By Daniel Knecht, M.D.
We are at an unprecedented moment in the history of health care in the United States, one that presents a unique opportunity for a more personalized approach. Consumers have come to expect more timely and individualized experiences that meet their unique needs.
One way to ensure people receive the right care for their specific needs and circumstances is through humanizing data—pairing it with deep clinical insights to measurably improve experiences and outcomes. When data are examined through this lens, it allows clinicians and payors to recognize patterns and gaps that may have previously gone unnoticed, resulting in improved experiences, reduced unnecessary costs and better overall health. This approach is actively being put into practice – and early results demonstrate its value.
CVS Health and Aetna, a CVS Health company, for example, recognized two areas wherein data can help us reach members during key impactable moments in their health journey. Two first-of-their-kind initiatives – Rush to Brush and the Guardian Angel program – demonstrate how data used as a clinical tool can go beyond mere numbers and drive improved patient outcomes.
Successfully fighting hospital-acquired pneumonia
Studies show that one of the best weapons against deadly hospital-acquired pneumonia (HAP) is good post-operative oral hygiene and care. Indeed, a clean mouth can reduce the incidence of HAP in patients by over 90 percent, inspiring Aetna to launch the first-of-its kind Rush to Brush program.
The program identifies members who are preparing for an inpatient surgery via precertification requests. For those members who are at an increased risk for post-operative pneumonia, our team mails personalized care packages directly to members’ homes about a week before admission. The kits contain high-quality oral care products, including a Colgate toothbrush and toothpaste, Listerine Zero mouthwash, Intellident Toothbrush Shields, a personalized get-well-soon card and educational materials that outline the dangers of HAP as well as how to maintain proper oral hygiene while in the hospital.
The kits have been met with a very warm reception by Aetna members. More importantly, interim results demonstrate that Rush to Brush improves outcomes–HAP has been cut by a substantial percentage for members who received kits. And the program has had a positive impact on members’ emotional and mental wellbeing, as the package helped them feel acknowledged and cared for.
Supporting patients struggling with opioid use disorder
Aetna’s Guardian Angel program was also designed to support members during times when they need care most – immediately following a life threatening opioid overdose.
Research has indicated that a prior non-fatal overdose is the best predictor of a subsequent, fatal overdose. Unfortunately, this issue hasn’t drawn much attention, which has resulted in patients falling into a terrible cycle of repeat overdoses and significant barriers surrounding addiction treatment. Every day, more than 130 people die after overdosing on opioids; many of these patients had overdosed previously. And this problem continues to grow, with the rate of new diagnoses of opioid use disorder (OUD) outpacing the rate of individuals with OUD seeking treatment.
Understanding that this particularly vulnerable patient population presents unique needs that require more specialized care, Aetna determined that emergency department claims data can serve as a warning system to monitor opioid overdose trends and develop appropriate support. Energized by the power of this data and opportunity for impact, Aetna launched the Guardian Angel program to engage and support patients struggling with OUD. The initiative is a lifeline that connects members and their loved ones with a specially trained case manager who educates them on treatment options, refers them to local health care providers and/or connects them with social support services.
This personalized health initiative has been highly successful, with higher rates of engagement than other telephone-based care management programs. Aetna has been able to initially engage with over 50 percent of the people whom our analytics have identified as benefiting from outreach.
Looking to 2020 and beyond, many opportunities remain for us to leverage clinical, behavioral and other data in new ways to better understand the needs and desires of consumers. This approach unlocks the power to identify and actively engage with patients to meet them on their unique health journeys. The programs also demonstrate that it’s possible to make massive impacts on patient lives with simple gestures that show we’re looking out for the people we serve, and that we care deeply about their ability to reach their health goals.
Daniel Knecht, M.D. is Vice President of Health Strategy and Innovation for CVS Health.