Ashul Govil, MD, MBA
According to the Centers for Disease Control (CDC) and a 2017 RAND Report, approximately 60% of the US population lives with at least one chronic condition and 42% are managing multiple chronic conditions. Chronic conditions, including heart disease, stroke, cancer and diabetes, are leading causes of death and disability. Although completely preventable, these conditions contribute THE 90% of the country’s $4.1 trillion in annual health care costs. As the incidence and cost of chronic diseases continue to rise, the personal and economic tolls require the implementation of improved solutions for primary care physicians to manage these conditions and reduce health care costs.
Chronic conditions are a challenge to manage within the confines of the current episodic care model, where a patient is seen for 15 minutes in an office visit several times a year. Effective management of these chronic conditions requires continuous real-time monitoring and increased patient-provider contact and engagement. Digital health technologies such as intelligent analytics and decision support, wearable sensors, remote patient monitoring (RPM), and patient-facing applications are promising innovations that can help primary care physicians optimize patient outcomes, improve quality and reduce health care costs. And according to a recent AMA report, doctors are increasingly on board: Two in five doctors plan to adopt new digital health technologies in the next year, and nearly three in five believe the technology can help in key areas such as chronic condition treatment and preventive care. This growing adoption of digital health technology could improve the management and prevention of chronic condition care in the future, and ultimately, help reduce trillions of dollars spent every year in the treatment of these conditions.
Effective digital health intervention optimizes primary care
When it comes to managing chronic disease, what happens in the doctor’s office is only one piece of the puzzle. Managing a chronic condition can be a decades-long or lifelong commitment. When patients see their primary care physician only once or twice a year with minimal communication between in-person visits, conditions can progress unknowingly and opportunities for intervention are missed. Infrequent patient-physician engagement leads to poorer health outcomes as can patients less likely to stick to their treatment plans and make long-term lifestyle changes, and doctors do not have all the information needed to optimize treatment.
Rather than simply trying to manage individual patients in the office visit, primary care must understand how to monitor their entire patient population and then identify and intervene with the right patient at the right time, before their disease to escalate. This is important for those providers who are in traditional fee-for-service (FFS) as well as those who are increasingly participating in value-based care and risk-sharing arrangements. The challenge is how to improve work efficiency and provide this type of care model at scale, despite the current resource strains experienced by all providers and practices.
Innovations in digital health, such as artificial intelligence (AI)-enabled data insights, telehealth appointments, asynchronous remote care, and patient-facing virtual resources, can help patients stay engaged between visits or on the go to see their providers in person is not an option. Digital health tools and virtual care programs also help primary care physicians and care teams better collect, monitor and act on patient health data to make real-time changes to treatment plans based on monitoring and outcomes. stable. For cardiovascular patients, for example, digital health tools can include home monitoring devices (blood pressure cuffs, heart rate monitors, scales, etc.), medication and lab instructions, and personalized titration plans to make patients target therapies and goals. These technologies and programs help to optimize treatment and improve communication between physicians, patients, care teams and caregivers and have been implemented with great success by health systems and cardiology practices across the country.
While digital health adoption and successes in this arena are growing, it can be difficult for providers looking for these tools to identify the best solutions and programs to implement as the health information technology (HIT) market becomes saturated. . One challenge is that many digital health tools only address part of a problem and do not provide an end-to-end solution to a patient’s chronic condition. RPM alone, for example, is not useful without the appropriate knowledge of the data and the ability to quickly take appropriate action if necessary, all without placing undue burden on the clinical team.
Furthermore, for a digital health solution to be effective and efficient, it is essential that it integrates seamlessly into existing clinical workflows. Electronic health record (EHR) integration is key to ease of use and physician engagement, as it prevents hidden data and allows patient care teams to develop more holistic, optimized care plans that incorporate EHR data along with information from home and outside the health system. Digital health technologies that lack EHR integration or that funnel data into the EHR into unstructured and incoherent sets can create more work than value for physicians and providers, requiring them to wade through and synthesize disparate sets of patient’s health data. This takes up valuable time that could be spent with patients or optimizing treatment plans. As a result, in the end, tools without proper integration have low usage and little impact on care. When deciding which digital health tools to implement, decision makers should consider scalability, flexibility, ease of use, and data integration capabilities as important factors.
Digital health can enhance the sensitive human touch
Digital health solutions and virtual care programs are vital to increasing the reach of our physicians, specialists and primary care teams. In particular, as healthcare staffing shortages continue to affect access to healthcare for patients, digital health and AI-enabled capabilities can make care more scalable, accessible and personalized by allowing doctors to tailor treatment plans. treatment for each patient’s unique needs, medical history, and social determinants of health. Innovations like virtual health coaching and patient-facing apps enhance the sensitive human touch of healthcare by making care management a higher-touch experience for patients and helping them feel more engaged and informed during their journeys of care. This can be especially critical for patients with chronic conditions, as symptom management and long-term treatment can be complex, emotionally taxing and overwhelming.
Digital health does not have to replace in-person doctor visits at all. Rather, it is most effective when used in conjunction with in-person visits to continuously collect and analyze patient health data and respond to patient needs in real time, providing patients with the support they need and ultimately optimizing health outcomes. . As we look to the future of healthcare and chronic condition management, we have the unprecedented opportunity to leverage digital innovations such as AI, remote care and patient engagement applications to improve population health at scale and bring timely and high-quality care for patients who need it most.
Ashul Govil, MD, MBA, is co-founder and chief medical officer of Story Health, where he oversees all medical and clinical aspects of the company’s products and services. A board-certified cardiologist practicing in the San Francisco Bay Area, Dr. Govil has spent years caring for heart patients, and that experience has given him a front-row seat to the gaps that exist in the health care system. Follow Dr. Govil inLinkedInand Twitter@ashul
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