Rethinking Chronic Care Management to Reduce Costs and Improve Outcomes

Chronic conditions affect a large number of people. These conditions, such as diabetes, cancer, heart disease, and even long COVID, are not only difficult to manage but due to high treatment costs, are increasingly burdensome on limited health budgets. The standard of managing these conditions has long been occasional checkups and self-managed solutions. However, these chronic conditions require consistent care, not only to manage the conditions but to prevent acute symptoms as well.

The problems with current chronic care management

The typical model for chronic care management looks like this: a patient sees their doctor, is evaluated, is suggested a treatment plan, and then goes on to manage their own care.

This model has many flaws. Patients often don’t follow the treatment plan that they’ve been recommended for any number of reasons (lack of understanding, inability, forgetfulness, lifestyle). When the patient’s disease isn’t managed properly, they can suffer acute symptoms and need to see a healthcare specialist or go to the hospital. This isn’t just damaging to the patient’s well-being but is costly for them and the healthcare system too.

Sometimes even patients that do follow their doctor’s guidance can find that their health is declining because of reasons they can’t control, and they too need a trip to the hospital.

The journey to better chronic care management

There is a need for an integrated care delivery model that can fill in the gaps between scheduled doctor’s appointments. A well-implemented integrated care model is coordinated across a range of professionals, is tailored to specific patient needs, and promotes shared responsibility between patients and caregivers. Not only does will approach give patients with chronic conditions better care, but it will also foster better connections between patients and their healthcare providers.

There has been some semblance of this in telehealth communications: Zoom sessions with a doctor, phone calls, and portals where you can message nurses. But these aren’t comprehensive and proactive enough to keep people with chronic conditions out of the hospital.

Instead, there must be regular patient monitoring and better engagement to monitor how diseases change over the course of time. This way, healthcare providers have the information that they need to approach their care with proactiveness.

How to move on

When a patient with a chronic condition visits their doctor and gets recommended a treatment and management regime, technology can be used to monitor, aid, and supplement that regime.

For example, a Bluetooth-connected scale to monitor weight and a mobile app that sends the patient task and activity reminders. The patient can report symptoms, track their condition, and exchange calls and messages with their provider.

Patients with more advanced, acute, and serious cases might need a hospital-at-home care team to provide services that are more constant and passive. This team could have their data synced with the patient’s other healthcare providers so that they are constantly up to date on how the patient is doing.

The bottom line is that chronic care management needs to be more involved and up-to-date so that costs can be reduced and outcomes improved. When patients are the focus, then finding ways to give them the best care possible must be the way forward.

Find out how Complex Care Plan software from Coalese Health can help with your chronic care management>>

Sources

Wolfberg, A. (2022, May 1). It’s time to rethink chronic care management. MedCity News.