How Managing Chronic Conditions Is Streamlined with Digital Technology

According to the CDC, 6 in 10 adults in the United States have a chronic conditionand 4 in 10 adults have two or more. As that numbercontinues to grow across the United States, it is creating significant challenges for both patients and their healthcare providers. On average,1 in 20 people qualify as high-risk由于他们的健康状况和并发症的复杂性，健康状况差，服务使用率高。这增加了卫生保健系统的总体成本，增加了本已负担过重的护理团队的压力，并对数百万人的生活质量产生负面影响。

As the prevalence of chronic diseases persists, it’s clear the traditional self-management approach to chronic care management isn’t effective. Healthcare needs a new digital strategy to lower barriers to care, identify gaps in care, slow disease progression, and provide the added support that patients need—not just during infrequent clinic visits, but as they live their everyday lives.

How to Leverage Digital Technology to Reduce Barriers for Care Teams and Patients

Relying only on a manual chronic care management approach presents significant challenges for healthcare providers who have limited time and resources. Adding automated, digital solutions to identify patients who need added support and deliver care beyond the clinic can help patients keep track of their care plan, reduce the burden on the care team, improve chronic care management efforts, and help organizations succeed in value-based care.

This technology-driven approach can support a more sustainable and effective solution for several reasons:

1.Scalability: Dedicating a member of the care team to regularly monitor patients with chronic conditions and identify those who may be at risk for developing one isn’t feasible. However, withdigital communication pathways, care teams can monitor, educate, and coach patients to keep them on track with their care plan without adding to care team workload. This type of automated and optimized patient engagement can improve outcomes across a range of chronic conditions, including hypertension, diabetes, and congestive heart failure via simple text-based communication.

2.Identifying care gaps: A technology-based solution canhelp bridge gaps in carethat may lead to disease progression or other poor outcomes. Identifying gaps, like missed routine screenings and health data related to chronic conditions, or risk of chronic conditions is essential to keep patients as healthy as possible. Using information integrated with the EHR, providers can streamline pre-visit planning and close gaps at the point of care where it’s most impactful. Patients receive more complete care and benefit from more efficient, well-planned visits.

3.Personalized patient communication治疗慢性疾病的护理计划可能会使病人感到困惑。如果他们患有一种以上的慢性疾病，跟踪药物治疗和生活方式的改变可能是难以承受的，特别是如果他们面临健康知识水平低下或语言障碍等挑战。如果患者不了解他们的护理计划或出于任何原因不能遵循它，他们有很高的不遵守和恶化健康的风险。Simple, text-based communication pathways canengage patients at every step.Using easy-to-understand language, and prompts, patients can automatically report issues and/or barriers so that the care teams are alerted when intervention is needed. When patients can engage on their own terms and revisit resources and information whenever they want, they are empowered for success.

4.Remote patient monitoring: Healthcare tends to be episodic, so in-person visits can be separated by weeks, months, or even longer. In addition, interactions with healthcare providers are also becoming shorter, which makes it challenging to accurately diagnose a condition, adjust treatments, or address barriers patients face in their day-to-day lives.Remote patient monitoringis a valuable tool that improves connectivity between patients and care teams and provides more comprehensive oversight of the patient’s health and lifestyle habits. As chronic diseases become more widespread, resources more strained, and social determinants of health continue to negatively impact some populations, it’s more important to stay closely connected to patients between visits and deliver proactive chronic care management.

Ensuring Patients Who Are Managing Chronic Conditions Receive the Right Care at the Right Time

慢性病患者可能有不同的生理需求和舒适度，使他们难以遵循护理计划和管理自己的健康。数字技术可以让患者更容易地获得护理并保持参与，帮助护理团队确定护理方面的差距，并使医疗保健组织能够为每位患者提供高质量的护理。

Interested in learning more? Download a case study, “Controlling Blood Pressure with Remote Physiologic Monitoring.”

Additional Reading

Would you like to learn more about this topic? Here are some articles we suggest:

• Why Patient Engagement is Critical for Chronic Disease Management
• Digital Patient Communication: A new best practice for managing hypertension
• Can Technology Improve How We Treat (or Prevent) Chronic Conditions?
• How Remote Patient Monitoring Can Reduce Healthcare Inequities
• People Managing Hypertension Can’t Do It Alone – Here’s How You Can Help