By Dr. Jeremy Corbett, Envolve Health
Nearly 30 million Americans are diabetic, and up to 90 percent of them have Type 2 diabetes. According to the NIH, the cost of treating and managing the disease reached $408 billion in 2015 and could expand to $622 billion by 2030.
Although this trend is concerning, there’s hope: The Centers for Disease Control and Prevention recently reported a 35 percent drop in newly diagnosed diabetes cases since 2009 and a long-running plateau in the number of existing cases.
Any decline is encouraging, but the public health initiatives helping to stem the tide ultimately won’t be enough to make a lasting impact on the lives of diabetic patients. To correct this, healthcare organizations and providers must reach patients when they need it most: before a dramatic diabetes-related health scare occurs rather than after a potentially preventable event.
Focusing On Diabetic Patients’ Behavior
Many healthcare organizations already have lifestyle programs and care initiatives in place. However, these organizations still find it difficult to address patient populations in a way that decisively influences their behavior. The reason why is as simple as it’s sobering: having a condition management program in place isn’t the same as having a condition management program that works.
Meeting patients where they are — both geographically and in time — is the critical difference. Human behavior is amazing, but it’s predictable. A successful program uses real-time data to tell providers what’s happening, employs human behavior change theory to show why it’s happening, and can offer course corrections thanks to novel clinical program design.
For example, reports show that diabetes educators can play a significant role in improving population health measures. As healthcare in the U.S. shifts toward value-based care, then, educators have a greater opportunity to join larger care teams and take active roles in identifying patients’ immediate needs. When patients have diabetes, they live with the daily fear that their condition might require an out-of-reach solution at any moment. With remote patient monitoring, a patient’s care team will become aware of any concerns immediately and can provide a patient with the answer he or she needs.
Removing Barriers To Care
Imagine a patient who registers a high glucose reading because he or she lacks access to insulin. Many patients in that situation report directly to an emergency room for definitive care — care that’s often as simple as providing a dose of medication. Unfortunately, the emergency room is one of the most expensive departments in any healthcare setting. It’s also the correct care setting for only a handful of cases.
Patients in every population face this situation daily, and some healthcare providers lack supportive programs that can reach out when their patients need them most. Stakeholders in healthcare now realize this, and venture funding has reached record-breaking highs for digital health companies seeking to provide that support.
Recently, I aided a patient who suddenly lost consciousness. After reviewing his electrocardiogram, I ordered an array of other tests to rule out serious pathology. After the results came back without any major abnormalities, I needed a solution to assess for arrhythmia outside of the emergency department while eliminating undue expenses and patient inconvenience.
In the past, my options would have been admitting him for telemetry observation or requesting a follow-up with cardiology specialists in the next 24 to 48 hours. Instead, I phoned the on-call cardiologist: We discussed placing mobile cardiac outpatient telemetry in my emergency department and sending the patient home. This would allow the cardiologist to monitor the patient’s rhythm remotely and bring him into the office following any abnormalities. With this technology-based approach, we created a quick solution, a happy patient, and an open hospital bed.
Fortunately, new healthcare technologies are taking hold across the board. Digital health startup funding reached $5.1 billion in the first half of 2019, and trends included funding systems that give patients power and make healthcare delivery more convenient. These types of systems boost patient engagement and make it easier to remove barriers to their providers.
These measures will make a greater impact on patient populations when organizations stop pretending to offer population health (in those cases, perhaps it’s more aptly titled “subpopulation health”). Inertia is tough to overcome but overcome it we must if we hope to provide better care to patients who need it most.
About The Author
Dr. Jeremy Corbett serves as a divisional chief health officer for Envolve Health, providing oversight and guidance in all aspects of product development. Dr. Corbett is a board-certified emergency physician focused on transforming the way we think about (and manage) chronic disease. His background in innovative digital product design and implementation, paired with his training in clinical medicine, gives him unique insights into population health management and the future of medicine, technology, and managed care.