The nation’s largest health care buyers – Medicare, state Medicaid programs, large employers, and health plans – are eager for ways to improve the quality and efficiency of chronic health conditions, which drive the bulk of health spending.  Payment reform and care delivery reforms are critically important.  Providers – particularly physicians, hospitals, and health systems – are under increasing financial, market, and regulatory pressure to improve chronic care management, eliminate unnecessary costs, adhere to evidence-based medical guidelines, and delivery high-quality, patient-centered care.

However, health care provider organizations face significant difficulties in doing this.  Chronic conditions are, by nature, highly complex and require extensive, on-going, and usually long term care.  These conditions include heart disease, stroke, cancer, obesity, and diabetes, as well as severe mental health diagnoses.  The CDC estimates that roughly 50% of Americans suffer from at least one chronic condition, and 25% of Americans suffer from multiple chronic conditions.  Chronic conditions lead to the majority of deaths in the United States by far, accounting for 7 out of every 10.  Chronic conditions are also very costly, often involving many different types of providers.  It is estimated that 66% of total health care spending is associated with caring for the 25% of Americans with multiple chronic conditions.  Medicare-Medicaid dual eligibles are the most challenging population to serve.  And ultimately, most providers lack the information and tools to genuinely coordinate and manage complex cases.

What role can technology play in improving chronic care management?

Technological Solutions for Chronic Condition Management:

Today, information and technology are increasingly seen as critically important to any effort to improve chronic care.  An interesting white paper by IBM, Addressing the Cost of Chronic Disease with Better-Informed and Coordinated Care, outlines several key, technology-driven steps that should be taken to improve chronic care management:

  • Improve community based chronic care.  Implement technological systems that allow complete, real time information to be delivered.  These IT systems should be capable of sharing appropriate data among providers, community agencies, and government programs that are involved in care provision.
  • Complete health information at point of care.  When providers are given up-to-date, real time, actionable information, they are far able to better address patient needs and reduce duplication of services.  Possible benefits include:
    • Improved care management.
    • Increased accuracy of care.
    • Increased compliance through remote patient monitoring and telehealth.
    • Enhanced transportation services to facilitate medical appointments.
    • Saving time and reducing costs through the use of electronic prescribing (e-prescribing or eRx).
    • Reduced utilization of costly acute care facilities.
  • Providing the right interoperability infrastructure by utilizing modern HIT solutions that provide:
    • Complete and accurate patient and provider data.
    • Scalability to address current and future coordination needs.
    • Near real time access to data.
    • Ease of implementation.
    • Appropriate level of data access for each audience.
  • Delivering comprehensive information to reduce healthcare costs and improve care.  Complete and accurate provider and patient data are essential for governments to successfully advance eHealth systems.

To read the white paper, click here (PDF).