Previously submitted to: Journal of Participatory Medicine (no longer under consideration since Oct 27, 2021)
Date Submitted: May 17, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
A Cloud-Based Solution to Support Patient Outreach and Engagement for Chronic Disease and Preventative Care-A Retrospective Study
ABSTRACT
Background:
Patients more actively engaged in their care have better clinical outcomes.
Objective:
To examine the performance of a widely adopted cloud-based patient engagement system for management of diabetes, hypertension, and preventative screenings at two large healthcare systems.
Methods:
We included patients with diabetes, hypertension, and those due for breast cancer screenings and/or bi-annual wellness visits and at Loudon Medical Group (LMG) in Virginia, and Basset Medical Group (BMG) in New York between 2019-2021. We examined outreach outcomes including successful contact rate (SCR), patient response rate (PRR), and adherent response rate (ARR). Associations between demographic characteristics and outcome measures were explored with Chi-square or Fisher’s exact tests.
Results:
Attempted contacts with patients with diabetes (N=2567) at LMG resulted in SCR of 87.1%, PRR of 47.2%, and ARR of 38.4%. At BMG, attempted contacts with patients with diabetes (N=3621), hypertension (N=10881), patients for breast cancer screening (N=2441), and wellness visits (N=9070) resulted in SCR values of 91.0%, 93.2%, 90.1%, and 92.1%; PRR of 57.0%, 59.8%, 50.8%, and 52.0%; and ARR of 45.2%, 39.8%, 6.8%, and 11.5% respectively. Outreach outcomes measures were significantly higher in patients with hypertension, and those carrying commercial or Medicare insurance vs. those who were self-insured or on Medicaid plans (SCR P<.0001, PRR P<.0001, and ARR P=.0013). Among diabetic patients, only SCR (P=.0008) was significantly associated with commercial or Medicare insurance. In general, rate of contact (SCR) had more favorable results as compared to the rate of follow-up visits (PRR, ARR), with higher PRR significantly associated with female sex (P<.0001), and a higher SCR seen among patients contacted by text (P<.0001). Age-stratified analysis showed that 60-69 years old diabetic patients had the highest SCR and ARR. Hypertensive patients between the ages of 70-79 had the highest SCR, PRR, and ARR.
Conclusions:
This cloud-based patient outreach system demonstrated high rates of contact in patients with hypertension, diabetes and/or eligible for preventative screenings. Overall response rates were over 50%, with moderate adherence rates for diabetes and hypertension, but low adherence for preventative screenings. Older patients had higher adherence rates. Additional strategies are needed to translate successful patient contact into response and adherence. Clinical Trial: NA
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