The existing approach to chronic disease management is ill-suited to address the dynamic and diverse factors at play with chronic illness, argue the authors. Increase patient engagement and tailoring care to address root causes can create a large value-add, they say.
Chronic disease takes a massive toll on our healthcare system as 60% of people in the U.S. are living with at least one chronic disease. This costs the U.S. more than one trillion dollars in direct care as well as patient’s lives; 7 out 10 deaths each year are due to chronic illness. Despite the ever-increasing arsenal of medications and the abundance of one-size-fits-all tech solutions, we have witnessed mixed success in long-term management of illnesses like diabetes and hypertension, and negligible success in the reversal of chronic conditions.
The reality is that our current approach to chronic disease management is flawed. We need to go beyond simply managing chronic conditions and associated complications to refocusing innovation around a holistic and personalized approach to solve or reverse conditions. This starts by restructuring chronic care to prioritize building, strengthening, and maximizing trust between doctor and patient, with our first step being increasing patient engagement.
Treatment and medication adherence is typically lower among patients with chronic illnesses. However, patients who interact more with their doctors are 2.57 times more likely to adhere to medication. This allows for a more holistic view of a patient’s condition and medical history given the onset, severity and long-term prognosis of a chronic illness is driven by a mix of lifestyle, environmental, and biochemical factors. Employing a holistic, high-touchpoint approach requires patients, physicians and broader care teams to spend time outside the hospital setting to help patients retool their lifestyles.
Our existing approach to chronic disease management is ill-suited to address the dynamic and diverse factors at play with chronic illness. This approach relies on medications to alleviate symptoms on a superficial level without addressing the root causes that impact the long-term course of the illness. These “Band-Aid solutions” only delay the worsening of symptoms and onset ofcomplications. By working toincrease patient engagement and tailoring care to address root causes, we create a large value-add in addition to leveraging technology and telemedicine in chronic care treatment.
Telemedicine and associated platforms allow for round-the-clock engagement between patient and provider. This can help patients make lifestyle changes, especially regarding diet and exercise patterns, figure out the best ways to remember to take medications each day, or employ new tools to manage stress. Furthermore, the use of digital health tools will expand the pool of potential physicians available to patients. This allows patients to choose physicians who have similar characteristics (race, ethnicity, gender, geographic origins) or life experiences which can improve trust and communication between patient and provider. For historically marginalized and underserved communities this can be especially true. Cultural concordance between patient and provider is important because it can help facilitate beneficial lifestyle interventions and digital health tools are primed with potential to foster environments for such connections.
Like all relationships, the patient-provider bond requires trust and open communication. These relationship rules are especially applicable when it comes to working together to tackle the obstacles associated with combating chronic illness. By leveraging technology to increase patient engagement and strengthen patient-provider relationships we can go beyond managing and advance boldly towards reversing chronic illness. With this aim in mind, we move one step closer to potentially curing and making “chronic” conditions a relic of the past.
Victor Agbafe is a third-year Deans and Medical Innovation Scholar at the University of Michigan Medical School and a joint M.D.- J.D. candidate at the University of Michigan Medical School and Yale Law School.
Innocent Clement, M.D., M.PH., MBA, is an internist and former CEO and co-Founder of Kaia Health. and current CEO andCo-Founder of Ciba Health.