CarePartner Model for Disease Management Support

John Pietti, Professor of Internal Medicine, University of Michigan

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Patients with chronic diseases need frequent health monitoring and behavior change services, but most health systems lack the resources required to provide the assistance that can prevent health crises. Family and friends are often in frequent contact, but lack the tools they need to support effective self-care. The University of Michigan is developing strategies for using widely-accessible information technology to support disease self-management and improve access to clinical follow-up. The CarePartner program includes regular automated telephonic assessment and behavior change calls to patients, with immediate feedback about health and behavioral problems. Patients participate along with an adult child or other social network member who serves as their "CarePartner" and receives feedback about the patient’s status via tailored emails, automated calls, and web-based reports. Clinicians receive alerts when patient responses indicate an urgent problem.

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