The Center for Medicare and Medicaid Innovation has awarded $8.7 million to VillageCare, a New York City community-based, not-for-profit organization serving people with post-acute and chronic care, as well as rehabilitation needs, to help HIV/AIDS patients by providing a multi-layered and tailored intervention aimed at improving their medication adherence via a mobile medication planner, text reminders, social networking, peer mentoring, virtual support groups, and virtual access to health coaches.     

Under the three-year project, called VillageCare Wellness Innovations, an integrated mobile web and app portal has been developed that includes a personal medication adherence plan, goals and mood tracking, an HIV/AIDS social support network, as well as video sessions and text messaging. The project, which “goes live” in April 2015, is part of a second round of CMMI Health Care Innovation Awards. The award is intended as a testing model of care delivery and payment that shows promise of improving medication adherence.

Ultimately, VillageCare will recruit 5,000 patients by working with providers and payers for referrals. The goal is to reduce total cost of care by improving treatment adherence. Targeted participants for the project include people who are living with HIV/AIDS in the New York City, Long Island and Westchester areas, are Medicaid or Medicare beneficiaries, and are prescribed HIV medications.

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“VillageCare has a long history of working with this population and there’s a lot of internal expertise and knowledge about the barriers to adherence,” said Jessamine Buck, Program Director for VillageCare Wellness Innovations. Based on feedback from its staff, Buck said Wellness Innovations’ patient engagement platform incorporates different tools to address those barriers to medication adherence such as text message reminders.

“Some participants have very complicated treatment plans,” she added. “We often hear that they are not sure when to take their medication or they forget. They’re also not clear on which medications to take. The medication tracker and reminder service addresses both of those challenges.”  

At the heart of the project is an emphasis on “patient activation” for people living with HIV/AIDS by enabling them to leverage professional and peer support that has the potential for overall health behavior change and medication compliance.

In addition, Buck said peer-to-peer mentoring and support group sessions   will provide one-on-one encouragement and advice, creating a community of supporters “who are walking in the same shoes.” The project’s private social network allows participants to connect with others and build a community of support while still maintaining their privacy. The platform allows for both clinician and patient access, and customized and timely healthcare information and messages will be sent to patients through the portal.

“What we identified, surprisingly, is that this population is very well versed in technology,” said Ricardo Santiago, Chief Information Officer at VillageCare. “While they have smartphones and are very in tune with social platforms, such Facebook and Twitter, it wasn’t until we started investigating it for the grant that we learned they are very heavily reliant on technology and their preferred method of communicating is text messaging.” 

Central Platform

Wellness Layers, a patient engagement digital health company, was selected by VillageCare to serve as a subcontractor for the CMMI-funded project to take VillageCare’s existing HIV/AIDS program—currently conducted in in-person group settings—and to bring that level of services into the digital realm so that it is “available anywhere, anytime.” Wellness Layers’ patent engagement platform is serving as the technology hub for Wellness Innovations. This single web and mobile platform combines an array of technology-enabled health supports that are securely and privately accessible via a website, mobile phone, and app.

“With this kind of peer mentorship and social motivation enabled by our platform, patients are no longer living in a silo but are part of an integrated system,” said Amir Kishon, CEO of Wellness Layers, which provides social web and mobile digital health solutions for organizations across health and wellness. At the same time, Kishon argues that because Wellness Innovations leverages mobile phones, it creates a simplified environment for patient engagement that is easy for users to navigate. Mobile apps for iPhone and Android are built in native and the Wellness Innovations platform can also be accessed on a web or mobile browser.

“The goal is to centralize the patient experience within Wellness Layers,” added Santiago, who said the project’s mobile participants use their own phones and that the platform is “carrier as well as device agnostic.”

Emma DeVito, Chief Executive Officer at VillageCare shared her support and excitement for the project stating that “this technology will be a monumental step towards improved health for the HIV/AIDS population in New York City. We are hopeful that this portal and app will dramatically improve medication adherence and overall life quality for HIV/AIDS patients in the city, making a much needed impact on the larger public health movement of controlling HIV/AIDS in the U.S.”

The project described is supported by Grant Number 1C1CMS331353-01-01 from the Department of Health and Human Services, Centers for Medicare and Medicaid Services. The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.

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