Increasing burden of Chronic diseases globally
In this era of sedentary lifestyle, the burden of chronic diseases is spreading drastically. Nearly 1 in 3 adults suffer from many chronic diseases. This then becomes a cause of financial constraints. Both the older populations and the individuals belonging to the younger age group are equally affected. The most common chronic diseases include diabetes, hypertension, cardiovascular diseases (CVD), asthma and obesity. The treatment expense for chronic diseases must be borne by the individual for a long period. This increases with each addition of chronic condition.
Current trends in Chronic Disease Management (CDM)
Chronic diseases have become the leading cause of death worldwide. The world’s biggest killer disease is ischemic heart disease. This is accountable for 16% of the world’s total deaths. People with chronic diseases tend to have higher health care requirements and account for a large proportion of health care spending. Owing to the increasing prevalence of chronic disease, various chronic disease management programs have are being initiated by the government and healthcare providers. CDM programs aim to provide an organized and proactive medical intervention that is more patient-centric. Health-care management of chronic diseases requires assessment of risk factors, early detection of disease, pharmacological/physiological interventions, adequate treatment approaches, long-term follow-ups, regular monitoring, and promotion of adherence to treatment. When monitored thoroughly, chronic diseases can be managed successfully.
Due to the increasing burden of the chronic diseases, CDM programs are more focused on educating the patients about the condition. The underlying risks and prevention measures, overdue tests or lack of medication adherence also come along. Many technologies like glucose meters, heart rate monitors, blood pressure monitors, and oximeters are developed to support chronic care. The parameters and vitals measured are noted by the patient. This informed to the healthcare provider during follow-ups. Due to normal human psychology, patients try to avoid the routine hospital visits, resulting in overdue tests and lack of medication. This can result in severe secondary complications. Improper monitoring and misplacement of the data by the patient or care- givers can also be fatal. Various social media applications are currently being developed to help patients communicate with peer groups and related communities.
Impact of technology on Chronic Disease Management
CDM is a lifetime task and has to be monitored by the patient on a daily basis. Successful management allows people to lead a free and independent life to some extent and also increases longevity. Integration of information technology in healthcare is a game changer. To ease the CDM, many hospitals have implemented health information technology (heath IT). Chronic disease management programs need to be long-term, proactive, planned, coordinated, and continuous. The traditional plans of chronic disease management programs used to typically focus on selected and specific conditions. It was more superficial. Today, plans are designed in a way that the focus is less on distinct conditions. A more patient-centric approach is developed. This addresses many chronic conditions, health risks and underlying causes.
Each patient is considered a unique case and treatment is planned accordingly. Vast majority of the plans offer integrated chronic care that covers not only the primary physical condition but also the psychological and social aspects of the illness of the patient as well as care-givers. CDM aims at stabilizing patients with chronic disease and preventing further problems. Like any preventive measure, these programs can be effective if they target the right opportunity. It can be cost-effective if they match the resources invested to the size of the opportunity.
Complex tasks such as follow-up care, authorization, and lab test review and treatment planning are automated and simplified by disease management software. Usage of electronic medical records (EMR) / Electronic health records systems (EHR) into the disease management programs proved to increase the success rates of these programs. Increased screening and testing helps because of the application of EMR/EHR systems. This helps in improving the health outcomes of chronic patients.
Healthcare technology improved disease management by:
- Maintain organized recording of patient health information- EMR/ EHR systems enable systematic storage of data. This is beneficial for quick retrieval of patient data and decision making.
- Design comprehensive care plan- Distinct care plans can be formulated for each patient based on physical, mental, cognitive, psychosocial, functional, and environmental (re)assessment. As well as, the impact of these on the primary chronic condition. Efficient EMR/ EHR use has the potential to help providers predict certain conditions before a diagnosis is even possible.
- Medical apps- EMR apps for mobile phones are more in demand. It is easy to use. Being highly portable the patient data can be accessed anywhere and anytime. It is life-saving during emergencies.
- Transitional care- Transitional care includes easy transmission and exchange of patient history, diagnostic and progress reports among healthcare providers. It facilitates smooth data retrieval after an emergency which can be lifesaving. It enables to easily communicate with the professionals within the same healthcare facility or its branches.
- Easy and regular access to care- Teleconsultations provide patients 24*7 access to healthcare providers and physicians. The follow-ups are more regularized. The caregiver, family and friends can also communicate with the physicians and other healthcare professionals. E-prescriptions and e-reports are provided.
- Lower economic burden- Incorporation of EMR/ EHR systems into disease management lowered the economic burden of the patients. This proved profitable for the care providing organizations.
