Reform depends on connected health

Just three years ago, Internet technology had barely anything to do with health care, writes physician and former Sen. Bill Frist in an introductory essay to February’s issue of Health Affairs. The issue centers on ideas and experiments in telehealth, telemedicine and mHealth – often called, collectively, “connected health.”

Health Affairs features two pieces of ACHP-affiliated research showing how patients – particularly those living with chronic diseases – might have the most to gain from connected health.

One article serves as a succinct case study of how ACHP member Kaiser Permanente Northern California (KPNC) has navigated industry obstacles to harness Internet, mobile and video technologies since 2008.

A patient with a rash can send a dermatologist a secure e-mail message with an attached digital image of the affected area. KPNC dermatologists are able to make a definitive diagnosis and prescribe the appropriate treatment … Thus, they can provide rapid diagnosis and treatment, without the patient’s having to miss work or school for an office visit.

Beginning this year, physicians are expected to respond to such e-mails within 24 hours. Despite industry obstacles – including the dominant fee-for-service payment model – KPNC has seen steady improvements in health outcomes, patient satisfaction and overall care delivery.

From Evolent Health, the population health start-up partially funded by ACHP member UPMC Health Plan, comes more evidence that connectivity improves outcomes and saves money for plans and participants. The featured study details a mobile health (mHealth) program that improved self-care for diabetic patients:

Participants in the program receive text messages about diabetes self-care, some prompts to engage in a particular action (for example, ‘Time to check your blood sugar;), and some questions (such as, ‘Do you need refills of any of your medications?’) … Participants follow a flexible education curriculum in which they move from one topic to the next at their own pace.

The program is a shared endeavor by insurer and provider, facilitating care coordination between nurses at the health plan and physicians at the medical center.

As these programs demonstrate, simply upgrading technology does not a successful connected health program make. To engage Internet and mobile tools meaningfully, and deliver on the promise of better care at lower costs, health plans require collaboration with physicians and a shared commitment to innovative benefit design.

-Sophie Schwadron