Communication Science is dedicated to achieving the lowest price of keeping people well. Lifestyle coaching, discharge planning and telemonitoring all use labor- or technology-intensive solutions. Where is the best ROI?
When nurses or nurse practitioners do healthcare activities for the patient, there are savings when compared to the cost of readmissions. Of course it’s done properly, but professional labor is about the most expensive way to do any task. It is also hard to scale: There are only 2 million nurses and tens of millions of patients in need.
When a program uses machines for automatic transmission of vital signs, patients are treated as a passive data source. Of course the transmission itself is inexpensive, but when the technology leaves the home, people revert to old habits. Moreover, the equipment is expensive to inventory and use on everyone with needs.
Care for chronic conditions at the lowest possible cost is done by the people, themselves. Self-Directed.
But lasting behavior change requires a new approach to preparing people for self care. Communication Science has demonstrated a new, successful approach: Adapting the techniques of retail new product development, marketing and advertising to explanations, instructions and devices for self care.
Why does this work? In Retail, the design of the product and the messaging to the public is the only means of influencing behavior. When a man wants to buy a new car, he doesn’t have a “Transportation Lifestyle Coach.” His insurance doesn’t pay for the car. All a manufacturer has to impact that decision is the design of the car and the messaging. So retail industries have honed their skills and techniques for influencing behavior through design and messaging—the four biggest are Ethnography, Cognitive Mapping, Sociolinguistics and Semiotics.
We make Self Care Kits. Do they make a difference?
· Communication Science’s first customer, a disease management company, stopped buying the kits after one year. “We’re not going to buy your kits any more. They make the patients so independent they say they don’t need our calls. And we are paid by the number of calls we make.”
· At Rush Medical center in Chicago, comprehension scores were 88 times higher on the Communication Science materials than on the hospital’s standard discharge handout. Patient satisfaction scores tripled.
—Hospital Peer Review Journal
· In Aurora Health System, WI, our Heart Failure kit reduced the rate of readmission by 74% .
· The University of Pittsburgh has been a customer for eight years—Kaiser even longer.
· A trial in Ohio pitted Labor-Intensive vs. Self-Directed. Diabetics were randomly assigned to classes or a kit. In the next 30 days, the people receiving kits had 57% FEWER trips to the hospital.
SelfCareKits can make labor or technology intensive programs more productive: Communication Science sells to over 200 home health agencies. One published in the Remington Report (2009) that they need fewer visits when the patients have kits. CSI also has five partnerships with technology companies. With one we took on a challenge from CMS. CMS said truckers were the hardest employee group to change behavior. To CSI’s knowledge, we are the only program to have achieved ROI with truckers: For every $1 spent, claims were reduced by $1.79. Another employer, in a prior year, had a labor-intensive program for hypertension. After 12 months, only 12% of the people were below 140/90. The next year they gave their employees SelfCareKits: After six months, 88% of them were below the threshhold.
Self Directed SelfCareKits: Lasting behavior change at a fraction of the cost.
Web address: www.communicationscience.com