to it. Although he declined to go into much detail about the findings, he observed that using a health IT platform to identify patients automatically for referrals to cardiac rehab programs has made a big difference in attendance. Using people to make these referrals tends to be less efficient.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Although population health is certainly one aspect of the program, Keteyian points out that when it comes to cardiac issues, it’s impossible not to personalize care. Does the patient smoke? Are they overweight? Is it an inherited condition? What type of heart surgery has the patient had? Are there other chronic conditions? Are they depressed? The answers to those questions influence the behavioral goals which guide a patient’s recovery.
Janssen is also developing mobile health care coordination platforms for schizophrenia and orthopedics — specifically hip and knee replacement. All of the platforms use hospitals as an intervention point.