- Managerial benefits- EMR/ EHR systems enable effortless and trouble-free administrative works like billing and appointment scheduling. It also helps in reducing workload.
CDM system is another IT tool which is used for managing chronic diseases. Yet, use of CDMS tool is not widespread. Unlike EMR systems, CDMS has not garnered popularity and the majority of clinicians are not familiar with it. CDMS is more population based with limited data and uses less advanced technology.
The other healthcare information technology tools used in disease management are:
I. Practice Management Software- It assists healthcare facilities and professionals to manage daily operations. It is more administrative than patient-centric.
II. Master Patient Index (MPI)- It helps to connect patient records to more than one database. MPI’s also avid inaccurate patient information and reduce duplicate patient records. This could result in patient claim denials.
III. Clinical Decision Support (CDS)- It analyzes data from clinical and administrative systems. The aim of this software is to assist healthcare providers in making informed clinical decisions. It filters information to assist healthcare professionals in caring for individual clients.
IV. Laboratory Information System (LIS)- This software allows doctors and lab technicians to coordinate inpatient and outpatient tests for microbiology, hematology, chemistry, and immunology to get clinical data. This system manages patient demographics, check-in information, specimen entry and processing, and result. This is the used for laboratory purposes.
Among all the tools available EMR/ EHR is most popular and uses advanced technology. It possesses all the facilities under one roof and is easy to use. EMR systems provide bidirectional data transfer. Robust storage of data, collaboration within the facility, enhanced and efficient care to patients, and quick data recovery makes the electronic medical records system the most used tool in CDM.
Impact on patients
Digital healthcare resulted in greater patient satisfaction. In developing countries, there is mobile health or m-health, which got its name from healthcare practices. Supported by mobile phones or handheld devices, is highly appreciated by the populations. But it still has a long way to go. Rural areas are highly benefited by this initiative. It receives equal opportunity and access to good healthcare management. Technological innovations are turning a mobile device into a key component of health care delivery. With inexpensive mobile devices, patients from lesser economic backgrounds can avail teleconsultation facilities.
In some regions there might be a gap due to lack of awareness. Along with development, imparting awareness is equally important. Ignorance can be lethal at certain times.
The benefits gained by the patients and their caregivers are:
- More frequent interactions with their care team – The patient has a better access to the care facility and health care professionals. Information and communication technology is considered as the key to enhanced and effective communication with health care providers.
- Demonstrated greater medication adherence – Healthcare information technology helps patients maintain a regularity on the medications and tests.
- Achieved greater control over the prevailing medical condition -Due to the regular and meticulous monitoring and follow-ups the patient has better control over the chronic condition like hypertension, diabetes, etc.
- Made fewer in-clinic visits to their primary care physicians – There is 29% reduction in clinic visits. This helps in saving both time and money and reduces stress. Digital prescriptions and reports are highly appreciated.
- Exhibited higher levels of satisfaction – Digitization of healthcare have increased patient satisfaction by 84%. Prognosis, diagnosis, prevention of secondary complications and prevention of probable risks turned out to be better and more efficient.
The healthcare system has come a long way. The journey from the days of traditional medicine to the modern technology-based care has been long and appreciable. The tremendous advancement in technology has helped the healthcare professionals to provide a better service to the patients. A healthy population makes the country prosperous. Thus, healthcare is now based more on the overall management of populations. They aim at keeping them healthy than just focusing on individual cases. Soon digital technology will be of prime importance in healthcare.
In the current scenario, the data recorded in the EMR/ EHR systems are generated by the healthcare professionals. The patient portal does not facilitate the data entry of the self-monitored vitals. With the development and availability of innumerable self-vital monitoring devices, it has been proposed that the patient portal of the EMR/ EHR system should include a new trove of patient-generated health data (PGHD). PGHD can store the data obtained by the patients themselves in a structured manner and that has been retrieved and analyzed whenever required. Chances of misplacement of data would be nil when entered correctly. The physician’s access to PGHD would be beneficial for better analysis and avert risks and complications.
Soon, to help a greater population it would be necessary for the healthcare professionals to work under one big umbrella. Collaboration and coordination are the key to success. Incorporating interoperability among the healthcare providers would lead to smooth data exchange without compromising the credibility of the data. A seamless and secure network is a necessity for working together. To achieve this standardization of data must be implemented.
Today technology enhanced the benefits provided by the chronic disease management programs. It helped in reaching out to a much larger population. It is anticipated that with constant advancements, technology will pull healthcare forward.
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