A long and deeply reported feature story in The WashingtonPost emphasized the grim effect of this on Tuesday an epidemic of chronic diseases is taking on too many millions of Americans.
“Forty years ago, small towns and rural areas were healthier for adults in the prime of their lives. Now the opposite is true,” he said After. “The death rate in cities has fallen sharply, while the death rate outside the country’s largest metropolitan areas has leveled off and then increased.”
A major driver of this grim fact is that “chronic diseases – obesity, liver disease, hypertension, kidney disease and diabetes – are on the rise among people aged 35 to 64,” according to the article – highlighting widespread health disparities and social problems. determining factors such as “inadequate insurance, minimal preventive care, poor nutrition and a weak economic safety net.”
The article also highlights that the US medical workforce is “aging and depleted,” while the country “needs thousands of additional primary care physicians.”
As has been shown many times, Lack of access to care is a major barrier to equity in health care and chronic disease management. But telehealth can help in an important way.
TimeDoc Health is a provider of technologies and services for virtual care management, chronic condition management and remote patient monitoring. In August, Brian Esterly was appointed CEO.
Esterly, previously Chief Growth and Strategy Officer at Centria Healthcare, was hired for his deep experience and keen knowledge of provider organizations, combined with his skill in leveraging technology to reach vulnerable populations.
Healthcare IT news recently caught up with him to discuss how telehealth and RPM can help manage chronic care – especially as the number of people with chronic diseases grows, the population ages, and the healthcare worker shortage worsens.
Q. What are the challenges facing chronic care management today and in the future?
A. The chronic care management market segment is experiencing a range of challenges that are not only widespread but also have a significant impact across the broader healthcare landscape. These challenges span a spectrum of issues that require our attention today and that will continue to shape the landscape of chronic care management in the future.
One of the most prominent challenges is the precarious balance between the escalating demand for chronic care services and the declining supply of healthcare providers. This dilemma reflects the broader healthcare scenario, where we are witnessing a simultaneous increase in the prevalence of chronic conditions and an aging population, against a worrying decline in the number of healthcare professionals available.
This challenging dynamic is illustrated by the prediction that by the end of this decade, approximately 80 million Americans will struggle with three or more chronic conditions. This figure, which is significantly more than double the previous decade, underlines the urgency of our mission.
This challenge is compounded by the projected shortage of 90,000 physicians over the next decade, underscoring the need for innovative healthcare solutions.
Success in chronic care management revolves around patient behavior change, a transformation process that is at the core of our mission at TimeDoc. Here, technology and healthcare services provide support to both patients and healthcare providers. However, in an environment full of technology-enabled solutions, selecting the precise tools and services that can translate into tangible results becomes a difficult endeavor.
Take, for example, remote monitoring of patients. While it has the potential to continuously monitor patient status, the challenge lies in identifying and deploying the right combination of technologies and services to achieve the desired outcomes. Our commitment is to strategically navigate this technology landscape, advance patient engagement and facilitate meaningful behavior change.
Finally, and of equal importance, it is necessary to identify and document the impact of our chronic care management initiatives. This is becoming increasingly meaningful as healthcare undergoes a transformation, embracing alternative payment models and value-based care.
Our ability to effectively communicate the value of the services we provide (or the value of any chronic care management program) is critical, especially as these models emphasize outcomes and quality of care over the volume.
Q. How exactly can telemedicine help solve each of these challenges?
A. Telehealth serves as a transformative force in healthcare, advancing the goal of equal access to top-quality care. By using technology to bridge access gaps, telehealth empowers patients, reduces health care disparities, and promotes an inclusive and patient-centered health care system. It goes beyond conventional limitations and addresses numerous factors that contribute to health care inequities.
What is striking is the convenience and accessibility inherent to telecare. Patients can now schedule virtual visits at their convenience, eliminating the hurdles associated with transportation, childcare or work commitments. This newfound convenience in seeking care increases patients’ ability to proactively manage their health.
