How technology can enhance patient self-management

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8/21/2018

Pamela Ballou-Nelson, RN, MSPH, PhD, CMPE

MGMA Stat Aug 21, 2018 Patient self-management is a critical part of value-based, patient-centered care. However, self-management skills need to be reinforced to effectively change patient behavior. One way to do so is through the use of technology. Targeting technology to patients' needs and their level of activation is critical to improve outcomes and reduce costs.

As such, in a recent MGMA Stat poll, 59% of respondents indicated that their organization has invested in technology to improve patient engagement in the last year, 36% have not and 5% were unsure.

The use of technology in patient self-management can be distinguished in three ways: patient communication, patient education and tracking of patient-generated health data (PGHD).

Patient communication

Using the patient portal with your EHR is an effective way to employ technology to communicate with patients. A study has shown that, "respondents who electronically accessed their medical records used the information foremost to monitor their health. Other popular uses for electronic medical files were downloading the information to a mobile device or sharing the information with another party like a family member or another healthcare provider."

Texting has become another means to effectively communicate with patients. A recent blog post by TeleVox Solutions showed patients' preference for texting is increasing: In 2018, 17% of patients texted a healthcare provider compared with 5% in 2011. In addition, 60% of patients say it is very or extremely important for their healthcare provider to text them about remote health monitoring, preventive care, disease management, billing and scheduling delays.

Patient education

A study conducted by Welltok and the National Business Group on Health found that wellness programs aren't always effective if they are not specific enough to the patient. The study, which surveyed 1,000 full-time employees with workplace wellness programs available to them, found that lack of personalization was the primary reason for program non-participation. This also holds true for patient disease management programs that lack specificity about patients' situations. Using technology to educate patients could include having them watch a video on carbohydrate counting and then download an app to monitor their carb consumption on their phone or a diabetic patient using an app to estimate the amount of insulin needed, based on diet and exercise levels.

Patient-generated health data

In his provocative keynote address at the American Medical Informatics Association (AMIA) 2011 Annual Symposium, Gregory Abowd, PhD, predicted "within five years, the majority of clinically relevant data … will be collected outside of clinical settings." We aren't there yet, but the interest in PGHD continues to grow, as it's become an important aspect of patient engagement.

PGHD does more than just add information to the EHR. It changes the way providers interact with their patients, helps providers monitor the effectiveness of medications or treatment plans and adjust accordingly, and ensures that patients become partners in their care. For example, remote monitors such as Bluetooth scales and blood pressure cuffs can be used to collect vital data while patients are recovering at home, helping providers determine the next steps in managing their care. The simple act of empowering patients often makes a difference in their care. By allowing patients to view their health information on the EHR or asking them to collect their own data to pass on to providers, they can contribute to the decision-making process of their care.

As the healthcare industry continues to shift toward value-based, patient-centered models, providers will need to boost patient activation to ensure success. One way to do so is by increasing knowledge, skill and confidence in patients' health and healthcare.

Additional resources

Eric Dishman makes a bold argument in Take health care off the mainframe.
MobiSante's affordable, portable ultrasound utilizes mobile networks and the power of smartphones.
Lifelens's app can detect malaria in a blood sample and help make a diagnosis from across the world.
University of Oxford's stethoscope kit is a low-cost way for patients to take recordings of their hearts and send to their doctors for analysis.
MIT Media Lab's NETRA is an inexpensive eye test that connects to a smartphone. Here, a look at the TED Blog Q&A with one of its creators.
Withings' blood pressure monitor allows users to take their own blood pressure with an iPhone, iPad or iPod touch.

Sources

Annual Symposium on Biomedical and Health Informatics. Washington, D.C.: October 22-26, 2011. Available from: bit.ly/2Pvppkc

Heath S. "3 key strategies for supporting patient self-management: Healthcare providers can utilize health technology and care programs to help motivate patient self-management." 2016. Available from: bit.ly/2BNLesz

Patel V., Barker W. & Siminerio E. "Trends in consumer access and use of electronic health information." October 2015. ONC Data Brief, no.30. Office of the National Coordinator for Health Information Technology: Washington D.C.. Available from: bit.ly/2P13JeC

"Provider-patient texting is poised for growth." Modern Medicine Network (July 30, 2018). Available from: bit.ly/2BxDnPm

Written By

Pamela Ballou-Nelson, RN, MSPH, PhD, CMPE

Pamela Ballou-Nelson, RN, MSPH, PhD, has more than 30 years of experience in healthcare management, focusing on practice process transformation, patient-centered medical homes (PCMH), workflow analysis, quality measures, care management, population health and patient activation across the continuum of care. Nelson has worked with both provider and payer organizations to help them work toward alternative care and payment models. As clinical quality director for Adventist Health Network in Chicago, Nelson was responsible for leading physicians and hospital directors in their clinical integration process. Nelson has also worked with numerous commercial payers on quality outcomes and effectiveness measures, including compliance with Medicaid care management programs, along with Medicaid insurance contracts and high-risk and dual-eligible patient programs. She has also trained, advised and mentored more than 80 practices in various levels of readiness, preparing them for value-based payment reform, process improvement, improved quality outcomes and increased efficiency through PCMH recognition with 2011 and 2014 standards. She has a BSN from the University of Utah, an MA from Wheaton College, and an MS and PhD in Public Health from Walden University. In addition, she is an NCQA 2014 PCMH certified content expert and frequently speaks on PCMH transformation for accountable care organizations and population health initiatives.