Imagine a world where a team of medical professionals provides critical care to you through your computer. Nalari Health is heading in that direction at rapid speed. Squarely at the intersection between technology, public health, and the delivery of health care, Nalari Health is not in the business of selling technology. Instead, they deliver a whole person / whole system of care by leveraging a technology-enabled platform, interdisciplinary clinical team, integrated behavioral health services and social supports that provide comprehensive services to improve outcomes for some of society’s highest risk, highest utilizing cohorts through health plans such as Medicaid and Medicare.
Nalari helps people who are significantly underserved by traditional brick and mortar health care systems. This population often lacks access to care—and quite literally, some people cannot physically get to the doctor. Nalari enables care teams to treat people who are immobile, disabled, non-communicative, or frail. These populations require sophisticated and complex treatment when they are symptomatic to achieve the best outcomes.
How can this be accomplished? Nalari’s President and School of Public Health Community Advisory Board member, Mark Treat, explains that their system of care is delivered in two ways. The first way is through a secure, HIPPA compliant, clinical encounter at partner locations, such as primary care locations, urgent care centers and FQHCs. Another way is by sending a health professional to the patient’s home with equipment to tele-present to the clinical team. What? That’s right. The team treats patients through an integrated virtual experience where they can not only monitor, but also actually diagnose, prescribe, and supervise care—anywhere, in the right setting at the right time.
The Nalari team is presently working with a health plan in Philadelphia on a patient population with sickle cell disease. Many adolescents and adults with sickle cell disease face a lifetime of chronic pain that can occur without warning. Patients often need to go to the emergency department (ED) for effective treatment. Visits to the ED can be frequent and are often followed by admittance to the hospital. To make matters even more complex, these patients can also suffer with comorbidities. Nalari has designed a way of managing and delivering care to this population in two parts. First, though the Nalari Care service, which extends and enhances care management and primary care services provided by the member’s health plan in order to deliver preventative care and improve compliance. Nalari assesses and documents a patient’s health history, comorbidities, medications, and treatment plans to identify and address gaps in care. An interdisciplinary team of behavioral specialists, medical specialists, and social workers write prescriptions and issue orders that Nalari configures through their on-demand system of care. This system is designed to be delivered at a relatively low cost and to help improve adherence and general health outcomes—it is preventive in nature. The second service, Nalari Crisis Care, improves the care experience and lowers costs during painful sickle cell crises. In this situation, a nurse or paramedic goes to a patient’s home to treat patients to stability under the supervision of a remote physician who is familiar with the patient. This method of care is delivered conveniently and safely from the patient’s home at a fraction of the cost it would be in an emergency department, making it financially viable for the health plan and a better experience for the patient.
You might call Nalari a health care convener. Treat explains it this way: “The technology alone doesn’t do much if you don’t create a system of care and an operating model to leverage medical expertise with integrated behavioral health and social supports. That is what Nalari’s role is. We are an integrator, aggregator, operator, and an arbitrator to align incentives to desired outcomes for all key stakeholders in the system.”