Additionally, telehealth advocates for continuity of care, especially benefiting those with chronic conditions or ongoing health care needs. Patients can maintain regular contact with their healthcare providers, contributing to better health outcomes and smaller healthcare disparities.
Q. What should CMOs, CMIOs, CIOs and other leaders know about virtual care when it comes to starting an effort to use technology to help the increasing number of patients needing chronic care?
A. For healthcare leaders venturing into technology-driven chronic care management, several key considerations must guide their path.
Starting a virtual care journey for chronic care management requires a holistic approach: recognizing transformative potential, building a robust technology foundation, fostering collaboration, advancing patient engagement, and prioritizing data-driven quality improvement.
First, these leaders must recognize the profound transformation that virtual care represents. It’s more than just adopting technology; it’s a fundamental shift in healthcare, moving beyond episodic visits and toward ongoing patient engagement.
Building a robust technology infrastructure is critical. This includes selecting the right telehealth platforms and ensuring seamless integration with existing electronic health records and healthcare systems, with an emphasis on interoperability.
Collaborative partnerships between organizational units and with suppliers are crucial. These partnerships facilitate the necessary engagement between healthcare providers and patients, unlocking the potential of chronic care management programs.
Finally, a commitment to results measurement and quality improvement is essential. Using data analytics to track the impact of virtual care on patient outcomes, costs and satisfaction will inform and improve care strategies.
Q. Describe in detail an example of a patient receiving chronic care through your company’s telemedicine and the results achieved.
A. Patient success stories are at the core of our mission and we share them daily on our internal chat channels. Here’s an example of a recent patient story that really highlights why our teams are so passionate about what we do.
Last month, a healthcare conversation with a patient uncovered a concerning health issue that highlighted the critical role we play in patient care and advocacy through chronic care management and remote patient monitoring.
During the conversation, the patient casually mentioned that his heart rate was persistently abnormally low and that his blood pressure had dropped significantly. Our care coordinator sensed the urgency of the situation, wasted no time and proactively inquired about the specific measurements.
To our horror, the patient revealed that his heart rate was consistently between 40 and 50 beats per minute, and his blood pressure had dropped to 60/40.
Our care coordinator recognized the seriousness of the situation and immediately took action. They immediately contacted the patient’s cardiologist, conveyed the urgency of the matter and made an appointment for the next morning.
After evaluation, the patient underwent a stress test followed by a cardiac catheterization procedure. Shockingly, the cardiac catheterization revealed a total occlusion, a critical blockage in one of the coronary arteries. Thanks to the prompt intervention of our care coordinator, the cardiologist quickly adjusted the patient’s medication regimen and emphasized the importance of closely monitoring heart rate and blood pressure.
During our recent care meeting with the patient, our care coordinator took the opportunity to educate him on the parameters for abnormal heart rate and blood pressure readings. Together they established a clear plan whereby, if the measurements fall outside the set parameters, the patient immediately contacts the cardiologist for further evaluation and intervention.
This patient success story highlights how a proactive approach can make a profound difference in the lives of our patients. It also underlines the critical importance of routine care calls and patient advocacy to ensure that potential health problems are quickly identified and addressed, ultimately leading to better patient outcomes and well-being.
As an organization, we follow these patient stories and the impact of our support on our clients’ goals. In fact, we recently conducted a collaborative initiative with StayWell Health, a federally qualified multi-specialty health center practice based in Connecticut, where we found that our programs had a significant impact on their clinical quality measures.
Notably, patients involved in the chronic care management program were found to be 40% more compliant with diabetic eye exams and showed a 12% improvement in A1c control. This same patient population showed 22% and 21% greater compliance with colorectal cancer and breast cancer screenings, respectively.
This is especially notable because many patients in lower socioeconomic populations face challenges related to transportation and other social determinants that hinder access to quality care.
Overall, this collaboration illustrates how innovative telemedicine solutions can positively impact patient outcomes, increase engagement, and optimize healthcare, even for patients facing social determinants of health conditions.
Follow Bill’s HIT coverage on LinkedIn: Bill Siwicki
Email him: bsiwicki@himss.org
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