Innovations in health care delivery: CVS Health

People with chronic health conditions face many challenges as they work to manage those conditions to the best of their ability. A 2018 survey of certified diabetes educators asked how many hours per day it would take a person to follow self-management recommendations. They responded that a typical adult with Type II diabetes needs about four hours per day while a typical child with Type I diabetes needs about five hours per day.[1]

Imagine if the person had diabetes and asthma, or diabetes, depression, and asthma. People with complex chronic condition and especially those with multiple complex conditions can easily be overwhelmed. Is my nausea due to a gastric complication of diabetes or a side effect of my medication?  If a person incorrectly assumes the latter, they are much more likely to stop taking their medications.[2]

When people visit their primary care provider (PCP) they have these and many other questions but don’t always have these questions addressed---either because they didn’t raise them at the time, the visit focused on other issues, etc. I will address the chronic under-resourcing of primary care, plus the crushing burden of administrative work that makes it very hard for PCPs to spend the time their patients are asking of them in a future blog.[3]

One of the solutions to the problem is to help the person by distributing the work and calling in experts who can rapidly identify issues and solutions. In one study, a multi-disciplinary team including a clinical pharmacist demonstrated that a quick review of information led to rapid improvement in diabetes care, especially for those with multiple complex conditions.[4]

I had the opportunity to speak with Dan Knecht, MD, Vice President of Clinical Product at CVS Health.  Dr. Knecht described how CVS clinical pharmacists can help identify gaps in care and opportunities to improve health outcomes by using a combination of health plan data (CVS owns Aetna) as well as other resources to forward recommendations to pharmacies. CVS Health is also launching nutritional support with dieticians helping people build meal plans.

Come listen to Dr. Knecht describe CVS Health’s innovations in health and health care on the Inside Angle podcast.

L. Gordon Moore, MD, is senior medical director, Clinical Strategy and Value-based Care for 3M Health Information Systems.

[1] https://spectrum.diabetesjournals.org/content/31/3/267 accessed 1/5/2021

[2] Wasson, John H, and Steve Bartels. “CARE Vital Signs Supports Patient-Centered, Collaborative Care.” The Journal of Ambulatory Care Management 32, no. 1 (March 2009): 56–71. https://doi.org/10.1097/01.JAC.0000343124.53585.9f.

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6262585/

[4] Lin, E. H. B., M. Von Korff, P. Ciechanowski, D. Peterson, E. J. Ludman, C. M. Rutter, M. Oliver, et al. “Treatment Adjustment and Medication Adherence for Complex Patients With Diabetes, Heart Disease, and Depression: A Randomized Controlled Trial.” The Annals of Family Medicine 10, no. 1 (January 9, 2012): 6–14. https://doi.org/10.1370/afm.1343.