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How connected care helps people achieve optimum health

How connected care helps people achieve optimal health

Your body is an incredible machine. Its various systems – circulatory, nervous, skeletal and so forth – work in concert to keep your mind and body working properly, allowing you to think, move, work and play.

Unfortunately, the health care system that’s intended to take care of your body is not so well organised, joined-up and efficient. That situation is clear to any patient who has received conflicting advice from different doctors or whose specialists don’t have access to their medical history and records. It’s also clear to any employer who has watched preventable illness reduce productivity and increase health care costs.

At Aetna International, we are doing our part to improve a broken health care system for the benefit of our customers and our members. We call our approach connected care.

What is connected care?

Connected care means integrated care – connecting the dots between the patient, their health care providers, including specialists and medical facilities, and the payer, be it an insurance provider or government. Its focus is improving health outcomes for the patient.

This requires everyone to work together to keep the patient well, to treat them more effectively when they’re ill, to increase health care quality and to lower health care costs. When you have broken health care systems where one doctor doesn’t talk to another doctor, you often have repeated tests and services – and you may even have conflicts such as when one prescribed medication interferes with another. You don’t want to have gaps in care or see people in hospital for longer than they should be.

The 6 principles of connected care

1. Evidence-based, personalised care: This approach means that doctors have all the information they need to provide the best evidence-based care for their patient, care which is uniquely tailored to their needs.

Connected care starts with understanding a person’s underlying needs. Consider someone who has a chronic health condition they’re not managing well. We can reach out to the person to make sure they’re taking good care of themselves – but for that to be effective, we also have to understand what is driving the problem. Maybe the patient doesn’t have time to take care of herself because she has a sick child. Maybe the patient can’t afford an essential medication because he’s unemployed. Maybe the patient lives in an area without access to the right medical specialists. Clearly, each of these situations would require a very different solution.

For example, we know it’s pointless to prescribe physical activity if clinical depression keeps the patient confined to bed … or physical therapy if the patient doesn’t have transportation or a support system … or an expensive treatment if the patient can’t afford it or their plan doesn’t cover it. In cases like these, there may be some emotional or work-life balance issues that need to be dealt with or social services that need to be brought in so that the patient can achieve the best possible outcome.

2. Whole-person health: Connected care also means addressing all the factors that can influence a person’s all-round health – the physical, emotional and mental – not simply the delivery of health care services.

Connected care is about connecting physical health, mental health, emotional health and financial health in a seamless, holistic way. Our ultimate goal is to help people achieve their optimal health. That means moving away from an approach where we look solely at health symptoms and toward one where we look at the whole person. It’s not just about “What’s the matter with you?” It’s about “What matters TO you?”

We also help get people the medical care and social services that they need through wraparound services that support people’s journey to optimal health. That includes preventive wellness services and webinars on topics such as reducing stress and managing high cholesterol. If people have a situation at work that may be stressful and they want to talk to somebody, we have counselling services at the ready.

As part of the whole-person health approach, connected care also takes social determinants of health into consideration. Studies show that health care delivery only has a 10% impact on how long people live. Meanwhile, 30% of the influence on our longevity comes from genetic influences we can’t do much about. Much more impactful are social and environmental factors: Individual behaviours such as smoking and how healthy and fit you are contribute 40%, while 20% relates to environmental factors such as local air and water pollution.

3. A predictive, preventive approach: When a patient’s health care team has a whole-person view of their health and well-being, the patient benefits. Doctors focus on keeping the patient well, helping them to recover quickly and effectively when they’re ill, and keeping them engaged in the process and their treatment journey.

Preventive care is important because the earlier we identify and address problems, the more we can keep them from becoming catastrophic. Connected care means analysing a lot of data, identifying trends and flagging potential problems. At Aetna International we can see things doctors can’t always see – such as when a patient is going to several specialists – and give this information to doctors to help them intervene earlier.

We also use predictive tools to identify people who may be at higher risk for health issues and reach out to them. And we offer group coaching programmes, health clinics and health fairs to help people stay ahead of health problems.

