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Congestive Heart Failure Patient Monitoring Program



Congestive Heart Failure (CHF) is a chronic condition that affects 5.7 million Americans at an annual cost of $31 billion dollars to the U.S. economy.  Each year, 550,000 people are newly diagnosed with CHF in the U.S.  Humana, a for-profit health insurance company, has over 13 million members including 344,000 Medicare members who are afflicted with CHF.

To reduce unnecessary hospitalizations due to acute CHF exacerbations, a project team was formed consisting of Experience Design, Innovation, Strategic Alignment & Integration, and IT team members.  

When a person retains more than 3 pounds of fluid in a day, it’s a likely indicator of an acute condition that requires immediate intervention.  Given this key indicator, the team designed a remote weight-monitoring pilot to help people better understand, monitor, and control their condition, in partnership with their nurses who actively oversee their status.  The predicted result is that acute hospitalizations will be reduced.

To design the pilot experience for all stakeholders, the team leveraged a human-centered design approach which included ethnographic research, expert interviews, habit development research; experience mapping; ideation; prototyping; testing; and scaled pilot launches.

First, they focused on defining what would be desirable from a member experience perspective to ensure engagement.  Next, they addressed feasibility with physicians through co-creation, ensuring that they would both adopt and continue engagement with the program.  Finally, they focused on viability, developing a management dashboard so business stakeholders can track progress and monitor return on program investment.

The program itself is simple.  People are given a cell-enabled, battery-powered scale and shown how to use it as part of a visit to their doctor.  Each morning when they weigh themselves, the scale automatically transmits their weight to their nurse.  Nurses interact with a custom-built online application to track patients’ weights and record interventions.  If a patient retains more than 3 pounds of fluid in a day, the nurse calls them to troubleshoot the issue and recommends an appropriate intervention.

Thus far, patient engagement and adherence have been high, and people’s relationships with their nurses has deepened.  Based on current tracking and interventions, it’s anticipated that the program has already prevented acute hospitalizations.  In addition, the CHF remote monitoring application is being used as a platform for other Humana remote monitoring programs. 
Within the enterprise, this initiative serves as a best-in-class example of human-centered design and emphasizes the value of embracing the needs and desires of all stakeholders as they work together to manage people’s health.


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