How the mix of tech and personalization helps improve adherence and outcomes

August 23, 2017
David Weingard
David Weingard

David Weingard, Founder and CEO of Fit4D.

One in four Americans has multiple chronic conditions according to the CDC.

One in four Americans has multiple chronic conditions according to the CDC[i]. Conditions such as poorly controlled diabetes is not only harmful to patients, but is also costly to payers and providers. Effective disease management keeps costs down and involves motivating people to take their medications as prescribed, to integrate healthy lifestyle behaviors (nutrition, exercise, weight management, etc.), to cope with ongoing emotional stresses of the disease, and to use and understand self-management tools in between doctor visits.

Tech solutions for Self-Management

One of the causes for poor health outcomes for chronic diseases is medication adherence, according to the World Health Organization, and it is estimated that 50% of patients are not adherent. In the last few years, there have been many technology solutions, such as mobile applications or emails, that try to solve for medication adherence by providing reminders and alerts

 

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Technology alone is insufficient for motivating patients to take their medication as prescribed and follow a healthy lifestyle, because there is a need for comprehensive and ongoing disease management education. Healthcare providers are not accessible to patients around the clock to show them how to use the apps and tools. And often the patients that need the help the most are not the ones who are proactively downloading apps and using sensors and devices.

 

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Other types of programs that offer group classes and telephonic outreach via a call-center, supplemented with educational mailings, have been found to have a mixed impact, largely due to the fact that every person is on a unique journey and faces different hurdles and barriers and responds differently to messaging and tactics.

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Health education must be personalized to meet patients where they are, delivered at convenient times based on an individual’s schedule and communicated using the best method for each person via a multichannel approach (text, email, video, phone, etc.) This is why apps alone have had limited impact on improving outcomes, especially as it relates to addressing the myriad of behavioral and socioeconomic factors that impact behavior change.

Motivational Coaching and Tech Drives Behavior Change

To date, motivational interviewing-based health coaching, coupled with self-management digital tools, is the only technique to consistently demonstrate causal and independent associations with positive behavioral outcomes. [ii]Therefore, when clinical expert coaches can access patient data through a technology platform, patients can get more timely encouragement and educational support tailored to their needs and barriers, empowering long-term behavior change.

 

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Helping patients overcome the initial barriers to starting new treatments or therapy, and addressing the obstacles they face, in real-time, will result in better disease self-management. It’s important to help patients as they hit bumps in the road with a focus on managing an individual’s entire condition, not just parts of it. Chronic disease health coaches can help patients identify real life barriers that apps and tools simply cannot, but they can also assist patients with learning how to use the technology to its fullest potential in order to get the positive outcomes needed.

 

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With 80% of an individual’s health being determined by behavior and socioeconomic conditions, a holistic, end-to-end, personalized approach, along with the assistance of technology, is needed to change behavior and drive long-term health outcomes. A new diagnosis can be overwhelming; being armed with support and education is vital, especially in the early stages. Interventions focused on providing education around emotional support, healthy diet, exercise and medication adherence can move the needle in improving health outcomes.

 

[i] https://www.cdc.gov/chronicdisease/about/multiple-chronic.htm

[ii] Butterworth S, Linden A, McClay W. Health Coaching as an Intervention in Health Management Programs. Disease Management & Health Outcomes 2007; 15(5):299-307.