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Harvard Pilgrim teams with Wellframe on app for members and caregivers

Care in the 21st century is tied to technology, but IT must amplify the work of the clinical organization, the insurer says.

Susan Morse, Managing Editor

Harvard Pilgrim Health Care announced a collaboration with Wellframe to create a secure mobile app that enables interactive communication between beneficiaries and nurse care managers.

Harvard Pilgrim offers customers support from a team of nurses as part of their health insurance coverage. Members who have questions can ask by text and Harvard Pilgrim's nurses send back answers. 

Texting is the preferred communication for most beneficiaries, said Norine Domenge, director of Case Management and Care Coordination for Blue Cross Blue Shield of Nebraska. 

Blue Cross Blue Shield of Nebraska has been using the app since starting a pilot program with Wellframe in 2015. The app has replaced phone calls, mailings that weren't always opened and even the digital portal, as the best way to interact with members.

"With a portal if it's not mobile, it's a problem," Domenge said. "We want to meet our members where they are and where they are is where their phone is."

Care in the 21st century is tied to technology, but IT must amplify the work of the clinical organization, Domenge said.

A mobile app reaches its target and it's been embraced by beneficiaries in a way that was at first a little bit of a surprise, she said. 

"I think the nurses were surprised," she added. "As a culture we're moving to a more innovative and mobile world."

One that doesn't stop at 5 p.m. Texts can be sent at 9 p.m. on a Sunday night and while in many cases the question won't be answered until the next day, a message goes back to them telling them this. 

Members write such messages as, "'This was on my mind, I know you're not working now,'" Domenge said. 

Members know there's a human being on the other side of the app, which keeps them engaged, said Alexis Bernstein, senior director of Client Strategy and Operations at Wellframe.

The insurer can target content to the individual asking about medication adherence and send out a daily health checklist, as a key component is being able to use a patient's data for personalized interventions.

Beneficiaries are able to load their medications into the app. A nurse will receive a dashboard alert if a patient is below adherence. 

There's also health coaching for chronic care management and a diabetes program.

"Nurse can hone in on an area they need to work on," Domenge said

The idea of insurers taking on care management is nothing new as both payers and providers use value-based initiatives to bring down the cost of care.

More than saving money, the app is about being able to connect with members in a more engaged way, said April Greene, vice president of Population Health and Clinical Operations for Harvard Pilgrim.

They can expand their services without adding cost to the system. 

Blue Cross Blue Shield of Nebraska has seen fewer complications and emergency room visits. It now has more than 65 percent of its programming to beneficiaries on the app, with the goal of that reaching 100 percent.

Productivity has increased, medication adherence has jumped 40-50 percent and clinical outcomes have improved, Domenge said.

"It's the notion of doing more with less," said Janie Tremlett, senior vice president of marketing at Wellframe. "It's being able to take on a lot more."

Wellframe's solution has been on the market for five years, and in April, the company announced it had been awarded the patent for the mobile app. Other payer clients include BCBS Excellus and Superior Health Plan.

Twitter: @SusanJMorse
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