This seminar will explain the paradigm shift in health care from acute diseases to chronic conditions. Based on this understanding the importance and potential of disease and case management programs as well as corporate health programs will be described. The role of self-management and the tremendous impact of HR on health and disease related costs will be highlighted. The relationship of patients to physicians is no longer the unique interaction in health care, but health coaches and HR interventions play a more and more important and effective role. At the end of the seminar HR representatives will be able • To understand what is a Disease Management and Case management program • To know how preventive Corporate Health Programs add value to HR functions • To evaluate which programs may support HR in controlling health insurance premium This presentation was used at HR Summit and Expo 2013 www.hrsummitexpo.com

1. How Disease Management, Case
Management And Corporate Health
Programs Can Support HR
Dr. Alfons Grabosch
Director Health Support
Daman National Health Insurance Company, Abu Dhabi

2. Agenda
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A Paradigm Shift in Health Care
Stakeholders in Health Care Today
Disease Management Programs
Case Management Programs
Corporate Health Programs
The role of HR Managers in Health Care

3. A Paradigm Shift in Health Care
Acute
diseases
Chronic
conditions
Like accidents, infections,
communicable diseases
Like obesity, diabetes,
hypertension, heart diseases
sudden onset,
lasting for a specific period
of time,
more or less unpredictable
insidious development,
lifelong lasting,
quite predictable

4. Chronic Diseases
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(Challenge and Chance)
more or less predictable
self management required
very much related to behavior and lifestyle
awareness and knowledge required
motivation to change
help to change
overcome of fragmentation

5. Stakeholders in Health Care Today
HR
Manager
Doctor
Medical
professionals
Patient
Health Insurance
Regulator

6. Medical Intervention
Classical Treatment
 Medication
 Surgery
 Medical procedures
Self-management
 Supported by
 Medical Education
 Disease Management
 Case Management
 (Corporate) Health Programs

7. Disease Management Definition
DM is the concept to reduce healthcare costs and/or
improve quality of life for individuals with chronic
disease conditions by preventing or minimizing the
effects of a disease or chronic condition through
integrative care…

8. Disease Management Objectives
Individual Level
 Encourage self-management of chronic conditions
 Reduce or avoid complications
 Better quality of life
System Level
 Monitor treatment (clinical pathways, evidence based
guidelines)
 Cost containment

9. Disease Management Daman Concept
TeleCoaching
Training
Tele
monitoring

10. DMP “Diabetes” Training tool
Daman offers an Interactive Group
trainings for Diabetes and Obesity
through the MEDIAS 2 program which
is translated into Arabic/English and
adapted to the Gulf/Arabian culture.
Daman’s Service:
3 month course with (12 lessons,
1 lesson/week, 10-20 Patients / group)
In order to:
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Understand diabetes
Change lifestyle
Lose weight
Live on healthy diet
Avoid diabetes complications

11. DMP “Diabetes” Telecoaching
Daman provides patients with a personalized health coach who
calls them regularly encouraging them to shift to a healthier
lifestyle using ProvidinCare® software:
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to motivate,
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to educate,
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to set targets and helping patients to achieve them and
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to evaluate health status.
Daman’s Service:
 Structured phone calls lasting 15-20 min.
 Initially one call per month
 After one year one quarterly call
•Permanent service

12. DMP “Diabetes” Telemonitoring
Telemonitoring refers to the continuous monitoring of a patient’s
condition to enable coaching, lifestyle changes and patient selfmanagement.
Daman’s Service:
Telemonitoring of diabetes:
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Check patient Data, alert functions etc.
Real-time data transmission
Bluetooth transmission
Glucose measurement

13. DMP “Diabetes”
Effectiveness – lowering HbA1c
HbA1c is the average blood sugar level for the past
three months
For a diabetic patient it should be lower than 6.0%
Lowering HbA1c by 1% can reduce the risk of:
Myocardial infarction
14%
Stroke 10%
Heart Failure 16%
Any diabetes related
death 21%

14. DMP “Diabetes”
Effectiveness – lowering HbA1c
 N=360
 Inclusion Criteria: HbA1c ≥ 7%
 Observation period:18 months
 t0= HbA1c starting the program
 t1= HbA1c after 18 months
 HbA1c reduction is comparable
for males and females
A reduction of 0.6 % points
was achieved after 18 months

15. DMP “Diabetes” (achieved targets after 12 months)

16. Diabetes Mellitus Predicted Cost
Diabetic UAE Nationals 2008-2019
2008
2009
2010
2011
2012
outpatient
2013
2014
inpatient
2015
total
2016
2017
2018
2019

17. Case Management Definition
…is a collaborative process of assessment, planning, facilitation
and advocacy for options and services to meet member’s health
needs through communication and available resources to
promote highest quality care.
Case Management Society of America

18. Case Management Concept
Evaluation
Clinical Results
Effectiveness
Network quality assessment
Cost effeciency
Assessment
Network
Patients
Case selection
Planning
Monitoring
Treatment plan
Review with patients
Treatment options
Reassessment
Provider options
Implementation
Facilitation
Tracking
Coordinate
Collaborate
Evidence based guidelines
Communication
Incentives
Software

19. Case Management Daman Services
Oncology
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Breast Cancer
Colorectal Cancer
Cervical Cancer
Prostate Cancer
Leukemia
Rheumatology
 Rheumatoid Arthritis

20. Case Management Decision Trees

21. Corporate Health Programs
Daman’s Concept
Stress
Management
Disease/Case
Fitness
Weight
Management
Management
Health support modules
Recommendations
Member portal (web, smart Phones)
Health Screening
Health Risk Assessment (HRA)
Smoking
cessation

22. Corporate Health Programs
Health Risk Assessment - Content
•
•
•
•
•
•
•
Lifestyle
Physical Activity
Nutritional habits
Health Risks
Sleep
Stress
Occupational well being

23. Corporate Health Programs
Health Risk Assessment - Example
Exercising
Occupational well-being
Light physical exertion (h/day)
Conflict management by superior

24. Corporate Health Programs
Health Screening
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Weight/BMI
Body Composition (Water/Fat/Muscle)
Blood pressure
Blood Sugar
Lipid panel
Diabetes risk (Find Risk/Ezscan)
VO2 max /Fitness/Heart age

25. Corporate Health Programs
HRA
Screening
Individual
Health Profile
Individual
Health Profile
Individual
Health Profile
Corporate
Health Profile
Corporate
Health Profile
Consultancy
Corporate
Health Program

26. Corporate Health Program Result
8.62
8.62
8.22
8.08
7.92
7.42
All personnel
Activation
MET PRE
Health Lab
MET POST
9.58
4.32
2.36
All personnel
Activation
Improvement in heart age (average)
Health Lab

27. Corporate Health Programs Benefits
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Improve Quality of Life of employees
Retention of employees
Avoid/reduce chronic conditions
Avoid/reduce complications of chronic conditions
Reduce absenteeism
Reduce claims cost
Improve productivity

28. The Role of HR Managers in Health Care
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Knowing possible interventions
Having knowledge of the corporate health profile
Selecting the right programs
Reduce absenteeism
Improving productivity
Reducing claims cost
Reducing premium

29. Conclusion
In the future HR Manager will play an active role in supporting
staff to maintain and improve individual health and by that
improve corporate health.
On a corporate and even community level the HR Manager
will be as important as the doctor.
HR Manager can substantially influence the health care
system.