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Digital Health Gets a Failing Grade in Chronic Care Management

Americans are motivated to use devices and apps for health and wellness - but they're not managing chronic conditions. That's where providers have to step in.

- Half of the nation’s newly insured consumers are using a fitness or wellness device and are enrolled in a wellness program at work – but very few are using wearables for clinical purposes.

The latest HealthMine survey highlights the divide between using a wearable to stay healthy and using one to manage an existing health concern, such as a chronic condition. This suggests that the wearable market is still very much consumer-driven, with growing support from payers but little acceptance from healthcare providers.

"Digital health tools have exploded in growth - but more so in the lifestyle management category than in clinical/disease management,” Bryce Williams, HealthMine’s CEO and president, said in remarks accompanying the March 2016 survey of 500 newly insured consumers. "Every member may not benefit from an activity tracker. For these tools to be effective, they must be tailored to individual needs and connect to the individual's bigger picture of health data."  

And that bigger picture may very well include a chronic condition.

According to the survey, 59 percent are dealing with at least one chronic condition. This coincides with a recent Blue Cross Blue Shield Association report that finds Americans enrolling in a health plan following the 2014 expansion under the Affordable Care Act have more chronic conditions and incur more medical costs. Simply put, these consumers are in more need of expensive healthcare services.

Those bills could be eased somewhat with a chronic care management plan that includes mHealth monitoring. And yet, of the almost 60 percent in the HealthMine survey who have a chronic condition, only 7 percent reported using a digital health tool for care management.

This time, however, the problem may not lie in engagement, but motivation. According to the survey, 52 percent are enrolled in a wellness program, and one-third received a digital health device and/or app from their wellness program.

Broken down further, 50 percent use an exercise, fitness or pedometer app, while 38 percent have a wearable activity tracker like a Fitbit or Jawbone. Other listed in the survey included a food/nutrition app (46 percent), weight loss app (39 percent), heart rate app (30 percent), pharmacy app (28 percent), patient portal 22 percent), sleep app (22 percent), blood pressure app (19 percent), smart/wireless scale (16 percent) and stress app (15 percent).

Most of those numbers are good, indicating consumers are using digital health devices and apps to improve their health and wellness. In fact, 42 percent of those surveyed cited “knowledge of my numbers” is the biggest motivator to using technology tools, while another 26 percent cited “improving my health” and 19 percent said “accountability – I know someone is tracking the results.”

Conversely, while two-thirds said their wellness program offers incentives for using digital health tools, only 10 percent listed that as the biggest motivator.

Taken as a whole, the survey indicates newly insured Americans are interested in using mHealth devices and platforms to track their health, and they’re motivated by personal responsibility more than rewards or incentives. But if they have a chronic condition – and more than half of them do, according to the survey – they aren’t using mHealth for health management.

More succinctly, according to the survey, only 5 percent use a telemedicine app, 6 percent use a smoking cessation app, 7 percent use a disease management app, and 9 percent use a blood glucose monitor.

That’s where mHealth may have the most immediate impact. Studies have shown that chronic disease costs billions each year in care management, with the typical high-end chronic disease patient spending 13 times more on outpatient services, 11 times more on professional services and 17 times more on medications than the average consumer.

That’s where healthcare use and costs are high. And that’s where the provider market need to step in and take a stand. 

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