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Welcome to the HealthAware Studio, where we are changing behaviors, reinventing care every day.

Hello and thank you, my name is Moz Mirbaba and today I am with Greg Gossett, Founder and CEO of HealthAware. For the past 20 years, Greg has been at the forefront of early disease detection and has worked with more than 250 health care systems across the nation.

Moz Mirbaba:  So tell me how is Kare-N® HealthAware’s program being used across the care continuum?

Greg Gossett:  Well I know that when you look at patients especially post-acute, behavior change and compliance really is the holy grail. Patients all know what to do and it’s almost a running joke they don’t do it and across healthcare systems. And we’re all still scratching our heads and how can we help them comply more effectively and how can we create efficacy across these patient populations.

And the other thing we do know that 80% of the healthcare costs is going to 20% of their population. A majority of that 20% of population are chronic patients. What I am seeing right now across the country is especially related to chronic care management the programs are creating basically three pathways:  low, medium, and high risk pathways.

Traditionally it’s been one care team reaching out to all chronic patients, on a periodic basis, and that’s really not scalable. And it really doesn’t make sense because people who are taking care of themselves and self-caring don’t really need attention. Our programs are creating efficiencies for the care teams across these low, medium, and high risk pathways.  In one hospital recently we have readmission rates among indigent patients less than 6% across CHF, COPD, and diabetes. Which is really astounding considering the national averages are hovering around 20%. What our focus is around behavior change and the mechanics and constructs using behavioral science to apply to these patients to help them self-care. So when we look at the three pathways across post-acute chronic care program, the low risk patients, those that don’t admit frequently don’t have multiple chronic conditions, really should be dealt with electronically. That is our program completely to help them self-care. Think of Kare-N® really as a caring, compassionate care giver. This is appropriate technology and resource to deploy to your low risk patients. The high risk patients on the other hand need to be high touch. Technology is useful, but at the end of the day the people that are coming 4 to 5 times a year and they have multiple chronic conditions these need to be dealt with in-person or in a clinic setting or with some kind phone calls with nurses etc., this is where technology needs to pull back a little bit.  However, Kare-N® can repurpose itself for the high risk individual and focus on helping them get connected to a clinic. If they can’t afford their meds, they can connect with their social worker but more importantly on the behavior change side is to help them understand the importance of managing their disease and the consequences of not managing their diseases. And again in a compassionate supportive and inclusive way. As we know many of these high risk patients suffer from psycho-social issues and so how you manage them, the wording and phrasing and supportiveness is absolutely critical.  Our focus groups have shown us, that wording the programs and the interactively of these high risk patients makes all the difference.

So the medium risk pathways are really the combination and that is goanna depend on the strategies of the local provider on how much touch they want to provide to the medium risk persons but no matter what the medium risk persons still needs to be managed and our Kare-N® program stays connected with them almost daily. We are communicating with the patients 18 out of 30 days, and that’s two-way communications. So just imagine, how much interaction and how much information you can get back from a patient if you are talking to them almost every day.

So across these pathways we have what we call tripwires.  Let’s talk about a COPD patient for example. Let’s say their consistency and their thickness of their mucus increases, and that’s an alarm for them and creating panic attacks in them. You need to know when that happens at that moment and since we are communicating with the patients and supporting them almost every day. It’s easy for us to say how’s the consistency and color of your mucus? And if we realize something has changed for the worse, we will alert the care team so they can step in manually. Our program Kare-N® really transforms the nature of the care team so they can be real time, and very quickly and very responsive to the patient’s emergent needs in real-time.

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