Comprehensive Disease Management Program
NovellaCare offers virtual chronic disease care using technology to enable real-time health monitoring and care management for patients with chronic conditions. The program includes the use of home-based devices like blood pressure monitors and glucose meters to transmit health data directly to the care team, allowing for early detection of health issues and timely interventions. For patients, this means not only a significant reduction in the need for in-person visits but also an improvement in their quality of life. For clinicians this program provides timely notification of patient deterioration to support early intervention in the community to prevent hospitalization as well as a wealth of data to support chronic disease coaching and support. The program works in synergy with your PCP through regular data sharing and predetermined clinical escalation pathways to support in person care.
NovellaCare supports patients with Chronic Disease via the following programs:
- Remote Patient Monitoring (RPM) – allows us to monitor and manage patients’ chronic conditions outside of traditional clinical settings. This program involves the use of digital technologies to collect health data from patients in real time, such as vital signs or glucose levels. The data is transmitted to NovellaCare staff who can track the patient’s health status and make timely interventions if necessary
- Chronic Care Management (CCM) – designed to support patients with multiple chronic conditions by offering continuous care coordination. Under this program, NovellaCare staff develop comprehensive care plans tailored to each patient’s needs, which include medication management, coordination between specialists, and ongoing patient communication. The goal of CCM is to improve the quality of life for patients by providing proactive, structured care, reducing the need for emergency interventions, and enhancing overall health outcomes.
- Preventative Screening – focuses on early detection of potential health issues before they become severe. This includes screenings for cancer (e.g., mammograms, colonoscopies), cardiovascular conditions, diabetes, and other diseases. By identifying risks early, preventative screening aims to reduce the incidence of serious health conditions, lower healthcare costs, and improve your longevity and quality of life.
NovellaCare’s programs are designed to manage a variety of chronic conditions, providing customized care plans and integrating technology with a focus on patient needs, thereby making chronic care management more accessible and efficient. The program supports the broader goals of value-based care by focusing on health outcomes, patient satisfaction, and cost efficiency, delivering tangible benefits to patients through improved health management and reduced healthcare expenditure. We operate in partnership with your existing PCP to give them more data about you to give you the best care possible.
