In many ways, the treatment of chronic conditions helped move the digital health agenda forward–years before we ever heard of COVID-19.
The management of chronic conditions has been a riddle that healthcare organizations have been trying to solve for decades.
The reasons are obvious. Chronic conditions are the leading causes of death and disability in the United States and the biggest contributors to the $3.5 trillion in annual healthcare costs.
The uptake of telehealth services during the COVID-19 pandemic has shone a spotlight on the power of digital technologies in healthcare. Telehealth platforms have connected patients and clinicians remotely, but telehealth’s growth has obscured a broader movement that had already been underway for some time: the use of digital health to transform care.
If stakeholders can pair evidence-based digital health solutions with telehealth adoption it could spark a care delivery revolution that would dramatically improve the management of chronic illness, ease clinician burden, and lower costs.
Whether an organization is just getting started, scaling a pilot, or bringing together several digital health solutions into a single model of care, following are five strategies necessary for the adoption of any digital health program.
1. Build the Infrastructure
Organizations must consider infrastructure and interoperability and the ways a patient’s data could move seamlessly—but securely—across that patient’s continuum of care.
Healthcare organizations will have to take the lead, but they won’t be able to do it alone. Addressing infrastructure challenges on such a scale must be a collaborative effort that includes multiple parties and entities.
Regulators and policy makers to health IT vendors, electronic health record (EHR) systems, and even entities that deliver broadband must work collaboratively so that the reach of digital health can be extended to rural communities.
2. Engage and Activate
Making digital health a mainstream aspect of care delivery requires significant buy-in from care teams and other stakeholders across the continuum. To help build the case, leaders must outline digital health’s benefits for all stakeholders, describe how to attain those benefits, and back up the claims with clinical and real-world evidence.
3. Extend High-Quality Care to Rural and Underserved Populations
Digital health can be a cost-effective and powerful tool for rural, vulnerable, and underserved populations. Digital health provides the continuity of care required to manage chronic conditions by reaching people who might otherwise feel reluctant to seek care. Digital health can also serve as a bridge to populations that are ethnically and linguistically diverse—not only patients and their families but also their care teams.
4. Connect Care Across the Continuum
It’s widely accepted that better management of chronic illness depends on improved collaboration across the healthcare continuum. Digital health solutions can help by creating a single source of rich and readily accessible patient data.
5. Focus on Whole-Person Care
Increasingly, providers are learning that exercise, food tracking, patient distress level, and social determinants of health are important drivers of both health and wellness. Digital solutions can bring together all of those types of data from multiple devices in order to significantly improve clinician visits whether virtual or in-person.
The anonymity of technology can encourage candor in the self-reporting of mental state and other social factors, and the connection to a wealth of additional data can give physicians more integrated and actionable information prior to a patient visit.
Digital Health in Action
One of the largest US public healthcare systems serves one of New York’s most vulnerable populations. As a safety net system, it also cares for one of the most ethnically diverse patient populations in the country.
Welldoc worked with the health system in a pilot program in which 273 participants with poorly controlled diabetes experienced a 1.1 percentage point reduction in A1C levels than matched controls did. The program achieved that result by taking advantage of moments when a patient is concerned and engaged to integrate and personalize information in easily understood, simple messages.*
The Call to Action
If the industry can overcome barriers, the next three to five years would finally get healthcare technology right by freeing providers to partner with patients for the truly important clinical decisions. It’s a chance to improve the health of those with chronic conditions and to spur a transformative era of digital health that could save and improve lives.
* Pilot description: Beginning in December 2018, patients with uncontrolled diabetes (n=273) were enrolled in the BlueStar pilot program. Participants were eligible if they had a diagnosis of type 2 diabetes, an A1C ≥ 9% and monitored over 6 months.
Mansur E. Shomali, MD, CM, Chief Medical Officer, oversees the clinical aspects of Welldoc’s chronic condition platform. He also supports patient care, serving people living with diabetes and other endocrine and metabolic conditions.