Our outcome focused approach to managing health
For every condition we work on, from diabetes to asthma,
we follow the same proven framework to deliver results.
Diabetes
Patients often struggle with diabetes, despite the best efforts of our health system, due to deeper issues underlying their struggle such as health literacy, limiting beliefs, social needs, etc. Peer mentors, who share a similar lived experience and cultural background as these patients, are an effective approach to activate and help.
About
We engage each patient with poorly-controlled diabetes and carefully match them with a peer mentor based on shared experiences, language, availability, culture, and background.
The mentor remotely delivers the program 1-1 via phone and smartphone, and involves key Experts like dietitians, pharmacists, housing navigators, as needed.
Results
- 71%+ enrollment rate. 278 minutes of phone interaction per dyad. And a 1.7 point average reduction in HbA1c (p<.01). See Lyles et al., JAMIA, 2020 for more details.
- Each 1-point reduction in HbA1c reduces healthcare complications by 40% (Stratton et. al, 2000) and costs by an estimated $99 per patient per month (Millman, 2012).
History
- Pioneering Research. Randomized clinical trials led by Dr. Judith Long MD and Dr. David Thom MD PhD showed a 1.1 point reduction in HbA1c with peer mentoring versus no significant change in HbA1c for patients with just usual care. These independent trials demonstrated the value of peer mentoring and inspired our future work.
- NIH Funding. With multiple funding awards from the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Institute on Minority Health and Health Disparities (NIMHD), InquisitHealth collaborated closely with Drs. David Thom MD PhD, Judith Long MD, Michelle Heisler MD, John Piette PhD, Joel Zonszein MD CDE, Edwin Fisher PhD, Nelson Eng MD, Tricia Tang PhD, Chris Norwood, Lisa Ferretti LMSW, Philip McCallion, PhD and many others to build and evaluate the efficacy of a tech-enabled diabetes peer mentoring intervention.
- Peer-reviewed, Real-world Data Published. In November 2020, Drs. Courtney Lyles PhD, Urmimala Sarkar MD and Sarah Lisker at UCSF published our outcomes in a peer-reviewed publication, the Journal of the American Medical Informatics Association (JAMIA).
Partner Spotlights
- 1199SEIU National Benefit Funds, a self-insured and self-administered health plan for health care workers, estimated that our peer-to-peer mentoring program would save the Funds “several thousand dollars per member above the cost of the program.”
- NYC Health + Hospitals, one of the largest public hospital systems in the country, implemented our diabetes program across two hospitals. Based on our successful engagement and HbA1c outcomes, the program has been expanded to a third hospital during the height of the COVID epidemic in NYC.
Clinical Outcome
Key outcome measure:
- 1+ point reduction in HbA1c (3-month blood sugar average)
Key Behaviors
Our Peer Mentors help coach patients with:
Due to success of this evidence-based diabetes program, InquisitHealth is recognized by the American Diabetes Association (ADA) as an official provider of Diabetes Self-Management Support (DSMS).
Mentor Perspective
Patient Perspective
Pre-Diabetes
Patients living in remote areas, with a disability or without access to the internet often do not participate in in-person or web-based Diabetes Prevention Programs (DPP). Unfortunately, those same patients are the ones disproportionately likely to develop diabetes. Our 1-on-1, telephone-first DPP program aims to reach and help those patients.
About
The Center for Disease Control (CDC)’s Diabetes Prevention Program (DPP) is an evidence-based program to promote a lifestyle-based approach to reduce the risk of developing diabetes.
Paula Trief, PhD and Dr. Ruth Weinstein, MD PhD at SUNY Upstate Medical University validated the success of a telephonic model of DPP.
With funding from the NIH’s National Institute on Minority Health and Health Disparities (NIMDH), InquisitHealth collaborated with Drs. Trief and Weinstein to create a landline-compatible DPP program designed to reach every patient with prediabetes.
Our model also focuses on addressing barriers related to the social determinants of health (SDoH), such as food insecurity and health literacy while activating healthy lifestyle changes related to healthy eating and increased physical activity.
Partner Spotlights
- New York City Department of Health + 1199SEIU National Benefit Funds. We delivered our program to 1199SEIU members with pre-diabetes who lived in New York City, helping patients achieve an average 5%+ reduction in weight from baseline — which translates into >50% reduction in developing diabetes.
- Alaska Department of Health + National Association of Chronic Disease Directors. With CDC funding, we increased the availability and accessibility of the DPP from just 7 in-person programs in 5 Alaskan cities to a statewide program available to each and every Alaskan resident with prediabetes. Importantly, we are now reaching remote areas with limited wifi. And, mentors living in Alaska have now been trained to deliver the program.
