Improving Outcomes By Connecting Care
EQUES CONNECTED HEALTHCARE OFFERINGS
Chronic Care Management
Chronic Care Management (CCM) provides a comprehensive care plan that addresses a patient’s health problem and goals by implementing personal care plans and engaging with the patient several times a month. Through our Eques Care Optimization Platform we also track their other providers, medications, and other pertinent information about a patient’s health. CCM can be deployed as a standalone service or combined with other services such as Remote Patient Monitoring (RPM) and Behavioral Health Integration (BHI).
Principal Care Management
Principal Care Management (PCM) is a service for monitoring and management of one complex chronic condition expected to last at least 3 months, and that places the patient at significant risk of hospitalization, acute exacerbation/ decompensation, functional decline, or death. The Eques Care Team works with the provider to develop a disease specific care plan and then monitors the patient throughout the month. The Team works with the patient to ensure the plan is having the desired impact, as well as working with the provider to determine personalized escalation protocols. As with CCM, PCM can be combined with RPM and BHI.
Remote Patient Monitoring
Remote Patient Monitoring (RPM) can be introduced in conjunction with CCM or PCM or during the Transitional Care Management (TCM) service period. RPM is designed to provide chronically ill patients (most commonly hypertension, diabetes, CHF, COPD and obesity) with an easy-to-use connected device that transmits daily readings to determine when a patient is outside of his prescribed protocol levels. We utilize the Eques Care Optimization Platform to monitor the patients readings. work with them to bring elevated numbers under control or notify the provider if the readings reach the specified escalation protocols.
TCM can be provided for patients leaving a skilled nursing facility and is designed to achieve interactive contact with the patient within two days of leaving the facility. An Eques Care Team member will review discharge information, schedule and facilitate a follow-up visit, collaborate with any specialist, and provide education for the patient, family, guardian or caregiver.
Transitional Care Management
BHI covers multiple elements including access to prevention and treatment services for substance use disorders, mental health services, crisis intervention and pain care; and further enable care that is well-coordinated and effectively integrated. The CMS Behavioral Health Strategy also seeks to remove barriers to care and services, and to adopt a data-informed approach to evaluate our behavioral health programs and policies.
Behavioral Health Integration
Remote Therapeutic Monitoring (RTM) is for the management of patients utilizing medical devices that collect non-physiological data while monitoring health conditions, including musculoskeletal system status, respiratory system status, therapy (medication) adherence, and therapy (medication) response. RTM can be used in conjunction with other approved services.
Remote Therapeutic Monitoring
“With online monitoring and alerts, plus advanced technology and the use of AI, Eques has created a patient-centric community that is vested in better outcomes.”
— SHANNON CLEMMONS