20-location multi-specialty primary care group leverages CAREMINDr’s mobile-enabled remote patient monitoring and a home kit with medical monitoring devices + education to change behaviors and improve outcomes
Patient engagement is closely tied to emotion. For example, when the symptoms of a chronic condition cause a health scare, pain or significantly impact a patient’s life and daily activities, that can trigger an emotional response. This often makes patients more engaged in their healthcare and behaviors.
However, healthcare providers would rather direct patients toward a path of better chronic condition management before such an issue occurs. The challenge then becomes to convince patients who don’t feel poorly or whose lives haven’t been adversely affected by a chronic condition yet to adhere to their care plan, such as taking needed medications and altering lifestyle behaviors such as diet and exercise.
The leaders at Reliance Medical Group, a 20-location, 36-year-old multi-specialty primary care group in the Atlantic City region of New Jersey, recognized this patient engagement opportunity. With the goal of better engaging patients to improve outcomes, the practice implemented a practice transformation effort focused around behavior change using mobile-enabled remote patient monitoring (mRPM) supported by CAREMINDr.
To jumpstart the patient engagement, the practice’s leaders created a memorable introductory kit packaged in a Reliance-branded, grocery-sized red canvas bag.
The Red Bag Kit and its contents—including patient education literature and home medical devices such as a blood pressure kit or a glucose testing kit, depending on the patient’s chronic conditions—reinforce the importance of the patient’s care plan and his or her responsibilities, thereby triggering the patient’s emotions toward engagement.
“Physicians can no longer give their patients a prescription, tell them to take it and then say ‘see you in six months,’” said Jon Regis, MD, Founder and CEO of Reliance Medical Group, a family medical practice. “The Red Bag changes the patient’s perception of the prescription. It drives home the message that their condition is their responsibility, too—and with CAREMINDr, we’re going to manage this together.”
The Red Bag idea originated from the community health fairs that Reliance Medical Group representatives attended over the years throughout their Atlantic coast coverage area. At the fairs and other similar public outreach events, Reliance would hand out red canvas bags with health information and wellness-related giveaways.
In that time, Reliance’s leaders re-focused their practice around population health management (PHM), targeting the chronic conditions common among their patients, such as hypertension, diabetes and asthma. As part of its PHM efforts and to support the use of the CAREMINDr mRPM solution, Reliance launched a Virtual Office late last year. The office houses nine care coordinators and two clinical leaders, who manage thousands of patients with chronic conditions in between face-to-face appointments with CAREMINDr’s technology. CAREMINDR’s innovative remote monitoring enables patients to be monitored in their homes for their chronic conditions and to be connected to providers in between their in-person appointments, to monitor their progress on their prescribed treatment plans.
“We needed a way to explain this remote patient monitoring concept so that was memorable, but also showed patients how important it was to their providers, too,” says Vincent J. Papaccio, MBA, Reliance’s Chief Operating Officer. “The Red Bag concept was the perfect way to package it, because not only do people love free stuff—but it gets their attention and shows them how everything inside is connected.”
Starting a ‘Journey’
In the bag, patients receive information about their condition, home health monitoring devices that align with their chronic condition needs, and information about CAREMINDr. The information supplements and reinforces the education the patients receive from the practice.
Through CAREMINDr, patients enroll in a “journey” specific to their condition where they follow a highly structured and carefully scheduled path where they “check-in” either once a day, once a week, or less frequently depending on their conditions, overall health, and their responses (the frequency is determined by their physician). At each check-in, the patient answers a series of short subjective and objective questions and enters biometric data from the home blood pressure cuff (if they have hypertension) or glucometer (if they have diabetes) provided in the Red Bag.
Each day, the clinical coordinators in the Virtual Office review patients’ responses to the clinically validated health survey questions that clients provide via the patient-facing app. CAREMINDr automatically flags responses or test results that may require clinical attention, and the care coordinator then calls the patient to investigate.
“The patients love that someone is following up on what they put into CAREMINDr,” Regis said. “They are happy to receive calls from our team when one of our coordinators notices a problem. This dynamic reinforces engagement where patients want to make sure they’re taking their medication, testing themselves and checking in on CAREMINDr. They feel someone is counting on them to follow the plan.”
Conversely, when clinical coordinators see that a patient is consistently not taking their medication, or not monitoring biometric data or using CAREMINDr, that information is flagged, and the patient receives an outreach call from their physician. This is also a powerful, behavior-changing emotional driver.
“I tell our patients: ‘If I see on CAREMINDr that you’re not taking your medication or not checking in, we’re going to have a talk,’” Regis said. “They realize we take this very seriously.”
Not only are patients delighted with the mRPM program that includes the CAREMINDr solution and the Red Bag, but the staff appreciates the program, too, Papaccio says. With previous care quality programs, there would be enthusiasm at first that would eventually fizzle out because the results were slow to emerge. With the Red Bag Kit and CAREMINDr, the clinical staff sees patients’ enthusiasm when the program is introduced and observe the positive effect their feedback has when they identify and intervene based on issues flagged via the technology.
“The immediacy with CAREMINDr is different,” Papaccio says. “They don’t have to wait to make an impact. It’s obvious to them how CAREMINDr and mRPM are relevant to keeping our population healthy.”
The daily monitoring and interventions help the clinical coordinators working in the Virtual Office feel professionally fulfilled and connected to the care teams in the practices, Regis says. Since any clinically significant data is shared with the patients’ physicians, the physicians and other clinicians at the practice are recognizing the benefits.
“When they see a patient’s blood pressure spike, it’s so gratifying because they wouldn’t have known about it before,” Regis said. “CAREMINDr helps the physician more quickly find the right medication and the right dosage for that patient and overcome any other obstacles in their way. The patient feels cared for in a way that extends into their home, which is enormously powerful.”
The Power of Emotion
That emotional link is essential for lasting behavior change. By activating emotions and repeated contact through CAREMINDr, Reliance Medical Group’s mRPM program introduced with the Red Bag is activating the patient’s imagination towards what is possible with their health.
Patients see the positive trend the prescribed medication and behavior changes are having on their condition through CAREMINDr, which likewise generates encouragement from their provider. The combined factors create a positive feedback loop that fosters stronger engagement with the care plan and enables additional lifestyle changes, such as more physical activity and smarter eating choices.
“The Red Bag and CAREMINDr distinguish our practice in our community and lets people know that we’re doing something different to move the needle forward on improving the health of our patients,” Regis said. “It has been a highly effective engagement tool for us, for both our patients and our staff.”