Not so long ago, case managers relied primarily on paper brochures and tip sheets when supplementing in-person patient education. Many might still use paper in addition to web-based information, but the newest frontier involves apps that bring education to a patient’s fingertips at precisely the moment he or she needs it.
“We believe in the importance of activating and engaging patients and families so they can be partners in their care,” says Kathleen Baudreau, MSN, RN, CPHQ, CPHRM, vice president of clinical advancement and patient safety at Carilion Clinic in Roanoke, VA.
Carilion uses educational apps to continue patient education after the hospital stay.
“We have patients for such a shorter period of time than we did before that it’s important we have information that helps them, not only during the inpatient stay, but when they go home,” Baudreau says.
Some call it precision engagement. It’s a way to leverage technology to create and paint a more holistic picture of a person’s care management, says Michael O’Neil, JD, founder and chief executive officer of GetWellNetwork, Inc., in Bethesda, MD.
All of healthcare is moving away from the “doctor knows best” way of telling patients what to do toward precision engagement, Baudreau says.
“We need to educate patients and families so they’re more informed consumers and can take care of themselves,” she adds. “It’s changing where patients and families can’t be passive anymore; they need to be active participants, and they need to understand ‘why’ and ‘what.’”
The usual way of sending patients home from the hospital has been to hand them a packet of discharge papers. “Those usually end up lodged in the coffee cup holder near your car seat, and then they’re thrown out,” O’Neil says. “This technology takes all of those patient handbooks, discharge instructions, and teaching sheets and puts them in a real workflow that can be part of a patient’s life.”
Precision engagement pulls community and other resources to the patient. For example, if a patient with Parkinson’s disease is being treated within the case management framework, then the app can serve as a platform for identifying the patient’s support structure.
“If we can paint a more holistic picture of him, then we can get the patient and his caregivers the right information at the right time, served in the right way, to help him be more effective at self-managing his care,” O’Neil says.
O’Neil offers the following ideas for some other ways the technology educates on a real-time basis:
• A mobile platform sends tailored information and checklists to patients and caregivers. Case managers can work off these tailored pieces, rather than having to rely on generic sheets.
• Case managers can monitor their patients via technology. They can see which patients are following their self-care instructions regularly and which have not logged in for a while. They can use the platform to send quick messages such as, “Hi, I’m your case manager, and I saw that you completed your checklist about what to eat. Great job! But I want to check on how your mobility is going.”
• For patients who need more visual educational information, case managers can send them a video and see how they perform on the post-education tests, supplementing on those items missed. “I see you completed this and understand it, but you’ve missed four questions, so let me follow up and make sure you have all the information you need.”
• The app contains a patient pathway for each person’s disease process. The patient’s doctor prescribes the app, and it helps the patient manage his or her disease. It acts as a virtual care coach, setting up daily reminders such as these:
- “It’s time to check in and weigh yourself.”
- “What did you eat today?”
- “Please reference the video on the new medication you were prescribed.”
• When a patient’s weight or other health indicators show a problem, the app sends the patient a notice, and the case manager and physicians can see this information.
“It provides case managers with more actionable data about their patient’s experience so they can intervene in a more patient-tailored and efficient way,” O’Neil says.
From an inpatient perspective, the technology helps prevent acute episodes among patients who are admitted for chronic illness crises, Baudreau says.
“We have a heart failure pathway, when patients cross over to outpatient,” she says.
The goal is to prevent recurrence and follow up on patients’ medication adherence.
“We also educate newly diagnosed patients about what heart failure is and about their diet, exercise, and when to call the doctor,” Baudreau says. “We’ve had about 150 patients use it, and they’re very positive about it so far.”
One of the challenges of educating newly diagnosed patients is their hospital length of stay is short and there is an overwhelming amount of information for them to absorb.
“You’re in the hospital and have new things going on, and so we’re really excited to move this into the GetWellGo app,” Baudreau says. “Patients will be able to access this when they go out.”
Using the technology after discharge is new to the health system, and the goal is to improve outcomes.
“We hope it will decrease readmissions, improve medication compliance, [and] provide better monitoring of weights and blood pressures,” Baudreau says.
From a case management perspective, the technology could provide patients with immediate access to videos about hospice care, discharge instructions, home health, rehab, and advance care planning, she says.
“We haven’t had a way, necessarily, that we could consistently use to educate people about those options, including palliative care,” Baudreau notes. “This can help patients understand what’s going on.”