By Eric Wicklund, mHealth Intelligence | June 7, 2019
Today’s health system isn’t built to treat patients with chronic diseases, yet 86 percent of our healthcare expenses go toward chronic care management. Telehealth can change that, and can better prepare providers to deal with what has become an epidemic.
To Richard Milani, MD, FACC, FAHA, Chief Clinical Transformation Officer for the New Orleans-based Ochsner Health System, today’s health system is built more to treat people in 1900. It doesn’t handle well the three pillars of chronic care management: medication, behavior change and surveillance.
“We have a model for delivery that doesn’t fit the problem for the population,” he told a packed room at Thursday’s Value-Based Care Summit for Telehealth in Atlanta.
Yet with connected care technology that includes mobile health devices, mHealth apps and telemedicine platforms, providers can tailor care delivery to the patient’s specific needs – including time, place and cost – and develop a health and wellness plan that stresses behavior change.
It’s a tall order, says the man at the front of one of the most telehealth-savvy health networks in the country.
“There is a science for behavior change, and we’re not taught it in med school,” he pointed out. “And pharma isn’t knocking on doctors’ doors pushing lifestyle change.”
Milani, who delivered the opening keynote at Xtelligent Healthcare Media’s two-day telehealth event, offered a glimpse into what it takes for today’s hospital to treat today’s patient. The average person sees a doctor four times a year, he pointed out, yet deals with health issues that can change on a weekly, if not daily, basis. A provider has to be able to interact with the patient whenever possible and necessary, not just in the office.
In addition, the provider’s methods for treating a patient have to change as well. To get in front of care management for chronic issues, Milani said, the provider has to take a look at the factors that affect the patient’s lifestyle choices, including health literacy, social environment, behaviors and an ability to pay for healthcare.
And to create a care plan that will have an effect on a patient, the provider has to use tools that address patient activation – methods that motivate a patient to take action or change behaviors. That might be as simple as sending a smoker home with an image of his or her lungs, or sending targeted e-mails or text messages beginning with each patient’s name.
“For me it’s about an hour’s worth of computer code,” he noted. “That’s it – I’m done.”
And yet that effect that has on a patient may be much more profound.
Today’s mHealth and telehealth tools give providers more opportunities to affect patient activation and compel behavior change, Milani said. But providers have to know how to use the technology at hand and create pathways to care that a patient will follow. It’s all well and good to tell someone to eat better, exercise and get more sleep, but if they aren’t following that advice or taking their prescribed medications, nothing will happen.
That said, today’s patients are looking for those nudges. Much of what is happening these days with digital health is coming at the request of the patient, who’s using smartphones, looking for on-demand health and wellness and keeping a close eye on the price tag.
“People are looking for an alternative other than just another pill,” Milani noted.