Managed Care - September 2008 - (Page 16)

under various treatment scenarios, and then of taking care of people who have chronic conpush that information back out through the elecditions. We found that by personalizing and pritronic medical record to the practitioner so that oritizing care, we can optimize the treatment it’s available when the patient is being seen in the strategy and get a higher benefit at a considerably office. At that point, instead of the system orlower cost. That’s the golden ring we all want to dering the physician to do something, the physigrab — improving quality while cutting costs cian would make a judgment. But all the inforsimultaneously. Another example is a project in mation would have been processed in a way that which we are describing optimal strategies for draws on much more information and a much preventing cardiovascular disease. There are better capacity for analytical reasoning than a more than a dozen national guidelines being rechuman mind can do. ommended for preventive cardiovascular disease. “Take aspirin,” “lose weight,” MC: Will there be a day when I, as a patient, will interact directly with The effect of a drug in a “stop smoking,” “lower your cholesa program such as this? setting where the level terol,” and so forth. We are able to analyze each one and find optimal EDDY: It already is happening. The of care is already very strategies — optimal ways of American Diabetes Association bundling them, and optimal ways of commissioned an application high might be very difdelivering them so as to maximize called Diabetes PHD, which stands ferent from the effect the benefit while minimizing costs. for Personal Health Decision- of the exact same drug maker. People can go onto the in a setting where the MC: Would Archimedes be a logical ADA’s Web site, www.diabetes.org, and useful tool to use in formulary level of care is very low. type in person-specific informadesign? tion, and receive information EDDY: Certainly. The effects of a about their risks relating to diabetes. They can drug on clinical outcomes and on costs are critalso explore the effects of different behavioral ical factors in deciding whether to put the drug changes and treatments. For example, if they on a formulary or whether to create incentives to smoke, they can explore the effects of quitting, or emphasize one drug over others. Archimedes is losing weight, or complying better with an antivery well set up to answer those questions. It can hypertensive regimen, or taking aspirin, or somedo so for a wide variety of drugs and a wide vathing like that. Then they’ll receive information riety of patient indications. So one drug might be about how the chosen intervention affects their most appropriate for people who have a certain risks. This has been in place now for several years set of indications, and a different drug might be and is quite popular. We have more powerful the appropriate choice as the first line of treatapplications that we put in place for health plans, ment for others. Those are the types of problems such as what I described for Kaiser Permanente. that can be analyzed with the population-based applications of Archimedes. MC: Can you give us some examples of the kinds of population-based projects you are doing with MC: Have health plans or pharmacy benefit manhealth plans? agers used it for that purpose? EDDY: We did an analysis for Kaiser Permanente EDDY: Not yet, but soon. that caused them to make major changes in their MC: Would health plans or pharmacy benefit manemphasis for the management of people with agers put the attributes of their particular popdiabetes. The central element was to have all ulations into the model? people with diabetes take aspirin, lovastatin, and EDDY: Yes. That’s a very important feature of the lisinopril, unless contraindicated, in addition to Archimedes model that distinguishes it from all glucose control. We analyzed a similar concept, other models. We can customize the model to a “diabetes polypill,” for the American Diabetes particular populations as well as particular setAssociation; it was featured in the ADA presitings. We can take information about a populadent’s annual address two years ago. We are also tion that’s of interest to a health plan — it might doing an analysis for Kaiser of the optimal way be their entire membership, people in a partic- 16 MANAGED CARE / SEPTEMBER 2008 http://www.diabetes.org

Table of Contents Feed for the Digital Edition of Managed Care - September 2008

Managed Care - September 2008 Editor’s Memo Contents Legislation & Regulation News and Commentary Medication Management Compensation Monitor Archimedes Lends Hippocrates a Hand Some Other Predictive Modeling Programs Messing With Medicare Advantage The Trouble With MAC MedPAC’s Suggestions Sound Familiar The Leader in Patient Satisfaction Formulary Files Plan Watch Tomorrow’s Medicine Ad Index Outlook

Managed Care - September 2008

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