Personal Health Management in Today’s Health Care Environment

Personal health management or self-management has been a basic tenet of chronic disease management for a long time. However, often the patient’s attitude towards healthcare has been to go to the doctor and say, “Fix me”. This approach is no longer viable because it provides only satisfactory responses to short-term problems and stretches medical professional resources thin. Add to this the basic fact that 75% of all adults over 65 have a chronic illness – half of this group has multiple illnesses– and it is easy to see how medical provider’s resources are struggling to provide cost-effective, quality care to their chronic disease patients. The end result is that self-management has to mean more than the patient following doctor’s orders. Self-management in today’s world needs to promote a more active role for the patient in their own healthcare solutions.

What does this mean, though? It means acknowledging that the patient should play a lead role in managing their care. This does not mean that the patient should go it alone, but a collaborative approach needs to be employed where medical professional and patient work together to define problems, set goals and create plans. Think of it as a team sport where the patient is the team captain and all of the medical professionals that the patient sees play specialized roles on the team. The patient is the leader and the coordinator, but each professional contributes important pieces to make the team successful.

Another difficulty in providing effective management of chronic disease is that often patients go several months between medical appointments. More frequent visits are simply too costly for patients and too time consuming for care givers. This is especially true in cases where appointments often include no actual medical treatment, but are used to exchange information between patient and medical professional. This strongly suggests that an effective self-management strategy must improve communication between medical visits.

Several different strategies have been looked at over the years to improve self-management, and according to the National Health Institute one thing is clear – any program adopted should be readily applicable to more than one condition. This is because multiple strategies make it difficult for the whole health care team to be on the same page. There are also six core strategies that should be included in any effective self-management routine:

  • Patient self-education about their condition
  • Routine monitoring and management of symptoms
  • Patient/Professional partnership in deciding when medical help is needed
  • Communication between patient and professional via means other than just face-to-face
  • Developing and maintaining appropriate exercise and nutritional programs
  • Finding ways to do the above with minimal impact on the patient’s life

There are several Internet-based personal health management solutions designed with many of these six strategies in mind. However, when looking at these solutions it is important to look for one that allows you to work with more than one aspect of your health at a time. This is important since most chronic diseases lead to complications that must also be tracked. Thus, having a system that can work with multiple conditions is cost-effective over time since it eliminates the need to learn and keep tabs on multiple software applications.

Most of these online tools do help patients achieve two primary goals of modern self-management healthcare: Empowering the patient and improving patient-doctor communication. Patient self-management is quickly becoming a key part of the solution to the growing health care crisis. These new online personal health management solutions help make simple, comprehensive, cost-effective self-management a reality.

To learn more about personal health management o visit the MedKeep website’s section on self management [http://www.medkeep.com/selfmanagement/default.aspx].

Changing Scenarios in Population Health Management

Health care management through IT became the order of the day for businesses. In this process, population health management is going through changing scenarios with respect to rapid strides in wellness aided by IT. Before going through the scenarios that portend the future, it is important to analyze the past.

The Earlier Scenario

A few years before, part of important healthcare information consisted of doctors’ handwritten prescriptions piled up in their cabins. As the population increased with segmentation of various illnesses, information management became cumbersome for the healthcare sector. This resulted in medical errors, misinterpretation of data leading to poor quality of healthcare service. It is from that stage healthcare sector made revolutionary progress in healthcare by diagnosis, prescription, and med care. Appropriate wellness programs followed after the patient got discharged from the hosptial. Healthcare data is explosively growing to reach 142 million this year according to Juniper Research. At this stage, it is important to analyze the key scenarios that revolutionize population health management.

Connectivity Scenario

The most important scenario that revolutionized population health management is the connectivity scenario. Earlier healthcare data was siloed in different systems across the healthcare network. We know how manual data management can lead to errors and ruin healthcare. In the changed scenario gathering, processing, and analyzing data from health records and integrate the data with financial data through predictive analytics, is immensely helping wellness providers. Thanks to connectivity, data is optimized from paid claims, laboratory information, pharmacy records, practice management systems, and EMR. Data needs to be leveraged. For that providers require an integrated network to facilitate sharing of data.

Connectivity makes sense for wellness providers. But what makes population health management efficient? This happens when data is processed to understand the risk factors to arrive at informed decisions. This scenario also helps in tracking all patients by creating patient registries to suggest care guidelines, to be precise organizing population into groups and subgroups for time bound services. The stratification is to understand how sick the population is, to receive support from care manager for preventive care. Predictive modeling algorithms help in predicting cases that may have higher health costs.

Engagement Scenario

Connectivity is preceded by engagement. This also comes with engaging patients, physicians, and provider network. Look at the various engagement levels with diverse stakeholders:

• Primary care physician
• Community resource specialist
• Nurse case manager
• Additional care management program team members
• Non-clinical home services
• Patient social assistance
• Resource coordinator
• Insurers

While providing PHM, providers need to ensure evidence-based care during doctor visits. If the executive is absent during doctor visits, the onus is on providers to motivate the patients to take care of themselves. This scenario is aided by provider motivation with the help of automated tools on their mobiles.

One of the key challenges of the population health management is the coordinated care of conditions across a population. With this providers can:

• Reduce the gaps in care delivery by organizing care across healthcare providers and settings
• Improve manage care transitions as patients go through the network
• Reduce hospital readmissions cases by diagnosing problems
• Add the referred ones to the wellness network
• Remove patients from the emergency room

Monitoring Scenario

Ongoing monitoring is important to ensure the patient is staying compliant with the care plan. Monitoring is done with the help of IT applications. A robust PHM application will have Application Service Provider (ASP) processing services designed to network large organizations such as pharmacy benefit managers, self-insured employer groups, managed care organizations, and retail pharmacy chains. That is why exactly at the conclusion of a wellness screening program, aggregate reports with rich insights into various service levels and giving access to users. The report generated aggregates population health data which in turn empowers employer decisions. At the same time care-giving organizations need to maintain users’ privacy.

Fightchronicdiseases.org states 130 million U.S. citizens with chronic disease costing more than $2.5 trillion annually. Such a dreadful scenario requires a concerted action plan to create all round wellness in the U.S. with the help of population health management; all intended to create a robust wellness scenario.