“Ever since I had COVID, it always smells like something’s burning,” explained a patient suffering from symptoms of long COVID. This burning smell has plagued her for more than three months and is coupled with fatigue, difficulty breathing, and a persistent cough. Long COVID recently joined other diagnoses, such as diabetes and Crohn’s, as one of the most common chronic conditions Americans are facing today. Treatment for chronic conditions requires ongoing support to address long-term care, including an extensive network of resources to help manage symptoms, relieve concerns, and provide innovative solutions that make health care simpler. The often-times debilitating symptoms of chronic condition don’t take a break which inspired our team to challenge ourselves to design a system that engages technology and utilizes digital tools to provide the necessary care patients need – where, when, and how they need it.   

Digital, personalized care for members  

To help people manage their chronic condition, such as diabetes, Crohn’s disease, and long COVID, our team of experts developed a digital care solution for consumers’ health and well-being.  

The digital platform headlines with a daily symptom tracker that asks health plan members to answer a few simple questions each day allowing the health plan’s care manager to identify patterns or note changes in the patient’s health. This information enables daily exchange via on-demand, text-based, two-way communications between the patient and his/her care team. The program also includes extensive access to a dedicated digital platform with health articles, videos, and other wellness content to self-manage chronic conditions like Crohn’s disease, diabetes, and cancer. 

As a physician and one of our Medicare clinical leaders, I witnessed the worry and confusion a COVID-19-positive diagnosis presented to patients, particularly those higher-risk individuals with pre-existing health conditions. In 2020, the concierge program identified nearly 2,000 members hospitalized with COVID-like symptoms and called to talk about how they were doing and how we could help. The goal was to provide members the ability to proactively track their conditions and symptoms and consult with a dedicated virtual and available care team.

We want to be able to help members better understand long COVID and what they can do next to manage their varying symptoms, helping to reduce the need to seek care from multiple areas of the health care system. Individuals with long COVID are significantly more likely to have an initial hospitalization during the acute phase and seven times more likely to have a hospitalization during the post-acute COVID recovery phase as compared to other COVID patients. Our internal analysis has also found that these individuals are also more likely to have an ER visit during the acute phase.

The program’s data teams then built a data analytics and clinical algorithm to identify members at risk for developing long COVID – a condition where patients continue to experience COVID-related symptoms after recovery. By identifying members at risk for long COVID early and equipping them with tools for self-management and easier access to care coordinators, the concierge care program is helping them improve their health and well-being, thus reducing overall health care costs for the member and the health care system.

While we are all still learning about the effects of long COVID, patients involved in the concierge care program can track their progress and receive support and medical guidance throughout their recovery. We have proactively treated fatigue, brain fog, insomnia, shortness of breath, and loss of smell and taste.

Virtual check-in triggers medical attention 

Thanks to a daily virtual check-in of one of our concierge care patients traveling to see her daughter, we were recently able to detect an acute situation with her that required urgent medical attention. The patient’s nurse care manager noticed the member was having trouble completing full sentences, a telltale sign of impending respiratory distress, and advised her on her options to find help in her area where she was able to receive medications that stabilized her breathing and likely averted further worsening of her condition.

Coordinated digital approach for customized care 

The concierge care program coordinates with other medical professionals and provider offices to offer a complete solution to help participants manage their health. Connecting the dots for a member’s comprehensive health plan can make the difference between average maintenance and exceptional care. Based on the information provided through regular communication, a member’s care management team can better respond to member questions on medications, mental health, diet, stress reduction, and complete wellness. Members can access condition-specific education and self-management tools, including videos from psychologists for stress management and psychotherapists for breathing exercises.

By appropriately leveraging health care and patient data as well as artificial intelligence capabilities, the concierge care program makes virtual care a solid solution for meeting consumer needs in today’s fast-paced, digital environment. As a physician, I generally only see patients when they visit me, but with concierge care, I feel like patients can get the important clinical contact and education – in between visits with their provider – that they need to help them manage their chronic condition.

Eugene Hsu is an anesthesiologist and physician executive.