Self-management products show early promise …
One example is Twine Health, a platform integrated into patents' Fitbits to monitor more than just steps taken throughout the day. It logs disease-related vitals, such as HbA1C or blood pressure, so that health coaches can monitor the data, then intervene when patients need additional support. Initial results out of the Joslin Diabetes Center shows patients experienced significant clinical improvements (reduced HbA1c by 3.2 and reduced blood pressure by 26mmHg) using this platform. CollaboRhythm, another example that was developed by MIT's research labs, allows providers to track patients' progress in clinical metrics (e.g., reduced blood pressure) over a secure platform. By monitoring self-reported clinical data and connecting with patients over instant message, study participants reduced blood pressure after 12 weeks (26.3mmHG vs. 19.0 mmHg).
… But self-management technology isn't yet a 'magic bullet'
Given these newer self-management technologies, some wonder if they will be the magic bullet for implementing chronic disease management. The potentially disappointing answer: No. Although innovative apps and web-based platforms hold promise, it's unrealistic to expect them to be a quick fix for patients with complex clinical and social needs. There are three major limitations of chronic disease management technologies:
- The key to the technology's impact relies on the existing activation level of the patient. Studies have shown that unless patients are truly engaged in their care, with all underlying needs met, technology won't make a meaningful impact. Providers have to invest in the basics of chronic disease management (e.g., self-management education, psychosocial support) before incorporating new technologies in patient care.
- Providers have expressed some concern regarding the accuracy of self-reported data. For some patients, it can be tempting to fudge their numbers to please their providers and caregivers. Providers don't want to rely only on self-reported data in case it's masking dangerous clinical escalation.
- Patients may not be incentivized to take on an additional self-management burden. High- and rising-risk patients likely won't have the time or energy to add something else to their plate. They're already juggling a complex medication regimen, a new diagnosis, or behavioral change expectations. These patients may not be able to take on the daily burden of self-reporting tedious and time consuming data points.
Technology can be helpful, but primarily for engaged patients who are comfortable with behavioral change and self-management—in short, not the patients you worry about the most. For high- and rising-risk patients, population health leaders should focus on becoming experts at offering the key components of chronic disease management (e.g., disease education, medication counseling, psychosocial support) and tailor services to patient acuity level.
To learn how to excel in the fundamental components of managing your patients' chronic conditions at scale, register for our upcoming webconference, How Providers Scale Disease-Agnostic Approaches to Patient Management here.
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