how disease management, case management and corporate health programs can support hr, alfons...
DESCRIPTION
This seminar will explain the paradigm shift in health care from acute diseases to chronic conditions. Based on this understanding the importance and potential of disease and case management programs as well as corporate health programs will be described. The role of self-management and the tremendous impact of HR on health and disease related costs will be highlighted. The relationship of patients to physicians is no longer the unique interaction in health care, but health coaches and HR interventions play a more and more important and effective role. At the end of the seminar HR representatives will be able • To understand what is a Disease Management and Case management program • To know how preventive Corporate Health Programs add value to HR functions • To evaluate which programs may support HR in controlling health insurance premium This presentation was used at HR Summit and Expo 2013 www.hrsummitexpo.comTRANSCRIPT
Dr. Alfons GraboschDirector Health SupportDaman National Health Insurance Company, Abu Dhabi
How Disease Management, CaseManagement And Corporate Health
Programs Can Support HR
Agenda
A Paradigm Shift in Health Care Stakeholders in Health Care Today Disease Management Programs Case Management Programs Corporate Health Programs The role of HR Managers in Health Care
A Paradigm Shift in Health Care
Acutediseases
Chronicconditions
Like accidents, infections,communicable diseases
Like obesity, diabetes,hypertension, heart diseases
sudden onset,lasting for a specific period
of time,more or less unpredictable
insidious development,lifelong lasting,
quite predictable
Chronic Diseases (Challenge and Chance)
more or less predictable self management required very much related to behavior and lifestyle awareness and knowledge required motivation to change help to change overcome of fragmentation
Stakeholders in Health Care Today
PatientPatient
Health InsuranceHealth Insurance RegulatorRegulator
DoctorDoctor Medicalprofessionals
Medicalprofessionals
HRManager
HRManager
Medical InterventionClassical Treatment Medication Surgery Medical procedures
Self-management Supported by Medical Education Disease Management Case Management (Corporate) Health Programs
Disease Management Definition
DM is the concept to reduce healthcare costs and/orimprove quality of life for individuals with chronicdisease conditions by preventing or minimizing theeffects of a disease or chronic condition throughintegrative care…
Disease Management Objectives
Individual Level Encourage self-management of chronic conditions Reduce or avoid complications Better quality of life
System Level Monitor treatment (clinical pathways, evidence based
guidelines) Cost containment
Disease Management Daman Concept
TeleCoaching
Telemonitoring
Training
DMP “Diabetes” Training tool
Daman offers an Interactive Grouptrainings for Diabetes and Obesitythrough the MEDIAS 2 program whichis translated into Arabic/English andadapted to the Gulf/Arabian culture.
Daman’s Service:3 month course with (12 lessons,1 lesson/week, 10-20 Patients / group)In order to: Understand diabetes Change lifestyle Lose weight Live on healthy diet Avoid diabetes complications
DMP “Diabetes” Telecoaching
Daman provides patients with a personalized health coach whocalls them regularly encouraging them to shift to a healthierlifestyle using ProvidinCare® software: to motivate,
to educate,
to set targets and helping patients to achieve them and
to evaluate health status.
Daman’s Service: Structured phone calls lasting 15-20 min. Initially one call per month After one year one quarterly call•Permanent service
DMP “Diabetes” Telemonitoring
Telemonitoring refers to the continuous monitoring of a patient’scondition to enable coaching, lifestyle changes and patient self-management.
Daman’s Service:Telemonitoring of diabetes: Check patient Data, alert functions etc. Real-time data transmission Bluetooth transmission Glucose measurement
DMP “Diabetes”Effectiveness – lowering HbA1c
Lowering HbA1c by 1% can reduce the risk of:Myocardial infarction
14% Stroke 10% Heart Failure 16% Any diabetes relateddeath 21%
For a diabetic patient it should be lower than 6.0%
HbA1c is the average blood sugar level for the pastthree months
DMP “Diabetes”Effectiveness – lowering HbA1c
N=360 Inclusion Criteria: HbA1c ≥ 7% Observation period:18 months t0= HbA1c starting the program t1= HbA1c after 18 months HbA1c reduction is comparablefor males and females
A reduction of 0.6 % pointswas achieved after 18 months
DMP “Diabetes” (achieved targets after 12 months)
Diabetes Mellitus Predicted Cost
Diabetic UAE Nationals 2008-2019
outpatient inpatient total 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Case Management Definition
…is a collaborative process of assessment, planning, facilitationand advocacy for options and services to meet member’s healthneeds through communication and available resources topromote highest quality care.
Case Management Society of America
Case Management ConceptAssessment
NetworkPatients
Case selection
PlanningTreatment plan
Treatment optionsProvider options
CollaborateEvidence based guidelines
CommunicationIncentivesSoftware
ImplementationFacilitation
TrackingCoordinate
MonitoringReview with patients
Reassessment
EvaluationClinical ResultsEffectiveness
Network quality assessmentCost effeciency
Case Management Daman Services
Oncology Breast Cancer Colorectal Cancer Cervical Cancer Prostate Cancer Leukemia
Rheumatology Rheumatoid Arthritis
Case Management Decision Trees
Corporate Health ProgramsDaman’s Concept
Disease/CaseManagement
Health support modules
Recommendations
Member portal (web, smart Phones)
Health Screening
Health Risk Assessment (HRA)
WeightManagement
WeightManagement
FitnessFitness
SmokingcessationSmokingcessation
StressManagement
StressManagement
Corporate Health ProgramsHealth Risk Assessment - Content
• Lifestyle• Physical Activity• Nutritional habits• Health Risks• Sleep• Stress• Occupational well being
Corporate Health ProgramsHealth Risk Assessment - Example
Light physical exertion (h/day)Exercising
Occupational well-being Conflict management by superior
Corporate Health ProgramsHealth Screening
Weight/BMI Body Composition (Water/Fat/Muscle) Blood pressure Blood Sugar Lipid panel Diabetes risk (Find Risk/Ezscan) VO2 max /Fitness/Heart age
Corporate Health Programs
HRAHRA ScreeningScreening IndividualHealth Profile
IndividualHealth Profile
IndividualHealth Profile
IndividualHealth Profile
IndividualHealth Profile
IndividualHealth Profile
CorporateHealth Profile
CorporateHealth Profile
CorporateHealth Profile
CorporateHealth Profile ConsultancyConsultancy Corporate
Health ProgramCorporate
Health Program
Corporate Health Program Result
4.32
2.36
9.58
All personnel Activation Health Lab
Improvement in heart age (average)
8.087.92
7.42
8.62
8.22
8.62
All personnel Activation Health Lab
MET PRE MET POST
Corporate Health Programs Benefits
Improve Quality of Life of employees Retention of employees Avoid/reduce chronic conditions Avoid/reduce complications of chronic conditions Reduce absenteeism Reduce claims cost Improve productivity
The Role of HR Managers in Health Care
Knowing possible interventions Having knowledge of the corporate health profile Selecting the right programs Reduce absenteeism Improving productivity Reducing claims cost Reducing premium
Conclusion
In the future HR Manager will play an active role in supportingstaff to maintain and improve individual health and by thatimprove corporate health.
On a corporate and even community level the HR Managerwill be as important as the doctor.
HR Manager can substantially influence the health caresystem.