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Innovative Solutions in Managing Chronic Conditions: An Interview with Dan Shields

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Dan Shields Discusses Healthcare Innovations at thINc360

In this interview, Dan Shields, Vice President at Ochsner Health, discusses innovative approaches to managing chronic conditions like diabetes and hypertension. He highlights the success of their remote patient management program and its impact on health outcomes. Dan Shields also shares insights on expanding these solutions nationwide.

You can view the full video interview here

Key Takeaways

  1. Chronic conditions like diabetes and hypertension are major health challenges, especially in Louisiana and Mississippi. Ochsner Health has developed a successful program to address these issues.
  2. The program utilizes remote patient management to support primary care providers. This approach ensures higher compliance with treatment and better health outcomes.
  3. By integrating remote monitoring data into electronic medical records, the program allows clinicians to adjust treatments in real-time. This results in more effective management of chronic conditions.
  4. The success of the program has led to its expansion beyond Ochsner Health. It is now available to employer plans, carrier plans, and other health systems across all 50 states.

Dan Shields on Ochsner Health’s Approach to Managing Chronic Conditions

Host Mabel Jong – thINc360:

“And welcome back. I’m Mabel Jong, and I’m here now with Dan Shields. He is Vice President at Ochsner Health. Dan, thank you so much for your time. Really great to see you, and also I understand that you are really sharing a lot of details about the work you’re doing in the diabetes area. Can you give me a few details?”

Host Mabel Jong – thINc360:

“Well, chronic conditions as a whole, specifically hypertension and diabetes, are where we focus the most nationally. But just a little bit about Ochsner Health—I know some folks probably aren’t as familiar with us.

Ochsner Health is actually an 80-year-old health system. We were founded in 1942 by a couple of doctors who went to a little place called the Mayo Clinic and said we could do this down in New Orleans, Louisiana.

They formed a clinic, and now, eight years later, we’re about an eight-and-a-half-billion-dollar health system. We cover largely Louisiana and Mississippi and have developed into about 40 different facilities, so a fairly full-service health system.

The reason why we’re here today is because, as a health system, we saw a challenge about eight years ago in our own patient population with managing chronic conditions. We have kind of a unique population that we serve.

So we, like everybody, struggle with keeping people doing what they’re supposed to be doing for chronic conditions. But specifically in Louisiana and Mississippi, we are literally the two least healthy states in the union. That’s actually statistically true; we always fit 49th to 50th. So we always kind of had that challenge of how do we do a better job with our patients.

The program that we’re talking about mostly today here at the event is a program that was really designed to meet those challenges for our patient population.

It just frankly works so well that now it’s grown over those eight years into something that we can offer in all 50 states to whether it be employer plans, carrier plans, or even our partner health systems as well.”

Innovative Approaches to Diabetes and Hypertension Management at Ochsner Health

Host Mabel Jong – thINc360:

“Very interesting, because diabetes is one of those conditions that is growing in terms of the number of people that suffer from it. So what is different, or what have you learned about the way you’re approaching it?”

Dan Shields:

“Well, the challenge we had was, as a health system, it’s a different approach to it than your typical Health Tech startup or whatever the case might be.

The challenge is that these conditions—diabetes, as you said, is growing and becoming more of a problem, and hypertension is actually even more prevalent.

It’s difficult to imagine, but there’s more people that have hypertension than diabetes. The challenge really was that the onus to manage this has been put on primary care, and obviously, we’ve got about 300 primary care providers, so we had that opportunity to say, well, what could we do differently?

What we found is that between changes in primary care, all the things that are being put onto primary care providers, and the lack of time they have with their patients just by sheer nature of provider shortages and the way that the business works, it really made it no longer the ideal setting to manage these conditions.

So we really built this program to serve as an adjunct to our primaries and say, let us kind of prioritize that and build a focus factory for those particular conditions.

We can now manage that remotely, serve as an adjunct to the primary, and manage that remotely. Now it’s grown to the point that the primary can be in Boston or Seattle or New Orleans.

We can serve as that adjunct to the primary, manage the condition like any other specialist, but most importantly, feedback into those primaries the relevant details to say this is how it’s being managed.

We close the loop on that overall care, and the result has been much higher compliance with medication, much higher compliance with what you’re supposed to do to manage these conditions, and much better outcomes.

So it really became something we built internally as a service to ourselves, but all hyperbole aside, the results were just so good we started having people asking us for it.

So, other employers, other carriers, we’re actually a leader in value-based care down in the Gulf largely because we have to be. We take risks on a lot of our patient population, so even our Medicare Advantage programs—the ability to offer this kind of serves them well and serves us well.”

Engaging Patients in Remote Monitoring and Management at Ochsner Health

Host Mabel Jong – thINc360:

“You talked a lot just now about remote monitoring. How do you get patients to buy into that?”

Dan Shields:

“Well, actually, remote monitoring is really just step one. So we do that remote monitoring of the condition, but the real difference for us is we gather the data with remote patient monitoring, but then we feed that data into an actual EMR and we assign a clinician and a coach to every member.

