Launched to help address health equity challenges facing Black cardiology patients, ChristianaCare said its digital medication-adherence platform, developed with Story Health, has delivered significant improvements in outcomes for patients with hypertension and heart failure – two to three times in some key metrics.

The health system plans to expand access to more patients.

WHY IT MATTERS

"This has made a huge difference in the lives of our heart failure patients, and has closed the gap in disparities," Dr. Kirk Garratt, medical director of the health system's Center for Heart & Vascular Health, told Healthcare IT News by email Wednesday.

ChristianaCare said Thursday it is expanding the medication adherence program to all primary care practice patients through its Center for Virtual Health. 

"Health equity is an incredibly important initiative, and we see our mission as critical to helping specialty and primary care providers drive more equitable care," Nita Sommers, Story Health cofounder and president, said in the health system's announcement about the expanded partnership.

ChristianaCare said that 32% of its heart failure patient population identifies as Black, and because Black Americans have a 30% greater risk of death from heart disease than other groups, it embarked on a medication-adherence program to enhance asynchronous care and improve cardiology patient outcomes.

With improved access to heart failure treatment and guideline-directed medical therapy, Black cardiology patients made the following gains, the health system said in the statement:

• 2.6x improvement on target doses of beta blockers – 76%.
• 2.7x improvement on target doses ACE/ARB/ARNIs – 54%.
• 2.2x improvement on target doses of MRAs – 57%.

Regardless of race, the digital coaching platform has made "remarkable progress" for all Center for Heart & Vascular Health patients, Garratt added. 

"The health coaches are in regular contact with our patients to answer questions, encourage them to take their medications, coordinate their lab work and help them get their prescriptions filled at reduced cost through prescription assistance programs," he explained.

"This has made a huge difference in the lives of our heart failure patients, and has closed the gap in disparities." 

Hypertension patients are having similar experiences, with significant reductions in blood pressure for those enrolled, Garratt noted. 

The platform has been able to address some of the social determinants of health that can drive poor outcomes and also create deeper, more accessible relationships between clinicians and patients, Dr. Sourin Banerji, ChristianaCare's medical director of Advanced Heart Failure and Mechanical Circulatory, said in a statement.

"The health coaches serve as an extension of the clinician to identify and resolve challenges such as medication adherence, lab work coordination, transportation arrangement and even prescription assistance that cause disruptions in a patient’s care journey and lead to negative outcomes," he explained.

THE LARGER TREND

The large Delaware-based health system has looked to technology to break social barriers and find ways to engage more patients before. In 2020, during the height of the COVID-19 pandemic, the health system developed the HIPAA-eligible Amazon Alexa skill for home health patients called Home Care Coach. 

The interface allowed providers to customize patient care plans, and patients to ask medication questions.

"Engaging patients digitally is more important than ever right now, as it will help them reach their health goals, improve their experience, and shape the future of health care as we know it," ChristianaCare president and CEO Dr. Janice Nevin said in a statement at the time.

In Georgia, Emory Healthcare is also using technology to reach patients and improve patient outcomes. 

The university health system said it will leverage HIPAA-compliant automated patient messaging, electronic prescription alerts and other features in the DrFirst management platform to improve medication adherence and deploy patient education.

ON THE RECORD

"Many of our patients struggle to manage high blood pressure, for example, and the use of a continuous care program offered through the Story Health platform will be an important tool to help with medication management, addressing social barriers to care and ensuring treatment goals are achieved," Garratt told Healthcare IT News by email. "Scaling this program to our entire patient population shows how much ChristianaCare believes in asynchronous care through remote patient monitoring."

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.