June 22, 2024

Care management has gone digital, with remote chronic disease management, in particular, becoming a more common modality.

Of course, there is still always a time and a place for in-person care, but the days of fully analog care management are over. With the insurgence of EHRs, connected health tools, and healthcare consumerism, patients and their providers are embracing the idea that some chronic disease management can be done from afar.

This notion gained most prominence starting in 2020 when the COVID-19 pandemic made it more difficult for patients to come to the clinic for in-person care. That enthusiasm for remote tools has tempered a bit, surveys have shown, but still, the digital front door is wide open, and it’s primed to support remote chronic disease management.

As healthcare organizations continue their embrace of digital health solutions, they should consider the different tools that can help support remote chronic disease management. While not all aspects of chronic care management can or should be done remotely, as patients continue to demand a digital patient experience and convenient care options, implementing and integrating key patient engagement tools will be key.

Telehealth

Telehealth is an extremely broad category of functionality that allows the patient and provider to connect remotely.

“Telehealth — sometimes called telemedicine — lets your health care provider care for you without an in-person office visit,” HHS says on its website. “Telehealth is done primarily online with internet access on your computer, tablet, or smartphone.”

There are numerous types of telehealth, including video visits, patient-provider messaging, and asynchronous visits (e.g., sending images for consultation). During a telehealth visit, providers can capture patient-report outcome metrics, discuss symptoms with patients, or even adjust medications.

Telehealth can be helpful in chronic disease management because it allows patients to meet with their providers without making the trek to the clinic or hospital. This can be more easier for patients, especially those managing chronic illnesses and who might have to juggle a complex appointment schedule.

According to December 2022 survey data, patients like telehealth because it’s convenient. When it’s easier to connect with a clinician, it is more likely that a patient will access care—either regular check-ups or consulting when symptoms are abnormal—which can improve chronic care outcomes.

Telehealth is not a silver bullet for chronic disease management. Certain conditions and symptoms simply require an in-person visit, not to mention patients are increasingly voicing a desire for more personal touches in medicine.

Remote patient monitoring devices

Remote patient monitoring (RPM) falls under the telehealth umbrella, but the tools that are considered RPM devices are varied.

Generally, RPM tools help track health metrics outside of the hospital or clinic.

“Remote patient monitoring (RPM) is a type of telehealth in which healthcare providers monitor patients outside the traditional care setting using digital medical devices, such as weight scales, blood pressure monitors, pulse oximeters, and blood glucose meters,” according to the Agency for Healthcare Research and Quality (AHRQ).

“The data collected from these devices are then electronically transferred to providers for care management. Automated feedback and workflows can be built into data collection, and out-of-range values or concerning readings can be flagged.”

For example, a Holter monitor could flag an irregular heart rhythm and alert a provider that a patient may need an intervention. Ideally, the RPM device would flag this issue early, making the intervention less invasive—and less costly.

RPM is showing extraordinary promise in streamlining chronic disease management with adoption off the charts. According to one March 2023 report, RPM adoption increased 1300 percent between 2019 and 2022. Its primary use cases ranged from internal medicine, cardiology, and family medicine. This is likely because these specialties are largely responsible for chronic disease management, the Definitive Healthcare researchers indicated.

Connected health apps

Chronic disease management technologies extend beyond those that support clinical care and patient-provider communication. They also encompass patient engagement tools that empower patients to manage their own care outside the clinic or hospital.

Connected health apps are tools that can help patients be the gatekeepers of their own well-being. Their functions are as varied as the diseases they are intended to help manage, but some of the most common applications include medication management apps, patient education apps, and patient navigation apps. They may also include diet and exercise trackers and other lifestyle or symptom trackers.

These technologies can be useful for both creating patient-generated health data and helping patients manage their chronic illnesses on their own. However, despite the increasing availability of these tools and the importance of patient activation and self-management, these tools aren’t always being used.

Some of the problem could be low digital health literacy, limited access to devices themselves, and poor access to infrastructure like high-speed internet. Even still, there are actual app features that can also support greater patient adoption.

A June 2023 Regenstrief Institute study looked at 92 adult patients who’d been managing Type 2 diabetes for at least 12 years. Patients told researchers the features that would most build their chronic disease self-management competence included patient data access, analytics and insights, messaging functions, and a simple user interface.

Patient portals

Similar to connected health apps, patient portals are integral to chronic disease self-management. Typically purchased as a part of the EHR suite, patient portals enable patient data access, secure direct messaging, prescription refill requests, appointment scheduling, and many other patient-facing functions. In many cases, it also allows patients to send their medical records to other providers.

The patient portal, which is increasingly being offered via mobile apps, can often integrate with other patient-facing tools, including some connected health and disease management tools. Because of the amount of information offered via the patient portal, the technology has emerged as integral to chronic disease management and has proven attractive to individuals with chronic illness.

In one 2020 study of patients with chronic illness, researchers found that the patient portal’s convenience, capabilities for data access and transmission, and integration with other tools compelled patient adoption. Of those who used the patient portal to help manage their chronic illness, around a third said the tool helped improve their health.

There’s also evidence that the patient portal, which is arguably more of a patient-facing administrative tool, is more useful to individuals with chronic illness than their peers. A 2023 study in the Journal of Medical Internet Research showed that with each increasing chronic illness diagnosis, the rate of patient portal usage (measured as the number of secure messages sent via the tool) increased, too.

Clinicians remotely managing chronic care patients should consider which tools are most amenable to their patients. After all, technology is only useful when someone actually uses it. To that end, patient education, user interface and experience, access to highspeed internet, and privacy and security safeguards will be essential to a good remote chronic care management plan.  

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