As the rate of chronic disease in the United States continues to climb, providers and policymakers alike are turning to new initiatives and technologies that promote wellness and patient engagement as a key component to achieving better health outcomes and lowering healthcare costs.
Julie O’Brien, vice president and chief operating officer of AliCare Medical Management, said there are still barriers when it comes to patient wellness and engagement.
There might be language or cultural differences between the patient and healthcare provider that make it difficult for the patient to understand the provider. Or, O’Brien says that there can be pushback from patients about a care plan or diagnosis.
“Sometimes it’s denial from patients because they don’t want to face it,” O’Brien says.
After being diagnosed with an illness or condition, some patients also have the mentality that lifestyle or behavioral changes – like getting more exercise or eating healthier – won’t help their condition.
Then there are patients that forget to take medications, putting themselves at risk for their symptoms reappearing and being hospitalized.
O’Brien says there are myriad reasons why patients aren’t engaged in their own health and wellness. They may not have access to a car and can’t drive to a grocery store or a gym. Or their income or health insurance status may limit them from accessing appropriate and timely medical services. Their family and friends may promote unhealthy behaviors, making it difficult for patients to make more healthful choices.
Unfortunately, patients usually don’t change their behavior when it comes to their health until something catastrophic happens – such as a heart attack. O’Brien says intervention after a major health event is the most effective time to change an individual’s behaviors and habits.
But even more effective than that, she says, is prevention – whether it’s preventing disease altogether, or preventing an unnecessary hospitalization or readmission.
That’s what her company, AliCare Medical Management, focuses on. AliCare provides services in case and disease management, utilization management, hospital readmission management, maternity management, wellness and health coach, independent physician review, and claims cost management services.
O’Brien says it will take shared responsibility to boost patient engagement and wellness in the United States. From the provider side, O’Brien says nurses need to take a proactive role in encouraging healthy behaviors in patients.
“I think it’s their job to plant the seed, and I think the nurses need to be able to work in adjunct to the doctor, so that the nurse can follow up with the patient,” O’Brien says.
O’Brien believes in the power of prevention, despite the costs that may come along with insurance companies and employers providing prevention and wellness programs to consumers. For health plans and employers that may be skeptical of providing these services to individuals, she says that higher spending on preventive services and wellness programs will lead to less spending in outpatient and inpatient care.
O’Brien says that both the employer and insurance plan have a role to play in patient engagement. For example, employers could offer free gym memberships to employees and other wellness programs. Health plans could also set lower premiums for members who don’t smoke or those who have achieved certain health goals.
While O’Brien says while healthcare should be a relationship between the patient and physician, she does think the government should play a supportive role in health promotion.
Technology could also play a role in patient engagement.
In a new study published in the Journal of Medical Internet Research, researchers looked at the impact of email and text messages on patient self-monitoring of activities and behaviors such as diet, exercise, and smoking.
The study found that patient self-monitored these behaviors more when they were prompted to do so via voice messages, texts and emails. Self-monitoring dropped off when prompting stopped.
Now, countless healthcare applications for smart phones and tablets can help patients better monitor their health by reminding them to do things like take their medication or check their blood sugar if they’re diabetic.