MANKATO — A monitoring program started in 2021 is helping limit emergency room visits for Mankato Clinic patients with chronic diseases, said Marti Wolter, the organization’s chief medical officer.
Patients with diabetes, heart failure, chronic obstructive pulmonary disease and select other chronic illnesses started voluntarily enrolling in the CareSignal program in August 2021.
The clinic sends texts or calls to about 1,984 patients on a regular basis requesting symptom updates, then uses the information to track their condition and contact them if any medical interventions are needed.
“We’re watching for those opportunities where people are starting to get toward a point where they’re going to need more care, but they don’t recognize it and end up in the emergency department,” Wolter said.
Mankato Clinic reported about 100 avoided emergency room visits since the program began. Wolter said they calculated the total in part by looking at instances when metrics were trending in the wrong direction enough to warrant a proactive call to them. If the trend kept up, the person was tracking toward an emergency situation.
In the case of a patient with diabetes, the key metric is blood sugar levels. Spikes up and down or a steady creep upward would prompt an alert.
A patient with asthma may report using their rescue inhaler more than usual. Blood pressure readings are tied to hypertension monitoring, while screening prompts aid the clinic in depression control.
Reaching out directly and frequently is a way to overcome a tendency among some patients to shrug off how they’re feeling, said Rebecca Corrow, a doctor of nursing practice and advanced practice registered nurse at Mankato Clinic.
“When people are chronically ill, it can be really hard for them to decide how sick is sick enough to be worried,” she said.
Subtle changes to symptoms aren’t always noticeable when someone has been dealing with a chronic illness for a while, she added. Texting in your updates during the at-least-weekly check-ins makes sure subtleties are tracked.
“The hard part about these chronic diseases is sometimes they’re silently causing problems,” Corrow said. “They’re not having symptoms but they’re still not controlled.”
Apart from interventions when a metric signals the need, providers are armed with more data on the patient’s condition at their regular appointments. It’s helpful to go into an appointment with the results compared to asking the patient to recall how they’ve been holding up since their last appointment, Corrow said.
From the clinic’s calculation of avoided emergency room visits, it estimated an associated $1.43 million in medical costs saved. Controlling costs for patients is the other clear benefit of proactive chronic disease monitoring, Wolter said.
A chronic disease diagnosis prompts the clinic to ask if a patient wants to enroll. They choose their preferred mode of contact, from a text to a call to an email, as well as the frequency.