The Blog to Transform Advanced Care

Advancing Care through Innovation, Observation and Collaboration.

As a young girl, Joan Harvey remembers her grandfather explaining his new research in open-heart surgery and her grandmother advocating for mental health issues on a national level. The two were trailblazers, and their work had a big effect on their granddaughter. 

“That is my link to the healthcare world,” says Harvey. “They were very large, give-back, greater-good folks. Growing up with that in my household, I really wanted to go into healthcare and make a difference.”

In the realm of advanced care, Harvey has been particularly drawn to caregiving — or as she says, “trying to bring solutions to the caregivers themselves as exponentially more Americans become caregivers every day.”

Harvey, who joined global healthcare giant Cigna in June 2012, is senior vice president overseeing consumer health engagement. She explains that Cigna services run the gamut from “babies being born to chronic illnesses, advanced care and the later stages of life.” But she’s particularly proud to point out that Cigna was one of the first, among the 140 member organizations, to join the Coalition to Transform Advanced Care.

Working together is key, says Harvey. “I really am proud of our greater community in the healthcare environment for tackling this as a group.” She points to Cigna and C-TAC partnering on research around “the true struggles facing family caregivers” as one example of a way to discover solutions. 

“If you look at what people need in advanced care, the mission’s right on – being able to choose and receive high quality patient-centered care that is consistent with their goals and honors their dignity,” says Harvey. “That’s something we felt strongly about at Cigna and have partnered with C-TAC in a variety of ways to move that forward.”

Understanding and committing to the choice and dignity that a person needs is where we need to go as a society, says Harvey.

And how do we get there? “Changing how we think of advanced care and really using technology and services and changing the structures we’ll need to put in place to allow caregiving in the home,” she says. “I think it’s a shift in mindset, a shift in laws and in regulations.”

She adds, “With CMS and health plans, how do we build the infrastructure to support the choice that someone is making?”

In April, CMS announced the Primary Cares Initiative, which includes a payment model that provides higher payments to practices specializing in treating high-need patients, such as those with serious illnesses. The project aims to make advanced care delivery more sustainable for providers and increase care quality for patients.   

What’s most important right now in advanced care, Harvey says, is simple: “From the consumer side of things, seven out of 10 people want to be at home; and the stat is the opposite — usually three people are home and seven are in the hospital.”

With those stats, she says, “There will be many changes necessary to shift to the home honoring the wishes of our aging loved ones.”

Using technology, such as Alexa, Amazon’s virtual assistant, could be one way that might help “coordinate care and allow health care professionals to have access to diagnostic and vitals in a virtual way” in the home, says Harvey. In addition, state level licensures — determining who is licensed to go into a home and what services are provided virtually — will need to be revised and updated.  

“That’s the path forward – consumer empowerment, execution, teaching hospitals and healthcare professionals how to have the conversation – helping them feel comfortable to execute that if they know that’s what the person wants,” says Harvey. “I think we have to continue pushing it all forward.”

Having conversations around advanced care isn’t as difficult as it used to be, she says, recalling the stigma her grandmother faced when talking about mental health. “Baby Boomers are not shy. They always have opinions. They want their goals, objectives and decisions honored. They have made a lot of changes in our communities and how we think about things, and I think they’re going to do the same thing here.” She adds, “It doesn’t have to be the sad end of life.”

Harvey points to the story of Driving Miss Norma. “I just love Norma. She went around and saw the world – had the best 14 months, year, of her life. Think what her son got out of that. It’s a beautiful example.”

And it’s one that her grandparents would have liked. “I think they would be very proud to see us honoring the overall health of a person,” says Harvey. “I think my grandparents would want to see the continuing of the greater-good movement to allow people to be taken care of in a well-structured way that is their choice.”

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