In yet another sign that the move to embrace mHealth is global, it was recently announced that a US-based disease management company will be working with an Australian insurer and telecom to provide targeted telehealth services.
Healthways, a Tennessee-based disease management company, will be working with Australian non-profit insurer HCF and telecom Telstra to provide telemonitoring services backed by a veritable army of nurses to approximately 3,000 patients.
According to the press release, the expanded My Health Guardian program will “utilize a range of easy-to-use WiFi-enabled devices, including weight scales, tools for measuring blood pressure, glucometers for monitoring blood glucose levels for people with diabetes or hypoglycaemia and oximeters for measuring the oxygen saturation levels in blood.”
Demonstrating both the rapid scalability of mHealth platforms as well as the zeal with which these tools are being implemented, this partnership can tell us a lot about the current state and direction of the mobile health industry.
While not explicitly stated in the press release, it’s likely that the 3,000+ patients being targeted by this partnership represent the highest utilizers of healthcare among HCF’s 1 million plus members. Often, these patients are elderly with multiple comorbidities–think the 70+ year old with diabetes, cardiomyopathy, hypertension, and vision problems. Reflecting on my own experiences, two particular challenges come to mind.
One challenge is that 15 minutes hardly seems like enough time to really help a motivated patient with high health literacy understand their disease on the level they desire, let alone design and implement a comprehensive self-management program in between the 3 month visits.
The other challenge is the patient facing more socioeconomic challenges and poor health literacy, where I found myself struggling to really identify the critical barriers to helping them improve their health.
The same solutions clearly will not serve each scenario, nor is this even close to a comprehensive assessment of the challenges faced by clinicians and patients in the management of chronic diseases. Perhaps it is a bit much to ask, but here is what I would love to have–once I’ve checked all the boxes demanded by the EMR for documentation purposes, I get to a screen of mHealth tools to choose from.
From here, I can choose to sign up my highly health literate patient with an iPhone for a self-monitoring portal that uses the IBGStar glucometer, a Fitbug pedometer, and a Withings blood pressure cuff. On the other hand, I can choose to connect my struggling working single diabetic mom with a social worker who can follow up by phone/SMS, sign her up for an SMS-based behavior change program designed for diabetics, and dispense a smart pill bottle so my nurse can call her if she forgets to take her metformin.
HCF certainly is not unique as far as insurance companies go in tackling this challenge; Cigna, Aetna, and BCBS have demonstrated that insurers are going from just simply payers to patient managers. At least one lesson I’ve learned over the past few years, though, is that an important part of success on a population scale is that there is no one-size-fits-all solution and hopefully as these programs develop they will become sufficiently dynamic and flexible to enable the clinician to design customized solutions for their patients.
Source: Yahoo News