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NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation Project Sonar Organization Overview • Takeda Pharmaceuticals U.S.A., Inc. is among the top 15 pharmaceutical companies in the United States • Takeda is committed to strive toward better health for people worldwide through leading innovation in medicine Background Inflammatory Bowel Disease (IBD) is a complex, often poorly controlled condition that can lead to high acute care costs. In 2012, BlueCross BlueShield of Illinois (BCBSIL) spent more than half of its Crohn’s Disease spending on inpatient hospital treatments due to condition-related complications. Many factors contribute to the high costs associated with IBD, including: • Tremendous variation in physician practice and hospitalization rates • Low patient engagement: less than 1/3 of BCBSIL patients admitted for inpatient care had any demonstrable provider interaction in the 30 days prior to admission Project Sonar is a community-based registry and disease management program, which was developed to not only improve the health and lives of IBD patients, but also to create efficiencies in IBD treatment practices and reduce overall costs. Program Details The program began as a pilot program between Illinois Gastroenterology Group (IGG), SonarMD, and BCBSIL in 2014, which served 50 patients. It has continued to expand over time, now involving up to 5,000 patient participants. Current partners include SonarMD, 16 multi-site GI practices (including IGG), BCBSIL, Health Care Services Corporation, Mutare Health, Takeda Pharmaceuticals USA, Xcenda LLC, and AmerisourceBergen. The objectives of the program are to: • Change GI practice focus from one patient-at-a-time to improving the health of populations • Utilize a care team approach to embrace mid-level professionals, care managers, social workers, dieticians, pharmacists and others as required • Engage patients as partners in their care alongside their healthcare team • Assess real-world IBD treatment patterns, treatment response, healthcare utilization, and reduced costs as a result of ProjectSonar participation Project Sonar has two core components: • A cloud-based registry that integrates monthly patient-reported symptoms and health-related quality of life information with electronic medical record (EMR) and claims data to provide comprehensive, real-time information to physicians and patients about IBD health status An Initiative of the 35 | Project Sonar
NDHI NAT IONAL DIALOGUE FOR Healthcare Innovation • An ongoing research project to demonstrate the clinical, humanistic, and economic outcomes associated with this chronic care program Project Sonar utilizes critical elements of the Chronic Care Model, including: • Patient engagement –– Patient involvement is initially facilitated through a ‘super visit’ with the nurse care manager to assess risk, treatment history, and patient preferences –– Patient adherence is promoted by the Sonar system, which ‘pings’ patients reminders via their smartphones • Proactive practice teams –– Patient care is managed through a team of nurse care managers and physician medical directors –– Treatment decisions are based on AGA Care Pathways for Crohn’s disease and Ulcerative Colitis • Clinical information systems –– Analysis of patient-reported outcomes data is sent to the practice team on a monthly basis –– Over time, this data produces a patient’s ‘Sonar Score,’ graphically representing the individual’s risk and changing health status, which is fed back into Sonar tools and dashboards to be used by the care team • During the first full year of Project Sonar data collection, patients with Crohn’s disease experienced: –– 57.14% fewer inpatient admissions –– 53.28% fewer emergency department visits –– 24.5% reduction in injectable biologics –– 8.97% increased use of infusible biologics • The platform and database also allow for additional clinical and economics outcomes studies Path Forward • Project Sonar will continue to serve patients in the existing program and conduct outcomes studies • Project Sonar is pursuing negotiations with Blue Cross Blue Shield plans across the country to integrate cost data • Long term goals include: –– National expansion to additional large multi-site GI practices –– Investigation into the feasibility of expanding into smaller independent practices –– Acquiring claims and cost data beyond Blue Cross Blue Shield health plans, which will be of critical importance to conduct national outcomes and cost effectiveness studies –– Conducting national outcomes and cost effectiveness studies on IBD topics Value Delivered • This program utilizes coordinated, comprehensive care and patient engagement to improve patient outcomes and reduces costs to the system Project Sonar | 36
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