We did some digital health research and identified four key requirements for the adoption of digital health solutions. In a series of panel discussions, we’ll explore each of these questions in more detail.
Part IV: Will it work in my practice?
Join us for our final discussion of the series focusing on the adoption of digital health. Our panel of experts will answer questions and share best practices around the selection, implementation, and scale of digital health solutions in practice.
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Another great question! I can speak from our experience that the sweet spot in digital health solution population alignment could be where the patient benefit is derived from learning self management skills to be more independent in management of their disease or situation. This is different from digital tools that target supporting provider efficiency or access constraints. So chronic disease management jumps to mind- where a digitally supported intervention can turn a patient into an active, self-manager that contributes to sustained clinical success (not just reliant on the times they are using their digital solution or getting support from their care team). This could be for diabetes, hypertension, metabolic syndrome/obesity, depression, asthma, medication adherence, etc. Diseases where enhanced management short term can result in lower cost long term are attractive to consider from an ROI measurement perspective.
The flip side is that supporting patients with digital health solutions doesn't have to be limited to chronic disease states. A patient could be in an episode of their life where what they really need is easy access to care or medical advice (virtually perhaps!), or targeted guidance on what supplies their doctor recommends during pregnancy. Then the benefit becomes more about the connection and trust between the patient and the provider/health network, as well as the ease of use and consumer facing access. This type of approach becomes attractive in a broader sense as it isn't immediately limited to a pre-specified "disease". However, measuring the outcomes clinically and financially may be more of a challenge.
Pending
This question would (also) be a terrific Topic to engage patients and family caregivers for a healthcare Tweet Chat, such as #hcldr #EngagedPatients #S4PM #bcsm #hcsm #hpm #BTSM #SpoonieChats etc.
Having broader access to digital health solutions would be a game changer for many people living with chronic illness, including complex congenital heart disease. Based on my 9 years participating on Boston Children's Hospital's Family Advisory Council, I am confident to say there are many chronic conditions that begin or occur in childhood which would be better comanaged using digital health solutions. For me wearing my mom caregiver / case manager hat, DH enhances data management and interpretation in such a way, helping to streamline communication with others on the team so effectively, that it also lends itself to creating innovative care improvements.
(One CF mom I know plotted her son's respiratory status based on multi factors including an unrelated med change... or so she thought. Turns out, stopping this particular med led to an increase in her son's CF flares. On Twitter as we say #HowMightWe use digital health solutions to track symptoms or perform multifactorial analysis of complicated illnesses like cystic fibrosis using DH... Then #HowMightWe share and spread DH CF trackers to every parent of a child with CF?)
The other advantage to using DH solutions early on in care of children with chronic illness is that kids like mine are digital natives: not only would it make the transition to adult care go more smoothly, it would also improve / enhance engagement of and adoption by the YA patient.
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I am optimistic dh solutions will meet patient needs in new ways. This is true across all patient populations.
Here are a couple of examples:
For the growing elderly population, these technologies will improve access, compliance, and care. Ex. Instead of having to travel to the doctors office when mobility may be compromised, tele-visits will enable access to care.
For differently-abled populations, enhanced connections to the community can help in many ways. Ex. I am aware of one solution that connects visually impaired individuals with seeing individuals via smartphone. The impaired individual shows his/her surroundings via the smartphone camera. Then, the non-impaired individual audibly describes the scene- thereby improving quality of life through increased independence.
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I have been investigating how to improve asthma control of child and adult patients using digital health solutions. The focus has been to improve patient adherence by 1) using sensors attached to metered-dose-inhalers and 2) a web app identifying patient adherence barriers and offering clinical decision support strategies for providers. Within the web app is a motivational interviewing training module, which helps the provider develop communication skills to deliver barrier specific strategies. MI skills are also developed via online training sessions.
Any disease with a patient population with severe symptoms in which 1) frequent treatment administration is required by the patient and 2) hospital or emergency care would result if the treatment were not followed, would be a candidate for an adherence digital health solution. Given the cost of remote monitoring of asthma patients, health plans are more likely to select adherence monitoring for their most expensive members.
My research has found that digital health adherence monitoring has been successful in both child and adult asthma patients with moderate and severe disease. Patients have had positive results with reduction in hospital days, emergency department visits, cost and improvement in quality of life. Medicaid Health Plans have expressed interest in asthma adherence digital health because of the potential for significant savings. They recognize that adherence digital health solutions have a place in population health, since knowledge and maintenance of patient adherence is fundamental to patient care. This program is being developed for a Delaware Medicaid health plan.
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One of the most common benefits that we heard in the research for the Digital Health Implementation Playbook was around patient adherence. I think it's important to consider both the direct and indirect benefits of digital health solutions Thank you for sharing a specific example where your research demonstrated this Dr. Weinstein.
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I love that you bring up the elderly population and the benefits that you can bring them via digital health solutions. It seems common to pass by this population in the assumption that they can't (or learn to) be tech savvy. While they may be less inclined to interact with technology vs. a millennial, we heard many success stories of older population engagement in the development of the Digital Health Implementation Playbook. Thanks for sharing!
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What a great example showing how digital health solutions can empower the patient (and/or their care giver) to be more engaged in their treatment and become a greater partner to their care team!
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I'm so happy that you mention the benefit of increased trust/connection between the patient and their provider Erika. So often we hear of fears that digital health solutions will cause a divide between the patient and their provider. Or, in some extreme cases, take over the role of the provider. When in reality, digital health solutions are really intended to support the provider and reduce administrative burden so they can spend time doing what they truly enjoy... being with the patient.