Patient non-compliance to treatment regimens has always been a significant challenge in chronic disease care. To quote an excerpt from a rather interesting MedScape CME education article, “Any drug that you do not take does not work” [1]. Patients' day-to-day decisions have a tremendous impact on the reported efficacy of treatment regimens and more importantly on their own health. Therefore, in the information age the favorable advocacy is for patients to be converted into active, informed participants taking ‘charge’ of their individual care management processes in order to guarantee the overarching success of the healthcare delivery system as a whole. Physicians must help patients take charge of their conditions by encouraging them to set self-management goals but also allow them to become actively involved with the diagnosis and selection of treatment options for their ailments.
The old models of care where physicians would tell patients what to do and try to motivate them to change their habits or ways does not have a place in today’s day and age for a plethora of reasons which eventually boil down to fact that the average internet-enabled individual today does not like being told what to do without forming his / her own opinions. Working out a fool-proof way of getting through to the modern patient is one with substantial medical and economic ramifications. To shed some light on the substantial cost implications of effectively taking control of patient behavior, it is interesting to note that a majority of healthcare spending (outside of public-health expenditure) is affected by consumer choices. In fact, 69% of healthcare spending – including spending for catastrophic events attributed to chronic conditions, discretionary care and end-of-life care – is largely subject to individuals’ choices and behavior [2].
Assimilating the facts, therefore, informing patient behavior clearly has ramifications on both the effectiveness of patient care as well as healthcare economics. Now let us go over some interesting approaches which are gathering momentum in regard to informing patients about the state of their health and therefore indirectly allowing the healthcare system to begin gaining control of ‘patient behavior’. One way to make patients active participants in healthcare administration is to allow them to actively partake in the diagnosis of their health and further actually ‘operate’ diagnostic devices without scheduling appointments. This very concept is being pursued by a startup company from Ohio – HealthSpot [3], as well as Mayo Clinic [4] in the form of ‘diagnostic kiosks’ and is expected to make a revolutionary impact in regard to patient empowerment and reducing healthcare costs. Such technology has potential for impacting diagnosis and administration of treatments for minor and common health conditions such as the cold, earaches, sore throat, sinus infections, upper respiratory infections, rashes and skin conditions and eye conditions but tend to be less suited to management of ailments of less able-bodied patients with chronic conditions.
Beyond the kiosk concept, several medical device startups – some with FDA 510k cleared product offerings – [5] as well as major technology firms such as Apple and Samsung are investing heavily in technology that can monitor a user's health using their mobile devices. As per a recent BBC News reported survey [6], more and more patients today are going to their general practitioner with preconceived notions regarding their expected treatment pathways which they glean based on information from apps and the internet. However, the BBC article also reports that often a patient's online diagnosis is not useful to the physicians.
From the standpoint of the Devil’s Advocate to the above concepts, the hypothetical scenario of generating a population of non-medical trained but highly opinionated patient could be quite worrisome… In such a scenario, what might begin as a social issue of inappropriate self-administration of inordinate doses of over-the-counter medication may in the long term create a faction of quasi-trained healthcare professionals – or worse still, medical software / apps – with a greater power over patient beliefs than physicians themselves! So, how far must be actually go with regard the liberties offered to the active and informed patients in the care management process..?
References:
[1] “Adherence: The Silent CV Risk Factor” on Medscape. http://www.medscape.org/viewarticle/582903
[2] McKinsey International Survey on Healthcare’s Digital Future: http://www.mckinsey.com/insights/health_systems_and_services/healthcares_digital_future
[3] HealthSpot: http://www.healthspot.net/
[4] Mayo Clinic Telehealth Kiosks: http://medcitynews.com/2014/10/mayo-clinic-telehealth-kiosks/
[5] http://medcitynews.com/2013/01/iphone-app-for-retinal-images-cleared-by-fda-could-expand-telemedicine-eye-exams-video/
[6] http://www.bbc.co.uk/news/technology-29458143
The old models of care where physicians would tell patients what to do and try to motivate them to change their habits or ways does not have a place in today’s day and age for a plethora of reasons which eventually boil down to fact that the average internet-enabled individual today does not like being told what to do without forming his / her own opinions. Working out a fool-proof way of getting through to the modern patient is one with substantial medical and economic ramifications. To shed some light on the substantial cost implications of effectively taking control of patient behavior, it is interesting to note that a majority of healthcare spending (outside of public-health expenditure) is affected by consumer choices. In fact, 69% of healthcare spending – including spending for catastrophic events attributed to chronic conditions, discretionary care and end-of-life care – is largely subject to individuals’ choices and behavior [2].
Assimilating the facts, therefore, informing patient behavior clearly has ramifications on both the effectiveness of patient care as well as healthcare economics. Now let us go over some interesting approaches which are gathering momentum in regard to informing patients about the state of their health and therefore indirectly allowing the healthcare system to begin gaining control of ‘patient behavior’. One way to make patients active participants in healthcare administration is to allow them to actively partake in the diagnosis of their health and further actually ‘operate’ diagnostic devices without scheduling appointments. This very concept is being pursued by a startup company from Ohio – HealthSpot [3], as well as Mayo Clinic [4] in the form of ‘diagnostic kiosks’ and is expected to make a revolutionary impact in regard to patient empowerment and reducing healthcare costs. Such technology has potential for impacting diagnosis and administration of treatments for minor and common health conditions such as the cold, earaches, sore throat, sinus infections, upper respiratory infections, rashes and skin conditions and eye conditions but tend to be less suited to management of ailments of less able-bodied patients with chronic conditions.
Beyond the kiosk concept, several medical device startups – some with FDA 510k cleared product offerings – [5] as well as major technology firms such as Apple and Samsung are investing heavily in technology that can monitor a user's health using their mobile devices. As per a recent BBC News reported survey [6], more and more patients today are going to their general practitioner with preconceived notions regarding their expected treatment pathways which they glean based on information from apps and the internet. However, the BBC article also reports that often a patient's online diagnosis is not useful to the physicians.
From the standpoint of the Devil’s Advocate to the above concepts, the hypothetical scenario of generating a population of non-medical trained but highly opinionated patient could be quite worrisome… In such a scenario, what might begin as a social issue of inappropriate self-administration of inordinate doses of over-the-counter medication may in the long term create a faction of quasi-trained healthcare professionals – or worse still, medical software / apps – with a greater power over patient beliefs than physicians themselves! So, how far must be actually go with regard the liberties offered to the active and informed patients in the care management process..?
References:
[1] “Adherence: The Silent CV Risk Factor” on Medscape. http://www.medscape.org/viewarticle/582903
[2] McKinsey International Survey on Healthcare’s Digital Future: http://www.mckinsey.com/insights/health_systems_and_services/healthcares_digital_future
[3] HealthSpot: http://www.healthspot.net/
[4] Mayo Clinic Telehealth Kiosks: http://medcitynews.com/2014/10/mayo-clinic-telehealth-kiosks/
[5] http://medcitynews.com/2013/01/iphone-app-for-retinal-images-cleared-by-fda-could-expand-telemedicine-eye-exams-video/
[6] http://www.bbc.co.uk/news/technology-29458143
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