More than 800,000 Americans die of cardiovascular disease every year. That’s one in three deaths.[1] But as we enter American Heart Month this February, the National Heart, Lung and Blood Institute (NHLBI) reminds us that self-care can protect #OurHearts so it doesn’t progress that far.
Cardiovascular disease is a general term for several conditions, including coronary heart disease, heart failure and peripheral artery disease. A number of factors impact cardiovascular disease, including:
- Cholesterol
- Blood pressure
- Diet
- Exercise
- Smoking
- Stress
Properly managing these factors with self-care can help prevent cardiovascular disease or limit its progression. Research shows that having the right support system aids in this type of self-care, such as healthy eating and regular exercise.[2] Health Dialog offers a Chronic Care Management solution that provides a personalized approach, giving members the support needed to help manage cardiovascular disease.
The Pathway to Managing Cardiovascular Disease
Using robust analytics we identify where members are in their healthcare journey—or along their Care Pathway—from condition onset to sentinel events, and predict their likely progression toward higher risk and higher cost stages. By identifying where an individual is on their Care Pathway, and predicting where he or she may be going, our Health Coaches are able to tailor specific clinical interventions and action plans to help them get the care they need, including motivating self-care, to manage their condition.
Following is an example of how our Health Coaches provide personalized support depending on where a member is on their Care Pathway:
Risks of Hypertension and Smoking Identified during a Primary Care Visit – Our Health Coaches can help the member take steps to reduce these risks, such as providing smoking cessation assistance and managing their blood pressure with increased activity and healthy food choices. We use our evidence-based behavior change model, Ready? Set. Go!™, to determine a member’s readiness to take action and then explore the barriers preventing them from doing so. This dynamic readiness-based approach encourages Health Coaches and members to build a trusted, collaborative partnership where, together, they set achievable goals that reduce the risk of cardiovascular disease.
Diagnosed with Metabolic Syndrome – Along with the risk factors of smoking and hypertension, metabolic syndrome increases the risk of cardiovascular disease. Health Coaches can continue to provide support on reducing the risk factors, while also working with the member to educate them on their condition, warning signs and symptoms of heart attack, stroke or other worsening conditions and what to do. The importance of taking medications as prescribed is also stressed.
Cardiologist Visit and Laboratory Results Indicate Heart Failure – The member is encouraged to stay on their medications and continue lifestyle changes. Routine cardiac checkups are also encouraged and any medication side effects are managed. Additionally, our Health Coaches discuss treatment options utilizing shared decision making tools that help the member understand their condition, providing the best available medical evidence. Shared decision making takes into account the member’s values and preferences while working with their healthcare team to aid the member in making an informed decision. At this stage, a critical intervention may be necessary to prevent heart attack, stroke, limb loss or death.
Advanced Imaging and Confirmed Diagnosis with Specialist Visit – Health Coaches work to ensure the member continues with their established treatment plan and help increase awareness of the warning signs of heart attack or stroke, developing an emergency plan with the member. Our Health Coaches encourage a good relationship and communication with the member’s healthcare providers. At this point, they may discuss advanced directives and living wills.
Heart Attack – Should the member experience a heart attack, the Health Coach can help them prepare the home environment for post-release from the hospital. This might include establishing a support network and helping to prevent complications and/or readmissions with care coordination and case management.
Rehab and Lifestyle Changes – Health Coaches help the member with rehabilitation, avoiding future complications and living a heart healthy lifestyle. They also provide support to prevent return to the emergency department, hospital readmission or another critical event. Health Coaches coordinate care management, rehab services and case management.
With this personalized approach, we have found an 18% lower progression to a more serious stage in a member’s Care Pathway for contacted individuals and a 2.5% reduction in sentinel events, such as acute myocardial infarctions (AMIs) and strokes.* This demonstrates how addressing the needs of the member based on where they are in their healthcare journey can help reduce the risk or progression of cardiovascular disease, and how Health Dialog is protecting the hearts of our members.
* Results from an internal analysis conducted between 2010 and 2014.
[1] National Heart, Lung and Blood Institute (2022). Know the Difference: Cardiovascular Disease, Heart Disease, Coronary Heart Disease. https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-month/fact-sheets.
[2] NHLBI (2022). Join #OurHears in Action. https://www.nhlbi.nih.gov/education/ourhearts.
