LifeMasters Supported SelfCare: Robert Slepin, Senior VP & CIO

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Many health systems focus on caring for the chronically ill and managing the symptoms and continual flair ups of their patients’ conditions. But LifeMasters Supported SelfCare, Inc. is reinventing the traditional approach to chronic disease management and challenging these preconceptions. The health improvement services company, which has been recognized for its clinical expertise and scientifically tested programs, activates patients to take charge of their care and their outcomes. With a long history of process and technological innovation, LifeMasters is leading the charge for a new way of thinking about chronic disease.

Necessity is the Mother of Invention

LifeMasters is a privately held company with its headquarters in Irvine, California. In operation since 1994, the company now boasts annual revenues of $75 million and 600 employees. “Our sole purpose is to improve health, lower the disease burden and return significant dollars on health care investments,” explains Robert Slepin, Senior VP & CIO.

LifeMasters began some 15 years ago focusing just on asthma and evolved to support other high-cost conditions like diabetes, congestive heart failure and coronary artery disease among others. Founder Dr. David Goodman’s vision was to create a coordinated approach to preventative care for chronic illness rather than simply managing the conditions.

“People with chronic disease often don’t know how to manage their disease,” says Slepin. “Or they do know what to do and they just don’t do the right thing, and that results in preventable hospitalizations.” Slepin adds that since human behavior is a major determinant of health status and chronic disease drives 70% of all medical expenditures, it’s obvious to see how patient involvement is critically important in improving health outcomes and reducing medical costs.

Helping Patients Help Themselves

On paper it’s easy to make the connection between patients taking better care of themselves and better, more cost-effective outcomes, but how do you get real people with chronic illnesses to make significant lifestyle changes and adhere to care plans? This is the area where LifeMasters has focused much of its research and innovation. Realizing that patients come to LifeMasters with a distinct personality, history and set of behaviors, LifeMasters customizes its care to each individual.

“We develop one-on-one relationships with participants, which inspires trust,” says Slepin. “We train our nurses and health coaches in motivational interviewing techniques to effectively guide each interaction so that our participants gain and sustain the skills, knowledge and confidence to do the right things health-wise, one step at a time. Our unique coaching model is designed to activate and educate participants and give them the tools to help them achieve their optimum level of health.”

Part of LifeMasters’ drive for innovation can be seen in its use of the Patient Activation Measure™ (PAM™). As the first disease management company in the country to introduce this highly validated tool, LifeMasters is leading the charge in how organizations assess and customize care.  Developed by Judith Hibbard, Ph.D., and colleagues at the University of Oregon, PAM™ is a health activation tool that surveys a participant’s knowledge, skills and confidence in managing their health. LifeMasters can then measure these qualities to assign an “activation level” to a patient, which then helps the health professional tailor the coaching style to fit the individual’s needs. “This ten question survey measures beliefs and health behaviors. For instance, you might be talking to one patient who doesn’t feel they have any role to play in their health and then in another case, talk to someone who understands that they need to take charge, but may have experienced a set back. Based on the answers, we understand their level of confidence and understanding and can better tailor our conversation with a participant to their level of expectation and overcome various barriers to behavior change.”

One important aspect of the PAM™ tool is that it provides coaches with a starting foundation from which they can guide patients toward optimum health. Since no two patients are alike, everyone begins at a different point.

“Because our coaches are trained in motivational interviewing techniques and in the PAM tool, we can help participants to develop confidence rather than encouraging behaviors they might not be ready to achieve,” he says. “With our program, we are collaborating with the participants in developing their plan of care. We conduct interviews and develop an action plan to help them reach their goals.  The goal might be that you want to dance at your granddaughter’s wedding. So we’ll ask: what steps do you need to take to get you there?”

Slepin says goals and progress are all documented in an electronic health record to support continuity of care across health coaching interactions.  “After we collaborate with participants on the phone or during an in-person session and document their interviews, we can then mail or e-mail them an individualized action plan as a reminder. On subsequent interactions, we can talk about their progress toward their goals, all the while considering their activation levels so we can tailor our coaching conversation to meet that person where they are at a particular point in time.”

Embracing Innovation

Technology plays a key role in LifeMasters’ success and is a high priority for the company. LifeMasters has integrated the Patient Activation Measure into its proprietary workflow software application and given staff access to tools that allow them to administer a PAM. “We capture and routinely monitor not only activation levels but also care plans, health history, biometric data, medications, medical claims, lab results, and other relevant clinical and demographic data,” explains Slepin. He says coaches can also use the software to record individuals’ goals and actions and also to easily request reports for distribution to participants or their physicians, which help to reinforce the desire on patients’ parts to change as well as alert physicians of urgent, important changes in health status warranting medical follow-up. Additionally, the company has innovated over the years in collecting biometric data and communicating with participants using interactive voice response, web portal, e-mail, and an on-line community. LifeMasters is planning to innovate further, employing alternative technological channels such as texting, chat, and symptom boxes to administer surveys, provide teaching instructions, exchange information, and sustain patient interest and involvement in managing their health issues.

In 2008 LifeMasters received the Vision Award for Business Impact from the BeyeNETWORK, an internationally recognized business intelligence and leadership organization. “They recognized us for excellence in data integration, which for LifeMasters is a strategic differentiator. We employ automation and standardization on the front end where we take data in and exchange data with our clients, our strategic care management partners and providers. We do a massive amount of data integration with tens of millions of records and different file formats, and our system is rapid and secure.” LifeMasters uses Pervasive Data Integrator™ from Pervasive Software to tackle all of these data-related tasks. Slepin says the recognition shows that the company was able to take a proven technology and innovate upon it to make it even more effective for delivering business value.

“Healthcare cost increases are attributable not only to increases in chronic disease but also fragmentation in the healthcare system. We are really proud of the fact that we have succeeded in deploying the Pervasive Data Integrator™ to eliminate data gaps and achieve seamless operability with health plans and our care management partners.” Slepin adds that this spans the continuum of care from obesity management and smoking cessation to chronic disease management and advanced care planning. LifeMasters has leveraged this technology to rapidly implement tight process integration with a variety of healthcare companies and has taken a leadership role in serving as the data integrator, giving them the ability to offer flexible plug-and-play solutions to their clients’ diverse needs for health improvement services. LifeMasters also exchanges data with Ingenix, whose proprietary predictive modeling software complements LifeMasters’ proprietary predictive modeling capabilities.

“We are re-inventing disease management 2.0 with a relentless focus on driving ROI through lower cost and more targeted interventions. We are continuing to innovate and decipher what works in terms of participant engagement and better outcomes through health activation. We are excited about our progress and our outlook for the future, because we believe we have a very important role to play in improving our participants’ health and quality of life and improving the economic health of our clients.”

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