HEALTH
Rango, which has a mobile app, helps individuals with H.I.V./AIDS and other serious health issues cope with their conditions and also stay
on top of their medication regimens.
VillageCare’s Rango: Innovative treatment adherence
BY VILLAGECARE
Being diagnosed with a chronic illness such
as H.I.V., diabetes or cancer can come as a
blow and an instant change of life. This was
the case for Diana, who received such news right
around her 44th birthday. She had lived most of her
adult life in a rough New York City neighborhood,
as she struggled with drug addiction and fell victim
to abusive relationships.
Diana had been urged to be tested for H.I.V. and
the result came back positive. It was earth-shattering
to her state of mind.
“I panicked and felt crushed,” she recalled. “I
thought I was going to die.” Diana was connected
to a clinic where doctors prescribed antiretroviral
therapy (ART), a combination of medications that
effectively allows people to manage the disease and,
in most cases, live longer and healthier lives.
Over the last few decades, these medications have
transformed H.I.V./AIDS from a death sentence to
a chronic condition. But staying compliant with the
strict ART drug regime and maintaining a positive
lifestyle that is integral to successful treatment can
be extremely diffi cult. This was the care for Diana
until she discovered Rango, an online platform and
mobile app designed to help people cope with the
disease through a combination of clinical and social
supports.
VillageCare is a community-based nonprofi t
organization that offers post-acute care, managed
care and community services for individuals with
chronic-care needs. In 2015, Village Care was
awarded a three-year, $9 million grant from The
Center for Medicare and Medicaid Innovation
(CMMI) to develop an online platform, as well as a
mobile app, that offered a variety of essential tools,
including medication and medical appointment reminders,
otherwise known as Rango.
Participants had access to virtual support groups,
discussion boards and live chats about issues related
to living with H.I.V./AIDS. Users could also access
databases for information about digital therapeutics
and social services.
With encrypted data transmission and privacy
protections, Rango became a safe online community
for people like Diana who otherwise felt isolated
and alone.
“Rango gave me a forum to speak my mind with
people like myself, without fear or judgment,” Diana
said. “It made me feel empowered.”
A critical component of treating these diseases is
ensuring that people consistently take their medications.
In exploratory research, VillageCare had
concluded that only 60 percent of individuals with
H.I.V., for example, reported full compliance with
their medication regimen. This is detrimental not
only to their health but also to slowing the rate of
new diagnoses, since full compliance with ART can
reduce the risk of transmission.
Rango prompted users to take their medications
and keep up with doctors’ visits through text notifi
cations and alerts. It also provided social support
such as health coaches and discussion boards that
tackled all aspects of living with H.I.V. in a confi -
dential-conversation environment.
“The live support was a key element in our design,”
recalled Emma DeVito, president and C.E.O.
of VillageCare. “While progress has been made to
remove the stigma surrounding H.I.V./AIDS, many
people prefer to keep their condition private.”
Studies confi rmed Rango’s positive impact on
health indicators and patient engagement. New
York University’s Health Evaluation and Analytics
Lab found that Rango users had a relative reduction
in hospitalizations of 8 percent, and a relative
increase in primary-care visits of 3 percent, assessed
against a comparison group. In the same
analysis, the rate at which users refi lled their H.I.V.
drug prescription rose by 6 percent.
Rango’s design can serve as a model for new
H.I.V. initiatives, including managing secondary
conditions like Hepatitis C or assisting those using
antiviral drugs to prevent transmission. It can also
be applied to other chronic conditions, such as diabetes,
reminding individuals to check glucose levels
or suggesting a more suitable diet
While technology can’t solve all health and
healthcare-management challenges, it can be leveraged
to help people with long-term chronic diseases
enjoy more stable, productive and healthy lives.
Recently, New York State named Rango a fi nalist
at the Social Determinants of Health Innovation
Summit. Constantly exploring new and innovative
ways to help individuals better manage their
chronic care needs, VillageCare is a data-driven
organization that strives for effectiveness resulting
in superior outcomes from the care provided. Its
data-driven culture ensures that its clients/patients,
as well as health-plan members receive the most appropriate
healthcare and related services through
the most effi cient means possible
Disclaimer: This publication was made possible
by Grant Number 1C1CMS331353 from the Department
of Health and Human Services, Centers
for Medicare & Medicaid Services. The contents
of this publication are solely the responsibility of
the authors and do not necessarily represent the
offi cial views of the U.S. Department of Health
and Human Services or any of its agencies. The
research presented here was conducted by the
awardee. Findings might or might not be consistent
with or confi rmed by the fi ndings of the independent
evaluation contractor.
Schneps Media TVG February 21, 2019 25