Transcript Creating the Personal Health Picture

Improving Health Care Quality
and Cost Effectiveness
Dean Souleles
Chief Operating Officer
November 21, 2008
RHI - Confidential and Proprietary - Do Not Copy
Resolution Health
Our Vision
Create a world where each individual achieves their optimal health
through the best, most cost effective health care.
Our Beliefs
It is possible to create that world.
Getting patients, doctors and relevant health information together
is at the heart of achieving this vision.
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Resolution Health
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Resolution Health
Our Mission
We send a smarter patient to the doctor.
We provide a more informed doctor for the patient.
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The Smarter Patient
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The More Informed Doctor
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Guiding the Way to Better Health Care
™
One Person at a Time
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Guiding the Way to Better Health Care…
™
One Person at a Time
Personal Health Picture™
 We assemble and organize personal health data for each health plan
member (not just those with “Big 5” chronic diseases)
Personal Health Scan™
 We identify specific opportunities for health care quality improvement
and cost reduction for the individual
Personalized Communications
 We provide actionable information to the individual, their physicians
and their care managers
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Personal Health Care Guidance
Our Expertise
Data
Analytics
Expertise
Personal Health Picture
™
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Personal Health Care Guidance
Our Expertise
Data
Analytics
Expertise
Clinical
Expertise
GAP IDENTIFIED !
Personal Health Picture
™
Personal Health Scan
™
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Personal Health Care Guidance
Our Expertise
Data
Analytics
Expertise
Personalized
Communications
Expertise
Clinical
Expertise
GAP IDENTIFIED !
Personal Health Picture
™
Personal Health Scan
™
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Our Customers
Entities at financial risk for health care costs
 Health Plans
 Self-Insured Employers
 Pharmacy Benefits Management Companies
 Unions
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Our Customers
Entities at financial risk for health care costs
 Health Plans
 Self-Insured Employers
 Pharmacy Benefits Management Companies
 Unions
Companies that help “at-risk” entities manage their risk
 Disease Management Companies
 Third Party Administrators
 Portal Companies
 Benefits Consulting Firms
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Our Customers
Entities at financial risk for health care costs
 Health Plans
 Self-Insured Employers
 Pharmacy Benefits Management Companies
 Unions
Companies that help “at-risk” entities manage their risk
 Disease Management Companies
 Third Party Administrators
 Portal Companies
 Benefits Consulting Firms
Current Client List
 193 Individual Accounts
 10 Major Health Plans

2 Major Pharmacy Benefits Management Companies

1 Major Portal Vendor
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What Differentiates Us
Our Business
Personal Health Picture™
 Sophistication and breadth of our of data analytics
 Focus on individuals in entire population, not just “Big 5” diseases
 Analysis of Lab Results, HRA -- moving toward real-time analyses
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What Differentiates Us
Our Business
Personal Health Picture™
 Sophistication and breadth of our of data analytics
 Focus on individuals in entire population, not just “Big 5” diseases
 Analysis of Lab Results, HRA -- moving toward real-time analyses
Personal Health Scan™
 Comprehensive, cutting edge rules library
 Rules which consider individuals’ plan benefit design details
 Glide path predictive modeling
 Johns Hopkins University School of Medicine relationship
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RHI - Confidential and Proprietary - Do Not Copy
What Differentiates Us
Our Business
Personal Health Picture™
 Sophistication and breadth of our of data analytics
 Focus on individuals in entire population, not just “Big 5” diseases
 Analysis of Lab Results, HRA -- moving toward real-time analyses
Personal Health Scan™
 Comprehensive, cutting edge rules library
 Rules which consider individuals’ plan benefit design details
 Glide path predictive modeling
 Johns Hopkins University School of Medicine relationship
Personalized Communications
 Focus on engaging and motivating individuals
 Consumer communications, behavioral science expertise
 Coordination of individual, physician and care manager messaging
 Personalized “tailoring” of messages and delivery methods
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What Differentiates Us
Our Impact
Matched-Control Study
 Proved member-targeted messaging increases compliance with
evidence-based guidelines and formulary preferences.
Randomized Control Test
 Proved physician-targeted messaging increases compliance with
evidence-based guidelines.
