IT Spending Guide: Place Your Bets
The avatars, which take the form of a cartoon cat or dog, integrate the care of a 24/7 team into a single persona, unlike traditional telemedicine with its seemingly endless succession of new caregivers' faces.
The experience blends software-driven health coaching—part chatbot—with the frequent involvement of care.coach's own team of caregivers, who step in to direct these avatars when software reaches thresholds that indicate human intervention is required.
Founded in 1995, Element Care, provider of Programs of All-Inclusive Care for the Elderly (PACE), has used an interdisciplinary, team-based approach to achieve these goals, funded and run through Medicare and Medicaid. As a capitated program, PACE enables providers to deliver all services participants need rather than only those reimbursable under Medicare and Medicaid fee-for-service plans.
Since Element Care is both the insurer and the provider of care to its customers, "the healthier we can keep our participants, the more likely they will be able to remain living safely in the community," says clinical administrative manager Kendra Seavey.
Element Care calls this "wraparound care" for its participants. When a participant has a care.coach avatar in the home, it can even be a tonic for loneliness, by offering word games or trivia games.
As with more traditional telemedicine, these patients are also under video surveillance, though at any time they can put the avatar and its tablet-based camera to sleep for privacy reasons, keeping in mind the system is designed to wake itself up after a prescribed time interval.
"Since receiving the avatar, [our patient] has had no emergency department visits or hospitalizations."
—Kendra Seavey, clinical administrative manager, Element Care
Element Care did a preliminary pilot program with the care.coach avatars from March through July 2017 with 12 participants and found that the potential financial rewards are substantial.
"We saw a reduction in emergency department utilization and hospital admissions, and we were able to reduce some of our costly after-hour nursing visits," Seavey says. "Our participants even reported that their degree of loneliness, nervousness, and anxiety had actually decreased since receiving their avatars."
As an example of the preliminary savings, one patient had recently suffered a significant loss in her personal life and had little support in her home.
"Since receiving the avatar, she has had no emergency department visits or hospitalizations, and we have logged 13 avatar interventions that have helped mitigate anxiety that previously would have resulted in an emergency department visit," Seavey says. "This is a projected savings of about $7,000."