While it may seem straightforward for some individuals, following medical instructions can bring up a host of challenges. Failing to fill a prescription, not making or keeping important appointments, and self-diagnosing can lead to unnecessary trips to the ER, hospitalizations, and higher long-term costs. The reasons for this vary by person.
Healthcare is very personal and sometimes patients need help, but don’t know how to ask. Doctor’s visits can be intimidating and appointments can be difficult to make. Having access to a “coach,” through a 24/7 nurse line or similar program, can put patients at ease and deliver the hands-on, one-on-one support he or she needs. At Health Dialog, every interaction between a health coach and individual is personalized to empower the individual to make informed decisions and successfully navigate the healthcare system.
In addition to filling the health information gap, health coaches help individuals:
- provide available condition and medication education
- redirect patients away from the ER or 911 when not clinically necessary, yet encourage those actually needing those services to move forward quickly
- find contracted providers and help schedule appointments
- complete Health Risk Assessments (HRA’s)
- avail themselves to specialized resources such as community service referrals, intake case management, behavioral health services, and disease management programs
Health Dialog’s health coaches work with members on personalized Member Action Plans (MAPs) and track the barriers members face in achieving their healthcare goals.
In 2018, the top barriers* are:
Time Management 32%
Physical Limitations 7%
Provider Related 7%
Side Effects 4%
*Health Dialog Book of Business, January – September, 2018
Through a nurse line program, health plans learn more about their membership and provider networks by looking at “member intent” data. Member intent looks at what the individual had first planned to do (which may include calling 911, visiting the emergency or an urgent care facility, contacting their provider office, attempting a home remedy, etc.) and - after speaking with a health coach about care options - the member’s post-call intent is recorded. This information can be used to identify patient education opportunities for both self-care and proper utilization of healthcare resources, and help health plans determine the effectiveness of existing programs and services.
In one study, 66% of callers who planned to visit the ER or call 911 as their first treatment options were appropriately redirected to a less emergent level of care by one of our nurses.
Member intent can be looked at by business line, region, network, or demographics and can uncover:
- Are there a certain regions where ER utilization is high? If so, accessing urgent care facilities may be an option for care.
- Are members calling in frequently with chronic conditions, like diabetes, without basic information on how to manage it? This might indicate that there should be more condition education and development of symptom response plans.
For more information, please click here: https://www.healthdialog.com/solutions/nurse-line