Aug. 7—Increasing use of wearable tech and mobile health apps that collect patient health information could be a game changer in treating chronic disease, yet few providers have the resources to analyze data that patients bring them.

“I think [our understanding of chronic disease] is going to change once the big data from patients matches the big data from our EHRs,” Gurpreet Dhaliwal, MD, professor of clinical medicine for the University of California, San Francisco, told attendees of ANI: The HFMA National Institute this past summer. “When we start analyzing these huge data sets of patients and start to learn more about how the disease works, then we might be able to say the patient who brings that kind of data in should prompt us to change our management one way or the other.”

For example, physicians’ understanding of diabetes “is very naïve in a molecular world,” Gurpreet says. More and more, these patients and others are coming to their physicians with stacks of statistics they’ve collected on their own—from wearable devices such as FitBits; from blood pressure cuffs they’ve purchased for in-home use; from blood sugar monitors and more.

“We understand [diabetes] as an insulin problem and a sugar resistance problem. If you’re coming in with much more granular data than we understand how to treat it, a lot of times, it’s almost like an art project: We’ll give you a gold star, and then it’s like, ‘Well, that’s great, but I’m still going to do what I would have done anyway without it,” Dhaliwal says.

Disruptive Innovation for Chronic Disease Management

Wearable health and fitness devices are the most popular forms of “wearable tech” used by Americans. In a 2013 survey, 71 percent of Americans who use wearable tech believed their use of such technology had enhanced their health (Centre for Creative and Social Technology, Goldsmiths, University of London). One research company predicts 170 million such devices will exist by 2017.

Joanne Rohde, CEO for Axial, believes there will be an increase in the secure exchange of health information from wearable tech and mobile health apps as providers move toward achieving meaningful use stage 2 and stage 3.

However, analyzing the data and using it to suggest interventions that could enhance health and wellness is something many providers are not yet equipped to do.

“Tracking patient health data is not hard from the technology side. The question is, are things in place within hospitals and health systems to use this data to help improve patients’ health?” Rohde says.

It’s what Dhaliwal calls “a 2014 question.”

Although Rohde believes providers will get to the point where they can use information from wearable devices and mobile health apps to gain greater insight on managing chronic disease, such progress is likely years away, she says.

“I don’t think providers are set up to track that information right now,” Rohde says. “It’s just not feasible for a physician or hospital to monitor all of your health and wellness activities and data. What is feasible is that patients can monitor their own health with the aid of these devices, and when they see something that isn’t consistent, they can feel empowered to share that information with their healthcare provider immediately so that the issue can be dealt with as quickly as possible.”

Getting There from Here

Today, patient engagement applications are helping patients learn about their condition and medications, track progress against their care plan, and discover strategies for staying well.

These apps are targeted to consumers, but more and more, hospitals are purchasing them on behalf of patients with chronic disease and other illnesses that put them at risk for readmission or that are difficult to manage without education and support.

One such app, developed by physicians at Mayo Clinic, provides consumer education and support regarding 2,000 conditions.

“Hospitals want a more meaningful, more healthful relationship with patients. This is particularly true as we move away from fee-for-service to value-based business models in health care: Hospitals have an incentive to help patients stay well and keep them out of the hospital,” Rohde says.

“Mobile health apps have the potential to create a more integrated relationship between hospitals and patients during the first days after discharge,” she says. “They offer a very simple, elegant way for people to understand what’s going on with their health and to have information at the ready when they need to speak to a healthcare provider—and to become more involved in interventions to better manage their health. Such applications also enhance patient satisfaction.”

The power of such applications lies not only in the ability of patients to gain information that empowers them to better manage their health and have more informed discussions with their providers, but also in the ability of providers to track trends in data for a particular patient group.

For example, one hospital that Axial has worked with discovered from the app that the No. 1 thing its diabetic patients were concerned about was not their glucose levels or their weight, but their risk for depression.

“This came as a surprise to the hospital,” Rohde says. “It’s sort of intuitive, when you think about it: If you’re depressed, it becomes much harder to initiate lifestyle changes, such as increased exercise, to better manage a chronic condition. But it was a real a-ha moment for the hospital. Once the hospital realized that the No. 1 thing on patients’ minds was depression, clinicians began to provide information regarding behavioral health management and what to do when you’re depressed to patients with diabetes.

“Broad-based trends such as this are something that hospitals can measure and react to today—and that provides huge promise for population health management,” Rohde says.


Jeni Williams is managing editor, content development, HFMA's Westchester, Ill., office. Follow her on Twitter.

Publication Date: Thursday, August 07, 2014