We spoke with David Weingard, CEO of Cecelia Health — www.ceceliahealth.com. This New York-based firm employs CDEs to coach people with diabetes.
Cecelia Health CDEs typically have 5-10 interactions with each patient per year. In 2018, they had 400,000 unique patient interactions in total and expect to double the number of patient interactions to 800,000 in 2019.
- They coach people living with T1D and T2D who are insured with commercial health insurance firms or employees of self-insured employers to improve their wellness.
- They also work with pharma/device firms to improve adherence among patients who use their products.
Engaged but Invisible
“We are part of a large package of services provided by our customers, so we are comfortable operating as part of their identity,” reports Weingard.
“Cecelia Health clients include pharmaceutical and device companies who need help to achieve initiation and persistence in use of their branded experience and to improve patient health. Additionally, we work with health plans and providers, who are struggling to achieve quality measures and lower costs.
Cecelia Health provides a scalable way for all these companies to engage with their patients to realize better outcomes.
“The company targets people whose diabetes is unmanaged or poorly managed. This includes people with T1D (both MDI and pump), people with the full spectrum of T2D from simple to advanced, and soon Cecelia Health plans to help people with other chronic diseases including obesity, cardiovascular issues, hypertension, and depression.
Diabetes is a job no one wants, states Weingard.
“When a person is diagnosed with diabetes or they get a poor blood sugar reading back from their A1C test, they may or may not take their medication. This starts a cycle of nonadherence. Presently, fifty percent of new patients will drop off their medications in the first six months. They may feel overwhelmed and they may be in denial. These patients are where our CDE’s are able to make the greatest impact.
“What has been missing is personalized human interaction for this population. Cecelia Health proactively reaches out to patients, building trust, educating them in a scalable way, and getting them to initiate and persist on use of their medication.
“Our bottom line is to help patients achieve better health and increase their sense of empowerment. It’s a win for the provider for their quality measures and the bonuses that they receive. And ultimately, it’s a win for the health plan for quality measures and lowering associated costs.
Big Data Benefits
Because Cecelia Health’s personalized clinical coaching platform is integrated into the wellness services provided by its customers, they get access to each person’s medical record, medication history, and connected device data stream.
This detail helps the CDE provide better coaching.
All patient interactions are tracked, and analysis of these interactions helps Cecelia Health fine-tune best practices, improve messaging, and reward good coaches.
As the body of patient interactions grows, Cecelia Health expects data-driven insight from this ‘big data’ analysis to lead to new treatment plans and practices that transform the lives and health outcomes of people living with chronic disease.
Jaeb Center for Health Research / Helmsley Charitable Trust Studies
“The initial phase of the pilot will recruit at least 30 T1D and T2D adult patients using basal-bolus insulin therapy who are not on CGM. The goal is to collect patient data, insights and clinical evidence to launch a commercially scalable program. Cecelia CDEs will work with patients virtually to educate and support them in selecting CGM options, train them on CGM use, help them understand and interpret CGM data, and how to use the data to help manage their condition. Each patient will be assigned a personal CDE they will work with throughout the three-month study.
“Most of the training and communication will be conducted via video coaching sessions. Cecelia Health CDEs will also use phone, email, and text messaging to interact with patients. Patients will be able to reach CDEs whenever and however they need to connect for training sessions or follow-up appointments and communications.
“The pilot is the first step towards achieving a model that evolves to include prescribing a CGM, onboarding, data interpretation, remote data monitoring, and eventually even adjusting insulin doses that can be titrated via a decision- support algorithm optimized for each individual by a Certified Diabetes Educator (CDE), under physician orders.
“What we learn from the pilot will be used to structure a larger study that could include the use of decision support to make dosage and titration recommendations, a “virtual clinic” that could include prescribing CGMs and initial dosage, and recommendations to Primary Care Providers and patients on subsequent changes in medications and dosage for insulin-using Type 1 and Type 2 diabetes patients, and mental health screening and coaching.
Risk-based Models at Scale
Cecelia Health knows that health insurance companies, pharmaceutical and device firms, and self-insured employers want to achieve great outcomes for patients and measurable business results.
Today, Cecelia Health charges a fee per engaged person per month with the amount depending on the condition.
The company is wholly focused on building technology, integrations, and practices to deliver successful outcomes at scale. Their goal is to serve millions of patient interactions each month.
To achieve this scale, Cecelia Health expects to charge customers based on success.
Building on their accumulated successes, in 2019 Cecelia Health will expand its mission to support patients living with other conditions such as obesity, hypertension, and cardiovascular disease.