Case study: Using mHealth to manage diabetes

From the mHealthNews archive
By Jonathan Javitt
07:39 am

A rapid increase in the prevalence of diabetes over several decades is now threatening the health and quality of life of millions of Americans. It also represents a major challenge for our nation’s overburdened physicians and provider organizations.

Diabetes currently affects more than 8 percent of the U.S. population, at a cost of $245 billion annually, and is projected to rise sharply over the coming decades due to an aging population. That’s because as people get older, their risk for type 2 diabetes increases. Older patients living with diabetes also face higher risks of complications from this disease such as heart attack, kidney failure, amputation and blindness, with attendant hospital stays and admission to long-term care facilities.

To make this situation even more challenging, older individuals with diabetes often suffer from multiple chronic conditions, driving a need for many different treatment plans and medications. This fact, compounded by the memory and dexterity issues that are associated with age, make it extremely difficult for these individuals to comply with regular monitoring of blood glucose levels. Research shows that regular glucose monitoring is essential to good self-management of diabetes and avoidance of complications. 

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As a result of all these issues, provider organizations have an urgent need for new technologies that can help address the specific needs of this patient population in a manner that is cost-effective, informative and engaging. New mobile health technologies can fill this void, providing education and support to patients with chronic conditions while simultaneously empowering providers with real-time information about an individual’s health. 

Enabling connected care
Given the increased risks that accompany diabetes in the elderly patient population, it is essential that both providers and family members stay closely involved in the care of these individuals. Mobile health technologies enable this ongoing support and care outside the clinical setting by connecting providers with real-time insight about a patient’s adherence with monitoring and immediate glucose control as well as trends over time. In response to this insight, care providers can offer highly targeted education during clinical interactions, rapidly change medications or adjust treatment plans and quickly intervene in cases where out-of-range readings may lead to acute events or complications.

These same devices can be configured to deliver automated, personalized messaging to patients and their families to reinforce good self-management behaviors and provide guidance for improved lifestyle choices.

Engaging patients in their health and lifestyle decisions
Diabetes is dramatically impacted by lifestyle decisions, and as such, patient engagement is a critical component to any successful disease management program. Mobile health tools promote this level of engagement by delivering information in the correct format during patients’ most teachable moment - when they are actively testing their blood glucose. These tools can also be configured to deliver educational messages, diet and exercise tips, health reminders and information about local health care providers and community resources.

Given that diabetes can be socially isolating, especially in the elderly, mobile health monitoring solutions can also promote a sense of connectedness and peace of mind. Some systems even provide opportunities for patients to connect socially through online communities and receive peer support from other individuals living with diabetes. And most importantly for elderly, chronically ill individuals, these technologies are convenient and insightful while being intuitive and easy-to-use.

Helping organizations improve care while managing costs
Research indicates that $36 billion will be saved globally in the next five years by remotely monitoring patients with chronic disease. Mobile health solutions help provide better care for more people at lower cost by enabling more targeted, personalized and data-driven interventions. For example, the insight provided by these tools in advance of an office visit can help providers maximize the value of the time they spend interacting with patients. Rather than reviewing paper logbooks or attempting to understand a patient's daily self-management challenges, providers can use this time to optimize an individual’s treatment plan or offering education to influence their behaviors. These devices also lower costs by helping to prevent complications and acute events by alerting providers about a patient’s out-of-range readings before these issues ultimately lead to a hospital admission or readmission.

Addressing the issue of technology adoption
Our nation’s seniors have historically been late adopters to the world of technology, but their movement into digital life continues to deepen, according to newly released data from the Pew Research Center. In order to further close the digital divide and get elderly patients to embrace new technology, providers will need to ensure that these individuals:

  • Understand the clinical value of mobile health;
  • Determine the most appropriate technology (tablet, smart phone, computer) for their lifestyle; and
  • Receive assistance or have a tutorial on using new tools

The need for mobile health technologies has never been greater and these innovations are becoming more useful, flexible and cost-effective. As such, now is an ideal time for provider organizations to look to these mHealth solutions to enable the next generation of disease management.

Jonathan Javitt, MD, MPH, is the CEO and vice chairman of Telcare, which specializes in mobile diabetes management solutions.

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