Applying mobile health strategies to drive greater patient engagement and provider accountability
Patient engagement and physician accountability are the cornerstones of today’s value-based care models. These strategies encourage patients to take an active role in their own health while offering the necessary incentives for providers to deliver effective, personalized health oversight and care to their patient population. By encouraging and pursuing these initiatives, population health can be improved by supporting patients both within and outside of the clinical setting. This is especially true when serving chronically ill populations, where these approaches can help prevent costly complications and acute care admissions.
Today’s mobile health technology provides an incredible opportunity to meet these demands by offering tools, insight and guidance that travels with patients as they go about their daily lives. This portability feature is crucial because patients are constantly making decisions that impact their health. Consumers make self-management choices throughout their day about diet, exercise, taking medication and/or following a treatment program for a specific health condition. Physicians don’t expect patients to manually log all of this information and, even if they did, most individuals wouldn’t comply. Even individuals who live with diabetes, a group expected to log blood sugar levels, rarely adhere to this cumbersome process, which often leads to inaccuracies and missed data.
With this reality, there is a missed opportunity – patients don’t have insight about how specific behaviors impact their health over time and providers lack validated information about a patient’s compliance and health status. This increases health and financial risk in patients with chronic conditions such as diabetes, high blood pressure and heart disease, where monitoring of health status and early intervention are crucial to best practices and lower costs.
The next wave of mobile health: Mobile monitoring devices.
Mobile health monitoring devices have the potential to address these issues by automatically tracking health and lifestyle data, storing it and transforming it into meaningful insight. While many are in the early stages of development, a variety of new mobile health monitoring products are being introduced at a rapid rate. These products are designed to be “smart” versions of existing medical devices – which could include blood glucose meters, blood pressure monitors and sleep apnea machines, to name a few. Since many patients with chronic illnesses are already actively using some form of these devices today, these optimized versions can provide an unobtrusive way to collect, manage and analyze validated data. Properly designed, these products are easy to use, require little to no manual data entry and can be easily transported with patients as needed.
Once data is captured by the device, wireless technology can transmit it to a secure cloud-based platform to store and track results over time. As a result, individuals have ready access to all liberated data and use it to better understand their health, while also sharing this real-time information with providers, caregivers or loved ones.
Empowering providers to improve outcomes.
By making it easy for patients to collect and store this data, mobile health monitoring devices will empower providers to offer a more personalized, patient-centered approach to care. While physicians are already inundated with information, from medical records to clinical journals, they are lacking key information about a patient’s daily behavior and compliance with treatment. By accessing the validated data derived from mobile health monitoring devices, providers will receive valuable insight for clinical decision-making support.
For example, data from these devices could give physicians the ability to determine whether a particular medication is having a positive impact on a patient’s blood pressure over time. Or a care manager may use this insight to determine that he/she needs to educate a diabetic patient on specific dietary modifications. By providing personalized data about a patient’s health status outside of a clinical setting, mobile health will truly “fill in the gaps” left by electronic medical records and eliminate the inaccuracies that come with self-reported data. As a result, these mobile health solutions can help providers improve outcomes and guide patients to make informed health and lifestyle decisions.
These devices could also be configured to alert providers to a specific or dangerous change in a patient’s health status that could lead to an acute event. These alerts could provide immediate notification of important data that might otherwise be overlooked by a busy physician’s practice. For example, if a patient’s blood pressure or blood glucose is very high over a sustained period, a provider could be automatically alerted and, if warranted, contact the patient to determine the cause, schedule an office visit or recommend appropriate action. During this critical time period, early intervention could be key to preventing devastating complications or avoidable hospitalization.
Reducing costs associated with chronic condition management.
A key part of the triple aim of health reform, reducing healthcare costs, relies heavily on the industry’s ability to prevent avoidable admissions and medical events, while also reducing duplication and waste. As the industry moves away from fee-for-service models, the ability to meet this goal will require intensive collaboration among providers, including data-sharing, and optimization of care management processes. Mobile health, specifically through monitoring devices and cloud-based connectivity, can support all of these processes.
Mobile health strategies also allow providers to offer holistic care based on an individual’s unique needs. A patient’s needs are dynamic, and many changes to a patient’s health status happen between office visits. Moreover, most of these changes do not elicit a patient to re-engage with his/her provider. By offering real-time monitoring and insight about a patient’s adherence with best self-management care practices and key markers of health, mobile health devices can provide the “missing link” that drives patient-centered care across the continuum.
The potential for cost savings through better management of a chronically ill population is significant. For example, the growing prevalence of diabetes within this country is having a substantial impact on healthcare costs. A study conducted by the American Diabetes Association determined that the total medical costs related to diagnosed diabetes has risen to $245 billion in 2012. This figure represents a more than 40 percent increase in just the past five years. Diabetes also costs our nation an estimated $69 billion in reduced productivity. These rising costs are putting a sizable burden on employers, healthcare organizations, patients and their families.
Providing peace of mind to patients and their loved ones.
In addition to its potential in improving healthcare quality and reducing associated costs, mobile health strategies can improve a patient’s overall satisfaction. Many patients, especially those with chronic conditions, feel “disconnected” from the healthcare system until they experience a serious medical event that requires intensive support. Mobile health devices can address this issue by enhancing the patient/provider relationship while also providing peace of mind to individuals through ongoing support.
For example, some devices offer two-way communication capabilities, allowing physicians or care managers to send personalized messaging in response to patient data or trends over time. These messages could point out opportunities for improvement, or reinforce positive behaviors and results. As a result, patients are more engaged and feel greater accountability for their decisions and a sense of connectedness with their care providers.
Offering insight into population health.
Beyond offering valuable patient insight at the point of care, data from mobile health devices can also be used to enhance population health management strategies. This data can reveal real-time insight about the effectiveness of health improvement efforts. It can also be used to refine risk profiles and predict future risk in groups that are non-compliant with care. Leveraging this unique data set and coupling it with traditional claims-based data sets, payers and value-based care models can better understand how patient behaviors, clinical interventions and outreach efforts are impacting overall population health and costs.
The future of mobile health monitoring in value-based care.
The popularity of mobile health is well documented within the wellness space, especially through mobile phone applications that track an individual’s fitness, nutrition and other health improvement activities. However, the potential for mobile health monitoring devices, especially in serving chronically ill populations, is still being realized.
As new and more robust products enter the market, we can envision a future where every medical device is enabled with wireless capabilities and connected to cloud-based data management. This vision of the future is well aligned with the intent of value-based care efforts – including the triple aim of improving care, reducing costs and enhancing patient satisfaction.
Mobile health strategies will help healthcare organizations stay plugged in to every patient’s unique needs and changing health status. Armed with this valuable insight, the healthcare industry can begin to make dramatic strides in achieving greater patient and provider accountability.
David Bjork, president of Telcare, Inc., has more than 20 years of executive experience in healthcare information technology and healthcare services. He has held leadership roles in a number of disciplines, including business development, strategic planning, M&A, sales, marketing, operations and product development.
A study from the Rand Corporation, a nonprofit research organization,