Positive results with digital supported self-care of chronical diseases
In 2019, a study of digital self-care support was conducted at Dartmouth-Hitchcock Medical Center in the US. The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition.
Caring for individuals with chronic conditions is labor intensive, requiring ongoing appointments, treatments, and support. The growing number of individuals with chronic conditions makes this support model unsustainably burdensome on health care systems globally. Mobile health technologies are increasingly being used throughout health care to facilitate communication, track disease, and provide educational support to patients. Such technologies show promise, yet they are not being used to their full extent within US health care systems.
The purpose of this study was to examine the use of staff and costs of a remote monitoring care model in persons with and without a chronic condition.
At Dartmouth-Hitchcock Health, 2894 employees volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team. Volunteers received bluetooth-connected consumer-grade devices that were paired to a mobile phone app that facilitated digital communication with nursing and health behavior change staff. Health data were collected, and automatically analyzed, and behavioral support communications were generated based on those analyses. Care support staff were automatically alerted according to purpose-developed algorithms. In a subgroup of participants and matched controls, we used difference-in-difference techniques to examine changes in per capita expenditures.
In an 8 months-study, 2,894 employees at Dartmouth-Hitchcock Health, volunteered to monitor their health, transmit data for analysis, and communicate digitally with a care team, of which 13 percent were diagnosed with hypertension, diabetes, heart failure or COPD. The results showed that the self-care model was possible to implement as a standalone component of the regular healthcare system. A sub-analysis compared healthcare costs for participants with chronic disease and matched controls. A difference-in-difference analysis indicated that the total cost of care was 16 percent lower for those who participated in the study.
The technology-based chronic condition management care model was frequently used and demonstrated potential for cost savings among participants with chronic conditions. The model appears to be a promising solution to efficiently provide patients with personalized care, when and where they need it.
You can read the full report here: Development and Implementation of a Person-Centered, Technology-Enhanced Care Model For Managing Chronic Conditions: Cohort Study
Comment from the author
”More people are living longer with chronic disease, which increases the burden on our healthcare systems. One reason is that there is no large-scale adaptation for people with chronic disease, since the development of the current system started in the 18th century with the aim of keeping the workforce working. We now need to develop models of care for chronic illness that are based on self-care in the person’s everyday life.”
Olof Norin, MD, PhD, former Chief Medical Officier, ImagineCare AB