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Can mHealth Make Chronic Care Patients Care About Their Health?

Recent studies have found that consumers aren't concerned about their health, even when they have a chronic disease. How can mHealth change that attitude?

By Eric Wicklund

- The path to telehealth and mHealth success lies in helping those with chronic conditions manage their health at home. Unfortunately, they don’t seem to be interested.

That’s the upshot of a new survey from Parks Associates, as well as a pointed reminder that mHealth will only succeed if care providers can figure out the patient engagement conundrum.

According to the Parks Associates survey, 55 percent of Americans with at least one chronic condition aren’t speaking with their primary care physician any more than once every three months. What’s worse, 11 percent don’t even have a PCP.

Harry Wang, Parks Associates’ senior research director, says healthcare providers now have access to the data they need to craft a good care plan, but they haven’t yet figured out how to make their patients care about that plan.

“Traditional chronic care management programs that use only health risks from claim and EMR data to stratify patients into different tiers fail to factor in behavioral and daily living factors in their patient engagement approach,” he said in a recent news release. “As a result, past chronic care management efforts couldn’t scale and be effective in improving care outcomes and patient care experiences.”

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According to the survey, only 20 percent of those with a chronic condition say they’re concerned about their health. Among those with three or more chronic conditions, slightly more than half – 56 percent – say they’re interested in their health.

The issue lies more in motivation than access. A HealthMine survey of newly insured Americans conducted earlier this year found that about 60 percent are dealing with a chronic condition – but while many have access to digital health tools and workplace wellness programs, only 7 percent are using them for health management.

In some cases, researchers have found that people with chronic conditions see mHealth tools and platforms as components of a wellness or fitness program – it’s more of a luxury or an exercise routine -  and they’re not making the connection to improved clinical outcomes. At other times, it’s an annoyance or a chore.

Not all the blame can be placed on the consumer. A recent study out of the University of California at San Francisco found that many of the most popular apps targeting chronic conditions like diabetes and depression are too difficult to use, especially by underserved populations who would benefit the most from using them. Another study, by Research2Guidance, found that doctors aren’t yet convinced that apps are reliable.

Yet another study, by Accenture, found that health systems aren’t using the right mHealth tools to reach patients.

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“Today’s consumers place more expectations on their providers to interact digitally, driven by the customer experiences they have had with services in other industries, and most providers are letting them down,” the Accenture report states. “Thus in the increasingly competitive healthcare market, providers that ignore the mobility needs of today’s always-on patients could lose them to competitors.”

Joseph Kvedar, MD, vice president of connected health for Boston-based Partners Healthcare, sees patient engagement as an ongoing mystery. Healthcare providers and mHealth entrepreneurs are coming up with newer and better ways to track health outside the doctor’s office and tie it to improved outcomes, but they’ve yet to find a way to keep the patient’s attention.

“Yes, we’ve done a great job of frictionless data capture, but we’ve lagged on engagement,” he wrote in a blog post earlier this year. “Designers of consumer mobile apps are constantly studying how to employ mobile technology to keep users engaged with their content. News apps get your attention through banners, notifications, etc. when there is fresh content. But I can’t think of a health app that does a good job at this.”

“For example, my favorite activity tracker app sends me the same three messages every day, ‘You’re almost there,’ ‘You reached your goal’ and ‘You’ve outdone yourself,’” Kvedar wrote. “It’s no wonder that the new industry phrase for measuring device success is ‘time to drawer.’ Or, stated another way, how long did you wear the thing before you got bored with it and threw it in the drawer?”

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