{"id":237280,"date":"2020-06-24T16:09:00","date_gmt":"2020-06-24T20:09:00","guid":{"rendered":"http:\/\/onecare.mysites.io\/?p=237280"},"modified":"2020-10-08T15:02:11","modified_gmt":"2020-10-08T19:02:11","slug":"using-data-to-connect-with-high-risk-patients","status":"publish","type":"post","link":"https:\/\/www.onecarevt.org\/news\/using-data-to-connect-with-high-risk-patients\/","title":{"rendered":"Using Data to Connect with High-Risk Patients"},"content":{"rendered":"

[et_pb_section fb_built=”1″ _builder_version=”4.3.2″ custom_margin=”0px||||false|false” custom_padding=”0px||||false|false”][et_pb_row _builder_version=”4.3.2″ background_size=”initial” background_position=”top_left” background_repeat=”repeat” custom_margin=”5px||5px||false|false” custom_padding=”0px||0px||false|false”][et_pb_column type=”4_4″ _builder_version=”3.0.47″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/www.onecarevt.org\/wp-content\/uploads\/2020\/06\/2020-06-23-COVID19-app-update-blog-post-3.png” alt=”Blog Illustration and Title – Using Data to Connect with High Risk Patients. Graphic shows illustration of a male doctor with a clipboard, and an elderly senior woman sitting in an arm chair with a laptop to communicate with the doctor.” title_text=”2020-06-23 COVID19 app update blog post 3″ _builder_version=”4.4.8″][\/et_pb_image][et_pb_text admin_label=”Main Body of the Post” _builder_version=”4.4.4″ header_3_font=”|600|||||||” header_3_text_color=”#4cb49f” header_3_font_size=”26px” header_3_line_height=”1.2em” z_index_tablet=”500″ text_text_shadow_horizontal_length_tablet=”0px” text_text_shadow_vertical_length_tablet=”0px” text_text_shadow_blur_strength_tablet=”1px” link_text_shadow_horizontal_length_tablet=”0px” link_text_shadow_vertical_length_tablet=”0px” link_text_shadow_blur_strength_tablet=”1px” ul_text_shadow_horizontal_length_tablet=”0px” ul_text_shadow_vertical_length_tablet=”0px” ul_text_shadow_blur_strength_tablet=”1px” ol_text_shadow_horizontal_length_tablet=”0px” ol_text_shadow_vertical_length_tablet=”0px” ol_text_shadow_blur_strength_tablet=”1px” quote_text_shadow_horizontal_length_tablet=”0px” quote_text_shadow_vertical_length_tablet=”0px” quote_text_shadow_blur_strength_tablet=”1px” header_text_shadow_horizontal_length_tablet=”0px” header_text_shadow_vertical_length_tablet=”0px” header_text_shadow_blur_strength_tablet=”1px” header_2_text_shadow_horizontal_length_tablet=”0px” header_2_text_shadow_vertical_length_tablet=”0px” header_2_text_shadow_blur_strength_tablet=”1px” header_3_text_shadow_horizontal_length_tablet=”0px” header_3_text_shadow_vertical_length_tablet=”0px” header_3_text_shadow_blur_strength_tablet=”1px” header_4_text_shadow_horizontal_length_tablet=”0px” header_4_text_shadow_vertical_length_tablet=”0px” header_4_text_shadow_blur_strength_tablet=”1px” header_5_text_shadow_horizontal_length_tablet=”0px” header_5_text_shadow_vertical_length_tablet=”0px” header_5_text_shadow_blur_strength_tablet=”1px” header_6_text_shadow_horizontal_length_tablet=”0px” header_6_text_shadow_vertical_length_tablet=”0px” header_6_text_shadow_blur_strength_tablet=”1px” box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px”]<\/p>\n

The Center for Health Care Strategies recently featured OneCare’s innovative\u00a0COVID-19 Care Coordination Prioritization tool in their profile,\u00a0Connecting with High-Risk Patients When In-Person Visits are Not Possible<\/a><\/em>. The tool is designed to help clinicians identify Vermonters who are at greatest risk for COVID-19 and has been accessed over 350 times by providers in the OneCare\u00a0network.<\/p>\n

\u00a0Dr. Norman Ward, OneCare chief medical officer, described how the tool can be used to support patient outreach. \u201cWhen you ask any clinician: \u2018Who are your high-risk people?\u2019 Even though doctors are proud to say, \u2018I know all my patients really well,\u2019 there\u2019s just no way that you can remember everybody,\u201d said Dr. Ward.<\/span><\/p>\n

