Health Technology: Helping Patients With Better Self-Management

Health Technology for Better Self-Management

Nearly 50 percent of Americans suffer from a chronic condition. Even more alarming is the fact that 86 percent of total medical costs are spent on these type of diseases. Furthermore, chronic diseases are on the rise — by 2020, 157 million Americans are expected to live with a chronic condition — and some will have multiple chronic complaints, making their care increasingly complex and challenging.

Ongoing and incurable diseases present an enormous burden on the health care system. Their management is time-consuming, and as a result, primary care physicians are experiencing bigger workloads. To keep up with demand, doctors are incentivized to minimize time with patients, often leaving patients feeling like they did not get adequate care.

New health technology is becoming an important aspect of chronic disease management. It is allowing patients to have more control over their health, and when disease is present take more responsibility for their own care. At the same time, with wider adoption of innovative health technology, routine visits to the doctor’s office are expected to decline as well.

Patients Need to Be an Integral Part of Their Care

New health technology is offering novel ways of engaging and activating patients. Empowering people so they can self-manage their condition is an important step in preventing health deterioration.

The Network for Excellence in Health Innovation (NEHI), a national health policy institute, asserts that when patients become an integral part of the health care process, their quality of life increases and the costs of care get reduced. In its 2012 report, NEHI identified 11 technological tools that can help manage and treat various chronic conditions, including stroke, diabetes, heart disease, and asthma.

These tools involve technological health modalities such as mobile clinical decision support, home telehealth, mobile diabetes management tools, medication adherence tools, and virtual visits. There has also been a rise in software applications that pair with a wearable or ingestible device that allow patients to actively manage their health. NEHI has identified several barriers that limit the adoption of these technologies. These range from limited data on return on investment (ROI) to data integration challenges and provider resistance.

One of the 11 tools featured in the NEHI report is Tele-Stroke Care. Tele-stroke, which is a part of telemedicine technology, has been evaluated as an invaluable tool for hospitals that do not have a specialist stroke center. These hospitals can now use Tele-stroke as their consultation link. Neurologist specialists can use a video link to speak to small and/or rural hospitals. They can also look at scans and tests through an electronic data sharing link. International studies show that since Tele-stroke has been in use, the number of stroke patients receiving tPA therapy (a clot-busting drug that needs to be administered as soon as possible) increased by approximately 10 fold.

Electronic communication methods have proved particularly useful for people who live in underserviced areas and have to travel far to meet with their health provider. They have enabled better exchange of health information between patients and health professionals, and also between hospitals. Caregivers, too, are benefiting from e-health techniques. For instance, researchers from the Netherlands are currently evaluating how to best support people with mild dementia by using digital tools that promote self-management.

Virtual Visits Allow Patients to Take Control

Virtual visits are another branch of telemedicine that is helping to meet the needs of patients remotely. Being able to see and speak with a doctor in real-time using technology can speed up the assessment and treatment process. A patient can explain his or her symptoms (and for simpler complaints), it is possible to receive a diagnosis or obtain prescriptions remotely. Virtual visits are being implemented in different areas of health care. This type of service can secure the continuity of care with conditions such as diabetes and hypertension. Weight, blood pressure and blood glucose measurements can now all be transmitted to health-care providers from wireless devices. For example, it has been suggested that women with gestational diabetes could alternate between virtual visits and office-based visits to ensure regular checks and safety during pregnancy.

Virtual visits are now also included in some health insurance plans. Since reimbursement issues have previously been identified as one of the barriers to wider adoption of virtual health, these developments might assist in making virtual visits more prominent in the future.

Virtual visits offer a lot of advantages compared to traditional medical models that rely on physical examination. As patients get better access to health providers and are offered more convenient arrangements, their experience is usually enhanced. Tele-nurses can be available around the clock, and patient monitoring and education can be performed continuously. Furthermore, there is now an option of e-ICU and e-emergency services, which offer patients quicker access to specialty services.

In-car Telehealth Requires More Research and Development

Some of the digital and communication technologies that support patient management and self-care are already well-established and evidence-based, while others need more time to fully develop. One area that has shown some potential, but has not been finalized yet is in-car telehealth, promoted as “the car that cares.” Ford and Toyota were working on this novel technology that would give people the opportunity to monitor their health whilst commuting. Car seats that would detect a heart attack, bring the car to a halt and call for assistance were proposed. However, in 2015, Ford, unfortunately, announced they were abandoning the research and transitioning to other projects. We will likely see this picked up again in the future. Jaguar, for instance, has been working on adding certain telehealth features to their cars. The company is developing brain-monitoring technology. The system would include sensors embedded into the steering wheel that could detect your level of alertness and respond appropriately, increasing our safety as we drive.

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