Digital Disease Management

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The need for better ways to manage chronic diseases is clear. According to the Centers for Disease Control, chronic diseases are the leading cause of death and disability and a leading driver of the nation’s $3.3 trillion in healthcare costs.

While initially promising, telehealth—the use of telecommunications to enhance patient care and promote disease prevention—hasn’t performed up to expectations. Studies have found that it is both underutilized and may not be as cost-effective as originally thought.

Many believe there are opportunities to improve telehealth by taking advantage of advances in mobile and digital technology on the front end, better data collection and integration on the back end, and using AI and machine learning algorithms to improve the timeliness and effectiveness of interventions.

Participants in a panel discussion on Reimagining Disease Management at the Partners HealthCare World Medical Innovation Forum in April confirmed that the potential exists.

To be effective, the panel felt that data- and technology-driven enhancements should be paired with a patient-friendly approach that encourages two-way communication with providers and speaks to patients in the same way they think about their health.

“Everything comes back to engagement,” said Murray Brozinsky, founder and Chief Strategy Officer for Conversa (could this be a link to their website?). “If you don’t get engagement, you’re not going to move the needle on anything.”


Making Better Use of Existing Data

A key theme of the discussion was that existing data sources are not being used to their full potential.

“There is an enormous amount that can be done with the data that exists today that not only improves the ability not just to stratify patients upfront but then to monitor them in real time,” said Jean Drouin, MD, CEO of Clarify Health Solutions.

“There’s a lot that could be done today, and there’s a lot of incremental value that could be unlocked by aggregating the existing data sets,” agreed moderator Sree Chaguturu, MD, Chief Population Health Officer for Partners Population Health Management. “And the more we can add, it’ll be exponentially more valuable.”

“Once we have aggregated data sets and incrementally organized them, then we need to develop algorithms that help us identify patients who would be amenable to these disease management programs,” Chaguturu added. “We could use artificial intelligence and machine learning as part of the development of algorithms.”


Technological Advances

Panelists also agreed that an effective telemedicine strategy should make broader use of digital devices that can be used to connect patients with providers.

“Digital is an area where I think there’s just an enormous amount of opportunity, and I think we’ll actually see much more impact from a digital approach to disease management then we saw with some of the earlier and now somewhat stigmatized approaches that happened in telephonic [medicine],” said Julian Harris, MD, President of CareAllies.

“[We would be] not just pushing out information or interventions, pulling in information and having the rigor of an artificial intelligence approach to be able to look across claims data, electronic health record data, remote data, patient-entered data, patient-reported outcomes, and to be able to make sense out of that and transition it from information into insights and actions.”


Connecting With Patients

Panelists said the key to patient engagement is finding ways to connect with patients on their own terms and to focus on outcomes that are important to them.

“Disease management is not the language that people actually living their lives through, so our interventions aren’t necessarily meeting them where they are,” said Erika Pabo, MD, Chief Health Officer of Humana Edge and an Associate Physician at Brigham Health.

“It is a very rare patient who comes to me and says, ‘I want to manage my COPD’ or ‘I want to manage my diabetes.’”

Conversation between patients and clinicians should instead take the form of an ongoing dialogue rather than occurring just at annual physicals or when there is an urgent medical need.

“Imagine if you were raising kids and you said, ‘We’ll check in once a year and other than that, if you’re not doing well, come see me,’” said Brozinsky.

“No one would ever dream of raising kids this way, yet that’s what we do in the healthcare system and that’s what we have done for a large part in disease management.”

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