Transcript ADT Well Health for Chronic Conditions

David J. Whellan, MD, MHS
Associate Professor
Director of Clinical Trial Outcomes
Department of Medicine
Jefferson Medical College
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Consulting/Grant
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NHLBI
Medtronic
Schering Plough
AstraZeneca
Johnson and Johnson
GE
Unipath/Inverness/Biosite
excellRx
Tyco/ADT WellHealth
Discharges in
Thousands
700
600
500
400
300
200
100
Male
03
Years
95
85
79
0
Female
Note: Hospital discharges include people discharged alive and dead
AHA. 2006 Heart and Stroke Statistical Update
The Major Reason for Heart Failure
Hospitalizations
Worsening chronic
heart failure (75%)
De novo heart
failure (23%)
Advanced/ end-stage
heart failure (2%)
Fonarow GC. Rev Cardiovasc Med. 2003; 4 (Suppl. 7): 21
Cleland JG et al. Eur Heart J. 2003; 24: 442
Acute event
• Medications
• Devices
• Surgery
Patient Status
Achieve Goals:
Time
Definition and Epidemiology of Acute Heart Failure Syndromes, Nieminen
MS,Harjola VP: American Journal of Cardiology, Supp to Vol. 96, #6; 13G
Patient
Healthcare
Costs
Physiologic Changes
Precede Symptoms
Patient
Healthcare
Costs
Early Detection of
Physiologic Changes
and Change in Treatment
Physiologic
Domain
Psychosocial
Domain
Initial
Loss of
Stability
Worsening
Signs and
Symptoms
Patient Functioning
Domain
Hospitalization/
Mortality
Baseline Risk Factors
Demographic
Domain
Resource Utilization
Domain
HFDM
Mechanism
Reducing Risk
Monitoring
Improve accuracy of knowledge about self-management
Promote Self-Management Skills
Develop Self-Efficacy
Required
to
continue
benefit
ADT Value
• Connected
with ADT for
complete
solution
Physician
Patient’s home
Alerts
Verify / Notify
Patient risk stratification
Med Compliance
Symptoms
Bill Turner
50%
wt + 5
Mike Lynch
50%
wt + 3
Mike Calhoun
71%
Katherine VanNiel
99%
Triage
and
connect
Monitoring Center
 Conduct daily survey
 Remind to take meds
 Verify status if an alert
 Notify healthcare
providers and family
 Provide help 24/7
Your healthcare providers
• Best devices
and health
services
Health Coach
PBM
EMS
Unit dials out
and
downloads a
session
Did you take your
medication today?
Y/N
PBM
Why did you not
take your
medication?
Forgot?
Side effect?
Out of medicine?
Call center operator is
immediately notified
Unit shipped to
participant
Participant is
enrolled in
program
EMS
Participant is connected
to help needed
Phone
support is
available if
needed
Participant
connects the
unit
Physician Health Coach
Complying with
your medication
regime is important
to your health. An
ADT operator will
contact you shortly.
Unit dials out
immediately if there
is an alert situation
Overview
 110
Chronically ill patients already
under disease management care
◦ Congestive heart failure
◦ Diabetes
◦ Asthma
6
months of daily surveys
conducted for
all patients
Results
 100%
successful self-install of
devices
 90%
satisfied with the program, 70%
felt better able to manage their
condition
 95%
completed daily surveys on
schedule
 Statistically
 Alerts
monitored by ADT
 Patients
with problems get help
when needed
 Dedicated
monitoring units were
drop-shipped to users’ homes
significant 24%
reduction in ER visits for patients
under 45 years old
 ADT
triaged out 40% of alerts with
SOPs
◦ Self-resolution
◦ Rx refills
◦ False alarms
 60%
of alerts were verified and
handed off to nurse for next steps
*Based on preliminary data
Devices can be dropped shipped directly to the
member
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The CMC’s act on more than 29 million alarm signals each year
◦ 93,000+ alarms daily
◦ 200,000+ total calls daily (inbound/outbound)
◦ 8,000+ customer contacts an hour 24/7
More than 19 million customer calls per year –
(3.3 calls per second)
ADT operates the only virtual monitoring centers in the industry.
If one monitoring center becomes non-operational, all calls are
automatically rerouted to another of ADT’s five centers, with no
interruption in service
All CMCs engineered, built and operated in full compliance with
the strict requirements of Underwriters Laboratory (“UL”)
standards
As a Department of Defense contractor, facilities are further
required to pass annual DOD inspections in order to
maintain certification.
Fleet of 6800 truck in the US
7 redundant call
centers across the US
6800 truck fleet in the
United States
ADT’s scale equals lower costs, enabling better ROIs
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Better health through enhanced compliance with doctor’s orders
◦ 24/7 support to help keep users on medication programs and detect
problems early
◦ ADT® response - get the help they need when they need it
◦ Encourage healthy behaviors - daily interaction and reminders
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Lower health care costs through daily communication and
early intervention
◦ Healthier employees use fewer health care resources
◦ Daily health checks avoid hospital stays, ER visits and trips to the doctor’s
office
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Increased efficiency through ADT procedures that save valuable
nurse and doctor time
◦ ADT verifies information from patients to determine whether intervention
is needed
◦ ADT links patients directly to all needed help, e.g., Rx benefits manager
for refills
Traditional DM
Tech-Based DM
ADT WellHealth
With ADT only
~60% of the 32
need a nurse
With remote
monitoring nurse
calls 32 people
who actually need
help
Patient’s
doctor
18
2
30
32
Need help
Okay
Need help
0
ADT
reinforcement only,
user error, etc
32
PBM
0
Need help
Nurse-to-patient ratio = ~320
Nurse-to-patient ratio = ~640
Nurse-to-patient ratio = ~1100
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Which patients need what?
How engaged are patients?
Who and how are DM providers
responding to signals?
What is the evidence?
◦ Incremental value?
◦ Class effect or system specific?
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Who will pay for this?
$5,000
$4,500
$4,000
$3,500
Card limit
Hospital
IHS Limit
CMS limit
$3,000
$2,500
$2,000
$1,500
$1,000
$500
$0
Clinic
Telephone
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