Technology is offering a new fix for one of the most confounding health-care challenges: getting patients with chronic disease to take better care of themselves.
About half of all adults suffer from one or more chronic diseases, which account for seven of 10 deaths and 86% of U.S. health-care costs. But preventing and treating such ailments requires time that doctors don’t have in brief office visits, and a degree of daily self-management that many patients have been unable to handle. They often become overwhelmed by the demands of their daily regimens, slip back into poor health habits, fail to take their medications correctly—and end up in the emergency room.
While there has been something of a national obsession with health apps like fitness trackers, most are aimed at exercise and lifestyle buffs and aren’t designed to link patients to health-care providers. There is generally no evidence to back their use in improving health outcomes for those who have chronic disease unless the patients’ own doctors are involved.
New studies, however, show that the emerging field of digital medicine—a combination of remote monitoring, behavior modification and personalized intervention overseen by the patients’ own doctors—can improve outcomes in some of the most costly and tough-to-manage categories such as diabetes, heart disease and lung disease. As a result, a growing number of hospitals and health systems are adopting digital programs that have been studied in clinical trials and can be delivered on a broad scale at low cost with the use of smartphones, wireless devices and sensors.
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In addition to raising patients’ confidence that they can manage their health—and providing some hand-holding and nudging when they don’t—experts say the innovations allow doctors to gather data about patient behavior and symptoms, and intervene when patients aren’t following their regimens or have a flare-up in their disease. They also enable care teams to deliver continuing and consistent support to change behavior, such as losing weight, taking medications as prescribed and exercising. “Digital medicine allows us to get into your life in a personal way, deliver interventions continuously and inspire you to be healthy in a way an office-based practice can’t,” says Joseph Kvedar, a physician and researcher who is vice president, connected health, at Partners HealthCare, which includes Brigham and Women’s Hospital and Massachusetts General Hospital in Boston.
Partners has tested such approaches as remote blood-pressure monitoring for hypertension patients, text messaging to motivate diabetes patients to exercise daily, and remotely monitored electronic pillboxes that alert congestive-heart-failure patients to take their medications. Such technology, if widely adopted, could deliver behavioral interventions to whole populations and engage patients in ways that were unimaginable in the past, Dr. Kvedar says.
Date:June 25, 2017