The Value That Clover Assistant Provides to Primary Care
One of the biggest privileges that primary care practice (PCP) provides is the opportunity to be an active part of a patient’s life journey and understanding what is important to them. Our goal as doctors is to ensure that our patients are receiving the best care possible. That said, it is a challenge to keep up with the literature, consistently updated and shifting guidelines, new medications and whole new drug classes (there were 146 novel drugs approved in the last 3 years alone). Simply staying up-to-date is more work than a full-time job in and of itself.
In the context of our visits and helping manage our patients, PCPs are also tasked with navigating the health care landscape — with the mazes and obstacles often set by insurance companies. Each plan has specific networks that determine the specialists I can refer my patients to and drug formularies determining which medications are easily available and less costly for my patients. When expensive procedures or unconventional medications are needed, more administrative hurdles must be overcome. Just getting my patients what they need to manage their health often feels like an uphill battle. Combine this with the additional time spent documenting in the electronic health record and I’m left with little time to spend with patients; to hear their stories, to understand what’s important to them, and to help improve their health.
To close this gap, and reduce the unnecessary burden facing PCPs, we at Clover Health are building Clover Assistant to bring the joy and purpose back into the primary care relationship. Clover Assistant uses the power of computing to power each visit, with automation helping clinicians surface important information specific to each patient during the visit. It is exciting, as a practicing physician, to have the opportunity to build tools that provide meaningful clinical value and support PCPs in the real world.
Healthcare is notoriously full of bad data, so Clover Assistant starts by asking the physician to confirm the conditions that a patient has, to ensure we are not responding to inaccurate information. We make sure that the PCP confirms the clinical realities of our members and, in turn, we share other information that may not be readily available to the PCP (e.g., when a patient has been seen in the ED or admitted to the hospital, or has new medications prescribed by other providers). Once Clover Assistant has this information, it’s able to provide basic reminders to the doctor, and office staff, such as when a patient with chronic conditions has not been seen or is overdue for standard preventive measures.
The technology inside Clover Assistant is now also powering better diabetes care. Using the Assistant while seeing Clover members automatically keeps PCPs up to date with the American Diabetes Association and American Heart Association guidelines. Starting with improving diabetes control, we have built management recommendations based on Clover’s formulary and member’s out of pocket costs — highlighting specific medications that might be more appropriate for that patient’s known comorbidities, such as cardiovascular disease. Clover Assistant also suppresses inappropriate recommendations, so if we know that a patient has a contraindication to a treatment (e.g., active liver disease), we will not recommend high-dose statin therapy. Most importantly, we share the specific reasons why a recommendation is being made to support the PCP’s clinical judgment. Our goal is to empower PCPs, and make their clinical decision-making as informed and impactful as possible.
Not only does Clover Assistant empower PCPs to provide diabetic patients the best care possible, but it also saves them the hassle of looking up which formulary medications can be easily prescribed. The Assistant gives PCPs back the time to discuss the recommendations and potential new medications with their patients.
We’re building the engine to help PCPs keep up with the evidence-based management of the most common chronic conditions in their practice, and while I’m proud of what we’ve already accomplished, I’m particularly excited about what we have planned for the future. Next, we’ll be focusing on the management of chronic kidney disease and helping simplify medication regimens. We’re also creating stronger ways to connect PCPs to our clinical programs (such as care management and navigation support) through Clover Assistant.
As a primary care physician, I’m excited to have a hand in delivering on the promise of technology we’ve been waiting for: automation that wrangles the rapidly evolving evidence base, and reduces the administrative burden so we can focus on giving our patients the attention and high-quality care they deserve.
