Empowering Patients: A Case Study on Transformative Patient Engagement in CCM Program


Healthcare, CCM


Python, Angular, TypeScript, REST, SOAP, Web Services

Client Background

The healthcare provider is a clinic providing services to diverse patients in the primary care specialty. The client has identified the importance of continuous patient engagement for managing the chronic conditions of patients throughout the CCM program. The clinic aims to provide high-quality care to the patients by keeping them engaged in the program.

Business challenges

The client has served a large number of patients in the primary care specialty and was facing challenges in ensuring patient engagement for continuous ongoing treatment. Some of the business challenges faced by the client are:

    1. Remote Care Coordination

Providing remote chronic care management services efficiently with necessary continuous patient interaction for various activities such as chart reviews, assessments, and resolving alerts was unorganized.

    2. Patient Engagement and Communication

Engaging patients throughout the program was a significant challenge, particularly with timely updates and resolving queries. The client found it difficult to maintain consistent communication channels, which hampered the patient’s confidence and program adherence.

    3. Inaccessible Patient Education

Educating patients about their chronic conditions and preventive care is essential and a contributing factor for quick recovery and avoiding complications. However, the client faced difficulties in providing accessible educational materials to patients, impacting their ability to make informed decisions about their health. This compromised an integral aspect of care delivery, taking the practice away from a patient-centric approach.

    4. Difficulties in Delivering Preventive Care

The existing software was incapable of receiving notification of an alert generated if the patient's health vitals exceeded threshold levels. This became an obstacle in providing effective preventive care to patients.

    5. Improper and Unscheduled Distribution of Activities to Providers

While handling more patients with fewer medical staff, the software restricted care providers from accessing the complete activities through the patient's profile, resulting in unsatisfactory health outcomes.


High patient engagement is the secret to getting expected health outcomes and also a factor in measuring the success of the program’s successful implementation. The client reached out to us for a platform to anticipate better patient engagement and care coordination among the care team to provide effective quality services.

To understand and fulfill the client's unique requirements, our team of business analysts and subject matter experts had multiple virtual interactions and demonstrations with the client. Upon completion of requirement gathering and getting approval from the client, the team has implemented the eCareMD platform of Medarch INC, which incorporates advanced technology and a patient-centered approach to managing patients' chronic conditions.

The implementation of the eCareMD platform resulted in increased patient engagement, higher customer satisfaction, and enhanced care coordination among the team. Thereby, the client has achieved significant growth in revenue from the insurance company.

Solution Highlights

After a complete understanding of the problem, it was concluded that the client required advanced technology features to promote the effective management of chronic diseases. eCareMD here proved to be the perfect all-in-one solution to the client's problem.

Here are the solution highlights that demonstrate how eCareMD addresses client challenges and problems:

    1. Secure Communication Channels

    Providing remote CCM services is a challenge. Hence, it is important for care providers to continuously interact with patients daily, weekly, and monthly for chart reviews and assessments, resolve alerts generated, assign care plans, and keep track of their progress.

    The communication facilities provided through the platform comply with HIPAA regulations and CMS guidelines to keep patients' health information secure.

    • Instant Calls and SMS

      Using the eCareMD platform, the care provider could instantly call patients to do any activity over the patient's profile and make informed decisions. This functionality boosted the patient's confidence and kept the patient engaged with the program.

      Also, the care provider can send SMS to the patient using the platform that helps keep the patient notified of the upcoming activities to be done by the patient and provider side. This functionality contributed to the timely completion of activities.

    • Call Schedulers

      The eCareMD platform provides instant and scheduled call functionality for providers to interact with patients. It enables quick communication and resolves patients' queries to avoid health complications and keep patients engaged in doing the activities prescribed.

    • Bulk Email/SMS

      Implementation of secure channels such as Email and SMS sent through the platform keeps the patient aware of the activities done by the providers and notifies them prior.

    2. Educational References

    This platform focuses on educating patients about their chronic conditions and preventive care for quick recovery and to avoid complications. With this platform, care providers could now share educational references with patients over email, allowing them easy access to the material and making necessary changes in their lifestyle for recovery.

    3. Real-time Alerts and Notifications

    In the eCareMD platform, if the patient's vitals go beyond the threshold limit, then alerts are generated as per severity: low, medium, and high. The alerts can be notified to the care providers using push messages, email, and SMS. Based on the alerts, the care providers could take prompt actions to reduce the health complications for patients.

    The real-time alert and notifications functionality enables care providers to make necessary interventions as per the requirements. Also, it helps maintain patients' safety and prevent health complications.

    4. Task Management

    By prioritizing the need for continuous monitoring for every patient, the eCareMD platform provides care providers with a simplified task management functionality. This functionality helps assign tasks to various care providers according to their skills and specialties.

    The care providers complete the tasks assigned by doing the necessary activities like daily, weekly, and monthly chart reviews of patients, provider reviews, alert resolution, etc.

Value Delivered

    1. Enhanced Communication

    The instant call/SMS, bulk email/SMS, and call schedular functionality facilitates secure and direct communication between the patient and providers, fostering seamless and efficient interaction.

    Also, these functionalities enable communication with a higher patient population for activities to be done on patient profiles.

    2. Enhanced Learning for Patients

    The rich repository/library of educational materials on the platform educates patients about chronic conditions/diseases, diet recommendations, and exercise schedules, helping the patient recover faster and adhere to the care plan.

    3. Timely Updates

    Real-time alerts and notifications prevent health complications for patients and keep care providers aware and notified of changes in patient health. This enables timely interventions from care providers that ensure secure patient health.

    4. Streamlines Organization and Effective Care Coordination

    The task management functionality enables care providers to take necessary actions on patient health that foster effective care coordination between various care providers.