Disease management requires technology―and an attitude change


Multiple chronic conditions are reaching epidemic proportions and putting an unprecedented financial and logistical strain on our health care system.
Chronic conditions in fact account for around 75 per cent of health care direct costs in North America. Diabetes, congestive heart failure, coronary artery disease, asthma, depression, alzheimer’s and dementia are responsible for the majority of these costs.  This presents a serious issue, given that expenses relating to treating people with one chronic condition are twice as great as for those without any chronic conditions.

With each additional chronic condition per patient, there is an exponential rise in the cost of service delivery. By way of example, when a patient reaches five or more chronic conditions their health care costs are about 14 times greater than spending for those without any chronic conditions, according to the Agency for Healthcare and Quality  in Rockville, MD. Research from Marc L. Berk and Alan C. Monheit, also shows that five per cent of the population – a segment largely made up of patients with multiple chronic conditions – incurs approximately 50 per cent of all health care costs.

It is evident that treating complex cases successfully will see the greatest improvement in terms of clinical outcomes, patient quality of life and cost reduction. One way to achieve that is the application of technology innovation to help patients manage their conditions independently.

It stands to reason that a major driver in reducing costs and improving patient outcomes and quality of life is to prevent the development of chronic disease in the first place; or at the very least, to ensure patients follow therapeutic guidelines once they are diagnosed. This however will first require a significant shift in attitude on the part of the system constituents, as well as the patients themselves.

The system must start by thinking of the patient as a central part of his or her health care team, and not merely a recipient of care. In order to enact this, there needs to be an effective infrastructure to enable active communications between patients and their care givers. Disease management must also address the fact that the patient’s family and other individuals can also play a key part in supporting their ongoing needs and as such, must be a part of the communications process.

A greater challenge is affecting a major behavioural change on the part of the patient. Many believe they have no control over their situation and are overwhelmed by stark health awareness programs that foster fear and mistrust. At the same time, the health system would be very well served by applying technology tools and incentives to help people make better decisions on their own about their health and to encourage behavioural change in terms of adhering to therapy, taking proper medications, and improving their diet and exercise regimens.

A critical element in putting patients in control of their own healthcare is more convenient, easy-to-use access to services. This entails a number of components, including web-based portals and information integration. Self-service technology is certainly not unfamiliar territory for consumers.

Cost-effective and flexible portal-based solutions are available and being implemented today that are empowering patients to easily manage their own appointments, receive automated reminders, track and report vital signs (e.g. blood pressure, heart rate, etc.), and receive advice and coaching on lifestyle changes etc. Given the fact that the chronic condition crisis will only increase in the years to come, it is increasingly evident that investments of this nature must be made today to support preventative care and monitoring and ensure future sustainability.