Nurse24 Program Overview

How the Program Works | Facts You Need to Know | Program Guidelines | Accrediting Organizations | Nurse24 Outcomes Reporting | Nurse24 Outcomes

How the Program Works

Nurse24^SM is a toll-free, nurse-driven telephonic support program that empowers participants to better manage their health. Available to a client’s entire population, Nurse24 offers a cost-effective solution for participants coping with chronic and acute illnesses, episodic or injury-related events and other healthcare issues. Highly trained registered nurses (health information managers) are available 24/7 to monitor and process healthcare inquiries that help participants make informed healthcare decisions, based on client-specific services.

Trained in telephone triage, our health information managers help participants navigate through questions and concerns about symptoms, appropriate treatment choices, co-morbid conditions and additional risk factors. Utilizing an accredited knowledgebase of more than 5,500 health topics, nurses have additional tools to help triage calls effectively and appropriately.

Nurses guide participants in making informed decisions about a multitude of health conditions, including:

• Caring for minor injuries and illnesses
• Seeking the most appropriate help based on the medical concern
• Identifying and addressing emergency medical concerns
• Preparing for doctor visits
• Understanding prescription medications
• Helping with lifestyle choices to improve health
• Providing education and support regarding decisions about tests

If an urgent situation is discovered during a call, nurses guide participants to the most appropriate course of action. Guidance can include referrals to hospital emergency rooms, urgent care centers, the 911 national emergency number or the participant’s physician.

Differentiators

• Provision of consistent, clinically appropriate information from the nationally recognized Healthwise® Knowledgebase
• Experienced clinicians: highly-trained registered nurses who are trained in health issue discovery and in initiating appropriate non-diagnostic guidance relevant to symptoms identified during a call
• Integrated with Alere’s disease management services to ensure coordination of care across programs and an enhanced participant experience
• Application of award-winning state-of-the-art computer telephony integration (CTI) and voice over internet protocol (VoIP), which exceeds current demand for nursing telecare support services
• Eligible participants with special needs can expect TTY service for the hearing impaired and the assistance of nurses who have access to translation services for more than 140 languages

Health Information Managers

We maintain one of the industry’s most experienced nursing staffs, with an average tenure of more than 10 years working in patient care. Requirements and qualifications of the staff nurses include:

• Current registered nurse (RN) licensure in the state where they work
• Ability to obtain licensure in all 50 states
• Minimum of five years of clinical experience (i.e., triage, critical care, case management, disease management)
• Demonstrated decision-making capabilities
• Established ability to perform under quality management guidelines

Alere’s registered nurses are subject to a thorough initial credentialing process and to regular evaluations thereafter. These evaluations reinforce established quality parameters, document goals, target objectives and review progress for each staff member.

Online Support

Our participant Web site offers a secure and private method for asking health-related questions of our health information managers. From the Web site, participants can click on the “Ask a Nurse” function, enter their questions or description of the issues and send to our health information managers, who will respond within 24 hours. Due to HIPAA requirements regarding some types of personal health information, nurses may sometimes request that the participant call in for a telephonic interaction to ensure personal, confidential support.

Direct Mail Support

Initially, participants will receive a welcome package that includes a magnet to help them easily access Nurse24 as their first source of support for healthcare questions. Participants requesting additional information can receive Healthwise Knowledgebase educational articles on any topic discussed during the call.

Benefits

For clients:

• Service available to entire client population, including those with special needs
• Promotes proper utilization of available health resources
• Enhances current benefit offerings by providing seamless, integrated program to leverage existing client-specific benefit resources
• Ensures quality delivery of service through accredited call center and support tools
• Increases potential cost savings related to improved care delivery, along with improved absenteeism, presenteeism and overall productivity rates
• Increases participant satisfaction through availability and utilization of program
• Effectively tracks utilization, data and cost trends of the program
• Provides program communications that reinforce participation and generate enthusiasm

For participants:

• Provides immediate clinical support for everyday health issues and questions
• Provides personalized support and education that empowers participants to better manage their health
• Offers reliable and accredited resource for clinical and medical information that supports participants and their healthcare decisions
• Enhances participant experience through coordination of care across programs

Facts You Need to Know

Statistics show that medical management companies offering nursing care through telephone practice, triage and call center nursing can help organizations improve overall population health and reduce healthcare costs as much as $2,562 per employee per year.1

Alere reports the top health concerns of participants who call Nurse24 include self-care conditions such as eye problems, bites, head injury and abdominal pain,2 all self-care conditions that often result in unnecessary physician and ER visits.

Program Guidelines

In an effort to triage calls effectively and appropriately, we utilize the Healthwise Knowledgebase to source clinical and medical information that supports our participants. Healthwise contains comprehensive, current, evidence-based and unbiased information that supports a variety of healthcare decisions, such as when a problem can be treated at home, when to see a doctor and what treatment options may be best for an individual.

The content of the Healthwise Knowledgebase is provided in English and Spanish, and includes more than 5,500 health topics. Healthwise is URAC-accredited, which ensures that the content that our staff access is clinically current and accurate. An independent Healthwise medical advisory board reviews and updates guidelines and protocols on a quarterly basis.

Accrediting Organizations

In 2007, the Nurse24 program received Health Call Center full accreditation from URAC, an independent, not-for-profit organization promoting healthcare quality. The accreditation standards assure that registered nurses, physicians or other validly licensed individuals perform the clinical aspects of triage and other health information services in a manner that is timely, confidential, and includes medically appropriate care and treatment advice.

Nurse24 Outcomes Reporting

The Nurse24 Program generates reports that evaluate a population’s main health concerns and issues. The reports determine how Nurse24 helps participants reduce potential complications from improperly managed medical events as well as overuse of expensive medical interventions resulting from inappropriate care decisions.

Currently, Nurse24’s standard reporting package includes:

• Call metrics
  • Number of calls
  • Abandonment rates
  • Average speed to answer
  • Average call length
• Types of calls
  • Communication
  • Follow-up calls
  • Triage
• Percentage of utilization
• Distribution of contacts by call type
• Chief reported medical concerns
• Caller demographics
• Pre-call intention (participant’s intention for treatment)
• Post-call intention (participant’s intention for treatment after talking with a nurse)
• Participant-directed care (comparison of pre-call and post-call intention to show impact)
• Referrals to other health management programs

Nurse24 Outcomes

• One-third of participants planning a visit to the emergency room who called Nurse24 were successfully redirected to appropriate healthcare services while 50 percent changed their pre-call decision to seek care after speaking with a nurse.
• Additionally, more than 87 percent of participants expressed satisfaction with Nurse24 services and would recommend the program to others.³