The United States spends more than $3.5 trillion dollars per year on healthcare, equating to almost 20% of our country’s GDP.
As our population continues to age, there is no debate about the unsustainability of this spend, but there is meaningful debate about how to control it.
Importantly, there is a consensus that we face an unprecedented problem and it needs to be fixed. We all like win-win situations, is there one to be had in this case?
The good news is that there is an obvious solve where all parties benefit.
Patients deserve better care, which improves quality of life.
Providers want to provide better care, so they can make their patients healthier, which now makes them more money.
And finally, payors want better care, so outcomes improve, and total patient spend goes down.
So, if there is an obvious solution to an obvious problem that obviously satisfies all parties involved, what is stopping us from solving for better care?
There are three key players in the care continuum: patients, providers and payors. Payors carry the stick and are the glue in the value chain; luckily, they completely support the idea of better care. Value based care has officially replaced fee for service, and the benefits have been tremendous. This fundamental shift in incentives has motivated the right changes in our health care system. We are still in the early innings of this philosophical transformation in reimbursement practices, but payors have forced the providers’ hands, and they have responded. Now we just need that to trickle down to the patient population.
Better care is tangible, measurable and repeatable. However, better care is only possible if patients are willing to change their behavior. If patients are willing to change their behavior and provide practitioners with more frequent data, practitioners can build better care plans. With more frequent data, care plans can be amended in real time, instead of at the next office visit. The healthcare system suffers from a lack of on demand data. The only time practitioners receive feedback is when their patients are already sick or just happen to be in the office for a routine visit. This reactive care is plaguing the system and needs to be fixed.
Patient Behavior Modification is Critical
Interestingly, we find ourselves in a situation where those who will benefit most from behavioral change are exactly those that need to perform that change. Patient behavior modification is the tip of the spear. If patients won’t change their behavior, better care is not a possibility. Here’s how we can make this happen:
1) Patients need to believe there are benefits
2) Patients need to understand what behavior changes are required
3) Patients need to feel and see the tangible benefits of their changed behavior
4) Patients need to stay motivated, so they form the necessary habits to sustain change
Change is never easy. Yet, there is a growing population of patients who are considered chronically sick. These patients are ripe for change management because they know they are sick, and they know that they need help. They also have closer relationships with their care teams because they are unfortunately in need of direct care more frequently than the average population.
There is a long list of chronic conditions; these patients consume a disproportionate share of overall healthcare spend. If patients with cardiovascular disease, diabetes, cancer, pulmonary disease and obesity were to embrace behavior change, the benefits would be immediate and tangible. Patients would live longer, improve their quality of life, spend less on care and most importantly do their part to positively impact the rest of the care continuum.
What patient behavior changes will have the highest potential impacts?
1) More frequent patient participation in the care plan in-between visits
2) Consistent collection of vital signs for transmission to the care team
3) Nutrition and activity tracking
4) Medication adherence
5) Question based feedback
6) Targeted content consumption that increases awareness and education
These changes in behavior will directly benefit patients by raising their level of awareness, empowering them to take more control of their care and by giving their care team the data and insight they need to make better care decisions on their behalf.
Behavior modifications that provide more frequent and more relevant qualitative and quantitative data to caregivers is the objective. This data helps practitioners identify trends, spot inconsistencies, and identify critical information that will lead to better care and better outcomes.
Practitioners typically rely on in office data collection to diagnose and treat patients. This interaction typically takes place after a problem already exists and symptoms are already presenting. Asking questions, collecting vitals and reviewing historical data from the patients’ EHR provide the care team with on the spot data they use to make care decisions. Patient mood, white coat syndrome, doctor work load and disparate EHR systems all can impact the quality of these interactions. Ultimately, the care plan that the practitioner concludes is best for the patient at that time is often based on less than ideal data.
After a care plan is established and the patient leaves, the care plan is not easily managed. The feedback loop to gauge plan efficacy, compliance and ultimate outcome is uneven and disjointed at best.
A well-crafted remote patient monitoring (RPM) system can help resolve a lot of the deficiencies that currently plague the healthcare system.
Providing patients and practitioners with a set of tools that bridge the gap between visits, collects and transmits vital signs, tracks nutrition and activity, provides medication reminders, poses easy to understand questions that then tailor content distribution for targeted consumption will give patients the incentives and convenience they need to change behavior.
This same remote patient monitoring system will give the care team the inputs they need to build more informed, preventative care plans that can be managed in real time between office visits. Care plan efficacy, adherence and ultimate outcome management will be easier to monitor. Patients and practitioners will gain the ability to have more meaningful interactions more of the time. As patients and their care providers have more opportunities to interact with meaningful data, both parties will be more prepared to play their part in producing better outcomes.