Member Conversion to Best Clinical Practices
Compared to Control Group
Conversion
Absolute Increase Relative Increase
(% of Population)
Versus Control
Versus Control
Member
Messaging
32%
Incremental +12% (s)
of population
Physician
Messaging
40%
Incremental +5% (s)
of population
60% increase in
compliance
14% increase in
compliance
(s) statistically significant at p < 0.01
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The Personal Health Picture
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™
™
Creating the Personal Health Picture
Personal Health Picture
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™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
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™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
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™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
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RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
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RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Lab Test Results
 Total Cholesterol 214 (May 23 2008)
 LDL Cholesterol 109 (May 23 2008)
 HDL Cholesterol 85 (May 23 2008)
 Triglycerides 100 (May 23 2008)
 Fasting Blood Sugar 123 (Mar 28 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
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RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Test Results
 Total Cholesterol 214 (May 23 2008)
 LDL Cholesterol 109 (May 23 2008)
 HDL Cholesterol 85 (May 23 2008)
 Triglycerides 100 (May 23 2008)
 Fasting Blood Sugar 123 (Mar 28 2008)
Biometrics
 Height 6’ 2” (May 23 2008)
 Weight 215 (May 23 2008)
 BMI 27.6 (May 23 2008)
 Abdominal Girth 39in (May 23 2008)
 Blood Pressure 145 / 90 (May 23 2008)
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
26
RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Test Results
 Total Cholesterol 214 (May 23 2008)
 LDL Cholesterol 109 (May 23 2008)
 HDL Cholesterol 85 (May 23 2008)
 Triglycerides 100 (May 23 2008)
 Fasting Blood Sugar 123 (Mar 28 2008)
Biometrics
 Height 6’ 2” (May 23 2008)
 Weight 215 (May 23 2008)
 BMI 27.6 (May 23 2008)
 Abdominal Girth 39in (May 23 2008)
 Blood Pressure 145 / 90 (May 23 2008)
Health Participation
 Disease Mgt Program – Enrolled
(Mar 17 2008)
 Wellness Program - Targeted
 Wt Loss – Targeted
 Smoker – Targeted
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
27
RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
Lab Test Results
 Total Cholesterol 214 (May 23 2008)
 LDL Cholesterol 109 (May 23 2008)
 HDL Cholesterol 85 (May 23 2008)
 Triglycerides 100 (May 23 2008)
 Fasting Blood Sugar 123 (Mar 28 2008)
Biometrics
 Height 6’ 2” (May 23 2008)
 Weight 215 (May 23 2008)
 BMI 27.6 (May 23 2008)
 Abdominal Girth 39in (May 23 2008)
 Blood Pressure 145 / 90 (May 23 2008)
Health Participation
 Disease Mgt Program – Enrolled
(Mar 17 2008)
 Wellness Program - Targeted
 Wt Loss – Targeted
 Smoker – Targeted
Lifestyle
 Exercise – 3X per week (Feb 18 2008)
 Smoker (Feb 18 2008)
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RHI - Confidential and Proprietary - Do Not Copy
™
Creating the Personal Health Picture
Personal Health Picture
Demographic
 Age 62
 Male
 Married
Medical History
 Atrial Fibrillation (Jul 22 2007)
 Diabetes (Mar 01 2006)
 Office Visit Dr. Lynn (May 23 2008)
 Office Visit Dr. Wilson (May 17 2008)
 Office Visit Dr. Jones (Apr 12 2008)
Prescriptions
 Metformin 500mg (May 01 2008)
 Metformin (Dec 01 2007)
 Lipitor 20 mg (Feb 10 2008)
 Lipitor 20 mg (Jan 18 2008)
 Accupril 20 mg (Mar 28 2008)
 Accupril 20 mg (Feb 18 2008)
 Accupril 20 mg (Jan 12 2008)
 Nexium 20 mg (Feb 12 2008)
 Nexium 20 mg (Jan 10 2008)
Lab Tests
 Cholesterol Panel (May 23 2008)
 Metabolic Panel (Mar 28 2008)
 CT X-Ray Sinuses (Feb 04 2008)
Lab Test Results
 Total Cholesterol 214 (May 23 2008)
 LDL Cholesterol 109 (May 23 2008)
 HDL Cholesterol 85 (May 23 2008)
 Triglycerides 100 (May 23 2008)
 Fasting Blood Sugar 123 (Mar 28 2008)
Biometrics
 Height 6’ 2” (May 23 2008)
 Weight 215 (May 23 2008)
 BMI 27.6 (May 23 2008)
 Abdominal Girth 39in (May 23 2008)
 Blood Pressure 145 / 90 (May 23 2008)
Health Participation
 Disease Mgt Program – Enrolled
(Mar 17 2008)
 Wellness Program - Targeted
 Wt Loss – Targeted
 Smoker – Targeted
Lifestyle
 Exercise – 3X per week (Feb 18 2008)
 Smoker (Feb 18 2008)
COMPLETE
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The Personal Health Scan
