James Bush, M.D., medical director of the Wyoming Medicaid program, is on the leading edge of using mobile health technology to improve outcomes.
Under his leadership, pregnant Wyoming Medicaid patients have access to a 24/7 engagement and education platform, Due Date Plus, which features common development milestones and clinical help. Launched in January 2014, the platform rapidly exited the pilot stage.
Developed by San Francisco-based Wildflower Health, the platform is managed by Xerox Informed Health, Wyoming Medicaid's utilization management vendor, and Bush is thrilled with the early numbers. Approximately 500 women in the state have enrolled in the program since its launch.
"We are estimating that we are currently capturing 30 percent of estimated Medicaid pregnancies as of three months after launch," he says. Particularly encouraging is an 80 percent monthly retention rate, which is double the typical retention rate for mobile health apps.
Bush says additional user data has revealed that 43 percent of users have clicked on the benefits link, 40 percent have identified at least one existing health issue, and 21 percent have been calling the department's Xerox nurse hotline.
"To get numbers like that, where 21 percent, by browsing their app, are suddenly calling their nurses--and this is too short for us to look at total outcomes, but if we can keep 80 percent retention, 20 percent calling hotlines, and recognize 40 percent with health issues--I think this is going to make a significant impact."
For example, he says, the platform can offer information and smoking cessation resources to a patient who smokes: "About 40 percent of our pregnant Medicaid patients are smokers. This is a big area, because if we can reduce their maternal smoking rate, we can reduce low birthweight babies and babies who have to may have to go into the NICU. First and foremost, it's better outcomes for our patients, but it's also very cost-effective for us."
The results may be particularly significant in Wyoming, Bush says, because Medicaid is the largest insurer and payer for pregnancy care in the state, counting for between 40 and 50 percent of pregnancies, depending on the year.
The Due Date Plus launch is just part of Bush's overall vision for using technology to better engage his patient base. In a state such as Wyoming, where population densities are extremely low and distances between patients and providers can be extremely high, such innovation is absolutely essential, he says.
"We are the ninth largest state geographically speaking, but 51st in population, counting Puerto Rico. Most of our state doesnt even qualify as rural, because we don't have enough people. We are a frontier state.
"People are very surprised to hear we still have frontier states, but the definition is less than five people per square mile. We only have 550,000 people in the whole state, with huge distances in between, and if we're not thinking on the cutting edge of technology, we're not getting the best benefits to our residents."
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