Step Four: Select Twine Coaching Goals and Measures

Selecting goals and how you'll measure them helps you evaluate your Twine service offering. Over time data drives improvements and shows the value offered by your team using Twine.

To evaluate coach team performance with your team, consider how process data (like satisfaction and patient/coach behavior in the Twine platform) drives what you observe as outcomes data (like clinical measures and returns on investment.) If your coaching program is not working like you expect, or if you're ready to push the boundaries of what you think is possible with your coaching practice, you can move forward using data to build your very own evidence-based coaching practice.

Pulling Data From Twine

In addition to using our real-time Results Dashboard, you can export data in the form of a .csv file by pressing the download button on the Enrolled, Not Enrolled, and Archived Dashboards.

 

With the exception of the Results dashboard, each dashboard has it's own .csv download feature. Here are the types of data you may export from Twine: 

Demographic Data Process Data Outcomes Data
  • Twine Patient ID
  • First/Last Name
  • Primary Coach
  • Secondary Coach
  • DOB
  • Age
  • Date Enrolled
  • MRN
  • Archival Status
  • Date Enrolled in Twine
  • Last Date Twine Accessed
  • Current Plan Date
  • Activity Score (%Adherence and Activity Score) 
  • Plan Tracking Status
  • Starting Systolic and Diastolic Blood Pressure, Blood Sugar, and Weight (Date and Value)
  • Current Blood Pressure, Blood Sugar, and Weight (Date and Value)
  • Goal Blood Pressure, Blood Sugar, Weight Loss (Date reached and value)

Remember that the reliability of your Twine outcomes data is impacted by many factors. Using the example of blood pressure, we would consider the instrument (patient or clinician collection? what kind of cuff?) and the environment (at home or in the clinic? during times of stress or after sitting calmly for a period of time?) when considering reliability. Prior to collecting data, try to understand and control the conditions in which your data was collected as best you can. 

Be mindful not to ask patients and coaches to collect data extraneous to what is relevant to them and naturally part of their typical work or user flow. Data fatigue may occur, especially for your patients, if they are asked to provide information that is not clearly connected to their goals and the Twine experience. 

How to Mix and Match Data to Tell Your Story

1. Always frame data against goals. Usually goals are pointed toward enrollment and patient care outcomes. When choosing data to collect and evaluate, be sure to answer two key questions:

  • How is our team doing based on the goals that led us to start using Twine?
  • What questions are we looking to answer when observing our progress? Where is our progress now? 

2. Share progress with your team on a regular basis. The purpose of communicating with your team is twofold: you want to tell the current story of the practice and write the next chapter together. The value of reporting data is how your team is able to respond to it. Particularly when communicating with coaches in the field, use reporting to drive dialogue for quality improvement. This is important feedback to inform coaching care. 

For example, let’s say there are no new enrollments in your coaching program on a particular week. and you expect 30 patients per week. If you only look at enrollment data once per quarter, your team may sense the gap but not have a clear understanding of what is happening or what they can do to help.

If this data was made available for review weekly, the team can pause as gaps are happening and ask “What do we know to be a best practice to respond to what we are observing?” It is likely that the team can come up with a solution and, since data review is part of the normal organizational routine, determine if the improvement is effective and should be continued. We find that when passionate teams in smart organizations see where they are in progression toward organizational goals, they are responsive toward working together for positive change. Here are some ways organizations evaluate team performance:

  • Enrolled population: Your enrolled population consists of patients who opt in to your coaching programs out of the available target population. This definition will allow you to see where your outreach methods are falling short. This category is the low-hanging fruit of health coach program improvement. What you want to track at this stage includes:
    • Enrollment rates: Enrolled/Available Population (by channel, by message, and by disease state)
  • Engaged Population: If a user hasn’t actively engaged with your program in the last month, you can be sure they aren’t engaged. Here’s what you want to track at this stage:
    • Percentage of patients with an active care plan (last 30 days)
    • Adherence: i.e. a patient’s interaction with an overall plan (percentage of health measurements/actions completed) and
    • Activity: by most recent-log in
  • Outcomes: When you measure the outcomes of your coaching program, it’s critical to include both process and outcome metrics together. You may decide to separate your analyses by the level of engagement you observe within your enrolled population. Coaching is like medicine; skipping "doses" as represented by low adherence and activity in Twine, does not show a true picture of impact. Look at the group as a whole and just by those who engage. What are the differences? This will allow you to identify and monitor program improvements for the engaged AND the unengaged. If you are doing rolling enrollments, time-sync data by duration of participation in the program. The outcomes metrics you may track include:
    • Clinical (Health Measurements)
      • Percent at target goal at a given timepoint (ex: those enrolled for 30 days or greater)
      • Time it took to get to target
    • Financial
      • Cost of care
      • Cost of outcomes: how much it cost to get your population to control
    • Process
      • Patient satisfaction
      • Coach satisfaction 
      • Time spent per patient
      • Patient panel size per coach

What data your team decides is meaningful is related to your goals as an organization. Don't be afraid to use outcomes to boost your coaches performance!

 

 





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