State-wide Nurse Care Curriculum Training Program

Care Transformation Collaborative of Rhode Island State-wide Nurse Care Curriculum Training Program September 28, 2018 xG Health Solutions, Inc. Confidential and Proprietary Information

Advancing Advancing the Primary Care the Primary Care Nurse Care Manager (NCM) Workforce (NCM) Workforce Nurse Care Manager CTC-RI, with funding from UnitedHealthcare, implemented a state-wide NCM core curriculum training program for 139 nurse care managers/faculty 2017 (Round One) =87 (includes 7 NCM faculty) 2018 (Round Two) =52 (includes 1 NCM faculty Training includes : xG Learn* web-based on line modules (up to 43 CEU s) NCM faculty led weekly cohort conference calls *Many thanks are extended to BCBSRI for introducing CTC-RI to this learning opportunity

Evaluation Results Evaluation Results What Goals Have You Achieved Via The xGLearn Learning What Goals Have You Achieved Via The xGLearn Learning Experience? Experience? Learned/Improved My Care/Case Manager Skills 88% Improved Time Management & Patient Risk Stratification Skills 60% Developed Patient Engagement Expertise 53% Other 7% 0 10 20 30 40 50 60 70 80 90 100 Comments -- 1) Reviewed body of knowledge for NCM 2) I feel I have been utilizing these skills but there is always more to learn especially when sharing with other NCM experiences 3) Working to top of license 4) I felt that the diabetes information was helpful...but very intensive on drug therapy. Did not enhance skills for new case managers. 5) Learned how to manage my day 73 Respondents (Not all learners completed evaluation in Round 2; with xG Learn platform upgrade, learners could generate certificates of completion without completing evaluation. CTC will work with xG Learn to change this process0

How would you rate your level of case/care management How would you rate your level of case/care management experience AFTER completing this online learning program? experience AFTER completing this online learning program? Progressed from novice to advanced 36% Progressed from advanced to expert 34% Progressed from beginner to novice 20% Expert: Had acquired expert status prior to xGLearn 8% Remained at beginner level-need additional experience 0.01% 0 5 10 15 20 25 30 35 40 70 out of 73 Respondents (results include 5 Learners from Round Two: 2018 Session)

xGLearn is a blended learning experience (modules and collaborative xGLearn is a blended learning experience (modules and collaborative support). How do you feel this model helped you to achieve your goals? support). How do you feel this model helped you to achieve your goals? (Check all that apply) (Check all that apply) Reinforced concepts I already know 48% All of the above 42% Helped me to apply my knowledge in my day to day role 36% Better understand new concepts 30% Improved my effectiveness as a case/care manager 29% Improved my efficiency in managing my case load 22% Other: 5% 0 10 20 30 40 50 60 Comments 1. Was not helpful to enhance case management skills 2. I think this is a good model. Collaboration was most valuable to enhance the information provided 3. Appreciated the phone call conversations 73 Respondents who completed (results include 5 Learners from Round Two: 2018 Session)

xGLearn also provides external reading links, case studies and companion xGLearn also provides external reading links, case studies and companion guides. How do you feel those tools enhanced your learning experience? guides. How do you feel those tools enhanced your learning experience? (check all that apply) (check all that apply) Helped me better understand new concepts or reinforced ones I already knew 32% All of the above 26% Reinforced my continued application of concepts in my role 26% Improved my overall learning experience 22% Other: 3% 0% 5% 10% 15% 20% 25% 30% 35% 73 Respondents (results include 5 Learners from Round Two: 2018 Session) Comments 1. not all links were accessible

What would you identify as the most beneficial quality of the What would you identify as the most beneficial quality of the modular portion of the xGLearn program? modular portion of the xGLearn program? (Check all that apply) (Check all that apply) All the above 32% Ease of access and navigation 21% Organization of material 22% Module companion guide 14% Pre-program instructions and navigation guide 4% Pre and post assessments 19% Learning from subject matter experts 27% Evidence based clinical content 37% 0% 5% 10% 15% 20% 25% 30% 35% 40% 73 Respondents (results include 5 Learners from Round Two: 2018 Session)

What would you identify as the most beneficial quality of the What would you identify as the most beneficial quality of the post module portion of the xGLearn program? post module portion of the xGLearn program? All the above 45% Interactive educational collaborative calls 24% Interacting with subject matter experts 13% Interactive coaching calls and capstone experience 13% Other 5% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Comments 1. Unknown 2. I did not find the post module portion beneficial. 62 out of 73 Respondents (results include 5 Learners from Round Two: 2018 Session)

Caseload post Caseload post xG xG Learn (All care team members) Learn (All care team members) 80-100 (+) patients 71% 50-80 patients 13% 10-50 patients 11% 0-10 patients 5% 0% 10% 20% 30% 40% 50% 60% 70% 80% 62 out of 73 respondents (results include 5 Learners from Round Two: 2018 Session)

Of your most challenging care management activities, which area did the Of your most challenging care management activities, which area did the xGLearn xGLearn assist you in improving your skill set assist you in improving your skill set?( ?(All care team members check all that apply) check all that apply) All care team members- - Providing team based care to meet patient needs 37% Managing exacerbations/preventing ED and hospital admissions 37% Engaging your patients in their care 37% Risk stratifying your patients 34% Educating patients and improving their self-knowledge 29% Planning your work day 22% Knowledge of community resources 19% Other: 5% I have no patient case load at this time 3% 0% 5% 10% 15% 20% 25% 30% 35% 40% 73 Respondents (results include 5 Learners from Round Two: 2018 Session) Comments 1. Delegation to other care team members 2. SMAPS are helpful 3. I feel my skill set has not changed

After completing the xGLearn experience, which of these topics, would After completing the xGLearn experience, which of these topics, would best address if any, your continued learning needs? (All care team best address if any, your continued learning needs? (All care team members members- -check all that apply) check all that apply) How to better manage patients with BH/MH challenges 45% Overcoming barriers to care 40% How to help decrease ED/hospitalization 26% Motivational interviewing and getting patients engaged 25% Decreasing provider non-adherence 21% How to increase Hedis measure compliance (Nurse CM only) 19% All my learning needs have been met 12% Other: 4% 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% Comments 1. Unknown 2. Overall, a good basic review of complexities of case management 73 Respondents (results include 5 Learners from Round Two: 2018 Session)

Choose an area in which you feel your care management skills have improved and in which you can Choose an area in which you feel your care management skills have improved and in which you can make a greater impact with your patients: (All care team members make a greater impact with your patients: (All care team members- -check all that apply) check all that apply) 45% Improved my effectiveness as a case/care manager 35% Decreasing ED/hospitalization in my patients 32% Knowing my role in the care team 30% Patient/family engagement 26% Helping patients access care 26% Overcoming barriers to care 26% Improving medication adherence (Nurse CM only) 25% Building a medical home 25% Improved my efficiency in managing my case load 18% Assisting patients obtaining medication 14% Helping patients with transportation barriers 10% Access to BH/MH facilities for my patients 8% Decreasing BH/MH or clinical ED/hospitalization 5% Access to substance abuse treatment centers 1% Increasing my case load 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% 73 Respondents (results include 5 Learners from Round Two: 2018 Session)

Questions: 13