Crafting a continuous engagement program

Sept. 25, 2015
Kathy Bellevin, Co-Founder and COO, Wildflower Health

The marketplace is saturated with mobile health apps, but few operate on an enterprise-grade level and can unite payers, providers, and patients in a friendly, seamless way. Even more elusive is a platform that fits this bill and is HIPAA compliant, guidelines based, and developed in conjunction with clinician thought leaders.

The challenges that face this endeavor include IT integration across stakeholder systems, meeting high user expectations, developing effective marketing channels, and navigating enterprise security requirements. All this, and it has to be engaging to consumers too.

Wildflower Health, a San Francisco-based technology company, is meeting these challenges and changing the engagement conversation. Since 2012, their smartphone-based maternity program, called Due Date Plus, has been helping women have healthier pregnancies by tracking their milestones, looking up symptoms and issues, and connecting to healthcare providers and services driven by health plans and Medicaid.

Mobile health (mHealth) programs are especially important in the Medicaid community, which makes up nearly half of all U.S. pregnancies. Smartphone penetration has increased over the last four years by 96.7 percent overall. Within low-income communities (households with income less than $30,000), smartphone use has skyrocketed from 22 percent in 2011 to 50 percent in 2015. In addition, nearly 50 percent of physicians use mHealth apps on a daily basis. The mobile platform has become the common denominator.

Partnering for maternal health

Since 2014, Wildflower has partnered with Xerox to bring Due Date Plus to Medicaid populations nationwide, starting with the state of Wyoming. With an eye to providing a Medicaid-based healthcare resource that can help ensure healthier pregnancies and increase patient engagement, Wyoming agreed to implement Wildflower’s Due Date Plus with Xerox because it is the only pregnancy app that links patients and their clinical information with community resources. The app collects data that can be shared with care managers and nurses, employs tap-to-call for nurse support, and enables access to other statewide Wyoming health resources and programs, such as the Public Health Nurse program and Wyoming’s tobacco quit line. The platform is integrated with Wyoming’s eligibility system to provide Medicaid benefits status.

The WYhealth Due Date Plus program was purpose-built to connect to the healthcare system and specifically support the physicians, nurses, and care managers that work with health plan members during pregnancy. Connecting users through Due Date Plus to their health plan programs and services provides additional maternity support and access to healthcare professionals who can help assess and address risks to the pregnancy. Up to 70 percent of Due Date Plus users access information and services like these within the application.

How does it work? Pregnant women use Due Date Plus to project and map their pregnancy health milestones – from upcoming tests, to fetal development milestones, to feeling the baby’s first kicks. They can track their own weight gain, which is an important issue in pregnancy, look up symptoms and issues, and connect to a 24/7 nurse hotline to get specialized help.

Combining access and analytics to manage risk

Behind the tools and content, Due Date Plus’ pregnancy health algorithm stratifies the pregnant population based on over 50 risk factors specific to pregnancy and refers high-risk women to the WYhealth Case Management program administered by Xerox. The goal is to refer the right women to the program at the right time so that the WYhealth team can better target women who need their services most.

From an engagement standpoint, the system relies on user-driven actions. While many programs employ health risk assessments that consist of one-time interactions and long lists of questions, the Due Date Plus platform allows for continuous engagement. This captures high-risk issues as they happen and provides a more user-friendly interface.

From an analytics standpoint, rolling up data that Wildflower captures in the application with outcomes data generated through medical claims that are analyzed by Xerox allows development of a rich story of actions that can be used to drive improved healthcare outcomes. The fruits of this analysis will become apparent as more and more users engage and have their babies, and reported outcomes data becomes available.

In order to facilitate this analysis, Wildflower has built a HIPAA-compliant data warehouse and analytics platform. This enables several types of reporting, from risk identification and notification services, to periodic reporting on performance and engagement, to deeper studies to look at particular areas, such as referrals to smoking cessation programs.

Case managers are a tap away

WYhealth’s Xerox case managers are an important part of the services that Wyoming provides to their Medicaid population. Their mission is to work with women who need extra support during health events such as pregnancy, especially for those with high-risk health conditions and with behaviors such as smoking and drug use that are dangerous during pregnancy. The mobile application supports these women between contacts with their case manager, giving them a resource to stay connected and involved with their pregnancy.

Due Date Plus is also integrated with the State of Wyoming network of public health nurses to promote the many health services they provide. The application contains a location-based lookup so that users can find the nearest nurse to them and reach out via phone, email, or in person. The connection goes both ways; nurses are important referrers to the program as well.

Because all of this happens on their smartphone, help is always at hand. This is especially important for moms having their second or third child, as they are less likely to be sitting at a computer when an issue arises. Access to a nurse or case manager is just a phone call away.

Meet the awareness challenge

Consumer outreach and education has been one of the toughest areas payers face, because of a historic challenge with member engagement. This is all changing with the rise of healthcare consumerism driven by the Affordable Care Act. The Wyoming pilot also has an added advantage as the app is available for use by anyone in the state, not just Medicaid patients. As such, OB/GYNs across Wyoming are engaged and, in turn, offering the program to their patients.

Xerox and Wildflower have developed a two-way engagement model whereby the application can refer users to WYhealth case managers, and conversely case managers refer users to the application.

Connected customers are happier

WYhealth Due Date Plus is a very cost-effective way to support maternal health. Women prefer to use their mobile devices to access health information, and this program is a convenient way for them to get connected to Wyoming Medicaid’s resources during pregnancy.

And mobile applications that connect health plans with their members create higher user satisfaction. Members who contacted their health plan via a mobile app at least once in the past year rated their plan satisfaction 108 points higher (on a 1,000-point scale) than those that hadn’t. In the end, it seems the numbers show that engaging patients with useful mobile applications yields better results for providers and patients alike.

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