Clinical Outcome
The key outcome measure:
- 90% of eligible patients enroll
- 90+% attend 9+ sessions in
first 6 months - 6.2% weight loss
(clinically significant) - 170+ minutes of physical
activity per week
Key Behaviors
Our Peer Mentors help coach patients with:
Technology Integrations
Each participant receives:
Full CDC Recognition
Our Diabetes Prevention program has received ‘Full Recognition’ from the CDC — the highest level of recognition awarded by the CDC for Diabetes Prevention Programs.
“InquisitHealth’s telephonic DPP has great retention and engagement. I believe this is primarily due to the peer-based approach. When participants are matched with mentors who share similar experiences and backgrounds, they build a strong relationship, and they want to continue engaging in the program. The outcomes then speak for themselves.”
Marti Macchi, MEd, MPH
Asthma
25 million people in the United States, including 6 million children, live with asthma. In 2016, 1.8 million people visisted an asthma-related ED visit and almost 200,000 were hospitalized because of asthma. Preventing asthma exacerbations requires education, coaching, self-management, and addressing barriers related to the social determinants of health.
About
Our pediatric asthma program pairs the parents of children with poorly-controlled asthma with certified asthma educators (AE-C) who are also parents of children with athma.
These Parent Mentors work 1-on-1 with parents to help identify and address the underlying social- and behavioral- determinants of health, provide coaching and connect parents with available resources to help better manage their child’s asthma.
History
- Randomized clinical trials led by Dr. Edwin Fisher and Dr. Jane Garbutt showed that coaching parents resulted in a 38% reduction in pediatric asthma hospitalizations and a significant decrease in ED visit, respectively.
- Dr. Glenn Flores, who pioneered the concept of Parent Mentors, documented in a randomized clinical trial that parent mentoring resulted in significant reductions in rapid breathing episodes, asthma exacerbations, and ED visits in minority children, and savings of approximately $600 per asthma exacerbation avoided.
- With funding from the NIH’s National Institute of Child Health and Human Development, InquisitHealth collaborated closely with Drs. Edwin Fisher PhD, Jane Garbutt MD, Glenn Flores MD, Edwin Strunk MD and Deepa Rastogi MD to build and evaluate the efficacy of a tech-enabled parent-to-parent mentoring intervention.
Partner Spotlight
- Since 2019, Healthfirst, New York’s largest not-for-profit health insurer, has offered our robust parent mentoring program to parents with children struggling with asthma. These parents were matched with Parent Mentors, who are certified asthma educators (AE-C) and also parents of children with asthma themselves. In 2021, HealthFirst is expanding the program to provide 1-on-1 mentoring for adult asthma patients, as well.
Clinical Outcome
The key outcome measure:
- Reduction in hospitalizations and emergency visits due to asthma exacerbations
Key Behaviors
Our Peer Mentors help coach patients with:
Parent Perspective
Hypertension
In the United States, more than 100 million people, or nearly 50% of Americans, have hypertension. High blood pressure and its complications cost our nation $46+ billion each year. The challenge of managing hypertension is complex — involves behavioral modifications (medication adherence, diet modifications, regular BP monitoring etc), as well as addressing any underlying social needs (housing instability food insecurity, etc).
About
Our mentoring program helps participants take control of their hypertension.
Each person receives 1-on-1 phone calls with their mentor; access to a secure smartphone app where they can view educational content, message their mentor, and track their goals; and a cellular blood pressure cuff that is integrated into InquisitHealth’s HIPAA compliant platform for real-time feedback and personalized support. Each member also receives written, culturally-tailored feedback from a dietitian.
Participants are matched with mentors based on factors such as shared availability, language, ethnicity, geography, and lived experiences.
Results
- -10.5 mmHg stystolic and -6.7 mmHg diastolic reduction in blood pressure
- Increase in the average blood pressure monitoring frequency from 0.6 times/week to 4.6 times/week
Partner Spotlight
- 1199SEIU National Benefit Funds, one of the largest self-insured unions in the US, has partnered with InquisitHealth to provide peer-to-peer mentoring for its members living with poorly-controlled hypertension.
This program seamlessly combines with our diabetes program since diabetes and hypertension are often co-occuring. Participants benefit from better blood pressure and blood sugar control.
Clinical Outcome
The key outcome measure:
- Reduction in systolic and diastolic blood pressure
Key Behaviors
The key outcome measure:
Technology Integrations
Each participant receives:
