The CareCoach® Model, Beyond the Brand...

Posted on Monday, August 25, 2014 under Healthcare

By:  Jim Murphy - Vice President Healthcare Strategy and Business Development 

As the person responsible for creating the branding for our services I am constantly searching for ways to differentiate what we do from others in our industry.  A cynical person might conclude that much of what marketers do is to take very small differences and inflate them to an extent that is well beyond the actual value they create for end users. This is particularly evident in the pharmaceutical industry where I spent the first half of my career. In that business some marketers, (perhaps even me), created whole campaigns based on a 5% difference in the efficacy or side effects of two drugs quoting a randomized controlled trial of 800 more or less homogeneous patients in which it was determined that the sample was large enough to show, using a P value of .05%, that one drug had in this population either more effectiveness or fewer side effects than another. We then proposed to our provider customers that they use that product on their patients, perhaps even ones that were not exactly the same as those in the study population.  

With this in mind it is still my job to try to demonstrate that the processes we use in our services will in fact create outcomes for our clients, their providers and the health system payer to justify choosing us over one of our competitors. We do in fact participate in outcomes based evaluation of our services and in the very near future will be able to prove, perhaps even to a P of .05%, that more people who are supported by our CareCoaches®  will stop using tobacco, exercise more or reach their target weight depending on the program in which they are participating.

Below I will be sharing what some would describe as basic anecdotal evidence, (i.e. some stories), which I think help explain why we really like the CareCoach® model of self-management support.  Why in fact it is different than other services that are provided to patients, their families and providers.

What is a CareCoach®?

We began using the term Care Coach in 2008 as a way to differentiate the approach we used to support people who were trying to stop using tobacco.  We had been supporting smokers since 2005 using a traditional medical model of care supported by registered nurses following a stepped care protocol developed at the University of Waterloo.  In early 2008 we were introduced to Motivational Interviewing (MI) as a model for behaviour change in healthcare by Rollnick, Miller and Butler’s book Motivational Interviewing in Health Care: Helping Patients Change Behavior.  While MI was well understood in addictions we had not been aware of therapeutic processes that would support brief interventions using MI to help people to lose weight, exercise more or to stop smoking.  We were also concerned that our coaches were not hearing the whole story from people because they did not really get a chance to bond with them since on every call a client might talk to a different counsellor.  Therefore, in 2008 we created a model where people with academic training and certification in behaviour change would play the role of a primary coach for people who were attempting to make changes in their lifestyles.  This was designed to take advantage of what some have called the working or therapeutic alliance that develops between a provider and her client. When we did switch to this model we did indeed start to uncover barriers to change during the third or fourth call,  once enough trust was built between the coach and the client. From 2008 until 2012 the model evolved to include multiple channels such as social media, web sites, email, and automated messages using interactive voice response (IVR).  Now our CareCoaches can interact with clients individually or in groups using the telephone, within on-line communities, using email and they can send them motivational messages or trigger a well-timed reminder call using our IVR.  

An “Aha” moment

Last week we had the pleasure of welcoming some of our partners to our London, Ontario site to discuss how we might integrate our services into a best practice model to help people who have been diagnosed with multiple chronic conditions.  To share what we do and to facilitate our discussions we tried to answer the question - How do we make sure that we have the right people available at the right time to provide competent and culturally safe care for the people that we help? When you see your service through the eyes of others you often see more clearly what makes it special.  It was while actually seeing our CareCoaches in action that I was truly convinced that there is something different about the way they interact with their clients that leads to the outcomes we are seeing. It was obvious that our coaches cared for their clients but just as obvious that our clients had a true partnership with the coach. In some cases these relationships have existed for over a year.  In one instance a caller who had “slipped” in their quit was reunited with their CareCoach to try again.  Because they had a relationship they were able to pick up right where they had left off… deep breathing exercises to induce the release of Dopamine, making a choice on a quit date, choosing the timing of the IVR call, promising to meet up on the Facebook page and discussing barriers, and finally setting goals that belonged to them as a team.  

deep breathing exercises to induce the release of Dopamine

We know that others use Motivational Interviewing and have their counsellors certified in cessation or chronic illness counselling , use other channels like web sites or IVR but we seem to have been successful by living by the motto that one size fits one. Readiness changes, barriers change, channel preference changes and we have created a solution that by being person centred is able to adapt.

Our partners left last week praising what they had seen.  After they left we took a moment to pause and reflect and one of my colleagues said “hey that CareCoach model is different, it is really cool what we do…”