<\/span><\/p>\n

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The pandemic presents new challenges for patients unable to receive in-person health care, and outreach calls\u00a0from providers can connect patients who are at greater risk or isolated. “Staying home saves lives during the COVID-19 pandemic. Yet, many people have been home by themselves for months and may be feeling very isolated,\u201d said Tyler Gauthier, OneCare director of value-based care. \u201cBy receiving these calls patients know someone is \u2018in this with them\u2019 and they will have a contact person in case they have additional concerns. Over time, practices that have been proactively reaching out to their high-risk patients may find that they have improved engagement of a traditionally hard-to-engage population and have built stronger relationships.\u201d<\/span><\/p>\n

[\/et_pb_text][et_pb_number_counter title=”Number of providers accessing the COVID-19 Care Coordination Prioritization tool as of 5\/15\/2020″ number=”350″ percent_sign=”off” _builder_version=”4.4.8″ title_text_color=”#ffffff” title_font_size=”28px” title_line_height=”1.2em” number_font=”|700|||||||” number_text_color=”#ffffff” number_line_height=”100px” background_color=”#80bc00″ custom_padding=”15px||25px||false|false”][\/et_pb_number_counter][et_pb_divider color=”#80bc00″ divider_weight=”7px” _builder_version=”4.4.8″ custom_margin=”15px||10px|” z_index_tablet=”500″ box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px”]<\/p>\n

[\/et_pb_divider][et_pb_testimonial author=”Tyler Gauthier” job_title=”Director of value-based care” company_name=”OneCare Vermont” portrait_url=”https:\/\/www.onecarevt.org\/wp-content\/uploads\/2020\/06\/Tyler-DSC_3615-Edited-BG.png” portrait_width=”280px” portrait_height=”280px” _builder_version=”4.4.8″ body_text_color=”#353535″ author_text_color=”#353535″ position_text_color=”#353535″ position_font_size=”14px” position_line_height=”1.5em” company_text_color=”#353535″ company_font_size=”14px” hover_enabled=”0″ border_radii_portrait=”on|200px|200px|200px|200px” border_width_all_portrait=”7px” border_color_all_portrait=”#4cb49f”]<\/p>\n

Staying home saves lives during the COVID-19 pandemic. Yet, many people have been home by themselves for months and may be feeling very isolated. By receiving these calls patients know someone is \u2018in this with them\u2019 and they will have a contact person in case they have additional concerns. Over time, practices that have been proactively reaching out to their high-risk patients may find that they have improved engagement of a traditionally hard-to-engage population and have built stronger relationships.<\/strong><\/h3>\n

[\/et_pb_testimonial][et_pb_divider color=”#80bc00″ divider_weight=”7px” _builder_version=”4.4.8″ custom_margin=”15px||10px|” z_index_tablet=”500″ box_shadow_horizontal_tablet=”0px” box_shadow_vertical_tablet=”0px” box_shadow_blur_tablet=”40px” box_shadow_spread_tablet=”0px”]<\/p>\n

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Tool Criteria<\/h3>\n

Criteria used in the tool to identify patients at greatest risk was developed by the World Health Organization, Centers for Disease Control, and Johns Hopkins. The OneCare COVID-19 tool includes\u00a0social determinants of health<\/a>\u00a0data, specifically patients at risk due to social isolation and food access. Other\u00a0risk factors include age greater than 60 with chronic conditions, frailty score, potential for fragmented care, mental health or substance use conditions, and high healthcare resource usage.<\/span><\/p>\n

How can this tool be used?<\/h3>\n

Part of the Center for Health Care Strategies\u2019 Innovations Amid COVID-<\/strong><\/em>19<\/strong> series, the profile describes how the tool can be used by OneCare providers to achieve the following objectives. <\/p>\n

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Providers can identify patients who may have slipped through the cracks in the stay-at-home environment.<\/h3>\n

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Providers can organize remote care delivery.<\/h3>\n

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Providers can adopt a population health approach to care.<\/h3>\n

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Questions?<\/span><\/p>\n

Please contact OneCare’s Analytics team at Data@onecarevt.org<\/a> with any questions about the application.<\/p>\n

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For more information:<\/h3>\n

Please contact Public Affairs at OneCare Vermont. public@onecarevt.org<\/a> | 802-847-1346<\/p>\n

To stay up to date on OneCare, please visit our news blog<\/a> and our social media channels on LinkedIn<\/a> and Twitter<\/a>.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

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