So we can actually change the medications, we can change the dose, change the frequency. We’re really doing everything that we could do in a brick-and-mortar primary care setting, but we are doing it remotely.

So there’s a lot of folks doing remote patient monitoring, but we very intentionally say it’s remote patient management because it’s a full management of those conditions.”

Host Mabel Jong – thINc360:


Dan Shields:

“And how do you get people engaged in it? It really depends on how we’re offering the program. I mean, obviously, it’s now become the preferred way that we treat these conditions as a health system, so our own primary care providers are moving their patients into it.

So that’s cheating a little bit, that’s our own providers. But externally, if it’s an employer plan, it’s not just the typical communication stuff.

It’s where else can we integrate? Do you have a care team at the carrier we can work with to build a referral network? Are there other benefits we can work with? Carriers are a great partner for us because they have that ability to have all that data and they can channel people to us.

So we see fairly high engagement rates with the people that have these conditions largely because of the outcomes we’ve been able to show.”

Host Mabel Jong – thINc360:

“Now, are the number of people outpacing the number of people you have on your care team?”

Dan Shields:

“You know, it’s growing fast, which is a good thing. We do have the ability, again, being a health system, we do have dedicated people to this program, so it’s not people moonlighting or anything like that.

We’ve been pretty good at managing when we have new carrier relationships or employer relationships come on. While we do the technical build of it over a couple of months, if we need to recruit or move some of our staffing around, we’ve been able to.

We’ve not—you know, it would be a horrible problem to have to suddenly be growing so fast that we need to scramble for people. But yeah, we’ve been able to manage that pretty well so far.”

Integrating Remote Monitoring into Insurance Plans and Employer Benefits at Ochsner Health

Host Mabel Jong – thINc360:

“And how about paying for it? Is it part of an insurance package to have this kind of monitoring from Step A all the way to what the condition needs?”

Dan Shields:

“So obviously in our carrier relationships, they’re usually embedding this program into some kind of a plan that they’re offering. We do a lot of work with Medicare Advantage and actually increasingly Medicaid plans around the country just because it’s an underserved population and we’ve shown really good results with it.

In the employer world, it’s a little bit different. It’s more of a plan-sponsored benefit, so in that, we typically would invoice the employer but only on those members that we’re actually managing.

It’s not a kind of universal coverage thing. It’s a per-engaged member. So if we’re working with a member to manage their hypertension or their diabetes, we obviously ask the employer to pay a little something for that. But if we’re not actually actively working with them, they’re not paying anything.”

The National Attention on Ochsner Health’s Innovative Program

Host Mabel Jong – thINc360:

“Why do you think it’s caught the attention of people across the country, the program that you’ve built up?”

Dan Shields:

“Well, I’d love for it to catch even more attention actually, but it has. I think the unique part about it is that we’re not that typical kind of startup seeking disruption for disruption’s sake.

We are an 80-year-old health system. We do things slowly and intentionally. We’re an academic health system, so nothing that we put out there hasn’t been vetted and looked at.

So there’s a little bit of credibility there that you don’t usually see. And I’m sure you’ve seen there’s been a study that came out last year that said of all these digital health startups, over half of them have little to no clinical efficacy.

So the fact that we’re approaching the market as a provider that’s been doing this for 80 years and by every metric—I mean, I’m a little biased obviously, I work for Ochsner—but by every metric, if you look at how health systems are judged, whether it be U.S. News & World Report or the more qualitative things like Leapfrog or HCAHPS, we’re considered a top-tier health system. So that credibility helps us, and the fact that we literally just built this to treat patients better.

With a lot of other folks, you build a solution and then you track the outcomes and say, did it work? We had the advantage of, we had the outcomes, we showed that it worked before we brought it out into the market.

And a lot of that was, I hate to say it, almost kind of by accident because we built it just to kind of help ourselves, and fortunately, it worked and other people heard about it.”

You may also like: Ochsner Health – Validated Program Report

Expanding Awareness and Networking Opportunities at thINc360

Host Mabel Jong – thINc360:

“Terrific, terrific. Why bring the message to thINc360? Who are you hoping to reach?”

Dan Shields:

“Oh, so for this particular event, it’s a great collection of people. We are a health system, and there’s a whole health system track here as well. So from an education and networking standpoint, it’s great there.

But also where we’re really hoping to grow this program and grow awareness is around the employer space. So, as some of the talks we’ve had today, the self-insured employers are really driving innovation in healthcare.

So we want to be part of that conversation and show that we can improve these outcomes. And then obviously with that comes the consulting market and some of the other tracks here.

This is a great collection of all of those people as well as some really good content. We’re in these sessions as well. As a matter of fact, one of our medical directors—another great thing about working for a big old health system is a lot of clinical talent—so one of our medical directors is actually speaking on one of the panels later today.

And it’s not about necessarily what we’re doing specific to this program. It’s just about how do we improve these outcomes, so it’s nice to take that more academic approach.”

Host Mabel Jong – thINc360:

“Great. Dan Shields, thank you so much. Really appreciate your time.”

Dan Shields:

“Thanks for the time.”

Host Mabel Jong – thINc360:

“Dan Shields, Vice President, Ochsner Health.”

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