To Improve Quality Outcomes, Harness Member-Generated Data

By Jessica Schiller, RN, BSN, Wellframe

As health plans increasingly prioritize member engagement, current health management programs face some key challenges. They rely on care plans, a collection of each member’s health history, diagnoses, problems, goals, and interventions. While they can be effective, they’re typically designed solely for clinicians, and are delivered over the telephone.

To build sustained engagement that improves quality outcomes, health plans must consider a new approach: delivering personalized, interactive care programs directly to members’ mobile devices. In doing so, plans can collect vast amounts of data on member activity, patient-reported outcomes (PROs), and more insights that can drive timely interventions.

Data-Generating Care Programs

When health plans deliver health education that is personalized, relevant, and accessible, members will engage more often, feel more satisfied, and learn how to self-manage chronic conditions more effectively. Plus, when members interact with these mobilized care programs, they generate data insights that care managers can utilize to deliver better care and build a trusted relationship.

The following examples demonstrate key use cases for collecting member-reported data that helps care managers provide more proactive care to improve quality outcomes.

Biometrics

Measuring biometrics such as blood glucose, blood pressure, weight, oxygen saturation, and pain scales can be useful for monitoring health conditions where the biometric is a direct indicator of health status or progress. When members record measurements manually or through device integration (many of the latest devices on the market can connect through Bluetooth to a mobile device) or enable passive data tracking, self-management efforts are enhanced, and the care team receives trackable health data on which to base their interventions. For example, if the care manager observes a pattern of suboptimal blood pressure control, she can discuss these findings with the member, set a goal for better control, assist with arranging any needed clinical follow-up, and help the member work towards improved blood pressure control over time.

Surveys & Scales

Another option for data collection via mobile is to use validated survey instruments and scales. These evidence-based tools are appropriate for gathering important information about current health status and patient-reported outcomes by asking members simple questions. The format may be multiple choice, slider (e.g. 1-10 scale), yes/no, numeric, or free text. Since many survey instruments are approved for mobile delivery, this approach can generate high-quality datasets for research studies on a wide range of data points. Additionally, PROMIS (Patient-Reported Outcomes Measurement Information System) instruments allow for delivery in sections, so a long survey (e.g. 12 questions) can be broken into three sets of four questions, which prevents survey fatigue and minimizes non-response.

Screening & Gaps In Care

Perhaps most relevant for quality outcomes, survey instruments can also be utilized to assess members’ status on recommended health maintenance screenings, provide timely education, and quickly close gaps in care. If a member responds affirmatively that they have received that screening, their real-time response circumvents the protracted timeline of claims processing. On the other hand, if the member reports they have not had the screening, then the ability to intervene is proximate and relevant to the member’s needs. Furthermore, delivery of data collection instruments can be automated at a regular, ongoing cadence, relieving the care team of significant outreach and documentation burden. Access to this member-generated data enables rapid support from the care team that drives satisfaction and improves clinical outcomes.

Alerts For The Care Team

One question you might be wondering is, “why do patients keep entering this data?”
The answer is simple: if this information goes into the digital ether without a clear objective, members will eventually stop entering it because it makes no difference whether they add it or not. However, when this information has a dedicated recipient on the other end—the care team, real clinicians who can understand the data in context due to their existing relationships with members—the data gains a tangible purpose. When members see how their responses are used and feel their input contributes to the quality of their care, they will continue to make an effort to share it.

The most striking difference from traditional health management is a major increase in inbound, member-generated data. For care teams worried they may not be equipped to handle this information influx, there is a solution: Let technology do what it’s good at—processing and displaying data. This, in turn, enables novel workflows that set up the care team to do what it’s good at—caring for members. Properly configured, this system can redefine care team workflows around members’ real-time needs, questions, and survey responses.

Turning To Needs-Based Workflows

Member-generated data and the information infrastructure to intelligently act on it, in fact, drive a fundamental shift toward needs-based workflows. With unprecedented insight into members’ needs, the care team focuses on medically complex members who are experiencing high-risk issues in real-time.

Alerts yield information for the care team based on the member’s response against predefined thresholds, and can provide evidence-based decision support designed to improve key health outcomes. For example, when a member responds to a given survey with an answer that indicates increased risk or an opportunity for a targeted intervention, the care team will be notified. As a result of this sequence and the immense decrease in data latency, the member will receive support in a timely fashion.

Key Findings

Delivering personalized, interactive care programs directly to members’ mobile devices can unlock tremendous opportunities for health plans. This new method of information delivery and data collection revolutionizes the information care teams are able to see and use, and in turn reshapes their entire workflow around members’ real-time needs. The positive feedback loop members experience when they engage with their care program results in more touch points with the care team and promotes long-term retention. And ultimately, this transformation advances the ability for health management to impact quality outcomes through improved insight, ability to intervene, and effective, sustainable member support and engagement.

About The Author

Jessica Schiller, RN, BSN, is director of clinical program at Wellframe www.wellframe.com.