By Tom Fee, VP, Hippo North America

Coactive Care allows certified caregivers to provide patient care under the direct guidance of remote clinicians (physician, PA, nurse, etc.) This new care delivery model improves access, cost, productivity and satisfaction by providing care at home to improve wellness for the 10% of patients who generate 70% of the healthcare costs. This is more than a “mobile” ambulatory model (or telehealth) and requires new workflow, tools, teamwork, roles and a patient-caregiver relationship to succeed.

Healthcare is in a state of turmoil in regards to productivity, access, outcomes and satisfaction. Patients, physicians and staff are fed up with the cost, stress and complexity of care delivery. The center of healthcare today is the hospital or clinic, “the box”. The doc-in-the-box model of assembly line medicine is frustrating everyone. How can we break out of this box to improve patient access, relationships and outcomes?

Health systems have grown in order to maximize revenue, focusing on delivery of high-paying procedures. This centralizes physicians on health system campuses (“boxes”) where they can optimize their time on expensive diagnostics and interventions. This is perfectly logical for a fee-for-service model that rewards sick-care.

Unfortunately, this has concentrated care in capacity-constrained regional medical centers and bypassed smaller hospitals and clinics that are going broke. Because physicians are scarce, we have developed an industrial pipeline productivity model that requires patient scheduling and long delays for doctor visits – leading to emergency care when their symptoms escalate while they wait. This factory model is causing healthcare workers at all levels to burn out.

What if we had an effective care delivery model that allows physicians to examine patients remotely and provide effective immediate care that reduces acute complications of chronic conditions?  Leading to better access, productivity, outcomes, costs and satisfaction for all! That is the Coactive Care Model.

Coactive Care can reduce delays, coordination and handoffs for physicians in the ER, inpatient, long-term care, rural clinic and home settings.  Just as medical assistants make physicians productive in the office by unloading the patient prep and education, allowing the physician to focus on 10 minutes of diagnosis and treatment, certified caregivers of all levels can provide remote specialists the patient prep, local assessment and patient education in remote settings. They provide specialists with the support they need to manage complex patients remotely. This Clinician Extender model is essential to increase patient confidence and nurture caring relationships that reinforce effective patient self-care.

Emergency nurses can support remote specialist consults, reducing delays and travel time. Inpatient nurses can assist specialist consults to clear patient discharges to improve throughput. Medical directors can provide immediate nursing home care, guiding local caregivers in patient admission care plans and urgent care response, rather than transporting patients to the ER. And, Clinician Extenders can support multi-chronic elderly patients with specialist remote visits at home, rather than dealing with the scheduling and travel hassles. These performance improvements are all profitable under fee-for-service care. But the major breakthrough is in value-based care, where “early and often” care at home can reduce emergency and acute care episodes – improving outcomes for patients, ACOs and payers.

Coactive Care works when implemented effectively. It hinges more on new roles, behavior and teams than on new technology. Improving health outcomes requires nurturing relationships between patient, family and caregiver than just the introduction of  automation and administration. Coactive Care is a care model of the future and a linchpin for value-based care. Take the time now to implement it in your organization, so that you will have the experience, expertise and confidence to scale it up across your organization when value-based care makes it crucial to your transformation and survival.