RHI - Confidential and Proprietary - Do Not Copy
™
Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
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Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
Evidence-Based Care Scan
 Has Condition Needs Drug
 Has Condition Needs Test
 Need Test Event Follow-up
 Need Preventive Test-Age
 Need Doctor Visit Follow-up ER
 Need Preventive Info Condition
 Need Info Warning Signs
 Need Info Lab Result Ranges
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
Evidence-Based Care Scan
 Has Condition Needs Drug
 Has Condition Needs Test
 Need Test Event Follow-up
 Need Preventive Test-Age
 Need Doctor Visit Follow-up ER
 Need Preventive Info Condition
 Need Info Warning Signs
 Need Info Lab Result Ranges
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
Evidence-Based Care Scan
 Has Condition Needs Drug
 Has Condition Needs Test
 Need Test Event Follow-up
 Need Preventive Test-Age
 Need Doctor Visit Follow-up ER
 Need Preventive Info Condition
 Need Info Warning Signs
 Need Info Lab Result Ranges
Rx Cost Savings Scan
 Brand Switch to Generic
 Brand Switch to Formulary Preferred
 Formulary-Preferred to Generic
 Pharmacy Purchase to Mail Order
 Test Result Indicates Doctor Follow-up
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
PERSONAL HEALTH SCAN
Rx Safety Scan
 Drug-Drug Interaction
 Drug-Condition Interaction
 Drug-Age Interaction
 Drug-Lifestyle Interaction
 Drug FDA Recall/BlackBox
 Has Condition Needs Drug
 Need Test to Optimize Drug
Dose
 Need Test to Assess Drug Side
Effect
 Test Result Indicates Dose Adjust
 Non-Compliance Drug Regimen
 Over-use of Drug
 Need Doctor Visit to Follow Start
New Med
 Need Drug to Prevent
Condition
Evidence-Based Care Scan
 Has Condition Needs Drug
 Has Condition Needs Test
 Need Test Event Follow-up
 Need Preventive Test-Age
 Need Doctor Visit Follow-up ER
 Need Preventive Info Condition
 Need Info Warning Signs
 Need Info Lab Result Ranges
Rx Cost Savings Scan
 Brand Switch to Generic
 Brand Switch to Formulary Preferred
 Formulary-Preferred to Generic
 Pharmacy Purchase to Mail Order
 Test Result Indicates Doctor Follow-up
36
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Guiding the Way to Better Health Care…
™
One Person at a Time
Adam is at risk for stroke.
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Personalized Communications
RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
Adam is at risk for stroke.
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Guiding the Way to Better Health Care…
™
One Person at a Time
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
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RHI - Confidential and Proprietary - Do Not Copy
Guiding the Way to Better Health Care…
™
One Person at a Time
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Making a Difference
Adam
Achieves “optimal health”
Risk of stroke reduced
Avoids Emergency Room visit
Avoids hospital stay
Avoids compromised lifestyle
Adam’s Employer
Adam remains at work
A productive employee
Avoids finding, training new employee
Adam’s Health Plan
Avoids medical claim
Avoids short / long term disability claim
Avoids post-stroke medical costs
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Resolution Health Message Types
Health Alerts
Urgent information about your health
Health Tips
Ways to help improve your health
Money Savings
Ways to save money on prescription
drugs and other health care services
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Reaching
The Individual
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Coordinated Communications
To Patient and Physician
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Patient / Physician Communications
Strong Results and Reaction
Success / Compliance Rate 44% On Clinical Issues
“It’s wonderful that my health plan does such a thing.
These communications make me proud
to be a health plan member.”
“Compiling the patient's information in this easy-to-read
format makes communication between the physician
and the patient more interactive…a better feeling.”
– Personal Care Note Recipient
– Family Practice Physician
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Resolution Health
Questions?
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Resolution Health
Thank You
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Improving Health Care Quality
and Cost Effectiveness
Dean Souleles
Chief Operating Officer
November 21, 2008
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