4. Participatory care: Connected care is about connecting patients to their own care, making them active participants rather than passive recipients. Clinicians must make sure that patients know why things are occurring, what they need to be doing about their conditions, and how they can contribute to making themselves as healthy as possible. For example, patients’ compliance with treatment regimens is a big problem in health care today. In the United States, for example, 20-30% of prescriptions are never filled and half of medications for chronic disease are not taken as prescribed. Connected care is a way to close those gaps.

5. Clear, patient-centric communications: Patients benefit from clear communications about their health, treatment and care. When treatment is medically appropriate and communicated clearly, patients are more likely to understand their care plan, follow that plan and have support, when and where they need it. Payers also benefit from clear communications because they know which procedures are being provided and why they are medically necessary.

At the heart of our outreach is actively listening to our members. When they contact us, we take the time to find out what’s going on in their lives and how they prefer to communicate with us.

6. Care that is accessible and convenient: Technology addresses issues of access to care by making it much easier to get care in the first place. With our vHealth by Aetna or Teladoc virtual care service, for example, people can access a doctor any time of day or night using their mobile device. Technology is also bringing greater convenience to self-help. For example, when we used technology to identify people who were at risk of developing a disease or were having trouble managing an existing disease, we had a nurse reach out and give them one-on-one support. Doing that reduced hospital admissions by more than half. And when people opted into our text message reminders, flu incidence dropped by 34%. We also make it easy for people access care in their local community. For example, our Care and Response Excellence (CARE) team offer one-to-one confidential, personalised support to help our members find culturally appropriate doctors and hospitals in their region, and much more. And for those in the United States, we’re delivering a simpler, more convenient health care experience via MinuteClinic and HealthHUB health care providers at CVS Pharmacy®.

How does Aetna’s connected care work in practise?

Enter the CARE team’s one-nurse-one-member care model, which involves having one nurse or clinician work with one member to make sure the person is getting the right procedures done, has needed pre-authorisations and understands the recommended care plan. The CARE team plays a critical role at many junctures, including after a person has been hospitalised. Here’s how that works.

When a patient leaves hospital, their doctor will rattle off a long list of things to do: You need to get this medication, you need to follow up with this procedure, you need to change your diet in this way. And many times patients don’t understand – or even retain – those instructions. With the person’s permission, we will talk to the doctor and document the care plan so we can refer back to it.

Then when the patient returns home, we can call and follow up: Did you get your prescription? Are you walking around the room like you’re supposed to be? Did you remove the salt from your diet? Having all those triggers actually helps patients follow through on what the doctor wants them to do and gets them healthier faster.

We also try to look at the 360° view of the person. Do they have a safe home environment? Are they getting the proper nutrition? Are they following the proper exercise regimen? All of these dynamics contribute to how healthy somebody can be.

How the principles of connected care support employers’ duty of care

Duty of care is changing. The pandemic and other social and environmental factors have brought into sharper focus the responsibilities facing organisations for looking after the health and well-being of their people.

Employers want to have productive, healthy workforces. However, many organisations across the world are straining under escalating costs of health care. When you connect the dots and identify problematic trends, you’re able to eliminate some of the inefficiencies in the provision of health and well-being services. This helps to ensure that workers are healthy, happy and productive, which benefits workers and employers alike.

Connected care helps prevent gaps in care and keeps people from being in hospital for longer than necessary. It also means that when employees are getting the education and support they need, they enjoy better all-round health and greater productivity. Similarly, when sick employees get the right care at the right time, they return to health and therefore to work sooner. And when you have a more efficient health care system, you wind up having a much more productive workforce overall.

Get #SeriousAboutDutyofCare

It’s critical to make sure you’re keeping up with changing duty of care responsibilities. Talk to us to find out how to put your people at the heart of your risk management strategy. Our global expertise is founded on the dedication and agility of our teams. Together, our people provide the strength and flexibility to support our clients and their employees whatever their situation, wherever they are in the world.

If you’re an employer and want to understand how we can support your employees, get in touch with one of our expert consultants today. Find a contact number for an office in your region here.