Managing Chronic Disease Through eHealth
The epidemiological and demographic transition of the last decades shows an increase of Chronic Diseases that is expected to double due to the ageing of our population. These conditions usually develop slowly, tend to have a long duration, and their severity increases over time. Chronic diseases can be controlled, but they rarely heal. Cardiovascular diseases, cancer, diabetes, noninfectious airways diseases such as asthma, along with pneumonia or influenza, Alzheimer's and cerebrovascular diseases, were some of the main causes of death and disability in the United States in 2010 - with cancer and cardiovascular diseases accounting for almost half of them. However, the burden of chronic diseases is not shared equally among the population. It has also been observed that, when compared to the rest of the population, people with low socioeconomic status, women, and older adults, have higher rates of morbidity, mortality and disability due to certain chronic diseases.
Today, about one third of the population suffer from chronic diseases which accounts for three quarters of our health care spending. While it is true that chronic diseases are among the costliest health problems and have the greatest impact on the quality of life of those who suffer them, they are among the most preventable conditions. Most chronic diseases can be prevented through primary and secondary interventions aimed at reducing the main risk factors in the population while improving, along with health care, the early detection of these. Some of the modifiable risk factors to which preventive efforts should be directed are: the use of tobacco, insufficient physical activity, poor eating habits, hypertension and high cholesterol (hypercholesterolemia). Similarly, efforts should be concentrated on populations where disparities are identified due to different factors and sociodemographic characteristics.
In general, the impact of chronic diseases on the health system could be significantly reduced if the focus is geared towards health strategies aimed at primary intervention and prevention, early detection, and the adequate management of diseases. The primary responsibility for prevention and control of chronic diseases should be shared among government agencies, non-governmental organizations, the community in general and, of course, health service providers. One of the ways chronic diseases are changing the relationship between the latter and the consumer-patient is through eHealth, a modern healthcare delivery model that depends heavily on the implementation and use of technology to enhance patient-provider communications. The growing demand for health management of our ageing population and the need to cut health spending has led to a growing demand for e-Health solutions throughout the world.
Among the advantages of using this modern technology, combined with health care management programs to improve treatment delivery for patients with chronic diseases, are: more options for an individually customized care plan, the reduction in general costs of care, the elimination of unnecessary visits to the doctor along with unnecessary (re)admissions to the hospital, and decreased mortality rate. In addition to the increased development of health apps and the creation of health games that promote healthy eating habits along with wearable devices for determining physiological parameters such as Google Glass, and new communication systems like Telefónica’s AxisMed also aim to promote health and the prevention of risks and/or diseases by enabling chronically diseased patients (who have a long-term relationship with their insurers and doctors) to acquire a higher level of knowledge of their condition(s) and assume a more active role in their own care, thus, strengthening clinical information systems, and decision and self-management supports.
Among the advantages of using this modern technology, combined with health care management programs to improve treatment delivery for patients with chronic diseases, are: more options for an individually customized care plan, the reduction in general costs of care, the elimination of unnecessary visits to the doctor along with unnecessary (re)admissions to the hospital, and decreased mortality rate. In addition to the increased development of health apps and the creation of health games that promote healthy eating habits along with wearable devices for determining physiological parameters such as Google Glass, and new communication systems like Telefónica’s AxisMed also aim to promote health and the prevention of risks and/or diseases by enabling chronically diseased patients (who have a long-term relationship with their insurers and doctors) to acquire a higher level of knowledge of their condition(s) and assume a more active role in their own care, thus, strengthening clinical information systems, and decision and self-management supports.
While the use of this technology to facilitate communication between providers and consumers can also be applied at a global scale and demonstrates many other strengths, there are some potential weaknesses of such approach. There are many factors to consider regarding society (including the quality and outcome of provider-consumer relationships) and confidentiality. One of these potential weaknesses can be attributed to health professionals and patients having different knowledge and attitudes towards the use of these systems, so it may be necessary to apply individualized approaches when explaining how it works. A lot of the elderly people don’t have any kind of contact with a computer and even less with any kind of virtual network. It’s necessary to provide clear information about the technology and its usage by both patients and health professionals. Access to clear, relevant, transparent and timely information about the system is the essential first step for its promotion and successful application. Assistance should be offered to patients, and even health professionals, who may find themselves in a more vulnerable position since they are less technologically inclined.
Aside from the quality of the interface and overall performance of such designs, it’s necessary to know which technological problems are of most concern to physicians and patients, since it is possible that the obstacles stem from the misinterpretation of the level of technological knowledge necessary to use the system. It could also be that both patients and health professionals overestimate the technology and knowledge necessary for a broader implementation. As this technology changes, it would be necessary to continuously assess and provide training to both patients and professionals.
To successfully build trust and promote the usage of this type of system among chronically diseased patients it is also necessary to offer them the guarantee that the implementation of such technology in their treatment will not negatively affect the patient-doctor relationship; that it will be used as a complement, not as a substitute for appointments and/or consultations with the provider. For patients to feel comfortable using these methods, it will be necessary to dispel any doubts pertaining to the system and its benefits, the level of technology required, personal contacts with providers, and data protection. As for the latter, having strong privacy and confidentiality policies will be essential. Although these may not considered as a major obstacle by some, the lack of confidentiality and privacy incentives, and the possible dissemination of some cases in which these have failed along with the outside use of these technologies by patients, could represent a setback very difficult to counteract. It’s important to keep in mind that technology has no ethics, it’s the people who decide how to use this technology. Strict legal devices must be implemented to protect ,both the patient and the health personnel, against the more controversial issues related to the integration of such these technologies into health services such as patient’s private information, diagnoses and protected dissemination, etc. whether such breach be attributed to malicious acts or just plain human error.
Technological advances play an important role in our daily life, to the point that without realizing it has become part of our habits. The concept of eHealth is not a fad, but rather a process of innovation that in recent years seen great development that allows a balance in health services and outweighs any administrative costs due to its initial implementation and any further maintenance. In the long term, it seeks savings and a reduction in costs while improving the quality of medical care. However, it’s important to remember that this can be achieved without any overdependence on it; new technologies should never be interpreted as a dehumanization of Healthcare. Their implementation should help deliver a system that operates more efficiently while complementing and strengthening the classic relationship between provider and consumer. It’s important to continue educating both the public and medical professionals according to their level of knowledge for the success of information dissemination, communication, intervention and prevention methods aimed at managing chronic disease.
How do you think technology changes the patient-provider relationship? What do you think are the weaknesses or disadvantages of relying on it? Feel free to comment below.
Thanks for reading!
How do you think technology changes the patient-provider relationship? What do you think are the weaknesses or disadvantages of relying on it? Feel free to comment below.
Thanks for reading!
[O2HealthVideos]. (2013, May 3). EHealth animated video - Chronic Disease Management [Video]. Retrieved from: https://www.youtube.com/watch?v=wyI7mtSFLdo&t=4s
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